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Evidence dates back more than 740 million years

Date:
May 25, 2016

Source:
University of California – Santa Barbara

Summary:
A paleobiologist has found evidence of predation in ancient microbial ecosystems dating back more than 740 million years. Using a scanning electron microscope to examine minute fossils, Porter found perfectly circular drill holes that may have been formed by an ancient relation of Vampyrellidae amoebae. These single-celled creatures perforate the walls of their prey and reach inside to consume its cell contents.

 

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Half-moon shaped holes (black arrows) and circular holes (white arrows) in 780–740 million-year-old fossils of shell-forming amoebae from the Chuar Group of the Grand Canyon, Arizona. Holes are approximately 15 to 35 micrometers in size: shells are 75 to 150 micrometers in length.
Credit: Susannah Porter

 

 

Vampires are real, and they’ve been around for millions of years. At least, the amoebae variety has. So suggests new research from UC Santa Barbara paleobiologist Susannah Porter.

Using a scanning electron microscope to examine minute fossils, Porter found perfectly circular drill holes that may have been formed by an ancient relation of Vampyrellidae amoebae. These single-celled creatures perforate the walls of their prey and reach inside to consume its cell contents. Porter’s findings appear in the Proceedings of the Royal Society B.

“To my knowledge these holes are the earliest direct evidence of predation on eukaryotes,” said Porter, an associate professor in UCSB’s Department of Earth Science. Eukaryotes are organisms whose cells contain a nucleus and other organelles such as mitochondria.

“We have a great record of predation on animals going back 550 million years,” she continued, “starting with the very first mineralized shells, which show evidence of drillholes. We had nothing like that for early life — for the time before animals appear. These holes potentially provide a way of looking at predator-prey interactions in very deep time in ancient microbial ecosystems.”

Porter examined fossils from the Chuar Group in the Grand Canyon — once an ancient seabed — that are between 782 and 742 million years old. The holes are about one micrometer (one thousandth of a millimeter) in diameter and occur in seven of the species she identified. The holes are not common in any single one species; in fact, they appear in not more than 10 percent of the specimens.

“I also found evidence of specificity in hole sizes, so different species show different characteristic hole sizes, which is consistent with what we know about modern vampire amoebae and their food preferences,” Porter said. “Different species of amoebae make differently sized holes. The Vampyrellid amoebae make a great modern analog, but because vampirelike feeding behavior is known in a number of different unrelated amoebae, it makes it difficult to pin down exactly who the predator was.”

According to Porter, this evidence may help to address the question of whether predation was one of the driving factors in the diversification of eukaryotes that took place about 800 million years ago.

“If that is true, then if we look at older fossil assemblages — say 1 to 1.6 billion years old — the fossilized eukaryote will show no evidence of predation,” Porter said. “I’m interested in finding out when drilling first appears in the fossil record and whether its intensity changes through time.”

Porter also is interested in seeing whether oxygen played a role in predation levels through time. She noted that the microfossils those organisms attacked were probably phytoplankton living in oxygenated surface waters, but like vampyrellid amoebae today, the predators may have lived in the sediments. She suggests that those phytoplankton made tough-walled cysts — resting structures now preserved as fossils — that sank to the bottom where they were attacked by the amoebae.

“We have evidence that the bottom waters in the Chuar Group in that Grand Canyon basin were relatively deep — 200 meters deep at most — and sometimes became anoxic, meaning they lacked oxygen,” Porter explained.

“I’m interested to know whether the predators only were present and making these drill holes when the bottom waters contained oxygen,” Porter added. “That might tie the diversification of eukaryotes and the appearance of predators to evidence for increasing oxygen levels around 800 million years ago.

“We know from the modern vampire amoebae that at least some of them make resting cysts themselves,” Porter said. “A former student of mine joked we should call these coffins. So one of our motivations is to see if we can find these coffins in the fossil assemblage as well. That’s the next project.”


Story Source:

The above post is reprinted from materials provided by University of California – Santa Barbara. The original item was written by Julie Cohen.Note: Materials may be edited for content and length.


Journal Reference:

  1. Susannah M. Porter. Tiny vampires in ancient seas: evidence for predation via perforation in fossils from the 780–740 million-year-old Chuar Group, Grand Canyon, USA. Proceedings of the Royal Society B: Biological Sciences, 2016; 283 (1831): 20160221 DOI:10.1098/rspb.2016.0221

 

Source: University of California – Santa Barbara. “Tiny ‘vampires’: Paleobiologist finds evidence of predation in ancient microbial ecosystems: Evidence dates back more than 740 million years.” ScienceDaily. ScienceDaily, 25 May 2016. <www.sciencedaily.com/releases/2016/05/160525161354.htm>.

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Date:
May 25, 2016

Source:
Society for Research in Child Development

Summary:
A new study analyzing a nationally representative US sample of 19,162 children, has found that frequent residential moves can lead to a decline in academic performance as well as higher rates of emotional and behavioral problems.

 

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A new study has found that each additional residential move that children experience is associated with a corresponding decline in reading and math scores, as well as less positive social skills and higher rates of emotional and behavioral problems.
Credit: © Halfpoint / Fotolia

 

 

America is a mobile society, with most children and their families moving once or more during childhood. Moving can bring new opportunities if families relocate to safer, more comfortable homes, or to communities with better schools. However, previous research has found that more frequent residential moves can lead to stress and disrupt children’s routines, with negative repercussions for healthy development. Now a new study has found that each additional residential move that children experience is associated with a corresponding decline in reading and math scores, as well as less positive social skills and higher rates of emotional and behavioral problems. The study compared children who move frequently with those who don’t move or who move less frequently.

The research was conducted at Boston College and appears in the journalChild Development.

The study analyzed data from a nationally representative U.S. sample of 19,162 children in the Early Childhood Longitudinal Study (Kindergarten Class of 1998-99) who were followed from kindergarten through eighth grade. Researchers sought to determine whether the effects of moving on children accumulated over time or were more salient during specific periods, and whether moving was more disruptive when it occurred in conjunction with changing schools.

They found that moving is differentially harmful for children’s well-being–that is, the effects depend on when the moves occur. “Moves during both early and middle childhood were associated with decreases in children’s social skills and increases in emotional and behavior problems, and these effects lasted for years,” explains Rebekah Levine Coley, professor of applied developmental and educational psychology at Boston College, who led the study.

“In contrast, moves during middle childhood and early adolescence–after children had started school–had shorter-term effects on children’s reading and math skills, and those effects diminished over time,” Coley adds. The study also found that while residential and school mobility was associated with small decreases in children’s functioning, these detriments could accumulate over multiple moves.

The researchers highlight the importance of addressing the myriad social and economic factors that might influence a family’s decision to move, such as changes in mothers’ employment, receipt of public assistance, family structure, or household income. These factors were accounted for in analyses predicting children’s functioning, and results revealed links between moves and children’s cognitive skills, social skills, and emotional and behavior problems, after considering the effects of these social and economic influences on moving residences.

The study also examined the role of moving homes and moving schools, finding that moving schools had unique and slightly stronger associations with children’s cognitive skills above and beyond the effects of just moving homes. Even without changing schools, though, the disruptions in daily routines and contexts caused by moving homes can interrupt children’s focus on their schoolwork and inhibit learning, the study concluded.

The study’s findings suggest that schools may play an important role in exacerbating or stabilizing the lives of children who move. Children might benefit from short-term supports from parents or school personnel after a move to help them retain their focus on academic work, according to the authors. The findings also confirm the importance of stability for children.

“As employment instability and high housing prices continue to destabilize American families, policymakers, school leaders, and teachers must develop strategies to counter the interruptions that home and school moves pose to children’s education and healthy development,” suggests Melissa Kull, formerly a doctoral student at Boston College, now a research scientist at the New York City Department of Health and Mental Hygiene, and the study’s coauthor.


Story Source:

The above post is reprinted from materials provided by Society for Research in Child Development. Note: Materials may be edited for content and length.


Journal Reference:

  1. Rebekah Levine Coley, Melissa Kull. Cumulative, Timing-Specific, and Interactive Models of Residential Mobility and Children’s Cognitive and Psychosocial Skills. Child Development, 2016; DOI:10.1111/cdev.12535

 

Source: Society for Research in Child Development. “Children’s social, academic functioning is impeded when their families move more often.” ScienceDaily. ScienceDaily, 25 May 2016. <www.sciencedaily.com/releases/2016/05/160525083914.htm>.

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10-year project revealed air pollutants accelerate plaque build-up in arteries to the heart

Date:
May 24, 2016

Source:
University of Washington Health Sciences/UW Medicine

Summary:
A major, decade-long study of thousands of Americans found that people living in areas with more outdoor pollution — even at lower levels common in the United States — accumulate deposits in the arteries that supply the heart faster than do people living in less polluted areas. The deposits in the coronary arteries accelerate the progression of atherosclerosis, which can contribute to heart disease and heart attacks.

 

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Air pollution monitors were deployed in more than 1,500 locations within the six different metro areas. In addition to air pollution data from state and local air agencies, these MESA Air monitors collected and measured variable levels of PM2.5, oxides of nitrogen, and black carbon, among other pollutants over two-week periods between 2005-2009.
Credit: MESA-Air

 

 

Long-term exposure to air pollution has been linked to an increased risk of heart disease, but the biological process has not been understood. A major, decade-long study of thousands of Americans found that people living in areas with more outdoor pollution — even at lower levels common in the United States — accumulate deposits in the arteries that supply the heart faster than do people living in less polluted areas.

The study is published May 24 online in The Lancet.

Previous epidemiological studies have shown associations between particle pollution, referred to as particulate matter, and heart disease. It has been unclear, however, how exposure to particulate matter leads to diseases of the cardiovascular system. Earlier studies had been shorter and had depended for their analysis on existing datasets collected for other purposes.

Now, direct evidence from the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air), a 10-year epidemiological study of more than 6,000 people from six U.S. states, shows that air pollution — even at levels below regulatory standards — accelerates the progression of atherosclerosis. The condition, also called hardening of the arteries, can cause heart attacks. Researchers repeatedly measured calcium deposits in the heart’s arteries by using CT scans. They also assessed each person’s exposure to pollution based on home address.

“The study provides important new information on how pollution affects the main biological process that leads to heart disease,” said Dr. Joel Kaufman, who directs MESA Air and is the lead author of the published paper. He is a University of Washington professor of environmental and occupational health sciences, and also a UW professor of epidemiology, and of medicine.

“The evidence supports worldwide efforts to reduce exposures to ambient air pollutants,” Kaufman said.

He added, “This was the most in-depth study of air pollution exposures ever applied to a large study group specifically designed to examine influences on cardiovascular health.”

The researchers calculated each participant’s exposure to ambient fine particulate matter that is less than 2.5 microns in diameter and too small to be seen by the naked eye. In addition to PM2.5, they also measured exposure to nitrogen oxide and nitrogen dioxide, and black carbon or soot.

The research team collected thousands of air pollution measurements in the study participants’ communities and at their homes. The research team developed and applied computational models that included local information on land use, roadway and traffic volumes, weather conditions, and local sources of air pollution. These models could generate accurate pollution concentrations at each person’s home. Meanwhile, between the years 2000 and 2012, participants visited study clinics several times to undergo CT scanning to determine the amount of calcium deposits in their heart arteries.

Results were strongest for fine particulate matter and the traffic-related pollutant gases called oxides of nitrogen. The study found that for every 5 µg/m3 higher concentration of PM2.5, or 35 parts per billion higher concentration of oxides of nitrogen — about the difference between more and less polluted areas of a U.S. metropolitan area — individuals had a 4 Agatston units/year faster rate of progression of coronary artery calcium scores. This is about a 20 percent acceleration in the rate of these calcium deposits.

“The effects were seen even in the United States where efforts to reduce exposure have been notably successful compared with many other parts of the world,” Kaufman said. Exposures were low when compared to U.S. ambient air quality standards, which permit an annual average PM2.5 concentration of 12 µg/m3. The participants in this MESA-Air study experienced concentrations between 9.2 and 22.6 µg/m3.

In an accompanying editorial in The Lancet, Dr. Bert Brunekreef, a professor at Utrecht University in The Netherlands, and Dr. Barbara Hoffmann, a professor of the University of Düsseldorf in Germany, described the study as “exemplary.” Noting that the results are sobering, they called for decisive action in controlling pollution levels worldwide.

10.1016/S0140-6736(16)00378-0


Story Source:

The above post is reprinted from materials provided by University of Washington Health Sciences/UW Medicine. The original item was written by Elizabeth Sharpe. Note: Materials may be edited for content and length.


Journal Reference:

  1. Joel D Kaufman et al. Association between air pollution and coronary artery calcification within six metropolitan areas in the USA (the Multi-Ethnic Study of Atherosclerosis and Air Pollution): a longitudinal cohort study. The Lancet, 2016 DOI: 10.1016/S0140-6736(16)00378-0

 

Source: University of Washington Health Sciences/UW Medicine. “Study shows how air pollution fosters heart disease: 10-year project revealed air pollutants accelerate plaque build-up in arteries to the heart.” ScienceDaily. ScienceDaily, 24 May 2016. <www.sciencedaily.com/releases/2016/05/160524212005.htm>.

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Neuroscientists boost ability of aging brain to recapture links between related memories

Date:
May 23, 2016

Source:
University of California – Los Angeles Health Sciences

Summary:
Neuroscientists have identified in mice how the brain links different memories over time. While aging weakens these connections, the team devised a way for the middle-aged brain to reconnect separate memories.The findings suggest a possible intervention for people suffering from age-related memory problems.

 

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UCLA neuroscientists artificially stimulated neurons to help the aging brain recapture connections between related memories.
Credit: UCLA/Silva Lab

Using a miniature microscope that opens a window into the brain, UCLA neuroscientists have identified in mice how the brain links different memories over time. While aging weakens these connections, the team devised a way for the middle-aged brain to reconnect separate memories.

The findings, which were published in the advance online edition of Nature, suggest a possible intervention for people suffering from age-related memory problems.

“Until now, neuroscientists have focused on how the brain creates and stores single memories,” said principal investigator Alcino Silva, a professor of neurobiology at the David Geffen School of Medicine at UCLA. “We wanted to explore how the brain links two memories and whether the passage of time affects the strength of the connection.”

“In the real world, memories don’t happen in isolation,” said first author Denise Cai, a researcher in Silva’s lab. “Our past experiences influence the creation of new memories and help us predict what to expect and make informed decisions in the future.”

In an intricate experiment, the UCLA team tested in young and middle-aged mice whether the brain linked memories of experiences separated by five hours versus seven days.

Watching neurons in real time

The lab used a miniature microscope, called a Miniscope, which was developed by UCLA neuroscientists Dr. Peyman Golshani, Baljit Khakh and Silva with funding from the presidential BRAIN Initiative and the Geffen School. The instrument’s powerful camera allowed the scientists to peer into the brains of young and observe their cells in action. The tiny, head-mounted microscope illuminated the animals’ neurons firing as the mice moved freely in their natural environments.

For 10 minutes at a time, each mouse was placed in three boxes, all unique in terms of fragrance, shape, lighting and flooring. A week’s time separated placement in the first and second boxes. Only five hours separated time spent in the second and third boxes, where the mouse later received a small shock to the foot.

Two days later, the team returned each mouse to all three boxes. As expected, the mice froze with fear when it recognized the inside of the third box.

What happened next, however, came as a surprise.

“The mouse also froze in the second box, where no shock occurred,” Silva observed. “This suggests that the mouse transferred its memory of the shock in the third box to its experience in the second box five hours earlier.”

When Silva and Cai examined the animals’ brains, the neural activity confirmed their hypothesis.

“The same brain cells that recorded the mouse’s shock in the third box also encoded its memory of the second box a few hours earlier,” Cai said. “We saw 20 percent more overlap in the neural circuits that recorded the animal’s experiences in the memories that unfolded closer in time.”

In other words, says Silva, “The memories became interrelated in how they were encoded and stored by the brain, such that the recall of one memory triggered the recall of another memory related in time.”

Exciting the brain

Based on an earlier Silva finding, the team knew that a cell is most likely to encode a memory when it’s aroused and ready to fire. Neuroscientists refer to this condition as excitability.

“The excitable brain is already warmed up,” Silva said. “It’s like stretching your muscles before exercise or revving your car engine before you drive.”

Suspecting that aging weakens neurons’ ability to fully excite, the UCLA researchers conducted a similar experiment in middle-aged mice. They introduced each of the mice to two boxes, five hours apart, and administered a foot shock in the second box.

When they returned the animals to the boxes two days later, the results could not have been more clear-cut.

“The older mice froze only in the box where they had received a shock,” Cai explained. “They did not react in the first box.”

A glimpse into the Miniscopes confirmed that the brains of the mice did not connect the two memories; each memory was encoded on its own neural circuit.

Rescuing lost connections

Next the team focused on boosting the older animals’ ability to link memories. Cai used a biological tool to excite neurons in a tiny part of the hippocampus — the memory center of the brain — before introducing the mice to the first box.

She stimulated the same cells before placing the mice in the first box and the second box, where they received a foot shock two days later.

“The proof in the pudding arrived when we reintroduced the middle-aged mice to the first box,” Silva said. “The animals froze — they now linked the shock that happened in the second box to the first. This suggests that increased excitability had reversed their age-related inability to link memories.”

Cai and Silva are currently testing an FDA-approved drug’s effect on the ability of middle-aged mice to connect memories.


Story Source:

The above post is reprinted from materials provided by University of California – Los Angeles Health Sciences. The original item was written by Elaine Schmidt. Note: Materials may be edited for content and length.


Journal Reference:

  1. Denise J. Cai, Daniel Aharoni, Tristan Shuman, Justin Shobe, Jeremy Biane, Weilin Song, Brandon Wei, Michael Veshkini, Mimi La-Vu, Jerry Lou, Sergio E. Flores, Isaac Kim, Yoshitake Sano, Miou Zhou, Karsten Baumgaertel, Ayal Lavi, Masakazu Kamata, Mark Tuszynski, Mark Mayford, Peyman Golshani, Alcino J. Silva. A shared neural ensemble links distinct contextual memories encoded close in time. Nature, 2016; DOI: 10.1038/nature17955

 

Source: University of California – Los Angeles Health Sciences. “How brain connects memories across time: Neuroscientists boost ability of aging brain to recapture links between related memories.” ScienceDaily. ScienceDaily, 23 May 2016. <www.sciencedaily.com/releases/2016/05/160523113730.htm>.

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Small Business Global Trade Award from World Trade Week NY 2016

 

This week, Target Health received the Small Business Global Trade Award from WORLD TRADE WEEK NYC 2016. The award was presented to Dr. Jules T. Mitchel, President of Target Health by Nancy Ploeger, International Women’s Entrepreneurial Challenge Foundation, and Maria Torres-Springer, President and CEO of the New York City Economic Development Corporation (NYCEDC).

 

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ON TARGET is the newsletter of Target Health Inc., a NYC – based, full – service, contract research organization (eCRO), providing strategic planning, regulatory affairs, clinical research, data management, biostatistics, medical writing and software services to the pharmaceutical and device industries, including the paperless clinical trial.

 

For more information about Target Health contact Warren Pearlson (212-681-2100 ext. 165). For additional information about software tools for paperless clinical trials, please also feel free to contact Dr. Jules T. Mitchel or Ms. Joyce Hays. The Target Health software tools are designed to partner with both CROs and Sponsors. Please visit the Target Health Website.

 

Joyce Hays, Founder and Editor in Chief of On Target

Jules Mitchel, Editor

 

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Podiatry

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Podiatric Surgery – by © Photographer – James C. Mutter / Podiatrist Kamran Jamshidinia, MD /, CC BY-SA 3.0,commons.wikimedia.org/w/index.php?curid=10953439

 

 

Podiatry or podiatric medicine is a branch of medicine devoted to the study of, diagnosis, and medical and surgical treatment of disorders of the 1) ___, ankle and lower extremity. The term podiatry came into use in the early 20th century in the United States and is now used worldwide, including countries such as the United Kingdom and Australia. Podiatry is practiced as a specialty in many countries, while in many English-speaking countries, the older title of 2) ___ may be used by some clinicians (not to be confused with chiropractic, which is unrelated). In Australia, the title is podiatrist or podiatric physician and the specialist is the podiatric surgeon. In many non-English-speaking countries of Europe, the title used may be podologist or podologo. The level and scope of the practice of podiatry vary among countries.

 

According to the American Association of Colleges of Podiatric Medicine, a Doctor of Podiatric Medicine (DPM) is a medical specialist who diagnoses and treats conditions affecting the foot, ankle, and structures of the 3) ___leg. The US podiatric medical school curriculum includes lower extremity anatomy, general human anatomy, physiology, general medicine, physical assessment, biochemistry, neurobiology, pathophysiology, genetics and embryology, microbiology, histology, pharmacology, women’s health, physical rehabilitation, sports medicine, research, ethics and jurisprudence, biomechanics, general principles of orthopedic surgery, and foot and ankle surgery. US trained podiatrists rotate through major areas of medicine during residency, including emergency medicine, orthopedic surgery, general surgery, anesthesia, radiology, pathology, infectious disease, endocrinology, sports medicine, physical therapy, biomechanics, geriatrics, internal medicine, critical care, cardiology, vascular surgery, psychiatric and behavioral health, neurology, pediatrics, dermatology, pain management, wound care and primary care.

 

In the United States, medical and surgical care of the foot and ankle is mainly provided by two groups of physicians: podiatrists (Doctor of Podiatric Medicine or DPM) and 4) ___ surgeons (MD or DO). The first year of podiatric medical school is similar to training that M.D. and DO. students receive, but with an emphasized scope on foot, ankle, and lower extremity. Being classified as a second entry degree, in order to be considered for admission an applicant must first complete a minimum of 90 semester hours at the university level or more commonly, complete a bachelor’s degree with emphasis on general/organic chemistry, biochemistry, biology, etc. In addition, potential students are required to take the MCAT, which stands for, 5) ___ ___ ___. The DPM degree itself takes a minimum of four years to complete. The four-year podiatric medical school is followed by a surgical based residency, which is hands-on post-doctoral training. There are two standard residencies: Podiatric Medicine & Surgery 24 and Podiatric Medicine & Surgery 36 (PM&S 24 or PM&S 36). These represent the two- or three-year residency training. As of, July 2013, all residency programs in podiatry are required to transition to a minimum three-years of post-doctoral training.

 

Upon completion of their residency, podiatrists can decide to become board certified by a number of specialty boards including the more common American Board of Podiatric Medicine and/or the American Board of Podiatric Surgery. The ABPMS or The American Board of Podiatric Medical Specialties has been certifying podiatrists since 1998. Within the American Board of Podiatric Surgery, PM&S 24 graduates can sit for Board Certification in Foot 6) ___Surgery and those that complete PM&S 36 can sit for Board Certification in Foot Surgery and Board Certification in Reconstructive Rearfoot & Ankle Surgery. Both boards in ABPS are examined as separate tracks. Though the ABPS and ABPM are more common, other boards are equally challenging and confer board qualified/certified status. Fellowship training is available after residency in such fields such as geriatrics, foot and ankle traumatology, infectious disease etc. In reality though, the residency training of most podiatry residencies today are already highly inclusive of these medical areas.

 

Podiatrists certified by the ABPS have successfully completed an intense board certification process comparable to that undertaken by individual MD and DO specialties. There are two surgical certifications under ABPS. They are Foot Surgery and Reconstructive Rearfoot/Ankle (RRA) Surgery. In order to be Board Certified in RRA, the sitting candidate has to have already achieved board certification in Foot Surgery. Certification by ABPS requires initial successful passing of the written examination. Then the candidate is required to submit surgical logs indicating experience and variety. Once accepted, the candidate has to successfully pass oral examination and computer questions of clinical simulation. While the majority of podiatric physicians are in solo practice, there has been a movement toward larger group practices as well as the use of podiatrists in multi-specialty groups including orthopedic groups, treating the effects of a disease like 7) ___, on feet, or in multi-specialty orthopedic surgical groups. Some podiatrists work within clinic practices such as the Indian Health Service (IHS), the Rural Health Centers (RHC) and Community Health Center (FQHC) systems established by the US government to provide services to under-insured and non-insured patients as well as within the United States Department of Veterans Affairs providing care to veterans of military service. Some podiatrists have primarily surgical practices. Some specialists complete additional fellowship training in reconstruction of the foot and ankle from the effect of diabetes or physical trauma. Other surgeons practice minimally invasive percutaneous surgery for cosmetic correction of hammer 8) ___ and bunions. Podiatrists utilize medical, orthopedic, biomechanical and surgical principles to maintain and correct foot deformities. Podiatrists may also be able to be a Chief of Surgery in a public or private hospital. Podiatrists use 9) ___laser products for plantar warts, neuromas, in- grown toe nails and for the ablation, vaporization and coagulation of soft tissue among other uses.

 

ANSWERS: 1) Foot; 2) chiropodist; 3) leg; 4) orthopedic; 5) Medical College Admission Test; 6) Surgery; 7) diabetes; 8) toes; 9) laser

 

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William M. Scholl MD

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William M. Scholl MD (1882-1968)

 

William M. Scholl (June 22, 1882 – March 30, 1968) was a pioneer of foot care and the founder of Dr. Scholl’s, a brand of foot care products. Scholl was born in La Porte, Indiana, one of 13 children. His parents were dairy farmers, his grandfather was a cobbler. His first job was at a shoemaker’s shop in Michigan City, Ind. Scholl came to Chicago in 1899 and worked at Rupert’s Shoe Store on East Harrison Street. Scholl studied medicine at Loyola University Chicago. During his studies, while working in a shoe store in the evenings, he became interested in podiatry. He graduated from Illinois Medical College (which later became part of Loyola University) in 1904.

 

In 1904, Scholl invented and patented an arch support and founded Dr. Scholl’s in order to sell it. He was joined by his brother Frank who directed the company’s overseas business, establishing Scholl Manufacturing Company, Ltd. in London in 1910. Three years later, after patenting some products to ease foot pain, he incorporated the Scholl Manufacturing Co., where the motto was “Early to bed, early to rise, work like hell and advertise!“ In 1912, he started the Illinois College of Chiropody and Orthopedics, located at 1321 N. Clark St. in Chicago. Scholl taught there, performed clinical work and financed the operation of the school until it was taken over by a non-profit corporation. Scholl went on to develop more than 1,000 foot aids. These included a silver clip designed in 1946 to treat ingrown toenails. While too soft to have much of a corrective effect and difficult to apply, it inspired later steel clip designs. Scholl practiced medicine in Chicago from 1905 until 1946 while also directing his company. He continued to serve as the company’s President and chief executive officer until March 1968, when he was elected Chairman of the Board. He worked in that capacity until his death. He left the bulk of his estate to the Dr. Scholl Foundation which he had established in 1947.

 

Scholl never married. His brother Frank, who had helped set up the original company, had sons who were doctors and were involved in the company and foot care. The William Scholl College of Podiatric Medicine at Dearborn and Oak Streets is not just a school, it’s the heart of an effort to make sure everyone has healthy feet, regardless of how much money they have or where they live. In 2001 the college merged with Finch University of Health Sciences/The Chicago Medical School. Most classroom and lab activities have relocated to Finch’s campus in suburban North Chicago. Here there is a teaching clinic where supervised students trim calluses and file toenails for $15. There’s also another clinic where the students and doctors offer free services from checkups to surgery for the uninsured and an award-winning program that takes students to homeless shelters around the city. Recently a new free clinic has opened to treat the foot problems connected to diabetes. More than 2,000 patients are treated courtesy of the Scholl College each year. “We’re the only source of foot care for a lot of people,“ said Dr. Philip Gianfortune, chairman of Scholl’s department of medicine and an alumnus, class of 1982. “We keep the senior citizens independent and the working poor working, so they don’t get unemployed or homeless,“ he said. “It’s part of our mission to educate students as well as treat those in need.“ We check reflexes and circulation, clip nails, ask about medical problems and medications and talk to about home, family and life in general.

 

The college changed names several times over the years, to reflect the changing language of the profession. It became the Scholl College of Podiatric Medicine in 1986. (The school is not affiliated with Shearing-Plough, which now owns the Scholl product company, although Shearing-Plough has been generous with donations.) The school expanded to 1327 N. Clark St. and remained there until 1973, when it hopped to its current home at 1001 N. Dearborn St. The building also houses the Foot and Ankle Clinics of America’s Gold Coast location, where supervised students can treat patients. Constructed in 1928, the building had been home to the Harriet W. McCormick YWCA and there are still elements of those grand old days. Just off the clean, modern lobby is the building’s original entryway. Here, the ceiling is a beautiful gold dome. The floors are marble and the walls are covered with elegant tiles, design elements from an earlier time. A large part of the patient population is based in the inner city. Making sure the most patients get the best services is important to the students and their instructors who started a foot-care program for the homeless, a program that would go to shelters. It’s essential for the homeless to remain ambulatory to seek adequate care, shelter and possible employment. This program, with the help of the Illinois Podiatric Medical Association, became a reality on a national level. Teams of traveling students and instructors examine feet, cut nails, give out socks and construct foam sheaths to protect hurt toes. Depending on circumstances, they may treat anything from frostbite to gunshot wounds to foot and ankle ulcers. Scholl doctors also have collected data from their shelter patients to determine the most serious problems faced by the homeless and to develop treatment plans.

 

The Illinois Department of Public Health, the U.S. Public Health Service and Department of Health and Human Services have given the program several awards and schools around the nation call Scholl for advice in setting up their own versions. Over the years, the college has “shared soles“ with the needy in the form of giant shoe drives. More than 150,000 pairs of shoes have been donated and more come in all the time. Shoe stores going out of business, donate to shelters and clinics, through the Scholl program. The William Scholl College of Podiatric Medicine teaching clinic operates Tuesdays and Thursdays from 8:30 a.m to 1:30 p.m. The clinic for the uninsured operates Tuesdays and Thursdays from 2:30 to 6:30 p.m. For information, call the Foot and Ankle Clinics of America’s Gold Coast location at 312-280-7886 or the college at 312-280-2880.

 

Americans don’t pay enough attention to the care of their feet. We rarely recommend physicians, however about a year ago we did give the name of an outstanding endodontist here in Manhattan, and with this publication we can recommend another outstanding doctor, podiatrist, Dr. Jennifer McCoy at 1125 Park Avenue.

 

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Increased Physical Activity Associated with Lower Risk of 13 Types of Cancer

 

Hundreds of previous studies have examined associations between physical activity and cancer risk and shown reduced risks for colon, breast, and endometrial cancers; however, results have been inconclusive for most cancer types due to small numbers of participants in the studies. A new study was recently published online in JAMA Internal Medicine (16 May 2016) showed that greater levels of leisure-time physical activity were associated with a lower risk of developing 13 different types of cancer. The risk of developing seven cancer types was 20% (or more) lower among the most active participants (90th percentile of activity) as compared with the least active participants (10th percentile of activity). The study pooled data on 1.44 million people, ages 19 to 98, from the United States and Europe, and was able to examine a broad range of cancers, including rare malignancies. Participants were followed for a median of 11 years during which 187,000 new cases of cancer occurred.

 

The study confirmed that leisure-time physical activity, as assessed by self-reported surveys, was associated with a lower risk of colon, breast, and endometrial cancers. They also determined that leisure-time physical activity was associated with a lower risk of 10 additional cancers, with the greatest risk reductions for esophageal adenocarcinoma, liver cancer, cancer of the gastric cardia, kidney cancer, and myeloid leukemia. Myeloma and cancers of the head and neck, rectum, and bladder also showed reduced risks that were significant, but not as strong. Risk was reduced for lung cancer, but only for current and former smokers; the reasons for this are still being studied.

 

Leisure-time physical activity is defined as exercise done at one’s own discretion, often to improve or maintain fitness or health. Examples include walking, running, swimming, and other moderate to vigorous intensity activities. The median level of activity in the study was about 150 minutes of moderate-intensity activity per week, which is comparable to the current recommended minimum level of physical activity for the U.S. population.

 

There are a number of mechanisms through which physical activity could affect cancer risk. It has been hypothesized that cancer growth could be initiated or abetted by three metabolic pathways that are also affected by exercise: estrogens and androgens; insulin and insulin-like growth factors; and proteins involved with both insulin metabolism and inflammation. Additionally, several non-hormonal mechanisms have been hypothesized to link physical activity to cancer risk, including inflammation, immune function, oxidative stress, and, for colon cancer, a reduction in time that it takes for waste to pass through the gastrointestinal tract. Most associations between physical activity and lower cancer risk changed little when adjusted for body mass index, suggesting that physical activity acts through mechanisms other than lowering body weight to reduce cancer risk. Associations between physical activity and cancer were also similar in subgroups of normal weight and overweight participants, and in current smokers or people who never smoked.

 

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Investigational Malaria Vaccine Protects Healthy U.S. Adults for More than One Year

 

The parasites that cause malaria are transmitted to humans through the bite of an infected mosquito. The PfSPZ Vaccine is composed of live, but weakened P. falciparum sporozoites — the early developmental form of the parasite. Previous research showed the PfSPZ Vaccine to be highly protective three weeks after immunization.

 

According to an article published online in Nature Medicine (9 May 2016), an experimental malaria vaccine protected a small number of healthy, malaria-naive adults in the United States from infection for more than one year after immunization. The vaccine, known as the PfSPZ Vaccine, was developed and produced by Sanaria Inc., of Rockville, Maryland, with support from several Small Business Innovation Research (SBIR) awards from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. NIAID researchers and collaborators at the University of Maryland School of Medicine in Baltimore, conducted the clinical evaluation of the vaccine, which involved immunization and exposing willing healthy adults to the malaria-causing parasite Plasmodium falciparum (P. falciparum) in a controlled setting.

 

The Phase 1 trial took place at the NIH Clinical Center in Bethesda, Maryland, and at the University of Maryland Medical Center and enrolled 101 healthy adults aged 18 to 45 years who had never had malaria. Of these volunteers, 59 received the PfSPZ Vaccine; 32 participants served as controls and were not vaccinated. Vaccine recipients were divided into several groups to assess the roles of the route of administration, dose, and number of immunizations in conferring short- and long-term protection against malaria.

 

To determine if the number of immunizations influenced protection, vaccinated participants received either three (nine participants) or four (28 participants) intravenous (IV) immunizations of the PfSPZ Vaccine at a higher dose than tested in previous human studies. To compare the protective efficacy of different routes of administration, eight participants received four immunizations via intramuscular injection (IM) at a dose approximately 10-fold higher than the dose administered intravenously. This was done to help the research team assess if IV administration was necessary and more efficient based on the dose required. To evaluate how well the PfSPZ Vaccine prevented malaria infection, all participants – including the control participants who were not vaccinated — were exposed at varying times to the bites of mosquitoes carrying the same P. falciparum strain from which the PfSPZ Vaccine was derived. The Walter Reed Army Institute of Research in Silver Spring, Maryland, carried out this controlled human malaria infection procedure — a standard process in early phase malaria vaccine trials.

 

To assess short-term protection, participants were exposed to the bites of parasite-infected mosquitoes three weeks after receiving their final vaccination. Scientists then took blood samples from each participant to measure parasite levels for evidence of protection. For nine participants who received three IV doses, three were protected, or had no detectable parasites in their blood. For the nine participants who received four IV doses, seven were protected. Only three of the eight participants who received four IM doses were protected, indicating that IV administration afforded higher levels of protection at a lower dose. To assess long-term protection, an additional group of 11 participants received four IV doses of the investigational vaccine and were exposed to the bites of malaria parasite-infected mosquitoes 21 weeks after their final vaccination. Results showed that six of 11 participants (55%) had no detectable parasites in their blood after this exposure. Four of these six participants, plus one of the participants who received the same four doses via IV and had no parasites in the blood after exposures at three weeks and 21 weeks, were exposed to mosquito bites again at 59 weeks after their final vaccination. All five participants exposed at 59 weeks did not develop parasites in their blood, while all six unvaccinated control participants became infected with malaria parasites.

 

Collectively, the data showed that the PfSPZ Vaccine provided malaria protection for more than one year in 55% of people without prior malaria infection. In those individuals, the PfSPZ Vaccine appeared to confer sterile protection, meaning the individuals would be protected against disease and could not further transmit malaria. The vaccinations were also well-tolerated among participants, and there were no serious adverse events attributed to vaccination. Additional results showed that antibodies may play a role in malaria protection early after the final immunization, but inducing T cells in the liver is likely necessary for durable protection. Long-term, reliable protection is important for people who are vaccinated but not exposed to malaria for months, such as travelers and military personnel. Durable protection is also important for mass vaccination campaigns in malaria-endemic regions aimed at interrupting transmission, according to the authors.

 

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FDA Approves New, Targeted Treatment for Bladder Cancer

 

Urothelial carcinoma is the most common type of bladder cancer and occurs in the urinary tract system, involving the bladder and related organs. The National Cancer Institute (NCI) estimates 76,960 new cases of bladder cancer and 16,390 deaths from the disease in 2016.

 

The FDA has approved Tecentriq (atezolizumab) to treat urothelial carcinoma. Tecentriq targets the PD-1/PD-L1 pathway (proteins found on the body’s immune cells and some cancer cells). By blocking these interactions, Tecentriq may help the body’s immune system fight cancer cells. Tecentriq is the first FDA-approved PD-L1 inhibitor and the latest in the broader class of PD-1/PD-L1 targeted biologics approved by the FDA in the last two years. Tecentriq is approved for the treatment of patients with locally advanced or metastatic urothelial carcinoma whose disease has worsened during or following platinum-containing chemotherapy, orwithin 12 months of receiving platinum-containing chemotherapy, either before (neoadjuvant) or after (adjuvant) surgical treatment.

 

The safety and efficacy of Tecentriq were studied in a single-arm clinical trial involving 310 patients with locally advanced or metastatic urothelial carcinoma. This trial measured the percentage of patients who experienced complete or partial shrinkage of their tumors (objective response rate). The study also looked at the difference in effect based on “positive“ versus “negative“ expression of the PD-L1 protein on patients’ tumor-infiltrating immune cells. In all patients, 14.8% of participants experienced at least a partial shrinkage of their tumors, an effect that lasted from more than 2.1 to more than 13.8 months at the time of the response analysis. In patients who were classified as “positive“ for PD-L1 expression, 26% of participants experienced a tumor response (compared to 9.5% of participants who were classified as “negative“ for PD-L1 expression). While patients who received Tecentriq experienced a tumor response across the study, the greater effect in those who were classified as “positive“ for PD-L1 expression suggests that the level of PD-L1 expression in tumor-infiltrating immune cells may help identify patients who are more likely to respond to treatment with Tecentriq. Therefore, today the FDA also approved the Ventana PD-L1 (SP142) assay to detect PD-L1 protein expression levels onpatients’ tumor-infiltrating immune cells and help physicians determine which patients may benefit most from treatment with Tecentriq. The most common side effects of treatment with Tencentriq were fatigue, decreased appetite, nausea, urinary tract infection, fever (pyrexia) and constipation. Tencentriq also has the potential to cause infection and serious side effects that result from the immune system effect of Tencentriq (known as “immune-mediated side effects“). These severe immune-mediated side effects involve healthy organs, including the lung, colon and endocrine system.

 

The FDA granted the Tecentriq application breakthrough therapy designation, priority review status and accelerated approval for this indication. These are distinct programs intended to facilitate and expedite the development and review of certain new drugs in light of their potential to benefit patients with serious or life-threatening conditions.

 

Tecentriq is marketed by Genentech based in San Francisco, California. The Ventana PD-L1 (SP142) assay complementary diagnostic for Tecentriq is marketed by Ventana Medical Systems, based in Tucson, Arizona.

 

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