Tuesday, December 31, 2013

Should music be a priority in public education?

 2013 Dec 6;4:855. doi: 10.3389/fpsyg.2013.00855.

High school music classes enhance the neural processing of speech.

Author information

  • 11Auditory Neuroscience Laboratory, Northwestern University Evanston, IL, USA ; 2Department of Communication Sciences, Northwestern University Evanston, IL, USA.
  • 21Auditory Neuroscience Laboratory, Northwestern University Evanston, IL, USA ; 2Department of Communication Sciences, Northwestern University Evanston, IL, USA ; 3Bilingualism and Psycholinguistics Research Group, Northwestern University Evanston, IL, USA.
  • 34Walter Payton College Preparatory High School Chicago, IL, USA.
  • 41Auditory Neuroscience Laboratory, Northwestern University Evanston, IL, USA ; 2Department of Communication Sciences, Northwestern University Evanston, IL, USA ; 4Walter Payton College Preparatory High School Chicago, IL, USA ; 5Institute for Neuroscience, Northwestern University Evanston, IL, USA ; 6Department of Neurobiology and Physiology, Northwestern University Evanston, IL, USA ; 7Department of Otolaryngology, Northwestern University Evanston, IL, USA.


Should music be a priority in public education? One argument for teaching music in school is that private music instruction relates to enhanced language abilities and neural function. However, the directionality of this relationship is unclear and it is unknown whether school-based music training can produce these enhancements. Here we show that 2 years of group music classes in high school enhance the neural encoding of speech. To tease apart the relationships between music and neural function, we tested high school students participating in either music or fitness-based training. These groups were matched at the onset of training on neural timing, reading ability, and IQ. Auditory brainstem responses were collected to a synthesized speech sound presented in background noise. After 2 years of training, the neural responses of the music training group were earlier than at pre-training, while the neural timing of students in the fitness training group was unchanged. These results represent the strongest evidence to date that in-school music education can cause enhanced speech encoding. The neural benefits of musical training are, therefore, not limited to expensive private instruction early in childhood but can be elicited by cost-effective group instruction during adolescence.

Genetic Mutation Screen in Early Lung Cancer Specimens

 2013 Nov 14. pii: S1525-7304(13)00231-3. doi: 10.1016/j.cllc.2013.11.005. [Epub ahead of print]

Genetic Mutation Screen in Early Non-Small-Cell Lung Cancer (NSCLC) Specimens.

Author information

  • 1Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel; Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel. Electronic address: bar.jair@gmail.com.
  • 2Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel.
  • 3Institute of Pathology, Sheba Medical Center, Tel-Hashomer, Israel.
  • 4Thoracic Surgery, Sheba Medical Center, Tel-Hashomer, Israel.
  • 5Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia.
  • 6Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel; Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel.



Testing for genetic abnormalities in epithelial growth factor receptor (EGFR), anaplastic lymphoma receptor tyrosine kinase (ALK), and potentially additional genes is a critical tool in the care of advanced NSCLC. There is conflicting evidence for the role of such tests in early NSCLC. We report a single-institute Sequenom testing for a wide range of mutations and their clinical correlations in early-resected NSCLC specimens.


Early NSCLC paraffin-embedded, formalin-fixed (FFPE) specimens were collected, DNA extracted, and using Sequenom-based matrix-assisted laser desorption/ionization-time of flight analysis, mutations in 22 oncogenes and tumor suppressor genes were evaluated. Clinical data was collected retrospectively.


The technique was found to be feasible. Thirty-six of 96 patients (37.5%) had any genetic abnormality identified, and 8 (8.3%) had 2 or more mutations. Kirsten rat sarcoma viral oncogene homolog (KRAS) and EGFR were the most common genes to appear mutated (15.6%); phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha (PIK3CA) was the gene to be found most commonly in tumors with co-mutations. Transversions were found mostly in KRAS gene mutations and to be nonprognostic. No difference in the spectrum of mutations was found between squamous-cell and non-squamous-cell lung cancers. Ever-smokers showed a trend for worse prognosis, with a similar spectrum of mutations.


Sequenom-based mutation screen is feasible using FFPE samples. More than a third of the patients were found to harbor some genetic abnormality, and 8% were found to have more than a single mutated gene. Wide-range gene screens using large sample depositories are required for further insight into the important genes at play in early NSCLC.

From Paul Bunn and colleagues: The evolution of tumor classification: a role for genomics?

 2013 Dec 9;24(6):693-4. doi: 10.1016/j.ccr.2013.11.019.

The evolution of tumor classification: a role for genomics?

Author information

  • 1Division of Medical Oncology, Department of Medicine, School of Medicine, University of Colorado, Denver, Aurora, CO 80045, USA. Electronic address: paul.bunn@ucdenver.edu.
  • 2Department of Pathology, School of Medicine, University of Colorado, Aurora, CO 80045, USA.
  • 3Division of Medical Oncology, Department of Medicine, School of Medicine, University of Colorado, Denver, Aurora, CO 80045, USA.


Lung cancers are divided into four types according to their histologic appearance. Therapeutic decisions are partly based on histology. A recent study indicates that certain molecular alterations associate with histology and that therapies directed to these molecular changes improve outcome, indicating that genomic information should be incorporated into future tumor classification.

Malignant Pleural Effusion

 2013 Dec 24. [Epub ahead of print]

Malignant Pleural Effusion.

Author information

  • Interventional Respiratory Unit, Department of Respiratory Medicine, Galway University Hospitals, Galway, Ireland.


Malignant pleural effusion (MPE) refers to the presence of neoplastic cells in the pleural fluid. Approximately 40,000 people per year in the United Kingdom are affected by MPE and it is associated with significant morbidity and an overall poor prognosis. Management should be prompt and care plans should be individualised and involve a multidisciplinary team of healthcare professionals. This article reviews the pathophysiology of MPE along with available investigations and management strategies for these patients.

Wow-so easily preventable: Over 1/3 of med mal cases for radical prostatectomy involved informed consent

 2013 Dec 10. pii: S0022-5347(13)06084-9. doi: 10.1016/j.juro.2013.12.003. [Epub ahead of print]

Influencing Factors Leading to Malpractice Litigation in Radical Prostatectomy.

Author information

  • 1Department of Urology, Wake Forest School of Medicine-Winston-Salem, NC. Electronic address: mcolaco@wakehealth.edu.
  • 2Department of Urology, Wake Forest School of Medicine-Winston-Salem, NC.



The litigious nature of the medical-legal environment is a major concern for American physicians with an estimated cost of $10 billion. The purpose of this study is to identify the causes of litigation in cases of radical prostatectomy, as well as what factors contribute to verdicts or settlements resulting in indemnity payments.


Publicly available verdict reports were recorded using the Westlaw legal database (Thomson Reuters, New York, NY). In order to identify pertinent cases we used the search terms "medical malpractice" and "prostate" or "prostatectomy" with date ranging from 2000 to 2013. Cases were evaluated for alleged cause of malpractice, resulting injury, findings and indemnity payment (if any).


Database search yielded 222 cases, with 25 being relevant to radical prostatectomy. 24.0% of cases were settled out of court and the remaining 76.0% went to trial. Of those cases that went to trial, 20.8% saw patients awarded damages. There was no significant difference in awards between verdict and settlement. 36.0% of patients claimed that they did not receive proper informed consent. 16.0% of cases claimed that the surgery was not the proper standard of care. Thirteen of the cases claimed negligence in the performance of the surgery with the bulk of these claims being the result of rectal perforation.


The main issues that arise in radical prostatectomy malpractice litigation are those of informed consent and clinical performance. Comprehensive preoperative counseling, when combined with proper surgical technique, may minimize the impact of litigation.

miR-126 in human cancers

 2013 Dec 21. pii: S0014-4800(13)00150-0. doi: 10.1016/j.yexmp.2013.12.004. [Epub ahead of print]

miR-126 in human cancers: clinical roles and current perspectives.

Author information

  • 1Cancer Molecular Pathology, Griffith Health Institute, Griffith University, Gold Coast, Australia.
  • 2Cancer Molecular Pathology, Griffith Health Institute, Griffith University, Gold Coast, Australia. Electronic address: a.lam@griffith.edu.au.


miR-126 has been implicated in the processes of inflammation and angiogenesis. Through these processes, miR-126 is implicated in cancer biology, but its role there has not been well reviewed. The aim of this review is to examine the molecular mechanisms and clinicopathological significance of miR-126 in human cancers. miR-126 was shown to have roles in cancers of the gastrointestinal tract genital tracts, breast, thyroid, lung and some other cancers. Its expression was suppressed in most of the cancers studied. The molecular mechanisms that are known to cause aberrant expression of miR-126 include alterations in gene sequence, epigenetic modification and alteration of dicer abundance. miR-126 can inhibit progression of some cancers via negative control of proliferation, migration, invasion, and cell survival. In some instances, however, miR-126 supportscancer progression via promotion of blood vessel formation. Downregulation of miR-126 induces cancer cell proliferation, migration, and invasion via targeting specific oncogenes. Also, reduced levels of miR-126 are a significant predictor of poor survival of patients in many cancers. In addition, miR-126 can alter a multitude of cellular mechanisms in cancer pathogenesis via suppressing gene translation of numerous validated targets such as - PI3K, KRAS, EGFL7, CRK, ADAM9, HOXA9, IRS-1, SOX-2, SLC7A5 and VEGF. To conclude, miR-126 is commonly down-regulated in cancer, most likely due to its ability to inhibit cancer cell growth, adhesion, migration, and invasion through suppressing a range of important gene targets. Understanding these mechanisms by which miR-126 is involved with cancer pathogenesis will be useful in the development of therapeutic targets for the management of patients with cancer.

Learn some Economics for the New Year in less than 20 minutes

Round One

Round Two

"...the criminal law in India has also not adequately addressed the problem of sexual assault of women with disabilities."

 2013 Dec 26. [Epub ahead of print]

"Our lives, our identity": women with disabilities in India.

Author information

  • Department of Education, Loreto College, Kolkata , West Bengal , India.


Although there is a world-wide trend towards women with disabilities attempting to establish their own identity in this complex society, their condition remains very different in the developing countries particularly, India. The plight of women with disabilities is very depressing as they face a triple handicap and discrimination due to their disability, besides the gender issues. Violence against women with disabilities can range from neglect to physical abuse to denying them even the traditional roles of marriage and childbearing. This article addresses the problem of sexual assault of women with disabilities in the Indian context, highlighting on some of the loopholes in the Indian legal system. 
Method: The article has primarily been based on review of various books, articles and government and other related documents. 
Outcomes: Review of literature has revealed that in majority of the instances a significant portion of perpetrators have been found to be male caregivers followed by the male family members and strangers constitute only a miniscule of the percentage of the abusers. Adding to this legal system has further aggrieved the situation as the criminal law in India has also not adequately addressed the problem of sexual assault of women with disabilities. 
Conclusion and implications: The article concludes by suggesting possible strategies to reinstall the position of women with disabilities in a community based rehabilitation setting. It advocates the need to create a supportive environment for disclosure of sexual assault and responses to it will be characterised by belief in the victim, dignity and respect. Implications for Rehabilitation In India, women with disabilities need to be provided with adequate knowledge about sexuality which will equip them to understand that they have been sexually assaulted. There is the need for policy makers to ensure greater accessibility to complaint and redressal mechanisms for women with disabilities. Efforts need to be made to strengthen the legal system and necessary legal aid/help to bring the perpetrators of such crime to justice has to be provided.

Health in Nepalese media: "Health is prioritized far less by the print media than politics despite the reader's appetite for it."

 2013 May;11(24):149-52.

Health in Nepalese media.

Author information

  • 1Save the Children.
  • 2Kantipur Daily.
  • 3Annapurna Post Daily.
  • 4Britain Nepal Medical Trust.


Background: Coverage of health in Nepali print media is quite a recent phenomenon despite readers' ample appetite for it. Dominated by politics, Nepal's print media has been marginally publishing news pieces, features, editorials and op-ed articles, photographs and cartoons on health, though marginally. But the media did not wake up to the issues of human resources for health until lately. 
Methods: We content analysed the coverage of health issues including, human resources for health in select Nepali print media Kantipur, Nagarik and Annapurna Post of select three months in 2012 April, August and December. News pieces and their placements, Op-eds, editorials, features, letters to the editor, photos and cartoons were subjected to analysis. 
Results: Over the study period, the papers covered 544 health news pieces, 44% of political news pieces. Health workforce news pieces contributed 24% to it. However, only 10% of the health news made to the front pages. Coverage of health in editorials, features, Op-eds, photographs, cartoons and letters to the editor is even more meager. For example, only 7% of the editorials are relating to health. 
Conclusions: Health is prioritized far less by the print media than politics despite the reader's appetite for it. Print media should give health a top priority, particularly in those areas that relate to health systems like human resources for health, for their massive impact on the lives of the people. 

Why the passenger pigeon became extinct


Why the passenger pigeon became extinct.


"The short answer is that it tasted good. Also, it was easy to kill and so abundant that it often seemed, in the days before refrigeration, like the quail that fell on the Israelites in Exodus. In 1781, after a crop failure, a flock of pigeons saved a large swath of New Hampshire from starvation. Despite the occasional apocalyptic shiver, most Americans looked up and decided that it was cloudy with a chance of meatballs."

Holidays can be rough for cancer patients. Good time to repost Jackie Fox's excellent "The 10 Commandments of Breast Cancer"

The 10 Commandments of Breast Cancer

The Battle of the Barbies

The Battle of the Barbies: Iconic vs. “Normal” vs. Plus-Size

Ninety percent of girls 3- to 10-years-old own at least one Barbie doll, with girls 3- to 6-years-old averaging 12 dolls each. That’s a lot of Barbie dolls in the hands of impressionable young girls."

Read more: http://www.care2.com/causes/the-battle-of-the-barbies-iconic-vs-normal-vs-plus-size.html#ixzz2p3Sa2WSt

Parent Health Literacy and "Obesogenic" Feeding

 2013 Dec 24. pii: S0022-3476(13)01423-6. doi: 10.1016/j.jpeds.2013.11.014. [Epub ahead of print]

Parent Health Literacy and "Obesogenic" Feeding and Physical Activity-Related Infant Care Behaviors.

Author information

  • 1Department of Pediatrics, New York University School of Medicine, New York, NY. Electronic address: yinh02@med.nyu.edu.
  • 2Department of Pediatrics and Center for Health Policy, Stanford University, Stanford, CA.
  • 3Departments of Internal Medicine and Pediatrics, Vanderbilt University Medical Center, Nashville, TN.
  • 4Department of Pediatrics, New York University School of Medicine, New York, NY.
  • 5Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
  • 6Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine and Cecil G. Sheps Center for Health Services Research, Chapel Hill, NC.



To examine the relationship between parent health literacy and "obesogenic" infant care behaviors.


Cross-sectional analysis of baseline data from a cluster randomized controlled trial of a primary care-based early childhood obesityprevention program (Greenlight). English- and Spanish-speaking parents of 2-month-old children were enrolled (n = 844). The primary predictor variable was parent health literacy (Short Test of Functional Health Literacy in Adults; adequate ≥23; low <23). Primary outcome variables involving self-reported obesogenic behaviors were: (1) feeding content (more formula than breast milk, sweet drinks, early solid food introduction), and feeding style-related behaviors (pressuring to finish, laissez-faire bottle propping/television [TV] watching while feeding, nonresponsiveness in letting child decide amount to eat); and (2) physical activity (tummy time, TV). Multivariate logistic regression analyses (binary, proportional odds models) performed adjusting for child sex, out-of-home care, Women, Infants, and Children program status, parent age, race/ethnicity, language, number of adults/children in home, income, and site.


Eleven percent of parents were categorized as having low health literacy. Low health literacy significantly increased the odds of a parent reporting that they feed more formula than breast milk, (aOR = 2.0 [95% CI: 1.2-3.5]), immediately feed when their child cries (aOR = 1.8 [1.1-2.8]), bottle prop (aOR = 1.8 [1.002-3.1]), any infant TV watching (aOR = 1.8 [1.1-3.0]), and inadequate tummy time (<30 min/d), (aOR = 3.0 [1.5-5.8]).


Low parent health literacy is associated with certain obesogenic infant care behaviors. These behaviors may be modifiable targets for low health literacy-focused interventions to help reduce childhood obesity.

From U Edinburgh: "Nurses are the healthcare workers who have the most prolonged and intimate contact with bodies."

 2013 Oct 15. doi: 10.1111/jocn.12380. [Epub ahead of print]

When the body is past fixing: caring for bodies, caring for people.

Author information

  • School of Health in Social Science, University of Edinburgh, Edinburgh, UK.



To discuss the social context within which end-of-life nursing care takes place and to consider palliative options of last resort and the differences between societal and professional views on these.


The distinction between life and death is not so straightforward as was once the case. Resuscitation and the increasing capability of intensive care to 'save' patients have implications for nursing practice in a society where there is an increasing demand that individuals should be able to choose the time of their death.


This is a discursive paper.


There are differences between the professional view on end-of-life options and the societal debates calling for a more libertarianapproach. The problem for professionals is that the call for choice of the individual involves a different approach to end-of-life care, an approach that does not sit well with current professional ethics. One way forward might be a gradual reconsidering of what end-of-life care might reasonably encompass.


Nurses are the healthcare workers who have the most prolonged and intimate contact with bodies. The way in which we conceptualise the body is central to much of the work carried out in the transition between life and death and is an important part of nursing.

Circulating Tumor Cells in Malignant Pleural Mesothelioma

 2013 Dec 4. [Epub ahead of print]

Circulating Tumor Cells (CTCs) in Malignant Pleural Mesothelioma (MPM).

Author information

  • Department of Thoracic Surgery, Hyogo College of Medicine, Nishinomiya, Japan.



To investigate the diagnostic and prognostic value of circulating tumor cells (CTCs), a potential surrogate of micrometastasis, in malignant pleural mesothelioma (MPM).


We prospectively evaluated CTCs in 7.5 mL of peripheral blood sampled from patients with a suspicion of MPM. A semiautomated system was used to capture CTCs with an antibody against the epithelial cell adhesion molecule.


Of 136 eligible patients, 32 were finally diagnosed with nonmalignant diseases (NM), and 104 had MPM. CTCs were detected in 32.7 % (34 of 104) of MPM patients but in only 9.4 % (3 of 32) of NM patients (P = 0.011). The CTC count was significantly higher in MPM patients than in NM patients (P = 0.007), and a receiver operating characteristic (ROC) curve analysis showed an insufficient capability of the CTC test in discrimination between MPM and NM, with an area under ROC curve of 0.623 (95 % confidence interval, 0.523-0.723; P = 0.036). Among MPM patients, CTCs were more frequently detected in patients with epithelioid subtype (39.7 %, 31 of 78) than in those with nonepithelioid subtypes (11.5 %, 3 of 26; P = 0.016). Positive CTCs (CTC count ≥1) were a significant factor to predict a poor prognosis among epithelioid patients (median overall survival, 22.3 months for positive CTCs vs. 12.6 months for negative CTCs; P = 0.004) and not in nonepithelioid patients (P = 0.649). A multivariate analysis showed that positive CTCs were a significant and independent factor to predict a poor prognosis (hazard ratio, 2.904; 95 % confidence interval, 1.530-5.511; P = 0.001) for epithelioid MPM patients.


CTC was a promising marker in diagnosis and prediction of prognosis in MPM, especially in epithelioid MPM.

"It should be highly recommended for every German hospital to establish the position of a patient advocate." (Where are the doctors?)

 2013 Dec 25. [Epub ahead of print]

Clinical Ethics and Patient Advocacy : The Power of Communication in Health Care.

Author information

  • , Glueckstrasse 10, 91054, Erlangen, Germany, inken.emrich@ethik.med.uni-erlangen.de.


In recent years, the rights of patients have assumed a more pivotal role in international discussion. Stricter laws on the protection of patients place greater priority on the perspective and the status of patients. The purpose of this study is to emphasize ethical aspects in communication, the role of patient advocates as contacts for the concerns and suggestions of patients, and how many problems of ethics disappear when communication is highlighted. We reviewed 680 documented cases of consultation in a 10-year period of patient advocates' activity at a big German university hospital with 1,300 beds. On the basis of this extensive material, the article will focus on the intersection of the advocate's work with the problems of patients in hospitals. Deficits in the level of communication between health care professionals and patients were frequently uncovered. Patients primarily complain about the lack of dialogue and empathy. Middle-aged patients consulted the patients' advocate disproportionately more often. Measured against this baseline, the group of 65 and older complained less frequently. Besides complaints the advocate was asked in more than one-third of all cases for information about medical matters, hospital regulations or administrative problems. Patients obviously see the advocate as a well-connected and ideally unbiased contact person for uncertainties concerning their malady or a potential stay in hospital. Those seeking help often set hope in the information given by the voluntary patient representative. It should be highly recommended for every German hospital to establish the position of a patient advocate. Furthermore, patients can profit from regular exchange between the advocate and the Ethics Committee, also, to help ensure that their rights are taken into account and implemented in an ethically desirable context.

From U Pennsylvania: Home smoking policies

 2013 Dec 23. pii: S0091-7435(13)00485-4. doi: 10.1016/j.ypmed.2013.12.015. [Epub ahead of print]

Home smoking policies in urban households with children and smokers.

Author information

  • 1Annenberg Public Policy Center at the University of Pennsylvania, 202S. 36th Street, Philadelphia, PA, 19104. Electronic address: ableakley@asc.upenn.edu.
  • 2Annenberg Public Policy Center at the University of Pennsylvania, 202S. 36th Street, Philadelphia, PA, 19104.
  • 3Philadelphia Department of Public Health, Philadelphia, PA.



We identified household, child, and demographic characteristics associated with not having a smoking ban and having a rule about smoking in the presence of children in an urban population.


We conducted a cross-sectional random digit dial telephone survey (n=456) of Philadelphia parents in June 2012.


Forty-eight percent of homes reported a full smoking ban. In homes that allowed smoking, over half allowed smoking in front of children. Cigarettes smoked in the home decreased as the restrictiveness of the bans increased. Multinomial logistic regression analyses showed that compared to having a full ban, banning smoking only in the presence of children was associated with being African-American, having a child >5 years old, and having an asthma-free child. These characteristics, as well as having both parents as smokers and not having an outdoor space, were also associated with not having any restrictions.


It is possible that households attempt to reduce home smoking by limiting smoking in the presence of children. Health communication messages should be used to inform families about the lingering effects of SHS in the home even when smoking does not occur in the presence of a child.

Elderly, dying patients and "automatic optimism"

 2013 Dec;91(4):690-728. doi: 10.1111/1468-0009.12030.

The Lake Wobegon Effect: Are All Cancer Patients above Average?

Author information

  • Ohio University.



When elderly patients face a terminal illness such as lung cancer, most are unaware that what we term in this article "the Lake Wobegon effect" taints the treatment advice imparted to them by their oncologists. In framing treatment plans, cancer specialists tend to intimate that elderly patients are like the children living in Garrison Keillor's mythical Lake Wobegon: above average and thus likely to exceed expectations. In this article, we use the story of our mother's death from lung cancer to investigate the consequences of elderly people's inability to reconcile the grave reality of their illness with the overly optimistic predictions of their physicians.


In this narrative analysis, we examine the routine treatment of elderly, terminally ill cancer patients through alternating lenses: the lens of a historian of medicine who also teaches ethics to medical students and the lens of an actuary who is able to assess physicians' claims for the outcome of medical treatments.


We recognize that a desire to instill hope in patients shapes physicians' messages. We argue, however, that the automatic optimism conveyed to elderly, dying patients by cancer specialists prompts those patients to choose treatment that is ineffective and debilitating. Rather than primarily prolong life, treatments most notably diminish patients' quality of life, weaken the ability of patients and their families to prepare for their deaths, and contribute significantly to the unsustainable costs of the U.S. health care system.


The case described in this article suggests how physicians can better help elderly, terminally ill patients make medical decisions that are less damaging to them and less costly to the health care system.