Common mistakes made by men during sex (Part II)

Mistake Number Five - Dirty Dan

Okay, so men have dangly bits. Rather like a dried floral arrangement. Don't go near a woman if you have not carefully cleaned your little appendage and the little ball bag. Make sure you lift up the scrotum and wash all those little gross creepy thingies that collect there. Like, some of your dingleberries that traveled and hid in what they hoped was a moist area. Never attempt sex unclean. Yugh! I need a drink just thinking about it. Women have a far more sensitive nose and we smell stuff you might not.

Mistake Number Six - Stopping before you really get started

How many times do women get to the point of orgasm, and then the man stops, and hops on for the ride? Just because she is lying there enjoying what you are doing, doesn't mean that you should stop! Only when she pushes you away do you know that she has achieved orgasm and her clitoris is far too sensitive for extra touching. Do we have to spell it all out for you? Not all women do a Meg Ryan and makes a racket so that even the windows vibrate. If you are not sure, ask. Don't just stop mid-stroke and leave her unfulfilled while you get your rocks off.

Mistake Number Seven - The socks

Don't ever ever ever ever remove your underwear before you remove your socks. There is nothing more pathetic, than a man standing wearing nothing but socks. It's a bit of a passion killer. And don't dare jump into bed wearing nothing but socks! I don't care how cold your feet are!

Mistake Number Eight - Meaningless Conversation

There is nothing worse than a man who after a good session of sex asks, "And how was it for you dear?" God, if you don't know, pretend you know. Because, by asking you are basically admitting that you don't have a clue what you are doing. Rather ask something like, "Did you prefer the front door to the back door?" Or something equally romantic. Asking how it was kills all the afterglow and desire for seconds.

Mistake Number Nine - Forceful Fellatio

As mentioned earlier, some women have a well-developed gag reflex. Licking the appendage as one licks an icecream is okay and acceptable for most women. Deep Throat was a movie and not necessary real life. Some women can't breathe through their nose when they have an erect member blocking their breathing passage. And if you get excited, going in deeper will literally tickle their tummies. Don't get upset if you end up with their dinner over your pride and joy. Pubic hairs stuck in teeth are not a substitute for floss. Remember, not all women like the taste of your manufactured product, so ask before you offload your wares.

Mistake Number Ten - Sweet Dreams

When all's done, and you've ejaculated at the right time, and in the right place, remember to cuddle and maybe chat a little. Rolling off sated, and lying on your back going straight to sleep, and snoring loudly, is not on at all. It's actually rather selfish. Women have needs after the deed is done as well.

Common mistakes made by men during sex (Part I)

Coitus Unpleasurablis

Many men think that sex is instinctive and is something that just happens naturally. But, leaving your woman fully satisfied takes hard work and practise. You have to know what you are doing, or where you are going, for it to be an enjoyable experience for your lucky lady. There are common mistakes made by the most practised and experienced of men, that they have gotten away with for many years, because women just lay back and pretend to enjoy it. The odd moan here and there while you are thinking of how you want to redo your lounge curtains is enough to keep a man pumping away. Well, the time has come for some honesty here. Men need to know that certain things they do that cause us to moan in frustration, or cry out in pain, are not signs that we are voicing our pleasure. If we don't tell them, they'll never know. Who cares about their fragile little egos, and that the truth might cause instant hydraulic failure. They need to know the truth, and I have volunteered to be the one to tell them. So, here it is.

Mistake numero uno - Going straight for the naughty bits

You give a little kiss, for you that might be the only foreplay, get them threads off and voila! Dive straight in. Guys, a kiss is not foreplay. We want more than that. Kiss + clothing removal DOES NOT = lubrication. Goodness, what are you men thinking? Just think of us as ice maidens that need to be warmed up first. And I mean, seriously warmed up. Some of you men think you are open cast mining and go straight for the hole. Others, have this fixation with the nipples. Licking and sucking is pleasurable, but sucking on them like a 3 month old baby who slept through the night for the first time and wakes up starving? That's not on. Nipples are sensitive, and if you give them callouses they'll stop working.

Mistake Number Two - Tonsil Hockey

For some men kissing is like playing a game of tonsil hockey. They think the deeper they stick in their tongue, the more sexy it is. Some of us do have the gag reflex, you know! Passionate kissing is an art form and something that you have to practise. A lot. Sticking a tongue in a mouth and using to try and floss the other person's teeth is not kissing.

Mistake Number Three - Uncalled for workmanlike behaviour

You might like women to use a bit of force when grabbing your golden banana, but when you use force on us it is extremely unpleasurable. In fact, it is quite painful. The clitoris has twice as many nerves as the penis, and they are all centred in a very small area. In fact, so small, it might be very hard to find. But finding it is not an expedition where you have to wear your wellington boots. Finding the clitoris is another art form. Most women know where theirs is, so just ask them to guide you. And when you do find it, don't treat it like Shakespeare with his, "Out damn spot." It's also not like shoes that you have to polish hard to make them shine. No matter how hard you polish the clitoris, it will never shine. Ever. What you will do with your rough workmanlike polishing or rubbing technique, will be to make it so painful and sensitive, that it will momentarily lose its ability to create pleasant sensations. And when that happens, the surrounding area becomes dessicated like coconut.

Mistake Number Four - Doing an Interview with a Vampire personation

Giving someone a hickey is not putting a mark on them. It's what teenagers do because they don't know better. It is not sexy, it is not erotic, and if someone tries to do that to me, I might accidentally knee them in the crotch. The same with nibbling on ears. Frankly, if someone touches me behind my neck or touches my ears I get cold shivers. So if you bite my ear, I'm afraid it's the death penalty, mister. You are not a vampire. Being eaten by another human being is what cannibals do. We have evolved from that. I remember when I worked on a racehorse stud farm, the over-excited stallion bit the mare on the neck, and she lashed out and kicked him in the gonads. And they were animals and it wasn't acceptable.

To Make Memories, New Neurons Must Erase Older Ones

Short-term memory may depend in a surprising way on the ability of newly formed neurons to erase older connections. That's the conclusion of a report in the November 13th issue of the journal Cell, a Cell Press publication, that provides some of the first evidence in mice and rats that new neurons sprouted in the hippocampus cause the decay of short-term fear memories in that brain region, without an overall memory loss.

The researchers led by Kaoru Inokuchi of The University of Toyama in Japan say the discovery shows a more important role than many would have anticipated for the erasure of memories. They propose that the birth of new neurons promotes the gradual loss of memory traces from the hippocampus as those memories are transferred elsewhere in the brain for permanent storage. Although they examined this process only in the context of fear memory, Inokuchi says he "thinks all memories that are initially stored in the hippocampus are influenced by this process."

In effect, the new results suggest that failure of neurogenesis will lead to problems because the brain's short-term memory is literally full. In Inokuchi's words, we may perhaps experience difficulties in acquiring new information because the storage capacity of the hippocampus is "occupied by un-erased old memories."

Of course, Inokuchi added, "our finding does not necessary deny the important role of neurogenesis in memory acquisition." Hippocampal neurogenesis could have a dual role, he says, in both erasing old memories and acquiring new ones.

Earlier studies had shown a crucial role for the hippocampus in memorizing new facts. Studies in people with impaired and normal memories and in animals also showed that information recall initially depends on the hippocampus. That dependence progressively decays over time as memories are transferred to other regions, such as the neocortex. Scientists have also observed a similar decay in the strength of connections between neurons of the hippocampus, a phenomenon known as long-term potentiation (LTP) that is considered the cellular basis for learning and memory.

Scientists also knew that new neurons continue to form in the hippocampuses of adults, even into old age. But it wasn't really clear what those newborn brain cells actually do. Inokuchi's team suspected that the integration of new neurons was required to maintain neural connections, but they realized it might also go the other way. The incorporation of new neurons into pre-existing neural circuits might also disturb the structure of pre-existing information, and indeed that is what their new findings now show.

The researchers found that irradiation of rat's brains, which drastically reduces the formation of new neurons, maintains the strength of neural connections in the hippocampus. Likewise, studies of mice in which hippocampal neurogenesis was suppressed by either physical or genetic means showed a prolonged dependence of fear memories on that brain region.

On the other hand, voluntary exercise, which causes a rise in the birth of new neurons, sped up the decay rate of hippocampus-dependency of memory, without any memory loss.

"Enhanced neurogenesis caused by exercise may accelerate memory decay from the hippocampus and at the same time it may facilitate memory transfer to neocortex," Inokuchi said. "Hippocampal capacity of memory storage is limited, but in this way exercise could increase the [brain's overall] capacity."

The study sets the stage for further examination of the connections between neurogenesis and learning capacity, the researchers say. They also plan to examine how the gradual decay of memory dependence on the hippocampus relates to the transformation of memory over time from a detailed and contextually-rich form to a more generic one.

H1N1 has killed 3,900 Americans, CDC says

WASHINGTON (Reuters) – H1N1 swine flu killed an estimated 3,900 Americans from April to October, including more than 500 children, U.S. health officials said on Thursday.

Better data than was previously available shows the flu pandemic has infected an estimated 22 million Americans and put 98,000 in the hospital, the U.S. Centers for Disease Control and Prevention said.

Children account for 8 million of the infected, 36,000 of those hospitalized and 540 deaths.

"We think the 540 number is a better estimate for the big picture that we are getting out there," the CDC's Dr. Anne Schuchat told reporters.

About 82 U.S. children die in an average flu season. The CDC said H1N1 has produced the worst flu season in the United States since 1997, when current measurements started.

"What we are seeing in 2009 is unprecedented," Schuchat said," Schuchat said.

The CDC said doctors need to treat severe cases quickly with antiviral drugs such as Tamiflu, made by Roche AG, Relenza, made by GlaxoSmithKline or for especially grave hospitalized cases, peramivir, made by BioCryst.

Schuchat stressed the pandemic was not worsening but noted that it takes time to gather data on flu cases and deaths. The count released on Thursday is not an actual reckoning of deaths but an extrapolation based on detailed data from 10 states.

CDC's previous estimate of U.S. flu deaths was 1,200.

In an average flu season, about 36,000 Americans die and 200,000 are hospitalized with 90 percent of deaths and hospitalizations among people over 65.

With H1N1, 90 percent of those infected and seriously ill are younger adults and children.

Schuchat said the pandemic would likely continue through the winter and early spring. "We have a long flu season ahead of us," she said.

Most confirmed flu cases are H1N1 and about 30 percent of people who show up at the doctor's office and are actually tested for influenza turn out to have flu, as opposed to some other infection.

(Additional reporting by Julie Steenhuysen in Chicago, edited by Alan Elsner)

Why doctors threaten to ditch Medicare patients

Medicare has become a scary word to the doctors at the largest private group practice in Kansas City, Mo.

It's so scary that most physicians at Kansas City Internal Medicine, with 65% of its nearly 70,000 active patients age 65 or older, have stopped accepting walk-in Medicare enrollees, said Dr. David Wilt, an internist at the group.

Wilt and his colleagues say they are shunning the area's growing senior population because they believe Medicare doesn't reimburse physicians enough to cover the cost of care.

"And if Medicare further cuts its reimbursement rates, then we'll be functioning at a loss," said Wilt.

Wilt -- and doctors with lots of senior patients -- are especially troubled by a 21% cut in Medicare payments to physicians scheduled to take place in 2010. Last week, the Senate voted against stopping that cut, and more annual cuts over the next decade, from taking place.

"If the [21%] cut happens, that cut in our payments will exceed our profits. The only option to us to stay in business will be to fire employees," Wilt said.

Physicians say a boycott against Medicare has already begun because they are tired of dealing with the yearly threat of a payment cut.

Dr. John Hagan, a Kansas City-area ophthalmologist, offers a unique perspective. "I can speak to both sides of this," he said.

As many as 75% of patients at his group practice are Medicare beneficiaries who are treated for problems such as glaucoma or undergo cataract surgery. And if payment rates are cut 21%, after already being reduced to about half the going $1,200 rate for cataract surgery and care in Missouri, Hagan said he won't be able to see more Medicare patients because he won't be able to cover his expenses.

But Hagan himself became Medicare-eligible this month -- and he's nervous. "If I accept Medicare for myself and my wife, I'm fearful I won't be able to stay with my cardiologist and my wife won't be able to stay with her physicians," he said.

Hagan has elected not to enroll in Medicare. Instead, he's paying extra out of pocket for his company's insurance coverage.

"At some point I won't want to work," said Hagan. "At that time, I will be on Medicare, and I am scared to death."

Perception versus reality?

The federal government's Center for Medicare and Medicaid Services (CMS) said it is aware of anecdotal reports of doctors not taking Medicare beneficiaries.

However, the agency maintains that its own data, and other industry reports, show only a small percentage of beneficiaries unable to get physician access.

CMS said 96.5% of all practicing physicians, nearly 600,000 doctors, currently participate in Medicare.

"Geographically, the level within every state is less than 5% of Medicare beneficiaries who have difficulties accessing a doctor," said Renee Mentnech, director of CMS' Research and Evaluation Group.

Mentnech also pointed to an August report from the Government Accountability Office (GAO), an independent branch of the Congress, that showed less than 3% of Medicare beneficiaries reported major difficulties accessing physician services in 2007 and 2008.

But these numbers do little to comfort seniors such as Earl Bean, 67. He recently told CNNMoney.com that he couldn't easily find a new primary care physician who accepted Medicare after his former doctor retired and Bean himself had to move to a new city.

"I had a company supplemental policy with drug coverage. It didn't matter," said Bean. "They wanted nothing to do with me."

Dr. Mark Laitos, a family physician based in Longmont, Colo., said Medicare-dependent seniors in his area are still able to find primary care physicians "but it takes some effort."

"They have to make a bunch of phone calls, get on waiting lists or go over to the next town," said Laitos.

He stopped seeing new Medicare seniors six years ago because of reimbursement issues. Laitos said Medicare on average reimburses him 80 cents on the dollar. "If I charge a patient under 65 one dollar for a service, for a Medicare patient I can only charge 80 cents," he said.

"As patients in my practice are getting older, the day they become Medicare-eligible, my reimbursement drops," he said.

Still, he's not ditching his long-standing patients who've aged into Medicare. "If I ran the practice like a business, I would," Laitos said. "This is a small town. It's hard to drop all Medicare patients."

"Doctors face this bizarre dance every year. Most are frustrated and resent this threat to cut our rates when our costs are increasing every year," he said.

Federal law requires that Medicare physicians' payment rates be adjusted annually based on a sustainable-growth rate that's tied to the health of the economy.

Physicians face a rate cut every year, although Congress has at the last minute blocked those cuts from happening in seven of the last 8 years.

Dr. Keith Jantz, an internist at Kansas City Internal Medicine, fears that if the 21% cut goes through next year, "physicians around the country would stop seeing any Medicare patients."

"It's happening in places like Las Vegas and in Anchorage, Alaska, and this could be a harbinger of what's to come unless Medicare maintains decent [payment] rates," Jantz said.

The AARP, the nation's largest senior-citizen advocacy group, not only wants the Senate to rescind this year's cut, it wants long-term action. "Short-term patches to preserve physician pay make the access problem [for seniors] worse by undermining doctors' confidence in the Medicare program," the group said in a statement

The American Medical Association (AMA), which represents doctors, is pushing for a permanent repeal of the reimbursement formula.

"We believe that as part of comprehensive health reform, physicians have to be incented to keep people healthy and out of the hospital," said James Rohack, president of the AMA. "Under this formula, they are penalized for doing it."

The Top five Things women want out of a relationship

Five things a women want out of a relationship. 1.Honesty 2.Love 3. understanding 4.Respect 5.commitment.

Being a women involved in pass relationships, there were many things; that was important to me in a relationship . I will start out by saying that honesty tops the chart, with me, honesty was and has been the number one thing ; that I look for in a man. I believe if a man can be honest with me and tell me the truth, that means, he's trustworthy.

Love comes next, I want my man to love me for the women that I am ,whether, I'm big ,little, black or white; I want his undying love and I will give him the same in return. I realize that the whole dating system works on looks mostly and that is a wrong idea ; because if you 're going only by looks alone, you're in big trouble. People are so superficial and materialistic; until finding what you're looking for in a mate, is like looking for a needle in a hay stack.

I wanted a mate that 's going to be committed to me and to us, you find so many people that want to play with you as a mate and play with mary,Jane, and Sue; they don't want a commitment because they want be able to play the game with all the women players as before. We all want to be in a relationship, where we know our man or women is with us 100% in our relationship.

Having understanding is important in a relationship, and that because we all go through life's changes, and we need someone in our corner; that's going to try and understand what we're going through and be there for us; no matter what. It's important to stand by your man or women in the midst of a crisis, it let's us know that you 're genuinely loved by that person; because he or she hasn't left you high and dry, yet.

Respect ,is another very important part of a relationship, I have always told my girls to make sure, the guy loves and respects his mother and sisters; if he passes that test, then you know he going to give you the same love and respect that he has for the other women in his life. But if you're with a guy and he's treating his mother and sisters like dirt; then you know what he's going to do for you.

You want your man to trust you to behave, when he or she isn't around; you want the kind of trust that say, my man or my women is in another world; but we know for a fact that everything is all right because we love and trust each other. It doesn't matter that we're a zillion miles a part, our trust will keep us cool. With trust it's, it's like respect, we have give it in order to receive it.

Make positively sure, that your man or your women have all of these qualities and more, in order to have a chance at a good relationship. I want you to remember the most important thing of all, in finding your Mr. or Ms. Right; don't let what you see on the outside, trick you into believing that there isn't anything worthwhile on the inside, because to be brutally honest , it's only what's on the inside that counts anyway. make sure you don't chose the package with the beautiful wrapping on the outside and get an ugly duckling inside.

As you know some people can be so graciously beautiful on the outside, but if, we look within we find a horrible nightmare inside;so lets not be vain. if you find a diamond in the rough, clean it and polish it up, and see the brilliance of it's shine for you.

Smoking Everywhere Electric Cigarettes Review Are They Safe

The Alternative to Tobacco.

In 2008, electronic cigarettes boomed in the UK and took Europe by storm then it made its way to the United States where the sales of Electric Cigarettes have sky rocketed prompting the FDA to consider more study of the long term side effects of electric cigarettes and health. Currently the FDA wants to have sales pulled in the U.S because there isn't enough study done to know it's long term effects.

As a smoker, let me put it to you this way. Nicotine does not cause cancer but the carcinogens in tobacco do. By now, smokers and non-smokers know that chemicals such as cyanide amongst others are added to tobacco which are the real killers. 90% of all lung cancer death is linked to smoking tobacco.

Here are you choices

My opinion of the situation with the FDA wanting to yank e cig sales from the market is because they need to make their money. If we already know that smoking regular tobacco cigarettes will cause death or lung cancer amongst other ailments such as emphysema, birth defects, premature birth and even fetal death, and the product has not been banned, then it would seem that the electronic smoke is the healthier alternative to smoking.

Most all electronic cigarette sales are made online. If you can find a smoke shop that does sell njoy electronic cigarettes, you are probably going to pay at least 10% more for the product. And yes, you still have to be 18 or older to purchase the e cigarette because it does contain nicotine. When all other products have failed such as the nicotine patch, gum and smokers sensations hot-lines or pricey Rx from the doc... all approved by the FDA and containing nicotine, then why not go with the electronic cigarette.

The electronic cigarette looks like a real cigarette and contains nicotine and water. When you inhale, the battery heats the nicotine cartridge which mixes with the water and creates a vapor that looks much like cigarette smoke but it's just water. All you inhale is nicotine and water vapor. A very small amount mind you. You probably inhale more water vapor on a humid day then you do with these things.

Who Sells Electronic Cigarettes?

Like I said, most sales of electronic cigarettes are made online. Amongst the many different brands of e cigarettes are Njoy by Smokers Everywhere, Blu E-cig, Envy Bliss and Marlboro flavored electronic cigarettes by E-Health Cigarette.

The starter kits start out anywhere from $40.00 up to around $200.00 they all come with nicotine refill cartridges, are reusable and you can smoke anywhere you want. Being a smoker, I know that it is really hard for me to quit out of habit. I am 31 years old and have been smoking since I was 14. That is 17 years of my young life dedicated to smoking and many years on the quit smoking bandwagon which has been a total fiasco. And why? Because smoking is a part of my life, my daily routine, a function in my life.

While I may not know if I am truly addicted to nicotine, I absolutely know that the act or the sensation of smoking is what I always miss when trying to quit which keeps me coming back. In my twenties I know every time I went out with friends to a bar the only thing I could think about when on the "I quite smoking wagon" was how much I just wanted to njoy a smoke. The act of smoking while drinking. And I am pretty sure that more often then not, it's the sensation or act of smoking that keeps smokers locked.

Plus, since you can smoke everywhere with the electronic cigarette, I get to smoke in bars again!

Alternatively I can say that I will probably never quit because the act is too powerful in my life but I do know that with the electronic cigarettes you have the options to use as much or as little nicotine as you want and you can ween yourself off of nicotine altogether and after a while probably give up the butt for good. So it's either one of two things; I will get lung cancer if I keep smoking expensive cigarettes at $5-6.00 a pack or I can e-smoke for about a $1.00 a pack and not get cancer.

The choice is simple really. Now all you have to do is pick which e cigarette company you want to go with. Again I would like to add that if the FDA approves the use of nicotine patches, Rx meds, nicotine gum and other alternative, help you quit products so you really have to ask yourself why the FDA wants the electronic cigarettes pulled from the market. I doubt very much they want it pulled for safety reasons. *wink*

So enjoy smoking everywhere get on the Electronic Cigarette wagon before tobacco takes you.

The Benefits Of Breast Augmentation (Yes, You Need Breast Implants)

I'm all for women being obsessed with getting bigger breasts. It keeps their minds busy, and out of things they have no business thinking about, like politics, and finance. Breast augmentation is a multi billion dollar industry, and though thousands of women get breast implants every year, there are still several million who haven't had the procedure yet. This hub is designed to educate those women on the importance and benefits of breast augmentation.

Here are just some of the benefits of breast augmentation, according to the experts who know. (I refer of course to the great people at docshop.com, who highly recommend breast augmentation to women.)

Potential Benefits of Breast Augmentation

• Increased Confidence
• Increased Self Esteem
• Aesthetic Improvement
• More Clothing Choices

Some people say that self esteem and confidence come from accepting yourself as who you are, and coming to value yourself for your intellect, your values, your unique soul, but those people are probably flat chested and ugly. It's pretty obvious that the real way to gain self confidence is by having your body hacked open and having silicone pillows stuffed into your flesh so that men ogle you more when you're out in public.

To help those of you who may not have grasped the importance of breast augmentation, I've prepared a graph. As this graph clearly shows, a woman's worth as a human being increases proportionally with the number of leering men ogling her breasts.

Finally we come to the last benefit on the list, increased clothing choices. Well, if being able to wear that pretty top in the shop window isn't worth going under general anesthetic and subjecting your body to major surgical trauma, then I don't know what is.

Remember folks, appearance is everything, and if a woman isn't sexually attractive to men, then she's pretty well just a waste of time, and nobody will ever love her, ever

H1n1 (swine) Influenza Guide: swine flu

Definition
Swine influenza is flu virus usually found in pigs. The virus occasionally changes (mutates) and becomes infectious in humans. When this happens, the disease becomes a concern to humans, who have little or no immunity against it. This means the virus has the potential to spread quickly around the world. It also may be more difficult to treat than the usual, seasonal human flu viruses.

Causes, Incidence, And Risk Factors
In the spring of 2009, cases of human infection with H1N1 flu were confirmed in Mexico, the United States, and many countries around the world. The H1N1 flu virus is contagious and can spread from human to human. At this time, it is unknown how easily it can spread between people. It is known that flu viruses can spread from pigs to people, and from people to pigs. However, you CANNOT get H1N1 flu virus from eating pork.
Human-to-human infection with the H1N1 flu virus likely occurs the same way as seasonal flu, when an infected person coughs or sneezes into air that others breathe in. People may also get infected by touching something with the virus on it, such as a door knob or counter, and then touching their mouth or nose.

Symptoms
Symptoms of H1N1 flu infection in humans are similar to classic flu-like symptoms, which might include:
* Fever above 100.4 °F
* Cough
* Sore throat
* Headache
* Chills
* Muscle aches
* Diarrhea
* Vomiting
Signs And Tests
If you think you have been exposed to H1N1 influenza, call your health care provider before your visit. This will give the staff a chance to take proper precautions to protect them and other patients during your office visit. If the H1N1 flu becomes widespread, there will be little need to continue testing people, so your health care provider may decide not to test for the flu virus.
Your doctor may perform the following physical exam:
* Auscultation (to detect abnormal breath sounds)
* Chest x-ray
Your doctor can test for the H1N1 flu virus using a nasopharyngeal swab (a swab of the back of the inside of your nose), or grow it in a culture. However, this will likely happen only if:
* You are at high risk for flu complications.
* You are very sick.
Treatment
Most people who get H1N1 flu will likely recover without needing medical care. Doctors, however, can prescribe antiviral drugs to treat people who become very sick with the flu or are at high risk for flu complications. The CDC currently identifies the following people as high risk:
* Children younger than 5 years old, especially those younger than age 2
* Adults 65 years of age and older
* People with:
o Chronic lung (including asthma) or heart conditions (except hypertension)
o Kidney, liver, neurologic, and neuromuscular conditions
o Blood disorders (including sickle cell disease)
o Diabetes and other metabolic disorders
o An immune system that does not work well, such as AIDS patients or cancer patients receiving chemotherapy

Other high risk people include:
* Pregnant women
* Anyone younger than 19 years of age receiving long-term aspirin therapy
* Residents of nursing homes and other chronic-care facilities

New Blood Pressure Drug Shows Promise

Treatment Targets Resistant Hypertension

By Salynn Boyles
Reviewed by Louise Chang, MD

Sept. 15, 2009 -- As many as 30% of patients with hypertension fail to achieve their target blood pressures levels with treatment, but an experimental drug may help them hit their blood pressure goals.
In a newly reported study, patients whose blood pressure remained high despite very aggressive treatment had significant reductions in both the top (systolic) and bottom (diastolic) blood pressure numbers by adding the drug darusentan to the mix.
The drug works in a novel way by blocking the production of the amino acid endothelin within the walls of the artery. Endothelin is believed to raise blood pressure by causing the blood vessels to constrict.
“When you block endothelin the arteries relax and blood pressure should drop,” researcher Michael A. Weber, MD, of the State University of New York, tells WebMD.

Blood Pressure Dropped by 10 Points
Weber led the study, which included 379 patients treated at 117 sites in North and South America, Europe, New Zealand, and Australia.All of the patients had elevated blood pressure despite treatment with at least three blood pressure medications, including a diuretic (“water pill”) at the highest dose the patient could tolerate.
In addition to these treatments, the patients received either a placebo or darusentan for 14 weeks at doses of 50 milligrams, 100 milligrams, or 300 milligrams taken once per day. Blood pressure was measured in all patients at the beginning and end of the 14-week study.
Compared to placebo, the experimental drug was found to reduce systolic blood pressure by an additional 10 points. This was true for all patients regardless of the dose of the experimental drug they took, how sick they were, and what other drugs they were on.
The main side effect of treatment was fluid retention, reported in 27% of the darusentan patients and 14% of patients in the placebo arm of the study. Weber says this side effect can be avoided in most patients by prescribing a more powerful diuretic than is typically given, but he adds that patients with heart failure should not take darusentan because of this side effect.
“The size of the [blood pressure lowering] effect with this drug was really encouraging,” Weber says. “For many people with treatment-resistant hypertension, adding this drug to the drugs they are taking would be all they would need to do to get their blood pressure down to where it needs to be.”

Second Trial to Be Reported
The study, which appears online in The Lancet, was funded by the drugmaker Gilead Sciences. The company is expected to seek FDA approval for darusentan as a treatment for resistant hypertension sometime next year. Gilead spokesman Nathan Kaiser tells WebMD that results from a much larger trial of the drug should be made public by the end of 2009.
In that trial, darusentan is being compared to the drug Tenex, which is often prescribed to patients who fail to achieve target blood pressure goals with conventional treatments.
In an editorial published with the study, blood pressure researcher Bryan Williams, MD, of England's University of Leicester, writes that important questions remain about the experimental drug.
“These findings do not mean that darusentan would necessarily be the best treatment for every patient with resistant hypertension,” he writes.
In an interview with WebMD, Williams notes that more study is needed to identify better treatments and treatment strategies for lowering blood pressure in patients with hard-to-manage hypertension.
"It is unlikely that a single treatment strategy is going to be the best for everybody, and while this drug may be perfect for some, there may be others who might respond better to different treatment options,” he says.
The problem, he adds, is that these other treatment options have not been as thoroughly studied.

Do Allergies Cause Asthma?

People who have certain kinds of allergies are more likely to have asthma. Do you have allergies that affect your nose and eyes, causing stuff like a runny nose or red, itchy eyes? If so, you're more likely to have asthma, too. Whatever causes the allergic reaction, such as pollen or dust, can also trigger asthma symptoms.

But not everyone who has allergies gets asthma, and not all asthma happens because of allergies. Huh? Allergies and asthma can be a little confusing, so let's find out more.

About 9 million kids in the United States have been diagnosed with asthma. Of these, about three out of four have asthma symptoms that are triggered by an allergy to something (called an allergen). In these people, the symptoms of asthma like wheezing, coughing, or trouble breathing are often brought on by being around allergens.

Allergies have a lot to do with your immune (say: ih-myoon) system. Most of the time your immune system fights germs and bacteria to help you stay healthy. But in a kid with allergies, the immune system treats allergens (such as pollen) as if they're invading the body, like a bad germ.

When the immune system reacts to an invading allergen, the body releases substances that cause allergy symptoms, such as a runny nose or red, itchy eyes. Some kids can also get asthma symptoms, like coughing, wheezing, or a tight feeling in the chest.

If you have asthma, it is a good idea to find out whether allergies may be causing your asthma symptoms. To figure out what they're allergic to, sometimes kids will visit a special doctor called an allergist (say: ah-lur-jist).

If the allergist finds out that you are allergic to certain things, the best way to prevent allergic reactions (and to help stop asthma symptoms from bugging you) is to avoid being around the allergens. The doctor may also prescribe medicine for your allergies, if you can't completely avoid what's causing them.

Beetroot Juice Boosts Stamina, New Study Shows

Drinking beetroot juice boosts your stamina and could help you exercise for up to 16% longer. A University of Exeter led-study shows for the first time how the nitrate contained in beetroot juice leads to a reduction in oxygen uptake, making exercise less tiring.The study reveals that drinking beetroot juice reduces oxygen uptake to an extent that cannot be achieved by any other known means, including training.

The research team believes that the findings could be of great interest to endurance athletes. They could also be relevant to elderly people or those with cardiovascular, respiratory or metabolic diseases.

The research team conducted their study with eight men aged between 19 and 38. They were given 500ml per day of organic beetroot juice for six consecutive days before completing a series of tests, involving cycling on an exercise bike. On another occasion, they were given a placebo of blackcurrant cordial for six consecutive days before completing the same cycling tests.

After drinking beetroot juice the group was able to cycle for an average of 11.25 minutes, which is 92 seconds longer than when they were given the placebo. This would translate into an approximate 2% reduction in the time taken to cover a set distance. The group that had consumed the beetroot juice also had lower resting blood pressure.

The researchers are not yet sure of the exact mechanism that causes the nitrate in the beetroot juice to boost stamina. However, they suspect it could be a result of the nitrate turning into nitric oxide in the body, reducing the oxygen cost of exercise.

The research was carried out by the University of Exeter and Peninsula Medical School and published in the Journal of Applied Physiology. The research team now hopes to conduct further studies to try to understand in more detail the effects of nitrate-rich foods on exercise physiology.

Corresponding author of the study, Professor Andy Jones of the University of Exeter's School of Sport and Health Sciences, said: "Our study is the first to show that nitrate-rich food can increase exercise endurance. We were amazed by the effects of beetroot juice on oxygen uptake because these effects cannot be achieved by any other known means, including training. I am sure professional and amateur athletes will be interested in the results of this research. I am also keen to explore the relevance of the findings to those people who suffer from poor fitness and may be able to use dietary supplements to help them go about their daily lives."

This study follows research by Barts and the London School of Medicine and the Peninsula Medical School (published in February 2008 in the American Heart Association journal Hypertension), which found that beetroot juice reduces blood pressure.

Mango Seeds May Protect Against Deadly Food Bacteria

Life in the fruit bowl is no longer the pits, thanks to a University of Alberta researcher. Christina Engels has found a way to turn the throwaway kernels in mangoes into a natural food preservative that could help prevent Listeriosis outbreaks like the one that killed 21 Canadians last year.

The findings can also apply to other fruit seeds like grapes, said Engels, who conducted the research to earn her master's degree from the Department of Agricultural, Food and Nutritional Science at the U of A. The research is published in the latest Journal of Agricultural and Food Chemistry.

Pure tannins, a plant component extracted from otherwise useless mango kernels by Engels, have proven inhibitory effects against various strains of bacteria including Listeria, a potentially deadly pathogen that infected some packaged meats and caused an outbreak of disease in Canada in 2008.

Engels' research focuses on a way to recycle wood-like mango kernels, which are usually thrown away or burned. "By processing the kernels for their tannins, businesses have a way to completely utilize all fruit parts and therefore increase their profit," she said. Currently, mangos are one of the main fruits marketed globally, ranked fifth in world production among the major fruit crops.

Baboon genes help fight parasites

Some baboons are born with an in-built resistance to a malaria-like disease, scientists have found. It is the first known example of a genetic variant in a non-human primate species that is correlated with a complex trait — in this case, resistance to a parasitic disease.

Like ancestral humans, baboons are large-bodied primates that roam the grasslands of East Africa. The research reveals that both groups have evolved similar solutions to fighting off malaria parasites that are common in that region.

"Our study suggests that looking at genetic differences between non-human primates may help us learn more about the possible solutions that evolution has come up with for us to cope with these sorts of things," says Jenny Tung, a graduate student at Duke University in Durham, North Carolina, who conducted the research with Gregory Wray, also of Duke, and Susan Alberts of Duke and the Institute of Primate Research at the National Museums of Kenya in Nairobi.

Mosquitoes against malaria?

Two malaria papers out this week in the New England Journal of Medicine have seen some press coverage. Undoubtedly the more concerning discusses the parasite’s increasing resistance to artemisinin-based drugs in Cambodia – see Nature’s news story.

The other, as Carlos Campbell of the PATH malaria vaccine initiative writes in an accompanying editorial, “reminds us that the whole malaria parasite is the most potent immunizing antigen identified to date”. In what AP describe as a “daring experiment” with “astounding” results, researchers found that ten people subjected to mosquito bites three times over three months whilst taking the drug chloroquine gained apparent immunity against malarial mosquito bites a month later.

It’s hard to see, however, that this finding adds much new to the vaccine-hunter’s arsenal.

It’s been known since the 1960s that sporozoites, cells that travel from the insect’s salivary gland to the bitten human’s liver can help provide immunity (which is why the first bout of malaria is usually the worst). This study has confirmed that. The difficulty is using this tactic to actually immunize patients – producing whole sporozoites for a real vaccine requires the breeding of many live mosquitoes and human blood to test on. As Campbell adds in his editorial, the carefully timed and controlled mosquito-inoculation approach, so far removed from the real world, “cannot be the basis for a human malaria vaccine”.

Right now, though, production of irradiated and weakened sporozoites – garnered from irradiated mosquitoes – is ongoing for injection in first-stage (safety) human trials at Maryland-based biotech company Sanaria (an effort that has taken over three decades). Meanwhile, in a PNAS paper last week which did not go through a rigorous peer review procedure, a collaboration of researchers reported that human trials would begin in early 2010 for another similar approach: this time weakening the sporozoite by snipping out two genes, rather than irradiating malaria.

Other malaria vaccine trials are based on using protein fragments, rather than the whole sporozoite to induce immunity. These include Glaxo’s RTS,S phase III trials which began a few months ago; while Dutch pharmaceutical company Crucell recently announced a collaboration with the PATH malaria vaccine initiative, to use adenoviruses to deliver a malaria antigen to the immune system.

New HIV came from gorillas

A new form of HIV from gorillas has been identified in a woman from Cameroon. The 62-year old woman, who is now living in Paris, appears to have a new human lineage of HIV virus type 1 and is the first definite human infection of HIV-1 from a non-chimpanzee ape source.

Jean-Christophe Plantier, of the University of Rouen in France, and his colleagues found the new virus to be highly similar to gorilla simian immunodeficiency virus but not to have undergone recombination with chimpanzee SIV. They propose the new lineage be labelled P as it is distinct from the currently known types M, O, and N.

“Our findings indicate that gorillas, in addition to chimpanzees, are likely sources of HIV-1,” write the authors in Nature Medicine. “The discovery of this novel HIV-1 lineage highlights the continuing need to watch closely for the emergence of new HIV variants, particularly in western central Africa, the origin of all existing HIV-1 groups.”

The current prevalence of the new HIV in humans is unknown. The researchers say that the woman detailed in the new paper currently shows no signs of AIDS and probably caught the virus from another person as she has not had contact with apes or bushmeat.

Paul Sharp, of the University of Edinburgh, believes the new strain probably transferred from chimpanzees to gorillas before arriving in humans. He also says it will probably not spread widely, which is fortunate as he adds, “the medical implication is that, because this virus is not very closely related to the other three HIV-1 groups, it is not detected by conventional test” (BBC).

An ‘aerial view’ of HIV

The complex shapes that the HIV genome twists itself into have been totally mapped by the first time by a team of US researchers. RNA viruses such as HIV like to fold themselves up and a proper picture of the shapes they form has been lacking, with researchers generally confining themselves to looking at small sections. In this week’s, Joseph Watts, of the University of North Carolina, and his colleagues set out to look at the bigger picture.

In the research paper, Hashim Al-Hashimi of the University of Michigan, Ann Arbor, notes that structural biologists usually “cut out” the motifs formed by RNA and then “zoom in to determine their three-dimensional structures in an attempt to further understand their function. … However, Watts et al. zoom out and provide an ‘aerial view’ of the secondary structure of the entire HIV-1 genome.”

What they produced is, in Wired’s words, “the cellular equivalent of a rough wiring diagram”. “What this may reveal is some of the proteins operating at a level below the structures, which may have all sorts of functions within the virus,” says David Robertson, of the University of Manchester (BBC). “More generally, if we can unpick the structures then we can compare the systems of different viruses and gain new understanding of how they work.” Study author Kevin Weeks says the technique used here with HIV could also be applied to other virus such as influenza and might open up new opportunities for drug treatmen.

New Drug-resistant TB Strains Could Become Widespread, Says New Study

The emergence of new forms of tuberculosis could swell the proportion of drug-resistant cases globally, a new study has found. The finding raises concern that although TB incidence is falling in many regions, the emergence of antibiotic resistance could see virtually untreatable strains of the disease become widespread. Australian researchers from the University of New South Wales and the University of Western Sydney have published the new finding in the latest issue of the Proceedings of the National Academy of Sciences.

Laboratory-based studies have suggested that antibiotic-resistant TB strains cause longer-lasting infections but with a lower transmission rate. Therefore, scientists have questioned whether drug-resistant TB strains are more likely than drug-sensitive strains to persist and spread – an important question for predicting the future impact of the disease.

One in three humans already carries the TB bacterium. Although it remains latent in most cases, the World Health Organisation (WHO) has estimated there were 9.27 million new cases of TB in 2007. There were 1.6 million TB-related deaths in 2005. Drug-resistant TB is caused by inconsistent or partial treatment, when patients do not take all their medicines regularly for the required period or because the drug supply is unreliable.

A research team led by UNSW's Dr Mark Tanaka used epidemiological and molecular data from Mycobacterium tuberculosis strains isolated from Cuba, Estonia and Venezuela to estimate the rate of evolution of drug resistance and to compare the relative "reproductive fitness" of resistant and drug-sensitive strains. "We found that the overall fitness of drug-resistant strains is comparable to drug-sensitive strains," says Dr Tanaka of the Evolution and Ecology Research Centre. "This was especially so in Cuba and Estonia, where the there is a high prevalence of drug-resistant cases."

The finding may reflect an inconsistency in drug treatment programs in these countries. Indeed, Estonia now has one of the highest rates of multi-drug resistance in the world. The intermittent presence of drugs and the resulting transmission of resistant strains would have let drug-resistant strains collectively spend more time within untreated hosts, allowing them to evolve ways to become more infectious and out-compete the drug-sensitive strains.

The study also reveals that the contribution of transmission to the spread of drug resistance is very high – up to 99 per cent – compared with acquired resistance due to treatment failure. "Our results imply that drug resistant strains of TB are likely to become highly prevalent in the next few decades," says UNSW's Dr Fabio Luciani, the study's lead author. "They also suggest that limiting further transmission of TB might be an effective approach to reducing the impact of drug resistance."

"Mathematical and statistical methods can add a lot of value to empirical data by allowing us to account for the processes behind them," says research co-author, Dr Andrew Francis from the University of Western Sydney. "In this case, we use samples of TB genotypes, together with information about drug resistance, to make inferences and predictions that wouldn't have been possible just a few years ago."

Regular Yoga Practice Is Associated With Mindful Eating

Regular yoga practice is associated with mindful eating, and people who eat mindfully are less likely to be obese, according to a study led by researchers at Fred Hutchinson Cancer Research Center. The study was prompted by initial findings reported four years ago by Alan Kristal, Dr.P.H., and colleagues, who found that regular yoga practice may help prevent middle-age spread in normal-weight people and may promote weight loss in those who are overweight. At the time, the researchers suspected that the weight-loss effect had more to do with increased body awareness, specifically a sensitivity to hunger and satiety than the physical activity of yoga practice itself.

The follow-up study, published in the August issue of the Journal of the American Dietetic Association, confirms their initial hunch.

"In our earlier study, we found that middle-age people who practice yoga gained less weight over a 10-year period than those who did not. This was independent of physical activity and dietary patterns. We hypothesized that mindfulness – a skill learned either directly or indirectly through yoga – could affect eating behavior," said Kristal, associate head of the Cancer Prevention Program in the Public Health Sciences Division at the Hutchinson Center.

The researchers found that people who ate mindfully – those were aware of why they ate and stopped eating when full – weighed less than those who ate mindlessly, who ate when not hungry or in response to anxiety or depression. The researchers also found a strong association between yoga practice and mindful eating but found no association between other types of physical activity, such as walking or running, and mindful eating. "These findings fit with our hypothesis that yoga increases mindfulness in eating and leads to less weight gain over time, independent of the physical activity aspect of yoga practice," said Kristal, who is also a professor of epidemiology at the University of Washington School of Public Health.

To test whether yoga in fact increases mindfulness and mindful eating, Kristal and colleagues developed a Mindful Eating Questionnaire, a 28-item survey that measured a variety of factors:

• disinhibition – eating even when full;
• awareness – being aware of how food looks, tastes and smells;
• external cues – eating in response to environmental cues, such as advertising;
• emotional response – eating in response to sadness or stress; and
• distraction – focusing on other things while eating.

Each question was graded on a scale of 1 to 4, in which higher scores signified more mindful eating. The questionnaire was administered to more than 300 people at Seattle-area yoga studios, fitness facilities and weight-loss programs, among other venues. More than 80 percent of the study participants were women, well-educated and Caucasian, with an average age of 42. Participants provided self-reported information on a number of factors, including weight, height, yoga practice, walking for exercise or transportation and other forms of moderate and strenuous exercise.

Higher scores on the mindfulness questionnaire overall (and on each of the categories within the questionnaire) was associated with a lower BMI, which suggests that mindful eating may play an important role in long-term weight maintenance, Kristal said."Mindful eating is a skill that augments the usual approaches to weight loss, such as dieting, counting calories and limiting portion sizes. Adding yoga practice to a standard weight-loss program may make it more effective," said Kristal, who himself scored high on the mindful-eating survey and has a BMI within the normal range.

Moving forward, Kristal and colleagues suggest that their Mindful Eating Questionnaire, the first tool of its kind to characterize and measure mindful eating, may be useful both in clinical practice and research to understand and promote healthy dietary behavior.

A screen for cancer killers

Method identifies drugs that target the cells behind cancer growth.

A new approach for identifying drugs that specifically attack cancer stem cells, the cellular culprits that are thought to start and maintain tumour growth, could change the way that drug companies and scientists search for therapies in the war against cancer.

"We now have a systematic method that had not been previously known that allows us to find agents that target cancer stem cells," says Piyush Gupta of the Massachusetts Institute of Technology and the Broad Institute in Cambridge, Massachusetts, and first author of the study, published online today in Cell. Applying the technique, Gupta and his colleagues discovered one of the first compounds that can selectively destroy cancer stem cells. The drug, an antibiotic commonly fed to pigs and chickens, reduces the proportion of breast cancer stem cells by more than 100-fold compared with a drug widely used in chemotherapy for breast cancer.

Although most cancer therapies wipe out the vast majority of tumour cells, they have not been able to eliminate the cause of the disease — the cancer stem cells — so the cancer often comes roaring back with a vengeance. Researchers have looked for drugs that preferentially target cancer stem cells, but these repeat-offender cells are so rare that screening for potential compounds has been nearly impossible. The study team, led by Robert Weinberg and Eric Lander, also from the Massachusetts Institute of Technology, exploited a trick, boosting the number of cancer-stem-cell-like cells to find a molecular missile that homes in on the real target.

By silencing a specific gene in breast cancer cells, the researchers coaxed them to convert from epithelial cells, which make up most of the human body, into mesenchymal cells, which have many stem-cell-like characteristics. They then used these cells — which have the same molecular signatures as cancer stem cells and are equally drug resistant — to screen around 16,000 chemicals. They found 32 contenders, then whittled the list down to one drug: salinomycin, an antibiotic often found in animal feed.

Better Sleep Is Associated With Improved Academic Success

Getting more high-quality sleep is associated with better academic performance, according to a research abstract that will be presented on Wednesday, June 10, at SLEEP 2009, the 23rd Annual Meeting of the Associated Professional Sleep Societies. The positive relationship is especially relevant to performance in math. Results indicate that higher math scores were related to greater sleep quality, less awakenings and increased sleep efficiency. Higher English and history scores were associated with less difficulty awakening. Increased sleep-onset latency over the weekend was associated with worse academic performance.

According to principal investigator Jennifer C. Cousins, PhD, postdoctoral fellow at the University of Pittsburgh Medical Center, it was surprising that although more and better sleep produced overall improvements, different types of sleep measures were related to different types of functioning.

"Sleep deficits cause problems for adolescents, but students differ in their personal resources and in how chaotic their sleep-wake schedules are," said Cousins. "The more regular and predictable their sleep is, the better they are likely to do when confronted with short-term sleep deficits. Therefore, participants with better sleep overall may be affected differently in a sleep condition compared to those who have a more varying sleep/wake schedule."

The study involved data from 56 adolescents (34 female) between the ages of 14 and 18 years who had complaints of daytime sleepiness and or insufficient sleep at night. Participants reported their subject grades and overall academic standing. Sleep was measured objectively with actigraphy and subjectively through sleep diaries. Higher math scores were related to less night awakenings, less time spent in bed, higher sleep efficiency and great sleep quality; there was also a trend for decreased sleep onset latency (SOL). Higher scores in English were associated with less nighttime awakenings. Increased SOL during the weekends was related to worse academic performance.

According to Cousins, poor sleep and poor sleep habits are associated with substance use, emotional problems, cognitive problems and a general decline in daily functioning. Sleep education may be a preventative tool to help increase awareness of the importance of sleep and of the negative consequences of poor sleep. Authors of the study state that results provide overwhelming evidence of the importance of sleep during a period of development that is critical in adolescents and highlight the importance of the development of sleep intervention programs for students in order to improve existing problems with sleep and daily functioning.

Child DNA donors should have their say

Biobanks should revamp how they handle DNA from healthy children, says an international team of bioethics experts. Children whose parents have signed them up for long-term studies should not have their genetic data distributed or made public until the donors consent at an older age, says the team, which publishes its recommendations today in Science.

"Children should be able to decide, when they're mature enough, about their full or fuller involvement," says Bartha Maria Knoppers, director of the Centre of Genomics and Policy at McGill University in Montreal, Canada, and an author of the paper. If implemented, the recommendation could help protect young participants' privacy, but critics say that it is arbitrary and will hamper research into children's health.

Many large biobank projects, including the US National Children's Study and the Norwegian Mother and Child Cohort Study, are now routinely collecting biological samples from healthy newborns and children. These young participants present a unique ethical challenge. They are too young to give informed consent, so authorization is needed from parents or guardians. But they will eventually become adults who may not wish to share their DNA.

David Gurwitz, director of the National Laboratory for the Genetics of Israeli Populations at Tel-Aviv University in Israel, and lead author of the study, says that the recommendations are needed to safeguard child donors from the risks associated with revealing personal genetic data. "Don't rush into distributing the DNA samples to external researchers, because DNA is a strong, unique identifier," he says. To avoid delays in paediatric research, in-house research facilities should be built so that analyses can continue without samples leaving the biobank until adult consent is obtained, Gurwitz adds.

Going To Bed Late May Affect The Health, Academic Performance Of College Students

College students who go to bed late are more likely to have poor quality sleep, which may affect their mental health and academic performance, according to new research.

The study, conducted by Jung Kim, PhD, of Pohang University of Science in Technology in South Korea, was based on a survey of 399 college students in Korea.

"The present study shows that the greater one stayed up at night, the more maladjusted in college life, in terms of global mental health, sleep quality and academic performance," said Kim. "It seems important to give relevant information and helpful guidance on good sleep habits to students from the beginning of college life."

The amount of sleep a person gets affects his or her physical health, emotional well-being, mental abilities, productivity and performance. Recent studies associate lack of sleep with serious health problems such as an increased risk of depression, obesity, cardiovascular disease and diabetes.

Experts recommend that adults get between seven and eight hours of sleep each night to maintain good health and optimum performance. An abstract of this research was presented June 13 at SLEEP 2007, the 21st Annual Meeting of the Associated Professional Sleep Societies.

Timeline: Swine flu

A chronology of the H1N1 outbreak.

A new strain of swine flu - influenza A (H1N1) - is spreading around the globe. This timeline will be continually updated with key dates, drawing on authoritative information from the World Health Organization (WHO), the US Centers for Disease Control and Prevention (CDC) and other sources. For more on the situation see the Nature News swine flu special, and read updates on The Great Beyond blog.

3 August 2009 : India confirms first death from H1N1, the victim being a 14-year old girl in the city of Pune.

29 July 2009 : Researchers from the US Centers for Disease Control and Prevention warn that pregnant women "might be at increased risk for complications from pandemic H1N1" in a research paper in The Lancet (more on this story).

The UK moves its swine flu response from 'containment' to 'treatment'. "Our national focus should be on treating the increasing numbers affected by swine flu," says health minister Andy Burnham. In the US there are or have been cases in all 50 states, including 17 deaths, according to the CDC. MedImmune, a biotechnology firm in Gaithersburg, Maryland, wins a $90 million contract from the federal government to begin developing a live attenuated vaccine for H1N1. "This virus may have given us a grace period, but we do not know how long this grace period will last," said Margaret Chan, WHO director-general. "No one can say whether this is just the calm before the storm."

Mexico has reported 48 deaths and the United States three. Worldwide, 30 countries have officially reported 4694 cases. A modeling study in Science suggests that the virus spreads at a rate comparable to that of previous influenza pandemics. The latest WHO figures say the virus has now spread to 21 countries. Mexico has reported 590 cases and 25 deaths while the United States has reported 286 cases and one death.

However, the Texas Department of State Health Services has confirmed a second person has died in the United States. The DSHS says a woman with "chronic underlying health conditions" died earlier this week.

The following countries have reported cases but no deaths: Austria, Canada, China (Hong Kong Special Administrative Region), Costa Rica, Colombia, Denmark, El Salvador, France, Germany, Ireland, Israel, Italy, Netherlands, New Zealand, Portugal, Republic of Korea, Spain, Switzerland and the United Kingdom.

Canadian authorities announce that H1N1 has been detected in a swine herd in Alberta. The pigs likely caught the virus from a Canadian who had recently visited Mexico, making this the first known case of human-to-animal transmission.

The WHO raises pandemic alert level to 4 having confirmed human-to-human transmission able to cause 'community-level outbreaks'. "Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion," says the organisation.

First Human Gene Implicated In Regulating Length Of Human Sleep

Scientists have discovered the first gene involved in regulating the optimal length of human sleep, offering a window into a key aspect of slumber, an enigmatic phenomenon that is critical to human physical and mental health.While most Americans obtain less than eight hours of sleep a night (the average on non-work days is 7.4 hours), and some may feel they succeed with less when engaged in exhilarating work, domestic life or recreation, scientific evidence indicates that, over time, the body suffers from this regimen, the researchers say.

"Short term and chronic disruptions in the length of optimal sleep can have serious consequences on cognition, mood and physical health, including cancer and endocrine function," says the senior author of the study, Ying-Hui Fu, PhD, UCSF professor of neurology. However, teasing out this impact can be challenging, she says, given access to such stimuli as coffee and chocolate.

The finding, she says, offers an opportunity to unravel the regulatory mechanism of sleep. While the mutation may be rare, it could offer a probe more generally into the regulatory mechanisms of sleep quality and quantity. Understanding these mechanisms could lead to interventions to alleviate pathologies associated with sleep disturbance.

Sleep remains a relatively inscrutable biological phenomenon. Scientists know that it is regulated in large part by two processes: 1) circadian rhythms -- genetic, biochemical and physiological mechanisms that wax and wane during a 24 hour period to regulate the timing of sleep, 2) and homeostasis – unknown mechanisms that ensure that the body acquires over time the necessary amount of sleep, nudging it toward sleep when it has been deprived, prompting it out of sleep when it has received enough. This regulation of sleep intensity is measured in non rapid eye movement sleep and REM sleep. Interactions between the circadian rhythms and homeostatic mechanisms influence the timing, duration and quality of sleep and wakefulness.

But "the details in the process are really completely unknown," says Fu.

In the current study, the team identified a small extended family in which a mother and her adult daughter had life-long shorter daily sleep requirements than most individuals. Fu's lab then studied blood samples from these women and their extended family. They identified a mutation in a gene known as hDEC2, which is a transcription factor that represses expression of certain other genes and is implicated in the regulation of circadian rhythms.

Next, the team genetically engineered mice and fruit flies to express the mutated human gene, and Ying He, PhD, a postdoctoral fellow in the Fu lab, studied its impact on their behavior and sleep patterns. Mice slept less, as seen in the extent of their scampering about in the dark (mouse preference) over the course of 24 hours and in electroencephalography (EEG) and electromyography (EMG) measurements indicating reduced nonREM and REM sleep. While lacking a Lilliputian size EEG to monitor the fruit flies, He studied the miniscule creatures' activity and sleep patterns by tracking the frequency of their movements through infrared light.

Next, the team compared the response of the genetically engineered mice and normal mice to the consequence of six hours of sleep deprivation. The engineered mice needed to compensate for their lost sleep to a much lesser extent – as seen in nonREM and REM measures – than their normal counterparts.

"These changes in sleep homeostasis in the mutant mice could provide an explanation for why human subjects with the mutation are able to live unaffected by shorter amounts of sleep throughout their lives," says Fu.

The next step, she says, is determining the DEC2's precise role. "We know the gene encodes a protein that is a transcriptional repressor and we know it makes the repressor's activity weaker. But we don't know if the weaker repressor is directly related to the shorter amount of sleep, because proteins can have many functions. It could be the protein functions as part of a larger transcriptional machinery, not necessarily as a repressor."

"The mouse model also provides an opportunity to investigate whether there are other behaviors or physiological conditions associated with a short sleep syndrome," says Fu. She suspects there will be.

Chemists Discover Twisted Molecules That Pick Their Targets

New York University chemists have discovered how to make molecules with a twist—the molecules fold in to twisted helical shapes that can accelerate selected chemical reactions. The research, reported in the latest issue of the Proceedings of the National Academy of Sciences (PNAS), could yield valuable methods for making pharmaceuticals and other chemicals that require precise assembly of complex structures.

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The NYU team performs studies in "biomimetic chemistry." This research pursues synthetic molecules with structures and functions resembling molecules found in nature. Many biological molecules, such as proteins and DNA, can fold themselves into ordered helices and bundles. Within the past decade, scientists have successfully synthesized molecular chains that can also fold into various shapes. Although these "foldamers" resemble biochemical forms, finding mimics of biochemical functions has been more elusive. Now, the NYU chemists are able to create folded molecules that can perform a complex function. In this case, the new molecules are catalysts—substances that speed up the rate of chemical transformations.

The PNAS paper describes how to embed a catalytic chemical group within a larger twisted architecture. The researchers' hypothesis was that the arrangement of the surrounding twist would help determine how contacts could be made between the catalyst and surrounding molecules. To test the functionality of their foldamer, they combined it with a pair of mirror-image molecules—those with identical composition, but whose atoms are distributed in opposing spatial locations, much like left-handed and right-handed gloves—to determine if it could correctly interact with one of the pair in order to form a new chemical. The ability of the foldamer to do so was evidence of its precision.

"Our molecules are particularly interesting in that they are 'selective'—they will recognize one type of target molecule and catalyze its chemical conversion," explained NYU Chemistry Professor Kent Kirshenbaum, one of the study's authors. "This is especially important for making complex chemical structures, so we think this may be eventually useful for the synthesis of new drugs."

"Molecules used in pharmaceuticals have to be manufactured in an extremely specific manner," he added. "The difference in resulting chemicals between two mirror-image molecules could be enormous, so it is crucial that a catalyst correctly make a distinction between similar structures. Once we learn the rules to connect different molecular folds to desired functions, there should be many new tricks and new tasks we can teach our molecules to perform."