Ask the Expert: Can You Be Addicted to the Internet?


A psychiatry professor tells us how to know if your Internet behavior is normal, and what to do if it isn’t.

For many of us, the average work day means eight or more hours in front of a computer. As if that’s not enough, we often go home and check email, Facebook, and Twitter over and over again. This behavior is constant, but is it an addiction? We asked Dr. Ronald Pies, a clinical professor of psychiatry at Tufts University Medical School for an answer.

Q: Is Internet addiction a real condition?

A: The whole notion of “Internet addiction” is very controversial within the mental health field, even though it’s clear that many people use electronic media in ways that greatly interfere with important aspects of their life. But is this really an addiction?

If someone shows a maladaptive or injurious pattern of Internet use—and I have in mind any sort of electronic device or medium—is this really a disease or disorder in its own right, or is it an underlying problem such as depression, bipolar disorder, obsessive-compulsive disorder, or severe social anxiety? These are complicated questions, and I don’t believe we have the necessary research to answer them conclusively. What we do know is that many persons diagnosed with Internet addiction appear to suffer from other psychological problems.

How do I know if I have it?

Psychiatry’s latest diagnostic manual, the DSM-5, considered and then rejected Internet addiction as a validated diagnosis. Nevertheless, in the section of DSM-5 titled “Conditions For Further Study”, the syndrome known as “Internet Gaming Disorder” (IGD) is described. Basically, IGD is described as “persistent and recurrent use of the Internet to engage in games, often with other players, leading to clinically significant impairment or distress.” Often, persons who fit this description have little or no control over their Internet use. They also seem to show tolerance and withdrawal symptoms analogous to those seen with addictive chemicals. For example, they may need to engage in more and more online gaming in order to satisfy their craving (tolerance), and may experience anxiety or depressed mood when they are unable to engage in Internet gaming (withdrawal).

That said, it is not clear if the same physiological abnormalities underlie IGD or other forms of excessive Internet use and substance-based addictions. We don’t have enough research to answer that, but so far, there is little evidence that IGD produces dangerous withdrawal symptoms—such as seizures or delirium—as often occur during alcohol or [drug] withdrawal. There are, however, occasional case reports of persons sitting at the computer for so many hours that they actually develop life-threatening blood clots!

There is great interest in the role of the brain chemicals dopamine and serotonin. One hypothesis is that all these conditions involve excessive release of dopamine in the brain, which seems to drive the brain’s reward system. The idea is that some people―for biological or psychological reasons—seem to need this dopamine “buzz” in order to “rev up” their under-active reward system. We need more research to confirm this hypothesis, however.

How can I treat it?

Many persons with IGD (or other forms of excessive internet use) go for long periods without food or sleep, and are unable to meet their obligations at school, work, or at home. These people often require professional help—for example, the reSTART Internet Addiction Recovery Program in Washington state—but I am skeptical that we have the necessary research to know what the best treatment is for these various Internet-related problems.

For anyone who believes he or she is experiencing IGD or something similar, I would recommend speaking first with your family physician, and then considering a general psychiatric evaluation to rule out underlying problems that may explain the excessive Internet use. Many such underlying problems—such as an anxiety or mood disorder—may respond well to some form of talk therapy, or, in more severe cases, to medication.


Cicadas Aren’t the Only Crazy Ones: Nature’s Most Bizarre Life Cycles.


The word ‘unnatural’ is often used to describe what’s considered weird or unusual. But is anything weirder than nature?

Just look at 17-year cicadas, poised to flood the U.S. East Coast after having stayed underground since Bill Clinton was President. And cicadas are just the start: Biology abounds with creatures that change shape, change sex, change locations and in some cases cause other creatures to do these things.

It’s a strange, marvelous world out there. On the following pages are gathered some of life’s oddest, most extraordinary journeys.


A Long Wait

Everyone’s wondered what it would be like to step outside time for a while, to disappear one day and return, years later, to the same spot in a changed world. That’s what cicadas of the Magicada genus have evolved to do.

The Magicada species are known as 13-year and 17-year cicadas, the latter of which will in coming weeks emerge from East Coast soils. In keeping with their name, they last visited 17 years ago, when they hatched from eggs laid on trees and plants and burrowed into the soil below.

Since then they’ve lived underground, drinking tree sap and slowly assuming adult form. After emerging, they’ll live for just one more month, devoting their final days to finding mates. In a few months, the next generation will hatch and begin the cycle anew.

Except for their 13-year cousins, it’s a life cycle unprecedented in the natural world. Scientists think itevolved as a defense mechanism: The time lag makes it difficult for predators to specialize in eating them, and when they do emerge, their overwhelming numbers make any losses insignifcant.



Why We Can’t Send Humans to Mars Yet (And How We’ll Fix That).


While humans have dreamed about going to Mars practically since it was discovered, an actual mission in the foreseeable future is finally starting to feel like a real possibility.

But how real is it?

NASA says it’s serious about one day doing a manned mission while private companies are jockeying to present ever-more audacious plans to get there. And equally important, public enthusiasm for the Red Planet is riding high after the Curiosity rover’s spectacular landing and photo-rich mission.

Earlier this month, scientists, NASA officials, private space company representatives and other members of the spaceflight community gathered in Washington D.C. for three days to discuss all the challenges at the Humans to Mars (H2M) conference, hosted by the spaceflight advocacy group Explore Mars, which has called for a mission that would send astronauts in the 2030s.

But the Martian dust devil is in the details, and there is still one big problem: We currently lack the technology to get people to Mars and back. An interplanetary mission of that scale would likely be one of the most expensive and difficult engineering challenges of the 21st century.

“Mars is pretty far away,” NASA’s director of the International Space Station, Sam Scimemi said during the H2M conference. “It’s six orders of magnitude further than the space station. We would need to develop new ways to live away from the Earth and that’s never been done before. Ever.”

There are some pretty serious gaps in our abilities, including the fact that we can’t properly store the necessary fuel long enough for a Mars trip, we don’t yet have a vehicle capable of landing people on the Martian surface, and we aren’t entirely sure what it will take to keep them alive once there. A large part of the H2M summit involved panelists discussing the various obstacles to a manned Mars mission.

“I’ve said repeatedly I’ll know when we’re serious about sending humans to the Mars surface when they start making significant technology investments in particular areas,” engineer Bobby Braun, former NASA chief technologist, told Wired.

The good news is that there’s nothing technologically impossible about a manned Mars mission. It’s just a matter of deciding it’s a priority and putting the time and money into developing the necessary tools. Right now NASA, other space agencies, and private companies are working to bring Mars in reach.

Here, Wired presents the most challenging obstacles we’ll have to overcome to get to Mars and how to fix them.


Mad Genius Buys Volcano, Transforms It Into Naked-Eye Observatory.


Way out on the edge of the Painted Desert in Arizona, 70-year-old Californian artist James Turrell has spent the past three decades excavating a 389,000-year-old extinct volcano. Roden Crater, as it’s known, is Turrell’s magnum opus. Whenever it’s finally complete, this black and red cinder caldera will be a monumental naked-eye observatory to surpass any throughout history.

Inside, the crater’s naturally lit viewing rooms are precision-engineered to observe specific celestial events. While outside, Turrell has reformed the rim of the crater to create a beautiful “vaulting effect” of the sky in a way that we almost never see it.

“I’m very interested in how we perceive, because that’s how we construct the reality in which we live,” Turrell says, “and I like to tweak that a little bit. I make structures that arrest and apprehend light for our perception.”

His work is the subject of three major retrospectives this summer, opening at the Los Angeles County Museum of Art this past weekend, the Museum of Fine Arts in Houston on June 9, and the Guggenheim in New York City June 21.

Even without Roden Crater, Turrell’s reputation in the art world is enormous—he’s one of the first visual artists awarded a MacArthur “genius” fellowship. But what sets him apart is his multidimensional approach. He’s a true polymath, fluent in engineering, mathematics, astronomy, history, literature, aviation (Turrell is an avid pilot; it’s how he went looking for Roden Crater) and ranching (a necessary requirement of his bank loan on the crater’s land).

Witness him describing his favorite subject.

“We take light through the skin and create vitamin D,” Turrell says. “So we are literally light eaters. But then it also has a strong emotional quality, which is pretty much what I work with—the kind of situation that’s actually a theta state, which is thinking, but it’s not thinking in words. So this is an art that can be a bit difficult describing. And that’s also where people have always had that challenge with: [describing] the spiritual side of light.”

As an undergrad Turrell studied perceptual psychology, then pursued his master’s degree in fine art at UC Irvine. His revelation came in his first semester, when he found himself more interested in the projector’s light dancing in the darkness than the slides it was showing. He’s said that all painting, from Rembrandt to Rothko, is the study of light. But Turrell doesn’t make art that’s about light; he’s literally gotten rid of the object and made it the subject. His art is light.

Turrell’s gallery work—brilliantly colored walls, cubes, holograms, tunnels, seamless spaces of light known as Ganzfelds, mysterious voids of glowing geometric perfection—all force viewers to question how they are seeing what they’re seeing. Turrell wants us to recognize what he calls “the thingness of light.” In his hands, it can appear to occupy space in our world through shapes. Or it can conjure the colors of sunrise and twilight. Taking it away can evoke our primal senses, as if we’re back in our ancestors’ caves.

He can also change the color of the sky entirely. Turrell has built 82 Skypaces worldwide—including at a Quaker meetinghouse in Houston. (Turrell grew up in the faith; his grandmother used to tell him to “go inside and greet the light.”) When the sky that’s seen through a small cutout in the roof contrasts with varying colors projected inside, it appears to come down into the room imbibed with a beautifully foreign, inky black tint.

“We all know that the sky is blue, but many of us don’t realize that we give the sky its blueness,” Turrell says. “And it’s only because we do that that I can change it.”

And after 48 years of this perceptual study, what’s it feel like for him to look back on a life’s work so far?

“There are things that I enjoy seeing that I haven’t seen for a while, and others that I wonder what I was doing—what I was thinking,” he says.

Each of the upcoming exhibitions illuminates different aspects of Turrell’s work. LACMA spans his entire career, and features a new Ganzfeld and one of his epic Perceptual Cells, where viewers lie prone in an enclosed chamber and get bombarded with a furious medley of colors. MFA Houston displays seven of Turrell’s popular installations, while the Guggenheim will feature a giant original work inside the Frank Lloyd Wright-designed rotunda.

As for Roden Crater, like many grandiose works of art, its completion date is continually pushed back. In fact, it no longer has one—it may be the Sagrada Familia of the New World. But though funding the crater has always been stop-start since its beginning, Turrell remains upbeat.

“I committed to the fact that I was going to open it in the year 2000, and I stick with that,” he says, satirically.

Even art’s luminary of perception chooses to see things his own way sometimes.


Sorry, Steak Lovers: Vegetarians Live Longer.

Plus: Testosterone prescriptions triple over last decade, and more health news.

People who eat a vegetarian diet live longer than meat eaters, according to a study published in the journal JAMA Internal Medicine. Researchers from Loma Linda University in Calif. followed members of the Seventh-Day Adventist Church, which encourages a vegetarian diet. The 73,308 people studied were followed for six years. During that time period, there were 12 percent fewer non-hazard deaths among vegetarians over that period compared to meat-eaters, the researchers reported. Vegetarians were found less likely to die from heart disease, diabetes, and kidney failure. Even more interesting is that the vegetarian diet seemed to be work better for men. [Discovery]

Television commercials are causing men to seek out prescriptions for testosterone. Despite weak research and health risks aplenty, the bombardment of “feel young again” ads touting a fountain of youth effect from taking testosterone have increased sales and prescriptions of the drug. Prescriptions have tripled in 10 years despite the risks of prostate cancer and liver damage. Doctors warn that men that this is nearing epidemic proportions because walk-in clinics are prescribing the drug without checking if the men really need it. [ABC]

Bone strength starts in the womb. Researchers followed 3,000 expectant mother’s diets to see if what they ate was later linked to their children’s bone mass. Researchers measured concentrations of vitamins in their blood and had the women write down everything they ate. When the children turned six, researchers used imaging technology to look at their bones. The study, published in The American Journal of Clinical Nutrition, found that the children whose mothers consumed more protein, phosphorus, and vitamin B12 when they were pregnant had the greatest bone mass and bone mineral content. But one interesting question is that the study doesn’t take into account what the mother’s fed the children after they were born. So does that not count? [New York Times]



How to minimize the side effects of cancer treatment.


Measuring enzyme levels in patients may reveal healthy cells’ ability to survive chemotherapy.

New research from MIT may allow scientists to develop a test that can predict the severity of side effects of some common chemotherapy agents in individual patients, allowing doctors to tailor treatments to minimize the damage.

The study focused on powerful cancer drugs known as alkylating agents, which damage DNA by attaching molecules containing carbon atoms to it. Found in tobacco smoke and in byproducts of fuel combustion, these compounds can actually cause cancer. However, because they can kill tumor cells, very reactive alkylating agents are also used to treat cancer.

The new paper, which appears in the April 4 issue of the journal PLoS Genetics, reveals that the amount of cellular damage that alkylating agents produce in healthy tissues can depend on how much of a certain DNA-repair enzyme is present in those cells. Levels of this enzyme, known as Aag, vary widely among different tissues within an individual, and among different individuals.

Leona Samson, a member of MIT’s Center for Environmental Health Sciences and the David H. Koch Institute for Integrative Cancer Research, is the senior author of the paper. She has previously shown that when alkylating agents damage DNA, the Aag enzyme is called into action as part of a DNA-repair process known as base excision repair. Aag cuts out the DNA base that is damaged, and other enzymes cleave the DNA sugar-phosphate backbone, trim the DNA ends and then fill in the empty spot with new DNA.

In this work, the researchers studied mice engineered to produce varying levels of Aag over a 10- to 15-fold range. This is similar to the natural range found in the human population.

The mice with increased levels of Aag resembled normal mice in their lifespan and likelihood of developing cancer, says Jennifer Calvo, a research scientist in Samson’s lab and lead author of the paper. However, “we found drastic differences when we started challenging them with these alkylating agents,” she says.

Mice with excessive or even normal levels of the Aag enzyme showed much greater levels of cell death in certain tissues after being treated with alkylating agents.

“It’s counterintuitive that extra DNA-repair capacity, or even the normal level, is bad for you,” says Samson, who is a professor of biological engineering and biology at MIT. “It seems that you can have too much of a good thing.”

A fine balance

It appears that too much Aag can upset the balance in the base excision repair pathway, the researchers say. This pathway involves several steps, some of which produce intermediates that can be extremely toxic to the cell if they do not promptly move to the next step. The researchers theorize that when Aag is too active, these toxic intermediates build up and destroy the cell.

Certain organs appear more vulnerable to this Aag-mediated tissue damage — in particular, the retina, pancreas, cerebellum and bone marrow — and the tissue damage is specific to certain types of cells within those tissues. Samson says all of the cells are likely experiencing similar DNA damage, but for some reason they don’t all respond the same way.

“It’s a very cell-specific phenomenon,” she says. “We haven’t completely gotten to the bottom of what it is that makes some cells behave in a certain way when they make zero or extra of a certain enzyme.”

That kind of specificity has not been seen before, notes Samuel Wilson, a principal investigator at the National Institute of Environmental Health Sciences. “It points to a different dynamic for base-lesion repair in different tissues,” says Wilson, who was not involved in the research. “That fundamental question of why there are tissue-specific differences would be very interesting to follow up on.”

The researchers found that an enzyme called Parp1 also plays an important role in Aag-related tissue damage. Parp1 helps to promote the  repair of single-stranded breaks in DNA; such breaks are readily produced after Aag cuts out a damaged base. When Parp1 recognizes such a break, it starts to coat itself with chains of molecules called PolyADP-ribose, which then helps to recruit some of the additional proteins needed to continue the repair process.

When there is too much Aag, Parp1 becomes overactive and begins to deplete the cell’s stores of NAD and ATP, which are critical for energy transfer in cells. Without enough NAD and ATP, the cell goes into an energetic crisis and dies.

Measuring levels of Aag, Parp1 and other enzymes before chemotherapy could be useful for doctors, not only to minimize side effects but also to maximize drugs’ effects on cancer cells, Samson says.

“Aag is just one of many enzymes that you’d probably want to know the level of, and in the end make some kind of matrix to determine what the therapeutic window would be,” she says. “We’re trying to develop ways of measuring the activity of a whole battery of different DNA repair pathways in one mega-assay.”

Source: MIT


New Research Exposes Possible Cancer Treatment.


Altering ‘super-enhancers,’ a powerful set of gene regulators, could mean big things for cancer treatment.

Scientists from the Whitehead Institute discovered important information about how cells’ identity and function are controlled, which, in turn, will help them understand what goes wrong in cancerous and diseased cells. The researchers discovered “super-enhancers,” genes regulators that keep healthy cells functioning properly. In cancer cells, however, super-enhancers are manipulated so much that they kick cancerous gene production into overdrive, leading to potentially fatal tumors.

Though there are countless factors that can “switch” cells on an off, the study, which will be published today in the journal Cell, finds that these super-enhancers are responsible for the majority of genes that actually account for substantial differences among cells. A report from the Whitehead Institute quotes the study’s author Richard Young:

“We have been marveling at the complexity of cellular control, with millions of enhancers controlling tens of thousands of genes in the vast array of cells that comprise human beings,” says Whitehead Member Richard Young. “So it was a surprise to find that only a few hundred super-enhancers control most key genes that give each cell its special properties and functions, and furthermore, that these special controls are hijacked in cancer and other diseases.”

While this discovery is important in its own right, it also could mean big things for cancer treatment. Young and his team found super-enhancers near notorious cancer-causing genes, some of which were actually producing their own super-enhancers to proliferate tumor-causing genes. And since super-enhancers are extremely sensitive and can be easily disturbed, it’s possible that researchers could develop a pharmaceutical to target the cancer-spreading super-enhancers. In the Whitehead Institute report, Dana-Farber Cancer Institute‘s James Bradner, who worked with Young in the study, says.

“It’s difficult not to be excited about the prospect of identifying super-enhancers in patient tumors and developing novel therapeutics to disrupt their control of key oncogenes,” says Bradner.

And, Young says, the discovery could help scientists better understand diseases across the board. He says:

“Looking at large genome association studies, one can find disease-related mutations occurring in super-enhancers,” Young says. “It’s possible that super-enhancers could become biomarkers that identify key disease genes and help guide the development of approaches to treatment.”



13 Tips for Living Happy, Wild, and Free.


Story at-a-glance

  • Happiness can be identified as “whatever gets you excited.” Once you’ve identified that activity, whatever it is, you can start focusing your mind around that so you can structure you life to do more of it
  • Simple things like eating light, talking less and listening more, turning off the TV and getting outdoors to enjoy nature and getting some sunshine can bring more joy into your life
  • Positive self-talk, affirmations and mantras can play a role in cultivating more happiness, as can keeping a gratitude journal, and seeking out reasons to laugh and to express yourself creatively


We all strive for happiness and a sense of joy in life. Like many, you probably think achievements such as education, marriage, family and social/financial status can make you happy.

However, studies of happiness have found that these achievements have little to do with your happiness. And for millions of people, happiness remains a rather elusive goal…

Happiness can be identified as “whatever gets you excited.” Once you’ve identified that activity, whatever it is, you can start focusing your mind around that so you can structure your life to do more of it.

A sense of adventure and freedom can also ignite that elusive feeling of happiness. This doesn’t require expensive tickets to some far-flung destination—a walk in the woods can do the trick, or simply taking a different route on your way home from work.

More often than not, it’s the small, simple things in life that bring the most joy and are the most invigorating. In the featured article, Lynn Newman writes about what gives her joy:1

“When I attune to the simple things that give me joy, my body and spirit ignites! I feel truly alive and wildly happy. I feel free of the heavier burdens, beliefs, and complicated constructs that kept me stuck by focusing only on the ‘storms’ within me.”

13 Simple Tips to Live Happy, Wild, and Free

In her article, Newman lists 10 simple tips for living “happy, wild and free.” I’ve also added a couple tips of my own at the end.

  1. Review the Happy List

I recently published a list of 22 things that happy people do differently. It was widely appreciated and commented on. So please be sure and review that list to find some novel additional behaviors that aren’t listed here.

  1. Write a list of simple things that give you pleasure… and do them at least a few times a week

Writing down the things that bring you a sense of pleasure and happiness, and reviewing your list on a regular basis, can help you remember to carve out the time to do those simple little things that reinforce your belief that life is indeed good.

  1. Get moving

Exercise boosts levels of health-promoting brain chemicals like serotonin, dopamine, and norepinephrine, which may help buffer some of the effects of stress and also relieve some symptoms of depression. Rather than viewing exercise as a tool merely for losing weight and preventing disease – all benefits that occur in the future – try viewing exercise as a daily tool to immediately enhance your frame of mind, reduce stress, and feel happier.

One of the newest recommendations I have based on NASA scientist Dr. Joan Vernikos, who I recently interviewed, is simply to set a timer when you are sitting and stand up every 10 minutes. I even modified further by doing jump squats at times in addition to standing up. This will help counteract the dangerous consequences of excessive sitting.

  1. Eat light—and right

What you eat directly impacts your mood and energy levels in both the short and long term. Whereas eating right can prime your body and brain to be in a focused, happy state, eating processed junk foods will leave you sluggish and prone to chronic disease. Ditto for over-eating, which can leave you feeling bloated and sluggish. My free nutrition plan is an excellent tool to help you choose the best foods for both physical and emotional wellness.

  1. Take a cold shower

Exposure to cold temperatures via cold water may offer health-boosting benefits for virtually everyone. Taking a cold showerincreases your circulation and helps minimize inflammation. It also tends to leave you feeling energized and invigorated, so it’s great first thing in the morning, or right after a workout.

  1. Talk less – listen more

Talking less and listening more can help increase heart-centered communication. Listening helps you soak in the wisdom of others and allows you to quiet your own mind at the same time, allowing you to feel content while helping you gain different perspective.

  1. Get some sun every day

Have you ever noticed how great it can feel to spend time outdoors on a sunny day? Well, it turns out that getting safe sun exposure, which allows your body to produce vitamin D, is great for your mood.

While I don’t agree with the author’s recommendation to slather on just any sunscreen, getting regular sun exposure is a critical factor for optimal health, happiness, and overall life satisfaction. Remember, if you use sunscreen, you are effectivelyblocking the sun’s rays, which means your body cannot produce any vitamin D. If you are going to be in the sun for an extended period of time, a non-toxic sunscreen may be necessary to prevent burning certain areas of your skin.

Getting a little bit of sun on bare skin each day is far better than spending hours outside on the weekends only, as overexposure could certainly be harmful to your skin. You always want to avoid getting burned. A better alternative to topical sunscreen is making sure you’re getting plenty of antioxidants in your diet from fresh fruits and vegetables. The carotenoid astaxanthin is particularly effective as an internal sunscreen to help protect you against UV damage.

  1. Turn off the TV

Evidence shows cutting back on TV time can add years to your life. According to one study, every hour of TV you watch equates to a 22-minute reduction in life expectancy. Watching TV also has a major impact on your brain chemistry. In fact, the longer you watch, the easier your brain slips into a receptive, passive mode, meaning that messages are streamed into your brain without any participation from you. So, rather than turning off your brain, why not turn off your TV and mindfully engage in something from your list of pleasurable activities instead?

  1. Create

As the author states, you don’t have to be an artist to be creative. Creativity can take any form, from gardening to cooking, to dancing and singing, to taking up a new hobby.

  1. Enjoy nature

Spending time in nature is an excellent mental health “prescription.” And while you’re at it, take off your shoes (as long as it’s safe to do so). Walking barefoot, grounding yourself to the earth has a wide range of health benefits over and above the simple feeling of connecting with the Earth.  Take up gardening, even if you have little room there is always enough space for a few plants.

  1. Know the simple truth about yourself

Positive self-talk, affirmations and mantras can play a role in cultivating more happiness. I like the author’s take on this:

“With enthusiasm and confidence, state what you know to be true about your authentic self. Ask yourself, ‘What is true about myself right now in this moment?’ For example, I am enough, I am worthy, I am good, I am loved, I have what I need, or I am a success. State this affirmation out loud a few times to embody the essence of who you really are in this very moment. Take it in! Believe this and you are free!”

  1. Express gratitude

People who are thankful for what they have are better able to cope with stress, and have more positive emotions. The best way to harness the positive power of gratitude is to keep a gratitude journal or list, where you actively write down exactly what you’re grateful for each day. Doing so has been linked to happier moods, greater optimism and even better physical health. Remember, your future depends very largely on the thoughts you think today. So think positive thoughts of hope, confidence, love and success. A simple habit to start is to express appreciation at every meal, either out loud or silently, whichever works for you.

  1. Laugh it up!

Laughing causes your body to release beneficial chemicals called endorphins, natural “pain killers” that contribute to your sense of well-being and may counteract the effects of stress hormones and cause blood vessels to dilate. Researchers have even found that just anticipating laughter can increase your endorphin levels, whereas laughing may help boost your immune system and reduce inflammation in your body, which is linked to a variety of diseases. So, if you’re going to watch TV, why not make sure it’s something really funny?

A Healthy Lifestyle Naturally Enhances Happiness

In many respects, a lifestyle that will optimize your health will also help you achieve a happier, more joyful state of mind. You cannot separate your physical health from your mental or emotional health. Once you adopt a happiness mindset, and even before you do, embracing healthy habits will help keep your mood elevated naturally even in the midst of stress. Happy people tend to be healthy people, and vice versa, so in addition to the tips offered above, the following lifestyle strategies will also help you achieve greater levels of happiness.

  1. Use an effective stress-management tool, such as the Emotional Freedom Technique (EFT)
  2. Drink plenty of clean water
  3. Limit your exposure to toxins
  4. Consume healthy fats
  5. Eat plenty of raw food, ideally organic and/or locally grown
  6. Optimize your insulin and leptin levels by cutting out sugar/fructose and grains from your diet, and adding high intensity interval training to your exercise regimen
  7. Exercise regularly
  8. Get plenty of high-quality sleep




Enterovirus 71 Vaccine Is Safe and Efficacious.

Two doses of an enterovirus 71 vaccine had an efficacy of 80% against EV71-associated disease in Chinese children.


Enterovirus 71 (EV71) is associated with hand, foot, and mouth disease (HFMD) and other, more-serious conditions. Infants and young children are most affected; epidemics have been especially severe in Asia (JW Infect Dis Jan 30 2013).

Investigators (with partial manufacturer support) recently conducted a multicenter, double-blind, phase III trial of an inactivated alum-adjuvanted EV71 vaccine based on genotype C4, the predominant strain in mainland China. Healthy children in that country, aged 6 to 35 months, were randomized to receive vaccine or placebo (alum adjuvant), administered on days 0 and 28. Of 10,245 enrollees, 96% received both doses.

During active surveillance (from day 56 to month 14), vaccine efficacy in the per-protocol population was 80% against EV71-associated disease and 90% against EV71-associated HFMD. Among 52 participants with laboratory-confirmed EV71-associated disease, 51 were seronegative; all EV71 isolates were genotype C4. Eight placebo-group and no vaccine-group participants were hospitalized for EV71-associated disease. Most participants with clinical HFMD were infected with Coxsackie A virus 16 or other enteroviruses; only 2.1% of episodes were associated with EV71. In the subset studied for immunogenicity, antibody titer was significantly higher in vaccine-group than placebo-group participants. The rate of serious adverse events was similar between groups (1.2% and 1.5%, respectively).

Comment: The authors caution that although EV71 vaccine could help to prevent severe cases of EV71-associated disease, its role in reducing the overall incidence of hand, foot, and mouth disease might be limited because EV71 is only one cause of this syndrome. They also note the need to assess whether the vaccine’s immunogenicity and efficacy are affected by concomitantly administered routine vaccines. Editorialists observe that future studies should examine cross-protection against other genotypes and — because neonatal EV71 infection can be particularly severe — vaccination of infants aged <6 months. Cost-effectiveness analyses can help in setting priorities among the several new vaccines that are efficacious and have acceptable safety profiles.


Source: Journal Watch Infectious Diseases

TAVR for Aortic Regurgitation: Proceed with Caution

According to a small, international study, the procedure can be successful in carefully selected patients with regurgitation but no stenosis who are ineligible for surgery.

Transcatheter aortic valve replacement (TAVR) is approved in the U.S. for treatment of aortic stenosis in patients who are ineligible for surgery or at high surgical risk. However, outside the U.S., TAVR is being used for a number of other conditions. In this study from 14 centers in Europe and Israel, investigators examined procedural success and outcomes with the self-expanding CoreValve device in 43 patients (mean age, 75 years; 53% women) with severe, native aortic regurgitation (AR) without aortic stenosis. All were considered unsuitable for open surgery because of comorbidities (mean Society of Thoracic Surgeons score, 10.2%).

Devices were successfully implanted in 98% of patients, 8 of whom required a second valve for residual AR (19%). One patient required conversion to surgery for severe residual AR. In the remaining patients, postprocedural AR grade was 

≤I in 79%, II in 16%, and III in 5%. At 30 days, all-cause mortality was 9%, and 2 patients had major strokes (5%). At 1 year, all-cause mortality was 21%.

Comment: This study demonstrates the feasibility of transcatheter aortic valve replacement with the CoreValve device for pure, severe native aortic regurgitation. Challenges to successful TAVR in this patient group include lack of calcification for positioning and fixation, large annulus, and relatively diverse and variable anatomy. The high mortality, frequent need for a second valve, and residual AR in this study will — for the time being — probably limit this therapy to patients with extremely high surgical risk.

Source: Journal Watch Cardiology