Saturday, October 1, 2011

Last week, Nature Genetics carried twin studies into the genetics of bipolar disorder and schizophrenia. This special report examines the month’s research into the illnesses in detail, with Wikinews obtaining comment from experts based in Australia, the United States, and the United Kingdom ahead of the U.S. Mental Illness Awareness Week, which starts tomorrow.

Eleven genetic regions were identified; seven of these were for schizophrenia and five of those were hitherto undiscovered. The parallel studies, conducted separately, examined more than 50,000 people worldwide and identified two genetic loci associated with both diseases.

Little is known about the two illnesses, each of which affects around 1% of people and is treated with strong medication. Bipolar sufferers experience extremes of mood – depression and mania, hence the previous name “manic depression” for the illness. Schizophrenia is associated with hearing voices, chaotic thoughts, and paranoia. There is no known cure.

The latest research examined both the healthy and the afflicted, using computers to scan genomes. Inheritance was thought to be a factor from prior knowledge of the diseases as a familial trait, but the original desire had been to isolate a single faulty gene. Instead it has become apparent that the genetic factors are many; in the case of schizophrenia, at most around 30% of the genetic components are thought to have been identified.

The University of Chicago’s Pablo Gejman, a lead researcher on the schizophrenia study, explained to Wikinews in a telephone interview from Buenos Aires, Argentina that “One of the goals of genetic research is to find druggable targets” – to “find treatments at the root of the problem”.

Whilst noting that there is no guarantee the genetic code identified is druggable, Gejman named calcium-activated neurochemical channels in the brain as candidates for new drugs. The channels were linked to schizophrenia in the study.

Gejman explained that a genetic locus called mir137 “suggests an abnormality of gene regulation.” The diseases are so poorly understood that it is uncertain if they are in fact two components of a single spectrum, or even each comprised of multiple illnesses.

The new and “provocative data” gathered showed the significant loci identified were “not part of the pre-existent hypothesis.” Calling this “interesting”, Gejman added that the team found no evidence that dopamine receptors are involved; current drug treatments target dopamine receptors. The findings are “not related to anything we thought we knew [about schizophrenia],” he told our correspondent.

Quizzed about the possibility variations in the genetic factors involved in expressing the diseases explained the variation seen in symptoms, Gejman was uncertain. “We will have the answer, probably, only when we sequence the whole [human] genome.” He notes that the relationship between genotype and phenotype is unclear, and that “We know very little of the genetic architecture of schizophrenia and” other disorders.At the time the results were published, participating scientist Professor Rodney Scott from the University of Newcastle in Australia said “The strength of this research is in the numbers. The findings are robust and give us a lot of statistical power to identify the genetic determinants of schizophrenia.” Scott told Wikinews that “If any single centre tried to undertake such a study, it would require millions of pounds. Since it was a collection of data from across the world the costs were spread. In this era of financial difficulty it will become increasingly difficult to secure funding for this type of project even though the pay-offs will be significant.”

Gejman expressed similar sentiment. “The research budget is not growing, which makes [funding] difficult,” he said, though he felt the cost “is not prohibitive because of the benefits.” “I think that it was money well invested” and “very well spent for the future,” he said, adding that organisations in Europe and the US were aware of the importance of such research.

Gejman also agreed on reliability – the study is “Very reliable because of the sample size; that should provide robust results… [we] have worked with a much larger sample than before.” Scott told us it was “a highly reliable study” that has the potential to lead to new treatments “in the long run”.

Another point was the two genetic loci identified as common to both – how much support do they lend to the notion the diseases are linked? “Until more information is available it is really only suggestive,” says Scott. “Strong enough to say there may be potentially a common pathway that bifurcates to give rise to two diseases.”

“It is an excellent demonstration,” said Gejman “because you have the same chains that are common to both disorders, in fact not just the same chains but also the same alleles.” He stressed uncertainty in how strong the relationship was, however.

Scott said examining how the variation of genetic factors may translate into varied symptoms being expressed “certainly is a good target for future research”; “It is not known how many genetic factors contribute to either of these diseases but it is likely that not all are necessary to trigger disease.” “New questions will always arise from any major study,” he told our reporter. “Certainly, new questions about bipolar and schizophrenia are now able to be formulated on the basis of the results presented in the two reports.”

These weren’t the only studies to look at the two diseases together in September. The British Medical Journal carried research by a team from the University of Oxford and King’s College London that examined mortality rates in England for schizophrenia and bipolar sufferers. They found both groups continued to suffer higher mortality rates than the general population – whilst these included suicides, three quarters of deaths were down to ailments such a s heart conditions. General death rates dropped from 1999 to 2006, but sufferers below 65 saw their death rate remain stable – and the over-65 saw theirs increase.

“By 2006, the excess risk in these groups had risk to twice the rate of the general population, whereas prior to that it had only been 1.6 times the risk, so it increased by almost 40%,” said Dr Uy Hoang of Oxford. The study looked at every discharged inpatient with a diagnosis of either condition in England in the relevant time.

Hoang said at the time of the research’s release that doctors should devote attention to predicting and preventing physical illness associated with mental disorders. His study comes at a time when the UK has launched a “no health without mental health” strategy which does attempt to screen for physical illnesses coinciding with mental illnesses. The government aims to reduce the death rate of those with mental disorders.

Rodney Scott described this research result to Wikinews as “Possibly” connected to genetic association with other hereditary ailments, such as cardiovascular disease; he told us another possibility is that “The continued raised mortality rates may be associated with the diseases themselves.”

“We believe the NHS [National Health Service] and Department of Health need to do more to support research and service development for people with bipolar disorder,” Wikinews was told by Suzanne Hudson, Chief Executive of London-based British charity MDF The Bipolar Organisation. “The provision of specialist services for bipolar is very limited in the UK and the demand for our services is unprecedented.”

“A genetic test for bipolar would be a useful tool but the science and ethics are very complex,” Hudson told us, referring to the Nature Genetics genetic study. “Just because someone has ‘bipolar genes’ does not mean they might go on to develop it. Family studies of bipolar show that this is a likely outcome of genetics research in this area. Even if it were possible to accurately predict bipolar in this way, questions about how you treat that person are difficult. For example do you start medication that is not necessary at that point in time?”

“Current treatment is not satisfactory” because it does not always work and has “side effects,” Gejman told us. Robert Whitaker, a US medical journalist and book author, told an audience in New Zealand at the end of August that evidence suggests antidepressant drugs may make children and teenagers worse – “You see many become worse and end up with a more severe diagnosis, like bipolar illness,” and the suicide risk may increase.

Whitaker blames commercial interests. “The adult market appeared saturated, and so they began eying children and teenagers. Prior to this, few children and youth were seen as suffering from major depression, and so few were prescribed anti-depressants.”

One possible alternative, raised by a connection between depressive illness and inflammation, is aspirin and similar compounds. “The link between inflammation and mood disorders has been known for sometime and the use of aspirin and other drugs in depression is now becoming more common in the literature,” Hudson says. “Any new treatments for bipolar, which is a very complex and co-morbid illness, has to be a good thing.”

Professor Dr. Michael Berk, chairman of psychiatry at Australia’s Deakin University, recently gave a talk to just this effect. Speaking at this year’s Congress of the European College of Neuropsychopharmacology, held this past month, he also highlighted statins as a treatment. Recognising the link to physical ailments, he told an interviewer “The brain does not exist in isolation, and we need to understand that pathways similar to those that underpin risks for cardiovascular disorders, stroke, and osteoporosis might also underpin the risk for psychiatric disorders, and that other treatments might be helpful.”

Berk also touched upon speed of diagnosis and treatment; “Early interventions can potentially improve the outcome” of bipolar sufferers, he told his audience. MDF The Bipolar Organisation claim an average of ten years is possible before a person is diagnosed. “This clearly is an issue, if we believe that earlier diagnosis and treatment facilitate better outcomes,” Berk told Wikinews. Though he questions the effectiveness of currently-used drugs on advanced bipolar cases, he does not go so far as to say drugs are actively harmful. He told us “it appears that our best treatments work best earlier in the illness course; and that seems to apply to psychotherapy and pharmacotherapy.”

Berk has already performed research using statins which suggests they can form a treatment. He now seeks funding for research involving aspirin. On funding, he tells Wikinews “psychiatric disorders comprise between 16% and 22% of the burden of disability (depending on who measures it), attracts^[sic] just over 6% of the clinical budget at least in Australia and 3% of the research budget. Research as a discretionary spending item is at great risk.”

Berk’s research, in the past, has been funded by companies including GlaxoSmithKline. Hudson told Wikinews this did not concern her charity; in fact, they welcomed it. “We believe it is important pharmaceutical companies continue to invest in the development of new medications for bipolar. This is how it works in all other health specialities and mental health should be no different.”

“There is a need for greater education for mental health professionals and GPs [general practitioners] about bipolar [in the UK],” she told us. “As the national bipolar charity we receive many, many calls and requests from GPs and other health professionals for our leaflets and information sheets which is fantastic. We very much welcome opportunities to work together for the benefit of individuals affected by bipolar.”

Wikinews contacted the UK’s National Institute for Clinical Excellence (NICE) to discuss issues raised in this article, including future treatments, genetic screening, and mortality rates. NICE did not respond.

Might statins and/or aspirin improve treatment – might they be cheaper, perhaps, or safer? “This is an area of research promise,” says Berk, “however it is too early to make any clinical treatment claims; [all] we can say is that this needs to be studied in properly designed trials capable of giving a more definitive answer.” And what of possible explanations for the increased mortality rate observed in England? Should researchers look at whether bipolar influences more than just the brain, or if it is linked to other genetic conditions?

“For sure,” he told us. “There is new evidence that similar pathways contribute to the risk for both medical and psychiatric illness, both in terms of lifestyle factors, and biomarkers of risk.”

Saturday, December 6, 2008

The Panamanian-flagged cruise ship MV Ushuaia, operated by Antarpply Expeditions of Argentina, ran aground near Cape Anna at the entrance to Wilhelmina Bay. Having been stuck on rocks in the Antarctic Peninsula, it suffered a puncture in two diesel fuel tanks, and was leaking fuel and taking on a “minimal amount of water.” It had two cracks, but is not in danger of sinking.

The passengers were rescued by Achiles, a Chilean Navy ship, which took them to Chile’s Base Presidente Eduardo Frei Montalva in Antarctica. The station has a 1300 metre-long airstrip which can facilitate airlifts for the passengers. They will be taken by a Hercules C-130 plane to the Port of Ushuaia, from which they can be flown back to South America.

Argentine Admiral Daniel Martin Alberto said that the 89 passengers onboard were all in good health. Argentina and Chile are both sending a rescue mission to the stricken ship, with 40 crew members. The Antarctic Dream, at seven nautical miles away, was reported to have changed course to collect and transfer passengers to Tierra del Fuego. However, the Chilean Navy got to Ushuaia first.

The Australian Antarctic Division announced that “as well as the New Zealander, there were 11 Australians, 12 Americans, 14 Dutch, nine Germans, seven Britons, six Chinese, six Spaniards, five Swiss, three Italians, two Irish, two French, two Canadians, a Cypriot and a Belgian. The crew consisted of 28 Argentinians, eight Chileans, three Uruguayans, and one Spaniard.”

Meanwhile, Jon Bowermaster, a writer aboard the National Geographic Explorer, described the situation: “We had hurricane winds yesterday — 103 miles per hour (166 kilometres per hour) and gusting — which may have contributed to the grounding.”

Although there is no major leak, containment efforts are being made by Chilean navy ship Lautaro to stem the fuel leak, which has spread for half a mile around the stranded ship. Salvaging the ship, however, was proving more of a problem.

Sunday, October 7, 2007

Shona Bracken is running for the Communist Party in the Ontario provincial election in Toronto—Danforth. Wikinews interviewed her regarding her values, her experience, and her campaign.

Thursday, August 4, 2011

The small African nation of Swaziland will receive a financial bailout from neighbouring South Africa. The South African government agreed to a loan of 2.4 billion rand ($350 million) after several organisations including the International Monetary Fund (IMF) rejected King Mswati III’s request for a bailout.

King Mswati III released a statement about the bailout saying, “We are thankful and also appreciate the assistance we have received from South Africa. This shows that they are good neighbours.” He added “But it must be stressed that this is not a gift but a loan, which naturally should be repaid. This is why every Swazi must play his or her role by working hard wherever he is to ensure that the country gets back to its feet the soonest.”

The King has been criticized for living with 13 wives in luxury while the majority of his country lives in poverty.

Despite the South African government’s agreement, the bailout has been met with some concern. The opposition in South Africa said that the government should reject the loan as Swaziland is an “undemocratic state”. However, the government has said that the bailout would bring stability to the state and surrounding region.

The loan is expected to help Swaziland, which is going through a financial crisis. The nation has reportedly been unable to pay some of its civil servants and could not afford antiretroviral drugs to treat HIV. Swaziland has the highest rate of HIV infection in the world.

Earlier this year, the country saw a wave of protests and demonstrations related to the economic situation.

Thursday, December 20, 2007

Wikinews reporter David Shankbone is currently, courtesy of the Israeli government and friends, visiting Israel. This is a first-hand account of his experiences and may — as a result — not fully comply with Wikinews’ neutrality policy. Please note this is a journalism experiment for Wikinews and put constructive criticism on the collaboration page.

Dr. Yossi Vardi is known as Israel’s ‘Father of the Entrepreneur’, and he has many children in the form of technology companies he has helped to incubate in Tel Aviv‘s booming Internet sector. At the offices of Superna, one such company, he introduced a whirlwind of presentations from his baby incubators to a group of journalists. What stuck most in my head was when Vardi said, “What is important is not the technology, but the talent.” Perhaps because he repeated this after each young Internet entrepreneur showed us his or her latest creation under Vardi’s tutelage. I had a sense of déjà vu from this mantra. A casual reader of the newspapers during the Dot.com boom will remember a glut of stories that could be called “The Rise of the Failure”; people whose technology companies had collapsed were suddenly hot commodities to start up new companies. This seemingly paradoxical thinking was talked about as new back then; but even Thomas Edison—the Father of Invention—is oft-quoted for saying, “I have not failed. I have just found ten thousand ways that won’t work.”

Vardi’s focus on encouraging his brood of talent regardless of the practicalities stuck out to me because of a recent pair of “dueling studies” The New York Times has printed. These are the sort of studies that confuse parents on how to raise their kids. The first, by Carol Dweck at Stanford University, came to the conclusion that children who are not praised for their efforts, regardless of the outcome’s success, rarely attempt more challenging and complex pursuits. According to Dweck’s study, when a child knows that they will receive praise for being right instead of for tackling difficult problems, even if they fail, they will simply elect to take on easy tasks in which they are assured of finding the solution.

Only one month earlier the Times produced another story for parents to agonize over, this time based on a study from the Brookings Institution, entitled “Are Kids Getting Too Much Praise?” Unlike Dweck’s clinical study, Brookings drew conclusions from statistical data that could be influenced by a variety of factors (since there was no clinical control). The study found American kids are far more confident that they have done well than their Korean counterparts, even when the inverse is true. The Times adds in the words of a Harvard faculty psychologist who intoned, “Self-esteem is based on real accomplishments. It’s all about letting kids shine in a realistic way.” But this is not the first time the self-esteem generation’s proponents have been criticized.

Vardi clearly would find himself encouraged by Dweck’s study, though, based upon how often he seemed to ask us to keep our eyes on the people more than the products. That’s not to say he has not found his latest ICQ, though only time—and consumers—will tell.

For a Web 2.User like myself, I was most fascinated by Fixya, a site that, like Wikipedia, exists on the free work of people with knowledge. Fixya is a tech support site where people who are having problems with equipment ask a question and it is answered by registered “experts.” These experts are the equivalent of Wikipedia’s editors: they are self-ordained purveyors of solutions. But instead of solving a mystery of knowledge a reader has in their head, these experts solve a problem related to something you have bought and do not understand. From baby cribs to cellular phones, over 500,000 products are “supported” on Fixya’s website. The Fixya business model relies upon the good will of its experts to want to help other people through the ever-expanding world of consumer appliances. But it is different from Wikipedia in two important ways. First, Fixya is for-profit. The altruistic exchange of information is somewhat dampened by the knowledge that somebody, somewhere, is profiting from whatever you give. Second, with Wikipedia it is very easy for a person to type in a few sentences about a subject on an article about the Toshiba Satellite laptop, but to answer technical problems a person is experiencing seems like a different realm. But is it? “It’s a beautiful thing. People really want to help other people,” said the presenter, who marveled at the community that has already developed on Fixya. “Another difference from Wikipedia is that we have a premium content version of the site.” Their premium site is where they envision making their money. Customers with a problem will assign a dollar amount based upon how badly they need an answer to a question, and the expert-editors of Fixya will share in the payment for the resolved issue. Like Wikipedia, reputation is paramount to Fixya’s experts. Whereas Wikipedia editors are judged by how they are perceived in the Wiki community, the amount of barnstars they receive and by the value of their contributions, Fixya’s customers rate its experts based upon the usefulness of their advice. The site is currently working on offering extended warranties with some manufacturers, although it was not clear how that would work on a site that functioned on the work of any expert.

Another collaborative effort product presented to us was YouFig, which is software designed to allow a group of people to collaborate on work product. This is not a new idea, although may web-based products have generally fallen flat. The idea is that people who are working on a multi-media project can combine efforts to create a final product. They envision their initial market to be academia, but one could see the product stretching to fields such as law, where large litigation projects with high-level of collaboration on both document creation and media presentation; in business, where software aimed at product development has generally not lived up to its promises; and in the science and engineering fields, where multi-media collaboration is quickly becoming not only the norm, but a necessity.

For the popular consumer market, Superna, whose offices hosted our meeting, demonstrated their cost-saving vision for the Smart Home (SH). Current SH systems require a large, expensive server in order to coordinate all the electronic appliances in today’s air-conditioned, lit and entertainment-saturated house. Such coordinating servers can cost upwards of US$5,000, whereas Superna’s software can turn a US$1,000 hand-held tablet PC into household remote control.

There were a few start-ups where Vardi’s fatherly mentoring seemed more at play than long-term practical business modeling. In the hot market of WiFi products, WeFi is software that will allow groups of users, such as friends, share knowledge about the location of free Internet WiFi access, and also provide codes and keys for certain hot spots, with access provided only to the trusted users within a group. The mock-up that was shown to us had a Google Maps-esque city block that had green points to the known hot spots that are available either for free (such as those owned by good Samaritans who do not secure their WiFi access) or for pay, with access information provided for that location. I saw two long-term problems: first, WiMAX, which is able to provide Internet access to people for miles within its range. There is already discussion all over the Internet as to whether this technology will eventually make WiFi obsolete, negating the need to find “hot spots” for a group of friends. Taiwan is already testing an island-wide WiMAX project. The second problem is if good Samaritans are more easily located, instead of just happened-upon, how many will keep their WiFi access free? It has already become more difficult to find people willing to contribute to free Internet. Even in Tel Aviv, and elsewhere, I have come across several secure wireless users who named their network “Fuck Off” in an in-your-face message to freeloaders.

Another child of Vardi’s that the Brookings Institution might say was over-praised for self-esteem but lacking real accomplishment is AtlasCT, although reportedly Nokia offered to pay US$8.1 million for the software, which they turned down. It is again a map-based software that allows user-generated photographs to be uploaded to personalized street maps that they can share with friends, students, colleagues or whomever else wants to view a person’s slideshow from their vacation to Paris (“Dude, go to the icon over Boulevard Montmartre and you’ll see this girl I thought was hot outside the Hard Rock Cafe!”) Aside from the idea that many people probably have little interest in looking at the photo journey of someone they know (“You can see how I traced the steps of Jesus in the Galilee“), it is also easy to imagine Google coming out with its own freeware that would instantly trump this program. Although one can see an e-classroom in architecture employing such software to allow students to take a walking tour through Rome, its desirability may be limited.

Whether Vardi is a smart parent for his encouragement, or in fact propping up laggards, is something only time will tell him as he attempts to bring these products of his children to market. The look of awe that came across each company’s representative whenever he entered the room provided the answer to the question of Who’s your daddy?