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Aging, Genetics, In the News, Research, Stanford News

"A lot more data" needed to determine what makes supercentenarians live so long

"A lot more data" needed to determine what makes supercentenarians live so long

Scientists from Stanford and elsewhere have been hunting for a genetic explanation for extreme longevity for the past four years and are realizing that it is a more difficult proposition than they initially hoped.

Their research compared the genomes of 17 “supercentenarians” – those who have lived 110 years and beyond – with those of 4,300 “regular” people recorded earlier in a National Institutes of Health study. The study was geared toward finding a single gene or group of genes responsible for a particular trait – in this case longevity – similar to genes which have been found to cause disease or confer immunity. But they have had no luck. Stuart Kim, PhD, a Stanford geneticist and molecular biologist and founder of the Kim Lab for the study of aging, commented in a San Francisco Chronicle piece:

We were looking for a really simple explanation in a single gene, and we know now that it’s a lot more complicated, and it will take a lot more experiments and a lot more data from the genes of more supercentenarians to find out just what might account for their ages.

However, data about the oldest people in the world still suggests that the reason they can live so long has to do with their genes, and not with lifestyle choices. The supercentenarians have average rates of cancer, heart disease, and stroke, although they have escaped many age-related diseases, and their smoking, alcohol, exercise and diet appear no different than among ordinary people. Furthermore, as noted in the article, the parents, siblings and children of the centenarians have also lived well beyond average.

Previously: Unlocking the secrets to human longevity and California’s oldest person helping geneticists uncover key to aging

In the News, Mental Health, Patient Care

Imagining voices: A look at an alternative approach to treating auditory hallucinations

Imagining voices: A look at an alternative approach to treating auditory hallucinations

Artistic_view_of_how_the_world_feels_like_with_schizophrenia_-_journal.pmed.0020146.g001Updated 12-2-14: The headline and parts of the first paragraph were edited for clarity.

***

11-13-14: The idea of hearing voices, or auditory hallucinations, is an experience that frightens many of us. It can be seen as a sign that you are no longer in control of your mind. Auditory hallucinations are also a symptom of schizophrenia, and those with the disease often hear voices which are hostile, mean and disturbing. But some clinicians, including Marius Romme, MD, PhD, a Dutch psychiatrist and president of Intervoice, are exploring alternate ways to treat the problem of hearing distressing voices. A recent interview with one of Romme’s colleagues, Dirk Corstens, MD, and two of his patients, was featured in The Atlantic.

Stanford anthropologist Tanya Luhrmann, PhD, has worked extensively with people who hear voices, and a recent study she conducted compared the experiences of psychotic patients with auditory hallucinations living in three very different locales – San Mateo, California; Chennai India; and Accra, Ghana. Her team found that the voices of Indian and Ghanaian patients were more likely to be playful and benign, whereas those of U.S. patients were on average more threatening.

When Luhrmann took time to talk with me to discuss the implications of her research and the approach, which calls itself the Hearing Voices movement, she noted early on that although the treatments espoused by the movement won’t work for everyone, “The Hearing Voices approach is very important and has an important kernel to it.”

Some of what the group advocates is controversial. “They often reject the idea of schizophrenia, are hesitant about medication, and have a model of hearing voices that identifies sexual trauma as the most important cause of hearing voices,” she says. But a growing body of scientific evidence shows that it may be useful to teach people to interact with their voices.

The Hearing Voices movement, says Luhrmann, advocates seeing the voices as meaningful, treats them as people, respects the voices and encourages patients to interact with them with the help of a trained clinician. One of the patients featured in The Atlantic piece described how he learned to work with the voices he heard:

[Dr. Corstens and I] started to work with each other five years ago, or more. I was around 20 years old. It took about two years of work to actually figure out what the relationships were, what the triggers for the voices were, and what feelings are coupled to these voices. Once you start to learn to express yourself and work out these problems on your own, the voices don’t have to act out their part. Now, when I hear voices, I know what triggered them. I ask, “What is happening with me? What am I neglecting in my own emotions?” Does that make sense?

Luhrmann says that while more research needs to be done, it seems that some patients appear to benefit and the voices they hear diminish, or at least become less aggressive and intrusive. But she cautions that the method may not be appropriate for all patients. “I think it’s important to remember that schizophrenia is a difficult heterogeneous experience,” she says. “It’s pretty clear, even at this early point, that these techniques don’t work for everyone.” At the same time, she points out, research on related practices like cognitive behavioral therapy has been shown to ease the severity of the voice-hearing experience.

The Hearing Voices movement is mostly centered in European countries at the moment, but Luhrmann notes that it’s growing fast in a grassroots kind of way, somewhat in the way Alcoholics Anonymous grew in the last century. She predicts that some of the approaches used by the group will probably be used among patients with schizophrenia here in the U.S. in the next decade.

Previously: The link between mental-health conditions and cardiovascular diseaseNew thinking on schizophrenia, it’s the mind, body and social experience and Study shows meditation may alter areas of the brain associated with psychiatric disorders
Image by Craig Finn

Events, In the News, Research, Science, Stanford News

Breaking through scientific barriers: Stanford hosts 2015 Breakthrough Prize winners

Breaking through scientific barriers: Stanford hosts 2015 Breakthrough Prize winners

6018618935_38997291a8_zYoung scientists, I have good news: Nearly all of the 2015 winners of the Breakthrough Prize in Life Sciences pledged to devote at least some of their new-found riches to education programs that encourage budding scientists. No details yet, as the prizes were less than a day old when the researchers announced their plans at the Breakthrough Prize Life Sciences Symposium hosted by Stanford  yesterday.

“The Breakthrough Prize winners have done such amazing things,” said Lloyd Minor, MD, dean of the School of Medicine. Minor lauded the  founders of the award, Silicon Valley luminaries Sergey Brin and Anne Wojcicki, Jack Ma and Cathy Zhang, Yuri and Julia Milner, and Mark Zuckerberg and Priscilla Chan. “They have put together this wonderful way of rewarding and awarding scientists for the work they are doing. It’s a real privilege for us at Stanford to host the symposium.”

The six scientists, who each won a $3 million award, fielded questions and let the audience in on a secret: the path toward scientific success wasn’t always easy.

“I would have never, ever in a million years have predicted I would have been sitting up here,” said C. David Allis, PhD, a professor at The Rockefeller University who was honored for his discoveries in chromatin biology, or the study of the proteins associated with DNA. Chromatin was once thought to be useless and Allis said he received plenty of criticism about his research focus.

Jennifer Doudna, PhD, a professor of molecular and cell biology and chemistry at UC Berkeley, said she didn’t know any scientists growing up in Hawaii. It wasn’t until a cancer researcher visited her high school, giving Doudna her first glimpse at her future career. Doudna, who is also affiliated with the Howard Hughes Medical Institute and the Lawrence Berkeley National Lab, won along with microbiologist Emmanuelle Charpentier, PhD, for their work on genome editing. Charpentier leads the department of regulation in infection biology at the Helmholtz Centre for Infection Research in Germany.

Gary Ruvkun, PhD, said that although he’s a professor of genetics at Harvard Medical School and the Massachusetts General Hospital, he still hasn’t mastered the art of mentoring. “I’ve had people in my lab refer to me as the least grown up,” he said.  Ruvkun was recognized — along with molecular biologist Victor Ambros, PhD, of the University of Massachusetts Medical School — for their work on microRNAs, small pieces of RNA that regulate gene expression.

All of the winners thanked their family, mentors, colleagues, but Alim Louis Benabid, MD, PhD, thanked his patients as well. Benabid, board chairman of the Clinatec Institute in France, said many patients are embarrassed when their doctor asks them to take off their clothes. His patients let him stick his fingers in their brains, he joked. Benabid was honored for demonstrating that deep brain stimulation can alleviate some symptoms of Parkinson’s disease.

In the full-day symposium, several former Breakthrough Prize winners spoke, and Bay Area graduate students and postdocs hosted a poster session.

Previously: Are big-money science prizes a good thing?, Funding basic science leads to clinical discoveries, eventually and Why basic research is the venture capital of the biomedical world
Photo by Petras Gagilas

Addiction, Behavioral Science, In the News, Mental Health, Research, Stanford News

Veterans helping veterans: The buddy system

Veterans helping veterans: The buddy system

image.img.320.highI interviewed Army specialist Jayson Early by phone over the summer, shortly after he completed an in-patient program for PTSD at the Veterans Affairs hospital in Menlo Park. This was for a Stanford Medicine magazine story I was researching about a pilot project to help get much needed mental-health services to the recently returned waves of Afghanistan and Iraqi vets. What struck me most after talking with Early was just how clueless he had been, first as a teenaged-recruit, then as a young veteran, about the fact that going to war could cause mental wounds.

As the mother of a 17-year-old boy, though, I completely understood: Early just wanted to serve his country. He requested to be sent to war. In 2008, he got his wish and was deployed to Iraq just a year after exchanging his high-school baseball uniform for military fatigues. His first field assignment, an innocuous-sounding public affairs errand to photograph a burned out truck at an Iraqi police station, would be the first of many that left him with permanent scars:

“There were body parts, coagulated blood, hair all over,” [Early] says, pausing. “I just wasn’t expecting it.” An Iraqi family had been executed in the vehicle, presumably by insurgents. Early had gone through intense military training to prepare for moments like these. He blocked any emotions. He followed orders, clicked the camera and moved on. It wasn’t until years later that he realized just how permanently those images, and many more like them, had burned into his brain.

Stanford psychiatrist Shaili Jain, MD, interviewed in a podcast about her work with PTSD and veterans, had told me about a new pilot project that connects veterans with other veterans as a unique way to bridge what she called a “treatment gap” – the difficulty of getting mental-health services to the veterans that need them. My article – which is a timely read, given that today is Veterans Day – tells the story of Early’s connection with one of the veteran’s hired through this project, Erik Ontiveros, who went through treatment for addictions and PTSD himself, and just why it’s so hard to get treatment to veterans. As one well-known expert on PTSD explains in the story:

“It’s wicked difficult to treat anyone with moral injuries from combat in the traditional medical model,” says psychiatrist Jonathan Shay, MD, an expert on PTSD known for his books on the difficulties soldiers face returning home from war. “It destroys the capacity for trust. What it leaves is despair, an expectation of harm, humiliation or exploitation, and that is a horrible state of being. The traditional medical model – in an office with the door closed – is the last thing they want. I’m convinced that’s where peers come in. Peers are indispensable.”

Early told me many of his horror stories from war – stories that he rarely talks about. The time he was called to another execution area where there were enough body parts for 12 people who had all been gagged, bound, shot and burned. But, he said, they could only put together eight people. “We were trying to find a way to identify them,” he said. “Whenever I grabbed a hand, it would just crumble to dust.”

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Ethics, Health Policy, In the News, Medicine and Society, Transplants

Moving the needle on organ donation

Moving the needle on organ donation

For the thousands of people on organ donation lists, news of an available heart, or lungs, or liver can’t come soon enough. But many don’t get that call in time. According to a new feature on The Atlantic’s website, 21 people die waiting for a transplant every day. That works out to more than 7,600 patients every year.

Unfortunately unless you’re personally touched by the issue… you don’t really think about it

Although many people say they support organ donation, in many countries, only a minority actually register as organ donors. (“Unfortunately unless you’re personally touched by the issue, unless you have a child that gets a virus and suddenly needs a new heart, you don’t really think about it,” one expert says in the piece.) It’s a paradox many people in the field are trying to unravel. The reasons they’ve uncovered so far include mistrust of medical professionals: Some people believe that if a medical team finds out that you’re an organ donor, they won’t work as hard to save your life, in order to harvest your organs. And how much TV a person watches can influence how much he or she trusts doctors. One study found that people who watched more of the TV series Grey’s Anatomy were more likely to mistrust doctors and nurses.

Religion also influences the picture, probably because of concepts of bodily integrity in the afterlife. Catholics are less likely to donate their organs, even though the Vatican officially supports organ donation.

So what can be done about the organ shortage? Some groups are working on solutions, as highlighted in the piece:

“What we’re trying to do in New York is move the cultural needle on the issue,” says Aisha Tator, executive director of the New York Alliance for Donation. “Organized tissue donation should be a cultural norm like we did with bike helmet and seatbelt interventions.” Her organization isn’t the only one. Throughout the United States there have been a smattering of recent educational campaigns and studies on their efficacy. Campaigns have targeted the young, the oldnursesDMV employees, and ethnic minorities who tend to donate less than white Americans or white Brits.

Another, more drastic change is to shift the U.S.’s current opt-in system to one that requires people to opt-out. Many experts point to Spain, which has an opt-out system – and one of the highest rates of organ donation. But the logistics of such a system would probably be difficult, best, to implement.

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In the News, Science, Videos

Using dance to explain science

Using dance to explain science

Circus enthusiast and University of Georgia PhD candidate Uma Nagendra used her aerial talent to create this year’s winning “Dance Your PhD” video. The contest is sponsored by Science AAAS and challenges scientists to use dance to translate their work. For the contest, Nagendra joined forces with her aerialist colleagues to produce the above video based on her research on how tornadoes can alter the dynamic of the ecosystem.

Science recently reported:

Tornadoes are destructive events, ripping up the surface of Earth, crushing buildings, and tossing automobiles in their paths. And based on some models of climate change, they are likely to become more frequent and damaging. But according to a study of forest soil ecology, tornadoes also do some good—for trees, that is. It turns out that tree seedlings get a respite from certain parasitic fungi in a tornado’s aftermath, allowing them to flourish.

For winning the BIOLOGY category and the overall prize, Nagendra receives $1000 and a free trip to Stanford University in May 2015, where her video will be screened.

Previously: “Dance Your PhD” finalists announced

Health and Fitness, In the News, Research, Sleep, Stanford News

Superathletes sleep more, says Stanford researcher

Superathletes sleep more, says Stanford researcher

alarm-clock-146469_640Hit snooze again – it just might boost your performance, Stanford sleep expert Cheri Mah believed. Seems intuitive, yet research findings were needed.

Mah originally tapped Stanford’s men’s basketball team to test her theory. When the team went from an average of 6.5 to 8.5 hours of sleep a night, they hit 11 percent more free throws and sprinted more quickly. Her work grabbed headlines at the time, and now it’s featured in Mark McClusky’s  forthcoming book, Faster, Higher, Stronger: How Sports Science is Creating a New Generation of Superathletes — and What We Can Learn from Them.

The Atlantic excerpted a key section from the book today; here’s McClusky (who also edits Wired.com):

For us humans, sleep is completely crucial to proper functioning. As we’ve all experienced, we’re simply not as adept at anything in our lives if we don’t sleep well…

It seems like certain kinds of athletic tasks are more affected by sleep deprivation. Although one-off efforts and high-intensity exercise see an impact, sustained efforts and aerobic work seem to suffer an even larger setback. Gross motor skills are relatively unaffected, while athletes in events requiring fast reaction times have a particularly hard time when they get less sleep.

McClusky goes on to write that Mah’s research “strongly suggests that most athletes would perform much better with more sleep – if they could get it.” But it’s tricky for top athletes to get enough sleep. Fly across the country, or the world, and your sleep schedule is skewered. And West Coast teams have it particularly hard:

In 2013, the Seattle Mariners flew more than 52,000 miles while the Chicago White Sox, with their central location and nearby division rivals, only flew about 23,000… Bouncing around the country, leaving late, arriving early, having to play the next day—it’s no surprise that travel and the management of sleep is a huge problem for athletes.

Some athletes squeeze in an afternoon nap to boost their rest times, McClusky said. And that sounds like a mighty fine idea to me.

Previously: Ask Stanford Med: Cheri Mah responds to questions on sleep and athletic performance, Expert argues that for athletes, “sleep could mean the difference between winning and losing,” Why your sleeping habits may be preventing you from sticking to a fitness routine and A slam dunk for sleep: Study shows benefits of slumber on athletic performance
Image by OpenClips

Aging, In the News, Mental Health, Women's Health

Love your body, love yourself

Love your body, love yourself

10227014165_7e464321d2_zAs someone with not much regard for my body, I can hear my nutritionist cackling with glee at the thought of this post. She’s spent months trying to brainwash me into liking it anyway. I fight back, chafing at the idea.

Now along comes Martha C. Nussbaum, PhD, a leading ethical thinker based at the University of Chicago, saying we should not just like our bodies or merely tolerate our young bodies in their prime. No, she writes in a recent New Republic essay, we should consider our bodies as “dynamic, marvelous, and, more important, just (as) us ourselves.” We should celebrate our bodies with the spirit captured by the 1970s movement Our Bodies, Ourselves, sparked by the book-turned-organization. The alternative is ugly:  Prejudice, bigotry and other social ills will surge when fueled by self-dislike.

Nussbaum mourns the loss of body-embracing spirit: “I fear that my generation is letting disgust and shame sweep over us again, as a new set of bodily challenges beckons.”

Flaccid muscles, graying hair, foreheads creasing with wrinkles. Not yuck, not gross, do not withdraw, do not hide in shame, she writes:

[The poet Walt] Whitman knew that we will not be able to love one another unless we first stop hiding from ourselves—meaning our bodies…

As we age, we are yielding to all the forces we tried, back then, to combat: not only the forces of external medical control, but the more insidious force of self-loathing. Whitman knew that disgust was a social poison. Psychologists studying the emotion today confirm his intuitions about its link with prejudice and exclusion.

If you don’t like yourself, your body, then what must you think of others, Nussbaum questions. Worth pondering, I’ll concede.

Previously: Ask Stanford Med: Director of Female Sexual Medicine Program responds to questions on sexual health, Blogging may boost teens’ self-esteem and Tai chi linked to mental-health boost, but more study is needed
Photo by Jennifer Morrow

Ebola, Global Health, In the News, Infectious Disease

Ebola: This outbreak is different

Ebola: This outbreak is different

15038945315_7613c40e54_zMisinformation about Ebola blankets the web. To clarify priorities, and spur action, Stanford global health specialist Michele Barry, MD, penned a strongly worded essay published today in Boston Review:

In the United States, the few cases imported have incited irrational fear which is not only unwarranted but actually undermines an appropriate response to the outbreak. By focusing on quarantine, we are ignoring the need for centralized public health systems and training to deal with inevitable cases of Ebola.

Ebola is not spread through air, water or food, but end-stage sick patients can have over a billion viral particles in a cubic centimeter — or about a fifth of a teaspoon — of blood making contact with bodily fluids highly contagious.

This Ebola outbreak is different, she says. Previously, the virus stayed close to its forest reservoir in Central Africa. Now, it’s in large cities, spreading through heavily populated areas that have been decimated by poverty and conflict.

As the virus spread, the World Health Organization was slow to respond, Barry writes. “The WHO was alerted to the cluster of cases in Guinea by March, but did not sound the alarm until August. Why did this happen?”

And what, now, can be done?

In actuality, the solution to this Ebola crisis is not drugs, mass quarantine, vaccines or even airdrops of personal protective gear. The real reasons this outbreak has turned into an epidemic are weak health systems and lack of workforce; any real solution needs to address these structural issues.

We have the tools to spot emerging outbreaks and to stop them. We know how to prevent transmission of Ebola. Orchestrating an international response, however, one that considers the welfare of patients and healthcare workers, the resilience of healthcare systems and the triumph of reason — that needs some work.

Previously: Stanford physician shares his story of treating Ebola patients in Liberia, How to keep safe while operating on Ebola patients and Ebola: A look at what happened and what can be done
Photo from the European Commission DG ECHO

In the News, Science

Luminous mouse brain among photomicrography competition winners

Luminous mouse brain among photomicrography competition winners

Entry26382_Ali_Erturk_mouse-brain

Nikon announced the winners of its annual Small World Photomicrography Competition yesterday, and among the group was this stunning image.

The photo was taken by Ali Ertürk, PhD, a researcher at the Institute for Stroke and Dementia Research at Ludwig Maximillian’s University in Munich, Germany. Ertürk and his colleagues’ research is focused on better understanding the “key mechanisms leading to neurodegeneration after acute brain injury.” This image depicts the mouse brain vasculature.

Via Wired Science
Previously: Video of innate immune reaction in the lymph node, Image of the Week: Osteosarcoma cell and Tiny wonders: Small World in Motion competition winners bring microscopic activity to life
Photo by Ali Erturk/Nikon Small World Photomicrography Competition

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