Health Meaning

TOKYO- After reporting the country's first case of Acquired Domestically dengue fever in Nearly 70 years yesterday, Japan's health ministry today confirmed finding two more patients. The initial patient, a girl in her teens, Had a sudden onset of high fever on 20 August and Was Hospitalized in Saitama City, near Tokyo. Hospital staff, suspecting dengue, on 26 August sent blood samples to the National Institute of Infectious Diseases in Tokyo, qui confirmed the diagnosis.

An epidemiological investigation turned up two more patients. All three are students at the Sami school in Tokyo and are members of a dance group That Regularly practices in a city park, leading the ministry to Conclude That students Were infected in the park.

Dengue is Widespread in the tropics and subtropics. Selon the ministry, about 0 Japanese contract the mosquito-borne viral disease Each year while traveling overseas. Purpose none of the three patients HAD Traveled overseas. A German woman Apparently the virus Acquired During a trip to Japan last September. After returning to Berlin, She Was Hospitalized for an acute fever and rash. Blood tests later confirmed a dengue infection.

The dengue virus's main vector, the Aedes aegypti mosquito, is not found in Japan, aim the tiger mosquito, Aedes albopictus , aussi can host the virus and is common Throughout much of the country. The ministry played down the risk of an outbreak.

Five researchers studying a cellular system for fixing misfolded proteins, deep brain stimulation for the disease Parkinson's and breast cancer genetic won this prestigious Lasker award of the year for biomedical research.

The Lasker Foundation announced today that its award for basic medical research goes to Kazutoshi Mori, 56, of Kyoto University in Japan and Peter Walter, 59, of the University of California, San Francisco, for their work on what is known as the unfolded protein response. From the late 1980s, their laboratories have revealed steps in how the endoplasmic reticulum, the cell factory for secreted and membrane protein processing, trafficking of proteins whose linear amino acid sequence n has not folded into a 3D form suitable. After detection of a dangerous accumulation of unfolded proteins, endoplasmic reticulum sends a signal to the nucleus that activates genes that work to solve the problem. The research has implications for diseases such as cystic fibrosis and retinitis pigmentosa. The price of basic research Lasker often precedes a Nobel Prize in medicine; 86 Lasker winners have gone on to win a Nobel Prize.

The Lasker Award for Clinical Research was awarded to Alim-Louis Benabid, 72, Joseph Fourier University of Grenoble, France and Mahlon DeLong, 76, of Emory University in Atlanta. Also starting in the 1980s, they demonstrated in animals and people who implant surgically into the brain with a device that stimulates the subthalamic nucleus may reduce tremors and other symptoms of people with Parkinson's disease. In 02, US authorities have approved the technique for the treatment of advanced Parkinson's disease.

Mary-Claire King, 68, of the University of Washington, Seattle, won the Lasker Special Achievement Award for his discovery of BRCA1 cancer risk breast in 190 and for the development of DNA analysis techniques to identify family members. First used to help find children separated from their parents during 1976-1983 military dictatorship in Argentina, the approach has since remains and victims of natural disasters and terrorist attacks 9/11 identified human.

The Cuban government is to send 165 doctors and nurses to combat the Ebola outbreak in West Africa, the World health Organization (WHO) announced this morning in Geneva, Switzerland, at a joint press conference with the Cuban Minister of public health, Roberto Morales Ojeda. Health care workers, 103 nurses and 62 doctors will be deployed in Sierra Leone in the first week of October.

This is the largest contribution health care staff by one country to date to help control the epidemic, noted WHO Director General Margaret Chan. "This will make a significant difference in Sierra Leone," said Chan

To put into perspective :. WHO has deployed about 500 foreign medical experts to the region. Because they run at any time about 170 of them are in the affected countries, Chan said.

Ebola has sickened at least 4784 people and killed in 2400 in the largest recorded epidemic and its spread further accelerated. Several governments have pledged support. For example, the British government and the Wellcome Trust medical charity announced they will spend £ 6.5 million to accelerate research on the Ebola virus vaccine candidates. German Ministry for Economic Cooperation and Development announced that it is increasing its contribution to WHO to fight against Ebola 1 million to € € 10 million. And the Bill & Melinda Gates Foundation has pledged $ 50 million for the fight against Ebola. But this does not solve the main problem, experts say. "Money, materials are important, but those alone can not stop the Ebola transmission," Chan said at the press conference. "The thing we need above all is the people."

According to WHO, more than 0 health workers are needed to run an isolation ward with 70 beds. Although it is still unclear how many patients Ebola ago total WHO estimates several hundred additional beds are needed in Liberia alone. at present there is not a single bed available in the country to treat Ebola patients, Chan said.

Several people on the ground in Liberia confirmed Ebola patients are being diverted to Monrovia treatment center to avoid staff being overwhelmed. "We need more action . We need to surge at least two to four times in order to catch outbreaks in these three countries, "said Chan." I hope today's announcement will stimulate more countries to break their support. "

* Ebola files: Given the current Ebola epidemic, unprecedented in terms of the number of people killed and rapid geographical spread, science and science Translational Medicine made a collection of research articles and news on the viral disease available for researchers and the General public.

Six months after the World Health Organization (WHO) has been informed of the Ebola outbreak in West Africa , experts have published a new study warning that the situation is growing rapidly worse and the Ebola virus can even "become endemic in the human population of West Africa, a perspective that has never been previously considered. "

the US Centers for Disease Control and Prevention (CDC) Atlanta, meanwhile, released a new model for the spread of the deadly virus. the worst case scenario estimated that up to 1.4 million people could be infected by the end of January. If the control efforts are strengthened fairly dramatically and prove surprisingly successful, however, the epidemic could be nearly complete at that time. "Delay is extremely costly in terms lives and efforts, "said CDC Director Tom Frieden told a news conference today.

the Ebola epidemic, which probably began in Guinea in December last year has sickened at least 5,843 people, according to the latest figures from the WHO, more than twice all known previous outbreaks combined and killed 2803. epidemiologists expect the actual numbers are two or three times, however, because only a fraction of cases is reported. And spread of the disease continues to accelerate.

The new study by experts and WHO scientists at Imperial College London, published today The New England Journal of Medicine , is "excellent" because it fills important gaps, says Preben Aavitsland, a Norwegian epidemiologist. "For example, the study gives an average of 6.4 days of stay in hospital," he says. It is important to know because it means that approximately as many beds are needed because it has there new Ebola cases every week. This also means that tens of thousands of beds will be needed by the end of November, said Aavitsland. "It is quite difficult to know where the beds and people for their personal will . "

the authors also found that the so-called virus levels in each country, representing the average number of reproductive individuals each infected person infects turn. it varies from 1.38 Sierra Leone to Liberia 1.51 to 1.81 in Guinea. This means that cases are almost doubling every 2 weeks in Guinea, every 3 weeks in Liberia, and every month in Sierra Leone, said Christl Donnelly, an epidemiologist at Imperial College London and one of the authors of the study. "the great thing is that we still see exponential growth and that must be stopped."

There are a month into his alleged Ebola Response Roadmap, WHO wrote that the number of cases "could exceed 20,000 during this emergency." In the new model, it projects that number to be reached by November 2, if the epidemic continues to grow unchecked.

there's more bad news. Although WHO said earlier that about half of patients die from Ebola, the paper estimates that the case fatality rate is actually just above 70%. "I think that can be fed through more aggressive therapy well below 50%," says Aavitsland. Offering a better chance of survival is important to convince patients to seek treatment instead of staying at home, he said, where they can infect other people. "for now, all these processing units have to offer is a lonely death."

in a perspective published with the article, Jeremy Farrar, Director of the Wellcome Trust, and Peter Piot, director of the London School of Hygiene & Tropical Medicine, warns that hitting the effects will kill many more people. "West Africa see a lot more suffering and more deaths during childbirth and from malaria, tuberculosis, HIV-AIDS, enteric and respiratory diseases, diabetes, cancer, cardiovascular disease and mental health during and after the Ebola epidemic, "they write . "Indeed, there is a real danger of a complete breakdown in civil society, as desperate naturally lose faith communities in established systems."

the model published by CDC today looks further, and its projections are even more sobering. If the virus continues to spread at its current rate, Liberia and Sierra Leone alone reported about 550,000 cases of Ebola January 20, the authors write. But if the official figures to date represent 40% of the actual load, which many believe could be the case, it would mean a total of 1.4 million cases of Ebola in both countries on 20 January. "I hope we do not see anything like these projections," Donnelly said. "But I think it is a realistic projection of what would happen if we did we organized."

Projecting what happening in Guinea is impossible because of the wild fluctuations in the number of cases, Frieden said. "You see three separate cases waves increased in amplitude" which probably reflect the reimportation of the two countries, he said at the press conference.

CDC also released the model as an Excel worksheet "so that planners in the countries and international organizations can model what might happen under different circumstances," said Frieden. He also said he does not believe that the most dire predictions are coming. "The model shows, and I do not think it has been shown by other modeling tools there, that the surge can now break the back of the epidemic," he said. Specifically, the epidemic begins to slow, and eventually peter out, though about 70% of patients in health care facilities or Ebola treatment units, or, if they are full are cared for in a so that they do not transmit the virus to others.

Although this may seem somewhat reassuring, it is unclear how this can be achieved, because doctors do not even know about 60% of all cases of Ebola in the region. "I do not see the huge influx in aid is needed to achieve this goal," says Jonas Schmidt-Chanasit, a virologist at the Bernhard Nocht Institute for Tropical Medicine in Hamburg, Germany. In part, Schmidt said Chanasit it is a matter of speed. The United States, for example, promised 17 field hospitals will be able to accommodate 100 patients each, but it is expected to take 50 to 100 days for those to be fully functional. in that time, the need will be much larger already

the CDC model shows the need for speed clearly :. for every additional 30 days it takes to get 70% of patients in treatment, the researchers estimate that the number of daily cases occurring at the peak of the epidemic will triple. Provide home care kits to protect people who care for family members themselves can help prevent the least some infections, said Schmidt-Chanasit. "It is certainly a good idea, but it will not by itself curb this epidemic." The key Aavitsland said, is still a massive increase in beds and staff. "It seems very difficult to stop now, but I think we all just to believe it is possible."

There is at least a glimmer of hope in the new data, Donnelly said. "Reproduction rate, at least in Sierra Leone and Liberia, was higher at the beginning of the epidemic. This may be a first sign that some efforts have an impact," she said. Christian Althaus, an epidemiologist at the University of Bern, warns that this may just be an artifact, though. As hospitals filled, the proportion of cases are not reported may have increased, creating the illusion of some improvement. "I wish it were true," said Althaus. "But I doubt it."

* Ebola files: Given the current Ebola outbreak unprecedented in terms of the number of people killed and the rapid geographic spread, Science and science Translational Medicine made a collection of research articles and news on the viral disease available for researchers and the general public.

- About 5 minutes of Tuesday's press conference outlining the first US Ebola diagnosis, Tom Frieden, director of the Centers for Disease Control and Prevention (CDC) , segued to speak of help on the ground in Africa, saying: "But in the end, we are all connected by the air we breathe"

This comment-for expressing the. importance of controlling the spread of the virus both abroad and in the United States Edward Goodman-constrained, epidemiologist at Texas Health Presbyterian Hospital of Dallas, who spoke after Frieden, specify: "Ebola is not transmitted by the air. It is not an airborne infection. "

many reports have drove home the point that the virus is spread primarily by direct contact with body fluids, people are not infectious when they develop symptoms, and it is unlikely that the Ebola virus will evolve to become airborne

But there are precious few data on some other practical issues :. Which body fluids harbor the virus? Does it linger on objects touched by an infected person?

The hard data are scarce, largely because the Ebola outbreaks have been sporadic, and because each outbreak before the present over before 500 people infected. Some epidemiological studies have examined the infected and their close contacts and said it does not spread through the air. Studies also suggest that the main transmission routes include touching an infected person, sharing a bed, and contact with bodily fluids during. Ebola patients funeral also showed extremely high risk because of rituals that involve touching the body, the group hand washing, and common meals.

One study examined the skin of people who have died of Ebola virus and suggested that sweat can play an important role. "One possible explanation for the role of physical contact in transmission is the presence of abundant particles and virus antigens in the skin and sweat glands around," the authors conclude. But the most comprehensive analysis to date noted that risk factors vary depending on the stage of the disease, and people with the disease at an advanced stage or death are much more likely to transmit the virus.

An essential document 07, published in The Journal of Infectious Diseases , offers perhaps the best available indication of where the risks are, and where they do not . He analyzed samples from confirmed cases during an epidemic in 00 in Uganda, including people who were seriously ill or convalescing. It also examined for the virus on objects, such as desks, walls, and gloves in an Ebola isolation ward. The figures in the study are small, but it is the most detailed analysis published to date.

The key tables in 07. A large consignment of study: Infection is unlikely to come to a fateful encounter with a doorknob, or even a handshake. The authors caution that the methods used to detect the Ebola virus has not been widely tested for use on objects, and the virus could be present to undetectable levels.

* Ebola files: given the current Ebola epidemic, unprecedented in terms of the number of people killed and the rapid geographic spread, science and science Translational Medicine made a collection of research articles and news on the viral disease available researchers and the general public.

Two candidate Ebola vaccines could be ready for testing in countries west- Africa hard hit in December, a month earlier than previously forecast. And a vaccine manufacturer said it may have million doses available by April, should studies prove it is safe and effective, a much more optimistic scenario described so far.

More and more resources are mobilized for the development of Ebola virus vaccines, the schedule is compressed, said Marie-Paule Kieny, Assistant Director-General of the World Health Organization (WHO) during a press conference about a high level meeting on vaccines that took place yesterday. "Things change from week to week," said Kieny, who also noted that several new donors have offered to assist in the production of vaccines finance and testing. Two new cases of Ebola, one in Mali and the other in New York, have added to the sense of urgency to contain the spread of the deadly virus. But the best-case scenarios discussed may be overly optimistic given the rapid spread of the Ebola virus, especially in Liberia, Sierra Leone and Guinea.

the meeting's objective was "access and financing" of vaccines, many workers in the field initially thought could be developed quickly enough to help this epidemic. But the epidemic continues to grow, there are nearly 10,000 cases officially reported to date, of which about half-dead efforts to accelerate the testing and production of vaccines have gained steam, and that was the last of several meetings related to WHO. ( Science Insider describes some of the key discussion points of the meeting on the basis of documents disclosed to the meeting yesterday ;. The documents were initially distributed to the participants, who included scientists and representatives of businesses, governments and regulators)

in a few weeks, meeting participants have learned enough data are available from small phase tests a vaccine manufactured jointly by the US National Institute of allergy and infectious diseases and GlaxoSmithKline I (GSK), which began in September to launch efficacy studies. A second vaccine, originally developed by the Public Health Agency of Canada and now made by NewLink Genetics of Ames, Iowa, who started the Phase I trials in October could have similar data available in December. Efficacy trials can test both vaccines simultaneously. But the question that looms is the quantity of those products will be available should they be effective, which could be known as soon as April.

Both GSK and NewLink Genetics said at the meeting that they might be able to produce much larger quantities of their vaccines they originally estimated. GSK said it could have 230,000 doses available in April, and could, if it had funding to produce more than 1 million doses per month by December 2015. This would be far from what is needed in the three countries most affected in West Africa, which have a combined population of nearly 22 million. In its most optimistic scenario, NewLink Genetics said it could have 12 million doses of its vaccine ready in April (see table below).

genetic NewLink presentation at the WHO meeting

NewLink genetics offered production estimates based on different doses of its vaccine.

the amount of NewLink vaccine that will be available will depend heavily on how much of the vaccine material is necessary to constitute a "dose" that can teach safely immune system to fight the virus Ebola. The phase I studies in courses should clarify this issue. If the higher dose is needed, 100 million viral particles, the company would have only 125,000 doses ready by April. But if the required dose is only 1 million viral particles, 100 times could be available, NewLink noted in a presentation at the meeting. Kieny stressed Science Insider that "it is not known at this time if [the lower dose] will be enough."

Ira Longini, an epidemiologist at the University of Florida in Gainesville who attended the meeting, said dosage decisions may further delay the NewLink vaccine. Despite the optimistic prediction, he warned that it might not be ready for testing in an efficacy trial which begins in December.

The liability issues are an important part, too, noted participant meet John Arne Röttingen, director of the Norwegian Institute of Public Health Division of Infectious Disease Control in Oslo. Some suggested responsibility should be treated similarly to the vaccine against H1N1, which was made quickly to fight against this pandemic in 09. For the vaccine, drug manufacturers have taken responsibility for product quality, but countries covered responsibility for its use. This model may not be appropriate, others said that the vaccine against H1N1 was a variation on the vaccine formula against flu established; more unknowns-and therefore more risk Surround these Ebola vaccines. Yet Röttingen said: "There seems to be a convergence to create a group that would finance and pay for vaccines and should also take responsibility for the liability issues in cooperation with affected countries"

Several. countries and organizations at the meeting offered to help the development and testing of medium vaccines, Kieny said. MSF is committed to creating a fund if necessary, and some governments and the World Bank have also committed to help finance efforts. GAVI Alliance for vaccines, a public-private partnership that bankroll the majority of vaccines in developing countries could play a big role. Keiny noted that representatives of GAVI "working on a proposal that they would put on their Board of Directors. "The Board of GAVI plans to meet in December

* Ebola files :. Given the current Ebola outbreak unprecedented in terms of the number of people killed and the rapid geographic spread, science and Science Translational Medicine made a collection 'research articles and news on the viral disease available for researchers and the general public.

nanoscale fibers BALTIMORE, Maryland- medical engineers have long used as robust scaffolds for growing tissue . Now researchers develop nanofiber mesh that could suck insects on wounds and accelerate healing, they reported here this week at the 61st annual meeting of AVS. The scientists injected nanofibers bearing cells in wounds to stimulate tissue repair, but to design a really smart dressing, they need to know how matter interacts with bacteria. After testing nanofibres of different sizes, the researchers found that the bugs transfer most easily nanofibers with diameters corresponding to the sizes of bacteria. When scientists nanofibers placed in a Petri dish Staphylococcus aureus , a bacterium involved in chronic infection, insects were quickly attached to the fibers 500 nanometer wide (as seen below above), but only on the fibers with larger diameters. When the researchers coated nanofibers with different compounds and test them on bacteria Escherichia coli , also responsible for chronic wounds, insects form bridges on the coated fibers allylamine, a colorless organic compound, but stayed away from fibers coated with acrylic acid. The researchers, who plan to test the stitches on composites that resemble human skin, hoping that they will eventually lead to smart dressing the wound that could prevent infection. Doctors could stick the nano-Band-Aid on a wound and simply remove it to get rid of germs.

Tumors grow and persist in part because they squelch the immune system, but researchers have recently turned the tables with treatments that fast track immune cells to malignant cells. The strategy is effective in some patients, however, and to date has been shown to work in only a few types of cancer. But online education today Nature reveal how an immunotherapy type is called the immune checkpoint inhibitors, can be targeted to new cancers -and how physicians can distinguish patients who are most likely to benefit from these drugs.

"as a unit, the papers fulfill many of the gaps in our understanding" about these cancer immunotherapies, said Jedd Wolchok, a medical oncologist at Memorial Sloan Kettering Cancer Center in New York, who was not connected to the study.

tumors can remove cytotoxic T cells that normally attack by the activation of two surface receptors of immune cells, CTLA4 and PD-1. But the CTLA4 and blocking PD-1 with antibodies can free T cells Several clinical trials with incurable cancer patients showed dramatic effects of these antibodies. "What we see is the control of long-term illness," said Wolchok. "In some cases, people are living long enough to die of other causes."

Timid researchers away from the c-word cure, but they say that these immune checkpoint inhibitors could eventually transform cancer into a manageable disease more like diabetes or HIV. "The immune system may be able to keep the tumor under control, even if it does not remove all the last cell," says immunologist cancer Drew Pardoll from Johns Hopkins University School of Medicine in Baltimore, Maryland. The prospects of such led Science to anoint cancer immunotherapy as discovery of the year for 2013.

Yet so far, published studies have confirmed that the checkpoint inhibitors only work in kidney cancer, melanoma, and lung cancer. even in these cancers, usually less than half of the patients benefit.

in one of the new studies, led a team by Thomas Powles oncologist at Queen Mary University of London tested a new antibody created by Genentech of South San Francisco, California, in a different cancer. a form of bladder cancer difficult to treat instead of blocking PD 1 of immune cells, the antibody disables PD-L1, a protein that cancer cells and other cells have to stimulate PD-1 and inhibit T cell study funded by Genentech showed that the antibody decreased the bladder tumors in 26% of patients. The therapy for this cancer has not progressed in 25 years, notes Hopkins medical oncologist Julie Brahmer, who was not connected to the research. "This is truly revolutionary," she said.

In a second study, also funded by Genentech, translational oncologist Roy Herbst of the Yale School of Medicine and his colleagues tested the antibody against several other types of incurable cancers. patients in this trial "had exhausted one, two, three lines of therapy," Herbst said, but he and his colleagues found that the antibody caused tumors to shrink in lung cancer, head cancer and neck, melanoma and other tumor types. "It is unexpected and exciting to see one drug affecting so many types of cancer," says Suzanne Topalian, a cancer immunologist at Hopkins who has not participate in any of the studies.

Still, less than 20% of patients in the Yale experiment saw their tumors reduced. "It is a great puzzle to predict who will benefit from these treatments," said Herbst When he and his colleagues analyzed the test patient tumors, they found a possible explanation. Variation in the amount of PD -L1 not manufactured by cancer cells but rather by immune cells that had invaded the tumor. (cancer cells can somehow force immune cells to make them self-inhibitory molecules.) If these cells produce a lot of invasion protein, patients are more likely to respond to antibody therapy. level test PD-L1 in tumors of patients may allow doctors to identify people who are most likely to benefit from the new antibody, said Herbst.

in a third Nature study, immunologist of the tumor and the doctor Antoni Ribas of the University of California, Los Angeles, and colleagues identified another biomarker that could help to improve the rate of successful antibody immuno-awakening. After examined biopsy samples of melanoma tumors from 46 participants to clinical trials treated with PD-1 blocking antibody, the researchers found that the best omen of successful treatment was plenty of cytotoxic T cells at the edge of you die. More cells crowded into the edge of the tumor, the better.

To confirm their findings and evaluate its usefulness, Ribas and his colleagues then analyzed biopsy samples from melanoma patients in a clinical trial at another hospital. Using this single function, they correctly predicted how 13 of the 15 patients would respond to antibody therapy. "A test that detects the presence of [cytotoxic T] cells in tumors could be the first decision point in the treatment of patients," said Ribas.

The researchers are already studying how to use the results of these studies improve cancer immunotherapy, possibly in combination with other types of treatments. "the next use is in combination with other drugs against cancer for more impact," says Topalian.