U.S. Farm Subsidy Policies Contribute to Worsening Obesity Trends.


Story at-a-glance

  • A new study highlights how agricultural subsidies that favor corn, soy and grains are fueling the obesity epidemic, putting small farms out of business and discouraging sustainable, biodiverse farming
  • Farm subsidies are no longer based on need; mega-farms receive an annual fixed cash payment based upon the number of acres on the farm, which are given whether they need them or not
  • Large corporate farms receive the majority of farm subsidies while the bulk of small farmers receive little or none
  • Farm subsidies are already in the budget; redesigning the system to provide incentives to farmers growing healthy crops and using sustainable farming methods may help fight obesity and protect the environment
  • Agricultural policies in the US are contributing to the poor health of Americans, and, specifically, government-issued agricultural subsidies are worsening the US obesity epidemic, concluded a new study in the American Journal of Preventive Medicine.1
  • At the root of the issue?
  • “Government-issued payments have skewed agricultural markets toward the overproduction of commodities that are the basic ingredients of processed, energy-dense foods,” the researchers wrote.
  • This includes corn, wheat, soybeans and rice, which are the top four most heavily subsidized foods.
  • By subsidizing these, particularly corn and soy, the US government is actively supporting a diet that consists of these grains in their processed form, namely high fructose corn syrup (HFCS), soybean oil, and grain-fed cattle – all of which are now well-known contributors to obesity and chronic diseases.
  • Despite this widespread knowledge, public health officials have had little to say about this agricultural practice, yet it seems quite clear that they should. With the 2013 Farm Bill set to be finalized by the end of September 2013, this could be a key time to implement important policy changes in the near future.
  • The US farm subsidy program is upside down, subsidizing junk food in one federal office, while across the hall another department is funding an anti-obesity campaign. This hypocrisy shows just how broken and wasteful our regulatory system really is.
  • Farm subsidies bring you high-fructose corn syrup, fast food, junk food, CAFOs (concentrated animal feeding operations), monoculture, and a host of other contributors to our unhealthful contemporary diet.
  • Why would a farmer choose to plant lettuce or Swiss chard when the government will essentially “insure” their corn crops, paying them back if the market prices fall below a set floor price? Likewise with wheat and soybeans, the second and third most heavily subsidized crops, respectively.
  • Most of them wouldn’t… and that’s why the US diet is so heavily loaded with foods based on the surplus, nutritionally devoid crops of corn, wheat and soy. One of the effects of the farm bill is creating a negative feedback loop that perpetuates the highly profitable standard American diet. The US government is, in essence, subsidizing obesity and chronic disease!
  • As the new study reported:2
  • “American agricultural policy has traditionally failed to offer incentives or support for fruit and vegetable production. Farmers are penalized for growing specialty crops (such as fruits and vegetables) 

    If they have received federal farm payments to grow other crops. In other words, federal farm subsidies promote unsustainable agriculture while also failing to reward good stewardship.

  • Further, although farmers may generate higher marketplace revenue from fresh produce, substantially lower economic security makes growing fruits and vegetables a risky proposition in an already risky industry.”
  • If you’ve ever wondered why corn and soy products are so ubiquitous not only in US processed foods but as feed for livestock, including cattle, you need look no further than the makeup of US cropland. It’s reported:3
  • “In 2004, 96% of U.S. cropland was dominated by the eight main commodity crops: corn (30%); soybeans (29%); wheat (23%); cotton (5%); sorghum (3%); barley (2%); oats (2%); and rice (1%).
  • According to the American Soybean Association, 70% of the fats and oils consumed by Americans are soy oil, found primarily in cooking oils, baking, and frying fats. A large percentage of cropland is cultivated on a 2-year rotation that favors soy one year and corn the next, another purported contributor to obesity. 

    A conservative estimate of high-fructose corn syrup (HFCS) consumption suggests a daily average of 132 calories for all Americans aged > 2 years, with the top 20% of consumers ingesting an average of 316 calories from HFCS per day.

  • Another important contribution of grains and oilseeds to the prevalence of obesity is their use as feed for livestock… As grain-fed livestock contribute to the oversupply of the commodities required to feed them, the harmful effects of grain and oilseed production are as widespread as they are indirect.”
  • Many are under the mistaken impression that farm subsidies are beneficial to small farmers, allowing them to stay afloat in years of poor harvests. Yet commodity subsidies are overwhelmingly going out to a select few mega farms — not to the small farmers who need them most! In fact, the broken farm subsidy system is responsible for not only encouraging monoculture but also for putting many small farmers out of business — while corporate-owned mega-farms grow ever larger.
  • Researchers continued:4
  • “Subsidies also have resulted in fewer farms and diminished agricultural diversity. Large farms often devote their entire capital and experience to producing one or two commodities, leaving smaller players to be regularly winnowed out at the profit of corporate farms and contractors. In 2001, large farms, which constitute 7% of the total, received 45% of federal subsidies, whereas small farms, constituting 76% of the total, received 14% of total payments.
  • Between 2003 and 2007, the top 10% of subsidized farmers received an annual average of $68,030, whereas the bottom 80% averaged $2312. Disproportionately allocated subsidies have contributed to forcing hundreds of small, biodiverse farms out of business at the profit of industrialized food processing.”
  • While farm subsidies initially were created to protect staple crops during times of war, reduce crop surpluses and provide monetary support to farmers when crop prices fell, today mega-farms receive subsidies whether they need them or not. The transition away from a needs-based system came in 1996, when lawmakers developed a “market transition” payment system for farmers.
  • The idea was to phase out the subsidies over a seven-year transition period, during which farmers would receive an annual fixed cash payment based upon the number of acres on the farm (these direct payments were given as long as the land was not developed — even if nothing was planted). Of course, this ensures that the largest farms also receive the largest payments, and contrary to its original intent, the payments have not declined annually nor has the program gone away.  As the Environmental Working Group (EWG) explained:5
  • “The industrial agriculture lobby has been defending the controversial “direct payment” form of taxpayer-funded subsidies ever since they were first authorized. These fixed, automatic checks go out every year to the largest growers of commodity crops, such as corn and cotton, whether farmers need them or not and despite the fact that farm household income has eclipsed average U.S. household income. Farm income for the largest operations, in particular, has soared sky high.”
  • And if you thought this all couldn’t get any more outrageous… it can, as it’s been revealed that under this absurd system, even dead farmers have received payments from the government. So have non-farmers who moved into residential areas that once were farmland, along with wealthy farmers who have received annual payments even when they are no longer growing the subsidized crop.
  • grain

·         The Farm Subsidy Program Is Junk — Literally

·         Just Eight Crops Make Up Virtually All of US Cropland

·         Farm Subsidies Favor Large Corporate Farms, Force Small Farms Out of Business

·         Farm Subsidies Are No Longer a Needs-Based System

Redesigning the System Could Help Fight Obesity and Protect the Environment

The time is ripe for change, and redesigning the system could help move us toward economic, and nutritional, recovery. The money is already there, but if we’re going to subsidize, let’s subsidize in a way that helps restore the health of our citizens and our land—programs that might just pay for themselves by the reduction in healthcare costs they bring about. The researchers noted:6

“A redesign of the subsidy system, rather than its elimination, is likely to yield more sustainable changes in the agricultural industry. Such revision could take the form of decoupling income supports from program-specific crops, and rewards for agricultural diversification.

The trickle-down effect of providing increased government support to farms growing sustainable, bio-diverse crops would not only help farmers reap greater economic benefits (as fruits and vegetables are among the products with the highest farm-retail value) but would contribute to large-scale efforts to address obesity by increasing the availability of fresh produce. Overall, government and public health activists should support policies that help disincentivize monocultural overproduction, not policies that fuel it.”

It sounds so logical, so obvious, doesn’t it? Yet it is the exact opposite of what is currently being done with farm subsidies. Mark Brittman of the New York Times similarly argued, back in 2011, that subsidy money, which is already IN the budget, could be redirected toward helping smaller farmers to compete in the marketplace.7 The money could be redirected, for example, in the following ways:

  • Funding research and innovation in sustainable agriculture
  • Providing incentives to attract new farmers
  • Saving farmland from development
  • Assisting farmers who grow currently unsubsidized fruits and vegetables, while providing incentives for monoculture commodity farmers (corn, soy, wheat, rice) to convert some of their operations to more desirable foods
  • Leveling the playing field so that medium-sized farms can more favorably compete with agribusiness as suppliers for local supermarkets

Help Support Small Farms with a Farm Bill That Works

If you don’t like the idea of your tax dollars lining the pockets of wealthy corporations that flood the market with sugary sodas, soybean oil and corn chips, now is the time to speak up. The Environmental Working Group has started a petition urging Congress to enact a Farm Bill that protects family farmers who help us protect the environment and public health, and you cansign it now.

But remember, you can also voice your opinion every day by voting with your wallet. Support small family farms in your area. Even if it means buying just one or two items at your local farmers market, instead of the big box store, those little purchases add up.

Return to a diet of real, whole foods—fresh organic produce, meats from animals raised sustainably on pasture, without cruelty, and raw organic milk and eggs. Say no to junk food producers by not buying it. Eating this way will earn you a long, healthy life—whereas the typical American diet may set you on the path toward obesity and chronic disease.

Source: mercola.com

Secret of Usain Bolt’s speed unveiled.


Scientists say they can explain Usain Bolt‘s extraordinary speed with a mathematical model.

His 100m time of 9.58 seconds during the 2009 World Championships in Berlin is the current world record.

They say their model explains the power and energy he had to expend to overcome drag caused by air resistance, made stronger by his frame of 6ft 5in.

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Writing in the European Journal of Physics, the team hope to discover what makes extraordinary athletes so fast.

According to the mathematical model proposed, Bolt’s time of 9.58 seconds in Berlin was achieved by reaching a speed of 12.2 metres per second, equivalent to about 27mph.

Less dynamic

The team calculated that Bolt’s maximum power occurred when he was less than one second into the race and was only at half his maximum speed. This demonstrates the near immediate effect of drag, which is where air resistance slows moving objects.

They also discovered less than 8% of the energy his muscles produced was used for motion, with the rest absorbed by drag.

When comparing Bolt’s body mass, the altitude of the track and the air temperature, they found out that his drag coefficient – which is a measure of the drag per unit area of mass – was actually less aerodynamic than that of the average man.

Effects of drag

Jorge Hernandez of the the National Autonomous University of Mexico said: “Our calculated drag coefficient highlights the outstanding ability of Bolt. He has been able to break several records despite not being as aerodynamic as a human can be.

“The enormous amount of work that Bolt developed in 2009, and the amount that was absorbed by drag, is truly extraordinary.

“It is so hard to break records nowadays, even by hundredths of a second, as the runners must act very powerfully against a tremendous force which increases massively with each bit of additional speed they are able to develop.

“This is all because of the ‘physical barrier’ imposed by the conditions on Earth. Of course, if Bolt were to run on a planet with a much less dense atmosphere, he could achieve records of fantastic proportions.

“The accurate recording of Bolt’s position and speed during the race provided a splendid opportunity for us to study the effects of drag on a sprinter.

bolt

“If more data become available in the future, it would be interesting to see what distinguishes one athlete from another,” added Mr Hernandez.

Bolt’s time in Berlin was the biggest increase in the record since electronic timing was introduced in 1968.

Large stride

John Barrow at Cambridge University who has previously analysed how Bolt could become even faster, explained that his speed came in part due his “extraordinary large stride length”, despite having such an initial slow reaction time to the starting gun.

“He has lots of fast twitch muscle fibres that can respond quickly, coupled with his fast stride is what gives him such an extraordinary fast time.”

He said Bolt has lots of scope to break his record if he responded faster at the start, ran with a slightly stronger tail-wind and at a higher altitude, where there was less drag.

Bolt’s Berlin record was won with a tail wind of only 0.9m per second, which didn’t give him “the advantage of helpful wind assistance”, he added.

“You’re allowed to have a wind no greater than 2m per second to count for record purposes, so without becoming any faster he has huge scope to improve,” Prof Barrow told BBC News.

Source: BBC

Association of plasma uric acid with ischaemic heart disease and blood pressure: mendelian randomisation analysis of two large cohorts.


Abstract

Objectives To assess the associations between both uric acid levels and hyperuricaemia, with ischaemic heart disease and blood pressure, and to explore the potentially confounding role of body mass index.

Design Mendelian randomisation analysis, using variation at specific genes (SLC2A9(rs7442295) as an instrument for uric acid; and FTO (rs9939609), MC4R(rs17782313), and TMEM18 (rs6548238) for body mass index).

Setting Two large, prospective cohort studies in Denmark.

Participants We measured levels of uric acid and related covariables in 58 072 participants from the Copenhagen General Population Study and 10 602 from the Copenhagen City Heart Study, comprising 4890 and 2282 cases of ischaemic heart disease, respectively.

Main outcome Blood pressure and prospectively assessed ischaemic heart disease.

Results Estimates confirmed known observational associations between plasma uric acid and hyperuricaemia with risk of ischaemic heart disease and diastolic and systolic blood pressure. However, when using genotypic instruments for uric acid and hyperuricaemia, we saw no evidence for causal associations between uric acid, ischaemic heart disease, and blood pressure. We used genetic instruments to investigate body mass index as a potentially confounding factor in observational associations, and saw a causal effect on uric acid levels. Every four unit increase of body mass index saw a rise in uric acid of 0.03 mmol/L (95% confidence interval 0.02 to 0.04), and an increase in risk of hyperuricaemia of 7.5% (3.9% to 11.1%).

Conclusion By contrast with observational findings, there is no strong evidence for causal associations between uric acid and ischaemic heart disease or blood pressure. However, evidence supports a causal effect between body mass index and uric acid level and hyperuricaemia. This finding strongly suggests body mass index as a confounder in observational associations, and suggests a role for elevated body mass index or obesity in the development of uric acid related conditions.

Source:BMJ

 

Unhealthy behaviours and disability in older adults: Three-City Dijon cohort study.


Abstract

Objectives To examine the individual and combined associations of unhealthy behaviours (low/intermediate physical activity, consuming fruit and vegetables less than once a day, current smoking/short term ex-smoking, never/former/heavy alcohol drinking), assessed at start of follow-up, with hazard of disability among older French adults and to assess the role of potential mediators, assessed repeatedly, of these associations.

Design Population based cohort study.

Setting Dijon centre of Three-City study.

Participants 3982 (2410 (60.5%) women) French community dwellers aged 65 or over included during 1999-2001; participants were disability-free at baseline when health behaviours were assessed.

Main outcome measure Hierarchical indicator of disability (no, light, moderate, severe) combining data from three disability scales (mobility, instrumental activities of daily living, basic activities of daily living) assessed five times between 2001 and 2012.

Results During the 12 year follow-up, 1236 participants (861 (69.7%) women) developed moderate or severe disability. Interval censored survival analyses (adjusted for age, sex, marital status, and education) showed low/intermediate physical activity (hazard ratio 1.72, 95% confidence interval 1.48 to 2.00), consuming fruit and vegetables less than once a day (1.24, 1.10 to 1.41), and current smoking/short term ex-smoking (1.26, 1.05 to 1.50) to be independently associated with an increased hazard of disability, whereas no robust association with alcohol consumption was found. The hazard of disability increased progressively with the number of unhealthy behaviours independently associated with disability (P<0.001); participants with three unhealthy behaviours had a 2.53 (1.86 to 3.43)-fold increased hazard of disability compared with those with none. Reverse causation bias was verified by excluding participants who developed disability in the first four years of follow-up; these analyses on 890 disability events yielded results similar to those in the main analysis. 30.5% of the association between the unhealthy behaviours score and disability was explained by body mass index, cognitive function, depressive symptoms, trauma, chronic conditions, and cardiovascular disease and its risk factors; the main contributors were chronic conditions and, to a lesser extent, depressive symptoms, trauma, and body mass index.

Conclusions An unhealthy lifestyle is associated with greater hazard of incident disability, and the hazard increases progressively with the number of unhealthy behaviours. Chronic conditions, depressive symptoms, trauma, and body mass index partially explained this association.

Source: BMJ

Improving antibiotic prescribing in acute respiratory tract infections: cluster randomised trial from Norwegian general practice (prescription peer academic detailing (Rx-PAD) study).


Abstract

Objective To assess the effects of a multifaceted educational intervention in Norwegian general practice aiming to reduce antibiotic prescription rates for acute respiratory tract infections and to reduce the use of broad spectrum antibiotics.

Design Cluster randomised controlled study.

Setting Existing continuing medical education groups were recruited and randomised to intervention or control.

Participants 79 groups, comprising 382 general practitioners, completed the interventions and data extractions.

Interventions The intervention groups had two visits by peer academic detailers, the first presenting the national clinical guidelines for antibiotic use and recent research evidence on acute respiratory tract infections, the second based on feedback reports on each general practitioner’s antibiotic prescribing profile from the preceding year. Regional one day seminars were arranged as a supplement. The control arm received a different intervention targeting prescribing practice for older patients.

Main outcome measures Prescription rates and proportion of non-penicillin V antibiotics prescribed at the group level before and after the intervention, compared with corresponding data from the controls.

Results In an adjusted, multilevel model, the effect of the intervention on the 39 intervention groups (183 general practitioners) was a reduction (odds ratio 0.72, 95% confidence interval 0.61 to 0.84) in prescribing of antibiotics for acute respiratory tract infections compared with the controls (40 continuing medical education groups with 199 general practitioners). A corresponding reduction was seen in the odds (0.64, 0.49 to 0.82) for prescribing a non-penicillin V antibiotic when an antibiotic was issued. Prescriptions per 1000 listed patients increased from 80.3 to 84.6 in the intervention arm and from 80.9 to 89.0 in the control arm, but this reflects a greater incidence of infections (particularly pneumonia) that needed treating in the intervention arm.

Conclusions The intervention led to improved antibiotic prescribing for respiratory tract infections in a representative sample of Norwegian general practitioners, and the courses were feasible to the general practitioners.

Discussion

The main effects of this study of a prescription peer academic detailing intervention (Rx-PAD) were a decrease in overall prescription rates for antibiotics for acute respiratory tract infections and, in particular, an increased use of the narrow spectrum agent penicillin V when an antibiotic was issued.

Whereas reductions were seen in the intervention arm, both prescription rates and proportions of non-penicillin V antibiotics increased in the control arm. The greater increase in the number of episodes of acute respiratory tract infections in the intervention arm after intervention compared with the control arm could have affected the prescription rates if the diagnostic drift mainly tended towards diagnoses with a low prescribing rate; however, we found no evidence of this. The general practitioners in the intervention arm would probably have had greater awareness of acute respiratory tract infection diagnoses as a consequence of the intervention and therefore have recorded them more often.

As measured by unadjusted means (table 2), the change in total antibiotic prescribing rate was relatively small and its clinical significance may be debatable. However, the reduction in prescribing of broad spectrum antibiotics was substantial and of clinical importance because of the reduction in promoting resistance. The adjusted outcome measures show a more consistent effect of the intervention, with odds ratios of 0.72 and 0.64, and are closer to the effect estimates of the study.

The larger effects on antibiotic treatment for acute bronchitis and acute sinusitis were intentional, as parts of the intervention focused on the overuse of antibiotics for these diagnoses. Another topic particularly covered in the intervention was the overuse of macrolides. A major part of the increase in the proportion of penicillin V can be explained by a decrease in use of this antibiotic group.

The control arm received another intervention, and the mere participation in a course could possibly have affected the outcome of antibiotic prescribing, although the topic of antibiotic use was not part of the control arm course. However, we found no indication of such effects when we compared the distribution of different prescribed antibiotics typically used for acute respiratory tract infections in the control arm with the total sales in Norway for the same period.

When we were planning this study, the hypothesis was that an improvement in prescription behaviour could be obtained in a group setting where the participants knew each other well and were used to discussing challenging topics related to their own clinical practices. In the continuing medical education group setting, each participant was confronted with, and had to reflect on, the baseline report on their own prescription practice. We believe that this was a key component for obtaining improved prescription habits.

We had an expectation of greater effects of the intervention among the general practitioners with the highest baseline prescribing rates, but this was not the case. Whether the effect of such an intervention would be higher in countries with high prescribing is not easy to predict from our data.

Source: BMJ

Patient-Targeted Googling: The Ethics of Searching Online for Patient Information.


With the growth of the Internet, psychiatrists can now search online for a wide range of information about patients. Psychiatrists face challenges of maintaining professional boundaries with patients in many circumstances, but little consideration has been given to the practice of searching online for information about patients, an act we refer to as patient-targeted Googling (PTG). Psychiatrists are not the only health care providers who can investigate their patients online, but they may be especially likely to engage in PTG because of the unique relationships involved in their clinical practice. Before searching online for a patient, psychiatrists should consider such factors as the intention of searching, the anticipated effect of gaining information online, and its potential value or risk for the treatment. The psychiatrist is obligated to act in a way that respects the patient’s best interests and that adheres to professional ethics. In this article, we propose a pragmatic model for considering PTG that focuses on practical results of searches and that aims to minimize the risk of exploiting patients. We describe three cases of PTG, highlighting important ethical dilemmas in multiple practice settings. Each case is discussed from the standpoint of the pragmatic model.

Source: Hhttp://informahealthcare.com/

AI scores same as a 4-year-old in verbal IQ test.


Computers aren’t really known for their way with words, but that could be about to change. An artificial intelligence program recently scored as high as a 4-year-old on a test of verbal IQ. The result may help AIs develop common sense.

AIs such as Google’s search engine or IBM’s Watson typically perform well in specific areas, like ranking web pages or answering game-show style questions. But these systems tend to fail when asked to do things outside of their narrow area of expertise. For years researchers have attempted to build systems with a more general “common sense” understanding, but have had mixed results.

iq

Step forward ConceptNet. Developed by Catherine Havasi and her team at the MIT Media Lab ConceptNet draws upon a crowdsourced database of millions of statements describing simple relationships between everyday objects, such as “a fawn is a deer” or “ice cream is capable of melting”.

Havasi describes the system as containing “the kind of information that everybody knows about the world but that nobody ever writes down because we learn it too early”.

To test ConceptNet’s overall intelligence, Robert Sloan and Stellan Ohlsson of the University of Illinois at Chicago, who were not involved in the system’s creation, used a standard measure of child IQ called the Wechsler Preschool and Primary Scale of Intelligence. The verbal portion of the test asks questions in five categories, ranging from simple vocabulary questions, like “What is a house?”, to guessing an object from a number of clues such as “You can see through it. It is a square and can be opened. What is it?”

To answer a question from the test, like “What do you wear on your head?”, ConceptNet searches its database for the object that is most closely related to the pair “wear” and “head”.

For the three main categories of questions – information, vocabulary and word reasoning – Sloan and Ohlsson found that the system’s aggregate verbal IQ was equal to that of an average human 4-year-old. “I didn’t expect to see 4-year-old performance,” says Sloan, who presented the results at the Association for the Advancement of Artificial Intelligence conference in Bellevue, Washington, last week. Havasi points out that this research only tested the system’s verbal ability and ignored parts of the test that covered spatial and symbolic reasoning.

She speculates that the latest version of ConceptNet, which has 17 million statements instead of the million available to the version tested, might score even higher. Sloan thinks that with better algorithms, ConceptNet could score as high as a 5 or 6-year-old.

Source: http://www.newscientist.com

 

New Hypothesis Explains Why We Sleep.


Every night, while we lie asleep, blind, dumb and almost paralyzed, our brains are hard at work. Neurons in the sleeping brain fire nearly as often as they do in a waking state, and they consume almost as much energy. What is the point of this unceasing activity at a time when we are supposedly resting? Why does the conscious mind disconnect so completely from the external environment while the brain keeps nattering on?

The brain’s activity during rest likely serves some essential function. The evidence for this importance starts with sleep’s ubiquity. All animals apparently sleep even though being unconscious and unresponsive greatly raises the risk of becoming another creature’s lunch. Birds do it, bees do it, iguanas and cockroaches do it, even fruit flies do it, as we and others demonstrated more than a decade ago.

Source: http://www.scientificamerican.com

Physicists Debate Whether the World Is Made of Particles or Fields–or Something Else Entirely


Physicists speak of the world as being made of particles and force fields, but it is not at all clear what particles and force fields actually are in the quantum realm. The world may instead consist of bundles of properties, such as color and shape.

Physicists routinely describe the universe as being made of tiny subatomic particles that push and pull on one another by means of force fields. They call their subject “particle physics” and their instruments “particle accelerators.” They hew to a Lego-like model of the world. But this view sweeps a little-known fact under the rug: the particle interpretation of quantum physics, as well as the field interpretation, stretches our conventional notions of “particle” and “field” to such an extent that ever more people think the world might be made of something else entirely.

The problem is not that physicists lack a valid theory of the subatomic realm. They do have one: it is called quantum field theory. Theorists developed it between the late 1920s and early 1950s by merging the earlier theory of quantum mechanics with Einstein’s special theory of relativity. Quantum field theory provides the conceptual underpinnings of the Standard Model of particle physics, which describes the fundamental building blocks of matter and their interactions in one common framework. In terms of empirical precision, it is the most successful theory in the history of science. Physicists use it every day to calculate the aftermath of particle collisions, the synthesis of matter in the big bang, the extreme conditions inside atomic nuclei, and much besides.

Source: http://www.scientificamerican.com

For Acute Venous Thromboembolism, Apixaban Compares Favorably with Conventional Treatment.


Apixaban was as effective as enoxaparin plus warfarin and produced fewer bleeding complications.
Apixaban (Eliquis), a factor Xa inhibitor, is one of several new oral anticoagulation drugs that require no monitoring. In this industry-sponsored, placebo-controlled trial, 5400 patients with acute venous thromboembolism (VTE) received 6-month courses of either apixaban (given twice daily) or conventional treatment with enoxaparin followed by warfarin. The qualifying diagnosis was deep venous thrombosis (DVT) in 65% of patients and pulmonary embolism (with or without DVT) in 35%.

Apixaban was noninferior to conventional therapy at 6 months: The primary efficacy outcome (recurrent symptomatic or fatal VTE) occurred in 2.3% of apixaban recipients and in 2.7% of conventional-therapy recipients. Rates of major bleeding were significantly lower in the apixaban group than in the conventional-therapy group (0.6% vs. 1.8%).

COMMENT

In this study, oral therapy with apixaban was as effective as — and possibly safer than — enoxaparin plus warfarin for patients with acute venous thromboembolism. In another recent trial, apixaban lowered the incidence of recurrent VTE (compared with placebo) in patients who already had completed initial 6- to 12-month course of conventional anticoagulation (NEJM JW Gen Med Jan 3 2013). However, apixaban currently is FDA-approved only for stroke prevention in patients with atrial fibrillation; the only new drug that is FDA-approved for fully oral treatment of acute VTE is another factor Xa inhibitor, rivaroxaban (Xarelto).

Source: NEJM