New Study Sheds Light on a Neurochemical Vulnerability that Could Contribute to Psychopathic Behaviors

Normal individuals who scored high on a measure of impulsive/antisocial traits display a hypersensitive brain reward system, according to a brain imaging study by researchers at Vanderbilt University. The findings provide the first evidence of differences in the brain’s reward system that may underlie vulnerability to what’s typically referred to as psychopathy.

The study in the current issue of the journal Nature Neuroscience was funded by the National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health.

Psychopathy is a personality disorder characterized by a combination of superficial charm, manipulative and antisocial behavior, sensation-seeking and impulsivity, blunted empathy and punishment sensitivity, and shallow emotional experiences. Psychopathy is a particularly robust predictor of criminal behavior and recidivism.

Since psychopathic individuals are at increased risk for developing substance use problems, the Vanderbilt team decided to investigate possible links between the brain’s reward system (activated by abused substances and natural reward), and a behavioral trait (impulsive/antisociality) characteristic of psychopathy. Researchers used two different technologies to measure the brain’s reward response.

In the first experiment, positron emission tomography (PET) was used to image the brain’s dopamine response in subjects who received a low oral dose of amphetamine. Dopamine is a brain chemical associated with reward and motivation.

In the second experiment, the same subjects participated in a game, in which they could make (or lose) money while their brains were being scanned using functional magnetic resonance imaging (fMRI).

The results in both cases show that individuals who scored high on a personality assessment that teases out traits like egocentricity, manipulating others, and risk taking had a hypersensitive dopamine response system. The picture that emerges from these high resolution PET and fMRI scans suggests that alterations in the function of the brain’s reward system may contribute to a latent psychopathic trait.

The researchers speculate that a heightened response to an anticipated reward could make such individuals less fearful about the consequences of their behavior, which, combined with a reduced sensitivity to others’ emotions and resistance to learning from mistakes, could lead to the manipulative and aggressive style of behaviors that is common in psychopaths.

The traits analyzed in this study have been previously shown to predict antisocial behavior and substance abuse in both incarcerated and community samples.

“By linking traits that suggest impulsivity and the potential for antisocial behavior to an overreactive dopamine system, this study helps explain why aggression may be as rewarding for some people as drugs are for others,” said NIDA Director Dr. Nora Volkow. “However, while having an antisocial trait may be a driving factor, it is clearly not sufficient to trigger aggressive behaviors; thus, we need to continue to investigate the other contributors to psychopathy.”

While the Vanderbilt researchers believe they’ve made an important first step showing that characterizations of psychopathic behavior are closely related to changes in brain activity, they hope to validate their findings with new studies on individuals who have been actually diagnosed as psychopaths.

“The amount of dopamine released was up to four times higher in people with high levels of these traits, compared to those who scored lower on the personality profile,” says Joshua Buckholtz, doctoral candidate in neuroscience and the lead author of the study.

“Because of these exaggerated dopamine responses, individuals with a latent psychopathic trait may become focused on a chance to get a reward, and less able to shift their attention until they get what they’re after. This pattern, along with other traits, could develop into psychopathic personality disorder.”

Researchers have long puzzled over why flu becomes so much more active in winter. A new study reveals that dry air is one likely culprit.

Scientists have proposed different explanations for why influenza makes more people sick in temperate regions during winter. One idea is that people simply spend more time indoors together because it’s colder, giving the virus more opportunity to spread.

Another idea is that environmental factors affect the survival and transmission of the virus. For example, laboratory studies have found that higher temperatures affect the flu virus’s coat. That could potentially explain why flu doesn’t spread during summer, but temperatures indoors, where most Americans spend the bulk of their time, are often tightly controlled.

Relative humidity is another suspect, but the data haven’t established a strong link between relative humidity and flu outbreaks. Relative humidity, which is what you hear in weather reports, isn’t the actual amount of water vapor in the air. Rather, given the current temperature, it tells you how close the air is to the point at which a cloud would start to form.

Dr. Jeffrey Shaman of Oregon State University wondered if absolute humidity—a measure of how much water vapor is in the air—could account for flu outbreaks. Last year, he reexamined laboratory data and found that absolute humidity could account for the airborne survival and transmission of the virus.

In the new study, Shaman and collaborators at several institutions, including NIH’s Fogarty International Center (FIC), compared death rates attributed to influenza over 31 years to absolute humidity readings nationwide. The researchers used a mathematical model of the influenza transmission cycle that incorporated Shaman’s previous findings of how absolute humidity affects the survival and transmission of the virus. The study was funded by NIH’s National Institute of General Medical Sciences (NIGMS), the Bill and Melinda Gates Foundation and others.

In PLoS Biology on February 23, 2010, the researchers reported that there were often significant drops in absolute humidity in the weeks prior to a flu outbreak. “This dry period is not a requirement for triggering an influenza outbreak, but it was present in 55-60% of the outbreaks we analyzed, so it appears to increase the likelihood of an outbreak,” Shaman says. “The virus response is almost immediate; transmission and survival rates increase and about 10 days later, the observed influenza mortality rates follow.”

This discovery might be used in the future to help predict when outbreaks will occur. It also has implications for treating influenza outbreaks. For example, hospitals may pay more attention to controlling humidity levels.

“Obviously there are tradeoffs because influenza is not the only pathogen out there,” Shaman says. “There are pathogenic molds that flourish in higher humidity. But if the immediate concern is an outbreak of influenza, it may be worthwhile to raise humidity levels.”

Lawrence Yun, NAR chief economist, said commercial real estate almost always lags the economy. “Because of the lingering impact from the deep recession over the past two years, vacancy rates will trend higher and many commercial property owners will need to make rent concessions,” he said.

“With the job market expected to turn for the better later this year, we’ll see rising demand for office and warehouse space, but that isn’t likely before 2011,” Yun said. “At the same time, improved consumer confidence would help sustain the retail sector and encourage more people to enter the rental market.”

Yun notes that commercial vacancy rates remain high in most market areas and are depressing rents.

The Society of Industrial and Office Realtors®, in its SIOR Commercial Real Estate Index, an attitudinal survey of more than 700 local market experts,¹ suggests a flattening level of business activity in upcoming quarters with 55 percent of members expecting the market to improve in the second quarter.

The SIOR index rose 0.2 percentage point to 35.5 in the fourth quarter, compared with a level of 100 that represents a balanced marketplace. This is the first gain following 11 consecutive quarterly declines. Although some indicators show that a decline in commercial property values is beginning to flatten, 86 percent of respondents report prices are below replacement costs.

Nearly nine in 10 survey participants said new commercial development is virtually nonexistent in their market areas, and rent concessions are reported almost everywhere.

An independent survey earlier this month showed a couple dozen banks are willing to expand commercial credit this year, which is critical. The lending expansion is aided by the Federal Reserve’s Term Asset-Backed Loan Facility, which is encouraging issuance of commercial mortgage-backed bonds. In addition, regulators are prodding lenders to extend terms for many existing commercial loans.

“We have a long way to go for satisfactory levels of commercial credit, but these are important first steps,” Yun said. “Given that about $1.4 trillion in commercial debt will come due over the next three years, more extensive action is needed and the Fed needs to more actively help resuscitate commercial mortgage-backed securities. The credit improvement will mean more commercial property sales in 2010, even some at deeply discounted prices.”

Looking at the overall market, commercial vacancy rates generally will stay at elevated levels, according to NAR’s latest COMMERCIAL REAL ESTATE OUTLOOK.² The NAR forecast for four major commercial sectors analyzes quarterly data in the office, industrial, retail and multifamily markets. Historic data were provided by CBRE Econometric Advisors.

Office Market

With a lot of sublease space currently on the market, vacancy rates in the office sector are forecast to rise from 16.3 percent in the fourth quarter of 2009 to 17.6 percent in the fourth quarter of this year; the longer term outlook is for vacancies to average 17.4 percent in 2011.

Annual office rent is projected to decline 7.2 percent in 2010, following a drop of 12.7 percent last year. In 57 markets tracked, net absorption of office space, which includes the leasing of new space coming on the market as well as space in existing properties, should be a negative 27.3 million square feet in 2010.

Industrial Market

There is proportionately less industrial sublease space on the market than in the office sector, but obsolescence remains a factor. Industrial vacancy rates will probably rise from 13.9 percent in the fourth quarter of last year to 14.9 percent in the closing quarter of 2010; they could average 14.5 percent next year.

Annual industrial rent is likely to fall 9.6 percent this year, after declining 10.9 percent in 2009. Net absorption of industrial space in 58 markets tracked is seen at a negative 93.5 million square feet in 2010.

Retail Market

Retail vacancy rates are expected to edge up from 12.4 percent in the fourth quarter of 2009 to 12.7 percent in the same period of this year, and may hold at that level in 2011.

Average retail rent is forecast to decline 2.4 percent in 2010, following a drop of 4.0 percent in 2009. Net absorption of retail space in 53 tracked markets should be a negative 3.4 million square feet this year.

Multifamily Market

The apartment rental market – multifamily housing – is poised to gain from a rise in household formation. Multifamily vacancy rates are likely to decline from 7.4 percent in the fourth quarter of last year to 6.6 percent in the fourth quarter of 2010, and possibly edge down to 6.1 percent next year.

Average rent is projected to decline 3.4 percent this year, following a decline 3.6 percent in 2009. Multifamily net absorption is expected to be 115,000 units in 59 tracked metro areas this year.

The COMMERCIAL REAL ESTATE OUTLOOK is published by the NAR Research Division for the commercial community. NAR’s Commercial Division, formed in 1990, provides targeted products and services to meet the needs of the commercial market and constituency within NAR.

The NAR commercial components include commercial members; commercial committees, subcommittees and forums; commercial real estate boards and structures; and the NAR commercial affiliate organizations – CCIM Institute, Institute of Real Estate Management, Realtors® Land Institute, Society of Industrial and Office Realtors®, and Counselors of Real Estate.

More than 81,000 NAR and institute affiliate members offer commercial brokerage services.
The National Association of Realtors®, “The Voice for Real Estate,” is America’s largest trade association, representing 1.2 million members involved in all aspects of the residential and commercial real estate industries.

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Streety reports he is feeling healthy, both emotionally and physically. His left arm, injured by a .45-caliber round, has healed well.  He is continuing with the physical therapy on his right hand so he can return to work and help other officers train and prepare for similar types of attacks.

The case against the defendant, Christopher Eddy, is progressing. Tammy Temple, who was in the car during the shooting, was in court today. She pleaded guilty to being an accessory after the fact to premeditated, attempted first-degree murder on a law enforcement officer and was sentenced to two years in prison and three years probation.

On July 15, 2009, Streety was checking a subject in a wooded area when the man shot him six times. With Streety seriously wounded and on the ground, the subject escaped, triggering a manhunt that lasted two days.

Throughout this difficult situation, Streety has persevered. His message to his fellow officers is to always be thinking and planning for the “what-if” scenarios.

“Wear your vest,” Streety said. “Sweat washes off; bullets don’t.”

To read more about the night of Officer Streety’s ordeal, go to the Police One Web site at www.policeone.com/pc_print.asp?vid=2000595.

Streety was recently nominated for America’s Most Wanted’s 2010 “All-Star” award.  To view the nominees or vote, go to www.amw.com/allstar/2010/.

The brains of infants who die of sudden infant death syndrome (SIDS) produce low levels of serotonin, a brain chemical that conveys messages between cells and plays a vital role in regulating breathing, heart rate, and sleep, reported researchers funded by the National Institutes of Health.

SIDS is the death of an infant before his or her first birthday that cannot be explained after a complete autopsy, an investigation of the scene and circumstances of the death, and a review of the medical history of the infant and of his or her family. According to the National Center for Health Statistics, SIDS is the third leading cause of infant death (http://www.cdc.gov/NCHS/data/nvsr/nvsr57/nvsr57_14.pdf), claiming more than 2,300 lives in 2006.

The researchers theorize that this newly discovered serotonin abnormality may reduce infants’ capacity to respond to breathing challenges, such as low oxygen levels or high levels of carbon dioxide. These high levels may result from re-breathing exhaled carbon dioxide that accumulates in bedding while sleeping face down. The findings appear in the Feb. 3 issue of The Journal of the American Medical Association.

“We have known for many years that placing infants to sleep on their backs is the single most effective way to reduce the risk of SIDS,” said Alan E. Guttmacher, M.D., acting director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute that funded the research. “The current findings provide important clues to the biological basis of SIDS and may ultimately lead to ways to identify infants most at risk as well as additional strategies for reducing the risk of SIDS for all infants.”

NICHD’s Back to Sleep (http://nichd.nih.gov/sids/) campaign urges parents and caregivers to place infants to sleep on their backs. Following the campaign’s launch in 1994, the rate of SIDS dropped by more than 50 percent. Widespread adoption of back sleeping appears to have reduced the occurrence of SIDS, but has not eliminated it.

For this study, senior author Hannah C. Kinney, M.D., of Harvard Medical School and Children’s Hospital Boston, and her colleagues examined small samples of tissue from the medulla, a region at the base of the brain that regulates basic functions such as body temperature, breathing, blood pressure, and heart rate. The researchers analyzed brain tissue from infants who died from SIDS and controls who died of other causes. Included in the analysis were 35 infants who died of SIDS, 5 infants who died unexpectedly of other causes, and 5 infants who were hospitalized and died for reasons associated with a lack of oxygen.

The researchers found that serotonin levels were 26 percent lower in tissue from infants who died of SIDS than in tissue from the group of infants who had otherwise died unexpectedly. Measurements of tryptophan hydroxylase, an enzyme needed to make serotonin, also were 22 percent lower.

In earlier work comparing SIDS cases with other infant deaths (http://www.nichd.nih.gov/news/releases/sids_serotonin.cfm), Kinney and her coauthors showed that the brains of infants who died of SIDS had higher concentrations of cells that use serotonin in the medulla oblongata, a region of the brain stem. For the current study, the researchers set out to see if this meant the SIDS infants’ brains in fact had altered levels of the brain chemical.

This abnormality appears to fit into the triple-risk model of SIDS, which holds that SIDS occurs only when three elements come together: an infant with an underlying vulnerability, a critical period of development, and an external stressor. The researchers speculate in this case that the low serotonin level would cause the underlying vulnerability. The first year of life is the critical period of development for stabilizing vital functions such as breathing. The final element of the model, sleeping face down, might provide the external stressor.

“Our research suggests that sleep unmasks the brain defect,” Dr. Kinney said. “When the infant is breathing in the face-down position, he or she may not get enough oxygen. An infant with a normal brainstem would turn his or her head and wake up in response. But a baby with an intrinsic abnormality is unable to respond to the stressor.”

“It’s no one single factor but a culmination of abnormalities that result in the death,” Dr. Kinney said. In fact, in 88 percent of the SIDS cases they examined, the researchers found two or more risk factors, such as the infant’s sleep position, an illness, or exposure to cigarette smoke.

Kinney hopes these findings will one day lead to a test that measures infants’ serotonin levels in the blood or other tissues that reflect brain serotonin levels. Such a test might make it possible to identify those at the highest risk for SIDS so that additional steps could be taken to protect them. In the near term, the findings will provide the basis for the development of animal models with serotonin deficiencies, to mimic what occurs in SIDS in human beings.

Scam: Advertisers offer kits that enable home workers to make money posting links on the Internet.

Example:

If you live in Canada or the US and you have been wanting to work from home, you might be in luck. Google has now released a new ‘Work From Home Program’ that will allow Americans to work for the titan from the comfort of their own homes.

To thousands of North Americans this means that they will soon have a safe and bright future working for one of the fastest growing companies in the world.

In the middle of this recession this country and the world is going through, Google has been thriving and reporting profits consistently every quarter.

Completely innovating the Search Engine industry in the late 1990′s, Google has had a history of development and innovation, and another one is about to come.

Google has now opened it’s doors and will be hiring everyday people to work from the comfort of their own homes posting links. The way this works is Google will allow people to signup and receive a package which will contain all the step by step instructions to get setup from home.

This will allow Google to hire talent in places like Canada that would otherwise be unreachable and compensate them based on results on a long term basis.

What you need: A Computer, an Internet Connection and the desire to make a living working from home. No special skills are required other than knowing how to use a computer and navigate the internet.

Mary, a mother from Toronto, who worked with Google in the experimental parts of this program, is thriving, in the middle of an economic recession, working in the comfort of her own home with Google.

From her website: ‘I get paid about $25 USD for every link I post on Google and I get paid every week… I make around $5500 USD a month right now’

Google has now officially released their new ‘work from home’ system out to the public. There will be thousand of spots available that are expected to go very soon in the next few days.

The way this works is very simple, Google says.

First you will need to apply for their work from home kits. Google has release a limited amount of kits, all distributed through local websites in your area throughout US and Canada, which will cost $2 of shipping and handling to the public.

Google says this charge is made to cover shipping costs but also to separate the people that are serious about working with them through this program.

Once you have ordered your kit (if you are one of the lucky few to get availability in your area) then you will receive a package that will contain all the instructions you need to start working from home for the online titan.

This kit will show you all you need to know, Google says. You will be performing simple and straightforward tasks such as posting links. ‘Anybody with basic computer skills will be able to perform these tasks’ adding to that they say that ‘We understand the psychology of working from home and we want to give our employees tasks that are simple and easy, and reward them generously in order to keep them motivated.’

Is this worth quitting your job? If you’re lucky enough to receive a kit, you might not even have to.

‘We start off our work from home program only requiring 1-2 hours a day of work, earning a great income from the start. This way our work from home employees will see the benefit and start devoting more and more time each day and their salaries will increase accordingly’ Google reports.

Although they are going very fast since their release earlier today, thousands of positions are still available at the time of this writing.

To apply for a job working from home for Google here are the three steps:

Step 1: Get the Google Work From Home Kit, only pay the $2.95 for shipping. (The shipping cost allows Google to screen for serious people).

Step 2: Follow the directions on your package and set up a Google account. Then they will give you the website links to post. Start posting those links. Google tracks everything.

Step 3: Google will send out your checks weekly. Or you can start to have them wire directly into your checking account. (Your first checks will be about $750 to $1,500 a week. Then it goes up from there. Depends on how many links you posted online.)
Variations: In December 2009 we began encountering a Yahoo version of the scam, which was the same as the Google scam discussed below, just with Yahoo’s name inserted in place of Google’s.

Origins: Those searching for employment opportunities that will allow them to work from home are all too often the very people who can least afford to be defrauded. Although many folks daydream about earning livable incomes from the comfort of their dens rather than having to make the trek to their offices each day, they do not as a general rule of thumb search for such job openings with the same fervor as do the elderly, the physically challenged, or parents committed to remaining at home with their preschool children. Members of those groups hunt for work-at-home opportunities because laboring in more traditional job settings is impossible for them. Because genuine offers of work of this nature are few and far between, with the need to secure a steady income becoming more of a pressing issue with each passing non-employed day, those folks are at far greater risk of being victimized by such schemes; their desperation leads them to be gulled by pie-in-the-sky promises and mollified by the wild backstories that go with them, while the financially better off

are more likely to remain convinced something is very wrong with the offer of mucho bucks in exchange for only a few hours’ labor performed from home each week by persons possessed of no special training or skills.

In 2009 a proliferation of seeming newspaper articles touting “Google Job Opportunities,” “Google Money Master,” “Easy Google Profit,” “Google Cash Kit,” “Google Fortune Kit,” and the like began popping up on the Internet. Such come-ons are typically emblazoned with “As seen on” taglines followed by an impressive array of logos, including those of ABC, AOL, CNN, MSNBC, and USA Today. Often these come-ons include what appear to be tearsheets from legitimate-looking publications, such as the New York Tribune and Los Angeles Tribune.

As for the publications supposedly reporting these stories, while there was a New York Tribune long ago, in 1924 it merged with the New York Herald to form the New York Herald Tribune. (Even that newspaper is no longer around; it went out of business in 1967.) As for the ostensible Los Angeles Tribune, that paper is wholly fictional; it existed only in the television show Lou Grant.

Web pages purporting to be personal reports of riches reaped through these programs have also popped up, such as the now defunct BryansMoneyBlog.com. They too were the same sort of come-on.

While the promise of vast riches to be gained through working from home is held out to those seeking an answer to their financial problems, that promise is but the worm used to entice the fish into biting down on the hook. Those who sign up for such kits will not soon find themselves on Easy Street; instead, they will find their bank accounts tapped to the tune of approximately $80 a month.

While prospective job seekers are told they need to pay a $2 charge for kits that supposedly contain the step-by-step instructions on how to begin working from home (often explained as Google’s way of sifting the serious from non-serious candidates), a closer examination of the Terms and Conditions associated with the programs applicants are signing up for reveals they are instead authorizing monthly charges either to their bank accounts or credit cards, usually to the tune of about $80 a month. Those who attempt to cancel these charges find the task a difficult one, in that only rarely does anyone at the phone number supplied for that purpose actually come onto that line.

Those still not convinced they haven’t just found the answer to their prayers are invited to closely examine the various web page come-ons. Usually, buried at the bottom of the page in fine print is a statement to the effect that “Google is in no way associated with this website.”

Barbara “web slight of hand” Mikkelson

How to Avoid Falling Victim to ‘Work From Home’ Scams:

• Don’t pay a company to hire you, not even if such payment is presented as your buying necessary training materials, obtaining required certification, or registering with databases of available workers. Remember, if the process involves your sending your “employers” money, it’s probably a scam.
• If you have questions about the legitimacy of a job listing, contact your Better Business Bureau, your state or local consumer agency, or the Federal Trade Commission.
• Examine your credit card and bank account statements every month, keeping an eye peeled for unauthorized charges. Immediately challenge items you did not approve.

“A simple blood test could help predict if someone is developing rheumatoid arthritis years before symptoms appear,” according to The Daily Telegraph. The newspaper says the test could enable patients to be treated earlier, helping to prevent some of the most devastating effects of the disease.

The news is based on a small study that examined blood samples from 86 patients with rheumatoid arthritis, taken before their symptoms developed. Researchers compared these samples with the blood make-up of 256 people who did not have the disease. They measured the levels of 30 substances that are linked to the immune system.

The possibility of identifying people with rheumatoid arthritis before they develop symptoms would be welcome as it may aid treatment to slow the disease. However, these 30 individual tests are probably not sensitive enough to do this yet. Further research must look at specific combinations of these tests.

Where did the story come from?

This study was conducted by Dr Heidi Kokkonen and colleagues from the Umeå University Hospital, and Department of Public Health and Clinical Medicine in Sweden. The study was supported by grants from several organisations, including the Swedish Research Council, the Swedish Rheumatism Association, and the European Community. The study was published in the peer-reviewed journal, Arthritis and Rheumatism.

The Daily Telegraph is one of the few papers to cover this story today. It provided a balanced report of the main findings from the study, and relevant quotes from experts.

What kind of research was this?

In this exploratory study, the researchers tested blood samples to see if they could find indicators of the future development of rheumatoid arthritis (RA). These blood samples were taken from individuals before and after they developed symptoms of RA, and from control subjects without the condition.

The researchers analysed the blood samples for a range of chemical messengers: cytokines, cytokine-related factors and chemokines. These substances are secreted by the immune system, and act to carry signals locally between cells.

Although small, this case-control study provides some hope for people living with RA. However, it will need to be repeated in order to examine in more detail which precise bloods test were most useful and how accurate they are. There is also a need for further studies looking at how asymptomatic people likely to develop RA could be targeted for these types of tests.

What did the research involve?

The researchers designed a nested case-control study. In this type of study, researchers collect a sample of patients with and without a disease from a larger population-based cohort. In this case, they drew participants from the Biobank study, which had taken blood tests since 1985. The participants from the Biobank study were all taken from the adult population of the county of Västerbotten in northern Sweden, who have been continuously invited to participate in the study. There have been several publications from this Biobank study already.

For their case-control study, the researchers selected patients with RA who fulfilled the American College of Rheumatology Classification criteria for RA, and who also knew the onset date of their symptoms of joint disease (the cases). From these, they found 86 people (65 females and 21 males) who had donated blood samples before the onset of any symptoms of joint disease. They matched them with 256 people who had also donated blood but did not have the disease (the controls). On average, the cases in the sample had given blood about 3.3 years before any symptoms of the disease.

The researchers measured the levels of 30 cytokines, related factors and chemokines in the blood samples, using standard lab-based techniques. However, these testing techniques are not yet in clinical practice. They then used advanced modelling techniques (Random Forest modelling) to analyse the associations between all these substances and the presence of RA. This analysis adjusted for the influence of smoking, sex and some genotypes.

Finally, the researchers translated their results into sensitivities and specificities, two measures of the diagnostic accuracy of the test.

What were the basic results?

Compared with the controls, several of the substances tested were significantly raised in the cases before the onset of their RA. These raised substances were linked to signs of general immune activation, specific immune activation and regulatory pathways. The levels of these substances were especially raised in individuals who were positive for rheumatoid factor.

The single test with the highest sensitivity for predicting RA was for one measuring a substance called ‘eotaxin’. When used alone, the test had a sensitivity of 22.4% at a pre-set specificity of 95.3%. This means that only about one in four people who go on to develop RA will test positive with this test. Sensitivity improved when all 30 tests were used together.

How did the researchers interpret the results?

The researchers conclude that people who went on to develop RA had significantly increased levels of several cytokines, related factors and chemokines prior to their symptoms. They say that the types of substances elevated before disease development suggests that at this stage the immune system is ‘adaptive’ (i.e. still responding to the triggers of rheumatoid arthritis). After the disease has started, the involvement of the immune system is more general and widespread.

They say that their findings present an opportunity for “better prediction of the risk of developing RA and, therefore, possibly preventing the disease progress”.

Conclusion

This was a small exploratory study that will be of interest to researchers in the field. The authors acknowledge some limitations, such as the small sample size: only a few patients had given samples both before and after the onset on RA. This means that there was only a small body of data to examine for the associations.

The tests themselves were not very sensitive when used on their own, and provided a lot of false negative results (i.e. failing to detect the presence of the condition). It remains to be seen whether it will be better to test for all these substances (which seemed to increase sensitivity) or whether there is a combination of fewer tests that are highly sensitive and specific.

The researchers also speculate about the biological processes in people with RA prior to symptoms, suggesting what might cause some of the elevation in cytokines and other substances. But these theories will need to be tested in further studies.

It is too soon to say whether these sorts of tests can become standard practice, or for whom they will be most useful. However, a combination of tests seems more promising for predicting people who will develop RA. This type of study does provide some direction for future research.

Most migraine sufferers know that light can intensify headache pain. A new study of blind patients with migraine may help explain why. The finding ultimately may lead to new approaches for calming severe light-induced headaches.

More than 1 in 10 people nationwide experience recurring headaches known as migraines. They’re often described as a pulsing or throbbing in one side of the head. Other symptoms include nausea, vomiting and extreme sensitivity to sound. Exposure to light often triggers or intensifies the pain, but the underlying mechanism has been unclear.

To gain a better understanding of light’s role, Dr. Rami Burstein of Harvard Medical School and his colleagues evaluated 20 migraine sufferers who were also blind. Six participants were unable to detect any light, either because their optic nerves had been damaged or their eyes removed due to disease. The remaining 14 were unable to perceive images, but their eyes could detect some light, even if they were not aware of it. Their sleep-wake cycles were normal, whereas the other 6 had disrupted sleep patterns. The study was supported by NIH’s National Institute of Neurological Disorders and Stroke (NINDS) and by Research to Prevent Blindness.

As reported in the January 10, 2010, online edition of Nature Neuroscience, the researchers found that light exposure intensified migraine pain in the 14 people with some light detection but not in the remaining 6 who were totally blind. The researchers concluded that the optic nerve, which carries light signals to the brain, must be key to light-induced migraine. But because the 14 had faulty rods and cones—the main light-detecting and image-producing cells in the eye—the scientists suspected that some other type of light-detecting cell must contribute to light-sensitive pain.

The scientists turned to rats to gain a better sense of the brain pathways that might be involved. They focused on rare light-sensing cells in the eye called intrinsically photosensitive retinal ganglion cells (ipRGCs). These cells, discovered only a decade ago, are crucial for maintaining sleep-wake cycles and for pupil response to light, but play no role in image formation.

The researchers traced the path of ipRGC signals through rat optic nerves, where they later converged on brain cells that transmit pain. Exposure to light rapidly activated the ipRGCs and the pain-transmitting cells, which previously had been linked to migraine pain. When the light was removed, the brain cells remained activated for several minutes.

“This helps explain why patients say that their headache intensifies within seconds after exposure to light, and improves 20 to 30 minutes after being in the dark,” says Burstein.

The findings point to a non-imaging-forming pathway for light-induced migraines, although the scientists note that additional mechanisms may be involved. “Clinically, this research sets the stage for identifying ways to block the pathway so that migraine patients can endure light without pain,” Burstein says.

ST. PETERSBURG – Governor Charlie Crist today highlighted his 2010-11 proposed budget for Pre K-12 education, recommending record level funding of $22.7 billion to continue learning gains achieved by Florida’s students during recent years. This includes state, federal and local funding, as well as an increase of more than $535.5 million over the current fiscal year.  The Governor announced his budget plan at his alma mater Bay Vista Elementary School in St. Petersburg.

“I gained valuable skills and knowledge here at Bay Vista, and I am committed to ensuring that all of Florida’s K-12 students have the best learning environment possible,” Governor Crist said. “Florida’s young people deserve a solid educational foundation for their futures, and we cannot – and must not – let them down.”

Governor Crist pointed to Florida’s decade of educational progress continued this year with an 8th-place national ranking by the 2010 Quality Counts: Fresh Course, Swift Current report. Florida’s ranking is due to improved student performance in elementary, middle and high schools; incentives for top-performing teachers and Florida’s ability to attract and retain a strong teacher workforce; high academic standards and rigorous testing programs; and the percentage of state funds spent on public schools and equitable distribution of those funds to school districts.

The Quality Counts report card issued annually by Education Week tracks state education policies and performance and assigns each state an overall point total to signify their education standing in the nation. This year’s ranking improves the Sunshine State’s ranking of 10th last year and 14th in 2008, up from 31st in 2007.

In addition, Governor Crist highlighted increased student achievement indicated by the National Assessment of Educational Progress (NAEP), a national sample of students in fourth, eighth and 12th grades, allowing math and reading results to be compared among states.  Florida’s students exceed the national average in both fourth-grade math and reading.

To continue Florida’s decade of educational progress, Governor Crist made the following budget recommendations:

Per-Student Funding – Governor Crist’s K-12 education recommendations for Fiscal Year 2010-11 include a 2.61-percent increase in per-student funding over the current year. This increase provides a $179 increase per student, for an average of $7,045 per student for the 2.6 million K-12 students expected during the 2010-11 school year.  If adopted, this per-student amount would be the second highest funding level ever for Florida’s students.

Voluntary Prekindergarten Program – Voluntary Prekindergarten Program provides a good early-learning foundation that leads to future academic success. As a result, the Voluntary Prekindergarten program is growing in popularity and is projected to grow by 5.8 percent in 2010-11 to include 152,795 students. To meet this growing demand, Governor Crist recommended a $44.8-million increase, for a total of $411.9 million to provide high quality early learning to eligible four-year-olds.

Teacher Bonuses – Governor Crist continues his commitment to reward teachers who work diligently to improve their teaching skills and student learning. Governor Crist recommended the following teacher bonuses:

·        Dale Hickam Excellent Teaching Program – $57.1 million for awards to teachers who earn national certification through the National Board for Professional Teaching Standards. The bonus is a salary supplement for 10 years, equal to about $5,000 for Fiscal Year 2010-11.
·        School Recognition Program – A 33-percent increase for the School Recognition Program, which rewards schools that improve a letter grade or maintain a grade of “A” by providing $100 per student, up from $75 in the current year, and usually provides bonuses to teachers at the receiving schools.
·        Merit Award Program (MAP) – Participating school districts and charter schools give top teachers a bonus equaling five to ten percent of the district’s average teacher salary.
·        Bonuses for College-level Course Exams – Teachers of Advanced Placement, International Baccalaureate, and Advanced International Certificate of Education courses earn a $50 bonus (up to $2,000 total) for each student who achieves a qualifying score on exams that are benchmarked nationally and internationally.  Governor Crist recommended increasing through legislation the bonuses for teachers in these programs and removing the $2,000 cap on the amount teachers will earn.

·                                Class Size – In 2002, Florida voters approved a constitutional amendment to reduce class sizes by 2010 to 18 students in prekindergarten through third grades, 22 students in fourth through eighth grades, and 25 students in ninth through 12th grades. As a result, 97 percent of traditional public schools’ classroom averages now meet constitutional requirements. To achieve this goal, Florida has invested $15.8 billion in reducing class sizes at all grade levels since the 2002-03 school year.

While Governor Crist expressed his continued support for limiting class sizes, he recommended providing school districts the flexibility in implementing the class size requirements in order to avoid continued increasing operational and construction costs.  In this spirit, the Governor announced his plan for legislation modifying the constitutional class-size requirements by calculating class-size compliance at the school level. The average class size for schools will remain at current levels, with no individual class exceeding the limit by three or more students in grades K through 3, or five or more students in grades 4 through 12.

Seminole Compact

Governor Crist again called upon the Legislature to approve the revised compact with the Seminole Tribe of Florida to provide funding for education programs.  The Governor’s proposed budget includes $433 million, including monies already paid by the Seminoles and a projected amount expected to be collected through the end of Fiscal Year 2010-11.

Race to the Top

Governor Crist commended Education Commissioner Dr. Eric J. Smith and the visionary teachers, superintendents and school boards that have partnered with the Florida Department of Education to apply for federal Race to the Top funds.  Florida’s past education reform efforts could qualify Florida for more than $1.1 billion over four years to further increase student achievement, teacher effectiveness and the talent pool of Florida’s graduates and workforce.

Through the federal Race to the Top competition, the U.S. Department of Education has challenged all 50 states to propose bold education reforms focused on helping struggling schools, elevating the effectiveness of teaching professionals and education leaders, building internationally recognized education standards and assessments, and improving state education data systems. Phase I winners of the competition are expected to be announced in mid-April of 2010.

Victoza is intended to help lower blood sugar levels along with diet, exercise, and selected other diabetes medicines. It is not recommended as initial therapy in patients who have not achieved adequate diabetes control on diet and exercise alone.

Insulin is a hormone that helps prevent sugar (glucose) from building up in the blood. People with type 2 diabetes have difficulty making and using insulin. Victoza is in a class of medicines known as glucagon-like peptide-1 (GLP-1) receptor agonists that help the pancreas make more insulin after eating a meal.

“Diabetes is a leading cause of death and disability, with more than 1.5 million new cases diagnosed annually,” said Mary Parks, M.D., director, Division of Metabolism and Endocrinology Products in the FDA’s Center for Drug Evaluation and Research. “Controlling blood sugar levels is very important to preventing or reducing the long term complications of diabetes, and Victoza offers certain patients with type 2 diabetes a treatment option for controlling their blood glucose levels.”

In five clinical trials involving more than 3,900 people, pancreatitis (inflammation of the pancreas) occurred more often in patients who took Victoza than in patients taking other diabetes medicines. Victoza should be stopped if there is severe abdominal pain, with or without nausea and vomiting, and should not be restarted if pancreatitis is confirmed by blood tests. Victoza should be used with caution in people with a history of pancreatitis.

The most common side effects observed with Victoza were headache, nausea, and diarrhea. Other side effects included allergic-like reactions such as hives.

Victoza was not associated with an increased risk for cardiovascular events in people who were mainly at low risk for these events. FDA approved Victoza, however, with several post-marketing requirements under the Food and Drug Administration Amendments Act (FDAAA) to ensure that the company will conduct studies to provide additional information on the safety of this product.

In addition to a cardiovascular safety study to specifically evaluate the cardiovascular safety of Victoza in a higher risk population, the company also is required to conduct a 5-year epidemiological study using a health claims database to evaluate thyroid and other cancer risks as well as risks for seriously low blood glucose levels (hypoglycemia), pancreatitis, and allergic reactions. To specifically evaluate the risk of medullary thyroid cancer, the company is required to establish a cancer registry to monitor the rate of this type of cancer in the United States over the next 15 years.

In animal studies, Victoza caused tumors of the thyroid gland in rats and mice. Some of these tumors were cancers, which were significantly increased in rats who received excessive doses that were 8-times higher than what humans would receive.

It is not known if Victoza could cause thyroid tumors or a very rare type of thyroid cancer called medullary thyroid cancer in people. For this reason, Victoza should not be used as the first-line treatment for diabetes until additional studies are completed that support expanded use. Also, Victoza should not be used in people already at risk for medullary thyroid cancer, such as those who have medullary thyroid cancer in the family or those with a rare genetic condition known as Multiple Endocrine Neoplasia syndrome type 2.

To ensure the safe and effective use of this product, Victoza was approved with a Risk Evaluation and Mitigation Strategy consisting of a Medication Guide and a Communication Plan to help patients and providers understand the risks of Victoza and to ensure that the benefits of the drug outweigh the risk of acute pancreatitis and the potential risk of medullary thyroid cancer.

Victoza is manufactured by Novo Nordisk of Bagsvaerd, Denmark.