There are lots of diseases and health issues for humans to worry about in general, and yet we tend to create more of them as time goes on. Lead poisoning, cancer from tanning beds, lots of stuff from smoking. And now that we're addicted to gadgets it was only a matter of time before the health effects starting showing.
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PUBLIC RELEASE DATE: 27-Oct-2013
ShareContact: Mark Derewicz
mark.derewicz@unch.unc.edu
919-923-0959
University of North Carolina Health Care
CHAPEL HILL, N.C. Dendrites, the branch-like projections of neurons, were once thought to be passive wiring in the brain. But now researchers at the University of North Carolina at Chapel Hill have shown that these dendrites do more than relay information from one neuron to the next. They actively process information, multiplying the brain's computing power.
"Suddenly, it's as if the processing power of the brain is much greater than we had originally thought," said Spencer Smith, PhD, an assistant professor in the UNC School of Medicine.
His team's findings, published October 27 in the journal Nature, could change the way scientists think about long-standing scientific models of how neural circuitry functions in the brain, while also helping researchers better understand neurological disorders.
"Imagine you're reverse engineering a piece of alien technology, and what you thought was simple wiring turns out to be transistors that compute information," Smith said. "That's what this finding is like. The implications are exciting to think about."
Axons are where neurons conventionally generate electrical spikes, but many of the same molecules that support axonal spikes are also present in the dendrites. Previous research using dissected brain tissue had demonstrated that dendrites can use those molecules to generate electrical spikes themselves, but it was unclear whether normal brain activity involved those dendritic spikes. For example, could dendritic spikes be involved in how we see?
The answer, Smith's team found, is yes. Dendrites effectively act as mini-neural computers, actively processing neuronal input signals themselves.
Directly demonstrating this required a series of intricate experiments that took years and spanned two continents, beginning in senior author Michael Hausser's lab at University College London, and being completed after Smith and Ikuko Smith, PhD, DVM, set up their own lab at the University of North Carolina. They used patch-clamp electrophysiology to attach a microscopic glass pipette electrode, filled with a physiological solution, to a neuronal dendrite in the brain of a mouse. The idea was to directly "listen" in on the electrical signaling process.
"Attaching the pipette to a dendrite is tremendously technically challenging," Smith said. "You can't approach the dendrite from any direction. And you can't see the dendrite. So you have to do this blind. It's like fishing if all you can see is the electrical trace of a fish." And you can't use bait. "You just go for it and see if you can hit a dendrite," he said. "Most of the time you can't."
But Smith built his own two-photon microscope system to make things easier.
Once the pipette was attached to a dendrite, Smith's team took electrical recordings from individual dendrites within the brains of anesthetized and awake mice. As the mice viewed visual stimuli on a computer screen, the researchers saw an unusual pattern of electrical signals bursts of spikes in the dendrite.
Smith's team then found that the dendritic spikes occurred selectively, depending on the visual stimulus, indicating that the dendrites processed information about what the animal was seeing.
To provide visual evidence of their finding, Smith's team filled neurons with calcium dye, which provided an optical readout of spiking. This revealed that dendrites fired spikes while other parts of the neuron did not, meaning that the spikes were the result of local processing within the dendrites.
Study co-author Tiago Branco, PhD, created a biophysical, mathematical model of neurons and found that known mechanisms could support the dendritic spiking recorded electrically, further validating the interpretation of the data.
"All the data pointed to the same conclusion," Smith said. "The dendrites are not passive integrators of sensory-driven input; they seem to be a computational unit as well."
His team plans to explore what this newly discovered dendritic role may play in brain circuitry and particularly in conditions like Timothy syndrome, in which the integration of dendritic signals may go awry.
###
Study co-authors were Ikuko Smith, PhD, DVM, Tiago Branco, PhD, and Michael Husser, PhD. This work was supported by a Long-Term Fellowship and a Career Development Award from the Human Frontier Science Program, and a Klingenstein Fellowship to S. Smith, a Helen Lyng White Fellowship to I. Smith, a Wellcome Trust and Royal Society Fellowship, and Medical Research Council (UK) support to T. Branco, and grants from the Wellcome Trust, the European Research Council, and Gatsby Charitable Foundation to M. Husser.
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
PUBLIC RELEASE DATE: 27-Oct-2013
ShareContact: Mark Derewicz
mark.derewicz@unch.unc.edu
919-923-0959
University of North Carolina Health Care
CHAPEL HILL, N.C. Dendrites, the branch-like projections of neurons, were once thought to be passive wiring in the brain. But now researchers at the University of North Carolina at Chapel Hill have shown that these dendrites do more than relay information from one neuron to the next. They actively process information, multiplying the brain's computing power.
"Suddenly, it's as if the processing power of the brain is much greater than we had originally thought," said Spencer Smith, PhD, an assistant professor in the UNC School of Medicine.
His team's findings, published October 27 in the journal Nature, could change the way scientists think about long-standing scientific models of how neural circuitry functions in the brain, while also helping researchers better understand neurological disorders.
"Imagine you're reverse engineering a piece of alien technology, and what you thought was simple wiring turns out to be transistors that compute information," Smith said. "That's what this finding is like. The implications are exciting to think about."
Axons are where neurons conventionally generate electrical spikes, but many of the same molecules that support axonal spikes are also present in the dendrites. Previous research using dissected brain tissue had demonstrated that dendrites can use those molecules to generate electrical spikes themselves, but it was unclear whether normal brain activity involved those dendritic spikes. For example, could dendritic spikes be involved in how we see?
The answer, Smith's team found, is yes. Dendrites effectively act as mini-neural computers, actively processing neuronal input signals themselves.
Directly demonstrating this required a series of intricate experiments that took years and spanned two continents, beginning in senior author Michael Hausser's lab at University College London, and being completed after Smith and Ikuko Smith, PhD, DVM, set up their own lab at the University of North Carolina. They used patch-clamp electrophysiology to attach a microscopic glass pipette electrode, filled with a physiological solution, to a neuronal dendrite in the brain of a mouse. The idea was to directly "listen" in on the electrical signaling process.
"Attaching the pipette to a dendrite is tremendously technically challenging," Smith said. "You can't approach the dendrite from any direction. And you can't see the dendrite. So you have to do this blind. It's like fishing if all you can see is the electrical trace of a fish." And you can't use bait. "You just go for it and see if you can hit a dendrite," he said. "Most of the time you can't."
But Smith built his own two-photon microscope system to make things easier.
Once the pipette was attached to a dendrite, Smith's team took electrical recordings from individual dendrites within the brains of anesthetized and awake mice. As the mice viewed visual stimuli on a computer screen, the researchers saw an unusual pattern of electrical signals bursts of spikes in the dendrite.
Smith's team then found that the dendritic spikes occurred selectively, depending on the visual stimulus, indicating that the dendrites processed information about what the animal was seeing.
To provide visual evidence of their finding, Smith's team filled neurons with calcium dye, which provided an optical readout of spiking. This revealed that dendrites fired spikes while other parts of the neuron did not, meaning that the spikes were the result of local processing within the dendrites.
Study co-author Tiago Branco, PhD, created a biophysical, mathematical model of neurons and found that known mechanisms could support the dendritic spiking recorded electrically, further validating the interpretation of the data.
"All the data pointed to the same conclusion," Smith said. "The dendrites are not passive integrators of sensory-driven input; they seem to be a computational unit as well."
His team plans to explore what this newly discovered dendritic role may play in brain circuitry and particularly in conditions like Timothy syndrome, in which the integration of dendritic signals may go awry.
###
Study co-authors were Ikuko Smith, PhD, DVM, Tiago Branco, PhD, and Michael Husser, PhD. This work was supported by a Long-Term Fellowship and a Career Development Award from the Human Frontier Science Program, and a Klingenstein Fellowship to S. Smith, a Helen Lyng White Fellowship to I. Smith, a Wellcome Trust and Royal Society Fellowship, and Medical Research Council (UK) support to T. Branco, and grants from the Wellcome Trust, the European Research Council, and Gatsby Charitable Foundation to M. Husser.
Share
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
KANSAS CITY, Mo. (AP) — The Kansas City Chiefs know that they're going to get the opposing team's best shot every time they step on the field.
That comes with being the NFL's lone unbeaten team.
They wouldn't want it any other way.
"We love it," Chiefs quarterback Alex Smith said. "You want the stages to get bigger. That's why you put all the work in. You want this opportunity. You want that honor."
The Chiefs got another stiff test from the Cleveland Browns on Sunday, racing out to a big first-half lead and then holding on through a harrowing second half.
The result was a tenuous 23-17 victory and just the second 8-0 start in franchise history.
"I mean, not that anybody sneaks up on anybody in this league, but yeah, we're the only undefeated team," said Smith, who threw for 225 yards and two touchdowns.
"I think that teams have recognized how we're playing and no question, they're coming prepared."
Jason Campbell, starting in place of the ineffective Brandon Weeden, threw for 293 yards and two touchdowns for the Browns.
His second scoring pass, a 17-yarder to Fozzy Whittaker out of the backfield, got Cleveland within a field goal early in the third quarter.
The Chiefs kept making stops down the stretch, though. They punted with 3:55 left, but forced Campbell out of the pocket on fourth down, and his pass bounced off wide receiver Davone Bess for an incompletion. It was one of several drops for Bess, who also fumbled on a punt return.
Ryan Succop tacked on his third field goal of the game with 17 seconds left, and the Browns were unable to do anything with their final possession before time expired.
"We weren't able to make the plays at the end there to win the game," Brown coach Rob Chudzinski said. "Kansas City started fast and we weren't able to get anything going early in the game. I thought our guys did a great job of fighting and getting back in the game.
"We were in position a couple of times," he said, "one break or one play."
Josh Gordon had five catches for 132 yards and a touchdown in what could be his final game for the Browns. They've been fielding offers for him ahead of Tuesday's trade deadline.
"I know just as much as you all know," Gordon said. "When it happens, if it doesn't happen, we'll know at the same time."
The Chiefs marched downfield on the game's opening possession before settling for Succop's first field goal, and then did the exact same thing when they got the ball back moments later.
Kansas City eventually reached the end zone early in the second quarter when Smith found fullback Anthony Sherman out of the backfield on third-and-10. He picked up a couple of marvelous blocks and rumbled 12 yards for his first career score and a 13-0 lead.
Meanwhile, the Browns' offense struggled to get on track, going three-and-out on their first three series. Campbell overshot a couple of wide receivers, but the real problem was their lack of a running game — they had three carries for minus-1 yard at halftime.
"We have to start faster," Campbell said.
It took some trickery for Cleveland to score. Campbell handed off to Willis McGahee, who flipped it back to the quarterback, and he hit Gordon in stride for a 39-yard reception.
The good vibes on their sideline were short-lived, though.
Jamaal Charles ripped off two long runs, including one to convert another third down — the Chiefs were 9 of 12 in the half — to get into Cleveland territory. Smith finished the drive by hitting Dexter McCluster down the seam for a 28-yard scoring pass.
The Browns managed to get a field goal to get within 20-10 just before the break, and then carried the momentum into the second half, closing within a field goal on Whittaker's TD catch.
That was as close as the Chiefs defense would allow them to get.
"The best you can be right now is 8-0 and that's where we're at," Chiefs linebacker Derrick Johnson said. "Everybody's going to give us their best. We know that. If we can take that punch and keep rolling, that's what we did today. It wasn't pretty, but a 'W' sure does look good."
Notes: Chiefs DL Mike Catapano left the game with a sprained ankle and did not return. ... Charles briefly left the game with a bruised knee. ... Browns WR Travis Benjamin left the game with a knee injury. ... Smith had thrown 122 passes without a TD completion before hitting Sherman in the second quarter.
___
AP NFL website: www.pro32.ap.org
Screens, considered by many to be the best VNC app for iOS and Mac, has been updated to version 3.1 and it brings with it a bevy of great new, and updated, features. You've got as-full-as-iOS-allows Bluetooth keyboard support, you can search through your saved screens, AirPlay Mirroring performance has been improved, Hot Corner support has been added, so have Disconnect Actions, and there are improved pasteboard transfers. It's also 64-bit on iPhone 5s, iPad mini Retina, and iPad Air. For more on the update, check out Luc Vandal's blog post over at Edovia.
If you already have Screens, the update is ready and waiting for you. If not, and you're looking for a great way to access your Mac or Windows PC remotely, get it now!
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FILE - In this Aug. 1, 2012 file photo, Jeffrey Zients testifies on Capitol Hill in Washington. President Barack Obama is calling Zients to help correct problems with the new federal health care website. The White House says Zients will assist a team that is said to be working around the clock on the site, www.healthcare.gov. (AP Photo/J. Scott Applewhite, File)
FILE - In this Aug. 1, 2012 file photo, Jeffrey Zients testifies on Capitol Hill in Washington. President Barack Obama is calling Zients to help correct problems with the new federal health care website. The White House says Zients will assist a team that is said to be working around the clock on the site, www.healthcare.gov. (AP Photo/J. Scott Applewhite, File)
WASHINGTON (AP) — It should be working well by the end of November. That's the Obama administration's rough timetable for completing a long list of fixes to HealthCare.gov, the new, trouble-plagued website for uninsured Americans to get coverage.
Summarizing a week's worth of intensive diagnostics, the administration acknowledged Friday the site has dozens of complex problems and tapped a private company to oversee fixes.
Jeffrey Zients, a management consultant brought in by the White House to assess the extent of problems, told reporters his review found dozens of issues across the entire system. The site is made up of layers of components that are meant to interact in real time with consumers, government agencies and insurance company computers.
It will take a lot of work, but "HealthCare.gov is fixable," Zients declared.
The vast majority of the issues will be resolved by the end of November, he asserted, and there will be many fewer screen freezes. He stopped short of saying problems will completely vanish.
The troubles have been nightmarish for the White House, which had promoted enrollment to be as simple as making a purchase on Amazon.com. This week, President Barack Obama declared himself frustrated by the setbacks while still trumpeting the benefits of the health care law and encouraging consumers to apply by phone if the website proved a hindrance.
In his weekly radio and internet address Saturday, Obama vowed that "in the coming weeks, we are going to get it working as smoothly as it's supposed to." In the meantime, he encouraged the public to call 1-800-318-2596 or visit LocalHelp.HealthCare.gov.
"We're only a few weeks into a six-month open enrollment period, and everyone who wants insurance through the marketplace will get it," he said.
As part of its effort to repair the system, the administration said it is promoting one of the website contractors, a subsidiary of the nation's largest health insurance company, to take on the role of "general contractor" shepherding the fixes.
Quality Software Services Inc. — owned by a unit of UnitedHealth Group— was responsible for two components of the government's online insurance system. One is the data hub, a linchpin that works relatively well, and the other is an accounts registration feature that initially froze and caused many problems.
HealthCare.gov was supposed to be the online portal for uninsured Americans to get coverage under Obama's health care law. Envisioned as the equivalent of Amazon.com for health insurance, it became a huge bottleneck immediately upon launch Oct. 1. The flop turned into an embarrassment for Obama and will likely end up as a case study of how government technology programs can go awry.
The briefing from Zients came a day after executives of QSSI and the other major contractor, CGI Federal, told Congress that the government didn't fully test the system and ordered up last-minute changes that contributed to logjams. Next week, Health and Human Services Secretary Kathleen Sebelius is scheduled to testify.
Visiting a community health center on Friday in Austin, Texas, Sebelius said that "in an ideal world there would have been a lot more testing" but added that her department had little flexibility to postpone the launch against the backdrop of Washington's unforgiving politics. House Republicans trying to defund the nation's health insurance program precipitated a government shutdown.
In the Republican address, Rep. Fred Upton of Michigan, the chairman of the House Energy and Commerce Committee, asked whether the problems evident now foreshadowed future troubles with the health care law.
"In a few short months, families across the country will be subject to penalties under the law's individual mandate," he said. "How can the administration punish innocent Americans by forcing them to buy a product many cannot afford, from a system that does not work?
Zients gave some new details about the extent of the problems, but administration officials are still refusing to release any numbers on how many people have successfully enrolled. Although 700,000 have applied for coverage through the new online markets, it's believed only a fraction of that number actually managed to sign up. Before the website went live, an administration estimate projected nearly 500,000 people would sign up in October alone.
The marketplaces are the gateway to obtaining health insurance under the new health care law, which requires most Americans to have coverage by Jan. 1. Middle-class people who don't have insurance on the job can purchase a private plan with new tax credits to make the premiums more affordable. Low-income people will be steered to an expanded version of Medicaid in states that agree to extend the safety net program.
The federal government is running the insurance markets or taking the lead in 36 states. The rest were set up by states themselves.
Consumers have until Dec. 15 to sign up for coverage to take effect Jan. 1. Under the law, pre-existing medical conditions will no longer be a barrier. But the markets also need lots of young, healthy customers to keep premiums affordable. Open enrollment season extends until Mar. 31.
Zients said almost daily fixes are already having an impact. For example, more than 90 percent of users can now complete one of the first steps, creating an account.
But the application process, which involves submitting and verifying personal information and income details, remains "volatile," he said. At one point, as few as one-third of users were getting through that part.
Zients said there are two big categories of problems. Performance issues involve the speed and reliability of the website. Functional issues are bugs that keep the software from working as intended. Among the high-priority issues is that insurers are getting enrollments with incomplete, incorrect or duplicative information.
___
Online:
Obama's address: http://www.whitehouse.gov
Republican address: http://www.gop.gov
Associated PressSource: http://hosted2.ap.org/APDEFAULT/89ae8247abe8493fae24405546e9a1aa/Article_2013-10-26-Health%20Overhaul-Problems/id-996600abe6f64425882602d39632b7b8Cinematography, art direction and visual effects are so blended in new movies that it might be time for a new Oscar category to be introduced, admitted Hawk Koch, past president of the Academy of Motion Picture Arts and Sciences and current co-president of the PGA.
His suggestion? Something along the lines of "visual imaging."
Koch, current Academy president Cheryl Boone Isaacs and past president Sid Ganis discussed this blurring of the lines during an AMPAS presidents session at Visual Effects Society’s annual summit Saturday at the W in Hollywood.
A key question was raised: how much does the success of VFX-driven films stem from visual effects, and how much does it depend on cinematography? And what impact might the answer to that question have on Oscar frontrunner Gravity?
STORY: 'Gravity' Crossing $300 Million Worldwide
"The action of Sandra [Bullock’s] body is key frame animation [meaning that it was animated by hand], that qualifies Gravity as an animated film," pointed out moderator Bill Kroyer, director of digital arts at Chapman University.
That led the group to raise other questions, for instance: "Did Gravity director of photography Emmanuel Lubezki photograph the film?"
Director Alfonso Cuaron has said that roughly 80 percent of Gravity was hand animated in the computer. In fact, when the actors are seen in space, only their faces come from live action photography. The environment, their bodies -- even the visors in front of their faces, are CG. The helmer also said that Lubezki was involved in determining the lightning for the entire film, which included going to lead VFX house Framestore to work with the digital artists.
In discussing this topic during the panel, Kroyer provided some history, “The Academy gave Oscars to the cinematography on Avatar and Life of Pi, and there was a lot of discussion into the fact that a lot of that was VFX. … [Life of Pi director of photography] Claudio Miranda was really setting the tone of the movie; on the other hand, there was so much other work happening.”
“We are constantly reviewing,” Boone Isaacs reported. “Technology is changing the definitions of what we do. Many members were confused between the Oscars for cinematography and visual effects on Life of Pi. We will be discussing the differences that have been made with these advancements.”
Acknowledging this "blending" of craft disciplines, Koch got a laugh from the crowd when he joked: “The only thing we still haven’t been able to figure out is what producers do.”
E-Mail: Carolyn.Giardina@THR.com
Twitter: @CGinLA
Berlin (AFP) - US President Barack Obama was personally informed of mobile phone tapping against German Chancellor Angela Merkel, which may have begun as early as 2002, German media reported Sunday.
Bild am Sonntag newspaper quoted US intelligence sources as saying that National Security Agency chief Keith Alexander had briefed Obama on the operation against Merkel in 2010.
"Obama did not halt the operation but rather let it continue," the newspaper quoted a high-ranking NSA official as saying.
Meanwhile newsweekly Der Spiegel reported ahead of its Monday issue that leaked NSA documents showed Merkel's phone had appeared on a list of spying targets since 2002, and was still under surveillance weeks before Obama visited Berlin in June.
The spying row has prompted European leaders to demand a new deal with Washington on intelligence gathering that would maintain an essential alliance while keeping the fight against terrorism on track.
Germany will send its own spy chiefs to the United States next week to demand answers following the allegations that US intelligence has been tapping Merkel's mobile phone, as the row threatened to fray transatlantic ties.
Merkel confronted Obama with the suspicion in a phone call on Wednesday saying that spying on allies would be a "breach of trust" between international partners.
The charges also prompted Berlin to summon the US ambassador -- a highly unusual move between the close allies.
The Frankfurter Allgemeine Sonntagszeitung reported Saturday that Obama had told Merkel during their call that he had been unaware of any spying against her. It did not cite its sources.
Der Spiegel said he had told her that if he had been informed of the operation he would have stopped it at once.
Other media reports said that Obama's National Security Advisor Susan Rice had also told German officials the president knew nothing of the spying.
Detroit officially makes its case for bankruptcy before a federal judge on Wednesday. The city is currently saddled with $18 billion in long-term debt, and officials see bankruptcy as their only choice.
Detroit officially makes its case for bankruptcy before a federal judge on Wednesday. The city is currently saddled with $18 billion in long-term debt, and officials see bankruptcy as their only choice.
In Detroit on Wednesday, a federal trial begins that will determine whether that city is eligible for the nation's largest-ever municipal bankruptcy.
Hundreds of the city's creditors are lining up to oppose the bankruptcy, arguing that Detroit is violating Michigan's constitution and that if officials tried harder they could find enough savings to pay the city's bills.
Officials here say a declining population, decades of mismanagement and at times corrupt city government has cost Detroit a lot of tax revenue, leaving it drowning in red ink.
So much so that in March, the governor appointed Kevyn Orr to be an emergency manager and take control of the city's finances. He spent months crafting payment arrangements with some creditors, but hundreds of others rejected offers that amounted to accepting pennies for every dollar they were owed by Detroit.
Orr says that leaves Detroit with roughly $18 billion in long-term debt, and no other option but bankruptcy.
"There's no way out," Orr says. "The mountain of debt we have to climb over simply is insurmountable without some kind of process to resolve it. We simply cannot pay it. That's it."
Where Business Stands
Detroit's business community overwhelmingly agrees with Orr.
Dan Gilbert owns Quicken Loans, the NBA's Cleveland Cavaliers and in recent months has bought more than $1 billion worth of buildings in Detroit's downtown. He's betting that Chapter 9 protection will allow Detroit to get out from under its crushing debt load and pour money back into city services, which would help make his investments pay off.
"As hard as that is to sort of suspend democracy, for a short period of time if you will, my view is, let's get it over with," Gilbert says. "Let's get it done. Let's stop talking about it [and] go through the pain and then move forward, and I think it will fade into the background."
But some of Detroit's longest-standing creditors are fighting a bankruptcy declaration, arguing that it would create big problems for them.
At the headquarters of AFSCME Council 25, the union representing the majority of city workers here, a half-dozen retirees are making phone calls. Juanita Scott says Detroit's potential bankruptcy puts her pension, her health care and her future on the chopping block.
"Because they're going to cut my medical, that's going to really hurt me bad," says the 86-year-old Scott. "Right now I'm under three different doctors' care and trying to stay in my neighborhood."
Scott says she has to have a burglar alarm because all the houses around her are going vacant. "This whole thing of bankruptcy, it's just bad," she says.
The union leadership argues Detroit's bankruptcy filing itself violates state prohibitions against cutting public pensions. Union attorney Herb Sanders even questions if Detroit is truly insolvent, because the state forbade city officials from approving tentative labor agreements that he says could have saved millions annually.
"When you think that the purpose of bankruptcy is to restructure debt, is to save the city money, and if that is your true intent then why wouldn't you sign the collective bargaining agreement with the unions that would indeed do that?" Sanders says.
The Possibility Of Lawsuits
The union will argue in court Wednesday that Detroit did not bargain in good faith. But bankruptcy attorney Douglas Bernstein says the judge may see things differently.
"There's no bright line which says what constitutes good faith and what isn't good faith," Bernstein says. "There's isn't an awful lot of precedent in Chapter 9."
Bernstein's firm worked with several of Detroit's creditors who decided not to fight the city's bankruptcy filing. He says those creditors and the city will be thrown into financial turmoil if the court finds Detroit is not eligible for Chapter 9 protection. The likely result would be a flood of lawsuits, he says.
"So they'll be fending off all the creditors in a variety of courtrooms where everybody in the creditor body is trying to get the best deal for themselves rather than in an organized, unified setting in the bankruptcy court," he says. "So you would have chaos."
And chaos is the last thing Detroiters need in a city that has seen more than its share of it in recent years. Former officials sent to prison for corruption, high unemployment and crime rates, faltering city services and now a fight over what's left in the city's coffers.
PUBLIC RELEASE DATE: 23-Oct-2013
ShareContact: Jackie Brinkman
jackie.brinkman@ucdenver.edu
303-724-1525
University of Colorado Denver
Aurora, CO (Oct. 23, 2013) The latest study co-led by a CU School of Medicine researcher has confirmed that a Gene Expression Classifier (GEC) test can drastically reduce the problem of unnecessary surgeries in thyroid nodule assessment. These indeterminate nodules are being evaluated with a new molecular diagnostic test that measures the expression levels of 142 genes. This test is able to identify which initially indeterminate nodules are highly likely to be benign, and thus allows patients to avoid unnecessary diagnostic surgery.
This multi-site study co-led by Bryan R. Haugen, MD, professor of medicine and pathology at the University of Colorado School of Medicine provides the first long-term look at how these patients fared, and its findings reaffirm the performance of the Afirma Gene Expression Classifier (GEC). Haugen said "Each year, tens of thousands of patients with thyroid nodules have surgery to remove all or part of their thyroids. This is due to fine needle aspiration (FNA) cell test results that are indeterminate or inconclusive yet raise suspicions for thyroid cancer. Often times, most of these nodules prove to be benign. Our findings suggest that when the GEC identifies an otherwise indeterminate thyroid nodule as benign which it does about 50% of the time it is comparable in accuracy to a benign diagnosis by cytopathology, This fact and the degree to which physicians and patients in the study opted against surgery when the molecular test result was benign underscore the test's potential to drastically reduce the problem of unnecessary surgeries in thyroid nodule assessment."
Researchers analyzed all patients who had received Afirma GEC testing following indeterminate FNA biopsy results at five academic medical centers between 2010 and 2013. The GEC identified 174 of 339 (51%) indeterminate nodules as benign and, among these, 71 had documented clinical follow-up for an average of 9 months. Of these, only one nodule proved cancerous, demonstrating a very high negative predictive value (NPV) for the GEC. This finding is consistent with results from an earlier prospective, multicenter clinical study. Additionally, in the new study only 6% of patients with nodules identified as benign by the GEC test underwent surgery. This is a substantial reduction compared to traditional surgical rates for patients with cytologically indeterminate thyroid nodules.
Thyroid nodules are common, but only approximately 5-15% prove malignant. Most nodules are evaluated using FNA, with approximately 525,000 thyroid nodule FNAs performed in the U.S. in 2011 to rule out cancer. In most cases, the results are benign, yet in approximately 15-30% of cases the results are indeterminate not clearly benign or malignant. Because of the risk of thyroid cancer, most of these patients have historically been recommended for surgery to remove all or part of the thyroid to obtain a final diagnosis. However, such indeterminate nodules prove ultimately benign in 70-80% of cases. For these patients, the surgery was not needed and they were unnecessarily exposed to the cost, risk and morbidity of this intervention. Additionally, most patients subsequently require lifelong thyroid hormone therapy.
The study is published online in the Journal of Clinical Endocrinology & Metabolism and its findings were presented recently at the 83rd Annual Meeting of the American Thyroid Association, held in Puerto Rico.
The long-term findings built on the previous study which demonstrates the Afirma Gene Expression Classifier's accuracy was published in the New England Journal of Medicine.
###
Faculty at the University of Colorado School of Medicine work to advance science and improve care. These faculty members include physicians, educators and scientists at University of Colorado Hospital, Children's Hospital Colorado, Denver Health, National Jewish Health, and the Denver Veterans Affairs Medical Center. Degrees offered by the CU Denver School of Medicine include doctor of medicine, doctor of physical therapy, and masters of physician assistant studies. The School is located on the University of Colorado's Anschutz Medical Campus, one of four campuses in the University of Colorado system. For additional news and information, please visit our online newsroom.
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
PUBLIC RELEASE DATE: 23-Oct-2013
ShareContact: Jackie Brinkman
jackie.brinkman@ucdenver.edu
303-724-1525
University of Colorado Denver
Aurora, CO (Oct. 23, 2013) The latest study co-led by a CU School of Medicine researcher has confirmed that a Gene Expression Classifier (GEC) test can drastically reduce the problem of unnecessary surgeries in thyroid nodule assessment. These indeterminate nodules are being evaluated with a new molecular diagnostic test that measures the expression levels of 142 genes. This test is able to identify which initially indeterminate nodules are highly likely to be benign, and thus allows patients to avoid unnecessary diagnostic surgery.
This multi-site study co-led by Bryan R. Haugen, MD, professor of medicine and pathology at the University of Colorado School of Medicine provides the first long-term look at how these patients fared, and its findings reaffirm the performance of the Afirma Gene Expression Classifier (GEC). Haugen said "Each year, tens of thousands of patients with thyroid nodules have surgery to remove all or part of their thyroids. This is due to fine needle aspiration (FNA) cell test results that are indeterminate or inconclusive yet raise suspicions for thyroid cancer. Often times, most of these nodules prove to be benign. Our findings suggest that when the GEC identifies an otherwise indeterminate thyroid nodule as benign which it does about 50% of the time it is comparable in accuracy to a benign diagnosis by cytopathology, This fact and the degree to which physicians and patients in the study opted against surgery when the molecular test result was benign underscore the test's potential to drastically reduce the problem of unnecessary surgeries in thyroid nodule assessment."
Researchers analyzed all patients who had received Afirma GEC testing following indeterminate FNA biopsy results at five academic medical centers between 2010 and 2013. The GEC identified 174 of 339 (51%) indeterminate nodules as benign and, among these, 71 had documented clinical follow-up for an average of 9 months. Of these, only one nodule proved cancerous, demonstrating a very high negative predictive value (NPV) for the GEC. This finding is consistent with results from an earlier prospective, multicenter clinical study. Additionally, in the new study only 6% of patients with nodules identified as benign by the GEC test underwent surgery. This is a substantial reduction compared to traditional surgical rates for patients with cytologically indeterminate thyroid nodules.
Thyroid nodules are common, but only approximately 5-15% prove malignant. Most nodules are evaluated using FNA, with approximately 525,000 thyroid nodule FNAs performed in the U.S. in 2011 to rule out cancer. In most cases, the results are benign, yet in approximately 15-30% of cases the results are indeterminate not clearly benign or malignant. Because of the risk of thyroid cancer, most of these patients have historically been recommended for surgery to remove all or part of the thyroid to obtain a final diagnosis. However, such indeterminate nodules prove ultimately benign in 70-80% of cases. For these patients, the surgery was not needed and they were unnecessarily exposed to the cost, risk and morbidity of this intervention. Additionally, most patients subsequently require lifelong thyroid hormone therapy.
The study is published online in the Journal of Clinical Endocrinology & Metabolism and its findings were presented recently at the 83rd Annual Meeting of the American Thyroid Association, held in Puerto Rico.
The long-term findings built on the previous study which demonstrates the Afirma Gene Expression Classifier's accuracy was published in the New England Journal of Medicine.
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Faculty at the University of Colorado School of Medicine work to advance science and improve care. These faculty members include physicians, educators and scientists at University of Colorado Hospital, Children's Hospital Colorado, Denver Health, National Jewish Health, and the Denver Veterans Affairs Medical Center. Degrees offered by the CU Denver School of Medicine include doctor of medicine, doctor of physical therapy, and masters of physician assistant studies. The School is located on the University of Colorado's Anschutz Medical Campus, one of four campuses in the University of Colorado system. For additional news and information, please visit our online newsroom.
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