‘Baron of Botox’ Dr Fredric Brandt Dead at Age 65


Fredric Brandt, MD, a world-renowned dermatologist, died at his home in Coconut Grove, Florida, on April 5. The 65-year-old hanged himself, according to the Miami, Florida, police.

His publicist, Jacquie Tractenberg, told the Washington Post he had been suffering from depression and was upset by a recent episode of Tina Fey’s Netflix comedy series, “Unbreakable Kimmy Schmidt,” in which Martin Short appeared to parody him. Short’s character had thinning blonde hair with a receding hairline, exaggerated cheekbones, and a face so frozen his speech was distorted.

“It definitely bothered him. It was a very mean portrayal,” she told the Post, but added, “He didn’t kill himself because of that one particular show.”
Dr Brandt was a pioneer in the use of onabotulinum toxin A (Botox Cosmetic, Allergan) and collagen fillers. He had dermatology practices in Manhattan, New York, and Coral Gables, Florida. “He was a giant in this field…he was recognized as a world leader in cosmetic medicine,” Roy G. Geronemus, MD, director, Laser and Skin Surgery Center of New York, told Medscape Medical News. “He really took the science and made it an art.”

“He was a brilliant and caring physician. He really helped transform the techniques for the approach towards the aging face and body,” he said.

Dubbed the “Baron of Botox” and the “King of Collagen,” Dr Brandt had reportedly used more Botox Cosmetic and collagen fillers than any other dermatologist in the world. His celebrity clients included the singer Madonna, television talk-show host Kelly Ripa, and comedian Joy Behar.


Dr Fredric Brandt.
Dr Geronemus said he has known Dr Brandt since 1978, when they were both at the University of Miami in Florida. Dr Brandt was a medical resident and Dr Geronemus was a medical student there. The two dermatologists had worked together for 20 years. Dr Brandt treated patients at the Laser and Skin Surgery Center of New York in Manhattan at the time of his death.

Loved by Patients and Colleagues.

“The staff that we shared absolutely loved him. He was very creative in making everyone feel like a part of his family. His staff were his family, his patients were his family. The response that we’re getting from his patients with his death is truly overwhelming. His patients are just devastated,” Dr Geronemus said.

Dr Brandt would often relax his patients by singing to them as he was treating them, Dr Geronemus said. “He was very, very knowledgeable about medicine; he was not just someone looking to put a few needles into someone’s face in exchange for a few dollars. He was very creative and really had a true vision for what a younger face should look like.”

“He was a good friend. Many of his patients became his personal friends,” Dr Geronemus added, noting that even colleagues who were considered competitors liked him.

Clinical Practices in Manhattan and Coral Gables

Dr Brandt was born on June 26, 1949, in Newark, New Jersey, to Irving and Esther Brandt and grew up there. He is survived by his brother, Paul.

He graduated with a Bachelor of Arts degree from Rutgers University in New Brunswick, New Jersey, in 1971 and earned a medical degree from Hahnemann Medical College (now known as Drexel University College of Medicine) in Philadelphia, Pennsylvania, in 1975.

Dr Brandt completed an internship at New York University in New York City from 1975 to 1976, a residency in internal medicine at New York University from 1976 to 1978, and a residency in dermatology at the University of Miami in Florida from 1978 to 1981, according to his curriculum vitae. The information in his curriculum vitae conflicts with media reports that say he completed medical residencies at New York University and Memorial Sloan Kettering Cancer Center in Manhattan, with residencies in nephrology and oncology.

Dr Brandt went into private practice in Coral Gables in 1982 and in New York City in 1996. He was the founder and chairman of the board for Cosmetic Dermatology Inc in Miami from 1990 until his death. It was there that he created the Dr Brandt skincare line, which has been sold in more than 40 countries. “He was very creative and thoughtful about what he was doing with [his product line],” Dr Geronemus noted.

He was a clinical voluntary associate professor in the Department of Dermatology at the University of Miami in Florida from 1999 until May 2001.

Esteemed Researcher, Author

He founded and was the principal investigator for the Dermatology Research Institute LLC in Coral Gables from 2006 until his death. “He had a clinical research program in Miami, [and] we did some drug studies in New York as well,” Dr Geronemus explained. “He was involved with the clinical development of many of the products that he used, so he understood them quite well. He understood their limitations, he understood their strengths, he understood which products should be used where, and would always look for any method possible for improving the outcome of his patients.”

“A lot of it was based on his own research, with the knowledge that he gained helping these companies develop their products or doing the phase 1, 2, and 3 clinical trials for the [US Food and Drug Administration],” he added.

Along with the multiple studies in which he was the principal investigator, Dr Brandt was also a sought-after presenter at scores of dermatology conferences around the world.

He was a board-certified member of the American Board of Internal Medicine and the American Board of Dermatology. He was a member of the International Society for Dermatologic Surgery, International Society of Cosmetic Laser Surgeons, American Medical Association, American Society for Dermatologic Surgery, Dermatology Foundation Leaders Society, and Florida Medical Association, among others.

Dr Brandt wrote two books about skin aging and maintaining a youthful appearance: 10 Minutes/10 Years: Your Definitive Guide to a Beautiful and Youthful Appearance and Age-less: The Definitive Guide to Botox, Collagen, Lasers, Peels, and Other Solutions for Flawless Skin.

“He had some novel ideas, concepts, and techniques in terms of the use of botulinum toxin and filler substances,” Dr Geronemus said. “[M]any physicians in the country and around the world have adopted them into their daily practice.”

Dr Brandt claimed he tested every product he used on himself before using them on his patients.

‘Brain dead’ US girl faces deadline


Jahi McMath, ‘brain dead‘ US girl: Life support extended

Undated photo of Jahi McMath
It is unclear how Jahi McMath’s tonsillectomy to treat sleep apnoea went so awry

The family of a US teenager declared brain dead after a routine operation went wrong has won an extension to the court order keeping her alive.

The court order keeping her on life support in California had been due to expire on Monday evening.

Jahi McMath, 13, had a tonsillectomy this month to treat a sleep disorder but she began bleeding heavily after surgery and went into cardiac arrest.

Her family says there is still hope for recovery.

However, the Children’s Hospital & Research Center, which carried out the procedure, wants to turn off her ventilator.

On Monday, Alameda County Superior Court Judge Evelio Grillo ordered the hospital to maintain Jahi on a ventilator until 7 January.

Jahi’s mother, Nailah Winkfield, said she wept when she heard about the ruling.

She said the delay was an answer to a prayer and a sign that she was right to keep fighting.

“Who wants to know the date and the time their child would die?” she said. “I don’t care what anyone has to say about what I’m doing… I have to do what is right for me and for Jahi.”

Jahi’s family believes she is still alive but the hospital in Oakland, California, has argued in court papers that there is no medical treatment they can give to the teenager because she is “practically and legally” dead.

An independent paediatric neurologist from Stanford University supported that view.

“Start Quote

We believe a parent has the right to make decisions concerning the existence of their child”

Jahi McMath’s family statement

In an earlier ruling, a judge at Alameda County Superior Court agreed and issued an order allowing Children’s Hospital to remove Jahi from a breathing machine at 17:00 local time on Monday (01:00 GMT on Tuesday).

Hospital spokesman Sam Singer said they would comply with the judge’s new order.

The McMaths are hoping that a New York facility will care for their daughter. Two California care homes have already withdrawn offers to accept Jahi.

It is unclear how the girl’s operation on 9 December went so badly awry. She was having her tonsils removed to treat her apnoea, a condition that causes sleepers to experience irregular breathing.

Jahi was declared brain dead three days after surgery.

The family said in a statement at the weekend: “We have our strong religious convictions and set of beliefs and we believe that, in this country, a parent has the right to make decisions concerning the existence of their child: not a doctor… and definitely not a doctor who runs the facility that caused the brain death in the first place.”

Children’s Hospital says it is willing to work with the family to transfer Jahi to another facility, as long as it can legally do so.

Nailah Winkfield, mother of 13-year-old Jahi McMath, cries before a courtroom hearing regarding McMath in Oakland, California, 20 December 2013
Jahi’s mother, Nailah Winkfield, cries at a court hearing last week

“We need to be able to talk to the other facility to understand what it is they are capable of doing,” Cynthia Chiarappa, a hospital spokeswoman, said.

“This is not transferring an individual in a vegetative state, but a dead body.”

Jahi’s family has launched an online fundraising drive, which had collected more than $22,000 (£13,000) by Monday morning, to transfer their daughter to another facility.

The McMaths’ lawyer, Chris Dolan, said he was waiting to hear from a hospital in New York, where officials have been considering the case.

“The family is together, and today everybody is praying and being together,” Mr Dolan told the Associated Press news agency on Sunday.

Nikola Tesla’s amazing predictions for the 21st Century.


In the 1930s journalists from publications like the New York Times and Time magazine would regularly visit Nikola Tesla at his home on the 20th floor of the Hotel Governor Clinton in Manhattan. There the elderly Tesla would regale them with stories of his early days as an inventor and often opined about what was in store for the future.

Photo of Nikola Tesla which appeared in the February 9, 1935 issue of Liberty magazine Read more: http://blogs.smithsonianmag.com/paleofuture/2013/04/nikola-teslas-amazing-predictions-for-the-21st-century/#ixzz2TGsCrQHl  Follow us: @SmithsonianMag on Twitter

Last year we looked at Tesla’s prediction that eugenics and the forced sterilization of criminals and other supposed undesirables would somehow purify the human race by the year 2100. Today we have more from that particular article which appeared in the February 9, 1935, issue of Liberty magazine. The article is unique because it wasn’t conducted as a simple interview like so many of Tesla’s other media appearances from this time, but rather is credited as “by Nikola Tesla, as told to George Sylvester Viereck.”

It’s not clear where this particular article was written, but Tesla’s friendly relationship with Viereck leads me to believe it may not have been at his Manhattan hotel home. Interviews with Tesla at this time would usually occur at the Hotel, but Tesla would sometimes dine with Viereck and his family at Viereck’s home on Riverside Drive, meaning that it’s possible they could have written it there.

Viereck attached himself to many important people of his time, conducting interviews with such notable figures as Albert Einstein, Teddy Roosevelt and even Adolf Hitler. As a German-American living in New York, Viereck was a rather notorious propagandist for the Nazi regime and was tried and imprisoned in 1942 for failing to register with the U.S. government as such. He was released from prison in 1947, a few years after Tesla’s death in 1943. It’s not clear if they had remained friends after the government started to become concerned about Viereck’s activities in the late 1930s and early 1940s.

Tesla had interesting theories on religion, science and the nature of humanity which we’ll look at in a future post, but for the time being I’ve pulled some of the more interesting (and often accurate) predictions Tesla had for the future of the world.

Creation of the EPA

The creation of the U.S. Environmental Protection Agency (EPA) was still 35 years away, but Tesla predicted a similar agency’s creation within a hundred years.

Hygiene, physical culture will be recognized branches of education and government. The Secretary of Hygiene or Physical Culture will be far more important in the cabinet of the President of the United States who holds office in the year 2035 than the Secretary of War. The pollution of our beaches such as exists today around New York City will seem as unthinkable to our children and grandchildren as life without plumbing seems to us. Our water supply will be far more carefully supervised, and only a lunatic will drink unsterilized water.

Education, War and the Newspapers of Tomorrow

Tesla imagined a world where new scientific discoveries, rather than war, would become a priority for humanity.

Today the most civilized countries of the world spend a maximum of their income on war and a minimum on education. The twenty-first century will reverse this order. It will be more glorious to fight against ignorance than to die on the field of battle. The discovery of a new scientific truth will be more important than the squabbles of diplomats. Even the newspapers of our own day are beginning to treat scientific discoveries and the creation of fresh philosophical concepts as news. The newspapers of the twenty-first century will give a mere ” stick ” in the back pages to accounts of crime or political controversies, but will headline on the front pages the proclamation of a new scientific hypothesis.

Health and Diet

Toward the end of Tesla’s life he had developed strange theories about the optimal human diet. He dined on little more than milk and honey in his final days, believing that this was the purest form of food. Tesla lost an enormous amount of weight and was looking quite ghastly by the early 1940s. This meager diet and his gaunt appearance contributed to the common misconception that he was penniless at the end of his life.

More people die or grow sick from polluted water than from coffee, tea, tobacco, and other stimulants. I myself eschew all stimulants. I also practically abstain from meat. I am convinced that within a century coffee, tea, and tobacco will be no longer in vogue. Alcohol, however, will still be used. It is not a stimulant but a veritable elixir of life. The abolition of stimulants will not come about forcibly. It will simply be no longer fashionable to poison the system with harmful ingredients. Bernarr Macfadden has shown how it is possible to provide palatable food based upon natural products such as milk, honey, and wheat. I believe that the food which is served today in his penny restaurants will be the basis of epicurean meals in the smartest banquet halls of the twenty-first century.

There will be enough wheat and wheat products to feed the entire world, including the teeming millions of China and India, now chronically on the verge of starvation. The earth is bountiful, and where her bounty fails, nitrogen drawn from the air will refertilize her womb. I developed a process for this purpose in 1900. It was perfected fourteen years later under the stress of war by German chemists.

Robots

Tesla’s work in robotics began in the late 1890s when he patented his remote-controlled boat, an invention that absolutely stunned onlookers at the 1898 Electrical Exhibition at Madison Square Garden.

At present we suffer from the derangement of our civilization because we have not yet completely adjusted ourselves to the machine age. The solution of our problems does not lie in destroying but in mastering the machine.

Innumerable activities still performed by human hands today will be performed by automatons. At this very moment scientists working in the laboratories of American universities are attempting to create what has been described as a ” thinking machine.” I anticipated this development.

I actually constructed ” robots.” Today the robot is an accepted fact, but the principle has not been pushed far enough. In the twenty-first century the robot will take the place which slave labor occupied in ancient civilization. There is no reason at all why most of this should not come to pass in less than a century, freeing mankind to pursue its higher aspirations.

Cheap Energy and the Management of Natural Resources

Long before the next century dawns, systematic reforestation and the scientific management of natural resources will have made an end of all devastating droughts, forest fires, and floods. The universal utilization of water power and its long-distance transmission will supply every household with cheap power and will dispense with the necessity of burning fuel. The struggle for existence being lessened, there should be development along ideal rather than material lines.

Tesla was a visionary whose many contributions to the world are being celebrated today more than ever. And while his idea of the perfect diet may have been a bit strange, he clearly understood many of the things that 21st century Americans would value (like clean air, clean food, and our “thinking machines”) as we stumble into the future.

Are Alzheimer’s and diabetes the same disease?


HAVING type 2 diabetes may mean you are already on the path to Alzheimer’s. This startling claim comes from a study linking the two diseases more intimately than ever before. There is some good news: the same research also offers a way to reverse memory problems associated with diabetes – albeit in rats – which may hint at a new treatment for Alzheimer’s.

“Perhaps you should use Alzheimer’s drugs at the diabetes stage to prevent cognitive impairment in the first place,” says Ewan McNay from the University at Albany in New York.

Alzheimer’s cost the US $130 billion in 2011 alone. One of the biggest risk factors is having type 2 diabetes. This kind of diabetes occurs when liver, muscle and fat cells stop responding efficiently to insulin, the hormone that tells them to absorb glucose from the blood. The illness is usually triggered by eating too many sugary and high-fat foods that cause insulin to spike, desensitising cells to its presence. As well as causing obesity, insulin resistance can also lead to cognitive problems such as memory loss and confusion.

Are brain changes associated with Alzheimer's (green) reversible? <i>(Image: Medical Body Scans/Jessica Wilson/Photo Researchers/SPL)</i>

In 2005, a study by Susanne de la Monte’s group at Brown University in Providence, Rhode Island, identified a reason why people with type 2 diabetes had a higher risk of developing Alzheimer’s. In this kind of dementia, the hippocampus, a part of the brain involved in learning and memory, seemed to be insensitive to insulin. Not only could your liver, muscle and fat cells be “diabetic” but so it seemed, could your brain.

Feeding animals a diet designed to give them type 2 diabetes leaves their brains riddled with insoluble plaques of a protein called beta-amyloid – one of the calling cards of Alzheimer’s. We also know that insulin plays a key role in memory. Taken together, the findings suggest that Alzheimer’s might be caused by a type of brain diabetes.

If that is the case, the memory problems that often accompany type 2 diabetes may in fact be early-stage Alzheimer’s rather than mere cognitive decline.

Although there is no definitive consensus on the exact causes of Alzheimer’s, we do know that brains get clogged with beta-amyloid plaques. One idea gaining ground is that it is not the plaques themselves that cause the symptoms, but their precursors – small, soluble clumps of beta-amyloid called oligomersMovie Camera. The insoluble plaques could actually be the brain’s way of trying to isolate the toxic oligomers.

To investigate whether beta-amyloid might also be a cause of cognitive decline in type 2 diabetes, McNay, Danielle Osborne and their colleagues fed 20 rats a high-fat diet to give them type 2 diabetes. These rats, and another 20 on a healthy diet, were then trained to associate a dark cage with an electric shock. Whenever the rats were returned to this dark cage, they froze in fear – measuring how long they stayed still is a standard way of inferring how good their memory is.

Memory boost

As expected, the diabetic rats had weaker memories than the healthy ones – they froze in the dark for less than half the time of their healthy counterparts. To figure out whether this was due to the beta-amyloid plaques or the soluble precursors, Pete Tessier at the Rensselaer Polytechnic Institute in Troy, New York, engineered fragments of antibodies that disrupt the action of one or the other.

When the plaque-disrupting antibodies were injected into diabetic rats, no change was seen. However, after receiving antibodies specific for oligomers, they froze for just as long as the healthy rats. “The cognitive deficit brought on by their diabetes is entirely reversed,” says McNay.

Until now, the standard explanation for the cognitive decline associated with type 2 diabetes is that it is a result of insulin signalling gone awry. One effect is to reduce the hippocampus’s ability to transport energy, or glucose, to neurons during a cognitive task. The fact that amyloid builds up in the brains of diabetic animals – and also in people, was seen as an unhappy consequence of insulin imbalance.

These experiments suggest oligomers are actually to blame. Previous work from other groups has shown that the same enzymes break down both insulin and beta-amyloid oligomers – and that the oligomers prevent insulin binding to its receptors in the hippocampus. So when there is too much insulin around – as there is in someone with type 2 diabetes – those enzymes are working flat out to break it down. This preferential treatment of insulin leaves the oligomers to form clumps, which then keep insulin from its receptors, causing a vicious spiral of impaired brain insulin signalling coupled with cognitive decline.

“We think that our treatment soaked up the amyloid oligomers, so that they could no longer block insulin from binding to its receptors,” says McNay, who presented the preliminary data at the Society for Neuroscience meeting in San Diego earlier this month. “Everyone thinks of amyloid build-up as a consequence of the events that cause cognitive impairment in diabetes, but we’re saying it’s actually a cause.” It means, he says, that the cognitive decline seen in type 2 diabetes may be thought of as early-stage Alzheimer’s.

It’s a bold claim, and if correct, one with big implications. Given that the number of people with type 2 diabetes is expected to jump from 382 million now to 592 million by 2035, we might expect to see a similar trajectory for associated Alzheimer’s (New Scientist, 1 September 2012). If beta-amyloid build-up can be stopped in people with type 2 diabetes and their cognitive impairment reversed – perhaps many of them will never progress to Alzheimer’s.

For the last few years, organisations like the UK’s Alzheimer’s Society have been backing clinical trials to look for diabetes drugs that may have an effect on Alzheimer’s patients. “We’re saying that this may be not the only way to think about it,” says McNay.

The next step is to repeat the work, and if the results are corroborated, start looking for a drug that would do the same thing as the group’s modified antibodies, without having to inject the drug directly into the hippocampus. It will also be necessary to work out just how much amyloid the brain can safely do without, since low levels are important for memory formation.

“The work opens the door to inoculating the most at risk group, people with type 2 diabetes,” says Tres Thompson of the University of Texas at Dallas. There have been plenty of failed attempts to use antibodies to relieve Alzheimer’s in the past. “But these were all in people with advanced stages of the disease. Vaccinating people much earlier could give better results.”

Some researchers are still wary of focusing on beta-amyloid when 20 years of working on a treatment for that particular aspect of the disease has come to nothing. “I think it’s brilliant work – he’s using new techniques that seem to be working, but it’s still very beta-centric,” says Olivier Thibault at the University of Kentucky in Lexington. He cautiously agrees that McNay’s data do seem to suggest a causative link between beta-amyloid and impaired insulin signalling but says the group needs to factor in the effect of ageing – both diabetes and Alzheimer’s become more likely as we grow older.

Jessica Smith, spokeswoman for the UK Alzheimer’s Society in London welcomes the work. “We need to tease out the difference between those with type 2 diabetes who develop Alzheimer’s and those who don’t. If people were developing the signs earlier than we thought, then perhaps we can intervene earlier, rather than waiting until they have full clinical Alzheimer’s.”

Of course, there is another solution to staving off type 2 diabetes and any consequential Alzheimer’s that requires no drugs at all. “Go to the gym and eat fewer twinkies,” says McNay.

Brain Clears Toxins During Sleep.


Scientists have long wondered why sleep is restorative and why lack of sleep impairs brain function.

Now, new animal research suggests how the sleep state may help clear the body of potentially toxic central nervous system (CNS) metabolites.

Proteins linked to neurodegenerative diseases, including β-amyloid (), are present in the interstitial space surrounding cells in the brain. In a series of experiments, researchers tested the hypothesis that Aβ clearance is increased during sleep and that the sleep-wake cycle regulates the glial cell–dependent glymphatic system, which is responsible for clearing waste from the brain and spinal cord.

“Basically, we found a new function of sleep,” said study lead author Lulu Xie, PhD, Division of Glial Disease and Therapeutics, Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester Medical Center, New York.

“When mice are awake, the brain cells continuously produce toxic waste. This waste can build up in the spaces between the brain cells and damage them. However, during sleep, the spaces between brain cells increase, which may help the brain flush out the toxic waste. Therefore, a good sleep can clear the brain.”

“Sleep changes the cellular structure of the brain. It appears to be a completely different state,” Maiken Nedergaard, MD, DMSc, codirector of the Center for Translational Neuromedicine at the University of Rochester Medical Center, who is a leader of the study, said in a statement from the National Institute of Neurological Disorders and Stroke, which supported the study.

The new research was published October 18 in Science.

Sleeping vs Awake Brain

The researchers infused fluorescent dye into the cerebrospinal fluid (CSF) of mice and observed it flow through the brain. At the same time, they monitored electrical brain activity and wakefulness with electrocorticography (EcoG) and electromyography (EMG)..

“In the sleeping brain, we found the CSF flushed into the brain very quickly and broadly,” said Dr. Xie. “After half an hour, we woke the mice up by gently touching their tails, and injected another color of dye. But what we saw is that CSF barely flowed when the same mice were awake.”

These results suggest that the awake brain may have more resistance to CSF influx, which leads to the assumption that the path of CSF flow into the brain is smaller in the awake brain, said Dr. Xie.

Next, the scientists inserted electrodes into the brain to directly measure the space between brain cells, and found that it increased by around 60% when the mice were asleep.

“Theoretically, big spaces lead to easier fluid influx,” said Dr. Xie. “So we presumed that the clearance of the toxic protein between cells will become more efficient.”

To test this assumption, they infused radio-labeled Aβ into the brain and measured how long it stayed in both the sleeping brain and the awake brain.

We found Aβ disappeared 2-fold faster in the sleeping mice brains as compared with awake mice,” noted Dr. Xie. “Based on this experiment, we can see that the sleeping brain is more capable of clearing out the toxic protein.”

Technically, it might be relatively easy to study these processes in humans, possibly using magnetic resonance imaging. However, Dr. Xie said she does not know when human trials, which involve “a lot more concerns” than animal experiments, might come about.

“These results may have broad implications for multiple neurological disorders,” said Jim Koenig, PhD, a program director at the National Institute of Neurological Disorders and Stroke (NINDS), which funded the study, in a statement. “This means the cells regulating the glymphatic system may be new targets for treating a range of disorders.”

US appeal over deadly pet treats


FDA warns of pet illness linked to jerky treats.

 

A pair of pug dogs getting a taste of Kohr Brothers Frozen Custard in Rehoboth Beach, Delaware on 19 June 2013

US food safety officials are appealing for help from pet owners to find the cause of an outbreak of deadly sickness in dogs who ate jerky-style treats.

The Food and Drug Administration (FDA) says 3,600 dogs and 10 cats have fallen ill after eating the treats since 2007. About 580 of those pets have died.

But the exact cause of the sickness, which can lead to kidney failure and gastrointestinal bleeding, is unclear.

Most of the jerky treats implicated have been made in China, the FDA said.

After running more than 1,200 tests, visiting pet-treat manufacturing plants in China and working with researchers, state labs and foreign governments, food safety officials are now approaching veterinarians and pet owners for more information.

“This is one of the most elusive and mysterious outbreaks we’ve encountered,” Dr Bernadette Dunham, head of the FDA veterinary medicine centre, said in a statement.

Pets’ symptoms have included reduced appetite, decreased activity, vomiting and diarrhoea within hours of eating treats sold as jerky tenders or strips made of chicken, duck, sweet potatoes or dried fruit.

“Our fervent hope as animal lovers,” Dr Dunham said, “is that we will soon find the cause of, and put a stop to, these illnesses.”

Older Workers Should Think Young.


It Can Help Deal With Young Co-Workers and Younger Bosses

At age 42, Shona Sabnis is one of the “older” workers in the New York office of public-relations firm Edelman. Though she prides herself on being able to get along with most people, she is sometimes puzzled by the actions of her 20-something co-workers who, in turn, don’t understand why the senior vice president of public affairs likes to distribute physical newspaper clippings.

Peter Ferguson

While dealing with a situation at the office, Ms. Sabnis was told by a junior co-worker that she should be handling her client differently. It wasn’t phrased as a suggestion, which surprised her since she knew the co-worker wasn’t that familiar with the account.

She later enlisted a 26-year-old co-worker to help her to get a better sense of where her young co-workers are coming from. He told her about the motivations of individual co-workers and what their expectations were. “I found that I was projecting my reality when I was that age on them and their reality seems very different,” says Ms. Sabnis. “I don’t always assume anymore that I know what they want. Now I ask them if I need to know.” Ms. Sabnis says she feels that she is now able to deal with young co-workers with more understanding.

With as many as four generations bumping elbows in the same office, a lack of understanding and empathy between groups can generate serious workplace tension that can alienate co-workers. That is why experts say that getting into a young mind-set through mentorships and relationship building can help older workers better identify with young co-workers and—inevitably—younger bosses. Thinking young can also offer valuable insight into emerging millennial workplace and customer trends that can help to extend careers. Especially since millennials—people born between 1981 and the early 2000s—will make up 36% of the American workforce by next year, estimates the Business and Professional Women’s Foundation.

Start with a clean slate. Don’t let stereotypes color your perception of young co-workers. People tend to act on their beliefs, which makes it difficult to establish productive workplace relationships if you automatically believe, for example, that all 20-somethings are narcissistic or lazy, says Ellen Langer, a professor of psychology at Harvard University who’s written books on successful aging and decision-making.

“People think they should be compromising or tolerant of certain behaviors but, instead, we should be understanding. It is more important to be mindful of an individual’s motivations. Make sense of why people do what they do,” says Ms. Langer. “You might drive behind somebody that is driving slow and be angry because they’re old. But in reality, that individual might be driving as fast as they are capable and it could be dangerous to do otherwise. If you saw what they saw, you’d probably respond the same way.”

Catch up on things that you feel like you’re falling behind on by participating in a reverse mentorship or group training. Many companies will pair an older employee with a younger employee who can offer fresh insight on technology, communication styles and social media as well as offer inside insight into the needs of other young co-workers, says Lisa Orrell, a workplace consultant from San Jose, Calif., who specializes in generational management. “The reverse mentorship can also give insight into the new generation of buyers and decision makers who are also millennials. Social-media channels [are] how they are all communicating, collaborating and doing research on what to buy.”

Keep an open mind about organizational shifts that companies will be making to accommodate new modes of working. Millennials enjoy working in collaborative and decentralized work environments, for example, that de-emphasize protocol and hierarchy. This may include a more open workplace culture that encourages frequent communication and unprecedented outspokenness, says Ms. Orrell.

Don’t dwell on the past at the office or talk about how things used to be unless you’re using past accomplishments to bolster present and future goals, says Russ Hovendick, president of Client Staffing Solutions in Sioux Falls, S.D. “Your young co-workers are in the early stages of their careers and motivated by what’s happening now. They’re not thinking about retirement—nor should you out loud when you’re trying to put yourself into a relevant context.”

You want to relate to interviewers and hiring managers that you have plans for the future and aren’t just looking for someplace to hole up until retirement.

Severe Sepsis Strategy Significantly Reduces Mortality.


Patients with severe sepsis or septic shock triaged and managed using 4 clinical goals were significantly less likely to die in hospital than patients who did not meet all 4 objectives, a new prospective study shows.

The take-home message is “simple saves,” said Jason D’Amore, MD, from North Shore University Hospital and Long Island Jewish Medical Center in Manhasset, New York.

He explained that the strategy his team developed is easier than targeting specific physiologic goals for patients with sepsis. The work, known as the Early Sepsis Prophylaxis Study, is in contrast to other efforts over the past decade, which manage sepsis using early physiologic-directed therapy.

Here at the American College of Emergency Physicians 2013 Scientific Assembly, Dr. D’Amore reported that his team evaluated all-cause in-hospital mortality using registry data from a healthcare system that include 11 acute care facilities, 3 tertiary centers, and 700,000 emergency department visits per year.

They assessed the impact of goal compliance in 5787 adults who either presented to the emergency department with severe sepsis or septic shock or developed these conditions during hospitalization.

Their sepsis bundle consists of 4 clinical goals:

  • blood cultures before antibiotics
  • lactate before 90 min
  • intravenous (IV) antibiotics before 180 min
  • 30 cc/kg of IV fluids before 180 min

In-hospital all-cause mortality was significantly lower when the goals were used than when they were not (22.6% vs 26.5%; P = .0005).

The strategy was fully implemented in January 2012. Mean in-hospital mortality for this patient population dropped from 30% in the first quarter of 2012 to 23% in the fourth quarter of 2012.

Table. Performance of the Sepsis Management Strategy

Measure

First Quarter

Last Quarter

Patients in full goal compliance (%)

32.4

57.1

Mean time

 

 

   To antibiotic administration (min)

140

102

   To fluid bolus (min)

96

71

   From lactate order to result (min)

45

54

 

On multivariate regression analysis, complete compliance with the goals was associated with a survival odds ratio of 1.194 (1.04 – 1.37; P = .013), even after adjustment for factors such as age, admission to the intensive care unit, vasopressor initiation, central venous catheter insertion, and monitoring of central venous pressure and central venous oxygen saturation.

The overall absolute risk reduction for in-hospital mortality was 3.9% (1.7% – 6.0%).

 

We’re not asking people to do anything other than take a good hard look at a patient, give timely antibiotics, timely fluids, and then remain vigilant.

 

On the basis of these figures, the team calculated the number of patients needed to treat to see a survival benefit. “Every 26 times we complete a bundle, we think we have an opportunity to save a life. That’s meaningful,” Dr. D’Amore said.

“We’re not asking people to do anything other than take a good hard look at a patient, give timely antibiotics, timely fluids, and then remain vigilant about decompensation,” he explained.

This study “certainly shows that the bundle improved care, relative to historic outcomes. We still don’t know if there’s an opportunity to improve this even more,” said session moderator Alan Heffner, MD, from the Carolinas Healthcare System in Charlotte, North Carolina.

Future research could evaluate whether the strategy combined with physiologic parameters or goal-directed therapy improves outcomes in patient with severe sepsis, Dr. Heffner added.

Source: American College of Emergency Physicians (ACEP)

Underwater wi-fi given test run.


University of Buffalo underwater wi-fi testing team
The team dropped two 40lb (18kg) sensors into a lake near Buffalo

Researchers have tested an “underwater wi-fi” network in a lake in an attempt to make a “deep-sea internet”.

The team, from the University of Buffalo, New York, said the technology could help detect tsunamis, offering more reliable warning systems.

They aim to create an agreed standard for underwater communications, to make interaction and data-sharing easier.

Unlike normal wi-fi, which uses radio waves, the submerged network technology utilises sound waves.

Radio waves are able to penetrate water, but with severely limited range and stability. Sound waves provide a better option – as demonstrated by many aquatic species such as whales and dolphins.

Wireless communication underwater has been possible for some time, but the problem lies in getting separate systems used by different organisations to communicate with each other.

The US National Oceanic and Atmospheric Administration (NOAA), for instance, uses acoustic waves to send data from tsunami sensors on the sea floor to buoys on the surface.

However due to infrastructure differences, this data cannot be shared quickly with other information gathered by the US Navy.

‘Unprecedented ability’

Therefore, the University of Buffalo team is attempting to create a shared standard.

“A submerged wireless network will give us an unprecedented ability to collect and analyse data from our oceans in real time,” said Tommaso Melodia, lead researcher.

“Making this information available to anyone with a smartphone or computer, especially when a tsunami or other type of disaster occurs, could help save lives.”

The test was carried out at Lake Erie, near Buffalo. The research team dropped two 40lb (18kg) sensors into the water – and were then able to use a laptop to transmit information to them.

In future, the team hopes the sensors could be used to help detect and solve environmental issues. With a shared standard, different research groups with varied equipment could potentially combine their data gathering efforts with greater ease, and in real-time.

More details of the team’s work will be presented at a conference for underwater networking to be held in Taiwan next month.

15 Reasons Why You Should Be Independent of the “good” Opinion of Others.


“Be independent of the good opinion of other people.” ~ Abraham Harold Maslow

We are often flattered by appreciation and hurt by criticism. While it is true that approval boosts our morale and criticism depresses us, quite often an obsessive quest for approval becomes a psychological problem. People almost go in a mode of complete self-negation and keep devising ways to please others.

free-of-criticism

This brings us to the importance of the need to think and act independently of what the people talk or think about us. It should, however, be noted that in our zest for independence we should not lose sight of the legitimate sensitivities of the people around us and also the need to remain with a certain amount of social discipline. Independent thinking does not mean being anarchic. Also we should be open to helpful and constructive criticism.

There are 15 reasons why we should not be obsessed with pleasing people to seek their appreciation.

1. Constant quest for appreciation may become a psychological problem.

Most of us who think that they are not getting the type and amount of approval they expect stop interacting with the people. They become introvert. The problem aggravates further when they try to create an imaginary world where they indulge in some sort of delusive self- talking especially with people whose favourable opinions and views they seek in the actual world, but cannot get.

“You will never gain anyone’s approval by begging for it. When you stand confident in your own worth, respect follows.” ~  Mandy Hale

 2. We are all born unique individuals.

Spiritually speaking, each one of us is born as a unique soul with individual ‘sanskars’ or certain naturally endowed thought patterns. Trying to cramp them to fit into the thinking moulds of others would mean going against the very laws of divinity and nature. If you do not believe in spirituality, still, it cannot be denied that biologically each one of us has unique genes and DNA.  Forcing them to go against their natural course may prove counterproductive.

Nonetheless, independent thinking does not mean ignoring the accumulated wisdom of the ages. It also includes listening attentively to the views of those who love and care for us and balance them with our own specific biological and spiritual needs.

3. Chasing approval from others may distract us from working to achieve our goals.

It dilutes our focus on what we really wish to pursue and may ultimately impede our progress and happiness resulting out of it.

“Do not look for approval except for the consciousness of doing your best.” ~ Andrew Carnegie

4. How many people can you please by seeking their approval?

There are hordes of them and each one has their own tastes, likes and dislikes. In trying to please everyone it is likely you end up displeasing most of them.

“People who want the most approval get the least and people who need approval the least get the most.” ~ Wayne Dyer

5. Independent thinking is essential for personal and social evolution.

What would have happened if Darwin had listened to the opinions of the ‘respected people’ of the society of those days and stopped pursuing his theory of evolution?

6. Truly independent people follow their own heart and soul even at great risks.

Socrates preferred to drink hemlock rather please the people in authority and seek their approval and live like their slave. He lived and died like truly free and fearless man.

7. Constant anxiety to seek approval from others causes tension and depression.

You are always looking sideways to see if someone is looking and risk losing your chosen path.

8. Anxiety about approval or disapproval suppresses creativity.

You need to follow your instincts to live a truly joyous and happy life.

“I too will something make
And joy in the making!
Altho’ tomorrow it seem’
Like the empty words of a dream
Remembered, on waking.” ~ Robert Bridges

9. Hypocrisy and self-deception

Working to always please others is self-defeating hypocrisy and dishonesty. You force yourself to obey others even if you think they are wrong. “It is not doing what you believe is wrong or right but what others believe is right or wrong for you”. In process you do not live for the pleasure of yourself, but for others. You are killing your soul.

10. Seeking approval is like living an imagined life in others’ breath.

Any person can breathe-blow you away like a useless piece of tiny straw.

11. Fear of approval or disapproval dissipates the raw, virginal and primordial instincts and feelings that our spirit is endowed with when we are born.

It kills the purity, simplicity, joy and innocence of our soul.

“The older I get, the less I care about what people think of me. Therefore the older I get, the more I enjoy life.” ~ Unknown

12. Fear of approval and disapproval kills initiative

Ability to take free and fearless initiative is the driving force for the evolution of self and society. It is the basic quality that defines true leadership that is marked by taking bold decisions regardless of what people think of you.

13. You live an artificial rather than a natural life.

If you follow your own instincts you can fly in the soaring heights of the limitless skies. On the other hand, you stay caged like a parrot with your wings clipped, howsoever beautiful and colourful you may look. You become a slave of others rather than being a master of your own free will.

14. Seeking appreciation of others stifles your divine powers of intuition, clairvoyance and foresight.

Most people stifle their innate divine powers of intuition and clairvoyance under the pressure of approval and disapproval of people around them.

15. Fear of disapproval leads to constrained and regimented living.

Quite often you come to grief for following the approval of others rather than your own instinct.

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