Scientific publishing is a long established process, often presenting its share of frustrations to authors. Lengthy peer review processes and subsequent rejections can prevent timely publication of important research. A recent article in the Economist (June, 2013) addressed the issue of scientific publishing, stating that “slowness” is often identified by authors as the primary drawback of the publication process. According to the article, the average time for publication is six months after submission, and frequently follows submissions to multiple journals, as the article may be rejected for publication by journal after journal despite high scientific quality. This contributes to the extended time to publication. In addition, the article must be peer reviewed by multiple experts in the field, which adds to the time for publication. This has been particularly true for print journals, in which the article, once approved, must also wait for publication of the particular edition of the journal.
A new generation of journals has been created in recent years. Cureus.com is an online medical journal with an Editorial Board that consists of hundreds of experts in a wide variety of medical specialties. The goal of the Cureus journal is to provide a transparent and rapid publishing process in which authors receive feedback, and an unbiased measure of the scientific merit of their papers via a novel crowd-sourcing algorithm, the SIQ, from reviewers and all readers. Authors on Cureus have the ability to have their work published in a timely manner, for no cost, and while retaining copyright at all times. The online accessibility also enables patients to access the most recent research on their particular medical condition. The structure and publication process provided by Cureus addresses and eliminates the historical problems in scientific publishing. Most importantly, it allows important research to be published quickly, and to be viewed by medical professionals and patients alike.
Stroke is a leading cause of death in the United States, killing one American every 4 minutes, according to the Centers for Disease Control and Prevention. A stroke is an interruption of the blow flow to the brain. Strokes and be caused by a blocked blood vessel, or one that bursts and bleeds into the brain. Strokes can occur at any point in life, but the risk of stroke increases with age. Each year, over 795,000 Americans have a stroke, resulting in long-term or permanent disability.
The speed at which a stroke victim receives treatment can mean the difference between recovery and long term, or even fatal, consequences. This was highlighted in a recent study published in the Journal of the American Medical Association by Dr. Jeffrey Saver, director of UCLA’s Comprehensive Stroke Center and his colleagues. In their study, Dr. Saver et al., found that the risk of suffering from stroke symptoms or death decreases by 4% for each 15 minutes doctors gain when intervening with a stroke victim. John Adler, MD, a Dorothy & TK Chan Professor of Neurosurgery and Radiation Oncology at Stanford University, and CEO of Cureus, Inc., stated “This paper by Saver et al. adds to a large body of now incontrovertible data. In the setting of ischemic stroke, the speedy restoration of brain perfusion with tPA leads to better functional outcomes. The big unmet public health challenge is ensure the fastest possible recognition of ischemic stroke to be followed by ever more timely therapeutic intervention.”
Common signs of stroke can include sudden numbness or weakness of the face, arm or leg, confusion, trouble seeing, loss of balance or coordination, or a sudden, severe headache. At risk are those with diabetes, poor diet, obesity, physical inactivity, and those who consume excessive amounts of alcohol. Concerned about your own risk of stroke? Use this stroke calculator developed at the UCLA Stroke Center:
The American Medical Association (AMA) announced last week that they are officially declaring obesity a disease. According to the AMA, obesity is a significant public health problem, causing 112,000 preventable deaths each year. By 2008, 34% of adults and 17% of children were considered obese, the prevalence having increased significantly between 1980 and 2008.
Supporters and opponents alike have expressed their views on this announcement. Those who disagree with the AMA’s decision to regard obesity as a disease say that this will cause more harm than good to those individuals who are fighting obesity themselves. Hank Cardello’s article in Forbes stated that this would happen, in part, by taking away a sense of personal responsibility from those who are obese. In addition, he said, the food industry’s recent progress in labeling foods and promoting healthier choices may suffer as they defend themselves in legal battles linking their foods to obesity. Their attempts at helping people with healthier choices may be interrupted or discouraged.
Supporters of the AMA’s decision include Lee Kaplan, MD, director of the Obesity, Metabolism and Nutrition Institute at Massachusetts General Hospital and professor at Harvard Medical School. In his Forbes article, Dr. Kaplan described obesity as a complex health situation whose subtypes and causes vary, as do effective treatments for each individual. The decision to identify obesity as a disease, according to Kaplan, will help those who need it to access various health interventions that they need to make healthful changes. Dr. Kaplan discussed obesity as a condition that can be chronic, progressive, and cause subsequent health problems and disease.
According to the Centers for Disease Control and Prevention, the risk for heart disease, diabetes, stroke, sleep apnea, some cancers, as well as other conditions, increase as weight increases. Regardless of the way in which obesity is categorized, prevention and treatment are critical in improving public health and preventing subsequent and related disease.
Recent research confirms a strong connection between emotional reactions and heart health. Specifically, a study by Mostofsky et al., in the February 2013 edition of the American Journal of Cardiology, identified a link between anger outbursts and heart attack.
The study included interviews over seven years of more than 3,800 patients after hospitalization for acute myocardial infarction (AMI). The researchers asked patients about anger outbursts in the two hours prior to the heart attack, as well as number of outbursts during the previous year. They also asked patients about the intensity of each outburst, having patients rate their intensity on a scale ranging from moderate anger to rage. Of all of the participants, 38% reported anger outbursts in the previous year. In addition to the outbursts themselves, the level or intensity of the anger contributed to the likelihood of a heart attack. The study found that those who experienced moderate anger increased their risk of heart attack by one and one half times within two hours of the outburst, as compared those who were not angry. Those with anger that fell in the middle of the scale were twice as likely to have a heart attack, and those who experienced a rage-type state were over four times more likely.
The researchers also identified differences in those patients taking beta-blockers to reduce blood pressure. Those who regularly used beta-blockers were less susceptible to heart attacks as the result of an anger outburst. This study provides a strong link between emotional experience and heart health, suggesting that those who are at risk for heart attack pay particular attention to managing strong, negative emotional states and avoiding intense anger episodes.
Managing childhood food allergies has long been a challenge for parents and physicians alike. A 2011 study by Gupta et al., published in the journal Pediatrics, found that 8% of children under the age of 18 have a food allergy, with peanut being the most prevalent allergen. Over one third of these children have severe and potentially life-threatening reactions. Peanut and tree nut allergies account for the majority of life-threatening reactions, and the prevalence of peanut allergy appears to be increasing, according to the American Academy of Allergy, Asthma, and Immunology (AAAAI). Some aspects of the allergic reaction may be determined by the region in which one resides. Research published in the November 2010 issue of the Journal of Allergy and Clinical Immunology (JACI) by Vereda and colleagues, demonstrated that peanut allergies have a different molecular basis in different geographic regions of the world. This may be due, in part, to varying pollen exposure, as well as the child’s age when peanuts are introduced into the diet.
In 2000, the American Academy of Pediatrics guidelines suggested that children should be introduced to more highly allergenic foods at older ages (such as milk after age 1, peanuts and fish after age 3), in order to prevent the development of food allergies. New recommendations by the AAAAI, however, include earlier exposure as a way to decrease the likelihood of food allergies. The organization suggests a slow introduction of these foods earlier in life, beginning soon after initial foods such as grains, fruits and vegetables, have been introduced and tolerated.
When children do become allergic, current interventions are focusing on decreasing the allergic response and altering the immune system itself. A study by Varshney et al. in the March 2011 issue of JACI was the first randomized, placebo-controlled study looking at oral immunotherapy (OIT), also known as desensitization, in the reduction of allergic response to peanuts. OIT also changes the immune system’s response to the peanut. They found that, after one year, all of the subjects using OIT were able to ingest significantly more peanut protein than those receiving the placebo. Desensitization to peanuts was also accompanied by peanut-specific immunologic changes. This new research is encouraging for parents and physicians of children with severe food allergies. While earlier introduction of potential allergens is now recommended in order to decrease the likelihood that children will develop allergies, there are also new treatments on the horizon for those who develop allergic responses to foods.
A recent New York Times article, by Bob Sullivan and Hugh Thompson, addressed the issue of multitasking. Specifically, the article discussed whether the act of multitasking has an effect on our cognitive functioning. Instead of managing multiple tasks at once, we are actually switching quickly from one context to the other, or performing “rapid toggling between tasks.” It seems that interruptions are the culprit when it comes to the quality of work that is produced when one is “multitasking,” but what actually happens to our work quality when we are engaged in multiple activities? In order to answer such questions, The New York Times asked Alessandro Acquisti, a professor of information technology, and Eyal Peer, a psychologist at Carnegie Mellon, to design an experiment. They looked at how individual cognitive functioning is effected by interruptions.
The researchers examined three groups, all of whom performed a standard cognitive skills test. Two of the groups were informed that they might be interrupted and given further instructions, while the third group completed the task with no anticipated interruptions. The two “interruption” groups were each interrupted twice; the third group was not. On a second test, the same group again went uninterrupted. Of the other two groups, one group was again interrupted; the second group was not, but was rather told to anticipate interruptions during the test. The researchers found that distraction, or even the anticipation of a distraction, led to poorer performance. The two interrupted groups provided incorrect answers at a rate 20% greater than the uninterrupted group.
The test was given to each group again. Part of the group was told they would be interrupted, but they were not. Those who were interrupted, however, did better, answering incorrectly at an improved rate of 14% of the time. Those who were warned of an interruption, but were not in fact interrupted, improved by 43%. What does this enormous change mean? Dr. Peer suggested that this group was able to prepare and learn from experience, as their brains adapted to the potential of interruptions. The authors concluded that the results suggest that “it is possible to train yourself for distractions, even if you don’t know when they’ll hit.”
Full article here
A recently published study provided new and encouraging information about the health benefits gained by those who actively employ the “relaxation response.” The relaxation response is a physiological state of rest and calm that directly opposes the state of stress and “fight or flight,” and is often elicited through techniques such as yoga and meditation. The study by Manoj Bhasin and Herbert Benson, of the Benson-Henry Institute for Mind-Body Medicine at Massachusetts General Hospital and Beth Israel Deaconess Medical Center, and their colleagues, identified benefits to certain, specific aspects of health that had not been previously known.
The study examined a novice group of individuals who were taught to induce the relaxation response during an 8-week training session, through the use of particular techniques including yoga and meditation. Blood samples were taken prior to the training course, immediately before and after participants listened to a 20-minute CD program on health education. After completing the course, participants came into the laboratory and practiced the relaxation response. Just before and after these sessions, blood samples for gene expression were taken from each subject. Fractional exhaled nitric oxide samples were also collected. This group was compared to another who had been practicing such techniques prior to entering the study.
The researchers found that practicing the relaxation response led to changes in the gene expression associated with insulin secretion, inflammatory response, energy metabolism, and mitochondrial function. A systems biology analysis revealed an upregulation of pathways involved in energy metabolism, and a suppression of pathways involved inflammation, stress, and cancer in those who practiced the relaxation response. Importantly, there was an immediate change in gene expression upon use of the relaxation response, which may provide insight into its short and long term health effects. While both groups displayed these changes, the long term practitioners showed stronger effects.
Read more about this study here