House passes Republican health bill with 39 Democratic votes

By Mark Felsenthal and Susan Cornwell

WASHINGTON (Reuters) - In the most significant legislative rebuke to President Barack Obama's healthcare overhaul, 39 members of his Democratic Party voted for a Republican bill in the House of Representatives on Friday aimed at undermining his signature domestic policy.

The measure, which would allow insurance companies to renew and sell inexpensive, limited-coverage policies that have been canceled because they don't meet the standards of the new healthcare law that took effect on October 1, passed 261-157.

The 39 Democrats who supported the bill - nearly one-fifth of the party's caucus - reflected the alarm that spread within Obama's party this week over the political damage from the botched rollout of the Affordable Care Act, also known as Obamacare.

Republicans have vowed to make Democratic support for the troubled law the top issue in the 2014 elections. Twenty-nine of the 39 Democrats who voted for the Republican bill are running for re-election in competitive races, according to rankings by the nonpartisan Cook Political Report.

Obama's approval ratings have plunged during the past six weeks, as the rollout of the healthcare program that is his top domestic achievement has been beset by technical glitches with the federal online insurance website designed to allow consumers to shop for policies.

In recent days, HealthCare.gov's problems have been overshadowed by reports that insurance companies were canceling the policies of millions of Americans whose policies did not meet the new law's requirements that policies cover emergency treatment, hospital stays and prescription drugs, among other things.

For years, Obama had promised that Americans would be able to keep their policies if they liked them.

But the wave of cancellations has fueled the biggest political crisis of Obama's presidency and led to an extraordinary scene at the White House on Thursday, as a contrite Obama took the blame for the healthcare program's dismal start.

He said he believed that he had to win back the confidence of the American people, and offered an administrative "fix" that would allow some people to retain their non-conforming insurance policies for at least a year.

Obama's plan dismayed some of his supporters who say that the cheap, limited-coverage plans that the new law aims to phase out often give consumers a false sense of having meaningful health coverage.

It also created concern in the insurance industry - which for years had planned the health insurance exchanges created by Obamacare - and among state insurance commissioners.

Industry advocates warned that Obama effectively was tinkering with the delicate and complex funding behind the healthcare law, and that premiums could begin soaring in 2015 if millions of consumers who were projected to be in Obamacare's health exchanges continued to hold limited-coverage policies instead.

Obama met with health insurance chief executives at the White House on Friday to discuss his proposal's potential impact on the insurance market.

"What we're going to be doing is brainstorming on how do we make sure that everybody understands what their options are," Obama told reporters in a brief photo opportunity as the meeting began. "We're going to be soliciting ideas from them."

'FRUSTRATED AND ANGERED'

Friday's bill, introduced by Republican Representative Fred Upton of Michigan, represented the latest in a series of legislative attacks on the healthcare law by the chamber, which has held more than 40 votes to limit or curtail Obamacare.

In touting his bill, Upton said that Obama "personally promised that if people liked their current health care plan, they could keep it ‘no matter what.' But cancellation notices are now arriving in millions of mailboxes across the country. It's cancellation today, sticker shock tomorrow."

It is unlikely to pass the Democrat-controlled Senate, and the White House has said Obama would veto the legislation if it reached his desk.

The House bill would allow people whose low-cost coverage was canceled to keep those policies, and also would allow insurers to continue selling policies that do not cover basic services and offer little financial help for catastrophic health events.

Critics said the House bill would undermine Obamacare's attempt to improve the healthcare system.

House Democratic opponents cast the vote as another Republican effort to sabotage the healthcare law.

Republicans "are perfectly satisfied with 40 million Americans having no health insurance at all," said Representative James McGovern, a Massachusetts Democrat. "If you want to go back to a system where the insurance companies can turn people away because they are sick, by all means vote for this bill."

But Representative Ron Barber, a Democrat from Arizona, summarized why he and 38 other Democrats voted for the Republican bill.

"I am frustrated and angered by the continuing problems with the healthcare website and I know Southern Arizonans are frustrated and angry, too," Barber said.

"Today I voted to give people the option to keep their current plan until these and other issues are resolved. That's only fair."

House Democrats were blocked in an effort to offer a scaled-down version of Upton's bill.

(Additional reporting by Roberta Rampton and Caren Bohan; Editing by Doina Chiacu, Ross Colvin and Grant McCool)

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Levels of hormones affecting the efficiency of cervical cancer medicine

New class of anticancer drugs may cause endometrial cancer that regulate growth hormone environment known as PARP inhibitors are sensitive substantially, UCLA's Jonsson Comprehensive Cancer Center researcher shows for the first time. Could lead to novel one-to-punch therapy to fight cancer of the endometrium survey offers particularly sophisticated is disease, limited effectiveness of conventional treatment for alternative options.

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New function of two molecules involved in metastasis

Nov. 14, 2013 — Researchers from IMIM (Hospital del Mar Medical Research Institute) lead by Dr. Sandra Peiro have described a new function for two key molecules involved in tumor progression. Transcription factor SNAIL1 and enzyme LOXL2 are essential to Epithelial-Mesenchymal Transition (EMT); meaning the process by which tumor cells are able to move and reach other tissues. The study has been published in the Molecular Cell Journal and places enzyme LOXL2 as a possible therapeutic target to treat cancers such as breast, lung or skin cancer.

Transcription factors are proteins that regulate gene expression. They activate or deactivate a gene's function. Researchers at IMIM have studied the function of one of these transcription factors, Snail1, in mouse cells during the Epithelial-Mesenchymal Transition (EMT). Sandra Peiro, a researcher from the IMIM Research Group on Epithelial-Mesenchymal Transition and Tumor Progression explains: "EMT is a process consisting of converting epithelial cells, the ones covering the internal and external surfaces of the body, into what are known as mesenchymal cells. In this process, the cells acquire a series of new characteristics that enable them to migrate and resist apoptosis (programmed cell death), self-regenerate and, finally, invade neighboring tissues and reach other areas of the body. When this process occurs at the tumor epithelial cells, the resulting mesenchymal cells can migrate and generate metastases."

The study shows that during the transformation into mesenchymal cells, DNA, folded in to chromatin cell, must then become reorganized to adapt to the now cell functions. Transcription factors Snail1, through LOXL2 is in charge of this transformation. Therefore, any mechanism that is able to block it would prevent Epithelial-Mesenchymal Transition and thus a metastasis. "Our research is basic, and therefore, our findings cannot be applied immediately, but the fact that LOXL2 is a key element in the process and an enzyme makes it a firm candidate to be a therapeutic target, since its activity can easily be inhibited or blocked with the right drugs," says Sandra Peiro.

Previous studies by this group had described, for the first time, that LOXL2 was present at the cell nucleus and played a key role in tumor development. These new outcomes show that the functions of the genome are found to go far beyond the simple DNA sequence and that, therefore, it is necessary to integrate all levels of regulation to understand genome regulation. Right now, the challenge for the researchers is to study how the genome is organized spatially during a vital process in the development of cancer as EMT.

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Early stages breast cancer could soon be diagnosed from blood samples

Nov. 14, 2013 — What could someday be the first blood test for the early detection of breast cancer was shown in preliminary studies to successfully identify the presence of breast cancer cells from serum biomarkers, say the Houston Methodist Research Institute scientists who are developing the technology.

With a New York University Cancer Institute colleague, the researchers report in an upcoming Clinical Chemistry (now online) that the mixture of free-floating blood proteins created by the enzyme carboxypeptidase N accurately predicted the presence of early-stage breast cancer tissue in mice and in a small population of human patients.

"In this paper we link the catalytic activity of carboxypeptidase N to tumor progression in clinical samples from breast cancer patients and a breast cancer animal model," said biomedical engineer Tony Hu, Ph.D., who led the project. "Our results indicate that circulating peptides generated by CPN can serve as clear signatures of early disease onset and progression."

The technology is not yet available to the public, and may not be for years. More extensive clinical tests are needed, and those tests are expected to begin in early 2014.

There are currently no inexpensive laboratory tests for the early detection of breast cancer, providing the impetus for researchers around the world to invent them.

"What we are trying to create is a non-invasive test that profiles what's going on at a tissue site without having to do a biopsy or costly imaging," Hu said. "We think this could be better for patients and -- if we are successful -- a lot cheaper than the technology that exists. While there's more to the cost of administering a test than materials alone, right now those materials only cost about $10 per test."

CPN is an enzyme that modifies proteins after the proteins are first created. Past studies have only shown the enzyme is more active in lung cancer patients. The present report in Clinical Chemistry is the first to show CPN isn't merely more active in breast cancer patients, but there's more of it.

The technology being developed by Hu's group combines nanotechnology and advanced mass spectrometry to separate and detect extremely low levels of small proteins (peptides) created by CPN. These peptides are believed to originate in or near cancerous cells, eventually making their way into the bloodstream.

In animal models and human biopsies, Hu's group first determined the presence of breast cancer tissue, characterized each sample's stage of development, and looked at how much CPN was being expressed. Blood samples were also taken from each individual.

Blood serum proteins were separated on a nanoporous silica chip dotted with four nanometer holes, which captured and isolated smaller proteins for spectrographic analysis. Using MALDI-TOF mass spectrometry, the researchers analyzed what remained for the light signatures of six peptides known to be created by CPN.

The researchers compared the stages of breast cancer tissue development in previously diagnosed patients to the presence of CPN-created peptides in their blood. They found all six peptides were at detectably higher levels, as early as breast cancer's first pathologic stage. (That stage is defined as having cancerous cells and a tumor of 2 cm or smaller, or no tumor at all.) The researchers also found that CPN peptides were at detectably higher levels in the blood of mice, compared to controls, just two weeks after the introduction of breast cancer tissue.

Interestingly, CPN activity dropped significantly over time in mice over the eight week study period, suggesting the blood test as currently configured may not work as well in detecting later stages of breast cancer. Hu said he plans to investigate the phenomenon.

"Even at the eighth week, CPN activity was still significantly higher than baseline," Hu said. "However, we suspect the activity of different enzymes goes up and down as the disease progresses. We will be looking at how we might add known and future biomarkers to the blood test to increase its robustness and accuracy."

Current means for the early detection of breast cancer are expensive and are not generally recommend for prevention by the American Cancer Society. Rather, the society recommends healthy women age 40 and older have a mammogram every year and work with their doctors to assess their individual risks of developing the disease. Prior to age 40, the society recommends women have a clinical breast exam whenever they visit their doctors, or else every three years.

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Multicenter study underscores need for uniform approach to bladder cancer

Nov. 15, 2013 — New study, involving eight Italian research centres, concluded that an aligned approach to the treatment of advanced bladder cancer is much needed, while confirming previously published results on survival estimates of associated salvage therapies.

According to the lead author, Dr. Francesco Atzori, progress in developing new effective drugs in bladder cancer has been stagnant in the last decades.

"In patients who recur or who are refractory to first-line therapy, response rates and outcomes are grim, and to date, no second-line therapy has been clearly established," he explained.

The authors state that while upfront chemotherapy (CT) confers over 50% response rate, progression free survival and overall survival rates are still dismal. While vinflunine is approved by the EMA for progressive bladder cancer after platinum-based therapy, the US FDA has no approved agents.

In the course of the study, the researchers retrospectively queried all patients receiving 2nd and 3rd line regimens in Italy in the period between 2001 and 2013. The inclusion criteria included failure of one or two prior CT regimens for metastatic disease and no exclusion of specific salvage regiments, including targeted agents. Distribution of treatments and outcome parameters were the primary endpoints.

The authors identified a total of 160 eligible pts across 8 centers nationwide. Median age was 67 years (IQR 39-82), most frequent sites of disease at relapse were: nodes 71% (nodes only 43, 26.9%); lung 30%, bone 26% and liver 20%. Bellmunt Score available in 147 out of 160 patients was 0, 1, 2 and 3 in 63 (43%), 59 (40%), 20 (14%) and 5 (3%) patients respectively.

Regiments used as upfront CT were cisplatin-gemcitabine in 65 patients (41%), carboplatin-G in 50 patients (31%), MVAC in 25 patients (16%), other combination CT in 5 patients (3%) and single-agent CT in 15 patients (9%).

In 2nd line 42 patients (26%) received paclitaxel, 40 (25%) vinflunine, 21 (13%) pazopanib, 10 (6%) MVAC, 47 (29%) other drugs alone or combined.

75 out of 160 patients (47%) received a 3rd line regimen: 19 (25%) paclitaxel, 15 (20%) pazopanib, 11 (15%) MVAC, 30 patients (40%) miscellaneous. Median time-to-relapse to 1st line was 2 months. Overall response rate in 2nd line was 21% (32 out of 160 patients) and 21% in 3rd line (16 out of 75 patients); median progression-free survival was 2,8 and 2 months in 2nd and 3rd line respectively, median overall survival was 16 months and 20 months, in 2nd and 3rd lines respectively. Patients treated with paclitaxel and vinflunine in 2nd line showed a median progression free survival of 2.7 and 3.3 months while overall survival was 13.5 and 13.4 months respectively.

The results of this study will be presented at the European Multidisciplinary Meeting on Urological Cancers, in Marceille, France, on 15-17 November 2013.

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Biologists ID new cancer weakness

Nov. 14, 2013 — About half of all cancer patients have a mutation in a gene called p53, which allows tumors to survive and continue growing even after chemotherapy severely damages their DNA.

A new study from MIT biologists has found that tumor cells with mutated p53 can be made much more vulnerable to chemotherapy by blocking another gene called MK2. In a study of mice, tumors lacking both p53 and MK2 shrank dramatically when treated with the drug cisplatin, while tumors with functional MK2 kept growing after treatment.

The findings suggest that giving cancer patients a combination of a DNA-damaging drug and an MK2 inhibitor could be very effective, says Michael Yaffe, the David H. Koch Professor in Science and senior author of a paper describing the research in the Nov. 14 issue of the journal Cell Reports.

Several drugs that inhibit MK2 are now in clinical trials to treat inflammatory diseases such as arthritis and colitis, but the drugs have never been tested as possible cancer treatments.

"What our study really says is that these drugs could have an entirely new second life, in combination with chemotherapy," says Yaffe, who is a member of MIT's Koch Institute for Integrative Cancer Research. "We're very much hoping it will go into clinical trials" for cancer.

Sandra Morandell, a postdoc at the Koch Institute, is the paper's lead author.

To kill a tumor

P53 is a tumor-suppressor protein that controls cell division. Before cell division begins, p53 checks the cell's DNA and initiates repair, if necessary. If DNA damage is too extensive, p53 forces the cell to undergo programmed cell death, or apoptosis. Tumors that lack p53 can avoid this fate.

"Usually p53 is the main driver of cell death, and if cells lose this pathway they become very resistant to different treatments that cause cell death," Morandell says.

Several years ago, researchers in Yaffe's lab discovered that in cancer cells with mutated p53, the MK2 gene helps counteract the effects of chemotherapy. When cancer cells suffer DNA damage, MK2 puts the brakes on the cell division cycle, giving cells time to repair the damage before dividing.

"Our data suggested if you block the MK2 pathway, tumor cells wouldn't recognize that they had DNA damage and they would keep trying to divide despite having DNA damage, and they would end up committing suicide," Yaffe says.

In the new study, the researchers wanted to see if this would hold true in tumors in living animals, as well as cells grown in a lab dish. To do that, they used a strain of mice that are genetically programmed to develop non-small-cell lung tumors. The researchers further engineered the mice so they could reversibly turn the MK2 gene on or off, allowing them to study tumors with and without MK2 in the same animal.

This new approach allows them, for the first time, to compare different types of tumors in the same mice, where all genetic factors are identical except for MK2 expression.

Using these mice, the researchers found that before treatment, tumors lacking both MK2 and p53 grow faster than tumors that have MK2. This suggests that treating tumors with an MK2 inhibitor alone would actually do more harm than good, possibly increasing the tumor's growth rate by taking the brake off the cell cycle.

However, when these tumors are treated with cisplatin, the tumors lacking MK2 shrink dramatically, while those with MK2 continue growing.

'A nonobvious combination'

The potential combination of cisplatin and MK2 inhibitors is unlike other chemotherapy combinations that have been approved by the Food and Drug Administration, which consist of pairs of drugs that each show benefit on their own. "What we found is a combination that you would never have arrived at otherwise," Yaffe says. "It's a nonobvious combination."

While this study focused on non-small-cell lung tumors, the researchers have gotten similar results in cancer cells grown in the lab from bone, cervical, and ovarian tumors. They are now studying mouse models of colon and ovarian cancer.

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China says not looking at broad one-child policy relaxation

BEIJING (Reuters) - China is not considering a broad relaxation of its strict one-child policy despite an easing of existing rules since it would be too disruptive, the health ministry said on Saturday.

The government announced on Friday that it would allow millions of families to have two children in the country's most significant liberalization of its strict one-child policy in about three decades. China, the world's most populous nation, has nearly 1.4 billion people.

Couples in which one parent is an only child will now be able to have a second child, one of the highlights of a sweeping package of reforms announced after the ruling Communist Party held a key meeting that mapped out policy for the next decade.

The plan to ease the policy was envisioned by the government about five years ago as officials worried that the strict controls were undermining economic growth and contributing to a rapidly ageing population the country had no hope of supporting financially.

In a statement carried on the ministry's website, deputy director Wang Peian said if everyone were suddenly allowed to have two children it would cause too many problems.

"Adjusting and perfecting family planning policy is not the same as abandoning it," he said.

"There has been no fundamental change to the fact that we are a very populous country, and the pressures on the economy, society, resources and the environment will be around for a long time," Wang added.

"The basic policy of family planning will need to be upheld over the long term and we cannot rest up on this."

Wang did not give a timeframe for when the new relaxed policy would begin, only that it would not take long and it would be up to each province to decide.

In areas where people were more likely to be able to take advantage of the relaxation, the government would encourage couples not to quickly have a second child, he said, to "prevent a rush of births".

A growing number of scholars has long urged the government to reform the policy, introduced in the late 1970s to prevent population growth spiraling out of control, but now regarded by many experts as outdated and harmful to the economy.

Although it is known internationally as the one-child policy, China's rules governing family planning are more complicated. Under current rules, urban couples are permitted a second child if both parents do not have siblings and rural couples are allowed to have two children if their first-born is a girl.

There are numerous other exceptions as well, including looser rules for ethnic minorities.

But any couple violating the policy has to pay a large fine.

Wang said the system of punishments would also remain.

Many analysts say the one-child policy has shrunk China's labor pool, hurting economic growth. For the first time in decades the working age population fell in 2012, and China could be the first country in the world to get old before it gets rich.

(Reporting by Ben Blanchard; Editing by Raju Gopalakrishnan)

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WHO and partners begin reaching people in need on many Philippine islands hit by typhoon

15 November 2013 | MANILA, Philippines - WHO is working with the Government of the Philippines and international partners to reach survivors of Typhoon Haiyan who need medical care. The full extent of the disaster is becoming increasingly clear, with dozens of separate sites needing assistance.

At least seven provinces have been hit by the disaster (Samar, Leyte, Cebu, Iloilo, Capiz, Aklan and Palawan) and a humanitarian hub is being established in each. But the scope of the disaster could be larger still. There are concerns that some 20 smaller islands with remote communities may have been impacted by the typhoon as well. This makes delivering relief exceedingly complicated.

“Because of the geography of the Philippines – an archipelago of many islands – and the fact that so many have been hit by the typhoon, it is essentially like mounting at least seven separate, simultaneous relief efforts. This multiplies the logistical challenges associated with the response,” says Dr Julie Hall, WHO’s Representative in the Philippines.

Health infrastructure – including the “cold chain” which is vital for safe storage and transportation of vaccines – has been severely damaged by the typhoon. Initial assessments have found that 18 of the 38 health facilities in affected regions are not functional.

Aid is beginning to reach those in need. A total of 22 Filipino medical teams have been deployed to typhoon-affected areas. For example, the Eastern Visayas Regional Medical Center – the only local health facility remaining operational in Tacloban – is being manned by teams from Metro Manila Hospitals. In addition, 11 foreign medical teams are operational in areas including Tacloban, Ormoc City, Panay, Guiuan and Palo, and another 14 foreign teams are on their way. WHO has teams on location in Tacloban and Cebu, coordinating the actions of foreign medical teams. Around 50 WHO experts have come to the Philippines to support government efforts, in excess of the staff who were already in the country prior to the typhoon.

There are estimated to be more than 200?000 pregnant women and 130?000 breastfeeding women in affected areas in need of specialized prenatal, postnatal, child health, health promotion and family planning services.

Guiuan is one of the hardest-hit areas, with every health facility destroyed, including the only facility in Eastern Samar province with capacity to help women with complications of child birth. However, reproductive health kits have been sent to Guiuan to treat patients with obstetric complications. A generator, a refrigerator to store medicines, a delivery bed, midwifery kits and hygiene kits have also been sent.

Some 1350 hygiene and dignity kits (containing items such as soap, sanitary napkins, toilet paper and underpants) have arrived in Tacloban City for distribution to pregnant and breastfeeding women.

For more information or interview requests, please contact:

Nyka Alexander (Manila)
Communications Officer
Telephone: +63 906 493 5097
E-mail: alexandern@wpro.who.int

Christy Feig
Director of Communications
Telephone: +41 79 251 7055
E-mail: feigc@who.int

Gregory Hartl
Coordinator, News and Social Media
Telephone: +41 79 203 6715
E-mail: hartlg@who.int

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Algorithm identifies individual grains in planetary regolith

Nov. 15, 2013 — Instruments on the Curiosity Mars rover not only measure the chemistry of rocks, elemental abundances of soils and wind speeds, but also take an incredible number of images from both mast-mounted cameras and up-close imaging systems mounted to robotic arms. The process of analyzing soil images can be daunting, particularly when there are thousands of images and when the particles can be on the order of only 5-10 pixels wide.

A team of researchers, led by Suniti Karunatillake at LSU's Department of Geology and Geophysics, and including Stony Brook University, USGS-Flagstaff AZ, and Rider University, developed an image analysis and segmentation algorithm specifically to aid planetary scientists with this very basic, but often difficult, task.

Planetary scientists use images to identify the distribution of grain sizes of large-scale (centimeter or larger diameter) rocks and small-scale (less than 1 cm) grains. These grain sizes tell scientists about the processes that distributed the particles from their source regions to where they are now. For example, were they derived from a water source, blown by wind, or show hydrodynamic sorting?

The algorithm, implemented in Mathematica, uses a variety of image processing steps to segment the image, first into coarser (foreground) and finer (background) grains. The image is then further segmented until most grains are outlined. The code processes a single image within 1 to 5 minutes.

The semi-automated algorithm, while comparing favorably with manual (human) segmentation, provides better consistency across multiple images than a human. The researchers are exploring the use of this algorithm to quantify grain sizes in the images from the Mars Exploration Rovers Microscopic Imager (MI) as well as Curiosity's Mars Hand Lens Imager (MAHLI). The grain size distributions identified in those images have the potential to reveal subtle trends with composition not considered previously. Ability to identify most of the grains in images also makes detailed, area-weighted, sedimentology possible. Applications extend to terrestrial data from less accessible sites such as deep lake basins or undisturbed river bed sediments.

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Overcoming brittleness: New insights into bulk metallic glass

Nov. 15, 2013 — From the production of tougher, more durable smart phones and other electronic devices, to a wider variety of longer lasting biomedical implants, bulk metallic glasses are poised to be mainstay materials for the 21^st Century. Featuring a non-crystalline amorphous structure, bulk metallic glasses can be as strong or even stronger than steel, as malleable as plastics, conduct electricity and resist corrosion. These materials would seem to have it all save for one problem: they are often brittle, with a poor and uneven resistance to fatigue that makes their reliability questionable. The creation of multicomponent bulk-metallic glass composites is addressing this issue but the problem remains for monolithic metallic glasses, which are major components of bulk metallic composites.

A new study by a collaboration of Berkeley Lab and Caltech researchers may point the way to improving the fatigue resistance of monolithic bulk glasses. The collaboration found that a bulk metallic glass based on palladium displayed a fatigue strength as good as the best composite bulk metallic glasses and comparable to regular polycrystalline structural alloys, such as steel, aluminum and titanium. This study was led by Robert Ritchie, a materials scientist with Berkeley Lab's Materials Sciences Division and Caltech's William Johnson, one of the pioneers in the field of bulk metallic glass fabrication.

"We found that the unexpectedly high fatigue resistance in monolithic palladium-based bulk metallic glass arises from extensive shear-band plasticity that results in a periodic staircase-like crack profile," Ritchie says. "The ease with which shear bands form in this palladium-based glass generates highly serrated cracks that resemble interlocking gear teeth and provide crack-tip blunting and shielding to limit the opening and closing of cracks. The effect is somewhat like trying to speak with a doughnut in your mouth."

Palladium is a metal with a high "bulk-to-shear" stiffness ratio that counteracts the intrinsic brittleness of glassy materials because the energy needed to form shear bands is significantly lower than the energy required to turn these shear bands into cracks.

"The effect of multiple shear-banding is multifold," Ritchie says. "The formation of shear bands leads to extensive crack-tip blunting, which leads to intrinsic toughening, whereas the resulting crack deflections and closures lead to crack-tip shielding, which leads to extrinsic toughening. These mechanisms, together with the high fatigue threshold, provide the major contributions to the excellent fatigue endurance strength shown by the monolithic palladium-based bulk metallic glass."

The results of this study have been published in the Proceedings of the National Academy of Sciences. It is titled "Enhanced fatigue endurance of metallic glasses through a staircase-like fracture mechanism." Ritchie and Johnson are the corresponding authors. Other co-authors are Bernd Gludovatz, Marios Demetriou, Michael Floyd and Anton Hohenwarter.

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The above story is based on materials provided by DOE/Lawrence Berkeley National Laboratory.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

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Journal Reference:

1. B. Gludovatz, M. D. Demetriou, M. Floyd, A. Hohenwarter, W. L. Johnson, R. O. Ritchie. Enhanced fatigue endurance of metallic glasses through a staircase-like fracture mechanism. Proceedings of the National Academy of Sciences, 2013; DOI: 10.1073/pnas.1317715110

Note: If no author is given, the source is cited instead.

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Clinical trials are not breast cancer high of searches concurrent therapy are required to achieve the pathological histological remission

Concerns can be associated with increased risk of cardiac toxicity as this combination is effective in the treatment of HER-2 positive breast cancer, given the concurrent Trastuzumab and anthracycline. University of Texas MD Anderson Cancer not required because new research from the Alliance in the Center, Department of Oncology, clinical trials for colleagues to achieve a high rate of Pathology histological remission of these agents at the same time shows.

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Japan's Tepco to shed more than 1,000 jobs: sources

TOKYO (Reuters) - Japan's embattled Tokyo Electric Power Co plans to shed more than 1,000 jobs via voluntary retirements by the second half of 2014, sources told Reuters, as it seeks to win more financial aid to clean up its crippled Fukushima nuclear plant.

Tepco is working on a reorganization plan to fend off more drastic proposals, including possibly dragging the company through bankruptcy in return for a publicly funded clean-up and shutdown of its Fukushima reactors.

The government has already agreed to spend 47 billion yen ($468.7 million) on dealing with some 1,000 tanks of radiated water at Tepco's crippled Fukushima nuclear power plant, which was wrecked by an earthquake and tsunami two years ago.

Japan's government is also considering paying part of the cost to decommission Fukushima's damaged nuclear reactors, and restructuring could help Tepco secure more government aid.

The utility hopes to secure 500 billion yen in funding from banks by the end of the year and hopes staff cuts will encourage banks to agree to the funding.

Tepco has been telling banks that it can return to an operating profit if it restarts two reactors at its Kashiwazaki Kariwa facility by fiscal 2014, sources have also told Reuters.

Three reactors suffered core meltdowns at the Fukushima Daiichi plant north of Tokyo after the March 2011 disaster that triggered explosions and forced the evacuation of 160,000 people from nearby towns and villages.

Tepco, which has floundered in trying to bring the plant under control in the two and a half years since the disaster, is now moving to full decommissioning at the six-reactor facility.

(Reporting by Stanley White; Editing by Michael Perry)

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Work the researchers to improve the outcomes of patients with lymphoma.

University of Nebraska Medical Center （ Fred & Pamela Buffett cancer center headquartered ） of researchers are diffuse large B cell lymphoma patient they discovered that do not respond to standard drug therapy used to treat this type of cancer if you have a high level of gene called STAT3. Findings will be published in medical journal 11 issue of the journal Clinical Oncology, Clinical Oncology, American society.

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What could possibly go wrong? A lot: Injuries from the Tough Mudder

Nov. 15, 2013 — The Tough Mudder, an extreme sports event that bills itself as "probably the toughest event on the planet," resulted in injuries ranging from multiple electrical burns to seizure-induced Todd's paralysis. A case series of serious injuries sustained by participants in one such race was reported online today in Annals of Emergency Medicine.

"No training on earth can adequately prepare participants for elements such as jumping from a nine-foot height or running through a field of electrical wires while wet and hot," said lead study author Marna Rayl Greenberg, DO MPH, of Lehigh Valley Hospital and Health Network in Allentown, Pa. "The volume and severity of injuries in the Tough Mudder race we studied was unusually high, possibly leading to some permanent disabilities. The 1.5 million people who are predicted to enter obstacle races like this in the next year should be well aware of the risks they are taking."

The Tough Mudder is a 10 to 12 mile endurance obstacle course known as "MOB (mud, obstacles, beer) runs." Dr. Greenberg and her team reported in depth on five patients injured at a 2-day event, who were treated (along with 33 other participants not included in the case series) at a local emergency department.

One patient, who had received 13 electrical shocks during the last obstacle in the Tough Mudder, had multiple burn marks from electrical injuries and inflammation of the heart muscle. After being treated in the emergency department, he was admitted to the hospital.

The second patient had sustained multiple electrical shocks to the head while running through water, which resulted in fainting and altered mental status. After being treated in the emergency department, he was admitted to the hospital.

The third patient, after completing 20 out of 22 obstacles, developed seizure-like activity and altered mental status. He was unable to move his entire right side. After treatment in the emergency department, he was admitted to the intensive care unit with Todd's paralysis and discharged from the hospital to a rehabilitation center 4 days later. Six months after the injury, he still had lower right leg disability.

Patient number four sustained face and head injuries after being struck by two electrical cords and landing face first in a hard mound of dirt. He was treated at the emergency department and discharged against medical advice.

A 25-year-old woman who sustained an electrical shock to the chest just before the finish line, after which she was given a beer to drink, was admitted to the hospital for dehydration and rhabdomyolsis, or muscle breakdown.

"In the past few years, obstacle racing has experienced a rate of growth that may be unprecedented in the history of participatory sports," said Dr. Greenberg. "Organizers, participants and local emergency services need to be prepared for a large number of diverse injuries at Tough Mudder and other similar obstacle races."

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How common chemotherapy drugs in bone marrow transplantation graft prevent rejection.

Johns Hopkins and Kimmel Cancer porting people to results of a study from the Center for bone marrow transplantation, chemotherapy drug called cyclophosphamide pieces can prevent (GVHD) versus host disease may explain why. Point the immune cells to protect patients from fatal form of evasion cyclophosphamide toxicity, GVHD is experimental. In the journal Science Translational Medicine Online 11/13 published findings may pave the way for preventative treatment of recurrence of cancer or prevent GVHD and new treatment, bone marrow transplant rejection, transplant after underlying improvement.

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Burkitt's Lymphoma of the NIH study found low-intensity therapy is very effective

Known as an excellent long term survival rate have of adult patients with burkitt's lymphoma cancer type-90% or more-treated with low intensity regimen, according to the discovery of a new clinical trial in below. Burkitt's lymphoma is the most aggressive type of lymphoma cancer begins in the cells of the immune system.

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Tobacco Myths Continue Half-Century After Landmark U.S. Report

And Americans continue to die from smoking-related lung cancer, experts note

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Induced mutations removing any single gene in yeast, genomic elsewhere.

In yeast cells leads to the Johns Hopkins University researchers reported that another one thing gene mutations in the genome of any single gene deletions, organic body to compensate for putting pressure on. They are applicable to most likely Human Genetics DNA across species and for ways to save, they found genetic analysis says that takes place in other areas of cancer and research method with big impact. The Johns Hopkins Kimmel Cancer Center in the House.

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WHO update on polio outbreak in Middle East

A comprehensive outbreak response continues to roll out across the Middle East following confirmation of the polio outbreak in Syria.

Seven countries and territories are holding mass polio vaccination campaigns with further extensive campaigns planned for December targeting 22 million children. In a joint resolution all countries of the WHO Eastern Mediterranean Region have declared polio eradication to be an emergency and called on Pakistan to urgently access and vaccinate all of its children to stem the international spread of its viruses. The countries also called for support in negotiating and establishing access to those children who are currently unreached with polio vaccination.

WHO and UNICEF are committed to working with all organizations and agencies providing humanitarian assistance to Syrians affected by the conflict. This includes vaccinating all Syrian children no matter where they are, whether in government or contested areas, or indeed outside Syria.

The first priorities are to resupply and reactivate the required health infrastructure, including redeploying health workers to deliver vaccine in worst-affected areas, and moving vaccine across conflict lines where necessary and possible. The government has committed to reach all children; information on which areas are not reached will guide corrective actions and planning for the next rounds. All parties are working to find solutions for conflict-affected areas.

Dr. Jaouad Mahjour, Director of Communicable Diseases Prevention and Control at WHO’s Eastern Mediterranean Regional Office, stressed the necessity of reaching all children inside Syria and in neighbouring countries. "WHO and UNICEF are coordinating the vaccination campaign with all concerned parties to make sure that all children are vaccinated no matter where they are located."

Larger-scale outbreak response across the Syrian Arab Republic and neighboring countries will continue, to last for at least 6 to 8 months depending on the area and based on evolving epidemiology.

For further information, please contact:

Sona Bari
WHO
Telephone: +41 22 791 1476
Mobile: +41 79 475 5511
E-mail: baris@who.int

Related links

• Polio Eradication Initiative
• More on polio

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Relief arriving in the Philippines, challenges for delivery persist

13 November 2013 | MANILA, Philippines - WHO and partners are getting people and supplies into the Philippines, but reaching those in need remains challenging.

Teams of WHO and other emergency responders have been positioned or are en route to the areas hardest hit by Typhoon Haiyan. Medicines and healthcare supplies have arrived in Cebu and are now waiting to be sent to areas in highest need.

WHO is supporting the Government of the Philippines in coordinating the deployment of international medical teams. To date, nine teams (from Australia, Belgium, Germany, Hungary, Japan, New Zealand, Switzerland and the United States of America) have confirmed that they are on their way or have arrived in the country. Two are positioned in Tacloban. The teams are self-sufficient – bringing their own hospital tents, supplies to perform surgeries, essential medicines and water, food and fuel.

“We’re working with the government to get the right people, medicines and supplies into the areas that have been hit hardest by the typhoon,” says Dr Julie Hall, WHO’s Representative in the Philippines. “But logistics still remain challenging, with airstrips, ports and roads badly damaged.”

Many people suffered cuts, wounds, and broken bones during the typhoon and others will have sustained injuries in subsequent flooding. People with chronic diseases have been without access to medication. Other vulnerable people such as children and those with disabilities may require medical attention.

With an outpouring of support from the international community, WHO has developed guidance for partners on donations of medicine and healthcare equipment, so that the Philippines receives the appropriate supplies for their emergency response.

For more information or interview requests, please contact:

Nyka Alexander (Manila)
Communications Officer
Telephone: +63 906 493 5097
E-mail: alexandern@wpro.who.int

Christy Feig
Director of Communications
Telephone: +41 79 251 7055
E-mail: feigc@who.int

Gregory Hartl
Coordinator, News and Social Media
Telephone: +41 79 203 6715
E-mail: hartlg@who.int

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HIV protein may impact neurocognitive impairment in infected patients

Nov. 15, 2013 — A protein shed by HIV-infected brain cells alters synaptic connections between networks of nerve cells, according to new research out of the University of Minnesota. The findings could explain why nearly half of all patients infected with the AIDS virus experience some level of neurocognitive impairment.

The research was published in the current volume of the Journal of Neuroscience.

"The synaptic changes didn't appear to be a symptom of nerve death," said Nicholas Hargus, Ph.D., lead author on the paper and a post-doctoral fellow in the Department of Pharmacology in the University of Minnesota Medical School. "Instead, the changes appeared to be a protective response resulting from the over-excitation of the network by the HIV protein transactivator of transcription (Tat). Essentially, the neuroprotective mechanism has gone awry."

HIV-associated neurocognitive disorders (HAND) are an indirect result of HIV, as the disease itself does not infect neurons. Tat has been shown to contribute heavily to the development of HAND in patients. Hargus and Stanley Thayer, Ph.D., professor in the Department of Pharmacology, wanted to learn more about the relationship between Tat and HAND to better understand how to treat the disorders.

Researchers replicated the impact of the Tat in a rat model and tracked the changes to the synaptic proteins. They found changes in both inhibitory and excitatory synapses were initiated by specific Tat binding activity. This discovery indicated a pharmacological change due to exposure to Tat.

"We found drugs altering synaptic transmission between nerve cells reversed the synaptic changes induced by Tat," said Thayer. "In the future, this could provide a target for the development of drugs to act upon and improve cognitive function in patients."

Ongoing experiments are investigating the relationship between drug-induced changes in synaptic connections and the changes in cognitive function. In the future, high throughput approaches to assess synaptic function will be developed for evaluating drug candidates.

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Copper intake makes tumors breathe

Nov. 14, 2013 — Copper imbalances have been associated with a number of pathological conditions, including cancer. Publishing in PNAS scientists at EPFL have found that copper in drinking water -- given at the maximum levels permitted in public water supplies -- accelerated the growth of tumors in mice. On the other hand, reducing copper levels reduced tumor growth. The study strongly suggests that copper is an essential factor for the growth of tumors in humans as well.

Copper is a key player in cell growth. In order to proliferate, cells require energy, which they produce and store in the form of a molecule called ATP. Like all cells, tumor cells produce energy in two different ways: respiration, which requires oxygen, and glycolysis, which does not. Of the two, respiration is the more efficient way to make ATP. However it involves a number of enzymes, and one of the most important ones requires copper for its activity.

In a study led by Douglas Hanahan, researcher at EPFL and holder of the Merck Serono Chair in Oncology, scientists sought to examine the role of copper in cancer. To do this, they used genetically engineered mice with pancreatic neuroendocrine tumors. "This study was motivated by our previous puzzling observation; namely that cancers, unlike healthy tissues, are especially sensitive to changes in systemic copper levels," said Seiko Ishida, the lead author of the paper.

Their research provides direct evidence that copper can enhance the proliferation of cancer cells. "The biggest surprise was that a small amount of copper added to drinking water accelerated the growth of tumors, indicating that copper is an essential nutrient for them, said Ishida.

Teaming up with Johan Auwerx, also at EPFL, the researchers found that copper insufficiency resulted in a lower activity of the respiration enzyme in tumors. PET scans also revealed that copper-deficient tumors took higher levels of glucose, suggesting that their cells were compensating more and more by using glycolysis rather than respiration for their energy. But despite this, ATP levels did not fully recover, and tumors did not grow further.

Importantly, the researchers do not think that copper causes cancer. Exposure of healthy mice to the same amount of copper via drinking water for up to two years did not result in an increased incidence of cancer. The authors suggest that copper levels could be monitored in cancer patients. They propose that minimizing copper in the patient's system may be beneficial in cancer therapy, especially when combined with drugs that block glycolysis. This two-step strategy would starve cancer cells -- which tend to require much higher amounts of energy than normal cells -- by limiting their two major pathways for ATP production.

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UnitedHealth drops thousands of doctors from insurance plans: WSJ

(Reuters) - UnitedHealth Group dropped thousands of doctors from its networks in recent weeks, leaving many elderly patients unsure whether they need to switch plans to continue seeing their doctors, the Wall Street Journal reported on Friday.

The insurer said in October that underfunding of Medicare Advantage plans for the elderly could not be fully offset by the company's other healthcare business. The company also reported spending more healthcare premiums on medical claims in the third quarter, due mainly to government cuts to payments for Medicare Advantage services.

The Journal report said that doctors in at least 10 states were notified of being laid off the plans, some citing "significant changes and pressures in the healthcare environment." According to the notices, the terminations can be appealed within 30 days.

Tyler Mason, a UnitedHealth spokesperson, was not immediately available for comment when reached by Reuters.

The insurer told the WSJ that its provider networks were always changing and that it expected its Medicare Advantage network to be 85 percent to 90 percent of its current size by the end of 2014.

UnitedHealth is participating in about a dozen new state insurance markets that launched on October 1 to offer subsidized health coverage under President Barack Obama's healthcare overhaul.

The insurer said previously it planned to withdraw from some markets in 2014 because of the government funding cuts.

Another top health insurer, Aetna Inc , also warned in October that it expected slowing growth in 2014 in its Medicare Advantage plans.

(Reporting by Zeba Siddiqui in Bangalore; Editing by Peter Cooney)

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Chronic diseases hinder good cancer survival rates

Nov. 15, 2013 — There are many people in this position and the number is increasing; cancer patients who not only have to fight against cancer, but also suffer from other diseases. So-called comorbidity is a large and growing problem, not least because we are becoming older and age increases the risk of contracting cancer as well as other diseases.

How much diseases such as diabetes, COPD (chronic obstructive pulmonary disease), arthritis, depression and cardiovascular disease mean for cancer survival depends on the type of cancer; but the overall picture is the same. Other diseases have a strong negative impact on both the one and five-year survival rate. For example, for breast cancer the five-year survival rate for patients without other diseases is 83 percent. For patients with one or two other chronic diseases the survival rate is 64 percent, while it is 50 percent for those with three or more diseases. This is shown by new figures from the Central Denmark Region that have just been published in a special edition of the scientific journal Clinical Epidemiology. This edition focuses on cancer and comorbidity and is based on research from Aarhus University and Aarhus University Hospital.

Poorer survival to be expected -- but not so poor

According to Henrik Toft Sorensen, professor of clinical epidemiology at Aarhus University and Aarhus University Hospital, it is to be expected that survival rates are worse if you have a poorer state of health. But it is problematic that a similar improvement in the survival rate of this group of cancer patients has not happened.

"Our studies show that other diseases have a very significant importance for survival, and we can see that these patients have not experienced the same progress in survival rates as other cancer patients have experienced during the last 15 years," says professor Henrik Toft Sorensen, who has written the editorial in the journal.

The problem has previously been overlooked, though there has been greater awareness following the publication of specific figures on the problem 10 years ago.

"It has long been the case that cancer doctors are concerned with cancer, arthritis doctors with arthritis and so on. But increasing attention is being paid to the significance of the patients having other diseases," he says.

Many patients have other diseases

It is estimated that around 40 percent of all Danish cancer patients have one or more other diseases with which they have been hospitalised. 30 percent have one or two other diseases, while 10 percent have three or more diseases. This appears from a systematic literature review (SLR) of all of the studies of comorbidity and breast, lung and colon cancer that have been carried out in Denmark and abroad over the past decade. The study is financed by the Danish Cancer Society and has just been published in the journal Clinical Epidemiology, along with the new figures.

That so many also have other diseases is due not only to age but also unhealthy lifestyles. According to Henrik Toft Sorensen, part of the explanation of the poor survival rate can also be found here. Smoking, alcohol and being overweight simply give a poorer rate of survival. After these factors, what means something here is the treatment. Among other things because patients with other diseases have a greatly increased risk of complications, but also because there is a risk of them receiving either too much or too little treatment.

Lack of knowledge about the proper treatment

Whether it is the cancer that the patients die of is unclear, explains PhDMette Sogaard, Clinical Epidemiological Department, Aarhus University and Aarhus University Hospital, who are behind the literature review.

"It is not clear what the patients die of -- whether it is the cancer or the other diseases. However, we can see that it is neither due to the fact that they have a more aggressive cancer, that the disease is more advanced when detected, or that the patients are older," she says.

What can be seen, however, is that cancer patients with other diseases do not receive the same treatment as other cancer patients. This is probably because they cannot tolerate the treatment quite as well and because they experience complications more often than other cancer patients. According to Mette Sogaard, it could nonetheless be interesting to investigate whether we use the right treatment.

"There are still a lot of unanswered questions -- not least whether some of these patients are receiving too little treatment," she says.

Frede Olesen, chairman of the Danish Cancer Society shares this assessment:

"It is obvious that the treatment must often be individually adapted when there are several concurrent diseases. But basically, the poor results are unsatisfactory and we must focus our research on the reasons for this lack of progress. We have to carefully examine whether the quality of the simultaneous treatment of several diseases is good enough," says Frede Olesen.

This journal can be accessed at: http://www.dovepress.com/clinical-epidemiology-journal

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Molecule critical to healing wounds identified

Nov. 15, 2013 — Skin provides a first line of defense against viruses, bacteria and parasites that might otherwise make people ill. When an injury breaks that barrier, a systematic chain of molecular signaling launches to close the wound and re-establish the skin's layer of protection.

A study led by researchers from the University of Pennsylvania's School of Dental Medicine and published in the Journal of Cell Biology now offers a clearer explanation of the role of one of the players in the wound-healing process, a molecule called FOX01. Contrary to what had been expected, FOX01 is critical to wound healing, providing researchers with a possible new target for drugs that could help speed that process for people with impaired wound healing.

Senior author Dana Graves is a professor in Penn Dental Medicine's Department of Periodontics and is vice dean for scholarship and research. He collaborated on the study with Penn's Bhaskar Ponugoti, Fanxing Xu, Chenying Zhang, Chen Tian and Sandra Pacio.

A critical element of wound healing involves the movement of keratinocytes, the primary cells comprising the epidermis, or the outer layer of skin. Previous research had found that FOX01 was expressed at higher levels in wounds, but scientists did not understand what role the molecule was playing. In other scenarios, such as in cancer cells, FOX01 promotes cell death and interferes with the cell reproduction, two actions that would seem to be detrimental to healing.

To investigate the role of FOX01 in wound healing, Graves and colleagues bred mice that lacked the protein in their keratinocytes and then observed the wound healing process in these mice compared to mice with normal FOX01.

"We thought that deleting FOX01 would speed up the wound-healing process," Graves said, "but in fact it had the opposite effect."

The mice that lacked FOX01 showed significant delays in healing. Whereas all wounds on control mice were healed after one week, all of the experimental mice still had open wounds.

Digging deeper into this counterintuitive finding, the researchers examined the effect of reducing FOX01 levels on other genes known to play a role in cell migration. They found that many of these genes were significantly reduced, notably TGF-β1, a critical growth factor in wound repair. When the team added TGF-β1 to cells lacking FOX01, the cells behaved normally and produced the proper suite of molecules needed for healing, indicating that FOX01 acts upstream of TGF-β1 in the signaling pathway triggered during the healing process.

Further experimenting revealed that mice lacking FOX01 had evidence of increased oxidative stress, which is detrimental to wound healing.

"The wound healing environment is a stressful environment for the cell," Graves said. "It appears that upregulation of FOX01 helps protect the cell against oxidative stress."

The fact that FOX01 behaves in this unexpected way could have to do with the specialized microenvironment of a cell in a wound, Graves noted. While FOX01 does indeed promote cell death when it is highly activated, it does the opposite when moderately activated. Which activity it promotes depends on the environment in which it is acting.

Taken together, the study's findings demonstrate that FOX01 plays an integral role in two key processes in wound healing: activation of TGF-β1 and protecting the cell against oxidative damage. Its involvement in these aspects of healing make it a potential target for pharmaceuticals that could help speed healing.

"If you had a small molecule that increased FOX01 expression, you might be able to upregulate TGF-β1 as well as protect against the oxidative stress associated with wound healing," Graves said.

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Patchy aid reaches typhoon survivors as Philippines struggles to rebuild

By Aubrey Belford

TACLOBAN, Philippines (Reuters) - Survivors began rebuilding homes destroyed by one of the world's most powerful typhoons and emergency supplies flowed into ravaged Philippine islands, as the United Nations more than doubled its estimate of people made homeless to nearly two million.

But the aid effort was still patchy, and bodies still lay uncollected as rescuers tried to evacuate stricken communities on Saturday, more than a week after Typhoon Haiyan killed at least 3,633 with tree-snapping winds and tsunami-like waves.

"We are very, very worried about millions of children," U.N. Children's Fund spokesman Marixie Mercado told reporters in Geneva. There are officially 1,179 people missing, according to the national count.

Survivors and officials in Tacloban, which bore the brunt of the storm, have said the death toll could be many thousands just in the city as more bodies are discovered every hour.

After long delays, hundreds of international aid workers set up makeshift hospitals and trucked in supplies on Saturday, while helicopters from a U.S. aircraft carrier ferried medicine and water to remote, battered areas where some families have gone without food and clean water for days.

Aid flown in to Tacloban's congested airport finally trickled into ravaged neighborhoods. Work crews and heavy equipment cleared debris from roadsides, but side streets remained piled with the sodden, tangled remains of homes.

In front of the San Fernando Elementary School, government workers distributed sacks of aid to a restless crowd of hundreds who had spent the last week camped in shattered wooden classrooms or in a main school building with floors covered in wet black sand. Nearby, about a dozen body bags were neatly lined up by the roadside.

Survivors living in the school said they had received little help since the disaster.

Rica Mobilla, an 18-year-old mother of one, said local authorities showed up two days after the disaster, handing out four kilograms of rice and a few packs of noodles for her family of thirteen. The family stretched this out with onions and garlic bought from the market.

"For the first two days after Yolanda, we didn't eat. After getting that packet, we eating once a day," she said, using the Philippine name for Typhoon Haiyan.

"I'm upset. I'm not blaming anyone. If there's aid there to give out we'll receive it."

President Benigno Aquino, caught off guard by the scale of the disaster, is scheduled to visit typhoon-affected areas on Sunday. He has been criticized for the slow pace of aid distribution and unclear estimates of casualties, especially in Tacloban, capital of hardest-hit Leyte province.

In Tacloban the death toll is written on a whiteboard at City Hall and bodies have been buried in mass graves since Thursday. Tacloban mayor Alfred Romualdez said people may have been swept out to sea after a tsunami-like wall of seawater slammed into coastal areas. One neighborhood with a population of between 10,000 and 12,000 was now deserted, he said.

SURVIVORS START TO REBUILD, HOMELESS RISE

Relief officials reported a surge in desperate, hungry survivors trying to leave the coastal city of Ormoc, 105 km (65 miles) west of Tacloban.

"People are fleeing in mass numbers and coming to Ormoc, where they stand in line all day to get on a ferry only to be turned away," said Arnaldo Arcadio, an emergency responder with the Catholic Relief Services group.

"Ormoc is teeming with people who haven't eaten in days. They're hungry, thirsty and tired. They want to get out."

Across Tacloban, survivors have begun to rebuild. The sounds of hammers ring out. Men gather in groups to fix motorbikes or drag debris off splintered homes and wrecked streets. Most have given up searching for lost loved ones.

The number of people made homeless by the storm rose to 1.9 million, up from 900,000, the United Nations' humanitarian agency said. In Tacloban, at least 56,000 people face unsanitary conditions, according to the United Nations' migration agency.

Captain Victoriano Sambale, a military doctor who for the past week has treated patients in a room strewn with dirt and debris in Tacloban, said the pace of aid relief was rising.

"I can see the international support coming here," he said.

But he is still overwhelmed. "Day one we treated 600-plus patients. Day two we had 700-plus patients. Day three we lost our count."

U.S. HELICOPTERS AID RELIEF EFFORT

Massive logistical problems remain. Injured survivors waited in long lines under searing sun for treatment. Local authorities reported shortages of body bags, gasoline and staff to collect the dead.

British Prime Minister David Cameron on Saturday pledged 30 mln pounds for international aid agencies working in the Philippines.

But the patchy initial aid response highlighted the need for international agencies and local governments to prepare for more frequent, more devastating natural disasters, said Kristalina Georgieva, European Commissioner for International Cooperation, Humanitarian Aid and Crisis Response.

"This is a mindset change that must happen if we want to be able to stand up to this trend," she told Reuters in Tacloban.

U.S. military assistance has been pouring into the Philippines since Thursday when the USS George Washington aircraft carrier and accompanying ships arrived off eastern Samar province, carrying 5,000 crew and more than 80 aircraft.

The Philippines is one of Washington's closest allies in Asia and a crucial partner in President Barack Obama's strategy of rebalancing U.S. military forces towards the region to counter the rising clout of China.

The Pentagon said on Friday that U.S. Navy amphibious ships will leave Okinawa in Japan "in the coming hours" carrying an additional 1,000 marines and sailors who will provide engineering equipment, relief supplies, and medical support.

U.S. sailors have brought food and water ashore in Tacloban and the town of Guiuan, whose airport was a U.S. naval air base in World War Two. The carrier is moored near where U.S. General Douglas MacArthur's force landed on October 20, 1944, in one of the biggest Allied victories.

The U.S. military estimates that it delivered some 623,000 pounds (283,000 kg) of U.S. relief supplies to the Philippines so far. The American military also estimated that it had moved nearly 1,200 relief workers into Tacloban and airlifted nearly 2,900 displaced people from affected areas so far.

(Additional reporting by Rosemarie Francisco and Eric dela Cruz and Manuel Mogato in Manila, Michelle Nichols at the United Nations and Stephanie Nebehay in Geneva, Ranga Sirilal in Colombo; Writing by Jason Szep; Editing by John Mair and Michael Perry)

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New malaria vaccines roadmap targets next generation products by 2030

“The new vaccines should show at least 75% efficacy against clinical malaria, be suitable for use in in all malaria-endemic areas, and be licensed by 2030”

Dr Jean-Marie Okwo Bele, Director of WHO’s Department of Immunization, Vaccines and Biologicals

14 November 2013 | Washington, DC - The world should aim to have vaccines which reduce malaria cases by 75%, and are capable of eliminating malaria, licensed by 2030, according to the updated 2013 "Malaria Vaccine Technology Roadmap", launched today. This new target comes in addition to the original 2006 Roadmap’s goal of having a licensed vaccine against Plasmodium falciparum malaria, the most deadly form of the disease, for children under 5 years of age in sub-Saharan Africa by 2015.

“Safe, effective, affordable vaccines could play a critical role in defeating malaria,” said Dr Robert D. Newman, Director of WHO’s Global Malaria Programme. ”Despite all the recent progress countries have made, and despite important innovations in diagnostics, drugs and vector control, the global burden of malaria remains unacceptably high.”

Current situation

The most recent figures by the WHO indicate that malaria causes an estimated 660?000 deaths each year from 219 million cases of illness. Scale-up of WHO recommended malaria control measures has been associated with a 26% reduction in the global malaria death rate over the last decade. Effective malaria vaccines could be an important complement to existing measures, if they can be successfully developed.

Final results from Phase III trials of the most advanced vaccine candidate, RTS,S/AS01, will be available by 2015. Depending on the final trial results, and depending on the outcome of the regulatory review by the European Medicines Agency, a WHO recommendation for use and subsequent prequalification of this first vaccine could occur in late 2015.

The Malaria Vaccine Technology Roadmap

The new roadmap, launched today at the annual conference of the American Society of Tropical Medicine & Hygiene in Washington DC and also announced in a letter published in "The Lancet", aims to identify where additional funding and activities will be particularly key in developing second generation malaria vaccines both for protection against malaria disease and for malaria elimination. These include next-generation vaccines that target both Plasmodium falciparum and Plasmodium vivax species of malaria.

“The new vaccines should show at least 75% efficacy against clinical malaria, be suitable for use in in all malaria-endemic areas, and be licensed by 2030,” says Dr Jean-Marie Okwo Bele, Director of WHO’s Department of Immunization, Vaccines and Biologicals. “The roadmap also sets a target for malaria vaccines that reduce transmission of the parasite.”

The 2013 "Malaria Vaccine Technology Roadmap" cites several reasons for the update, among them changing malaria epidemiology associated with the successful scale-up of malaria control measures in the last decade; a renewed focus on malaria elimination and eradication in addition to the ongoing need to sustain malaria control activities; and new technological innovations since 2006 including promising early work on so-called transmission-blocking malaria vaccines.

WHO lists 27 malaria vaccine candidates currently in clinical trials, with most in early stages of testing; RTS,S/AS01 is the only one currently in late-stage development.

The Roadmap’s vision centres on developing safe and effective vaccines against Plasmodium falciparum and Plasmodium vivax that prevent disease and death and prevent transmission to enable malaria eradication, and is built around two strategic goals:

• Development of malaria vaccines with protective efficacy of at least 75% against clinical malaria suitable for administration to appropriate at-risk groups in malaria-endemic areas.
• Development of malaria vaccines that reduce transmission of the parasite and thereby substantially reduce the incidence of human malaria infection. This will enable elimination in multiple settings. Vaccines to reduce transmission should be suitable for administration in mass campaigns.

The "Malaria Vaccine Technology Roadmap" is the result of a consultative process led by WHO, which brought together the global community of malaria vaccine researchers and product developers, and is supported by an informally-organized group of malaria vaccine funders. The Malaria Vaccine Funders Group comprises the Bill & Melinda Gates Foundation, the European & Developing Countries Clinical Trials Partnership, the European Vaccine Initiative, the European Commission, the PATH Malaria Vaccine Initiative, the US Agency for International Development, the US National Institute of Allergy and Infectious Diseases, the Wellcome Trust, and WHO.

For more information please contact:

Dr Vasee Moorthy
WHO Geneva
Mobile: +41 79 540 6919
E-mail: moorthyv@who.int

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Nature pulls a fast one on astronomers: Two galaxies caught masquerading as one

Nov. 15, 2013 — What might look like a colossal jet shooting away from a galaxy turns out to be an illusion. New data from the National Science Foundation's Karl G. Jansky Very Large Array (VLA) reveal that two galaxies, one lying behind the other, have been masquerading as one.

In a new image highlighting the chance alignment, radio data from the VLA are blue and infrared observations from NASA's Spitzer Space Telescope and Wide-field Infrared Survey Explorer (WISE) are yellow and orange, respectively. Visible data are also shown, with starlight in purplish blue and heated gas in rose.

The closer galaxy, called UGC 10288, is located 100 million light-years away. It is spiral in shape, but from our viewpoint on Earth, we are seeing its thin edge. The farther galaxy, seen in blue, is nearly 7 billion light-years away. Two giant jets shoot away from this galaxy, one of which is seen above the plane of the closer galaxy's disk.

Earlier radio images of the two galaxies appeared as one fuzzy blob, and fooled astronomers into thinking they were looking at one galaxy. Thanks to the VLA pulling the curtain back on the disguised duo, the scientists have a unique opportunity to learn otherwise-unobtainable facts about the nearer galaxy.

"We can use the radio waves from the background galaxy, coming through the nearer one, as a way to measure the properties of the nearer galaxy," said Judith Irwin, of Queen's University, Canada, lead author of a recent paper on the findings, appearing online Nov. 15 in the Astronomical Journal.

Observations from Spitzer and WISE helped to reveal new structures above and below the plane of the closer galaxy's disk. For example, Spitzer helped confirm an arc-like feature rising more than 11,000 light-years above the disk, which was seen in the radio observations.

Irwin worked with an international team of astronomers from North America, India and Europe who are part of the "Continuum Halos in Nearby Galaxies -- an EVLA Survey" (CHANG-ES) consortium.

The National Radio Astronomy Observatory is a facility of the National Science Foundation, operated under cooperative agreement by Associated Universities, Inc.

NASA's Jet Propulsion Laboratory, Pasadena, Calif., manages the Spitzer Space Telescope mission for NASA's Science Mission Directorate, Washington. Science operations are conducted at the Spitzer Science Center at the California Institute of Technology in Pasadena. Spacecraft operations are based at Lockheed Martin Space Systems Company, Littleton, Colorado. Data are archived at the Infrared Science Archive housed at the Infrared Processing and Analysis Center at Caltech. Caltech manages JPL for NASA. For more information about Spitzer, visit http://spitzer.caltech.edu and http://www.nasa.gov/spitzer .

JPL manages and operates the WISE mission for NASA's Science Mission Directorate. The WISE mission was selected competitively under NASA's Explorers Program managed by the agency's Goddard Space Flight Center in Greenbelt, Md. The science instrument was built by the Space Dynamics Laboratory in Logan, Utah. The spacecraft was built by Ball Aerospace & Technologies Corp. in Boulder, Colo. Science operations and data processing take place at the Infrared Processing and Analysis Center at Caltech. Caltech manages JPL for NASA. More information is online at http://www.nasa.gov/wise and http://wise.astro.ucla.edu and http://www.jpl.nasa.gov/wise .

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Water a pressing concern for typhoon survivors

TACLOBAN, Philippines (AP) — Since the typhoon hit, Danny Estember has been hiking three hours round-trip into the mountains each day to obtain what he can only hope is clean water for his five daughters and two sons.

The exhausting journey is necessary because safe water is desperately scarce in this storm-ravaged portion of the Philippines. Without it, people struggling to rebuild and even survive risk catching intestinal and other diseases that can spread if they're unable to wash properly.

While aid agencies work to provide a steady supply, survivors have resorted to scooping from streams, catching rainwater in buckets and smashing open pipes to obtain what is left from disabled pumping stations. With at least 600,000 people homeless, the demand is massive.

"I'm thirsty and hungry. I'm worried — no food, no house, no water, no money," said Estember, a 50-year-old ambulance driver.

Thousands of other people who sought shelter under the solid roof of the Tacloban City Astrodome also must improvise, taking water from wherever they can — a broken water pipe or a crumpled tarp. The water is salty and foul tasting but it is all many have had for days.

The U.S. Institute of Medicine defines an adequate daily intake of fluids as roughly 3 liters (100 ounces) for men and about 2.2 liters (75 ounces) for women. Given the shortages and hot climate, it's certain that most in the disaster zone aren't getting anything like those amounts, leaving them prone to energy-sapping dehydration.

Providing clean, safe drinking water is key to preventing the toll of dead and injured from rising in the weeks after a major natural disaster. Not only do survivors need to stay hydrated, they also need to be protected from waterborne diseases such as cholera and typhoid.

Haiti's devastating 2010 earthquake was followed by a cholera outbreak that health officials say has killed more than 8,000 people and sickened nearly 600,000. Some studies have shown that cholera may have been introduced in Haiti by U.N. troops from Nepal, where the disease is endemic.

Washing regularly, using latrines and boiling drinking water are the best ways to avoid contracting diarrhea and other ailments that could burden already stressed health services.

It took several days for aid groups to bring large quantities of water to Tacloban, the eastern Philippine city where the typhoon wreaked its worst destruction. By Friday, tankers were arriving. Philippine Red Cross workers sluiced water into enormous plastic bladders attached to faucets from which people fill jerry cans, buckets, bottles and whatever other containers they might have.

"I'm thirsty," said Lydia Advincula, 54, who for the last few days had been placing buckets out doors to catch some of the torrential downpours that have added to the misery of homeless storm survivors.

Water provisioning should get a big boost with the recent arrival of the U.S. Navy aircraft carrier USS George Washington, a virtual floating city with a distillation plant that can produce 1.5 million liters (400,000 gallons) of fresh water per day — enough to supply 2,000 homes, according to the ship's website.

Britain also is sending an aircraft carrier, the HMS Illustrious, with seven helicopters and facilities to produce fresh water, Britain's Ministry of Defense said. It said the ship is expected to reach the area about Nov. 25.

Filtration systems are now operating in Tacloban, the center of the relief effort, and two other towns in Leyte province, the hardest-hit area. Helicopters are dropping bottled water along with other relief supplies to more isolated areas.

Other more high-tech water purification solutions are also available, such as water purification bottles developed since the 2004 Indian Ocean tsunami that devastated parts of Thailand, Indonesia, India and Sri Lanka. Those contain systems that filter out parasites, bacteria and other dangerous substances from virtually any water source, making it safe to drink and alleviating the high cost and logistical difficulties that shipping in bottled water entails.

Longer-term water solutions will come once the crucial issues of shelter and security are settled and will likely have to wait several months, said John Saunders, of the U.S.-based International Association of Emergency Managers. Those water systems are far more complex, requiring expensive, specialized equipment and training for operators, he said.

"I can bring in a $300,000 water system that provides thousands of liters per day of drinking water, but who pays for the system and how is it maintained and distribution managed?" Saunders said.

Long-term solutions are a distant concern for Jaime Llanera, 44, as he stands in a shelter he and his family have fashioned out of broken plywood and a tarpaulin.

A single 500-milliliter (12-ounce) bottle of mineral water delivered by the military three days earlier is all that's available for his parents, sister, brother-in-law and a friend. To stretch their supply, they've been collecting rainwater in buckets and any other containers they can find and boiling it. They're also using rainwater to clean: His mother dunks clothing into a bucket of rainwater and tries to scrub out the filth.

The family plans to wait one more week. If help hasn't come by then, they'll try to find a way out of Tacloban so they can stay with relatives elsewhere. "We have no house. We have no home. But we're still intact," Llanera said.

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Christopher Bodeen reported from Beijing.

Copyright c 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Taking a new look at carbon nanotubes

Nov. 12, 2013 — Despite their almost incomprehensibly small size -- a diameter about one ten-thousandth the thickness of a human hair -- single-walled carbon nanotubes come in a plethora of different "species," each with its own structure and unique combination of electronic and optical properties. Characterizing the structure and properties of an individual carbon nanotube has involved a lot of guesswork -- until now.

Researchers with the U.S. Department of Energy (DOE)'s Lawrence Berkeley National Laboratory (Berkeley Lab) and the University of California (UC) Berkeley have developed a technique that can be used to identify the structure of an individual carbon nanotube and characterize its electronic and optical properties in a functional device.

"Using a novel high-contrast polarization-based optical microscopy set-up, we've demonstrated video-rate imaging and in-situ spectroscopy of individual carbon nanotubes on various substrates and in functional devices," says Feng Wang, a condensed matter physicist with Berkeley Lab's Materials Sciences Division. "For the first time, we can take images and spectra of individual nanotubes in a general environment, including on substrates or in functional devices, which should be a great tool for advancing nanotube technology."

Wang, who is also a professor with UC Berkeley's Physics Department, is the corresponding author of a paper describing this research in the journal Nature Nanotechnology. Co-authors are Kaihui Liu, Xiaoping Hong, Qin Zhou, Chenhao Jin, Jinghua Li, Weiwei Zhou, Jie Liu, Enge Wang and Alex Zettl.

A single-walled carbon nanotube can be metallic or semiconducting depending on its exact structure. Semiconducting nanotubes can have very different electronic bandgaps, resulting in wildly different electronic or optical properties.

"To fully understand field-effect devices or optoelectronic devices made from single-walled carbon nanotubes, it is critical to know what species of carbon nanotube is in the device," Wang says. "In the past, such information could not be obtained and researchers had to guess as to what was going on."

The physical structure and electronic properties of each individual species of single-walled carbon nanotubes are governed by chirality, meaning their structure has a distinct left/right orientation or "handedness," which cannot be superimposed on a mirror image. As a result, achieving chirality-controlled growth of carbon nanotubes and understanding the physics behind chirality-dependent devices are two of the biggest challenges in nanotube research.

"Polarization-based optical microscopy and spectroscopy techniques are well-suited for meeting these challenges, as polarized light is extremely sensitive to optical anisotropy in a system and has long been exploited to study chirality in molecules and crystals," Wang says. "However, the small signal and unavoidable environment background has made it difficult to use polarized optical microscopy to study single carbon nanotubes."

Difficulties arise from an apparent contradiction in polarization-based optical microscopy. For any optical microscope, a large numerical aperture (NA) objective is crucial for high-spatial resolution, but polarized light passing through a large NA objective becomes strongly depolarized. With their new technique, Wang and his colleagues were able to do what has not been done before and simultaneously achieve both high polarization and high spatial resolution.

"The key to our success was the realization that light illumination and light collection can be controlled separately," Wang says. "We used a large NA objective for light collection to obtain high spatial resolution, but were able to create an effectively small NA objective for illumination to maintain high polarization purity."

In their set-up, Wang and his colleagues collected nanotube-scattered polarized light with a 0.8 NA objective but used a much more narrow incident beam to create illumination light from a supercontinuum laser with a much smaller NA. The result was polarization an order of magnitude higher than what has been achieved with conventional polarized microscopy and spatial resolution at the nanoscale. This enabled them to obtain complete chirality profiles of hundreds of as-grown carbon nanotubes, and to perform in-situ monitoring in active field-effect devices.

"We observed that high order nanotube optical resonances are dramatically broadened by electrostatic doping, an unexpected behavior that points to strong inter-band electron-electron scattering processes dominating the ultrafast dynamics of excited states in carbon nanotubes," Wang says.

In addition to individual single-walled carbon nanotubes, Wang and his colleagues say their technique can also be used to greatly enhance the optical contrast of other anisotropic nano-sized materials that are "invisible" to conventional optical microscopes, including graphene nanoribbons, semiconductor nanowires and nanorods, and nanobiomaterials such as actin filaments.

This research was supported by grants from the National Science Foundation, the Center for Integrated Nanomechanical Systems, and by DOE's Office of Science.

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