Offering a novel clue about the basic biology of pancreatic cancer, researchers at Dana-Farber Cancer Institute have confirmed a decades-old discovery of a link between blood type and the risk of developing the disease.The finding, published online by the Journal of the National Cancer Institute on March 10, is based on an analysis of blood type and pancreatic cancer occurrence in participants of two large health-tracking studies, the Nurses’ Health Study and the Health Professionals Follow-Up Study.The new study demonstrates that while people’s overall risk of pancreatic cancer is relatively low — with nearly 40,000 new cases diagnosed annually in the United States, compared with nearly 150,000 new cases of colorectal cancer — people with blood types A, B, or AB were more likely to develop the disease than those with type O.“Except for several rare familial syndromes, the genetic factors that raise or lower an individual’s risk for pancreatic cancer are largely unknown,” said the study’s lead author, Brian Wolpin, an instructor in medicine at Harvard Medical School. “Studies done several decades ago suggested a link between blood type and the risk of various malignancies, including pancreatic cancer, but they were limited by the fact that they ‘looked back’ at cancers that had already occurred and involved relatively few cases. We wanted to see if the association held up using modern patient cohorts and research techniques.”They found that, compared to participants with type O blood, those with type A had a 32 percent higher chance of incurring pancreatic cancer, those with type AB had a 51 percent higher chance, and those with type B had a 72 percent higher chance.Within the entire group, 17 percent of pancreatic cancers were attributable to inheriting a non-O blood group. But because the lifetime risk of developing the disease is relatively low (estimated at 1.3 percent) and the increased risk associated with blood type relatively modest, screening tests for pancreatic cancer risk are unlikely to be based on blood type alone. The real value of the findings is what they suggest about the inner workings of the disease, the authors say.The four human blood groups are defined by the type of glycoproteins — confections of sugar and protein — found on the surface of red blood cells and other cells, including those in the pancreas. A gene known as ABO helps construct these glycoproteins by ordering the placement of sugar molecules on a protein “backbone” called the H antigen. The pattern formed by these sugars determines whether an individual’s blood type is A, B, AB, or O. (In the O type, no sugars are attached to the antigen.)Experiments by other investigators have shown that normal pancreas cells carry a different pattern of these blood-type antigens than pancreatic tumor cells do, suggesting that changes in the ABO gene’s activity may occur as the cells become cancerous. Researchers speculate that alterations in the antigens may interfere with the cells’ ability to signal and adhere to one another, and with the immune system’s ability to detect abnormal cells — potentially setting the stage for cancer.Blood-type antigens may also affect the level of inflammatory proteins in a person’s blood. Chronic inflammation has been linked to pancreatic cancer risk.Intriguing as these findings are, they don’t necessarily prove a direct link between blood-type antigens and pancreatic cancer development, the authors assert. It is also possible that the ABO gene is merely a marker for other, nearby genes that are more directly involved in cancer development.“The association between blood type and pancreatic cancer risk provides a new avenue for getting at the biological mechanisms that underlie the disease,” Wolpin says. “Understanding the biology will put us in a better position to intervene so the cancer doesn’t develop or progress.”The study’s senior author is Charles Fuchs of Dana-Farber and Brigham and Women’s Hospital (BWH). Co-authors include David Hunter and Edward Giovannucci of BWH and the Harvard School of Public Health (HSPH); Andrew Chan of BWH and Massachusetts General Hospital; Patricia Hartge and Stephen Chanock of the National Cancer Institute; and Peter Kraft of the HSPH.
Editor’s note: This is the eighth in a series of 14 team previews on NASCAR.com. Next up: Chip Ganassi Racing on Feb. 12. A list of team previews already published is at the bottom of this story.Wood Brothers RacingManufacturer: FordEngine: Roush-Yates Drivers: Paul Menard, No. 21Crew chiefs: Greg Erwin2017 standings: Menard, 23rd in final standings (with Richard Childress Racing); Ryan Blaney piloted the No. 21 Ford to a ninth-place finish in the standings in 2017.What’s new: Menard joins up with Wood Brothers Racing as Blaney moves to Team Penske to be the team’s third Monster Energy NASCAR Cup Series driver after his breakout 2017 year. Menard had spent the past seven seasons at RCR. Veteran crew chief Greg Erwin moves over from Team Penske – with that technical partnership still in place – to serve as the pit boss. He most recently served as the crew chief for the No. 22 Team Penske Ford, which won the Xfinity Series Owners’ title in 2017. The team also reached an agreement to secure a charter from Go Fas Racing for the 2018 season and beyond.What to watch: Wood Brothers is one win away from 100 wins in the storied organization’s history. The Daytona 500 will serve as Menard’s 400th start in the Monster Energy NASCAR Cup Series. After seven years at RCR, Menard joins a new organization that is fresh off a run to the Round of 8 of the playoffs.Key question(s): Can Menard carry forward the momentum established by Blaney with Wood Brothers? Is a fresh start just what Menard needs for a career resurgence? Will Menard snap his 232-race winless drought and earn win No. 100 for the Wood Brothers?DRIVERSJared C. Tilton | Getty Images Paul Menard, No. 21 Menards Ford: After making the playoffs in 2015, Menard is coming off two straight seasons outside the top 20 in the standings. A move to Wood Brothers could serve as a catalyst for a resurgence for the veteran driver whose lone premier series win came at Indianapolis in 2011. “It’s going to take a little bit to work out a few bugs like it does with any new situation,” Menard said of his new team. “These first few races will be pretty important to open up communication and just be totally honest with each other, push each other and learn each other so that when the summer rolls around we’re ready to continue for top 10s, top fives and wins.”PREVIOUS TEAM PREVIEWSFeb. 1: Front Row MotorsportsFeb. 2: Richard Petty MotorsportsFeb. 3: Leavine Family RacingFeb. 5: JTG Daugherty Racing Feb. 6: Germain Racing Feb. 7: Roush Fenway RacingFeb. 8: Richard Childress Racing
Mequel PhillipsChester, Va.Virginia State UniversityFootball Terry McCrayPompano Beach, Fla.University of MiamiFootball Dasmond TautalatasiConcord, Calif.Arizona State UniversityFootball Name HometownUniversityPrimary Sport DAYTONA BEACH, Fla. — Following a national talent search at universities across the country, NASCAR and Rev Racing have invited 12 collegiate athletes to compete for roles as tire changers, carriers and jackmen at the fourth annual NASCAR Drive for Diversity National Pit Crew Combine in Concord, North Carolina, on Friday, May 24.The annual event will be held at the NASCAR Research and Development Center and features athletes from colleges and universities across the nation with aspirations of a professional career in NASCAR. This year’s competitors include football, soccer and baseball student-athletes.Led by Phil Horton, Rev Racing director of athletic performance, the four-hour combine will test the athletes in a series of strength, agility and flexibility exercises to assess their fitness for a NASCAR pit crew. Additionally, each athlete will learn how to perform tasks required of over-the-wall crew members.“We’re excited to witness the impact this year’s competitors bring to NASCAR and the overall pit crew development program,” said Jusan Hamilton, NASCAR director of racing operations and event management. “Each athlete possesses something special and has demonstrated the potential to work in a fast-paced, highly competitive environment. Rev Racing’s recruiting efforts have identified some phenomenal athletes who can translate what they’ve accomplished in their respective sports to success on pit road. We look forward to training those selected to the program and positioning them for successful NASCAR careers.”Top performing athletes will earn a spot in the NASCAR Drive for Diversity Pit Crew Development program where they will spend six months training as pit crew members at Rev Racing, with hopes of one day pitting for a national series team.“We couldn’t be prouder of the journey both our pit crew development program and program graduates have taken from its inception,” said Max Siegel, owner and CEO of Rev Racing. “With the expansion of our recruiting efforts across the country, the talent level rises, and our program continues to evolve and create more opportunities for advancement at a higher level. We’re energized by the opportunity to work with these talented athletes and foresee a very impactful future on pit road for those selected to participate in our program.”Since the NASCAR Drive for Diversity Pit Crew Development Program began, more than 100 athletes have participated, and 65 graduates are now working in NASCAR. Thirty-five crew members have reached and competed in the sport’s national series, including the Monster Energy NASCAR Cup Series™.Program alums include Raphael Diaz, rear tire changer for Roush Fenway Racing, and Jordan Paige, now a jackman for Richard Childress Racing. Earlier this season, Breanna O’Leary and Brehanna Daniels became the first female graduates of the NASCAR Drive for Diversity Pit Crew Development Program to go over the wall in the DAYTONA 500. Both women participated in the 2016 pit crew combine and now pit regularly across the national series.As part of the recruiting process, NASCAR and Rev Racing traveled to host student-athlete workouts at Alabama A&M University, Alcorn State University, Arizona State University, Coppin State University, Virginia State University and the University of Miami.This year’s combine will feature Dalanda Ouendeno from Paris, France, a former University of Miami women’s soccer player. Ouendeno played for the Paris St. Germain soccer club from 2009 to 2015, won the Gothia Youth World Cup and the IberCup Portugal, and was part of five Isles of France championship teams.Dasmond Tautalatasi will join the pit crew combine from Arizona State where he played safety for the Sun Devils football team. Hadji Gaylord, an undefeated high school wrestler and defensive lineman at Norfolk State University, returns for his second combine with hopes of earning a spot in the development program.The 2019 NASCAR Drive for Diversity National Pit Crew Combine participants include: Hadji GaylordNorfolk, Va.Norfolk State UniversityFootball Dalanda OuendenoParis, FranceUniversity of MiamiSoccer Matthew SawyerBaltimore, Md.Coppin State UniversityFootball Following Friday’s event, the pit crew combine participants will attend the NASCAR Xfinity Series Alsco 300 on Saturday, May 25 at Charlotte Motor Speedway.NASCAR Drive for Diversity also offers a driver development program, operated by Rev Racing, and fields vehicles for six drivers in the NASCAR K&N Pro Series East and NASCAR Whelen All-American Series, as well as legend cars for four youth racers in the US Legend Car Series. Successful graduates now competing in the Monster Energy NASCAR Cup Series include drivers Kyle Larson, Daniel Suárez and Bubba Wallace.The Monster Energy NASCAR Cup Series’ Coca-Cola 600 will be broadcast live from Charlotte Motor Speedway on Sunday, May 26 at 6 p.m. ET on FOX, PRN and SiriusXM NASCAR Radio, channel 90, with additional coverage on NASCAR.com. Leishaun EaleyJacksonville, Fla.Alcorn State UniversityFootball Alvin WilsonLexington, Miss.Alcorn State UniversityFootball Deonte ParkerHuntsville, Ala.Alabama A&M UniversityBaseball Robin LozaCharlotte, N.C.Central Piedmont Community CollegeFootball Josh PokrakaHonolulu, HawaiiArizona State UniversityFootball Raynard RevelsRichmond, Va.Norfolk State UniversityFootball
President Barack Obama and Gov. Mitt Romney debated domestic policy Wednesday evening in the first of three presidential debates during an evening that seemed to focus more on style than substance at the University of Denver. In a reversal of the usual pattern, Romney’s poised, polished performance seemed to outshine Obama’s lackluster appearance, political science professor Michael Zuckert said. “Romney knew exactly how he wanted to put things and he put them pithily, he put them smartly and sharply ⎯ he was very smooth,” Zuckert said. “Obama was still looking for words and ways to formulate things … He should have had better formulations right at hand that he could have relied on and spoken more forcefully, instead of groping around for ways to express things that he could have had on the tip of his tongue.” This impressive showing from Romney won him the debate, at least stylistically, Zuckert said. “In terms of overall impression, Romney carried a lot of the debate, but in terms of issues, I think Obama carried it,” Zuckert said. “I saw the polls afterward and they said that they thought Romney could handle the economy better, that Romney could handle jobs better.” The thermometer measuring audience reaction on the bottom of the CNN broadcast of the debate seemed to indicate that the audience was reacting more to style than substance, Zuckert said. “It isn’t clear to me how much of the content of what they actually said made an impression, but I do think that style counts a lot,” Zuckert said. “That’s an example of why rhetoric is important – people react more to the impressions things leave on them rather than the substance of what is there … and the impression in this performance was that Romney is ‘presidential.’” Film, Television and Theatre professor Susan Ohmer said Romney’s structured answers helped him retain attention. “It was striking to me that he numbered his points,” Ohmer said. “That’s a strategy that you see in formal debate that helps keep listeners organized – a very smart strategy on [former] Governor Romney’s part.” Moderator Jim Lehrer, executive editor and former news anchor of PBS news hour, told the candidates that the debate would be divided into six units of 15 minutes, each structured around different focal points. The first question asked the candidates to speak to their plans to create jobs, which focused the debate on differences between two disparate plans to stimulate the economy. Economics professor Eric Sims said this beginning gave Romney a lot of momentum starting the debate. “I think people vote with their pocketbooks,” Sims said. “People want to ask the question ‘Are you better off now than you were four years ago?’ and I don’t think many people can say yes to that question – the president is taking a hit for that.” Rarely has an incumbent candidate been reelected to the presidency after presiding over a downturn in the economy, Sims said. “Historically speaking it is surprising that a president would be running this well with the economy in this shape,” Sims said. “To be fair it is hard to tell how responsible President Obama is or is not for that… he did walk into a bad situation but it is very unusual that we are in a recession and he is polling so well.” Both candidates have very different visions on how to solve the jobs problem, but Romney’s points were more salient because he was able to put Obama on the defensive, Sims said. The president failed to refocus the discussion of the economic progress and job creation during his term as an analysis on improvement, rather than focusing on its current status, Zuckert said. “Bill Clinton gave Obama a script that he could have used more effectively on that issue, and though Obama did try, he didn’t push it as forcefully as he might have done as a ‘Look where we started from and look where we are type of thing’ as opposed to ‘Look where we are at the absolute moment,’” Zuckert said. “Obama didn’t emphasize the trends, some of the trends are not great but they’re better than Romney portrayed them.” Zuckert said the focus on the economy played right into Romney’s hands. “Criticism of Obama on unemployment is still Romney’s best technique, but I’ve been waiting to hear more details about how he would actually change [unemployment],” Zuckert said. “I just haven’t heard a policy to me that sounds persuasive enough yet, to me it’s just not enough detail.” Romney was able to contrast his experience with business and economic policy with the relative lack of progress made in those areas in the past four years, Sims said. “That’s Obama’s weakest point. Barack Obama has a lot of pluses: he’s very likeable, at least four years ago he brought this attitude of hope and change to Washington, but the reality is that the economy stinks,” Sims said. “I think this was playing to Romney’s wheelhouse, domestic and economic policy: That’s where he has experience… In their discussion Romney came across as having a very good grasp of economics, in contrast I thought the President looked a little timid at times.” One of the strongest points Romney made was a criticism of the timing of Obama’s health care law, Sims said. “Romney’s point was that he was surprised that Obama was going to move this healthcare reform through [Congress] so fast right in the middle of an economic downturn, and that though we do need that kind of legislation – some kind of healthcare reform in the long term – when the real issue should have been jobs, President Obama was pushing through healthcare reform that created a lot of uncertainty,” Sims said. “Uncertainty is not conducive to a healthy labor market on both ends.” Ohmer said the differences in policy between Romney and Republican vice presidential nominee Paul Ryan were highlighted during the debate and by the work of fact checkers after the debate. “Ryan has endorsed legislation that will [end] Pell Grants, while Romney has said he wouldn’t do that,” Ohmer said. “Romney has also said that he won’t cut five trillion dollars when fact checkers said he would.” The degree to which each candidate moved toward the middle was striking, Zuckert said. “Even though people have said the issues were really strongly defined, they moved back towards each other,” Zuckert said. “Romney did maybe more than Obama, but both did substantially: Obama did in his litany about small businesses and job creation, and Romney in how he tailored his position from what we have heard before.” The fundamental difference between the candidates is the role that each envisions for the government within the economy, Sims said. “They characterize each other as free market capitalism and socialism, but on the broad level it is really that one side wants less government intervention and more power and choice in the hands of the individual, while the other side wants more government involvement – I think at the end of the day that’s the main difference here,” Sims said. The debate has changed America’s perception of the choice to make in November, Sims said. “Last night Romney came across as in control of the debate, and looked presidential: He helped himself a lot,” Sims said. “I think the Obama camp will have a different strategy next time around … as they move away from domestic policy to foreign policy it will be interesting to watch – we have a much closer race today than we did 24 hours ago.”
The Identity Project of Notre Dame (IDND), a student club that addresses issues of sexuality and human dignity through the lens of Catholic Church teaching, is in the midst of planning its annual Edith Stein Project Conference.“The Edith Stein Project Conference is the largest student-run conference in the United States,” Hailey Vrdolyak, club co-vice president and junior, said. “The conference brings together 30 speakers to discuss what the Catholic Church can offer to the discussion of issues faced on college campuses, such as the hook-up culture, pornography and other topics regarding human sexuality.”Vrdolyak said past conferences have been attended by more than 300 people, including Notre Dame, Saint Mary’s and Holy Cross students and professors. This year’s conference, to be held Feb. 6-7 in McKenna Hall, will address the theme of “Radiant Image: Cultivating Authentic Identity in the Modern World” and will focus on the central idea of living in God’s image, according to the IDND website.The conference namesake, Edith Stein, was canonized in 1998 as St. Teresa Benedicta of the Cross and “fought for the truth and the dignity of women through her writings and frequent letters,” according to the IDND website. Working as a teacher, nurse and philosopher and eventually as a cloistered Carmelite nun, she was martyred at Auschwitz in 1942. The club website states: “We look to Edith Stein for inspiration as a model of turning one’s heart to God and as someone who lived her vocation with the genuine spirit of self-gift.”This year marks the tenth anniversary of the Edith Stein Project Conference.“The club was founded in 2004, and the first conference was held in the spring of 2005,” IDND president and senior Mary Kate Martinson said. “The Identity Project has hosted an annual conference every spring since its founding.”Although the annual conference serves as the club’s main event, IDND co-sponsors other campus events that promote the Catholic identity of Notre Dame and help students develop as Catholic leaders, Alexandra DeSanctis, IDND co-vice president and junior, said.The club meets on Tuesday nights at 7 p.m. in the McNeill Room of LaFortune.“We foster fruitful conversation about issues of identity … and healthy relationships,” DeSanctis said. “We often read articles on these topics and discuss in a group. The meetings are also often used as a time to plan for the conference.”Contact [email protected] or visit the club Facebook page at https://www.facebook.com/identityND for more information about the club or the conference. Register for the conference online at www3.nd.edu/~idnd/. Registration is free for Notre, Saint Mary’s and Holy Cross students.Tags: carmletine nun, Edith Stein, Edith Stein Project Conference, Identity Project, Identity Project Notre Dame, IDND, St. Teresa Benedicta of the Cross
As much fun as it can be to track every ride, creating maps and competing with frienemies, for the most part I ride in order to get away from the connected world: satisfied to know only how much daylight remains and how far I am from home. And for that, I’ve long been a fan of Cateye’s wireless computers.A long-time player in the on-bike electronics market, Cateye is a company that not only supports local shops but also the end user. For a couple of generations now, their wireless head units and sensors have been interchangeable, and every spare that an owner could want is reasonably priced and available directly from their US office in Boulder. Building on the Strada line’s body-as-button architecture, the Micro Wireless adds a customizeable third display line and a bit of bulk while shaving $5 from the equivalent Strada’s price tag. After several months on multiple test bikes, has the Micro lived up to its predecessors’ reputation? Hit the jump to find out!Because bikes are fun and colors are fun, the Micro Wireless is available in black, white, lime, red, and blue.Mounting quickly and easily to most stems or handlebars with the brand’s secure FlexTight bracket, only a change to Syntace’s massive Megaforce stemforced a swap to the similarly secure $2(!) Zip Tie Bracket kit shown here. Basic clock and wheel size setup is quick and easy using the supplied manual. In what may be a first, Android and iPhone apps are also available to walk users through the process.For riders who like to keep an eye on the clock, their distance, or average speed without cycling through other functions, the Micro’s signature feature is the ability to change the top display line to show the metric of their choice.While riding, the bottom third of the computer serves as the button which cycles the bottom display through its views and the clicks are nice and distinct. Pressing down on the center nub starts/stops the stopwatch- a nice feature. Finally, a “night mode” can also be selected in which a button press will activate the backlight for 5 seconds (in order to spare the battery, night mode deactivates after the bike has stopped for 10 minutes or if the battery is low).There should be a nub there.Cateye figure that the inexpensive, nickel-sized CR2032 battery is good for about a year’s worth of riding at 1hr every day- which awfully nice when compared to charge-weekly GPS units. The same battery is used for both the head unit and the sensor and while a low battery indicator is provided, inconsistent cold-weather performance or dim displays are a good indicator that it’s time for some fresh juice.Using an analog signal, the Micro Wireless is susceptible to interference from high-powered bike lights- but that’s not uncommon and interference-resistant digital models tend to cost significantly more. My only real complaint with the Micro (and Strada) Wireless is the fact that the little retaining nub on the mounts is prone to snapping off if the computer is removed in cool weather. Unfortunately, daylight savings time both begins and ends when temperatures are low and sure as spring follows winter, a ($5) bracket replacement followed this spring’s time change.All in all, the Micro wireless is a nicely-featured computer in a nice, compact package. Bracket nub aside, the Cateye has been a great, reliable, and easy to use little computer. At $60, it’s not cheap– but past Cateye computers have held up to years’ of on- and off-road use in all weather without asking so much as a 75-cent battery now and then. If your ride documentation needs don’t extend much beyond distance, speed (including average and max), and the need to make it home for dinner, then the Micro Wireless is a great choice. Just leave it on the bike when the weather’s cold.marcwww.cateye.com
As previously announced, the sixth annual Shubert Foundation High School Theatre Festival will take place on June 15 at 7PM ET. Jelani Alladin, a former Broadway.com vlogger, is set to host the virtual event, which will spotlight over 160 students. The evening will also include appearances from Adam Chanler-Berat, James Harkness, Carly Hughes, George Salazar and Sherie Rene Scott. Viewers will be able to stream it here or at the bottom of this page.The event is a celebration featuring five outstanding high school student productions from the 2019-2020 school year, which were selected from over 30 productions across the city by a panel of professional theater artists and educators. Over the course of the festival’s six-year history, school productions from all five boroughs have performed at the event. On June 15, students will present excerpted scenes and musical numbers from Aida, The Wolves, Fame, Lucky Stiff and Hairspray. Jelani Alladin(Photo: Emilio Madrid for Broadway.com) View Comments
May 26, 2011 (CIDRAP News) – It has long been suspected that influenza increases the risk of heart attacks, but the connection has been nebulous because it’s difficult to distinguish the effects of flu from the effects of cold weather, which prevails in flu season in temperate regions.Now, a British-Chinese research team says its analysis of 10 years’ worth of flu, heart-attack, and weather data in the United Kingdom, a temperate country, and Hong Kong, a subtropical place, provides stronger evidence that flu contributes to myocardial infarction (MI).Writing in the Journal of Infectious Diseases, the researchers conclude that up to 5.6% of MI-related deaths in Hong Kong and up to 3.4% of such deaths in England and Wales between 1999 and 2008 were attributable to flu.”We found a consistent association between seasonal influenza circulation and acute MI-associated hospitalizations and deaths in 2 different settings characterized by differing populations, climates, and patterns of health-seeking behavior,” says the report. The study was led by Charlotte Warren-Gash of Royal Free Hospital in London.In an accompanying commentary, two flu specialists from the US Centers for Disease Control and Prevention (CDC) say the study strengthens the case for a link between flu and heart attacks and points up the need for flu vaccines that are more effective in elderly people.Comparing MIs and flu activityThe authors say their study apparently is the first to examine the connection between flu activity and national rates of fatal and nonfatal MI in two different places and populations.The researchers used government sources to gather data on MI-related hospitalizations and deaths in England and Wales and in Hong Kong for the period January 1999 through December 2008. They also relied on official sources for daily temperature and humidity data. For comparison, they also gathered data on two conditions not likely to be associated with flu: colon cancer and femoral neck fractures.To track flu activity, the team examined general practitioner (GP) flu consultation rates for influenza-like illness (ILI) in the UK, while in Hong Kong they used the percentage of respiratory specimens that tested positive, since ILI data are deemed less specific for flu in subtropical areas. They compared the flu activity and MI data by week and used a regression analysis to control for the effects of temperature and humidity.The analysis showed there were 1,219,150 MI-related hospitalizations and 410,204 MI-related deaths in England and Wales during the 10 years, for a median of 2,421 hospitalizations and 777 deaths per week, with a marked winter peak. ILI consultations ranged from 0.8 to 270.8 per 100,000 population per week and were highest in 1998-99 and 1999-2000.For the same period, Hong Kong had 65,108 MI-linked hospitalizations and 18,780 deaths, for medians of 110 and 32 per week, respectively. The Hong Kong data showed a large winter peak and a small summer rise in MIs.A strong associationAfter adjusting for temperature and humidity, the scientists found a “strong association” between GP consultations and MI-linked deaths in England and Wales. The association was clearest in models featuring “lag times” of 1 or 2 weeks between MI-related deaths and increases in flu indicators. For a 1-week lag, the incident rate ratio (IRR) was 1.051 (95% confidence interval [CI], 1.043 to 1.058; P<.01).An association between flu activity and MI-related hospitalizations was also found for England and Wales, but it was smaller than the link between flu and MI deaths.For Hong Kong the analysis showed a strong link between the proportion of specimens positive for flu and MI-related deaths occurring in the same week (no lag time) (IRR, 1.077; 95% CI, 1.013 to 1.145; P=.018), after adjustments for temperature and humidity. The analysis showed a slightly smaller association between flu diagnoses and MI hospitalizations in Hong Kong.Depending on the seasonality model used, the researchers estimated that in England and Wales, 3.1% to 3.4% of MI-related deaths and 0.7% to 1.2% of MI-related hospitalizations were due to flu. For Hong Kong the estimates were 3.9% to 5.6% of deaths and 3.0% to 3.3% of hospitalizations. All of the estimates were found significant, with P values of .018 or lower. In both countries, the link between flu and MI was strongest in the oldest groups (80 years and older).The findings were most striking for weeks of peak flu activity, according to the authors' models. At those times, 9.7% to 13.6% of MI deaths in Hong Kong and 10.7% to 11.8% of MI deaths in England and Wales were attributable to flu.The analysis showed no association between flu activity and colon cancer or fractures of the femoral neck.Study helps build the caseIn the commentary, Lynn Finelli and Sandra S. Chaves of the CDC write, "This well-designed and -analyzed study adds to the pool of evidence supporting a relationship between influenza and AMI [acute MI] independent of temperature and humidity and is the first to our knowledge to propose influenza-attributable proportions for acute myocardial hospitalization and death."The commentators note a couple of limitations in the study. For one, the authors did not look into the effects of viruses other than flu. Another problem is the "inconsistent lag times observed between countries and among outcomes for ILI visits/influenza circulation and hospitalizations and deaths."The study does not address exactly how influenza might contribute to cardiovascular events. Finelli and Chaves say acute respiratory infections trigger responses such as an increase in white blood cells and release of cytokines, which may make atherosclerotic plaques more prone to rupture and block coronary arteries.As for the overall case for flu as a contributor to MI, the commentators say, "There is consistent ecologic evidence that overall cardiovascular mortality is related to influenza virus circulation and ILI activity, and there is consistent ecologic and individual level evidence that occurrence of AMI can be temporally related to acute respiratory infection including ILI."The data "are compelling so far," but the evidence is not yet conclusive, they add. Still needed are prospective studies of MI in individuals with laboratory evidence of flu infection.Praise and questionsThe study drew qualified praise from another veteran flu researcher, Lone Simonsen, PhD, research director at Georgetown University's Department of Global Health in Washington, DC."This is a carefully conducted time series analysis, making a good case for MI being associated with influenza. I especially like the consideration of non-influenza outcomes like colon cancer and hip fractures," she commented by e-mail.She also hailed the use of two locations with different climates and flu seasons and the tracking of MI events in entire populations—"very different from longitudinal studies where the number of MI events is typically limited."However, Simonsen said she was bothered by the finding that in the UK, the link between flu and MI was clearest in models showing increased MI events before, rather than after, increases in flu activity."Usually in this type of study one would expect to see a temporal pattern of influenza peaks followed by MI peaks," she said. "For example, it is understood that pneumonia hospitalizations and deaths typically peak a few weeks AFTER peak influenza activity. . . . For England and Wales, the MI peak for hospitalizations (and deaths) occurred 2, 3, and 4 weeks BEFORE the influenza peak."This may of course be explained by some delay in adult patients seeking care for influenza—2 to 3 weeks is a long time. But one has to wonder about the possibility that other winter-seasonal pathogens are playing a role; for example RSV [respiratory syncytial virus] activity often peaks earlier than influenza."Simonsen suggested that further research on the issue should focus on flu epidemics with unusual timing, such as the early flu season of 2003-04 and the H1N1 pandemic in the summer and fall of 2009. If there were early peaks of MI activity in those seasons, it would strengthen the evidence that the association is real, she said.The study authors address the issue of the UK lag times between MI and flu activity in their discussion, commenting that one British study showed that phone calls to the National Health Service for colds and flu preceded GP reports of the same symptoms by 1 to 3 weeks. "This may explain why we saw the best model fits, and greatest estimates of effect, when UK influenza data was lagged by -1 to -3 weeks (representing our assumptions that reported ILI consultations represent illness occurring in the community some time earlier)."However, they acknowledge that "peaks in MIs might precede GP reports of ILI if triggered by other synchronous environmental events." But they add that they used sensitivity analyses to control for temperature.Policy implicationsFinelli and Chaves comment that the findings imply that increasing vaccination coverage in people at risk for heart attacks might reduce their risk of such events. However, they note that several retrospective studies of the effects of flu vaccination on the risk of cardiovascular events have yielded inconsistent results."Because influenza vaccine effectiveness is suboptimal, especially in older people, the opportunity to prevent influenza-related complications in this population will benefit from the development of more immunogenic and effective vaccines," they write.Warren-Gash C, Bhaskaran K, Hayward A, et al. Circulating influenza virus, climatic factors, and acute myocardial infarction: a time series study in England and Wales and Hong Kong. J Infect Dis 2011 Jun 15;203(12):1710-7 [Abstract]Finelli L, Chaves SS. Influenza and acute myocardial infarction. (Commentary) J Infect Dis 2011 Jun 15;203(12):1701-4 [Full text]See also:Sep 21, 2010, CIDRAP News story "Study on flu shots and heart-attack risk questioned"
Although “watchful waiting” (WW) is the recommended approach to antibiotic treatment for acute ear infections in young children, a recent survey of parents suggests that relatively few physicians fully explain the rationale for this approach, including the nature of acute otitis media (AOM) and the risks of antibiotic overuse.The survey, described in the Journal of Applied Communication Research, showed that only 10% of parents recalled receiving information about the adverse effects of antibiotics, and only 4% reported receiving comprehensive information about the why and how of WW.But the study also showed that parents who did remember hearing detailed information about WW were more likely to follow that advice.Parents often skepticalAs noted in the report, WW involves providing antibiotics for young children with AOM but advising caregivers not to use the drugs unless symptoms persist. Although studies support the practice, parents “remain skeptical and generally unenthusiastic,” and consequently the approach is underused, the authors say.In the study, five researchers from Pennsylvania State University questioned a nationwide sample of 134 parents of children under 5 years old who had AOM. The parents had been provided with antibiotics to be used in case their children’s symptoms didn’t improve within a specified time.The study’s twofold aim was to examine how well parents’ recall of healthcare providers’ explanation and instructions matched American Academy of Pediatrics (AAP) guidelines on WW, and to assess the relationship between parental recollections and reported compliance with WW.The AAP guidelines for pediatric AOM advise providers to use the clinical exam to determine if the patient has AOM, which is bacterial, as opposed to a viral condition, the report notes. For severe AOM, immediate antibiotic treatment is recommended, but the guidelines suggest WW for patients under 2 years old who have mild AOM and for those 2 years and older who have “nonsevere” AOM.The guidelines say providers should explain the self-limited nature of most AOM episodes and the potential adverse effects of antibiotics. In addition, providers are advised to tell parents to monitor their children’s condition, use analgesics (such as acetaminophen), and obtain follow-up care.Few parents heard about antibiotic risksOnly 10% of the parents recalled getting information about the harmful effects of antibiotics, while 58% reported learning about the nature of AOM, and 64% reported being told about one or both of these topics, the report says.Three fourths of the parents recalled being told to monitor their child’s symptoms, but only 29% reported getting advice about medication for pain, and 22% reported an offer of follow-up care during the WW period.Only 4% of the parents recalled receiving at least one of the two types of explanation (risks of antibiotics and the nature of AOM) and all three types of instruction, the authors found.The survey also revealed that 27% of the parents did not comply with WW.”Of parents who complied with WW, 63% reported that the physician explained the nature of AOM (versus 42% of noncompliant parents), 88% reported being instructed to monitor their children’s symptoms (versus 61% in the noncompliant group), and 38% reported instruction to use medication to manage pain (versus 14% of the noncompliant parents),” the report says.A statistical analysis indicated that compliance was significantly associated with having received information and advice on these three topics. The analysis showed that explaining the risks of antibiotics and instructing parents on follow-up care did not have statistically significant effects. But the number of parents who recalled hearing about antibiotic risks was so low (10%) as to prevent a strong test of the effect of this information on compliance, the authors said.Misunderstandings revealedIn other findings, even when parents reported hearing explanations about the risks of antibiotics, their understanding of the subject was not necessarily correct, the survey showed. One participant reported, “If children are given antibiotics when it is not necessary, they can build up an immunity to them.” This misunderstanding illustrates the challenge of understanding antibiotic resistance and the need for healthcare providers to more clearly communicate the dangers of overuse, the authors said.The findings, the researchers said, suggest that providers don’t fully follow the AAP guidelines when communicating with caregivers about WW, an interpretation that is consistent with high rates of injudicious antibiotic prescribing for AOM. But the results almost certainly also reflect parents’ difficulty in understanding and remembering what providers tell them.”The current study provides evidence that health care providers are not powerless to resist parents’ misconceived desire for antibiotic treatment, but can use explanation and instruction to guide them toward compliance with WW,” the researchers comment. “A starting point is ensuring that key elements of explanation and instruction are actually provided, which will also bring providers into alignment with AAP guidelines.”MacGeorge EL, Caldes EP, Smith RA, et al. Reducing unwarranted antibiotic use for pediatric acute otitis media: the influence of physicians’ explanation and instruction on parent compliance with ‘watchful waiting.’ J Appl Commun Res 2017 (published online May 30) [Full text]See also:Related Jun 5 press release
CLEVELAND — Eaton Corp. has announced that Kenneth Davis has been named president of its Vehicle Group, effective Jan. 1, 2011, succeeding Joseph Palchak who has announced his decision to retire at the end of June, 2011. AdvertisementClick Here to Read MoreAdvertisement Palchak will continue to report to Craig Arnold, vice chairman and chief operating officer – Industrial Sector, and will be assisting with the transition in addition to some specific projects until his retirement. In his new role, Davis will report to Craig Arnold and will be responsible for the company’s automotive and truck businesses. Davis’ current role as president – Americas for Eaton’s Vehicle Group will not be filled. “Ken’s deep knowledge of the vehicle segment combined with his global business experience and strong leadership skills will be instrumental as we continue to grow in critical markets around the world,” said Craig Arnold, vice chairman and chief operating officer – Industrial Sector. “We are pleased he will be assuming this leadership role.” Since joining Eaton in 1986, Davis has held management positions of increasing responsibility including president – Americas for Eaton’s Vehicle Group, president of the company’s Light- and Medium-Duty Transmission business and vice president and general manager for Eaton’s Clutch business. He earned a bachelor’s degree in management from Purdue University in Indiana and a master’s degree in business administration from the University of Michigan. He will continue to be located in Galesburg, Mich. Advertisement Joe Palchak will continue to report to Arnold and assist with the transition process until June, 2011. “During the past three years, Eaton’s automotive and truck businesses have come together under Joe’s leadership,” said Arnold. “He has created a streamlined regional organization that adapts quickly to the evolving business environment and responds efficiently to customer needs. I want to thank him for continuously embodying Eaton’s values and for his steadfast leadership of our Vehicle Group during the recent volatility of the past several years.” Palchak joined Eaton in 1973 as a trainee with the Forge Division. Since then he’s served in a variety of leadership positions including president – Vehicle Group, president – Automotive Group, president – Engine Air Management Business and president – Powertrain and Specialty Controls Operations. He holds a bachelor’s degree in business from Susquehanna University in Pennsylvania and a master’s degree in business administration from the University of Louisville in Kentucky.