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ADVANCE Discourse: Lab

New Target for Heart Disease Screening in Middle-Aged Black Women
September 30, 2016 3:59 PM by Michael Jones

[Editor’s Note: This article was contributed by Allison Hydzik at UPMC.]

According to a recent study conducted by the University of Pittsburgh Graduate School of Public Health and School of Medicine, middle-aged African American women have higher levels of a protein in their blood, which has been associated as a predictor of heart disease, than their Caucasian counterparts—even after other factors like obesity are taken into consideration.

The finding, reported in Menopause, suggested routine blood testing of black menopausal women may be warranted to determine their heart disease risk and, potentially, when to start therapies like aspirin and statins. The research was funded by the National Institutes of Health (NIH).

“Multiple previous studies have shown that black women are at higher risk for heart disease than white women; however, guidelines for assessing cardiovascular disease risk in asymptomatic adults do not recommend selective race- or ethnic-based risk-assessment,” said lead author Norman C. Wang, MD, MS, assistant professor in Pitt’s School of Medicine. “Our study revealed for the first time that, in black but not white women going through menopause, higher levels of an easily measured risk factor for heart disease are associated with higher amounts of early atherosclerosis, even after accounting for other risk factors for heart disease. A clinical trial to determine whether routine screening in this population can save lives may be warranted.”

Wang and his colleagues, including Karen A. Matthews, PhD, Emma J.M. Barinas-Mitchell, PhD, and Chung-Chou H. Chang, PhD, all of Pitt., examined medical records, blood samples and heart CT scans for 372 women of both racial backgrounds from Pittsburgh and Chicago enrolled in the Study of Women’s Health Across the Nation (SWAN). The women averaged just over 51 years old, were not on hormone replacement therapy and had no known heart disease when enrolled.

The researchers looked at blood levels of five biomarkers linked to inflammation; all of which were associated with coronary artery calcification, a predictor of heart disease that is measured with a heart CT scan. When the researchers then took into account the participants’ body mass index (BMI), a measure of overall body fat, they found that obesity was a key factor linking most of the elevated inflammation biomarkers and coronary artery calcification.

Regardless of BMI, however, black women with higher levels of one particular biomarker, C-reactive protein, were more likely to have coronary artery calcification than white women. In fact, black women with coronary artery calcification had an average level of C-reactive protein in their blood that was almost double that of their white counterparts.

“We clearly demonstrated that obesity, inflammation biomarkers and coronary artery calcification are linked for both black and white mid-life women, further emphasizing the need to promote lifestyle changes to combat obesity at mid-life when women are subjected to many physiological and biological changes that could potentially increase their risk for heart disease,” said senior author Samar El Khoudary, PhD, MPH, assistant professor in Pitt Public Health’s department of epidemiology. “Future research should build on our findings regarding black women and C-reactive protein by testing similar associations over time, which could potentially yield interventions that can help these women avoid developing heart disease.”

The researchers noted that their study only looked at black and white women, so the results are not generalizable to other racial or ethnic groups.


Gray Hair Gene
April 15, 2016 10:48 AM by Lindsey Nolen

Playing an influential role in appearance throughout American society, the value aging adults place on deterring hair grayness remains great. Although the dyeing of hair color can mask this sign of aging, the potential for a scientific cure for this phenomenon has never before been presented – until now.

In an international study led by University College London (UCL), the first gene for graying hair has been discovered, confirming that hair graying has a genetic component and is not solely environmental. The study, which was published in the journal Nature Communications, analyzed a sample of 6,630 volunteers from a cohort recruited in five Latin American countries to target new genes associated with hair physiognomies.1

"We already know several genes involved in balding and hair color but this is the first time a gene for graying has been identified in humans, as well as other genes influencing hair shape and density," explained Kaustubh Adhikari, PhD, the lead author of the study, in a statement.

Study Details
Through their analysis, the researchers performed a categorical evaluation of men and women to assess hair shape, color, balding and graying, the presence of a monobrow, eyebrow and beard (in men) thickness. Participants were then genotyped and their information yielded significant correlation values for all the traits examined, with the highest heritability being estimated for hair color and the lowest for hair graying.2

"This is really the first study on the genetics of hair graying in humans," further explained Adhikari. “A drug that has effects on the melanin-production pathway in hair follicles as the follicles develop internally might reduce the need to apply external hair dyes on the scalp hair after it comes out. This is certainly a research avenue worth pursuing.”

The identified and influential gene, known as IRF4, has been proven to help regulate the pigment responsible for hair color as well as the color of the skin and eyes, melanin.3

Hair graying is caused by an absence of melanin in hair so the scientists want to find out IRF4's role in this process. Understanding how IRF4 influences hair graying could help the development of new cosmetic applications that change the appearance of hair as it grows in the follicle by slowing or blocking the graying of hair.

Additionally, according to UCL human geneticist Andres Ruiz-Linares, people with a certain version of this gene are predisposed to hair graying. This is because hair graying is not driven exclusively by genetics, but rather by a number of contributing factors such as stress or experiencing a traumatic event.

"As soon as you identify a cause, then you can create an effect to change something. Now there is a target to work with," explained William Yates, MD, a hair-loss doctor and hair-replacement surgeon practicing at Dr. Yates Hair Science in Vernon Hills, Ill. "The gene identified [by UCL] accounts for 30% of people who are graying, mostly people with light color or blonde hair. It doesn't appear to account for the other group of people with darker hair that gray."

Seeing as that constantly dyeing hair to cover natural graying can cost people a lot of time and money, one of the hopes resulting from this discovery is that a more permanent method of treatment or prevention can be developed. However, it may still be some time before that result can be obtained.

“I think this study is a start. Identifying genes has not led to many preventive treatments in medicine, but this work may lead to better understanding of mechanisms of disease or of hair processes. As these mechanisms are further defined, it will allow for drugs or substances with the compatible mechanisms to be identified,” commented Nicole Rogers, MD, FAAD, a hair-transplant surgeon practicing at Old Metairie Dermatology in Metairie, La. “At this time, how these genes are modified or interact with one another is extremely complex and not close to being worked out yet.”



1. https://www.sciencedaily.com/releases/2016/03/160301113842.htm

2. http://www.nature.com/ncomms/2016/160301/ncomms10815/full/ncomms10815.html

3. http://canmua.net/washington/scientists-identify-gene-behind-gray-hair-for-first-490539.html

Consequences of Flint’s Water Crisis, Part 2
March 16, 2016 11:11 AM by Lindsey Nolen

A major challenge facing the Flint community in years to come will be identifying which children are at the highest risk of contamination-related problems and determining all future evidence of injury. This will be critical because, even after lead exposure stops, the effects could last for years—or can even become permanent.

Making future treatment additionally challenging, no drugs are available to reverse the developmental damage that can be caused by lead ingestion. However, because blood tests can reveal levels of lead within a person’s system, the tracking of this byproduct is possible.

“Distributing bottled water and point-of-use filters that require regular replacement are only short-term interventions. The solution requires financial investment in comprehensive and effective water treatment and the replacement of obsolete, damaged and toxic infrastructure,” Rubin said. “Nothing short of that—and effective, enforced regulation, monitoring and oversight—will ensure that children are being protected from exposure to lead and/or hundreds of other harmful contaminants in municipal water systems.”

Steps Being Taken
Trying to get her city back on the right foot after dozens of lead-positive blood tests, the mayor of Flint, Karen Weaver, said during a December 2015 press conference that she is seeking support from the federal government to deal with the “irreversible” effects of lead exposure on the city’s children. She said she believes that these health consequences will lead to an enhanced need for special education and mental health services, as well as developments in the juvenile justice system.

The Flint physician who first raised red flags about the elevated lead levels in children, Mona Hanna-Attisha, director of Hurley's pediatric residency program and an assistant professor in the Department of Pediatrics and Human Development at Michigan State University, has been selected to head a collaboration between Hurley Medical Center, Michigan State University and other community organizations. This collaboration intends to fight to combat lead exposure among children and residents who were exposed to harm after the disastrous city water switch, according to Michigan Live.4

Additional external assistance is also being offered to the city from companies like AQUAhydrate, a bottled water company owned in part by Mark Wahlberg and Sean “Diddy” Combs. AQUAhydrate has stated that it will send 5,000 cases of water to Flint.

Ultimately, in the midst of this crisis, the general public, government and health officials must continue to work to find effective ways to treat the people who have consumed the contaminated water.



1. Flint Water Study. Pediatric Lead Exposure Presentation from Hurley Medical Center doctors concerning Flint MI. http://goo.gl/Lk6CEm

2. World Health Organization. Lead Poisoning and Health. Available at: http://goo.gl/R7H989 

3. Centers for Disease Control and Prevention. Health Problems Caused by Lead. http://goo.gl/aZKuax 

4. Michigan Live. Flint doctor will head team to fight health problems from Flint water crisis. http://goo.gl/KYUs5N 

Trump’s 7-point Healthcare Plan, Part 2
March 7, 2016 2:52 PM by Michael Jones

[Editor’s Note: This blog was originally contributed by ADVANCE staffer Valerie Neff Newitt.]

Major news organizations have been quick to examine and critique the policy, and have noted that requests for further details from Trump headquarters have so far gone unanswered.

The Los Angeles Times reported March 3 that, to date, the ACA “has expanded coverage to about 20 million Americans, driving the largest decline in the uninsured in at least half a century. It is unclear what would happen to these people if Obamacare were repealed. …Trump has not specified how he would help these people, beyond promising that his plans would make healthcare substantially more affordable. That is disputed by many experts. Interstate sale of health insurance, for example, might slightly lower premiums, but would not address the much larger issue of high prices by hospitals and other medical providers, which are increasing their market power by consolidating in communities across the country.”

CNN.com also picked up on the lack of language pertaining to universal coverage. The news outlet reported, “Trump called in his healthcare plan for eliminating the individual mandate, which under Obamacare requires all Americans to have health insurance and which Trump suggested he was in favor of less than two weeks ago.” CNN quoted Trump’s words from a Feb. 20 interview with Anderson Cooper during a televised town hall event: “I like the [individual] mandate. Here's where I'm a little bit different. I don't want people dying in the streets.”


Trump’s earlier, more liberal, stance on healthcare raised the ire of the GOP when he told the CBS program “60 Minutes,” “…everybody's got to be covered. …the government's gonna pay for it.” CNN made the point that Trump's plan now makes no such promise that every American will be insured.

Forbes.com, while not opposed to some of the planks of Trump’s plan, also noted the inconsistency in Trump’s changing position, “The Donald has previously insisted that he likes the individual mandate, and that he is opposed to Medicaid reform. If he has changed his mind in the last week, great, but we have no assurance that he won’t change his mind again.” Forbes also pointed out that the plan does not deal with pre-existing conditions, a concept that was central to the ACA and generally heralded as one of its better tenets.

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One New York Times commentator noted that the plan, overall, is sketchy: “It is possible that Mr. Trump’s document, now a sketch, will be filled in later with a plan to help people with pre-existing conditions, or with some new financing system to provide health insurance for poor Americans. But, for now, the policies he has chosen to highlight won’t help them. He may describe himself as more compassionate and generous on healthcare than his rivals, but there’s a huge gulf between that rhetoric and the practical consequences of his policies.”

The most meaningful assessment of Trump’s healthcare reform plan ultimately will be revealed at the polls, as voters determine if his proposals reflect their best interests and warrant his selection as the next Republican presidential candidate.



1. www.donaldjtrump.com/positions/healthcare-reform


Trump’s 7-point Healthcare Plan, Part 1
March 4, 2016 1:52 PM by Michael Jones

[Editor’s Note: This blog was originally contributed by ADVANCE staffer Valerie Neff Newitt.]

GOP frontrunner Donald Trump wants to dump Obamacare on day one of his intended presidential administration. It is one strategy, he says, to “make America great again.” On March 2, Trump released his 7-point plan to repeal the Affordable Care Act (ACA), also known as “Obamacare,” and redesign American healthcare should he succeed in his bid for the White House.

The plan, not surprisingly called “Healthcare Reform to Make America Great Again,” is available in its entirety on Trump’s campaign website.1 In it, he rails against the ACA, stating, in excerpt, “This legislation… has tragically but predictably resulted in runaway costs, websites that don’t work, greater rationing of care, higher premiums, less competition and fewer choices. Obamacare has raised the economic uncertainty of every single person residing in this country. …The damage done by the Democrats and President Obama, and abetted by the Supreme Court, will be difficult to repair unless the next president and a Republican Congress lead the effort to bring much-needed free market reforms to the healthcare industry. But none of these positive reforms can be accomplished without Obamacare repeal. On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.”

Trump’s position is one based on free market principles which, when implemented “with sound public policy,” will “broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans,” according to the Republican presidential hopeful.

The 7-Point Plan
Trump puts responsibility squarely on the shoulders of Congress to repeal the ACA, and to consider and enact healthcare reform based on his following published policy points. (The italicized opinions within these points are Trump’s alone and do not reflect any approval or disapproval from ADVANCE):

“1. Completely repeal Obamacare. Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to.

“2. Modify existing law that inhibits the sale of health insurance across state lines. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.

“3. Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.

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“4. Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.

“5. Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.

“6. Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.

“7. Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers.”



1. www.donaldjtrump.com/positions/healthcare-reform

Consequences of Flint’s Water Crisis, Part 1
February 17, 2016 4:28 PM by Lindsey Nolen

No one expects having to fear consumption of their local water supply. Yet residents of Flint, Mich., are currently experiencing just that due to the city’s self-induced water crisis. After dangerous amounts of lead were found in Flint’s drinking water, a state of emergency for the area was declared.

This water crisis stems from the city government’s decision to replace the formerly safe drinking water with a cheaper alternative, despite knowledge of its high toxicity. When residents began to complain to the city council that the water smelled, tasted foul and appeared cloudy, multiple tests confirmed amounts of total coliform and fecal coliform bacteria in the water. In response, three boil water advisories were issued during a 22-day span in the summer of 2015.

Health Risks
Although lead is considered toxic to everyone, the small, growing bodies of unborn babies and young children make them especially susceptible to both absorbing and retaining the chemical element. A study1 released by Flint’s Hurley Medical Center in September of 2015 confirmed that the proportion of infants and children with above-average levels of lead in their blood had nearly doubled since the city’s switch from using the Detroit water system to the Flint River as its water source in 2014.

The knowledge of this contamination is essential and should be used to reevaluate the community’s well-being because, according to the World Health Organization,2 “lead affects children’s brain development, resulting in reduced intelligence quotient, behavioral changes such as shortening of attention span and increased antisocial behavior and reduced educational attainment. Lead exposure also causes anemia, hypertension, renal impairment, immunotoxicity and toxicity to the reproductive organs. The neurological and behavioral effects of lead are believed to be irreversible.”

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Additionally, prolonged exposure to lead can cause a person to experience abdominal pain, constipation, depression, distraction, memory loss, irritability and nausea. If exposed to high levels over a short period of time, a person may also feel increasingly tired and weak or experience headaches, a loss of appetite or pain or tingling in the hands and/or feet.3 Over a longer period of time, lead may also cause liver, kidney or central nervous system problems and an increased risk of cancer.


“Lead is an unbelievably potent neurotoxin; it quite literally takes only a microscopic amount to poison a child. Very high levels of lead exposure—if not quickly recognized and treated— cause convulsions, organ failures, comas and deaths. Generally, those outcomes are rarer than they used to be, as medical interventions such as chemical chelation regimes have been developed which can be effective in these cases,” explained  Tamara Rubin, executive director of the Lead Safe America Foundation. “It could be argued, though, that in one sense, the ‘worst case scenario’ is at the other end of the spectrum: the low-level chronic exposures that so commonly go unnoticed and unreported due to few or no immediately observed symptoms.”



1. Flint Water Study. Pediatric Lead Exposure Presentation from Hurley Medical Center doctors concerning Flint MI. http://goo.gl/Lk6CEm

2. World Health Organization. Lead Poisoning and Health. Available at: http://goo.gl/R7H989 

3. Centers for Disease Control and Prevention. Health Problems Caused by Lead. http://goo.gl/aZKuax 

4. Michigan Live. Flint doctor will head team to fight health problems from Flint water crisis. http://goo.gl/KYUs5N 

Benefits of Chocolate, Part 2
January 4, 2016 10:23 AM by Lindsey Nolen

In other research, scientists have found that eating up to two bars of chocolate a day can also help prevent stroke. In a study at the University of Aberdeen in Scotland, researchers analyzed the snacking habits of 21,000 people older than 12 and found that the odds of experiencing a stroke fell by 23% in patients who consumed up to 100 g of chocolate—the equivalent of about two classic Hershey's bars—each day in any form.

Cacao, the primary ingredient in chocolate, is the source of its stroke-preventing capability. This component of chocolate contains a reasonable amount of magnesium, which is a crucial macro mineral necessary for optimal health. This means at least 100 mg of magnesium is required per day to remain health by assisting in keeping blood pressure normal, cholesterol balanced and to naturally keep blood from thickening. Researchers in the Cochrane Hypertension Group found that flavanol-rich chocolate and cocoa products may have a small but statistically significant effect on lowering blood pressure by 2 mm Hg to 3 mm Hg in the short term (1).

Furthermore, Sweden’s Karolinska Institutet found that study subjects who ate the most chocolate, and therefore cacao, had a decreased report of stroke. Thus, experts believe that the more cacao in a chocolate product (30% in milk chocolate to 90% in dark chocolate), the more health benefits the chocolate product will deliver.

In addition, data from the American Academy of Neurology suggests that chocolate consumption is associated with an acute change in cerebral vasomotor reactivity, independent of metabolic and hemodynamic parameters. It also shows that this acute effect may contribute to the observed relationship between long-term chocolate consumption and stroke risk (2).

Cosmetic Uses
Aside from medical responses to chocolate ingestion, a 2015 study published in the Journal of Nutrition (3) found that cocoa flavanol supplementation reduces wrinkles and has a positive effect on the appearance of skin in older women. Korean women between the ages of 43 and 86 with visible facial wrinkles were recruited to participate in this double-blind, randomized and controlled trial.

During the study, the cocoa consuming group took a supplement containing 320 mg of cocoa flavanols, and the control group received a calorie-matched placebo. After 24 weeks, the women in the group consuming cocoa flavanols had a reduced appearance of facial wrinkles and improvements in their skin’s elasticity. Thus, it is reasonable to conclude that cocoa flavanol supplementation may contribute to the prevention of the progression of photoaging.

Chocolate has also been suggested to reduce wrinkles through less collagen breakdown as a result of cocoa’s ability to reduce stress hormones. Flavanols also help by protecting skin from UV damage, fighting free radicals, increasing blood flow, and even by improving skin hydration and thickness.

Consume Carefully
While the medical and cosmetic benefits of chocolate are evident, it is still not recommended that people consume high amounts of chocolate. Researchers do not recommend that people start eating several chocolate bars a week to derive these benefits, for chocolate also possesses some unhealthy elements.

Regular chocolate bars can contain a fair amount of saturated fat and sugar—both of which can lead to obesity, diabetes, tooth decay and hypertension. Although there is no established serving size to guarantee health benefits, chocolate consumers should always choose chocolate with no extra ingredients or limited extra ingredients, to avoid unnecessary fat and calories.

“Ideally you want to get dark chocolate that is 85% to 90% cacao,” explains Jamie Logie, author of the book Taking Back Your Health. “But [this] can be an acquired taste. Starting with 70% helps you build up to that, and after a while you will learn to love the deep, rich, natural flavor and won't want to touch a candy bar again!”



1. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008893.pub2/abstract

2. http://www.neurology.org/content/80/12/1173.2.full

3. http://jn.nutrition.org/content/early/2015/11/18/jn.115.217711.abstract


Benefits of Chocolate, Part 1
December 2, 2015 9:36 AM by Lindsey Nolen

It’s officially the time of year when all types of treats begin to fill tables at holiday celebrations, office parties and family gatherings. While conventional wisdom holds that desserts can be detrimental to a person’s overall health, recent studies have reported some sweeter findings—perhaps justifying that extra piece of chocolate this holiday season.

Medical History
The medical uses of chocolate date back as early as 1900 B.C., when it was first consumed by pre-Columbian cultures of Mesoamerica, such as the Olmec, and used as a tool for administering foul-tasting medicines. Initially mixed with spices, this form of chocolate was far from the sweet delicacy that is popular today. However, by the 16th century, a much sweeter form gained popularity in Europe. It later fell into question due to its assumed risks based on increased sugar intake.

According to data from Euro-Monitor, Americans will eat about $18 billion worth of chocolate in 2015—that is roughly 18% of the world's chocolate. Since so many people indulge in this sweet treat, much research has been conducted to identify the health effects of chocolate.

Cardiovascular Risk
Over the years, a number of studies have found that chocolate intake is correlated with a reduced risk of death by heart attack. High demand for methods to protect against cardiovascular disease, the leading cause of death in the United States, makes this correlation significant.

One study, published in 2015 in the journal Heart (http://heart.bmj.com/content/101/16/1279), examined the long-term effects of diet on human health and concluded that, in patients who ate 15 grams to 100 grams of chocolate a day, risk of heart disease dropped more than in patients who completely avoided consumption. Of the 25,000 study volunteers, more reported eating milk chocolate than dark chocolate, which has long been considered healthier. A primary reason why dark chocolate is regarded as healthier than milk chocolate is because it contains less milk and sugar and more flavonoid content.

“Research shows that organic [chocolate] has more nutritional value than conventional, and that milk chocolate does not provide the same benefits as dark chocolate. This is not only because of the low cacao content, but also because dairy in milk chocolate binds with the beneficial antioxidants,” explained Nichole Dandrea, MS, RD, owner of Nicobella Organics.

Chocolate is linked with reduced cardiovascular risk because it is full of flavonoid antioxidants, which improve function of the endothelium, or inner lining of the blood vessels. Chocolate can also improve arterial function, increasing high-density lipoprotein or “good” cholesterol and decreasing low-density protein or “bad” cholesterol (1).

Cognitive Benefits
Chocolate has also been linked with improved cognition. Research shows that cocoa consumption significantly improves self-reported mental fatigue and performance. It contains theobromine and caffeine, which confer the positive responses and positively influence mood and alertness (2).

People with mild cognitive impairment benefit from the health effects of chocolate as well. Although flavonoids may have direct effects on neurons and neurodegenerative brain processes, it is really chocolate’s ability to heighten insulin sensitivity—affecting blood sugar and ultimately brain function—that fosters optimal brain health.

Other micronutrients found in chocolate, known as polyphenols, have prompted the development of a cocoa extract as a natural remedy to promote optimal brain health. The cocoa polyphenols are believed to reduce the production and buildup of beta-amyloid and tau proteins that have been linked to conditions such as Alzheimer’s disease (3).

“While the overall goal of many chocolate manufacturers is to try to identify the best way to have polyphenols maintained in the chain of production, the work we have been doing is trying to identify mechanisms through certain polyphenols from different sources, including grape and cacao, to promote resilience to psychological stress and cognitive degeneration or impairment,” said Giulio Maria Pasinetti, MD, PhD, a professor of neurology at the Icahn School of Medicine at Mount Sinai in New York, in an interview with ADVANCE. Pasinetti is also the director of biomedical training at the J.J. Peters Bronx VA Medical Center in New York.

Approximately 20% of people older than 70 experience mild cognitive impairment, and each year 5% of them will progress to dementia, according to the University of California’s Berkeley Wellness blog. If chocolate can help deter cognitive impairment, midlife and older adults may want to consider increasing their chocolate intake.

“Our work in the next few years hopes to provide the opportunity for the development of a biological compound to deliver polyphenols orally and to thereby exert beneficial effects on cognitive function,” Pasinetti said.




2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672386/

3. http://www.j-alz.com/content/researchers-explore-cocoa-novel-dietary-source-prevention-cognitive-deterioration-alzheimer

MLP Workforce Report
October 29, 2015 6:09 PM by Chelsea Lacey-Mabe

The attrition of lab professionals due to aging and retirement will open ample opportunities for new technicians and technologists. The need for diagnostic lab services will continue to increase with the aging population.

Donning gloves, a protective mask and goggles, they operate microscopes, study blood samples and analyze tissue samples for normal or abnormal findings, some even analyzing cells for an indication of a cancerous growth. This is all in a day’s work for medical laboratory professionals.

According to the U.S. Bureau of Labor Statistics, job growth of 22 percent is expected between 2012 and 2022 for medical laboratory professionals, a rate that is much faster than the average growth for a career field. And that number could go even higher.

Jon Harol, laboratory recruiter for Lighthouse Recruiting, expects a vacancy rate of up to 40 percent in medical labs by 2018 because of older staff members retiring. Not only does this leave potential for new lab staff to enter the job field, it gives current laboratory professionals with a few years of experience under their belt to move up the career ladder as baby boomers exit the work force, leaving behind their career titles and higher pay scales.

Those same baby boomers are autonomously adding to the aging population, increasing the demand for medical lab procedures used to diagnose cancer and other diseases, according to the U.S. Bureau of Labor Statistics. This will further strengthen job security for medical lab technicians and technologists who perform the procedures.

Launching a Lab Career
When considering this profession, it’s important to know that as with any job, new hires will likely have to pay their dues.

“Early on in your career you are probably going to end up working a lot of nights and holidays,” Harol said in an interview with ADVANCE. “However, if you stick with it you can usually work your way on to a day shift and be called on to work less holidays.

When employers are looking to hire, they’ll assess whether someone is right for the job. Similarly, people researching occupations should ask themselves whether they’re right for this line of work. Valuable qualities for medical laboratory professionals to possess are an ability to use technology, attention to detail, dexterity in order to work closely with needles and other lab equipment and physical stamina, since they may need to lift or turn a patient in order to collect a sample.

Most entry-level technologist jobs require a bachelor’s degree, usually in medical laboratory technology or life sciences. An associate’s degree is usually required to become a medical laboratory technician. Both types of programs typically include courses in chemistry, biology and mathematics.

Something else to take into account is that a number of schools and programs are accredited by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS), which assures quality, value and innovation for healthcare providers, according to its website.

Requirements & Earnings
After graduation, some states require a license or certification to secure employment in the field. Harol finds that states with these requirements, such as New York, California and Florida, are often most in need for medical laboratory technologists and technicians due to the added requirement to enter the workforce.

As a group, medical laboratory professionals make an average of $47,820 annually. Technologists command higher salaries in the range of $57,000 according to the U.S. Bureau of Labor Statistics. Technicians educated at an associate’s degree level make slightly less. With job demand for these positions on the rise, salaries are expected to increase accordingly over the next few years.

Patient-centered “Pre-analytics” in clinical laboratories
July 16, 2015 6:11 PM by Michael Jones

[*Editor’s Note: The following is a guest blog post contributed by Biju Joseph, PhD, MT(ASCP), MB(ASCP).]

Patient-comfort oriented specimen collection techniques are vital for clinical laboratories for boosting customer base and revenue generation. The workflow could be less invasive, less painful blood collection devices and easy to use collection and transport kits. Multiple easy to use specimen collection devices and application specific protocols are available in the market. Pain-free, single use lancets for blood collection and mouth rinse specimen kits for DNA isolation in place of buccal swabs are typical examples.

Saliva testing has been suggested for several cancers that include breast cancer and prostate cancer. Clinical laboratories will be forced to allocate time for switching to much more patient-friendly devices and collection protocols as they are increasingly available due to the following reasons:

1. Home-based testing that was widely used for pregnancy tests is being adopted for self-monitoring of hemoglobin level.

2. In the near future, patients will be able to self-order a few tests to begin with, collect the results personally and could review the results with help from their physician

3. Precision medicine initiatives by the federal government. The general population will increasingly undergo genetic tests (on their own or directed by physician) that would help healthy lifestyles, and create awareness about susceptibility/resistance to specific genetic or infectious diseases. The revolutionary nature of these changes is evident when we compare this to the discovery of resistance of sickle red cells to malarial infection based on clinical symptoms in the past

4. Changes in regulations (i.e., blood glucose monitoring), re-classified as moderate complexity tests, necessitate use of devices that are comforting to the patient.

5. Liquid biopsies are entering molecular diagnostics for cancers due to inaccessibility or significant patient discomfort using the existing techniques.

In molecular testing, avoiding specimen processing for nucleic acid isolation, though not directly related to patient comfort, could contribute to guaranteed completion of test and report generation by direct sample-to-answer testing. This also has potential applications in infectious disease testing (limited nucleic acid material that could be lost during extraction), significant time reduction in the generation of results and the ability to detect multiple pathogens from a single specimen.



1.            Elizabeth Franzmann. Saliva as a diagnostic tool. Special feature. MLO 2015: 47(7);24-25.

2.            https://www.whitehouse.gov/the-press-office/2015/01/30/fact-sheet-president-obama-s-precision-medicine-initiative

Distractingly Sexy
June 15, 2015 4:10 PM by Michael Jones

After winning the Nobel Prize1 in 2001 for his research in cell division, Nobel Laureate Tim Hunt recently made headlines for his attempt to prove the existence of foot-in-mouth disease while speaking at the World Conference of Science Journalists (WCSJ). According to an article2 from the Guardian, Hunt’s “single-sex lab” comments were delivered while “addressing a convention of senior female scientists and science journalists.” The effects of the remarks (seen below) were immediate.

“Let me tell you about my trouble with girls,” said Hunt at the WCSJ Conference. “Three things happen when they are in the lab… You fall in love with them, they fall in love with you and when you criticize them, they cry.”2

Hunt partially apologized,3 but his efforts were too little, too late -- as the comments had already gone viral. An ongoing social media campaign featuring women from many different fields in the sciences using the hashtag, “#distractinglysexy,” has become increasingly popular.4 Hunt has since resigned5 from his post at University College London (UCL) following the social media backlash.

The Guardian article2 mentioned that the statistics for women working in science, technology or engineering (STEM) are low -- just 13 percent. It also cited the gap in academia, in which 84 percent of full-time STEM professors are male. In the clinical laboratory environment, however, the ratio seems to be less severe -- albeit similarly troubling.  ADVANCE for Laboratory’s 2014 salary survey pointed to disparaging wage and career gaps when analyzed based on gender -- despite an overall female majority.

As laboratory professionals, what do you think about the perception of women in science-related careers? 


1. http://www.theguardian.com/education/2001/oct/08/research.highereducation1

2. http://www.theguardian.com/uk-news/2015/jun/10/nobel-scientist-tim-hunt-female-scientists-cause-trouble-for-men-in-labs

3. http://www.independent.co.uk/news/uk/home-news/nobel-prize-winner-tim-hunt-partlyapologises-over-sexist-comments-and-says-he-was-just-being-honest-actually-10309577.html

4. http://www.theguardian.com/higher-education-network/2015/jun/11/distractinglysexy-twitter-campaign-mocks-tim-hunts-sexist-comments

5. http://www.theguardian.com/education/2015/jun/11/nobel-laureate-sir-tim-hunt-resigns-trouble-with-girls-comments

"A Defining Moment"
June 2, 2015 1:04 PM by Michael Jones

The global fight against HIV has improved dramatically in the past decade, but the results of a recent study could lead to an enormous change in the way the virus is treated moving forward. An article from the New York Times noted how the study was stopped after just two months due to the drastic difference in outcomes. With those who received immediate treatment with antiretroviral drugs “53 percent less likely to die during the trial,” the impact of fast clinical action following a diagnosis was unprecedented. 

“This is a defining moment for social justice,” said Michel Sidibé, executive director of UN AIDS, in the New York Times article. “People will be scared, saying, ‘Oh, it will be a big number.’ But this puts an end to the false debate about whether to pay for treatment.”

While not necessarily in the budget, groups like The Global Fund to Fight AIDS, Tuberculosis and Malaria have been pushing for better funding in an effort to start treatment more immediately for all patients internationally – a costly endeavor. According to the NY Times article, New York has recommended immediate treatment locally here in the Unites States since 2011, as the “several other studies have shown that people taking their drugs regularly are more than 90 percent less likely to infect others.” With that said, the story also noted that many patients are slow to start treatment while they are still healthy given the reputed harsh side effects of antiretroviral drugs from the 1990s. Fortunately, with the introduction of tenofovir in 2001, modern drugs have fewer side effects.

“The evidence for this has been building for quite some time,” said Susan P. Buchbinder, MD, director of HIV prevention at the San Francisco department of public health, in the story. “But now it’s clear that people should be offered treatment right away and told why it’s beneficial.”

Current international regulations vary depending on the respective nation. A normal CD4 count (CD4 cells per cubic millimeter) ranges between 500 and 1,200, but HIV patients routinely fall under 500 and “”full-blown AIDS” patients fall under 200. Although it is now being recommended that treatment starts at a 500 CD4 count, many nations simply don’t have the funding to start so soon. Due to the undeniable results of the recent study, there is potential for dramatic improvement of the standards for both local and international treatment. 

Nanoparticles Assemble!
March 6, 2015 2:05 PM by Michael Jones

As a kid, the concept of humans using nanotechnology was something I assumed was reserved for science fiction, but apparently clinical research has already proved me wrong. According to a recent article from Dark Daily, not only do researcher possess the technology, but they have been studying the effect of nanoparticles in the diagnosis of cancer. The study, led by Nicholas J. Long, PhD, senior author and professor in the chemistry department at Imperial College London, utilizes nanoparticles manipulated to attach themselves to cancer cells in order to allow the presence of a tumor to appear more clearly in MRIs.

“Our aim is to help doctors spot something that might be cancerous much more quickly,” explained Long in the Dark Daily piece. “That would enable patients to receive effective treatments sooner, which would hopefully improve survival rates from cancer. ”

The story described the nanoparticles as coated in a protein that finds and adheres to cancer cells. Once these are found, they “self-assemble, aggregating into larger particles that show up well under MRI.” Despite the undeniable potential this technology has in the identification of cancers, however, there are still a lot of important questions to be answered. For example, scientists are unclear on the best size relative to their toxicity to the human body or how to improve the signals sent out by the tiny particles.

“We’re now looking at fine-tuning the size of the final nanoparticle, so that it is even smaller but still gives an enhanced MRI Image,” said Juan Gallo, PhD, of the department of surgery and cancer at Imperial College London, in the Dark Daily article. [“] If it is too small, the body will just secret it out before imaging. But too big, and it could be harmful to the body. Getting it just right is really important before moving to a human trial.”

Although the study is in its early phases, currently using mouse models, and the researchers still have a lot of work ahead of them, the plan is to be able to start human trials within three to five years. The article noted the study as an important example of multiple specialties working to improve cancer diagnostics in their own fields. The impact of success with the nanoparticles could have a substantial, long-term impact on the role of clinical laboratory professionals and pathologists, as well as radiologists and imaging professionals.

Basket Cases
February 27, 2015 4:29 PM by Michael Jones

Thanks to the quick evolution of improved genetic sequencing capabilities, the concept personalized medicine has changed the way clinicians and physicians are thinking about patient treatment. Traditionally, the trial and testing period for clinical drugs going through the FDA approval process can be challenging, lengthy and exhausting for all parties involved – especially the patients. A recent article from the New York Times highlighted a new approach to drug prescriptions for cancer patients focused more on their individual genetic mutations than the specific type or origin of the cancer itself.

According to the article, Erika Hurwitz, a patient with a rare white blood cell cancer, was treated with a drug typically reserved for melanoma patients and somehow recovered despite the odds. The new technique, referred to as “basket studies,” involves screening patients for mutations and applying drugs that target those specific mutations regardless of the drug’s intended use or what part of the body the cancer has affected. Not only have these “blanket studies” been applied in individual healthcare facilities and networks, but the federal government has stepped in to continue the research with a screening program to be introduced in the spring.

Introduced fairly recently as the accessibility and price of genetic sequencing became reasonable, “Basket studies” are typically smaller and without control groups.  The studies have produced results in the extreme on either end of the spectrum, having both dramatically improved patients and shown no effect at all. Despite the black-and-white nature of the results, the article noted the drastically higher response percent of the new approach – a response rate of 50-60 percent as opposed to 10-20 percent in traditional studies, according to Richard Pazdur, MD, of the FDA in the NY Times story.

The NY Times story noted the Memorial Sloan Kettering study, which included Erika Hurwitz, saw several patients respond positively to the melanoma drug, but not everyone’s results were so successful. One stomach cancer patient, Eleni Vavas, entered the study, but didn’t respond to the drug. She passed away in July.

Vaccination Perspectives
February 17, 2015 3:35 PM by Michael Jones

A combination of the continued national debate over the connection between autism and vaccines -- despite the hypothesized link having long-since been disproved -- and events like the measles outbreak spawning from Disneyland have led to a lot of vaccination-related headlines recently. Diseases like measles, which had been almost completely eliminated, have only resurfaced lately after movements in opposition of vaccinations became popularized. While many U.S. citizens consider vaccines to be perfectly safe and effective, there is also a growing population leaning the other way.

One particularly hard to digest piece of information, according to a piece from the Guardian, is that the millennial generation is actually the largest contributor to this expanding group -- specifically, “21% of people 18 and 29 believe in a link [to autism].” A different pole from TIME also had younger generations more inclined to support the idea that vaccines aren’t safe (though just 15 percent as opposed to 21 percent). Being a Millennial and having written about it somewhat extensively, I can certainly identify with the Guardian author’s similar situation and point-of-view.

A story noted above on the measles outbreak from the LA Times noted the importance of adult immunizations now more than ever, as “Adults pose a greater risk than children of passing on the disease because they travel and come into contact with more people.” It went on to note that some adults have not been fully vaccinated, due to a second dose only being recommended in 1989, and that there should be more “checkpoints between kindergarten and adulthood” in order to prevent these individuals from slipping through the cracks – this is especially relevant in educational organizations, where it’s important for both students and teachers to have been properly vaccinated.

Nonetheless, the TIME article brought up the interesting concept of “Herd immunization,” which relies on “92-95%” of a population to be vaccinated in order to safeguard the community. At present, “vaccination rates in the U.S. hover around 91%.” Although this isn’t necessarily a bad number, it could always be better and the recent upsurge in groups coming out against vaccinations could potentially lead to more troubling numbers.

As laboratory professionals, what are some of our readers’ thoughts on the subject? 



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