Synopsis: 5. medicine & health:


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California in clean-fuel drive: Nature Newsthe state of California has adopted regulations to curb greenhouse-gas emissions from transportation fuels,


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Nature News caught up with Whitty, a clinical epidemiologist at the London School of Hygiene & Tropical Medicine, to find out more about the department's ambitious five-year research strategy.

With your background of clinical research on malaria and other tropical diseases, what do you think you will bring to the job?

and have a major impact in reducing poverty and diseases that kill people, and improving nutrition, we have to have a much stronger research base.

Health and sustainable agriculture have historically been areas that DFID has had a big interest in and we intend to continue that,

In all of the five areas we're interested in health sustainable agriculture, climate change, growth and governance we're increasing our spend.

What sort of research will DFID's health programme support? Our job is to improve the lives of people in developing countries.

so fundamental research into diseases of poverty is extremely important, but is not our particular area of interest.

for example we invest heavily in public-private partnerships for developing new drugs, new diagnostic techniques, new vaccines.

We also do quite a lot on health-systems research because we recognize that for most diseases in Africa and Asia,

for example malaria, every case could be cured with existing drugs, yet most people don't get them.

There's a researchable question in why 70%of the people who need the drugs for malaria don't get them.

What does governance research involve? It's a massive area, but to take an example,

How does a clinical malaria researcher oversee social-policy research? I think one of the reasons that DFID asked me to do this job is that

a new antimalarial was launched as a licensed drug recently. It was a paediatric version of artemether-lumefantrine,


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but could also pose an infection risk. Researchers have used also the genome sequence to assemble a collection of more than 37,000 locations in the genome that contain frequent single-base changes in DNA sequence2.

and much more diverse than dogs, says Kim Worley, a genome researcher at the Baylor College of Medicine in Houston, Texas,

Genetic markers will help breeders to improve the health of their herds as well as the quality

estimates Van tassel. The new sequence also shows that the human genome is more similar to the genome of cattle than to mice suggesting that, for some diseases,

In the past, work on cattle led to the development of the smallpox vaccine and in vitro fertilization techniques.


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Nature Newsthe US Environmental protection agency (EPA) today declared greenhouse gases a threat to public health and welfare, a move that gives the Obama administration broad powers to regulate greenhouse gases without going through Congress.

The document specifically cited greenhouse gas emissions from vehicles as a danger to public health. California Democrat Barbara Boxer, who handles climate regulation in the Senate as chairwoman of the Environment and Public works Committee


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widely thought to state that the greenhouse gases are pollutants endangering the public's health.


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and collide, the crust fractures and these clathrates release gases, which carry up ice particles with them to form the icy plumes.


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Patchy pig monitoring may hide flu threat: Nature Newspublic-health experts are warning that a lack of surveillance may be allowing the 2009 pandemic H1n1 flu virus to go undetected in pigs.

This raises the risk that the virus could circulate freely between humans and pigs, making it more likely to reassort into a deadlier strain,

they say. Pig surveillance is largely the remit of animal health organizations, agriculture ministries and the farming industry.

Their main concern tends to be that any reports of the pandemic virus in pigs might provoke overreactions such as the mass culling of pigs that took place in Egypt

Within minutes of the World health organization (WHO) announcement on 11 june that swine flu had become a pandemic, Bernard Vallat, director-general of an intergovernmental trade body,

So far the role of animals has not been demonstrated in the virus's epidemiology or spread,

But some experts say that is an artefact of patchy to nonexistent flu surveillance in pigs.

2009), Gavin Smith, a flu geneticist at the University of Hong kong, and his colleagues concluded that the lack of systematic swine surveillance allowed for the undetected persistence and evolution of this potentially pandemic strain for many years.

The virus originated from a mixture of swine flu strains, and pigs are an obvious part of the epidemiology of the new virus,

says Smith. Yet the number of swine-flu sequences in the international Genbank database is about a tenth of that for avian flu viruses.

Circulation of the virus between pigs and humans is definitely a possibility he adds. The pandemic virus has so far been found in pigs from just one farm, in Alberta, Canada,

where it spread throughout the herd. But noone has been able to pin down how the herd became infected.

Scientists at the Veterinary Laboratories Agency in Weybridge, UK, have shown that pigs can easily become infected with the virus,

Past pandemic viruses have gone also on to become endemic in pig populations. It's absolutely surprising that a virus this contagious in both humans and swine

and a member of the organization's flu task force. It is highly likely that more pigs are infected in more places.

Absence of evidence of the pandemic virus in pig populations is not evidence of absence,

concedes Steve Edwards, chairman of the OIE-FAO Network of Expertise on Animal Influenza (OFFLU),

which coordinates work done by animal-flu surveillance labs worldwide, and former chief executive of the Veterinary Laboratories Agency.

Whereas flu surveillance has improved over the past six years in poultry and wild birds, pigs have been below the radar,

says Ilaria Capua, an animal-flu expert at the Experimental Animal health Care Institute of Venice in Legnaro, Italy.

The avian H5n1 flu virus leads to serious disease in poultry and causes huge economic losses,

flu viruses, although common, tend to cause only mild disease, so there is no obligation to report cases of swine flu,

much less take samples for genetic and antigenic analysis. The OIE has asked, however its member states to voluntarily report any occurrences of the 2009 pandemic virus in pigs.

Surveillance for swine flu is not something that has been high on the agenda of government services,

says Edwards. It is seen as a farming-industry problem. Most flu surveillance in pigs is passive,

relying on farmers or vets sending material to government labs. Active targeted surveillance with diagnostic tests is rarer,

as it is more expensive. OFFLU has called on labs worldwide to share what information they have on swine flu,

and to sequence any samples they have obtained recently. So far, however, the response has been limited, says Edwards. A meeting between experts from OFFLU

and THE WHO on 21 may the conclusions of which were made public last week recommended scaling up flu surveillance efforts in pigs,

The European Surveillance Network for Influenza in Pigs, which was created in 2001, comprises nine European labs and one in Hong kong.

Network members hope that with the pandemic highlighting the need for better pig surveillance new funding will be forthcoming.

-and public-health communities underestimated the potential for pigs to generate a pandemic virus . Although pigs can be infected with many subtypes of flu,

the three most common endemic strains are H1n1, H1n2 and H3n2. Most expected that any new pandemic would involve the introduction of a viral subtype not previously seen in humans,

such as the avian H5 subtype, explains Capua. The consensus was that a pandemic could not be caused by H1,

H2 or H3 because the current human population would have antibodies against them, she says.

The emergence of the reassorted H1n1 pandemic virus which current research indicates noone has any immunity to, apart, perhaps,

from some people older than 60 has changed that thinking. Moreover, Nature has learned that the international community was warned of such a risk in a presentation at a closed meeting between the OIE, THE WHO and the Food and agriculture organization of the united nations in Paris in February.

In the presentation, the results of which are in press at the journal PLOS Pathogens, Capua showed that serum samples from people vaccinated against seasonal flu strains showed little or no cross reactivity against H1,

H2 and H3 bird viruses, meaning that they would have no immunity. This shows that the world needs a comprehensive surveillance system of all influenza subtypes

and their evolution across many animal species, says Capua: We should be looking at the bigger picture.


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Sexual gene shuffling suppressed in plants: Nature Newsusing a combination of three genetic mutations, plant researchers have disrupted the usual process of genetic shuffling during the formation of reproductive cells male pollen and female ova.


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and plant breeders who are searching for crops that can withstand the effects of climate change or emerging diseases.


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resistant to a variety of insects and diseases and able to withstand the vagaries of climate change,

Will increasing production put greater stress on the environment? No. If you doubled yields in Africa from one tonne to two tonnes per hectare, you would only need half the land


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Pandemic flu viruses brew for years before going global: Nature Newsfamily trees for pandemic influenza have revealed that components of deadly flu viruses probably lurk in humans

and other animals for years before they emerge as a worldwide threat to human health.

The work suggests that a more thorough characterization of circulating flu viruses could provide clues to an emerging pandemic before it hits.

According to results published this week in Proceedings of the National Academy of Sciences1, two genes from the 1918 influenza virus,

which killed an estimated 50 million people, would have been present in human and swine flu viruses at least 6 years earlier.

During the intervening years the authors of the work suggest, swine and human flu viruses would have swapped genes with avian viruses,

ultimately giving rise to the dangerous assortment of genes carried by the 1918 virus. This work suggests that the generation of pandemic strains

and the adaptation to humans could be involved much more than was thought previously, says Raul Rabadan, a biomedical informatician at Columbia University college of Physicians and Surgeons in New york,

who was involved not in the study. It reinforces the idea that systematic surveillance, not only in humans but in other mammalian and avian hosts,

is key to identifying possible pandemic strains and their future evolution. Yi Guan of the University of Hong kong, Robert Webster of St jude Children's Research Hospital in Memphis, Tennessee,

and their colleagues compiled the available data on known bird, swine and human flu viruses and created family trees based on DNA sequence information.

By estimating the amount of time it would take to accumulate the differences in DNA sequences found in human and swine viruses,

the researchers determined that a precursor to at least one 1918 flu gene was present in mammals before 1911.

The results run counter to previous hypotheses that the human 1918 flu strain had evolved directly from a bird flu virus2.

Instead, the new findings suggest that an avian strain entered pig and human populations, and then swapped genes with mammalian flu viruses before becoming a pandemic.

Meanwhile, elements of the 1957 pandemic flu virus also thought to be a mosaic of human

and avian flu genes were introduced probably into human populations two to six years before the pandemic, the researchers found.

These analyses were completed before the current pandemic swine flu strain made its mark, but the researchers argue that their results have implications for future pandemics.

Results from 1918 and 1957 pandemic flu suggest that public-health authorities should track the sequences of all influenza virus genes in emerging strains

the authors argue, rather than focusing largely on the gene that encodes the haemagglutinin'protein,

which is critical for vaccine production, as is the current practice. Nevertheless, reliance upon patchy data from historical flu viruses has its limitations.

Michael Worobey, who studies pathogen evolution at the University of Arizona in Tucson, says that his own analyses have suggested also that human

and swine forms of H1n1 shared a common ancestor years before 1918. But he remains unconvinced by the series of genetic swaps proposed by the paper.

Using different assumptions, you can get very different results, he says. We can't say much for certain about these events given the current data.


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Swine flu shares some features with 1918 pandemic: Nature Newsas far as your immune system is concerned, the pandemic H1n1 (swine flu virus currently circling the globe bears an uncanny resemblance to an influenza virus that wreaked havoc nearly a century ago,

researchers have found. For months, it has been apparent that swine flu strikes the young more often than the old an unusual pattern that suggests older patients could have been exposed to similar viruses in the past.

A new study released today By nature suggests that people alive during the infamous 1918 influenza outbreak have the greatest protection against the current swine flu1.

The study also included experiments in a veritable menagerie of animals including mice, miniature pigs, ferrets and macaques.

In all but the pig, the virus yields an infection in the lungs that is more severe than would be expected from an average seasonal flu, according to Yoshihiro Kawaoka of the University of Wisconsin-Madison and his colleagues,

Kawaoka's team also confirmed that some commercially available antiviral drugs, including oseltamivir (marketed by Roche as Tamiflu)

and zanamivir (marketed by Glaxosmithkline as Relenza), are effective against the new pandemic virus in human cells grown in the lab. These drugs are already being used to treat some infected patients.

Meanwhile Kawaoka's studies generally echo the findings of two Science papers released last week,

which reported that swine flu reproduces more aggressively and produces more severe disease in ferrets than seasonal flu (see Swine flu reaches into the lungs and gut).

Kawaoka's team observed this virulence in mice and macaques as well, but pigs showed no outward signs of disease

even though the virus reproduced capably in the swine respiratory system. This, the authors suggest, could explain why farmers have not reported an outbreak of sick pigs.

The animal studies used higher doses of virus than humans would normally encounter a practice that is common for such experiments.

Nevertheless, one alarming feature of the macaque results was the development of severe pneumonia that extended throughout the lungs, notes Earl Brown, a virologist at the University of Ottawa.

Pneumonias are localized normally more he says. When you start to hit all areas of the lungs severely,

and found that those born before 1918 were more likely to produce antibodies capable of neutralizing the swine flu virus. That protection is somewhat counterintuitive:

But it is still possible that the immune response elicited by one virus can offer protection against the other (see Old seasonal flu antibodies target swine flu virus). Oddly,

exposure to similar viruses that circulated from the 1920s to 1950s was not enough to elicit these antibodies a result that doesn't mesh with the lower infection rates among those who are over the age of 60

One possible explanation is that antibodies that are not able to fully neutralize a virus can

nevertheless offer some protection against infection, Brown says. At present, most swine flu infections are mild, and the severity of the present pandemic does not come close to the 1918 flu,

but experts worry that the new virus could become more virulent over time. Meanwhile, the virulence seen in the animal studies is disquieting,

says Brown. We're trying not to push the panic buttons, but we're trying to be realistic,


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Pests could overcome GM cotton toxins: Nature Newslaboratory studies suggest that it may be possible for insects to overcome two disparate toxins produced by genetically modified cotton.

The results strike a cautionary note at a time when developers are racing to create crops that produce many different pesticides.

Insects can become resistant to individual insecticides in much the same way as bacteria develop resistance to antibiotics.

and create crops that produce multiple toxins that target the same pest. This is the current trend of all the companies,

One of the most common'pyramided'crops on the market is cotton that produces two different'Bt'toxins made naturally by the bacterium Bacillus thuringensis.

The two toxic proteins, Cry1ac and Cry2ab have very different amino-acid sequences and bind to different target sites.

As a result, mutations that confer resistance to both toxins were thought to be unlikely, says Bruce Tabashnik, an entomologist at the University of Arizona in Tucson.

The main way that insects become resistant is by altering the binding site of the toxin,

These two toxins don't bind to the same site if the insects altered the Cry1ac binding site,

so the team raised a number of different laboratory strains of pink bollworms on a diet that contained the toxin.

Although the binding sites of the two toxins differ, both toxins are activated via the same pathway in the insect.

A change in the protease responsible for activating the toxins could provide an avenue to cross-resistance,

Tabashnik says. Other changes in the insect's ability to cope with damaged cells could also play a part,

The results show that cross-resistance between the two toxins is possible. But this does not pose a threat for control by the current pyramided Bt cotton of this insect Tabashnik says.

The resistant pink bollworms were able to withstand high concentrations of both toxins in their diets,


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according to a study released by toxicologists. Industry may have to spend  9. 5 billion (US$13. 6 billion) on toxicity testing six times more than expected

and the number of animals used in the tests could rise by 20 times to 54 million.

Pandemic flu: People infected with the H1n1 swine flu virus who are otherwise healthy should not routinely be given antiviral drugs,

the World health organization (WHO) warned last week. Its recommendations are at odds with current practice in many countries,

where oseltamivir (Tamiflu) is given routinely out to all those suspected of having contracted H1n1. Although those with uncomplicated illness should not get oseltamivir or zanamivir (Relenza),

THE WHO did recommend giving drugs to those presenting with severe illness, to children under five and to pregnant women (see http://tiny. cc/WHOH1N1).

Renewable energy: On 20 august, Australia's parliament approved laws that require the country to produce 20%of its electricity from renewable sources by 2020 up from around 8%today.

the US Food and Drug Administration (FDA) halted plans for the world's first clinical trial of a therapy generated from human embryonic stem cells.

The product's manufacturer, Geron in Menlo Park, California, had hoped to start human testing of its potential treatment for spinal-cord injury this summer (see Nature 457,516;

and from investigations of the product's use for other neurodegenerative diseases. It added that it was working closely with the FDA to review the data.

Drug development: Eli lilly abandoned development of its osteoporosis drug arzoxifene, after results from an advanced clinical trial suggested it did not offer sufficient benefit over currently available treatments.

The company, headquartered in Indianapolis, Indiana, had hoped arzoxifene would be a successor to its blockbuster osteoporosis treatment raloxifene (Evista),

which will lose its patent protections by 2014. Meanwhile, Amgen, of Thousand Oaks, California, has received more positive news for its new-mode-of-action osteoporosis treatment, denosumab.

The monoclonal antibody gained recommendations from an advisory committee at the Food and Drug Administration on 14 august,

and awaits full approval. Business watch Despite the economic crisis countries are still installing solar capacity at a rapid rate,

as the cost of solar panels plummeted in the first half of 2009 (see also Nature 460,677;

Facilities Medical collaboration: The University of California, San diego (UCSD) and the Indian Institute of technology Kharagpur signed a pact last week to develop allied research, teaching and medical programmes.

The agreement also calls for a joint Indian-US medical centre in Kharagpur. India will fund the 300-bed facility,

with UCSD collaborating on clinical care and research. Researchers will study drug development, bioengineering and imaging technologies at the two campuses. The chance to test therapies on different populations makes the collaboration particularly attractive for physicians.

Isotope shortage: A nuclear reactor in Petten, The netherlands, that supplies radioactive isotopes for use in medical imaging reopened last week after a month's scheduled maintenance partly alleviating a global shortage of the isotopes (see Nature 460,312-313;

2009). ) But the reactor is due to shut down again next March for six months of repairs.

Canada's Chalk River, Ontario, reactor whose closure precipitated the isotope crisis will not reopen until 2010.

Tobacco regulation: Lawrence Deyton (pictured) was appointed to direct the new Center for Tobacco Products in Silver Spring, Maryland, part of the Food and Drug Administration (FDA.

Deyton, who will start his new job on 14 september, is a physician at George washington University's School of medicine and Health Sciences in WASHINGTON DC,

and a public health officer at the US Department of veterans affairs. He has led also research on allergy and infectious diseases at the National institutes of health.

The FDA won powers to regulate tobacco for the first time in its 103-year history under legislation passed by Congress in June (see Nature 459,901;

2009). ) Environment Mercury contamination: A quarter of fish sampled from 291 streams across the United states between 1998 and 2005 contained levels of mercury higher than those deemed safe for human consumption,

according to a non-peer-reviewed report from the US Geological Survey (USGS). More than two-thirds contained levels exceeding the Environmental protection agency's level of concern for the protection of fish-eating mammals,


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and fend off fungal infections. Having these genes in more vulnerable rice varieties could save billions of dollars and feed millions more people.

Japan, has found a gene that helps some types of rice fight off fungal infection and successfully isolated it from a linked stretch of DNA responsible for the terrible flavour of the wild varieties.

Rice blast disease destroys around 10-30%of global rice crops enough food to feed about 60 million people each year.

Some rice plants are resistant to the pernicious fungus responsible the disease, but the rice from these plants often has undesirable qualities,

and showed that plants with two rare deletions had around 10 times fewer blast lesions than wild-type rice,


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Nature Newsthe health of the world's forests and their capacity to lock away carbon could be jeopardized by logging


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And the approach could be combined with other transgenic pest control methods such as using genetically modified crops that carry toxins.

John Pickett, a biological chemist from the Rothamsted Research institute in Harpenden, UK, is pleased also that negative environmental effects of pesticides can be avoided.


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leading to more malnutrition. The report calls for additional investments of at least US$7 billion per year for research, to increase agricultural productivity,


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The International Society for Stem Cell Research has created a committee to weed out companies that offer unapproved stem-cell'therapies'.

and a 2009 report from the California Department of Pesticide Regulation (DPR) warned of significant health risks.

and Drug Administration (FDA) to approve a device to repair damaged knees against the recommendations of its own scientists,

Research HIV vaccine: An experimental HIV vaccine has shown moderate success at preventing infection by the virus. A US$119-million study involving more than 16,000 HIV-negative men

and women from Thailand found that a combination of two older drugs, which had failed to work individually, together reduced the risk of contracting HIV by nearly a third.

It's the largest step forward that's ever occurred in the HIV-vaccine field, says Dan Barouch of the Beth Israel Deaconess Medical center in Boston, Massachusetts.

Click here for a longer version of this story. Mars delay: The launch of Russia's Phobos-Grunt mission to study Mars

and collect soil samples from one of its moons has been postponed to 2011, together with China's first Mars probe,

the orbiter Yinghuo-1. Both crafts were supposed to take off in October this year, carried on a Russian rocket,

The US National institutes of health announced 115 new awards for high-risk research on 24 september. The grants, which total US$348 million over five years, come in three varieties:

Business Drug deal: The drug company Abbott laboratories in Abbott Park, Illinois, is to buy Solvay Group's pharmaceutical business for  4. 5 billion (US$6. 6 billion.

The company will pay cash for the deal, which includes Solvay's vaccines business, based in Belgium.

The acquisition will also see Abbott increase its annual US$2. 7-billion pharmaceutical research and development investment by $500 million.

Climate rift: Exelon of Chicago, Illinois, the largest US nuclear-power provider, has become the latest company to quit the US Chamber of commerce because of differences over climate change.

The week ahead 5-7 october The 2009 Nobel prizes for physiology or medicine, physics and chemistry are announced. http://nobelprize. org 5-7 october Singapore hosts the Stem Cells

and Regenerative Medicine Congress Asia. http://www. terrapinn. com/2009/stemcellsasia 8-11 october The American Association for Cancer Research holds its'Frontiers in basic cancer research'conference in Boston,


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