Reasons for Optimism in Lung Cancer.

Targeted therapies
A decade ago, researchers at Dana-Farber identified a series of gene mutations in the cancer cells of some lung cancer patients that caused them to respond differently to certain oral chemotherapies. Since then, researchers continue to identify gene mutations that drive lung cancer and develop more effective drug therapies that target those mutations.

Tarceva (erlotinib), for example, targets tumors with mutations in the EGFR, while Xalkori (crizotinib) attacks tumors with a DNA rearrangement in the ALK gene. With the advent of these targeted mutations, lung cancer patients and their treating physicians are having conversations that involve the word “years.”

“We’re excited that we’re finding a mutation that is either known to be targetable or hypothesized to be targetable in over half of patients with lung adenocarcinoma,” says Jackman. “At present, there are newer agents in clinical trials that are attempting to attack these and other altered proteins in lung cancer.”

For decades, researchers have attempted to harness the body’s immune system to fight off lung cancer. A major advance came in 2000, when Dana-Farber scientists described the interaction between PD-1, a protein on the surface of T cells of the immune system, and PD-L1, a protein on the surface of some cancer cells. Interaction between these two proteins normally allows cancer cells to hide themselves from the immune system. Within the last few years, Dana-Farber physician-scientists have helped develop drugs that block this interaction, leaving lung cancer cells vulnerable to attack by the immune system.

“These studies are still very early in their development,” Jackman notes. “It may be years before we can determine whether there is sufficient efficacy and safety to warrant their approval. But we are excited about their potential.”

Precision surgery and radiation
For localized lung tumors, surgery can be an effective treatment, and in many cases, a cure. Surgical oncologists continue to develop minimally invasive thoracic surgery techniques for removing tumors that hope to get patients cured and back on their feet faster than before. Similarly, in
 radiation therapy, more precise aiming of the X-ray beams allows radiation oncologists to maximize the effect of radiation on cancerous tissues while minimizing the impact on surrounding, healthy tissues.

Source; DFCI



Meet the NASA scientist devising a starship warp drive.

To pave the way for rapid interstellar travel, NASA propulsion researcherHarold “Sonny” White plans to manipulate space-time in the lab


The idea that nothing can exceed the speed of light limits our interstellar ambitions. How do we get round this?
Within general relativity, there are two loopholes that allow you to go somewhere very quickly, overcoming the restriction of the speed of light. One is a wormhole and the other is a space warp.

What is a space warp and how can it help?
A space warp works on the principle that you can expand and contract space at any speed. Take a terrestrial analogy. In airports we have moving walkways that help you cover distance quicker than you would otherwise. You are walking along at 3 miles an hour, and then you step onto the walkway. You are still walking at 3 miles an hour, but you are covering the distance much more quickly relative to somebody who isn’t on the belt.

What would a starship with warp drive be like?
Imagine an American football, for simplicity, that has a toroidal ring around it attached with pylons. The football is where the crew and robotic systems would be, while the ring would contain exotic matter called negative vacuum energy, a consequence of quantum mechanics. The presence of this toroidal ring of negative vacuum energy is what’s required from the math and physics to be able to use the warp trick.

What would it be like to travel at warp speed?
You would have an initial velocity as you set off, and then when you turn on the ring of negative vacuum energy it augments your velocity. Space would contract in front of the spacecraft and expand behind it, sending you sliding through warped space-time and covering the distance at a much quicker rate. It would be like watching a film in fast forward.

Even if travelling at warp speed is theoretically possible, don’t the huge energy requirements make it unlikely?
When the idea was first proposed mathematically in 1994 it required a vast amount of negative vacuum energy which made the idea seem impossible. I did some work in 2011 and 2012 as part of the 100 Year Starship symposium and discovered ways to reduce the energy requirements by many orders of magnitude, so for a 10-metre diameter spacecraft with a velocity of 10 times light speed, I can reduce the negative energy needed.

How close are you to making this a reality?
We are very much in the science rather than the technology phase. We have got some very specific and controlled steps to take to create a proof of concept, to show we have properly understood and applied the math and physics. To that end we will try to generate a microscopic instance of a warp bubble in the lab and measure it.

If successful is the next stop Alpha Centauri?
We don’t just go from the lab to an interstellar mission. There will be intermediate steps, other things we would do with this long before we get to some of the romantic pictures of a captain on the bridge telling the helmsman to engage warp drive.



Harold “Sonny” White is advanced propulsion theme lead at NASA’s Johnson Space Center in Houston, Texas. He is also a keynote speaker at this week’s Icarus Interstellar Starship Congress.



10 Top Ways to Stay Active as a Family.

Story at-a-glance

·         Most families, adults and kids alike, are not getting enough physical activity

·         Combining family time with fitness is an easy way to increase physical activity and its associated health benefits

·         Scavenger hunts, family Olympics, water days, mileage goals and even doing chores together are examples of ways to stay active as a family


Despite the seemingly infinite benefits that physical activity has for your health, most people are not very active. The latest statistics from the US Centers for Disease Control and Prevention (CDC) state that just over 20 percent of adults are meeting recommended physical activity guidelines for both aerobic and muscle-strengthening physical activity!1

In case you’re wondering, those guidelines recommend at least 2.5 hours of moderate-intensity activity, or 1 hour and 15 minutes of vigorous-intensity activity a week, plus muscle-strengthening activities two or more days a week.

This trend extends to kids, too – only one in three US kids are physically active every day.2

It’s clear that many families also feel there aren’t enough hours in a day to spend quality time together, between work, school and other obligations, so it makes perfect sense to make your family time active time as much as possible. This way, you’re spending time together while also boosting your fitness and modeling a healthy lifestyle for your kids.

10 Top Ways to Stay Active as a Family

Going to the gym is fine for adults, but when kids are involved you’ve got to get more creative … and more fun!

1. Go on a Scavenger Hunt

Make a list of challenges (find an orange leaf, get a neighbor’s signature, snap a photo of a playground, etc.), split your family into teams, set a time limit and then head off (on foot or on bike) to see who can complete the most items.

2. Have a Water Day

Tossing water balloons, splashing in a kiddie pool and running through a sprinkler in the backyard are fun ways to stay cool and active on a hot summer day.

3. Set ‘Mileage’ Goals for the Weekend

Decide as a family how many steps, or how many miles, you want to travel over the weekend, then have fun trying to reach the goal. You can use pedometers to measure steps taken while running errands, going on hikes, playing tag and more, and can challenge the family to increase your goal each weekend.

4. Wash the Car

Washing the car uses key core muscles and can be a fun, bonding experience, especially if you take time to cool off with the hose, too.

5. Family Olympics

Get together with a group of families and compete in events like hula-hoops, 50-yard dash, relay race, basketball shoot, and an obstacle course. You can even make it an annual event!

6. Family Fitness Classes

If you like a more structured routine, try a fitness class designed for families, like stroller workouts, mom/dad and baby workouts or family yoga.

7. Do Chores Together

Vacuuming, washing windows, weeding the garden, raking leaves and even doing laundry work your muscles and burn calories while teaching your kids the value of responsibility. Make chores fun by setting a time limit and turning up the music while you work together as a family.

8. Plan Seasonal Outdoor Activities

Swimming, biking, canoeing and hiking are great in the summer, while sledding, ice skating, building a snowman or skiing are fun – and great for your fitness goals – in the winter.

9. Play Together

Tag, hide-and-go-seek, hop scotch, doing cartwheels and dancing in the kitchen are so much fun you won’t even realize it’s exercise in disguise.

10. Try Out Family Sports

A backyard game of softball or volleyball, shooting hoops or taking a trip to a golf course give you quality time as a family while staying active.


You Can Even Stay Active on Your Family Vacation!

Whether you’re going to grandma’s house for the weekend, planning a trip abroad or even having a “staycation,” family getaways are another opportunity to fit in fun activities that promote fitness. While on vacation, try:

Walking tours

Museums, zoos and theme parks (lots of walking!)

Collecting seashells

Jogging or walking on the beach

Using the hotel gym or doing bodyweight exercises in your hotel room (this will be mostly for mom and dad)

Power walking in the airport terminal

Snorkeling, hiking, beach volleyball and other outdoor activities

Exploring new locales by foot or bicycle


What Will Your Kids Gain by Staying Active?

Leading a physically active lifestyle is a good habit to instill in your child from an early age because although it’s never too late to start exercising, the sooner you do it, the better. Keeping kids active is a superb way to increase learning, focus and even test results.   As many of you reading this have likely experienced, if your mind is feeling cluttered or you’re having a mid-afternoon slump, a brisk walk or a quick workout can give you a renewed sense of clarity and focus. This is certainly true for kids and teenagers, too. There are a multitude of short- and long-term health benefits your child can gain from regular physical activity, including:


Reduced risk of diabetes and pre-diabetes

Improved sleep and mood

Stronger bones

Reduced restlessness or hyperactivity; helps decrease symptoms of ADHD

Improved immune system function

Decreased risk of suicide in teens

Weight loss

Increased energy levels

What Will YOU Gain by Staying Active?

The benefits that kids receive extend to adults as well, although as you age you’ll begin to reap the benefits of a lifetime of exercise in the form of better mobility, muscle mass and brain power. One of the primary benefits of exercise is that it normalizes your insulin and leptin levels, with the secondary benefits of weight loss and normalization of blood sugars. These basic factors in turn cascade outward, creating a ripple effect of positive health benefits, which include:


Improving your brainpower and boosting your IQ

Lowering your risk of heart disease and cancer

Building strong bones

Lowering your blood pressure

Curing insomnia

Losing weight

Relieving pain

Balancing your mood and fighting depression

Increasing your energy levels

Acquiring fewer colds

Lowering your risk of diabetes and reversing pre-diabetes

Slowing down your aging process

Limiting Screen Time is a Key Part of Staying Active

Once you’ve committed to staying active as a family, you may notice that the time you all spend sitting in front of a computer or the television naturally decrease, and this is a very good thing. More than two hours a day of screen time is associated with increased emotional and behavioral difficulties, regardless of the time spent exercising. According to one study:3

·Children who spent more than two hours a day watching TV or using a computer were 61 and 59 percent more likely to experience high levels of psychological difficulties, respectively

·Children who spent more than two hours a day watching TV, and also failed to meet physical activity guidelines, were 70 percent more likely to experience high levels of psychological difficulties

·This risk increased to 81 percent for children who used a computer for more than two hours a day while also failing to meet recommended exercise guidelines

So remember that it is imperative to limit your child’s TV, computer, and video game time in addition to encouraging your child to spend more time doing various forms of physical activity.





How an ocean went into hiding in Australia.

A chunk of the oceans took a wrong turn in 2011. Instead of going from sky to rain, into rivers, and then back into the oceans in the usual water cycle, it got stuck in Australia, caught up in record-breaking floods and rivers that run backwards into the continent. So much water got lost down under that global sea levels fell and stayed low for more than a year.


John Fasullo of the National Center for Atmospheric Research in Boulder, Colorado, noticed something amiss while looking at trends in global sea levels. They had been rising steadily by about 3 millimetres every year, but in the second half of 2010, they suddenly plummeted. By early 2011, they had dropped by 7 mm, the biggest drop since satellite measurements began in 1992.

The reversal lasted until late 2011. Not many people noticed: at the time, the world was preoccupied with massive floods in Australia. Fasullo wondered whether the two events might be linked. If more water than usual was evaporating from the oceans and falling on Australia, that might help to explain both the floods and sea level drop.

Satellite data showed that more water was stored on land in 2011 than in previous years, most of it in Australia, South America and South-East Asia (Geophysical Research Letters, An early explanation was a strong La Niña, which funnelled warm, moist air towards Australia. But La Niña events happen every few years and regularly make it rain in Australia, says Fasullo. “Why don’t we see massive sea level drops after all La Niñas?”

Triple whammy

Re-examining weather records revealed two other factors. The Indian Ocean was much warmer in the east than in the west, pushing yet more warm, moist air towards Australia. This had not happened for 20 years. At the same time, a band of winds circling Antarctica shifted to the south, boosting the effect still further (Geophysical Research Letters,

The rare combination of events led to unusually heavy Australian rainfall, says Fasullo. But why did the water stay out of the oceans for so long? Extra rainfall on land should get washed back out to sea by rivers within a few months.

It turns out that Australia has an uncanny ability to trap water for long periods. River channels are sparse in the west, so rainwater tends to sit in the sandy soil. And in the east, many of the channels run into a low-lying desert basin at the centre of the continent rather than out to sea. With heavy rains, the basin fills up to become Kati Thanda-Lake Eyre; fish eggs lying dormant in the soil hatch, and an ecosystem briefly comes to life. “It’s an instant inland sea,” says Fasullo.

The unusual weather and geology offer a convincing explanation for the sudden drop in sea levels, says John Church of CSIRO Marine and Atmospheric Research in Hobart, Tasmania. But his colleague Xuebin Zhangsays questions remain. He calculates that the extra water on land accounts for about 3.75 mm of the 7 mm fall in sea levels.

Similarly heavy rain fell on Australia in 1973-74, but sea-level records from then are not detailed enough to draw conclusions, and the three climate systems might not align again for decades.


Deadly coronavirus found in bats.

Discovery hints at virus’s source, but how it spreads to humans remains unknown.

Bats have been pinpointed as a source of the coronavirus that has infected 94 people, killing 47 of them, since it emerged in the Middle East in April last year.

An international team of researchers has found a tiny genetic fragment that seems to be from the virus in a faecal sample from an Egyptian tomb bat1. The scientists surveyed 96 bats in Saudi Arabia in October and April, after the first cases of Middle East respiratory syndrome coronavirus (MERS-CoV) were reported there.


“Although it’s a short fragment, because it’s 100% identical, it indicates this is the same virus,” says epidemiologist Ian Lipkin of Columbia University in New York city who led the study. His team reported the result on 21 August in the journal Emerging Infectious Diseases.



Because bats carry many types of coronavirus, it was widely thought that they were the ultimate source of MERS-CoV, which causes severe pneumonia in humans. But researchers have struggled to gather information that could help them to understand how the virus spreads, including which animals transmit the infection.

Identity crisis

Lipkin believes that he has got solid proof that bats are a reservoir for the virus. But other researchers are not convinced that the fragment his team has identified confirms the presence of MERS-CoV. Chantal Reusken, an infectious-disease researcher at the National Institute for Public Health and the Environment in Bilthoven, the Netherlands, points to weaknesses in the data linking the bat virus to the MERS-CoV that infects humans.

Reusken notes that the study authors could sequence only a 190-nucleotide-long segment of the 30,000-nucleotide coronavirus genome. Studies have suggested that sequences of at least 800 nucleotides are necessary to accurately determine how closely viruses are related2.

“It can absolutely not be ruled out that it is a sequence derived not from MERS-CoV but from another, closely related MERS-CoV like virus,” Reusken says.

Patrick Chiu Yat Woo, a bat-coronavirus expert at the University of Hong Kong, agrees. “The finding is, of course, important, but it has to be reproduced by others, and it has to be found in other bats.” Woo says that when a new coronavirus is found, the whole genome should be sequenced if possible. Small differences in the genomes of related viruses can hint at the types of animal that a virus infects.

So far, camels are the only other animal implicated in the spread of MERS-CoV, on the basis of the results of blood antibody tests3. But because few people encounter bats or camels, researchers speculate that other animals spread the virus to humans.

Despite the gaps in these latest findings, Stanley Perlman, a coronavirus researcher at the University of Iowa in Iowa City, says the research is important because it confirms that bats carry MERS-CoV or a related virus. “It’s certainly closely related,” he says, “but you can’t say how closely related.”


Deal done over HeLa cell line.

Deborah Lacks wanted answers. In 1974, she asked a leading medical geneticist to tell her about HeLa cells, a tissue-culture cell line derived from the cancer that had killed her mother Henrietta in 1951. The researcher, who was collecting blood from the Lacks family to map HeLa genes, autographed a medical textbook he had written and said that everything she needed to know lay within its dense pages.

It would be more than 30 years before the family got a better explanation.

Now the director of the US National Institutes of Health (NIH), Francis Collins, is trying to make up for decades of slights. Over the past four months, he has met Lacks family members to answer questions and to discuss what should be done with genome data from their matriarch’s cell line.

“We wanted to get a better understanding of what information was going to be out there about Henrietta, and what information was going to be out there about us,” says Henrietta’s grandson David Lacks Jr. (Deborah Lacks died in 2009.) On 7 August, Collins announced that the family has endorsed case-by-case release of the information, subject to approval by a committee that will include family members .

The consensual approach is a sea change from the dismissive treatment of the past, says Rebecca Skloot, the journalist who recounted the scene between Deborah Lacks and the researcher in her 2010 book The Immortal Life of Henrietta Lacks. “It was the first time in the very long history of HeLa cells that any scientists have sat down and devoted complete attention to explaining to the family what was going on,” she says (see ‘The Lacks legacy‘).

The agreement allows the publication of a US government-funded HeLa genome sequence as well as the re-release of data that were pulled from public view soon after publication in March because of the family’s concerns. Nature’s News team learned of the negotiations last month but agreed to delay coverage so as not to impede the talks. Brokered during meetings at Johns Hopkins School of Medicine in Baltimore, Maryland, the deal rekindles debates over consent and ownership of tissues, and data that arise from their study, at a time when the NIH is updating such rules.

The HeLa cell line was established in 1951 from a biopsy of a cervical tumour taken from Henrietta Lacks, a working-class African-American woman living near Baltimore. The cells were taken without the knowledge or permission of her or her family, and they became the first human cells to grow well in a lab. They contributed to the development of a polio vaccine, the discovery of human telo­merase and countless other advances. A PubMed search for ‘HeLa’ turns up more than 75,000 papers. “My lab is growing HeLa cells today,” Collins told Nature in an interview on the NIH campus in Bethesda, Maryland. “We’re using them for all kinds of gene-expression experiments, as is almost every molecular-biology lab.”

On 11 March, weeks before Collins drove to Baltimore to meet the Lacks family for the first time, a team led by Lars Steinmetz at the European Molecular Biology Laboratory (EMBL) in Heidelberg, Germany, published a paper called ‘The genomic and transcriptomic landscape of a HeLa cell line’ (J. J. M. Landry et al. Genes Genomes Genet.; 2013). News coverage (see noted the link to Henrietta Lacks, but not privacy concerns.

Skloot, in a later article for The New York Times, made clear that family members were unhappy that — yet again — they had not been consulted. “I think it’s private information,” Henrietta’s granddaughter Jeri Lacks-Whye told Nature. “I look at it as though these are my grandmother’s medical records that are just out there for the world to see.” The EMBL team removed the data from public access, and hoped that a solution could be reached.

As the controversy erupted, Nature was preparing to publish an even more detailed sequence of the HeLa genome, according to senior author Jay Shendure, a genome scientist at the University of Washington in Seattle. His team, funded by the NIH, started decoding HeLa DNA in 2011, as part of an effort to develop new sequencing techniques. They also hoped that the genome would be useful for other researchers, a motivation shared by the EMBL team. They submitted their paper to Nature in November 2012.

The paper’s reviewers did not raise privacy concerns before recommending it for publication; nor did Nature, Shendure says. He considered contacting the Lacks family before publication, and restricting access. “Figuring out how to reach out to the family was very much on the table when events overtook us.”

After Skloot’s article on the EMBL paper came out in March, Collins learned about Shendure’s NIH-funded project. He saw an opportunity. He was already at work reforming the rules that govern research on human subjects. “It looked as if this was a moment to get everybody in the same room,” he says.

And so, on the evening of 8 April, Collins met a group of Henrietta Lacks’ children and grandchildren for dinner and discussion at the Johns Hopkins campus. Along with Collins was his chief adviser and two mediators from the university. Skloot phoned in to the meeting, which was to be the first of three.

Collins says that family members told him how unsettling it had been to learn about HeLa cells decades after Lacks died. They peppered Collins with questions about genetic sequencing and how Lacks’ cells had been used. “I felt like I was taking ‘Biology 101’,” says Lacks-Whye. Collins told them that Shendure’s team might have identified the genetic change that made their grandmother’s tumour so aggressive and HeLa cells so prolific. The NIH later put the family in touch with experts in clinical genetics who told them what health information could be gleaned from the genome, and the NIH offered to help family members have their own genomes sequenced and interpreted.

Collins says that he did not pressure the family to agree to the release of the HeLa genome data; he was open to leaving the NIH-funded work unpublished. But he told the family that it would be impossible to keep the data locked away. NIH researchers had calculated that 400 genomes’ worth of HeLa data are already publicly available in piecemeal form — parts of projects such as the Encyclopedia of DNA Elements — and that scientists in thousands of labs around the world could easily and cheaply sequence the cell line themselves.

Some Lacks family members raised the possibility of financial compensation, Collins says. Directly paying the family was not on the table, but he and his advisers tried to think of other ways the family could benefit, such as patenting a genetic test for cancer based on HeLa-cell mutations. They could not think of any. But they could at least reassure the family that others would not make a quick buck from their grandmother’s genome, because the US Supreme Court had this year ruled that unmodified genes could not be patented. Lacks-Whye says that the family does not want to dwell on money — and that her father has often said he “feels compensated by knowing what his mother has been doing for the world”.

In the end, the family decided that it wanted the data to be available under a restricted-access system similar to the NIH dbGaP database, which links individuals’ genetic make-up to traits and diseases. Researchers would apply for permission to acquire the data and agree to use them for biomedical research only, and would not contact Lacks family members. A committee that includes family members will handle requests, and papers that use the data will recognize Henrietta Lacks and her kin. The first of these papers, the NIH-funded paper, is published in this issue..

In discussing HeLa cells and the agreement forged with the family, Collins and others often use the word “unique”. No other human sample matches the cell line for ubiquity, notoriety or celebrity (Oprah Winfrey is producing a film based on the story). The NIH does not see the deal with the family as a guide to handling other human samples. “It’s not going to be a precedent,” says Collins’ chief adviser Kathy Hudson.

But it will probably inform other cases, she adds. The US government is redrafting rules that govern the relationship between federally funded researchers and participants. New rules aim to give subjects greater say in how their tissues and personal data are used. “Going forward, I’m very much of the mind that the most appropriate way to show respect for persons is to ask,” Collins says. “Ask people, ‘Are you comfortable having this specimen used for future genomic research for a broad range of biomedical applications?’ — if they say no, no means no.”

As for the myriad other tissues out there that were obtained without consent, Collins says that it would slow science too much to ban their use. Laura Rodriguez, a policy official at the NIH who works on guidelines for genome sequencing, says that there is a low risk of donors of such samples being identified. But in January, researchers working on a genomics project showed that it is possible to identify anonymous participants — and their families — by cross-referencing their genomes with genealogy DNA databases.

Hank Greely, a biotechnology lawyer at Stanford University in California who has advised the EMBL group, says the HeLa agreement is a “good solution”, but applying it to other unconsented cell lines and data would be unwieldy and impractical. “The one thing we really should be doing is making sure every­thing we collect from here into the future is acceptable.”

Lacks-Whye has similar advice. Researchers can make major breakthroughs, she says, while still respecting the wishes of patients and their families. “Have them involved,” she says. “That’s not only for HeLa sequences, but anybody who participates in research.”



Quantum Paradox Seen in Diamond.

A real-life version of Zeno’s ancient Greek conundrum could advance quantum computing

A quantum effect named after an ancient Greek puzzle has been observed in diamond, paving the way for the use of diamond crystals in quantum computer chips.

The quantum Zeno effect gets its name from the Greek philosopher Zeno of Elea, who lived in the fifth century bc and suggested that if the position of a flying arrow is well-defined for a moment of time, then it makes no progress in that moment, and so can never reach its destination.

In the quantum version of the arrow paradox, theoretical physicists posited in 1977 that if a quantum system is measured often enough, its state will be unable to progress, as if it were true that ‘a watched pot never boils’. The hypothesis arises from a fundamental postulate of quantum theory, which says that measuring a property of an object, such as its position, affects its state. The quantum Zeno effect was first observedexperimentally in 1989 in laser-cooled ions trapped by magnetic and electric fields.

Now, quantum physicist Oliver Benson and his colleagues at Humboldt University in Berlin have seen the effect in a diamond crystal — a material that would be easier to manufacture on a large scale for quantum computing. The team posted its paper on the arXiv and it has been accepted for publication in Physical Review A.

Disrupted oscillations
The researchers focused on nitrogen–vacancy (NV) centers, imperfections in diamond that arise where an atom of nitrogen and an empty space replace carbon atoms at two neighboring spots in the crystal lattice. The team used microwaves to change the magnetic spin state of an electron located at an NV center, and then used a laser beam to trigger red fluorescence that revealed which of two possible states the electron was in at any given moment. When they measured the NV center in this way, the researchers found that the oscillation between the two states was disrupted — just as would be expected if the quantum Zeno effect were operating.

“The first step is to see the effect is there, but the next step is to implement quantum gates based on diamond,” says Benson, referring to the quantum analogue of the logic gates that form the integrated circuits in ordinary computer chips. In quantum computing, information is stored in the quantum states of carriers such as photons or diamond defects. But so far, decoherence, a degradation of the delicate states caused by noise in the environment, has prevented researchers from storing more than a few bits of linked quantum information in a diamond crystal at a time. Constantly measuring the states could protect them from uncontrolled decay and allow researchers to scale up the amount of information stored, says Benson.

Ronald Walsworth, an atomic physicist at Harvard University in Cambridge, Massachusetts, whose team made a tentative suggestion in 2010 that the quantum Zeno effect operates in diamond, says that evidence is growing, but that it will probably need to be clearer that the disruption of oscillations is due to the quantum process, and not other effects, before it can be used for quantum computing.

Quantum physicist Ronald Hanson, who works with nitrogen vacancies at Delft University of Technology in the Netherlands, says that Benson’s experiment, together with an April paper showing that spins in NV centers located 3 meters apart can be linked, indicates that diamond is gaining ground as a convenient material for quantum computing. “In a few years, we will be overtaking the ion traps,” he says.


Unique Brain Pattern May Explain Superior Math Skills in Autism.

A unique pattern of brain organization may explain why children with autism spectrum disorder (ASD) often possess superior math skills.

A small brain imaging study showed that children between the ages of 7 and 12 years with ASD had significantly superior numerical problem-solving abilities, including the use of more sophisticated strategies to figure out single-digit addition questions, than their age-, sex-, and IQ-matched healthy peers.

In addition, participants with ASD showed different activation patterns in the ventral temporal-occipital cortex (VTOC), the posterior parietal cortex, and the medial temporal lobe during mathematical problem solving — with activation patterns in the VTOC region actually predicting these superior abilities.

“Our findings suggest that altered patterns of brain organization in areas typically devoted to face processing may underlie the ability of children with autism to develop specialized skills,” lead author Teresa Iuculano, PhD, from the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine, in California, and from the Stanford Cognitive and Systems Neuroscience Laboratory, said in a release.

She told Medscape Medical News that because children with ASD are often bad at recognizing faces, this particular area was recruited instead for math abilities in this patient population.

“However, this isn’t a universal finding, and we know that the spectrum is very broad. So there could be many different talents discovered, including music and drawing, and should be assessed on a case-by-case basis,” said Dr. Iuculano.

“If a parent sees that a child is strongly interested in something, they should help them to follow their passion. This is important for all children, but especially those with autism. It can be used as a relaxation tool and to help them to enjoy life more.”

The study was published online August 19 in Biological Psychiatry.

Mostly Anecdotal Evidence

The investigators note that although past research has suggested that individuals with ASD often have high mathematical skills, the evidence has been “mostly anecdotal and descriptive.”

For the current study, they sought to assess both the cognitive and neural characterizations of these skills.

“We thought that because math is such a concrete discipline, and with many rules, it could represent a good way to look at superiorities in a group of children on the spectrum,” said Dr. Iuculano.

The researchers enrolled 18 children with ASD (78% boys) and 18 children without the disorder, who were considered the “control group” (also 78% boys).

Standardized tests given during the study’s recruitment stage showed that all of the participants had IQs considered to be in the normal range; and those with ASD had “normal” verbal and reading skills. Standardized math tests were also administered.

While undergoing functional magnetic resonance imaging (fMRI) scans, all children were asked to solve addition problems, one at a time.

During the scans, the researchers also interviewed the participants to determine which of the following types of problem-solving strategies were being used: remembering an answer already known (retrieval), counting on fingers or in their heads, or decomposition.

The latter strategy is a comparatively sophisticated method and consists of breaking down a problem into several components.

Significant Differences

Results showed that the group with ASD had significantly higher scores on the numerical operations subscale of the Weschsler Individual Achievement Test–Second Edition for mathematics (WIAT-II) than the control group (P= .012).

They also displayed significantly greater use of decomposition (P = .033), “suggesting that more analytic strategies, rather than rote memory, were the source of their enhanced abilities,” the investigators note.

There were no between-group differences in use of counting or retrieval strategies or on any of the 4 working memory measures assessed.

The MRI scans showed “several cortical regions where arithmetic complexity-related activity patterns differed significantly” between the 2 groups.

“Notably, high cross-validation classification accuracies (80% to 90%) were in [VTOC], including bilateral inferior lateral occipital cortex and fusiform gyrus, as well as posterior parietal cortex, including the left intraparietal sulcus, angular gyrus, and the left precuneus,” write the researchers.

Significant differences in activity patterns were also found in medial temporal lobe regions.

Finally, “numerical abilities in the ASD group were predicted by the pattern of neural activity in an area of the left VTOC encompassing the left fusiform gyrus and lateral occipital cortex,” whereas numerical abilities in the control group were predicted by activity patterns in the left dorsolateral prefrontal cortex.

Not Universal

Overall, “there appears to be a unique pattern of brain organization that underlies superior problem-solving abilities in children with autism,” senior author Vinod Menon, PhD, professor of psychiatry and behavioral sciences at Stanford and from the Child Health Research Institute at the Lucile Packard Children’s Hospital, said in a release.

He added that although instant recall of calendar dates (a skill often found in individuals with ASD) is not likely to help with academic and professional success, “developing good mathematical skills could make a big difference in the life of a child with autism,” including possibly leading to future employment.

“Our study supports the idea that the typical brain development in autism can lead not just to deficits but also to some remarkable cognitive strengths. We think this can be reassuring to parents,” said Dr. Menon.

However, he noted that it is important to realize that not all children with ASD have superior math skills. So future research should examine the neural basis of variations in problem-solving abilities.

Dr. Iuculano added that she is excited about the current study’s findings on both research and clinical levels.

“As a scientist, it’s great that we’re understanding how the brain works in children with autism. And on a practical level, it’s important because it can raise awareness of the fact that these individuals can be contributing in a very good way to society,” she said.

Not Limited to Math

“I think this is not new as such, but it’s a very good study and important because it extends some things we already know,” Laurent Mottron, MD, PhD, professor of psychiatry at the University of Montreal, Quebec, Canada, and scientific director of the University’s Center of Excellence in Pervasive Development Disorders, toldMedscape Medical News.

He added that mathematic cognition has not been really studied before in ASD; but the take-away message is not that these findings are specific only to mathematics.

“This overactivation of the occipital region, and specifically the fusiform gyrus, is found in all tasks involving any visual information,” said Dr. Mottron, who was not involved with this research.

As reported at the time by Medscape Medical News, his investigative team published findings from a meta-analysis in Human Brain Mapping 2 years ago. Their analysis of 26 fMRI studies and more than 700 individuals showed that those with ASD had higher activity in the temporal and occipital regions in relation to visual-based tasks than those without the disorder.

“As scientists, we are happy when something is replicated. Here it’s more than replication, it’s specification. But I think if you want to see the big picture, you need to realize this isn’t only related to mathematics. Because autistics, when reasoning in general, use more of their perceptual expertise than other people,” he said.

“And I’m quite happy that now it’s become a kind of consensual message about autistic intelligence.”



Feds Investigate Antipsychotic Prescribing in Children.

The US Department of Health and Human Services’ Office of Inspector General (OIG) has launched a probe into the prescribing of atypical antipsychotic medications to children under Medicaid.

“We will determine the extent to which children ages 18 and younger had Medicaid claims for atypical antipsychotic drugs during the selected time frame,” the office said in a summary of the plan.

“On the basis of medical record reviews, we will also determine the extent to which the atypical antipsychotic drug claims were for off-label uses and for indications not listed in one or more of the approved drug compendia.”

The time frame is a 6-month period from January to June 2011, when 84,654 children were prescribed antipsychotics in the 5 states selected for the probe, where Medicaid prescriptions are the highest — California, Texas, Illinois, New York, and Florida — said OIG spokesperson Donald White.

Psychiatric experts have been recruited to evaluate approximately 700 of the medical records as part of the ongoing effort, White told Medscape Medical News.

“We are currently conducting the medical record reviews, and the probe will likely last several months, possibly into 2014,” he said.

Lack of Funding for CBT

The probe is focusing on atypical antipsychotics such as aripiprazole (Abilify, Otsuka Pharmaceutical Co., Ltd.), risperidone (Risperdal, Ortho-McNeil-Janssen Pharmaceuticals, Inc.), quetiapine fumarate (Seroquel, AstraZeneca Pharmaceuticals LP), and olanzapine (Zyprexa, Eli Lilly and Company).

A previous probe by the OIG on the overuse of antipsychotics in nursing homes, which resulted in action by the Centers for Medicare and Medicaid Services (CMS) to reduce the use of the drugs by 15%, was launched in response to a request from Congress; however, the new probe was launched by the OIG itself, White said.

Concern over the overprescribing of antipsychotics to children in the Medicaid program is not new — a 2004 study found that children in the healthcare system from low-income families were 4 times as likely to be prescribed antipsychotics as those who were privately insured.

As reported by Medscape Medical News, a more recent study showed that the use of antipsychotic medications among Medicaid-insured children from low- or very-low-income families soared 7-fold to 12-fold between 1997 and 2006.

Among side effects of concern associated with atypical antipsychotics are weight gain and diabetes, and little is known on the long-term neurologic effects of the drugs used in early childhood.

One important reason why the prescribing of antipsychotics to children is believed to be higher among children under Medicaid coverage is that the system simply is not as accommodating to the best-known alternative — cognitive-behavioral therapy, according to Pensacola, Florida–based child psychiatrist Scott R. Benson, MD.

“The reimbursement for the kind of cognitive-behavioral therapy that could help these children is lower with Medicaid, so children who are covered by private insurance may have access to a better range of therapies,” he told Medscape Medical News.

“But part of this is our own fault on a professional level — we [psychiatrists] have not made a good enough case for the value of psychotherapy in helping children,” added Dr. Benson, who is a member of the American Psychiatric Association.

Infants, Toddlers Prescribed Atypicals

Dr. Benson said clinicians too often associate the option of cognitive-behavioral therapy with being arduous and time-consuming.

“The patient doesn’t necessarily have to be coming in 3 times a week over 10 years — there is plenty of evidence showing, especially for children who have been traumatized, that even short-term therapy, maybe once-a-week visits over 20 weeks, can be a very effective treatment.”

Among the more alarming figures regarding prescribing atypical antipsychotics to children are those showing prescriptions to the very young, including toddlers and infants.

As reported in a recent article in the Wall Street Journal, the inspector general’s 5-state probe found 482 children aged 3 years and younger who were prescribed antipsychotics during the 6-month period in question, including 107 children who were aged 2 years and younger.

Six children prescribed the drugs were younger than 1 year, and 1 was listed as being 1 month old.

Importantly, the records did not identify the diagnoses involved, and Dr. Benson speculated that some may have included children with certain severe disorders, such as autism.

“It’s important to remember that the majority of these prescriptions are not even written by child psychiatrists,” he said. “In the case of the very young children, these may have represented prescriptions from neurologists who were treating patients with severe autistic disorders.”

Quick Fix?

Others, however, may have been practitioners such as pediatricians, who, facing heavy patient loads, are often under pressure to make a quick diagnosis and reach for a quick fix — an antipsychotic.

“A practitioner may observe a few behaviours, say ‘that’s terrible,’ and simply prescribe something the patient doesn’t really need because there wasn’t enough time or interest in doing the kind of good, standard evaluation that all of us would expect for our children,” Dr. Benson said.

“Certainly all patients deserve that, regardless of their insurance situation.”

A complex range of psychiatric issues may cause a child to appear dysregulated, and a full evaluation is essential before writing that prescription, said Mary Margaret Gleason, MD, an assistant professor in child psychiatry and pediatrics at Tulane University in New Orleans, Louisiana.

“Especially in younger children, the causes of impulsive or disruptive behaviors can be quite broad,” she toldMedscape Medical News.

“A thorough assessment looking into psychological, environmental, and biological factors that might cause someone to look impulsive and disruptive needs to be done to know what is driving the impulsivity.”

“One of the biggest things that needs to be looked at, for instance, is if the child has been exposed to trauma, and if someone is considering using a medication that has as long a list of potential side effects as atypical antipsychotics, they do need to really be certain of what they’re treating first.”

Source: Medscape/com


System-Wide Effort Improves Hypertension in 80% of Patients.

When Kaiser Permanente Northern California (KPNC) initiated a program to control hypertension in its patient population in 2001, less than half of patients diagnosed with hypertension had their blood pressure under control. Nine years later, 80% of KPNC hypertensive patients had blood pressures lower than 140/90 mm Hg, an improvement rate that exceeded both state and national trends.

Marc G. Jaffe, MD, from the Department of Endocrinology, Kaiser Permanente South San Francisco Medical Center, California, and colleagues tracked data from KPNC, 1 of 8 divisions of the integrated managed care organization, Kaiser Permanente, as it adopted a system-wide program employing several strategies to improve blood pressure control. They published the results of the program in the August 21 issue of JAMA.

In the quality improvement program, patients were identified each quarter for inclusion in a hypertension registry based on diagnostic codes, pharmacy data, and hospital records. Hypertension control rates were generated every 1 to 3 months for each KPNC medical center and distributed to center directors. The group used those data to identify practices associated with higher control rates, which they disseminated to other centers.

A hypertension control algorithm, based on emerging evidence, was updated every 2 years, suggesting a step-wise approach to hypertension medications for blood pressure control. In addition, in 2005, single-pill combination therapy of lisinopril-hydrochlorothiazide was incorporated into the regional guideline as first-line medication. In 2007, KNPC added patient follow-up visits with medical assistants 2 to 4 weeks after a medication adjustment to monitor medication control success.

Between 2001 and 2009, the KPNC hypertension registry population grew from 349,937 patients (15.4% of the adults in KPNC) to 652,763 patients (27.5% of the adults in the system).

By 2009, the hypertension control rate for KPNC was 80.4% (95% confidence interval [CI], 75.6% – 84.4%) compared with the initial control rate of 43.6% (95% CI, 39.4% – 48.6%) in 2001 (P < .001 for trend).

In comparison, the Healthcare Effectiveness Data and Information Set national mean hypertension control rate improvement failed to meet statistical significance, rising from 55.4% to 64.1% (P = .24 for trend) during the same period. The increase across California, available only since 2006, also failed to reach statistical significance, rising from 63.4% to 69.4% (P = .37 for trend).

Moreover, the KPNC hypertension control rate has continued to rise in years after the study, climbing to 83.7% in 2010 and 87.1% in 2011, the authors report.

Abhinaval Goyal, MD, MHS, assistant professor of medicine, Division of Cardiology, Emory School of Medicine, Atlanta, Georgia, and William A. Bornstein, MD, PhD, chief quality and medical officer, Emory Healthcare, Atlanta, authors of an accompanying editorial, call the KPNC study “an important contribution to the science of improving systems of care to detect and treat community-based hypertension.”

Dr. Goyal and Dr. Bornstein write that fee-for-service environments are less likely to implement approaches such as those used in the KNPC study because of the dual risks of increased costs and decreased reimbursements. “Fully integrated health systems (such as KPNC) that assume full responsibility by both insuring and delivering health care are particularly invested in managing risk factors to reduce downstream costs,” they write.

However, a transition to value-based models in all health sectors and the growth of accountable care organizations and shared savings models could ultimately make this kind of approach more widespread.


Source: JAMA.