Studying Climbers On Everest to Help Heart Patients at Home

It's a natural laboratory for studying heart disease, lung problems, muscle loss, sleeping disorders and new medical technologies. It's also the highest mountain in the world. Mount Everest's extreme altitude puts climbers under the same conditions experienced by patients suffering from heart disease, obesity or advanced age. To take advantage of that, Mayo Clinic researchers are joining an expedition to Everest with National Geographic, The North Face and Montana State University. The Mayo group will monitor up to nine climbers from base camp for the duration of the climb, which will run from mid-April to mid-May.

"We can simulate some conditions in oxygen tents and hyperbaric chambers, but only for short periods," says Bruce Johnson, Ph.D., Mayo Clinic physiologist and leader of the scientific expedition. "We're studying the effects of extreme altitude on healthy, active individuals as well as these extreme athletes because what they experience mimics aspects of heart disease."

Dr. Johnson, who has conducted research at the South Pole and other mountain ranges, will be joined by three other Mayo investigators: physician-researcher Doug Summerfield, M.D., and scientists Bryan Taylor, Ph.D., and Amine Issa, Ph.D. Mayo Clinic also will send its own reporter to cover the research expedition. Joel Streed of the Mayo Clinic News Network will blog and shoot video from base camp.

The expedition and other research initiatives are part of Mayo's work to transform medical care. The data generated by the expedition is expected to provide new insights into aging patients and heart disease, and help Mayo develop high-quality, affordable options for patients who need cardiac monitoring.

The Projects

Sleep Physiology It's hard to get a good night's sleep in a cold tent, especially at 18,000 feet. Sleep apnea is common, and such starts and stops in breathing also trouble many overweight patients or those with chronic heart failure. Sleep apnea can decrease oxygen in the blood, a serious condition at sea level and at high altitude. Poor sleep quality occurs due to restricted space, high wind, hard surfaces; even clothing or equipment may play a role. Researchers will study oxygen during sleep and sleep quality as it relates to other high altitude problems.

Muscle Loss at High Altitude Previous studies show that climbers lose weight rapidly at high altitude -- primarily muscle, not fat -- and extra food intake has negligible impact. Muscle wasting is a common problem with many chronic diseases, including heart disease. The hypothesis is that weight loss is related to more severe hypoxia, especially at night. The team will track calories, sleep quality, sleep hypoxia and body composition.

Lung Fluid Regulation Pulmonary edema, fluid in the lungs common in heart patients, remains a mystery on mountains. Some think it's caused by an uneven constriction of blood vessels in the lungs, a response to the lower inspired gas pressures. Yet it doesn't happen to everyone who climbs, so there may be other factors, such as genetic susceptibility. Researchers will look at pressures in the lungs, gas transfer across the lungs and other factors.

Remote Monitoring Testing Remote monitoring and recording devices will be tested, some for the first time under such extreme conditions. Ensuring they are rugged enough for Mount Everest and function under extreme cold and pressure changes will be valuable for future climbs and sea-level use. One monitor developed by Mayo researchers will get its first field test. If reliable data capture works on Mount Everest, quality should be assured in monitoring heart patients remotely in their homes, providing a tip-off when medication needs to be adjusted or a visit to the doctor is needed.

The expedition is funded by National Geographic and The North Face, with support from Montana State University.

GM to invest $1 billion in Australia operations

U.S. car maker General Motors on Thursday committed to invest A$1 billion (US$1.04 billion) in its Australian operations over the next decade after securing Australian government support to help it keep its car plant open until at least 2022.

Prime Minister Julia Gillard said the national and two state governments would inject A$275 million into GM Holden in the latest hand out to the country's struggling auto makers to protect manufacturing jobs.

Australia's three car makers - GM Holden and the Australian arms of Toyota Motor Corp <7203.T> and Ford Motor - have all cut jobs due to falling sales and exports, blamed on the global downturn and a record high Australian dollar, which has traded above parity with the U.S. dollar.

"It is a strategic investment that will boost our economy," Gillard told reporters, adding that GM Holden's future was secure for the next 10 years.

"It will be making cars and competing in economic circumstances where we expect the Australian dollar to be around about parity with the U.S. dollar," she said.

The funding will secure the jobs of 12,000 people employed by GM Holden's Adelaide car plant and engine manufacturing plant in Victoria, and shore up thousands more manufacturing jobs in the components sector.

GM Holden cut 140 jobs from its Adelaide car plant in February, while Toyota said in January it was cutting 350 jobs at its Australian manufacturing operations.

The latest government figures show Australia produced nearly 250,000 cars in 2010, falling steadily from about 320,000 in 2008 and more than 400,000 in 2004.

The industry employs about 55,000 people and supports 200,000 other manufacturing jobs.

The government has been determined to keep the industry afloat and protect jobs after Japan's Mitsubishi Motors Corporation <7211.T> closed its Australian car plants in 2008.

The funding for GM Holden comes from the national government's 12 year car industry support package, announced in 2008 and budgeted at A$5.4 billion to 2020, which commits the government to co-invest with car makers to support manufacturing jobs.

"Co-investment of this kind is critical for our industry," GM Holden's managing director Mike Devereux told reporters.

The Australian dollar has traded at record highs above parity with the U.S. dollar over the past year and around 40 percent above its long term average, putting a strain on manufacturing and export industries.

New Test May Predict the Possibility of a Heart Attack

New findings from a landmark research study led by Scripps Translational Science Institute (STSI) -- a collaborative program between Scripps Health and The Scripps Research Institute (TSRI) -- shows a promising new blood test may be useful in helping doctors predict who is at risk for an imminent heart attack.

Results of the study, titled "Characterization of Circulating Endothelial Cells in Acute Myocardial Infarction," were published this week in Science Translational Medicine. The study concludes that circulating endothelial cells (CEC) from heart attack patients were abnormally large and misshapen and often appeared with multiple nuclei, which indicates that CECs are promising biomarkers for the prediction of acute ongoing arterial plaque rupture.

"The ability to diagnose an imminent heart attack has long been considered the holy grail of cardiovascular medicine," said Dr. Eric Topol, the study's principal investigator and director of STSI. "This has been a tremendous collaboration of two institutions on the research side, three health care systems in San Diego, and a life science industry leader, which has resulted in an important discovery that may help to change the future of cardiovascular medicine."

CEC counts and cell features dramatically altered in heart attack patients

The study involved 50 patients who presented to emergency rooms with heart attacks at four acute care hospitals in San Diego. Using different cell isolation platforms, including the Veridex CellSearch System, the researchers found that CEC counts and the cell structural features were dramatically altered in the heart attack population when compared to the healthy control group.

"We are pleased to have collaborated on this important investigational study, said Mark Connelly, PhD, Director, Cellular Research, Veridex. "CellSearch has proven to be a powerful tool for oncology research and the care of metastatic cancer patients. This study highlights the value of accurate rare cell capture and analysis in areas beyond oncology."

The study was co-authored by physicians and scientists from Scripps Health; STSI; TSRI; Veridex, LLC (a Johnson & Johnson company); Palomar Health; and SharpHealthCare. Funding came from a $2 million grant from the National Institutes of Health.

The findings are significant, as more than 2.5 million U.S. individuals experience a heart attack or ischemic stroke, most commonly the result of obstructive coronary artery disease, according to Paddy Bennett, MD, lead investigator at STSI. If the arteries get abruptly and completely occluded by the buildup of fatty cholesterol, it will cause a massive heart attack that will likely lead to a sudden death, as was the case involving former NBC News Washington Bureau Chief Tim Russert.

Test may be developed for widespread use soon

"With some additional validation, the hope is to have this test developed for commercial use in the next year or two," said Raghava Gollapudi, MD, who was the principal investigator from Sharp HealthCare. "This would be an ideal test to perform in an emergency room to determine if a patient is on the cusp of a heart attack or about to experience one in the next couple of weeks. Right now we can only test to detect if a patient is currently experiencing or has recently experienced a heart attack."

This study is an extension of Scripps Health's leadership in heart care and research. Scripps is currently building the $456 million Prebys Cardiovascular Institute, a center for innovation that will bring together top researchers, physicians and staff. The institute will incorporate leading-edge wireless technologies and individualized medicine for the best in patient care when it opens in 2015.

Annually, more than 55,000 patients receive their cardiovascular care from Scripps, making it San Diego County's largest heart care provider. Scripps is the region's only cardiovascular program consistently recognized by U.S. News & World Report as one of the best in the country.

Antioxidants May Aid Chemotherapy Patients

There is no evidence that antioxidant supplements interfere with the therapeutic effects of chemotherapy agents, according to a recent systematic review of the use of antioxidants during chemotherapy, available in the May, 2007 issue of the peer-reviewed journal Cancer Treatment Reviews. In fact, they may help increase survival rates, tumor response, and the patient’s ability to tolerate treatment.

This conclusion has important implications for patients whose oncologists discourage the use of antioxidant supplements during treatment. Until now, their concern has been that these supplements may counteract the tumor-shrinking abilities of the chemotherapy.

“This review demonstrates that there is no scientific support for the blanket objection to using antioxidants during chemotherapy. In addition, it also appears that these supplements may help mitigate the side effects of chemotherapy,” said Keith I. Block, MD, lead author of the study and Medical Director of the Block Center for Integrative Cancer Treatment. “This is significant because it increases the likelihood that patients will be able to complete their treatment.”

Co-author Dr. Robert Newman, Professor of Cancer Medicine at M. D. Anderson Cancer Center said, “This study, along with the evolving understanding of antioxidant-chemotherapy interactions, suggests that the previously held beliefs about interference do not pertain to clinical treatment.”

The analysis, titled “Impact of Antioxidant Supplementation on Chemotherapeutic Efficacy: A Systematic Review of the Evidence from Randomized Controlled Trials,” evaluated 845 articles from five scientific databases that examined the effects of taking natural antioxidant supplements concurrent with chemotherapy.

Out of the 845 studies that were analyzed, 19 met all evaluation criteria. These included the use of randomized trials with a control group, and the reporting of treatment response (tumor shrinkage) and survival data. The 1,554 patients represented had a variety of cancer types, and most had advanced or relapsed disease. Some of the antioxidants used in the trials included glutathione, vitamin A, vitamin C, vitamin E, ellagic acid, selenium and beta carotene.

Among the findings:

All of the studies that included survival data showed similar or better survival rates for the antioxidant group than the control group.
None of the trials supported the theory that antioxidant supplements diminish the effectiveness of chemotherapy treatments.
All but one of the studies that reported treatment response showed similar or better response in the antioxidant group than in the control group.
15 of 17 trials that assessed chemotherapy toxicities, including diarrhea, weight loss, nerve damage and low blood counts, concluded that the antioxidant group suffered similar or lower rates of these side effects than the control group.

The authors noted that reducing side effects may help patients avoid having to cut back on their chemotherapy dosing, interrupt scheduled treatments, or abandon treatment altogether. This in turn, is likely to favorably impact treatment outcomes. A recent study of a group of colon cancer patients indicated that those who completed their full prescribed schedules of chemotherapy had survival rates nearly double those of patients who abandoned their chemotherapy treatment prematurely.

This new study encourages further exploration of the potential importance of antioxidant supplements as a means of improving cancer survival.

Can Our Genes Be Making Us Fat?

While high-fat foods are thought to be of universal appeal, there is actually a lot of variation in the extent to which people like and consume fat. A new study in the March issue of the Journal of Food Science, published by the Institute of Food Technologists, reported that two specific genes (TAS2R38-a bitter taste receptor and CD36-a possible fat receptor), may play a role in some people's ability to taste and enjoy dietary fat. By understanding the role of these two genes, food scientists may be able to help people who have trouble controlling how much fat they eat.

Most food scientists acknowledge the texture of fat plays a big role in how fat is perceived in the mouth. For example, ice cream is typically "rich, smooth and creamy." And certain fats, scientists have determined, can be detected by smell. Only recently have food scientists explored that most fats have a taste too. Researchers are now investigating the gene (CD360) that is responsible for detecting the taste of fats (fatty acids) in the mouth.

In the recent Journal of Food Science study, investigators focused on one ethnic group to limit genetic variation that could reduce the ability to detect associations with the gene of interest. They determined the fat preferences and CD36 status of more than 300 African-American adults. The investigators from the New York Obesity Research Center identified a genetic variant present in 21 percent of the African-Americans that was associated with higher preferences for added fats and oils (e.g. salad dressings, cooking oils, etc). They also found study participants with this genetic variance ranked Italian salad dressings creamier than those who have other genotypes.

The other gene explored by these investigators, TAS2R38, is the receptor for bitter taste compounds. About 70 percent of U.S. adults and children are "tasters" of these compounds, while the remaining 30 percent are "nontasters." Results indicate that nontasters of these compounds tend to be poor at discriminating fat in foods; therefore individuals who can't detect fat's presence may consume higher fat foods to compensate. This is in part due to the fact that nontasters have fewer taste buds than tasters. While researchers recognize that the cause of obesity is multifaceted, they continue to examine the role of these genotypes in weight management.

Genetic testing within the food industry may not be too far off. Once studies like these are more fully developed, there may be a role for genotyping study participants when it comes to testing a new product. For example, a company wanting to test out a dressing may include people with different genes relating to fat perception in order to get a more accurate opinion. In addition, the food industry will be able to create different kinds of foods for certain populations.

Antioxidant Supplements Seem to Increase Mortality, Review Shows

Previous research on animal and physiological models suggests that antioxidant supplements have beneficial effects that may prolong life. Some observational studies also suggest that antioxidant supplements may prolong life, whereas other observational studies demonstrate neutral or harmful effects. Our Cochrane review from 2008 demonstrated that antioxidant supplements seem to increase mortality. This review is now updated.

The current evidence does not support the use of antioxidant supplements in the general population or in patients with various diseases.

The present systematic review included 78 randomised clinical trials. In total, 296,707 participants were randomised to antioxidant supplements (beta-carotene, vitamin A, vitamin C, vitamin E, and selenium) versus placebo or no intervention. Twenty-six trials included 215,900 healthy participants. Fifty-two trials included 80,807 participants with various diseases in a stable phase (including gastrointestinal, cardiovascular, neurological, ocular, dermatological, rheumatoid, renal, endocrinological, or unspecified diseases). A total of 21,484 of 183,749 participants (11.7%) randomised to antioxidant supplements and 11,479 of 112,958 participants (10.2%) randomised to placebo or no intervention died.

The trials appeared to have enough statistical similarity that they could be combined. When all of the trials were combined, antioxidants may or may not have increased mortality depending on which statistical combination method was employed; the analysis that is typically used when similarity is present demonstrated that antioxidant use did slightly increase mortality (that is, the patients consuming the antioxidants were 1.03 times as likely to die as were the controls). When analyses were done to identify factors that were associated with this finding, the two factors identified were better methodology to prevent bias from being a factor in the trial (trials with 'low risk of bias') and the use of vitamin A. In fact, when the trials with low risks of bias were considered separately, the increased mortality was even more pronounced (1.04 times as likely to die as were the controls).

The potential damage from vitamin A disappeared when only the low risks of bias trials were considered. The increased risk of mortality was associated with beta-carotene and possibly vitamin E and vitamin A, but was not associated with the use of vitamin C or selenium.

Sweden ends row over Nobel Peace Prize attribution

The Nobel Foundation has defended the award of its annual Peace Prize to U.S. President Barack Obama, Yemeni rights campaigner Tawakul Karman and others by persuading a Swedish regional body that the awards remained consistent with its founder's wishes.

The County Administrative Board of Stockholm said on Thursday in an emailed statement that it had received a reply from the Nobel Foundation which supported its view that the foundation "fulfils its obligation to examine how the Nobel committees work".

It added that it believed the foundation was ready to act if the Norwegian Nobel Committee -- which awards the Peace Prize -- was deemed to not be fulfilling the rules stipulated in the will of founder Alfred Nobel.

"Therefore there is currently no reason for the County Administrative Board to further intervene against the foundation's work...and the matter is to be closed," the board said in the statement emailed to Reuters.

The issue has dogged the Norwegian Nobel Committee since 2008, when Oslo-based author and lawyer Fredrik Heffermehl began arguing that the prize had drifted from Nobel's intent to promote disarmament and peace congresses.

Heffermehl complained to the Stockholm County Administrative Board -- whose duties extend to ensuring that registered foundations fulfill the wishes of their dead benefactors -- that Peace Prize choices have ignored Nobel's directives since 2001.

Nobel, who invented dynamite, wrote in his 1895 will that the peace prize should go to "the person who shall have done the most or the best work for fraternity between nations, for the abolition or reduction of standing armies and for the holding and promotion of peace congresses."

While the annual Nobel Prizes in physics, chemistry, medicine, literature and economics are given in Stockholm, Nobel specified that a committee appointed by the Norwegian parliament should pick the peace prize winner. It is given in Oslo.

Heffermehl told Reuters in February that human rights campaigners like Liu Xiaobo, the jailed Chinese dissident who won in 2010, and advocates of the poor like Muhammad Yunus, who won in 2006 for popularizing micro-loans, were fine people but "wrong" for the prize.

Nor did he approve of the three 2011 winners: Liberian President Ellen Johnson Sirleaf, Liberian peace activist Leymah Gbowee and the Yemeni democracy advocate Karman.

"After last year you would think it's a prize for democracy and women's rights," he said.

U.S., Canada 2011 box office slumps, global sales up

Ticket sales at U.S. and Canadian theaters suffered a 4 percent slump in 2011 to $10.2 billion despite a slew of big studio-funded hits that helped boost the global box office, a Hollywood industry group said on Thursday.

The U.S. and Canada film box office fell from 2010's $10.6 billion in revenue, according to the Motion Picture Association of America, which represents major U.S. film studios.

U.S. and Canadian theaters sold 1.3 billion tickets in 2011, its lowest level in a decade and its second consecutive year of declines, a troubling statistic for both the theaters and Hollywood studios, which have traditionally relied on theatrical showings to promote their movies for later sales on DVDs and through digital outlets.

John Fithian, president of the National Association of Theater Owners, called the slump "disappointing to our U.S. operators."

Despite a year in which studios released big-budget crowd pleasers such as "Harry Potter" and "Twilight," Fithian said "a few more good movies" were needed for the box office to recover in the aftermath of 2010's first-quarter box office hits "Avatar" and "Alice in Wonderland."

Offsetting the dour domestic numbers, the global box office increased by 3 percent from 2010, raking in $32.6 billion during 2011, strengthened by ongoing growth of theaters in international markets.

China's box office alone grew by 35 percent in 2011, as the nation stepped up construction of 3D and large-screen Imax theaters.

Last year's five top-earning films in the U.S. and Canadian market was led by the final installment in the "Harry Potter" franchise, followed by "Transformers: Dark of the Moon," "Twilight Saga: Breaking Dawn - Part 1," "The Hangover 2" and "Pirates of the Caribbean: On Stranger Tides," with box office revenues ranging from $241 million to $381 million each.

Sales of movie tickets for 3D films fell by $400 million in 2011 from $2.2 billion in 2010, which was spurred by the success of "Avatar."

Frequent theater-goers, who represent only 10 percent of the U.S. and Canadian population but purchased half of all cinema tickets in 2011, were led by the 25-39 age demographic compared to the 18-24 demographic leading 2010.

GLOBAL GROWTH

The foreign box office's $22.4 billion market was led by Japan with $2.3 billion in sales, ahead of China and France with $2 billion each.

Currently, China is building eight cinema screens a day and has plans for 175 Imax theaters this year, said former U.S. Senator Chris Dodd, chairman and CEO of the MPAA.

Fithian said global box office growth was the result of three factors -- greater access in important places like China, building modern cinemas in emerging markets, and a diverse mix of films overseas.

"When you have more diverse movies to offer, combined with good cinemas, you continue to drive growth," he said.

Despite the slow domestic year in 2011, Dodd said his MPAA members were excited for 2012, buoyed by an almost 15 percent increase in the 2012 box office so far, compared to last year.

"We're looking forward to a tremendous year, if the first couple of months are any indication, we're ahead," said Dodd.

The MPAA chairman saw "The Hunger Games" as a potential box office leader for a summer of big hits that includes "The Avengers" and the next installment of the "Batman" franchise, "The Dark Knight Rises."

"The Hunger Games" has already sold out 2,500 show times ahead of its release on Friday, and is currently selling 10 tickets a second on ticket sales website Fandango, the site's spokesman said on Thursday.

Dodd added that distributors were adding "more screenings by the minute" on Thursday, with more than 4,600 complexes and 10,000 screens showing the film in its opening week.

(This story has been corrected to reflect that the \"lowest level in a decade\" refers to the 1.3 billion tickets sold in 2011, not to the $10.2 billion in ticket sales that year.)

(Editing by Phil Berlowitz)

Oracle investor sues over $200 million settlement

An Oracle Corp. investor sued the company and members of its board of directors on Thursday for allegedly trying to "stonewall" a whistleblower lawsuit that ultimately resulted in a $200 million settlement.

The lawsuit filed by investor Jordan Weinrib in Delaware state court said the defendants, including Oracle CEO Lawrence Ellison and other past and present members of the company's board of directors, breached their duty to shareholders by engaging in prolonged litigation over the whistleblower's allegations, which the defendants allegedly knew to be true.

"The board forced the government to expend additional resources litigating the action when the board knew the company was in a significant liability position and that additional litigation would certainly raise the ultimate price of settlement," Weinrib said in the complaint.

The settlement in question was the result of a whistleblower lawsuit filed in 2007 by Oracle's former senior director of contract services, Paul Frascella, who accused the company of violating price-reduction clauses in federal contracts covering $775 million in goods, extending discounts to commercial clients without doing the same for government buyers.

The U.S. Department of Justice intervened in the lawsuit in 2010. In 2011, Oracle paid more than $200 million to settle the lawsuit, including interest and payments for the whistleblower, the largest of its kind under the federal False Claims Act.

"Despite substantial evidence of wrongdoing, Oracle's board of directors did not admit that these acts had occurred, enact remedial measures and negotiate a resolution that involved a small payment," Weinrib said in the complaint. Instead, by litigating the case, Oracle drove up the ultimate settlement price, harming taxpayers and shareholders alike, Weinrib said.

Weinrib is seeking an unspecified amount in damages on behalf of shareholders. A spokesman for Oracle did not immediately return a request for comment Thursday.

Smog linked to behavior problems in children

Women who breathe in smog while pregnant are more likely to give birth to children with behavioral problems, a new study says. The study, published in Environmental Health Perspectives, found that children exposed to powerful airborne pollutants called polycyclic aromatic hydrocarbons (PAH) while in the womb were more likely to suffer from anxiety, depression and attention problems.

The study builds on previous research finding links between prenatal exposure to pollutants and health problems.

However, this particular study is the first that specifically links behavior problems in school-age children to two types of PAH exposure, which are air concentrations and the levels of pollutants found in mothers' umbilical cord blood, U.S. News & World Report‎ said.

"What I take away from this is neurodevelopment is really sensitive to stresses of various kinds," Shanna H. Swan, a reproductive endocrinologist at the Mount Sinai School of Medicine, told ABC.

The study follows mothers children who live in urban areas. But researchers aren't suggesting that all pregnant women move to the countryside. Instead, they say that governments needs to place stricter regulations on the businesses responsible for the pollution.

"Pregnant women and their families can support local, state and federal legislation promoting improved overall indoor and outdoor air quality," Dr. Maida P. Galvez, associate professor of preventive medicine and pediatrics at Mount Sinai School of Medicine, told ABC.

Swan added: "This is really a paper about social justice."