The tip of the iceberg? @ Wikipedia Today I'd like to focus on the paper by Kalle Kurppa and colleagues  and their suggestion that: "GFDs [gluten-free diets] benefit asymptomatic EMA-positive [endomysial antibody] patients" with coeliac (celiac) disease in mind.Asymptomatic, when it comes to a condition like coeliac disease (CD) - an autoimmune condition linked to the consumption of gluten - is not necessarily all that surprising given the numbers of cases where the words 'clinically silent' are used . Indeed, the term 'coeliac iceberg'  is something I remember from my very earliest reading about CD reflective of the quite large numbers of people walking around with the serological and/or histopathological markers of the condition yet not seemingly experiencing the more classical signs of the disease or at least not severe enough to seek medical advice.The Kurppa paper concluded that even in those cases where clinically silent is a feature of someones CD, the adoption of a gluten-free diet should still be considered. If anything because outside of changes (improvements) to the serological marker measures and any gastrointestinal (GI) symptoms: "The GFD group also had reduced indigestion (P=.006), reflux (P=.05), and anxiety (P=.025), and better health, based on the visual analog scale (P=.017), than the gluten-containing diet group".Reduced anxiety eh? Well, obviously I don't want to make too much of a meal of this one even though that previous Catassi 'iceberg' study  talked about "decreased psychophysical well-being" as being part and parcel of "low-grade intensity illness". What I will however draw to your attention are two potentially important things:The possible 'autism' connection. I doubt that readers will remember my post a while back on the paper by Jonas Ludvigsson and colleagues  talking about a sort of not-quite-coeliac-disease condition seemingly present in some children diagnosed with an autism spectrum disorder (ASD). Ludvigsson et al concluded that: "there was a markedly increased risk of ASDs in individuals with normal mucosa but a positive CD serologic test result". Ergo, not coeliac disease (CD) but something perhaps along the lines of a non-coeliac gluten sensitivity (NCGS). Tagged on to the the paper by Giacomo Caio  (open-access here), I'm wondering whether the Kurppa results might indeed hold some research promise when applied to at least some diagnosed as being on the autism spectrum perhaps with those CD serological markers? Particularly given that something like anxiety, when it occurs comorbid, can be absolutely disabling for some on the autism spectrum (see here) alongside other mention of a possible link between things like anxiety and GI issues with autism in mind (see here). Just thinkin' out loud.Gluten exposure and feelings of depression?The paper by Simone Peters and colleagues  talked about in another post (see here) might also fit with some of the Kurppa findings. I know I'm probably stretching things a little bit here but the Peters finding of that gluten ingestion "induced current feelings of depression" specifically in cases of "self-reported non-coeliac gluten sensitivity (NCGS)" may be related. Again with the speculating machine in full operation, I do wonder if the relationship between psychological health and wellbeing seemingly linked to CD or NCGS might hint at some shared mechanisms between the two states?As per my blogging caveats - no medical or clinical advice given or intended - I'm not suggesting anything above and beyond what the Kurppa findings reported. There are also quite a few other potential explanations for the results they got insofar as not just what was excluded from the diet (gluten) but what might have also been added to the diet too also affecting health and wellbeing . What I would perhaps champion however is a research agenda further tuned to the potential role that gluten may have on psychological health and wellbeing bearing in mind what gluten-free might have to cover . As per the review paper by Genuis & Lobo  talked about in a previous post (see here), whether this important foodstuff might have much more to answer for than just CD. Oh, and then there are the results from Volta and colleagues  to also consider...Music to close. Don't you worry child...---------- Kurppa K. et al. Benefits of a Gluten-free diet for Asymptomatic Patients with Serologic Markers of Celiac Disease. Gastroenterology. 2014 May 13. pii: S0016-5085(14)00609-X. Tursi A. et al. Prevalence and clinical presentation of subclinical/silent celiac disease in adults: an analysis on a 12-year observation. Hepatogastroenterology. 2001 Mar-Apr;48(38):462-4. Catassi C. et al. The coeliac iceberg in Italy. A multicentre antigliadin antibodies screening for coeliac disease in school-age subjects. Acta Paediatr Suppl. 1996 May;412:29-35. Ludvigsson JF. et al. A nationwide study of the association between celiac disease and the risk of autistic spectrum disorders. JAMA Psychiatry. 2013 Nov;70(11):1224-30. Caio G. et al. Effect of gluten free diet on immune response to gliadin in patients with non-celiac gluten sensitivity. BMC Gastroenterol. 2014 Feb 13;14:26. Peters SL. et al. Randomised clinical trial: gluten may cause depression in subjects with non-coeliac gluten sensitivity - an exploratory clinical study. Aliment Pharmacol Ther. 2014 May;39(10):1104-12. Gautam M. et al. Role of antioxidants in generalised anxiety disorder and depression. Indian J Psychiatry. 2012 Jul;54(3):244-7.  Sjöberg V. et al. Noncontaminated dietary oats may hamper normalization of the intestinal immune status in childhood celiac disease. Clin Transl Gastroenterol. 2014 Jun 26;5:e58. Genuis SJ. & Lobo RA. Gluten Sensitivity Presenting as a Neuropsychiatric Disorder. Gastroenterol Res Pract. 2014;2014:293206. Volta U. et al. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Medicine 2014, 12:85----------... Read more »
Kurppa K, Paavola A, Collin P, Sievänen H, Laurila K, Huhtala H, Päivi Saavalainen, Mäki M, & Kaukinen K. (2014) Benefits of a Gluten-free diet for Asymptomatic Patients with Serologic Markers of Celiac Disease. Gastroenterology. PMID: 24837306
Using search engines to predict the future of infectious diseases: computer science meets epidemiology.... Read more »
Yuan, Q., Nsoesie, E., Lv, B., Peng, G., Chunara, R., & Brownstein, J. (2013) Monitoring Influenza Epidemics in China with Search Query from Baidu. PLoS ONE, 8(5). DOI: 10.1371/journal.pone.0064323
Running with a minimalist shoe increases plantar pressures... Read more »
Bergstra, S., Kluitenberg, B., Dekker, R., Bredeweg, S., Postema, K., Van den Heuvel, E., Hijmans, J., & Sobhani, S. (2014) Running with a minimalist shoe increases plantar pressure in the forefoot region of healthy female runners. Journal of Science and Medicine in Sport. DOI: 10.1016/j.jsams.2014.06.007
Big data doesn't always get us closer to truth. Especially if there a fair bit of luck involved. And many think this applies to football/soccer games (Sally and Anderson, for example, say that soccer results are 50% luck). Yet data analysis provides valuable, sometimes counter-intuitive insights into this beautiful sport and the science of winning and losing in general.How many measurable elements of a soccer game contribute to the outcome? 2014 FIFA world cup's statistics page displays scores calculated with sophisticated motion analysis from thousands of player movements along with more straightforward measures such as goals scored, short, medium and long hits, completion rate of passes, blocked and saved shots, attempts off target, tackles and blocks. And there are also flops, screams, winces, poundings of the grass and other theatrical elements that may also decide the fate of the game.Just a quick glance at the FIFA statistics page (refreshed after each game) might bring surprises. On June 24th, the best defending team was Columbia that advanced to the next round, while the best attacking team, Côte d'Ivoire, and the team with the highest number of successfully completed passes, Spain, were not able to make it. The leader board is now featuring winning teams as the best attacker (France, as of June 25th) and the best passer (Germany, as of June 26th), but obviously neither of these achievements alone is sufficient to predict the winner. Data from the last seasons of the British Premier League demonstrated that scoring a goal was twice less valuable than not conceding a likely goal. Yet England - #6 on the list of top attackers, #8 on the list of best passers and #11 on the list of best defenders - did not make it into the top 16, while France - #32 as a defender and one of the very best attacking teams has advanced to the round of 16. Only three teams among the top ten attackers won the 1st round and all three - Argentina, France and Germany - are leaders in their respective groups. Compare it to seven from the ten best defending teams that advanced to 1/16th finals. Note that all of them took second, not the 1st positions in their groups. So the ability to defend against counter-attack is definitely crucial to success, but the propensity to attack increases both the risk and the potential return.A good example of skill in soccer is the elegant passing style of Spanish players dubbed Tiki-taka. This approach, based on speed, unity and a comprehensive understanding of the field geometry, helped Spain to win in Euro 2008, the 2010 FIFA World Cup and Euro 2012. Network analysis of interactions among the players (Cota t al., 2011; Peña & Touchette, 2012) highlighted the importance of skillful passes, yet the ability to do it well doesn't always lead to success - as was demonstrated by Brazilian team during the 2013 FIFA Confederations Cup (they won despite possessing the ball only 47% of the time vs 53% for Spain) and by Netherlands and Chile that knocked Spain out in the group stage.How can we measure luck in soccer separate from skill?One way would be to forecast game outcomes in terms of probabilities (as a researcher from Wolfram Alpha did for the upcoming round of 2014 world cup -- see the figure) then look at the distribution of actual results of games between these teams. Another useful tool adopted from ice hockey analysis is PDO - the sum of a team's shooting and save percentages (fraction of shots resulted or not resulted in a goal scored). Neither of the approaches was able to pinpoint particularly lucky teams. In analysis of a 2010/2011 season, good and bad teams appeared to be equally "lucky" or "unlucky"."I am a great believer in luck,"said Thomas Jefferson, "and I find the harder I work, the more I have of it".Perhaps we need to focus on values like amounts of running during the game - as a proxy for hard work? US defender Michael Bradley holds the trophy for the 1st round of world cup (largest distance covered), but average distance ran by players that advanced or did not advance to the next round seems to be about the same. However, if we compare players from higher and lower divisions of national teams, the differences in these distances become more dramatic. In one Dutch study, top-class players performed 28% and 58% more high-intensity running and sprinting, respectively, than the moderate players (Mohr et al., 2003). Better goalkeepers ran more too, as seen from a recent Italian study (Paduli et al, 2014). So hard work (and good health to carry on) is very important, indeed. At least in order to join the elite soccer club.The amount of data created every minute for the analysis of soccer games is absolutely amazing. In order to accurately predict the outcome of the game played by almost equally skilled & hardworking teams one needs to know minute-to-minute movements of every player. Like the weather, the scores of such games might be hard to forecast past a certain timeframe. Yet, better models and more sophisticated computations will be yielding more accurate results (as shown by Aurametrix for subtle cause-effect relationships contributing to how you feel on a daily basis).But for now let's call it luck when we can't see the unseen and predict things before they happen. And let's enjoy top-flight soccer for the next few weeks.REFERENCESJavier López Peña, & Hugo Touchette (2012). A network theory analysis of football strategies In C. Clanet (ed.), Sports Physics: Proc. 2012 Euromech Physics of Sports Conference, p. 517-528, \'Editions de l'\'Ecole Polytechnique, Palaiseau, 2013. (ISBN 978-2-7302-1615-9) arXiv: 1206.6904v1... Read more »
Javier López Peña, & Hugo Touchette. (2012) A network theory analysis of football strategies. In C. Clanet (ed.), Sports Physics: Proc. 2012 Euromech Physics of Sports Conference, p. 517-528, \'Editions de l'\'Ecole Polytechnique, Palaiseau, 2013. (ISBN 978-2-7302-1615-9). arXiv: 1206.6904v1
Cotta, C., Mora, A., Merelo, J., & Merelo-Molina, C. (2013) A network analysis of the 2010 FIFA world cup champion team play. Journal of Systems Science and Complexity, 26(1), 21-42. DOI: 10.1007/s11424-013-2291-2
Padulo J, Haddad M, Ardigò LP, Chamari K, & Pizzolato F. (2014) High frequency performance analysis of professional soccer goalkeepers: a pilot study. The Journal of sports medicine and physical fitness. PMID: 24921614
I’m not sure where Quinoa falls on the dietary good-evil spectrum these days. Many value it for its high protein and mineral content. It can be a staple food for the health-minded vegetarian. On the other side of the spectrum, Quinoa has been on the do-not-eat list for followers of the Paleo diet because advocates […]
The post Quinoa is high in Protein and Stimulates Protein Synthesis via Phytoecdysteroids appeared first on WODMasters: Stiff Competition.
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Dinan L. (2009) The Karlson Lecture. Phytoecdysteroids: what use are they?. Archives of insect biochemistry and physiology, 72(3), 126-41. PMID: 19771554
Báthori M, Tóth N, Hunyadi A, Márki A, & Zádor E. (2008) Phytoecdysteroids and anabolic-androgenic steroids--structure and effects on humans. Current medicinal chemistry, 15(1), 75-91. PMID: 18220764
Foucault AS, Even P, Lafont R, Dioh W, Veillet S, Tomé D, Huneau JF, Hermier D, & Quignard-Boulangé A. (2014) Quinoa extract enriched in 20-hydroxyecdysone affects energy homeostasis and intestinal fat absorption in mice fed a high-fat diet. Physiology , 226-31. PMID: 24534167
The paper by Ane Birgitte Telén Andersen and colleagues  (open-access here) concluding "no evidence of an increased risk of ASD [autism spectrum disorders] among children born to parents with IBD [inflammatory bowel disease]" caught my eye recently.Qays and Layla @ Wikipedia Based on an analysis of one of those Danish Registries which seem to be providing all-manner of important correlations and non-correlations, the authors looked for the presence of parental IBDs such as ulcerative colitis (UC) or Crohn's disease (CD) in the files of over a million children, including some who went on to receive a diagnosis of autism or ASD. They reported that: "The 10-year risks of ASD were 0.7% among children of parents with IBD and 0.9% among children of parents without IBD". Indeed, judging by those figures one might even assume that a parental diagnosis of IBD might actually be somewhat protective against offspring autism...This is interesting data. I've talked before about the strength of these types of large datasets; big data in action you might say. This authorship team are also no strangers to looking at the offspring risks or not following a parental diagnosis of an IBD. Take for example their results on paediatric asthma  (open-access here) similarly concluding no evidence for "an increased risk of asthma in offspring with a parental history of IBD".Certainly the numbers being talked about by Andersen et al mean their results have to be taken seriously and as the authors note "reassuringly suggest that neither maternal or paternal IBD increases the overall risk of ASD in a child". That being said, I was also intrigued by how the Andersen findings contrasted with other studies in this area. Take for example the results of the much smaller study by Mouridesen and colleagues  covered in a previous post (see here) which hinted at some increased frequency of autoimmune related conditions in parents of children with autism. Maternal UC was noted as a potentially important variable in that study. Obviously there is quite a difference in the participant numbers between the two studies but still it's a contrast.It is important to note that Andersen et al are only commenting on how parental IBD diagnosis seems not to be related to offspring autism risk. They are not saying that the known IBDs or even some prodromal / new-variant IBD (see here) are not related to at least some cases of autism. I'm also minded to suggest that the Andersen results might even offer some support to the idea that IBDs, when established in cases of autism, might have more of an 'acquired' element to them over and above a genetic link. I say this if one (a) assumes that some cases of autism have an autoimmune element to them, and (b) that certain factors listed in relation to autism such as early antibiotic use  might also might have some bearing on the 'acquisition' of the IBDs (see here).Music to close... Before Candy Crush there was Orange Crush by REM.----------- Andersen AB. et al. Autism spectrum disorders in children of parents with inflammatory bowel disease - a nationwide cohort study in Denmark. Clin Exp Gastroenterol. 2014 May 7;7:105-10. Andersen AB. et al. Parental inflammatory bowel disease and risk of asthma in offspring: a nationwide cohort study in Denmark. Clin Transl Gastroenterol. 2013 Aug 22;4:e41. Mouridsen SE. et al. Autoimmune diseases in parents of children with infantile autism: a case-control study. Dev Med Child Neurol. 2007 Jun;49(6):429-32. Niehus R. & Lord C. Early medical history of children with autism spectrum disorders. J Dev Behav Pediatr. 2006 Apr;27(2 Suppl):S120-7.----------Andersen AB, Ehrenstein V, Erichsen R, Frøslev T, & Sørensen HT (2014). Autism spectrum disorders in children of parents with inflammatory bowel disease - a nationwide cohort study in Denmark. Clinical and experimental gastroenterology, 7, 105-10 PMID: 24855384... Read more »
Andersen AB, Ehrenstein V, Erichsen R, Frøslev T, & Sørensen HT. (2014) Autism spectrum disorders in children of parents with inflammatory bowel disease - a nationwide cohort study in Denmark. Clinical and experimental gastroenterology, 105-10. PMID: 24855384
I'd been thinking about writing this post on scurvy, vitamin C and autism for quite a while. The paper by Kitcharoensakkul and colleagues  really made the decision for me, following their discussions on three young children with walking difficulties who were eventually diagnosed with scurvy, one of whom was diagnosed with autism. The authors concluded: "These clinical manifestations and radiologic findings highlight the importance for rheumatologists to have a higher index of suspicion for scurvy in nonambulatory children". Nonambulatory by the way, means not able to walk about (independently). "Interestingly, all patients had concomitant vitamin D deficiency" was another important point made in the Kitcharoensakkul study which is something I'm always a little interested in on this blog (see here).Limes... @ Fludkov @ Wikipedia Scurvy, as some people might already know, is a condition characterised by a lack of sufficient vitamin C (ascorbic acid). It can manifest in a variety of ways including fatigue, lack of appetite, irritability alongside various functional gastrointestinal (GI) symptoms. Gingival swelling or bleeding (the gums) is perhaps one of the best known [oral] signs of the disease. Nowadays it is quite a rare condition.In other blog entries I've referred to myself as a Limey reflective of a slang phrase for someone from these hallowed Isles called Great Britain (Britain, Britain, Britain..), which seems to derive from the practice of giving lime juice to British sailors way back when, to prevent scurvy.Suffice to say however that the Kitcharoensakkul paper is not the first time that scurvy has appeared alongside the word autism or words autism spectrum disorder (ASD) as I'll attempt to show you...Case studies describing scurvy concurrent to a diagnosis of autism can be found in the peer-reviewed research literature . The description by Mawson  is typical although some symptoms reported in that particular case as being perhaps complicated by "treatment with indomethacin, which lowers vitamin C levels" is an important addition. I do think it is important to raise the point that some medicines can interfere with the availability of things like vitamins and minerals similar to such nutraceuticals affecting some medicines.Cole and colleagues  talked about the continued presence of scurvy "among susceptible populations" which includes "certain unique populations-particularly the elderly subjects, patients with neurodevelopmental disabilities or psychiatric illnesses, or others with unusual dietary habits" in their report on a "10-year-old autistic child". 'Unusual' dietary patterns are no stranger to autism  (open-access here) over and above any special dietary regimes being implemented (see here).Congidi and colleagues  described another case of scurvy in "an autistic child with food-avoidant behavior". They also described MRI findings for their patient. Indeed, this is something also described in the report by Tetsu and colleagues  who reported that the: "imaging findings of the thigh showed diffuse signal abnormality in the bone marrow, periosteum, and the femoral muscle". Further: "A biopsy specimen of the femur showed hematoma, proliferative fibroblasts, and few collagen fibers, which suggested a deficiency of vitamin C".Slightly outside of the issue of scurvy is the study presented by Dolske and colleagues  "exploring the effectiveness of ascorbic acid (8g/70kg/day) as a supplemental pharmacological treatment for autistic children in residential treatment". Although this was a small trial in terms of participant numbers, it was a "double-blind, placebo-controlled trial" lasting 30 weeks. The authors reported "a reduction in symptom severity associated with the ascorbic acid treatment" making specific mention of "sensory motor scores". Obviously I'm not making any recommendations about these findings (no medical or clinical advice given or intended) but do find them to be interesting and perhaps overlapping with other research where vitamin C supplementation has been included. So, think back to the Jim Adams trial data (see here) based on some older research . As to the hows and whys, well, unlike the chatter about vitamin C therapy potentially impacting on Epstein-Barr antibodies no biological measure was used in the Dolske study so we are left speculating...As you've probably realised, most of the research evidence surrounding the presence of scurvy in cases of autism is based on individual case reports. I can't for example, provide you with any population estimates of how prevalent scurvy might be in cases of autism because no-one has really looked at this issue with any great assiduity. I can point you in the direction of other work talking again about cases of scurvy appearing alongside schizophrenia for example  but will only say that a poor diet lacking in sources of vitamin C is as much to blame in those examples as it probably is where cases of autism are discussed.Just before I go, there are a few other things to note about vitamin C and autism which may also be pertinent to other issues. I've talked about iron before on this blog and how there is some data suggesting issues with iron for some on the autism spectrum (although certainly not all). It's quite long been recognised that vitamin C also plays a role in the absorption of iron  particularly non-heme iron sources and a deficiency in vitamin C is probably not going to be conducive to 'optimal' function. Quite a while back I also talked about autism and oxalates (see here) but will say no more than re-iterating the study by Chai and colleagues  with the requirement for lots more investigation in this area.To close, I was saddened to hear of the death of Prof. Paul Patterson this week, a real research pioneer who's studies on autism and schizophrenia were frequently discussed on this blog (... Read more »
Kitcharoensakkul M, Schulz CG, Kassel R, Khanna G, Liang S, Ngwube A, Baszis KW, Hunstad DA, & White AJ. (2014) Scurvy revealed by difficulty walking: three cases in young children. Journal of clinical rheumatology : practical reports on rheumatic , 20(4), 224-8. PMID: 24847751
Sensory deficits in runners with an overuse injury... Read more »
, ., Switlick, T., Kernozek, T., & Meardon, S. (2014) Differences in Joint Position Sense and Vibratory Threshold in Runners With and Without a History of Over-Use Injury. Journal of Sport Rehabilitation. DOI: 10.1123/jsr.2013-0089
I must admit that I cringe slightly every time I try to think about healthcare from an economics perspective. To me, this comes a little close to putting a dollar value on human beings, which feels uncomfortably post-humanistic to me. Nonetheless, there is no ignoring the ways in which economic concerns factor into policy decisions that drive our human services, including health care.
There are also a number of pragmatic reasons for thinking about the costs associated with illnesses; talking in dollars and cents can make for a convincing argument when seeking funding to do research on a particular illness, for example. The ability to reduce healthcare costs is incredibly compelling in a time of fiscal restraint.
Crow (2014) published a short article about the economic costs of eating disorder treatment. In this article, he highlights some recent studies that have examined factors related to “the economics of eating disorders” and suggests avenues for future research in this area.
I will preface my analysis by noting that healthcare economics are not my area of expertise, and I doubt …
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"Our findings lend support to anecdotal reports of increased rates of suicidal ideation in adults with Asperger's syndrome, and depression as an important potential risk factor for suicidality in adults with this condition".Sunrise @ Wikipedia That was the very stark conclusion reached by the study by Sarah Cassidy and colleagues  (open-access) looking at self-reported rates of suicide ideation and suicide plans/attempts in a sample of adults newly diagnosed with Asperger syndrome attending a "specialist diagnostic clinic" between 2004 and 2013. That depression seemed to play an important role in the engagement of such extreme thoughts or behaviour was also important. The press release accompanying the research can be read here.As per some previous discussion on this topic (see here), suicide, whether attempted or completed, is a difficult topic to talk about. Not only because of the emotions which it invariably stirs up but also because the various paths towards someone reaching such an extreme point are complex, often very individual and still not well understood. Among the various risk factors suggested to be linked to [completed] suicide  some key points quite consistently come out including (a) a previous history of suicide ideation or suicide attempts, (b) the presence of psychiatric comorbidity such as depression or psychotic illness, and (c) some degree of social exclusion or alienation. I should mention that this is not an extensive list of risk factors, merely those which seem to appear with greatest frequency in the various research literature in this area.The Cassidy paper is open-access but a few points are pertinent:As part of their attendance at clinic, nearly 400 adults ranging in ages from 17 - 67 years old at time of diagnosis, completed a self-report "patient screening questionnaire" containing items of about suicide and mood. The paper states the relevant questions: "have you ever been diagnosed with depression?", "have you ever felt suicidal?" and "if yes, have you ever planned or attempted suicide?".Participant were also asked to complete the Empathy Quotient (EQ) and the Autism Spectrum Quotient (AQ) questionnaires, both self-report measures which provide information about empathy and some of the "cognitive-behavioural traits associated with autism". Data derived from the suicide questioning items were compared with "published rates of suicidal ideation in the general population and other clinical groups".Results: "a 66% lifetime experience of suicidal ideation and a 35% lifetime experience of planned or attempted suicide supports the assertion that these occurrences are common in people with Asperger's syndrome". Compared with the population control data on these issues, the authors report that their sample were "more likely to report lifetime experience of suicidal ideation than were individuals from a general UK population sample". This included those with medical illnesses or psychotic illness. But... those with drug dependency and ADHD were still marginally more likely to report suicide ideation.Depression also seemed to play it's part in the reports. "Individuals with a history of depression ... were more likely to report suicide ideation ... and more likely to report suicide plans or attempts" compared with those without depression. And as for the EQ and AQ data, well higher scores on the AQ seemed to link with those reporting suicide plans or attempts but that was about it.There are limitations to this study based on issues like the use of self-report questionnaire items asking about things like planned or attempted suicide or depression diagnosis without other evidence sources. Also as the authors note, their focus on "the population of people who reach adulthood without a diagnosis of Asperger's syndrome" is relevant. But the results are pretty stark particularly in respect to the numbers who have actually planned or attempted suicide. Going back to those more generalised population risk factors linked to suicide ideation or completion, it's not difficult to see how many of those might especially apply to some diagnosed with Asperger syndrome. Comorbidity such as depression is quite a well-known issue in relation to the autism spectrum . Indeed, not so long ago I was interested to read the paper by Gotham and colleagues  on how rumination - "compulsively focused attention on the symptoms of one's distress" - might play a role in depression in some cases of autism and where this could lead from a therapeutic standpoint. I'll also direct you to the paper by Ljung and colleagues  concluding that: "Attention-deficit/hyperactivity disorder [ADHD] is associated with an increased risk of both attempted and completed suicide" which might tie into the links being made between autism and ADHD (see here).Insofar as other conditions more generally linked to suicide such as psychosis  there is also perhaps something to do with the Cassidy results in mind, as a consequence of Asperger syndrome not being protective against the development of psychosis (see here). Social exclusion or alienation is also something reported with regards to the autism spectrum. I'm due to publish a mega-post quite soon on some of the research literature looking at quality of life (QoL) with autism in mind. Certainly in amongst that collected work, there are multiple examples of how loneliness and social isolation can be very detrimental factors to QoL.At this point I'm also minded to bring in the possibility that suicide ideation or planning might not be just solely due to psychological or societal factors but rather may be influenced by something like biology too. Regular readers of this blog probably already know about my fascination with all-things vitamin D. It's timely that I talked about some of the collected literature looking at vitamin D deficiency in relation to something like depression recently (see here). Even perhaps more timely that said deficiency of the sunshine vitamin/hormone might also be something to look at with [adult] autism in mind (see here). I'm not necessarily suggesting a cause-and-effect scenario linking these elements, merely that this could be something to look at in future. Perhaps also in the same light as looking at another interest of mine: gluten and "feelings of depression"? How about other trace minerals and suicide too?Whatever the reasons for thoughts of suicide to be linked to the autism spectrum, there is an important message to come from the Cassidy results and other papers on this topic: "inform appropriate service planning and support to reduce risk in this clinical group". Or I could just say make greater efforts to ensure that everyone knows how valuable their lives are, how valued they are as individuals and that there are people to talk... Read more »
Sarah Cassidy, Paul Bradley, Janine Robinson, Carrie Allison, Meghan McHugh, & Simon Baron-Cohen. (2014) Suicidal ideation and suicide plans or attempts in adults with Asperger's syndrome attending a specialist diagnostic clinic: a clinical cohort study. Lancet Psychiatry. info:/doi:10.1016/S0140-6736(08)61345-8
Dietary restriction holds the key to longevity. It’s no secret that as you drastically reduce calories, your metabolism will slow down with it [ask anyone who's tried to crash diet […]... Read more »
Yu Z, Wang R, Fok WC, Coles A, Salmon AB, & Pérez VI. (2014) Rapamycin and Dietary Restriction Induce Metabolically Distinctive Changes in Mouse Liver. The journals of gerontology. Series A, Biological sciences and medical sciences. PMID: 24755936
Animal testing is an incredibly controversial subject, with strong opinions on both sides. Whilst animal testing for cosmetics has now been banned in the EU, animals continue to be used in science, where they serve a vital role in biomedical research and drug development. Their importance is often overshadowed by the ethical issues surrounding the treatment of animals in research environments, and it’s important that people understand why and how they are used, as well as what measures are taken to ensure that they are treated correctly and replaced where possible.
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Although I had other tips in the pipeline, I’m bumping this one up because it is time sensitive. It’s about a competition (or challenge, as they describe it) to use data from cases of leukemia to model make predictions about the outcomes, which could help drive treatment decisions someday. It is called the Acute Myeloid […]... Read more »
Boutros Paul C, Kyle Ellrott, Thea C Norman, Kristen K Dang, Yin Hu, Michael R Kellen, Christine Suver, J Christopher Bare, Lincoln D Stein, & Paul T Spellman. (2014) Global optimization of somatic variant identification in cancer genomes with a global community challenge. Nature Genetics, 46(4), 318-319. DOI: http://dx.doi.org/10.1038/ng.2932
Dolgin Elie. (2014) New platforms aim to obliterate silos of participatory science. Nature Medicine, 20(6), 565-566. DOI: http://dx.doi.org/10.1038/nm0614-565
Vampire bats sense heat via pit organs in their nose-leaves, but they find their victims by sight, smell and echolocation. New research shows that an alternatively spliced version of the capsaicin receptor TRPV1 is responsible for the heat sensing, but what do they use it for? Their teeth are so short that they must find blood vessels close to the surface – shallow vessels give off more heat than do deep vessels or skin where there is no large vessel.
Vampire bats occasionally feed on humans, and they will return to the same individual for several nights. How do they find the same individual? Research shows that vampire bats can discriminate between individuals via their breathing sounds. To keep the blood flowing in their nightly buffet, vampire bats have many anticoagulants in their saliva. New research is showing how good these may be as clot buster in stroke victims, and a proteomic survey suggests that dozens more anticoagulants are present and ready for discovery.
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Vanderelst D, De Mey F, Peremans H, Geipel I, Kalko E, & Firzlaff U. (2010) What noseleaves do for FM bats depends on their degree of sensorial specialization. PloS one, 5(8). PMID: 20808438
Patel R, Ispoglou S, & Apostolakis S. (2014) Desmoteplase as a potential treatment for cerebral ischaemia. Expert opinion on investigational drugs, 23(6), 865-73. PMID: 24766516
Ma D, Mizurini DM, Assumpção TC, Li Y, Qi Y, Kotsyfakis M, Ribeiro JM, Monteiro RQ, & Francischetti IM. (2013) Desmolaris, a novel factor XIa anticoagulant from the salivary gland of the vampire bat (Desmodus rotundus) inhibits inflammation and thrombosis in vivo. Blood, 122(25), 4094-106. PMID: 24159172
Gröger U, & Wiegrebe L. (2006) Classification of human breathing sounds by the common vampire bat, Desmodus rotundus. BMC biology, 18. PMID: 16780579
Gracheva EO, Cordero-Morales JF, González-Carcacía JA, Ingolia NT, Manno C, Aranguren CI, Weissman JS, & Julius D. (2011) Ganglion-specific splicing of TRPV1 underlies infrared sensation in vampire bats. Nature, 476(7358), 88-91. PMID: 21814281
The paper by Yu Wang and colleagues  (open-access here) concluded that: "reduced ENO2 expression may be a biomarker for a subset of autistic children" following their genome-wide methylation study of autism. For those who've picked up the word 'methylation' in that first sentence, this is yet another sign that epigenetics - the science of changes to gene function not entailing structural genomic changes - is starting to impact on autism research.Silentio! @ Wikipedia Based on an initial analysis of 5 pairs of participants - five diagnosed with autism, the other five being asymptomatic controls - drawn from a larger study population (n=131 pairs), researchers conducted a genome-wide study of venous blood samples for methylation variations in gene promoter regions and CpG islands using a method called MeDIP. Candidate genes (LASS3, PANX2, SLC15A4 and ENO2) which showed differential methylation patterns between the autism vs. control samples were selected for further investigation, after which ENO2 became the target gene for the study. It was then a case of verifying the methylation status of ENO2 (via BSP sequencing) in cases and controls of the larger participant groups followed by some analysis of the expression of ENO2 with regards to RNA levels and protein expression.The results: "hypermethylation of a single gene, ENO2, may be associated with about 15 % ofautistic cases". All of the children with ENO2 hypermethylation had "significant language development disorder" which contrasted with the other children in the autism group who "had more or less spoken language" although I didn't note any specific language measure to be used in this trial. ENO2 RNA levels were "reduced by about 70% relative to that in controls" and ENO2 protein expression in the hypermethylated group "was about half of that of controls".Ergo, "ENO2 expression may be a biomarker for a subset of autistic children".OK first things first, CpG sites and DNA. Imagine if you will, that in amongst the very complicated genetic blueprint which guides things like eye colour or whether you've inherited that magnificent nose from dad or mum, there are islands of DNA which contain a particular sequence separated by phosphate: cytosine - phosphate - guanine (CpG). The cytsosine part of the CpG site can be methylated - the addition of a methyl group - to form 5-methylcytosine; methylation in this respect generally taken to mean gene silencing or at least a reduction in gene function which can then lead to decreased gene transcription and onwards less protein expression.The Wang results basically plotted how from looking at the methylation status of the genome, a specific candidate gene showing something like a distinct methylation pattern in some cases of autism was followed through to see how said methylation affects gene function. It goes without saying that this was a very preliminary study and judging by the participant numbers needed in more traditional studies looking at structural changes to the genome (SNPs, CNVs et al) replication on a much grander scale (and looking at specific tissues) is absolutely implied before anyone gets too carried away. That also it's most probably autisms over autism together with the the principles of RDoC are other issues to be kept in mind.Still, I don't want to take anything away from the Wang results and what they 'could' potentially mean in light of other research in this area. Whether or not ENO2 survives future replicative studies is to some extent secondary to the question of why this gene was hypermethylated in the first place? Does this suggest a role for some of the DNA methyltransferases in relation to autism? What about the mechanisms of methyl donation and the functions of things like S-Adenosyl methionine (SAMe) in that process? Lots of different layers of complexity to be added to our knowledge of the genome.Music to close. Coldplay and Magic...---------- Wang Y. et al. Hypermethylation of the enolase gene (ENO2) in autism. Eur J Pediatr. 2014 Apr 17.----------Wang Y, Fang Y, Zhang F, Xu M, Zhang J, Yan J, Ju W, Brown WT, & Zhong N (2014). Hypermethylation of the enolase gene (ENO2) in autism. European journal of pediatrics PMID: 24737292... Read more »
Wang Y, Fang Y, Zhang F, Xu M, Zhang J, Yan J, Ju W, Brown WT, & Zhong N. (2014) Hypermethylation of the enolase gene (ENO2) in autism. European journal of pediatrics. PMID: 24737292
There have been a few different things linked to children who fall under the Autism Spectrum Disorder. A combination of genetic and environmental factors, along with complications during pregnancy have been associated […]... Read more »
Shelton, J., Geraghty, E., Tancredi, D., Delwiche, L., Schmidt, R., Ritz, B., Hansen, R., & Hertz-Picciotto, I. (2014) Neurodevelopmental Disorders and Prenatal Residential Proximity to Agricultural Pesticides: The CHARGE Study. Environmental Health Perspectives. DOI: 10.1289/ehp.1307044
Electronic or e-cigarettes are a tobacco cigarette alternative that is growing in popularity.Proponents of e-cigarettes note the product contains no carbon monoxide, tar or other tobacco residue. The inhaled vapor in e-cigarettes is primarily nicotine.Additionally, some proponents of e-cigarettes declare the product is associated with reduction or cessation of tobacco-based cigarette use.Unfortunately, this is an area where public health trends come before scientific research data is collected. Few studies of the safety and effectiveness of e-cigarettes in smoking cessation have been published.One large study of electronic cigarettes and smoking cessation was completed and recently published in the journal Lancet.In this study, 657 smokers who wanted to quit were randomized one of three interventions: 16 mg nicotine e-cigarettes, 21 mg nicotine patches or placebo e-cigarette (nicotine free). Abstinence from cigarettes was verified by low concentrations of carbon monoxide.At the end of the study the cigarette abstinence rates for the three groups were:E-cigarettes: 7.3%Nicotine patch: 5.8%Placebo e-cigarettes: 4.1%These low rates of abstinence across all interventions were surprising to the researchers conducting the study. The overall low rates of abstinence reduced the statistical power of the study and no statistical difference across the three groups could be proven.Some smokers adopting e-cigarettes do not desire or intent to quit. In this group, a separate research question is what is the natural history of cigarette smoking in high-risk populations who start to use e-cigarettes?One small study looking at this question has been published in a group of 14 smokers with schizophrenia.In this study, smoking subjects were allowed to use ad lib an e-cigarette product. Subjects kept a diary of the number of tobacco cigarettes smoked.The results of this study found 2 of the 14 subjects quit tobacco cigarettes over the year long course of the study. An additional seven subjects reduced the number of cigarettes smoked by 50% or more by the end of the study. No adverse effects on schizophrenia symptoms levels were noted by participation in this study.With such a limited research database, it is really too early to make a recommendation about e-cigarettes as a tool for smoking cessation.There are quite a few studies in the pipeline that should inform smokers and clinicians. A query using the search term e-cigarette at the clinicaltrials.gov website produced 27 research study listings. Readers can access this list here.Readers with more interest in the two studies summarized here can access the abstracts and free full-text (schizophrenia study only) in the citations below.Photo of skimmer birds at sunset on South Padre Island, TX is from the author's files.Follow the author on Twitter at: WRY999Bullen, C., Howe, C., Laugesen, M., McRobbie, H., Parag, V., Williman, J., & Walker, N. (2013). Electronic cigarettes for smoking cessation: a randomised controlled trial The Lancet, 382 (9905), 1629-1637 DOI: 10.1016/S0140-6736(13)61842-5Caponnetto P, Auditore R, Russo C, Cappello GC, & Polosa R (2013). Impact of an electronic cigarette on smoking reduction and cessation in schizophrenic smokers: a prospective 12-month pilot study. International journal of environmental research and public health, 10 (2), 446-61 PMID: 23358230... Read more »
Bullen, C., Howe, C., Laugesen, M., McRobbie, H., Parag, V., Williman, J., & Walker, N. (2013) Electronic cigarettes for smoking cessation: a randomised controlled trial. The Lancet, 382(9905), 1629-1637. DOI: 10.1016/S0140-6736(13)61842-5
Caponnetto P, Auditore R, Russo C, Cappello GC, & Polosa R. (2013) Impact of an electronic cigarette on smoking reduction and cessation in schizophrenic smokers: a prospective 12-month pilot study. International journal of environmental research and public health, 10(2), 446-61. PMID: 23358230
Macrophages are important immune cells which regulate inflammation, host defense and also act as a 'clean-up crew'. They recognize, kill and engulf bacteria as well as cellular debris, which is generated during an acute infection or inflammation. As such, they are present in nearly all tissues of the body, engaging in 24/7 surveillance. Some macrophages in a tissue are derived from circulating blood monocytes which migrate into the tissue and become "phagocytic" - acquire to ability to "eat". Other macrophage types permanently reside within a tissue such as peritoneal macrophages in the abdomen or microglia in the brain. Macrophages constitute a highly diverse population of cells. For example, their tissue localization determines what genes are turned on in any given macrophage type and how they will function. One of the most important recent developments in macrophage biology and immunology has been the realization that tissue macrophages can be broadly divided into at least two very distinct subsets: M1 and M2.... Read more »
Okabe Y, & Medzhitov R. (2014) Tissue-specific signals control reversible program of localization and functional polarization of macrophages. Cell, 157(4), 832-44. PMID: 24792964
We read this week that ‘Black Box’ Warning on Antidepressants Raised Suicide Attempts A so-called “black box” warning on antidepressants that the medications increase the risk of suicidal thinking and behavior in kids may have had a horrible side-effect. New research finds the warning backfired, causing an increase in suicide attempts by teens and young […]The post The FDA’s Antidepressant Warning Didn’t Really “Backfire” appeared first on Neuroskeptic.... Read more »
Lu CY, Zhang F, Lakoma MD, Madden JM, Rusinak D, Penfold RB, Simon G, Ahmedani BK, Clarke G, Hunkeler EM.... (2014) Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study. BMJ (Clinical research ed.). PMID: 24942789
New national lab research has found a specific quantum dot structure optimized for multiexciton generation, an exciting new lead for improved solar cell efficiency.... Read more »
Cirloganu CM, Padilha LA, Lin Q, Makarov NS, Velizhanin KA, Luo H, Robel I, Pietryga JM, & Klimov VI. (2014) Enhanced carrier multiplication in engineered quasi-type-II quantum dots. Nature communications, 4148. PMID: 24938462
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