Madden D.,University College
Journal of Biosocial Science | Year: 2014
There is now fairly substantial evidence of a socioeconomic gradient in low birth weight for developed countries. The standard summary statistic for this gradient is the concentration index. Using data from the recently published Growing Up in Ireland survey, this paper calculates this index for low birth weight arising from preterm and intrauterine growth retardation. It also carries out a decomposition of this index for the different sources of low birth weight and finds that income inequality appears to be less important for the case of preterm births, while father's education and local environmental conditions appear to be more relevant for intrauterine growth retardation. The application of the standard Blinder-Oaxaca decomposition also indicates that the socioeconomic gradient for low birth weight appears to arise owing to different characteristics between rich and poor, and not because the impact of any given characteristic on low birth weight differs between rich and poor. © 2013 Cambridge University Press. Source
NEW ORLEANS — Eating nuts has been linked to a number of health benefits, such as a reduced risk of obesity, diabetes and heart disease. Now, new findings from South Korea suggest that a nut-rich diet may also reduce a person's risk of colon cancer. The researchers found a reduction in this risk for both men and women, according to the findings, presented here today (April 18) at the American Association for Cancer Research's annual meeting. Eating a serving of nuts three or more times a week appeared to have a big effect on risk, said Dr. Aesun Shin, an associate professor of preventive medicine at Seoul National University College of Medicine in South Korea and an author of the study. In the study, a serving of nuts was considered to be 15 grams (0.5 ounces), Shin told Live Science. That's a smaller amount than what's considered a serving in the United States, she added. (A serving in the U.S. is 28 g, or 1 oz.) Although the researchers included many types of nuts in their analysis, peanuts were the most widely consumed nuts among people in the study. This may be due to the availability of peanuts in South Korea, the researchers said. [6 Foods That Are Good For Your Brain] To examine the relationship between eating nuts and colon cancer risk, the researchers looked at 923 patients who had been diagnosed with colon cancer and compared their diets with those of 1,846 people who did not have colon cancer. The researchers found that men who reported eating three or more servings of nuts a week had a 69 percent lower risk of colon cancer than those who reported eating no nuts. Women who ate three or more servings had an 81 percent lower risk than those who ate no nuts, according to the study. In addition, the researchers looked at several different types of colon cancer, based on the location in the colon where the cancer is found. Nut consumption was associated with a reduced risk across all of the different locations that the researchers examined, Shin said. The study does not prove a cause-and-effect relationship between eating nuts and having a lower risk of colon cancer, the researchers said. However, the researchers hypothesized that some of the compounds, including fiber and antioxidants, found in nuts may help reduce a person's risk of colon cancer. [Top 10 Cancer-Fighting Foods] Shin noted that a limitation of the study is that participants were asked to recall their own nut intake, and it's possible that they may have made mistakes. The findings have not been published in a peer-reviewed journal. Copyright 2016 LiveScience, a Purch company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Robert McNeill Alexander defined many fundamental properties of how animals move. He combined elegant mechanical and mathematical analyses to reduce problems in flight, swimming, walking, running and anatomy to their simplest level. He explained the importance of inertial forces versus gravitational ones in determining which gaits land animals use to move at different speeds, and he predicted the pace at which dinosaurs probably moved. His work showed why animals of different sizes move in similar ways, as well as the importance of the elastic energy stored in tendons in reducing the metabolic cost of jumping and running. Alexander wrote 20 books, including his classic text Animal Mechanics (Sidgwick and Jackson, 1968). He published more than 280 scientific papers. On most subjects in biomechanics, it would be wise to first read what Alexander had to say. Born in 1934 in Lisburn, UK, to the chief engineer of the city of Belfast Robert Alexander and author Janet McNeill, he was inspired at school by his biology teacher Arnold Benington, a BBC radio naturalist. Aged 16 or 17, Alexander published his first paper 'Behaviour of the robin during laying' (Brit. Birds 44, 389–390; 1951), after a pair nested on top of a wardrobe in his bedroom. That year, he also won an essay prize from the Royal Society for the Protection of Birds for an experiment to test if birds would remember which trough on his windowsill contained hidden food. At the University of Cambridge, Alexander read natural sciences. He completed a PhD on the function of swim bladders in fish. His supervisor was James Gray, a pioneer of comparative experimental studies of animal locomotion. He also acted, including a memorable appearance as the giant Harapha in a production of John Milton's Samson Agonistes. And he travelled extensively in Europe, meeting his wife Ann, also a student at Cambridge, on a trip to Italy in 1956. He was an expedition scientist on a Cambridge trip to the jungles of Guyana in 1960. After a lectureship at the University College of North Wales (now Bangor University) from 1958 to 1969, Alexander became professor of zoology at the University of Leeds, until his retirement in 1999. In the early 1960s, the functional analysis of animal form was driven by descriptive comparisons of morphology that largely lacked mathematical expression. Alexander addressed this by combining field studies with laboratory experimentation and theoretical modelling. In collaboration with Harvard University physiologist C. Richard Taylor and Kenyan veterinary scientist Geoffrey Maloiy, he examined movement in African mammals as diverse as dik-dik and buffalo. He formulated a model that explained how and why animals move in similar ways, and he used Froude numbers (previously deployed by Victorian engineer William Froude in his analysis of the bow waves of ships) to explain how the length of limbs affects speed and gait over ground. Alexander also built theoretical models of foraging and migration, suggesting that only birds or large mammals benefit from the risks and energy costs of long-distance travel. Alexander compared the athletic performance of humans with that of other animals. He discovered that small animals rely on the rapid release of elastic energy stored in their tendons to jump high and far, whereas humans and larger animals stretch their muscles with force to achieve greater heights. And he evaluated the evolutionary and energetic consequences of building and maintaining physiological and mechanical structures that are necessary for locomotion, such as those that facilitate respiratory gas transport and musculoskeletal support. His family indulged his research endeavours. In the 1970s, while developing an approach to derive the speeds of dinosaurs from their fossilized tracks, Alexander took his two children to Snettisham beach in Norfolk, UK. There, they walked and ran along various textures of mud, counting their strides and timing themselves with a stopwatch. These antics are recorded in the paper 'Estimates of speeds of dinosaurs' (Nature 261, 129–130; 1976). Alexander's work fuelled the emerging field of biorobotics. He participated in a European effort to build a robot dinosaur, advising on the probable gait and a simplified arrangement of joints for the creature. His findings also contributed to improved gait rehabilitation and prosthetic devices for people. His coffee-table book Bones (Prentice Hall, 1994) reveals the beauty inherent in the biomechanics of animals. His 1995 educational CD How Animals Move was widely used in schools and universities; it remains the best teaching aid of its kind. Neill was devoted to comparative biomechanics and its wider appreciation. He served as secretary to the Zoological Society of London from 1992 to 1999 (after the reversed decision to close London Zoo). He served as president of the Society for Experimental Biology and the International Society of Vertebrate Morphology and as editor of the journal Proceedings of the Royal Society B. Among his many honours, Neill was elected fellow of the Royal Society in 1987 and appointed Commander of the Order of the British Empire in 2000. The gong that gave him the most amusement — and best captured his Gandalf-like status — came in 1996, when British newspaper The Mail on Sunday listed him as one of “Britain's Nuttiest Professors — Ten Sages Who Really Know Their Onions”. In retirement, Neill continued to attend professional meetings, give lectures and serve on examination committees. He advised on television documentaries, including the BBC's 2001 series Walking with Beasts. As a reviewer, he was always succinct, insightful and supportive of good science. He visited every poster at conferences, where he conveyed his passion to students and remained a role model. Neill was warm and animated in conversation and broad-minded when communicating his science. He was an inspiration and generous mentor to many of today's leaders in the scientific field that he established.
"It is impossible to explain enormous variations in age at maturity and other developmental milestones just by looking at differences in this daily rhythm," said Dr. Timothy Bromage, a professor of Biomaterials & and of Basic Science & Craniofacial Biology at the New York University College of Dentistry. "This suggests that another biological timing mechanism is at work." Through metabolomic analysis of blood plasma, Dr. Bromage and his team, have for the first time, linked these variations to another biological timing mechanism operating on multi-day (multidien) rhythms of growth and degradation. The findings were published today in the online journal PLOS ONE. This research builds upon earlier studies by Dr. Bromage that observed multi-day biological rhythms within incremental growth lines in tooth enamel and skeletal bone tissue first published in the February, 2009 issue of Calcified Tissue International. "These rhythms, originating in the hypothalamus, a region of the brain that functions as the main control center for the autonomic nervous system, affect bone, body size, and many metabolic processes, including heart and respiration rates," Dr. Bromage hypothesized. "The rhythms affect an organism's overall pace of life and its lifespan, so a rat that grows teeth and bone in a fraction of the time of a human, in fact also lives faster and dies at a much younger age." In his current research, Dr. Bromage and his team further characterized these rhythms through metabolome and genome analysis of blood plasma from a medium-sized mammal, the domestic pig. The study, "The Swine Plasma Metabolome Chronicles "Many Days" Biological Timing and Functions Linked to Growth," is the first ever use of metabolomics to address a question in evolutionary biology. The researchers found that blood plasma metabolites and RNA drawn from 33 domestic pigs over a two-week period oscillate on a five-day rhythm. Using microscopic analysis, the investigators also observed a corresponding five-day rhythm in the pigs' tooth enamel. Further study revealed two five-day rhythms in tandem—one controlling tissue growth and a second one beginning three days later for degradation of growth-related molecular compounds back to their basic biological entities for use in the next growth round. "These findings provide new insight into biological processes regulating growth and body size and controlling gestation length, weaning, age at maturity and other developmental milestones," said Dr. Bromage. "We believe this to be a key component to what regulates species' life history evolution."
News Article | April 20, 2016
Leslie Parks* was 34 and ready to start a family, but struggled for a year and a half to conceive. Before embarking on fertility treatments, her doctor required that she and her husband get screened to determine their carrier status for various genetic diseases. He recommended a Silicon Valley-based startup called Counsyl and assured her that the test would be fully covered by her insurance. Weeks later, Parks received a bill for more than $1,494 after her insurer deemed the test "experimental." Parks was shocked. As she later learned, that is the rate that Counsyl charges insurance companies; by contrast, their fee for uninsured patients is $349. Under Counsyl's guidance, Parks entered into a lengthy appeals process with her insurance company, writing letters and making phone calls for months. She asked Counsyl representatives if she could pay the uninsured patient rate of $349, but they declined and insisted she press ahead with the appeals process. More than six months later, her insurance company upheld their denial of the claim, and she was still faced with the $1,494 bill. She called Counsyl and asked again to pay the $349 uninsured patient fee instead. The representative finally agreed. In the meantime, Parks got pregnant. Two months into her pregnancy, her ob-gyn recommended that she have an advanced version of the routine prenatal testing. While Parks didn't have any high-risk factors, she would be 35 years old by the mid-point of her pregnancy, putting her in the "advanced maternal age" category. Her doctor said this would qualify her for a blood test at 11 weeks to determine whether her unborn child was at high risk of genetic conditions like Down Syndrome. Again, she was informed by her doctor that her insurance company would pick up the tab, or at the very most she'd have to pay a "couple hundred dollars" if the test was out of network. Yet a few weeks later, "basically the exact same thing happened again," she says. But this time, Parks received an $8,000 bill. The company, Natera, based in San Carlos, California, and founded in 2004, was a little more forthcoming when Parks called, distraught that she'd have to pay such a large sum. She says that Natera promised that they would handle the appeals process with her insurance company. If the claim was denied, however, they would send her another $8,000 bill but she could call and ask to pay the patient adjusted rate of $200. She asked if she would receive a bill for this adjusted amount. The representative said no, they wouldn't put that rate in writing. Parks says that the bills she received from both Counsyl and Natera made no indication that there was another tier of pricing, and it was only after calling and pressing for alternatives that the lower price was revealed. A Counsyl spokesperson says the company doesn't comment on individual patient cases, but that its goal is to offer transparency around billing. "Health care pricing is dynamic and complicated, but Counsyl is fully committed to providing patients with a clear and transparent assessment of screening costs," a statement reads. The company also pointed to its new billing section, which explains the process to patients. A Natera spokesperson says, "It is unfortunate that the patient . . . experienced shock at receiving such a big bill. However, in the health care industry, a company’s "list price" is typically substantially higher than the price ultimately paid by a patient. The final amount paid by a patient is dependent upon the price for the testing that was negotiated by the insurance company, the patient’s insurance plan’s coverage, and the plan’s associated copayment and deductible." Stories like Parks's are becoming increasingly common as hundreds of genetic tests flood the market. Forums for new and expecting parents, like Babycenter.com, are now filled with endless comment threads of patients fighting their insurance company after a claim is denied, or sharing feelings like being "misled" or "used" by the genetics companies, their doctors, their insurance—or a combination of the three. The crux of the problem is that genetic testing has exploded, but regulation has been slow to catch up. The U.S. Food and Drug Administration is still finalizing its guidance for how it will oversee the category of lab-developed tests, which includes some 60,000 genetic testing products already on the market. Furthermore, insurance companies are in the midst of determining whether to reimburse for all or part of the cost of genetic tests that do not offer clear diagnoses, but instead dabble in probabilities. Some insurers have opted to cover genetic tests in cases where the patient is deemed high risk (a common case is the breast cancer risk test, which insurers tend to pay for only when the patient has a family history of cancer). Other insurance companies will only reimburse for tests that it determines are "medically necessary." "Insurance coverage of genetic testing is an underappreciated, but huge and important question," says Patti Zettler, an associate professor at Georgia State University College of Law, who specializes in health policy. According to Zettler, coverage will vary depending on the person's medical history, their employer, and the state that they live in. The final bill is also dependent on the patient's deductible, whether they meet certain medical criteria, and whether the testing company is in-network or out-of-network. "Private insurance companies can essentially make their own decisions about what are medically necessary services and what are not," Zettler explains. And these decisions aren't particularly clear cut to anyone, let alone patients. "You've put your finger on why we got out of the reimbursement business," says Troy Moore, chief strategy officer for Kailos Genetics, in response to hearing Parks's story. "It was simply too frustrating for everyone involved." For two years, Kailos offered a reimbursement model. The company pulled in higher revenues overall by filing claims to insurers, but it also meant dealing with calls from confused and angry customers. According to Moore, many would demand the lesser, out-of-pocket rate after their insurance company rejected their claim, but it wasn't always that simple. Moore says many insurers don't have a problem with a genetics company offering a lower cash rate to patients who don't use insurance. The assumption is that it is cheaper to avoid insurance, as there's no administrative burden in filing and dealing with claims. But that doesn't apply to cases in which the claim has already been filed and rejected by the insurance company; in that case, it's harder to justify a vastly different cost for the patient. Moore says it might be considered fraudulent to overbill the government in cases where the patient is using Medicare or Tricare. For these reasons, his team recently made the decision to offer all their tests for a flat rate of a few hundred dollars. No insurance. No angry phone calls. No tedious billing process, which might involve faxing forms to insurers that are filled out with the requisite blue ink. But that also meant taking a good portion of the company's revenues off the table, which had to somehow be replaced. "Now, to make the same amount of money, we have to reach a lot of people and keep them happy," says Moore. "If they order once, we hope that they'll order again." Other genetic-testing companies remain divided on the question of whether to accept insurance and the hassle that comes with it. Most have settled on a mix of insurance (with different rates for in-network and out-of-network), flat cash rates, and financial assistance for those who need it. In that category: Counsyl, Natera, Myriad Genetics, and Invitae. Others, like Color Genomics, are taking a similar approach to Kailos by refusing to take insurance altogether. For her part, Parks just wishes the process was more clear. During one of her countless phone calls she expressed her frustration, saying, "Can you imagine how upsetting it is to be surprised with an $8,000 bill?" The representative replied, "Yes, I imagine so." *Parks requested to use a pseudonym, as she is still in the negotiations process.