Riviste scientifiche

At least 75 per cent of our DNA really is useless junk after all

New Scientist - Ma, 18/07/2017 - 16:00
After decades of arguing whether junk DNA exists, a study has calculated that without it we’d all have to reproduce in huge numbers to escape harmful mutations

UK government wants only 12 per cent of adults to smoke by 2022

New Scientist - Ma, 18/07/2017 - 14:15
Smoking is already down to 15.5 per cent of adults in England, but the government wants to go further, and is also targeting a teenage smoking rate of 3 per cent

Prenatal test spots genetic anomalies linked to miscarriage

New Scientist - Ma, 18/07/2017 - 13:19
A fetal test for Down’s syndrome has been extended to chromosomal anomalies across the whole genome. The test may help prepare parents for difficult pregnancies

Signatures of inflammation and impending multiple organ dysfunction in the hyperacute phase of trauma: A prospective cohort study

PLoS Medicine - Lu, 17/07/2017 - 23:00

by Claudia P. Cabrera, Joanna Manson, Joanna M. Shepherd, Hew D. Torrance, David Watson, M. Paula Longhi, Mimoza Hoti, Minal B. Patel, Michael O’Dwyer, Sussan Nourshargh, Daniel J. Pennington, Michael R. Barnes, Karim Brohi

Background

Severe trauma induces a widespread response of the immune system. This “genomic storm” can lead to poor outcomes, including Multiple Organ Dysfunction Syndrome (MODS). MODS carries a high mortality and morbidity rate and adversely affects long-term health outcomes. Contemporary management of MODS is entirely supportive, and no specific therapeutics have been shown to be effective in reducing incidence or severity. The pathogenesis of MODS remains unclear, and several models are proposed, such as excessive inflammation, a second-hit insult, or an imbalance between pro- and anti-inflammatory pathways. We postulated that the hyperacute window after trauma may hold the key to understanding how the genomic storm is initiated and may lead to a new understanding of the pathogenesis of MODS.

Methods and findings

We performed whole blood transcriptome and flow cytometry analyses on a total of 70 critically injured patients (Injury Severity Score [ISS] ≥ 25) at The Royal London Hospital in the hyperacute time period within 2 hours of injury. We compared transcriptome findings in 36 critically injured patients with those of 6 patients with minor injuries (ISS ≤ 4). We then performed flow cytometry analyses in 34 critically injured patients and compared findings with those of 9 healthy volunteers. Immediately after injury, only 1,239 gene transcripts (4%) were differentially expressed in critically injured patients. By 24 hours after injury, 6,294 transcripts (21%) were differentially expressed compared to the hyperacute window. Only 202 (16%) genes differentially expressed in the hyperacute window were still expressed in the same direction at 24 hours postinjury. Pathway analysis showed principally up-regulation of pattern recognition and innate inflammatory pathways, with down-regulation of adaptive responses. Immune deconvolution, flow cytometry, and modular analysis suggested a central role for neutrophils and Natural Killer (NK) cells, with underexpression of T- and B cell responses.In the transcriptome cohort, 20 critically injured patients later developed MODS. Compared with the 16 patients who did not develop MODS (NoMODS), maximal differential expression was seen within the hyperacute window. In MODS versus NoMODS, 363 genes were differentially expressed on admission, compared to only 33 at 24 hours postinjury. MODS transcripts differentially expressed in the hyperacute window showed enrichment among diseases and biological functions associated with cell survival and organismal death rather than inflammatory pathways. There was differential up-regulation of NK cell signalling pathways and markers in patients who would later develop MODS, with down-regulation of neutrophil deconvolution markers. This study is limited by its sample size, precluding more detailed analyses of drivers of the hyperacute response and different MODS phenotypes, and requires validation in other critically injured cohorts.

Conclusions

In this study, we showed how the hyperacute postinjury time window contained a focused, specific signature of the response to critical injury that led to widespread genomic activation. A transcriptomic signature for later development of MODS was present in this hyperacute window; it showed a strong signal for cell death and survival pathways and implicated NK cells and neutrophil populations in this differential response.

Find your next must-play game by flying through a virtual galaxy

New Scientist - Lu, 17/07/2017 - 17:45
Letting algorithms suggest games and movies we might like could trap us in a filter bubble. Showing the choices as a navigable galaxy let us pick more freely

Large carnivores have lost more than 90 per cent of their range

New Scientist - Lu, 17/07/2017 - 17:30
The hunting grounds of lions, tigers and the red and Ethiopian wolves have shrunk dramatically in the past 500 years, but a few species aren't doing as badly

Ravens can plan for future as well as 4-year-old children can

New Scientist - Lu, 17/07/2017 - 17:00
The smart birds seem to have evolved this flexible cognitive ability independently from hominids as the two lineages diverged about 320 million years ago

AI doctors should improve healthcare, but not at any cost

New Scientist - Lu, 17/07/2017 - 12:00
Algorithms can already outperform specialists at disease diagnosis, but we must come up with a clear framework for what data they are allowed to use

AI coach will train hopeless chatbots to pass the Turing test

New Scientist - Lu, 17/07/2017 - 12:00
A neural network trained to rate how human-like an AI is could turn Alexa and Siri into much more convincing conversation partners

Laws of mathematics don’t apply here, says Australian PM

New Scientist - Lu, 17/07/2017 - 12:00
Inspired by the UK’s Investigatory Powers Act, Malcolm Turnbull has proposed a new cybersecurity law to circumvent encryption – and he won’t be beaten by maths

Battle lines are being drawn on the best way for babies to sleep

New Scientist - Do, 16/07/2017 - 14:00
Paediatricians say sharing a bed with your baby is dangerous, but anthropologists say it is natural and beneficial. Who's right?

[Editorial] Public genomes: the future of the NHS?

The Lancet - Sa, 15/07/2017 - 00:00
On July 4, Sally Davies, the UK Chief Medical Officer, issued her annual report. Entitled “Generation Genome”, the report examines the potential for genomics to form a major part of British health policy in the future.

[Editorial] Canada’s feminist foreign aid agenda

The Lancet - Sa, 15/07/2017 - 00:00
Since his election in November, 2015, Prime Minister Justin Trudeau’s Liberal Government has promised forward-looking health policies. Canada has always been seen as a global citizen in health, international affairs, and foreign aid, but under Stephen Harper’s Conservative Government (2006–15), credibility was questioned as he tilted Canada’s development programme for health and overseas aid priorities to align with trade goals, and his flagship Muskoka Initiative for maternal and child health ignored women’s reproductive health rights.

[Editorial] Curbing the rise in gonococcal AMR

The Lancet - Sa, 15/07/2017 - 00:00
Last week, at the start of the G20 summit and ahead of the Sexually Transmitted Infections (STI) & HIV World Congress, on July 9–12, WHO released new data on antimicrobial resistance (AMR) in gonococci. 70 (97%) of 72 countries surveyed from 2009 to 2014 reported finding resistant Neisseria gonorrhoeae isolates. Continued and increased resistance to primary antibiotics was observed and 51 (66%) of 77 countries surveyed reported some resistance to last-resort antibiotics.

[Comment] Eliminating acute rheumatic fever and rheumatic heart disease

The Lancet - Sa, 15/07/2017 - 00:00
Acute rheumatic fever and its major sequela rheumatic heart disease are conditions of poverty. Acute rheumatic fever is an autoimmune response to pharyngitis caused by infection with Streptococcus pyogenes that is characterised by various combinations of fever, arthritis, cardiac valvular disease, chorea, and skin manifestations. Chronic valvular damage due to repeated episodes of acute rheumatic fever is known as rheumatic heart disease and is the major cause of morbidity and mortality from acute rheumatic fever.

[Comment] Offline: The G20 and health—platitudes and broken promises

The Lancet - Sa, 15/07/2017 - 00:00
Imagine “Anycountry”. A low-income nation-state with a weak health system. People have begun to report a mysterious respiratory infection that is rapidly fatal. The cause is an unknown virus. A localised outbreak quickly spreads from village to village. The virus is not only extremely pathogenic but also highly transmissible. The epidemic soon crosses the country's border to neighbouring states. A global health emergency beckons. This scenario is fictional. But earlier this year G20 health ministers were locked in a room in Berlin to test their ability to deal with such a global health crisis.

[World Report] What lies in the future of the UK's medicine regulation?

The Lancet - Sa, 15/07/2017 - 00:00
In a letter to The Financial Times, the UK Government offers a rare glimpse of the plan for medicine regulation after its departure from Europe. Experts say they need more insight. Talha Burki reports.

[World Report] Staff protest against care conditions for child patients

The Lancet - Sa, 15/07/2017 - 00:00
Concern over a budget-driven care plan for child patients with cancer in top hospital in Israel has led to staff resignations, supported by parents’ hunger strike. Sharmila Devi reports.

[World Report] France bans sodium valproate use in case of pregnancy

The Lancet - Sa, 15/07/2017 - 00:00
France has imposed a partial ban on prescribing sodium valproate for women and girls, claiming to be the first country in Europe to take such a step. Barbara Casassus reports.

[World Report] Frontline: the vital need for information

The Lancet - Sa, 15/07/2017 - 00:00
Vickie Hawkins is the executive director of Medecins Sans Frontières (MSF) UK. She was recently in Libya, where conversations with detainees made her aware of the limitations of medical care, and the need for information.
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