Research

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Chronic Fatigue Syndrome

By DENISE GRADY

Many people with chronic fatigue syndrome are infected with a little known virus that may cause or at least contribute to their illness, researchers are reporting.

Health Guide: Chronic FatigueThe syndrome, which causes prolonged and severe fatigue, body aches and other symptoms, has long been a mystery ailment, and patients have sometimes been suspected of malingering or having psychiatric problems rather than genuine physical ones. Worldwide, 17 million people have the syndrome, including at least one million Americans.

An article published online Thursday in the journal Science reports that 68 of 101 patients with the syndrome, or 67 percent, were infected with an infectious virus, xenotropic murine leukemia virus-related virus, or XMRV. By contrast, only 3.7 percent of 218 healthy people were infected. Continuing work after the paper was published has found the virus in nearly 98 percent of about 300 patients with the syndrome, said Dr. Judy A. Mikovits, the lead author of the paper.

XMRV is a retrovirus, a member of the same family of viruses as the AIDS virus. These viruses carry their genetic information in RNA rather than DNA, and they insert themselves into their hosts’ genetic material and stay for life.

Dr. Mikovits and other scientists cautioned that they had not yet proved that the virus causes the syndrome. In theory, people with the syndrome may have some other, underlying health problem that makes them prone to being infected by the virus, which could be just a bystander. More studies are needed to explain the connection.

But Dr. Mikovits said she thought the virus would turn out to be the cause, not just of chronic fatigue, but of other illnesses as well. Previous studies have found it in cells taken from prostate cancers.

“I think this establishes what had always been considered a psychiatric disease as an infectious disease,” said Dr. Mikovits, who is research director at the Whittemore Peterson Institute in Reno, a nonprofit center created by the parents of a woman who has a severe case of the syndrome. Her co-authors include scientists from the National Cancer Institute and the Cleveland Clinic.

Dr. Mikovits said she and her colleagues were drawing up plans to test antiretroviral drugs — some of the same ones used to treat HIV infection — to see whether they could help patients with chronic fatigue. If the drugs work, that will help prove that the virus is causing the illness. She said patients and doctors should wait for the studies to be finished before trying the drugs.

Dr. William Schaffner, an infectious disease expert at Vanderbilt University, said the discovery was exciting and made sense.

“My first reaction is, ‘At last,’ ” Dr. Schaffner said. “In interacting with patients with chronic fatigue syndrome, you get the distinct impression that there’s got to be something there.”

He said the illness is intensely frustrating to doctors because it is not understood, there is no effective treatment and many patients are sick for a long time.

He added, “This is going to create an avalanche of subsequent studies.”

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Dementia Studies Show Diet And Exercise Matter

By CARRIE PORTER

Two studies published in this week’s Journal of the American Medical Association add to evidence that long-term lifestyle habits may reduce the risk of mental decline in old age.

The first study, a long-term look at 1,880 elderly people in New York City, found that a Mediterranean-type diet and physical activity each were linked to less risk for Alzheimer’s disease. The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain at Columbia University Medical Center released the data as part of a larger research project on aging.

The second study, a shorter-term observation of 1,410 patients in France, found some correlation between a Mediterranean-type diet and slower cognitive damage.

Nikolaos Scarmeas, the author of the first study, grew up eating fish and vegetables in Athens, Greece. Now the neurologist suggests more people take up his mother’s cooking. Marked by high consumption of foods such as vegetables, legumes and cereals, served with olive oil, in addition to moderate fish and alcohol intake, the traditional diet has long conferred better cardiovascular health.

Starting in 1992, researchers at Columbia University monitored elderly patients every 18 months for diet, exercise and mental health, in addition to a number of controls including age, sex and education. “This is one of the first studies to tease apart the independent contributions of diet and exercise for dementia prevention,” says Ronald Petersen, director of the Alzheimer’s Disease Research Center at the Mayo Clinic in Rochester, Minn., who was not involved in the research. “It suggests that aging need not be a passive process.”

These studies are observational and not definitive, but they hint at what might reduce the chances of Alzheimer’s or dementia. In the Columbia research, those who adhered most closely to the diet reduced their risk for Alzheimer’s by 40%, while those with the highest physical activity decreased their risk 33%, compared with people who didn’t adhere closely to the diet or were not physically active.

The French study found that subjects who adhered to the Mediterranean-type diet experienced a slower rate of mental decline than those who did not eat the diet, but did not prove a link for dementia, which requires a clinical assessment of a variety of mental and social functions.

Doctors in the field are careful to note that none of these findings demonstrate a causal relationship, but instead reflect the advantages of a continual healthy lifestyle. “The benefits don’t just occur at age 70 when you suddenly stop eating McDonald’s and start eating Brussels sprouts,” says David Knopman, a neurologist at the Mayo Clinic in Rochester, Minn., who wrote the editorial accompanying the studies in JAMA and wasn’t involved in either study. His editorial highlights confounding variables in the studies. “Healthy diet and exercise is part of a package of lifelong healthy living.”

Zaven Khachaturian, a senior science adviser to the Alzheimer’s Association, agrees. “This offers interesting insight but we need to turn it now into clinical trials,” says the former director of the Office of Alzheimer’s Disease Research at the National Institutes of Health.

These findings arrive a few weeks after new research identified a gene that could help predict who will develop Alzheimer’s—the leading cause of dementia—and at what age. The report, given in mid-July at the International Conference on Alzheimer’s Disease, concentrated on DNA surrounding the ApoE gene. Researchers say more studies are needed before the findings can be confirmed.

For now, Dr. Scarmeas says his studies strongly suggest that a Mediterranean diet and exercise both confer independent and positive health benefits. But together, they are even better.

“The relative risk reduction for Alzheimer’s is about 60% when you combine the diet and exercise,” he says.

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Why insults are better taken lying down

by Ewen Callaway

If you really must offend someone, wait until they are lying down: people handle anger differently when they’re lying on their backs, compared with sitting upright.

University students who heard personal insults while seated exhibited brain activity linked to so-called “approach motivation” – the desire to approach and explore something. This potential urge disappeared when students took their insults lying down, despite their anger remaining.

“In the upright or leaning forward state one might be more likely to attack,” says Eddie Harmon-Jones, a cognitive scientist at Texas A&M University in College Station, who led the study. “Maybe in the reclining state you’re more likely to brood.”

Harmon-Jones worries that MRI studies performed on subjects lying on their backs – which is practically all of them – could miss the neural signatures of certain emotions.

Seeing red
It isn’t every study that requires researchers to infuriate their volunteers, and Harmon-Jones and his colleagues have honed their technique over more than decade.

Students are not told that they are participating in an anger study. The researchers instead ask them to pick a hot-button issue, such as abortion or public smoking, and write a brief essay on their stance. Next, they are hooked to an electroencephalograph, which measures electrical pulses created by firing neurons, and told that a person in an adjacent room will evaluate the essay.

This is a ruse, and Harmon-Jones’s team play a voice recording of someone disparaging the intelligence, likeability and logical skills of the essayist. “People get angry in response to this kind of feedback,” he says.

Chilled out
Volunteers who heard these insults while on their backs felt as angry as volunteers who were seated. But EEG recordings showed that, for the upright volunteers, a brain region called the right prefrontal cortex was more active than its counterpart in the brain’s left hemisphere. Other research has linked this lopsided activation to anger and approach motivation.

Volunteers who received their digs while lying down, however, exhibited EEG patterns no different from subjects who got slightly positive reviews, Harmon-Jones says.

He thinks lying down could affect how the brain handles other emotions, such as desire and happiness. The mental shift provoked by lying down may even be strong enough to affect the results of brain-imaging studies performed on people lying on their backs.

Unnatural circumstances
“It’s unknown how much of an effect this has, but this study suggests that people should start looking to see if body position is affecting processing in other types of experiments,” Harmon-Jones says, noting that most of our decisions are made while we’re upright, not lying down.

Peter Bandettini, a brain imager at the National Institute of Mental Health in Bethesda, Maryland, agrees – to a point. “It never occurred to me that body position might influence behavioural or neuronal activity in the context of aggression – but it makes sense,” he says. “I do think that this is somewhat specialised to things like aggression or anger.”

After all, he says, it’s not as if neuroscientists pretend that massive, tunnel-like MRI scanners are exact replicas of regular human environments. “The scanner noise, closed space, and generally very alien context might influence the results of other studies as well,” Bandettini adds.

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Only 15% Of US Elementary Schools Offer Foreign Language

By LAURAN NEERGAARD

The best time to learn a foreign language: Between birth and age 7. Missed that window?

New research is showing just how children’s brains can become bilingual so easily, findings that scientists hope eventually could help the rest of us learn a new language a bit easier.

“We think the magic that kids apply to this learning situation, some of the principles, can be imported into learning programs for adults,” says Dr. Patricia Kuhl of the University of Washington, who is part of an international team now trying to turn those lessons into more teachable technology.

Each language uses a unique set of sounds. Scientists now know babies are born with the ability to distinguish all of them, but that ability starts weakening even before they start talking, by the first birthday.

Kuhl offers an example: Japanese doesn’t distinguish between the “L” and “R” sounds of English — “rake” and “lake” would sound the same. Her team proved that a 7-month-old in Tokyo and a 7-month-old in Seattle respond equally well to those different sounds. But by 11 months, the Japanese infant had lost a lot of that ability.

Time out — how do you test a baby? By tracking eye gaze. Make a fun toy appear on one side or the other whenever there’s a particular sound. The baby quickly learns to look on that side whenever he or she hears a brand-new but similar sound. Noninvasive brain scans document how the brain is processing and imprinting language.

Mastering your dominant language gets in the way of learning a second, less familiar one, Kuhl’s research suggests. The brain tunes out sounds that don’t fit.

“You’re building a brain architecture that’s a perfect fit for Japanese or English or French,” whatever is native, Kuhl explains — or, if you’re a lucky baby, a brain with two sets of neural circuits dedicated to two languages.

It’s remarkable that babies being raised bilingual — by simply speaking to them in two languages — can learn both in the time it takes most babies to learn one. On average, monolingual and bilingual babies start talking around age 1 and can say about 50 words by 18 months.

Italian researchers wondered why there wasn’t a delay, and reported this month in the journal Science that being bilingual seems to make the brain more flexible.
The researchers tested 44 12-month-olds to see how they recognized three-syllable patterns — nonsense words, just to test sound learning. Sure enough, gaze-tracking showed the bilingual babies learned two kinds of patterns at the same time — like lo-ba-lo or lo-lo-ba — while the one-language babies learned only one, concluded Agnes Melinda Kovacs of Italy’s International School for Advanced Studies.

While new language learning is easiest by age 7, the ability markedly declines after puberty.

“We’re seeing the brain as more plastic and ready to create new circuits before than after puberty,” Kuhl says. As an adult, “it’s a totally different process. You won’t learn it in the same way. You won’t become (as good as) a native speaker.”

Yet a soon-to-be-released survey from the Center for Applied Linguistics, a nonprofit organization that researches language issues, shows U.S. elementary schools cut back on foreign language instruction over the last decade. About a quarter of public elementary schools were teaching foreign languages in 1997, but just 15 percent last year, say preliminary results posted on the center’s Web site.

What might help people who missed their childhood window? Baby brains need personal interaction to soak in a new language — TV or CDs alone don’t work. So researchers are improving the technology that adults tend to use for language learning, to make it more social and possibly tap brain circuitry that tots would use.

Recall that Japanese “L” and “R” difficulty? Kuhl and scientists at Tokyo Denki University and the University of Minnesota helped develop a computer language program that pictures people speaking in “motherese,” the slow exaggeration of sounds that parents use with babies.

Japanese college students who’d had little exposure to spoken English underwent 12 sessions listening to exaggerated “Ls” and “Rs” while watching the computerized instructor’s face pronounce English words. Brain scans — a hair dryer-looking device called MEG, for magnetoencephalography — that measure millisecond-by-millisecond activity showed the students could better distinguish between those alien English sounds. And they pronounced them better, too, the team reported in the journal NeuroImage.

“It’s our very first, preliminary crude attempt but the gains were phenomenal,” says Kuhl.

But she’d rather see parents follow biology and expose youngsters early. If you speak a second language, speak it at home. Or find a play group or caregiver where your child can hear another language regularly.

“You’ll be surprised,” Kuhl says. “They do seem to pick it up like sponges.”

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Why Fighting Taliban Is A No-Win

by Medical News

Insurgent groups like the Taliban can only be effectively engaged with timely and accurate military intelligence, and even good intelligence may only succeed in containing the insurgency, not defeating it, according to a new study in the current issue of Operations Research, a flagship journal of the Institute for Operations Research and the Management Sciences (INFORMS®).

“Why Defeating Insurgencies is Hard: The Effect of Intelligence in Counterinsurgency Operations – A Best-Case Scenario” is by Moshe Kress and Roberto Szechtman of the Naval Postgraduate School. The study appears in the current issue of Operations Research.

The study is the first of its kind to combine military intelligence, attrition and civilian population behavior in a unified model of counterinsurgency dynamics.

The authors stress the role of obtaining intelligence about the insurgency. Absent intelligence, they write, not only can the insurgents escape unharmed and continue their violent attacks; but resultant poor government targeting causes innocent civilian deaths, which increases popular support for the insurgents and thus generates more recruits to the insurgency.

Recent attacks on Taliban strongholds by U.S. drones have shown that deaths among civilians may end up hindering American lead efforts, Kress notes. Ill-targeted actions taken by Israel and Colombia, for example, also have shown that unintended deaths among civilians have led to increased support for insurgents.

In their paper, the authors model the dynamic relations among intelligence, collateral casualties in the population, attrition, recruitment to the insurgency, and reinforcement to the government force.

Even under best-case assumptions regarding the government actions, they show that the government cannot totally eradicate an insurgency by force. The best it can do is containing it at a certain fixed level. The containment or stalemate points may be either fragile or stable. If the violence level is low, the containment point is fragile, in which case the insurgents can “break away” and eventually win. If the government commits large forces and applies a heavy hand (for example, the “surge” of United States forces in Iraq) then the stalemate point is stable.

The model and analysis, they write, represent a best case situation from the government perspective under the parameters put forward where (a) government force is steadily reinforced by new units, (b) it has unlimited endurance (it surrenders to the insurgents only when it is totally annihilated) and (c) the only recruitment to the insurgency is due to collateral casualties in the general population that generate resentment to the government, and therefore more recruits to the insurgency.

“If a government does keep its intelligence gathering capabilities high,” says Szechtman, “it can keep a hold on the insurgency, and after a while, when the insurgents realize they can’t win, a political compromise may be reached.”

That may be the most a government can expect, Kress and Szechtman warn.

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Meditation And Happiness

By Daniel Goleman

I recently spent an evening with Yongey Mingyur Rinpoche, the Tibetan lama who has been dubbed “the happiest man in the world.” True, that title has been bestowed upon at least a few extremely upbeat individuals in recent times. But it is no exaggeration to say that Rinpoche is a master of the art of well-being.

So how did he get that way? Apparently, the same way you get to Carnegie Hall. Practice.

I’ve had the pleasure of knowing Rinpoche a bit over the years, and always found him in good cheer. This meeting was no different. When I called him at his Manhattan hotel to arrange to get together before we were to discuss his new book, “Joyful Wisdom” at the 92nd St. Y, he told me he was in the middle of a shower – but not in the usual sense. The shower, he told me, had run out of hot water midway. When he called the front desk, he was told to wait several minutes and there would be more hot water. In this situation, I probably would have been peeved. But as Rinpoche told me this, he was laughing and laughing.

The only momentary glitch I’ve witnessed — a few years back — was slapstick: he sat down in an office chair with a faulty seat that suddenly plunged several inches with a thump. Once when this chair had done the same to me I cursed and groused about it for a while. But Rinpoche just frowned for a second — and the next moment he was his upbeat self again. Quickness of recovery time from upsets is one way science takes the measure of a happy temperament.

While annoyances like these are hardly life’s greatest tests, handling them gracefully takes a composure that few of us seem to have at our disposal.

Mingyur Rinpoche was not born into wealth and comfort. He spent his earliest years in a remote Himalayan village lacking even the most basic amenities. Nor was he a lucky winner in the genetic lottery for moods. In his book he recounts being extremely anxious as a child in Nepal, having had what a Manhattan psychiatrist would likely diagnose as panic attacks, and how he cured himself of this chronic anxiety by making his fears the focus of his meditation. He has had to earn his good cheer.

Rinpoche seems eclectic in studying paths to well-being, including Western recipes. A few years ago, he attended a five-day meeting at the Mind & Life Institute that brought together a group of neuroscientists and the Dalai Lama to discuss ways to overcome destructive emotions. He found that the Western scientific findings on emotions had much in common with his own approach to cultivating well-being.

But when it comes to his own pursuit of happiness, Buddhist theory and practice are Rinpoche’s chosen tools. He has done several years-long meditation retreats, under the tutelage of some of the most renowned Tibetan masters. Of course, what we mean by “happiness” can be elusive, what with the myriad varieties of good feeling running from ecstasy to equanimity. One flavor of happiness at which Rinpoche seems to excel has been well-studied by scientists specializing in how emotions operate in our brains.

Richard Davidson, who heads the Laboratory for Affective Neuroscience at the University of Wisconsin, has found one distinct brain profile for happiness. As Davidson’s laboratory has reported, when we are in distress, the brain shows high activation levels in the right prefrontal area and the amygdala. But when we are in an upbeat mood, the right side quiets and the left prefrontal area stirs. When showing this brain pattern, people report feeling, as Davidson put it to me, “positively engaged, goal-directed, enthusiastic, and energetic.”

Mingyur Rinpoche came to Davidson’s lab as one of a dozen or so meditation adepts, each of whom had put in anywhere between 10,000 and 50,000 lifetime hours of meditation. Research on expertise in any skill shows that world-class champs have put in at least 10,000 hours of practice; these were Olympic-level meditators.

One of the first findings from the research showed that when these adepts meditated on compassion, their left prefrontal areas jumped in activity an average 100 percent — by contrast a control group who were taught the same meditation practice showed an increase of just 10 percent. Two of the adepts had spectacular increases, in the 700-to-800-percent range, in key neural zones for good feeling. The more lifetime hours of practice, the greater the increases tended to be. All this seems to confirm the idea that in the realm of positive moods, as in nearly every endeavor, worldly or spiritual, practice matters.

So can we all get a taste of Rinpoche’s bliss?

Davidson worked with Jon Kabat-Zinn, a teacher of mindfulness meditation from the University of Massachusetts Medical Center, to see how a group of novices might gain from these methods. Kabat-Zinn, who has pioneered this contemplative method with medical patients to ease their symptoms, taught mindfulness at a high-stress biotech company; these beginners meditated for 30 minutes a day for eight weeks. Davidson’s measures showed that after the eight weeks they had begun to activate that left prefrontal zone more strongly — and were saying that instead of feeling overwhelmed and hassled, they were enjoying their work. So while the Calvinist strain in American culture may look askance at someone sitting quietly in meditation, this kind of “doing nothing” seems to do something remarkable after all.

Of course, there’s no guarantee of greater happiness from meditation, but the East has given us a promising path for its pursuit.

Another fruit of these spiritual practices seems to be a healthy dose of humility. When Rinpoche told my wife that he was being billed as “the happiest man in the world,” he laughed as though that were the funniest joke he’d ever heard.

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Your Insula – A Cossroads Of Time And Desire

by Sandra Blakeslee

The recent news about smoking was sensational: some people with damage to a prune-size slab of brain tissue called the insula were able to give up cigarettes instantly.

Suppose scientists could figure out how to tweak the insula without damaging it. They might be able to create that famed and elusive free lunch — an effortless way to kick the cigarette habit.

That dream, which may not be too far off, puts the insula in the spotlight. What is the insula and how could it possibly exert such profound effects on human behavior?

According to neuroscientists who study it, the insula is a long-neglected brain region that has emerged as crucial to understanding what it feels like to be human.

They say it is the wellspring of social emotions, things like lust and disgust, pride and humiliation, guilt and atonement. It helps give rise to moral intuition, empathy and the capacity to respond emotionally to music.

Its anatomy and evolution shed light on the profound differences between humans and other animals.

The insula also reads body states like hunger and craving and helps push people into reaching for the next sandwich, cigarette or line of cocaine. So insula research offers new ways to think about treating drug addiction, alcoholism, anxiety and eating disorders.

Of course, so much about the brain remains to be discovered that the insula’s role may be a minor character in the play of the human mind. It is just now coming on stage.

The activity of the insula in so many areas is something of a puzzle. “People have had a hard time conceptualizing what the insula does,” said Dr. Martin Paulus, a psychiatrist at the University of California, San Diego.

If it does everything, what exactly is it that it does?

For example, the insula “lights up” in brain scans when people crave drugs, feel pain, anticipate pain, empathize with others, listen to jokes, see disgust on someone’s face, are shunned in a social settings, listen to music, decide not to buy an item, see someone cheat and decide to punish them, and determine degrees of preference while eating chocolate.

Damage to the insula can lead to apathy, loss of libido and an inability to tell fresh food from rotten.

The bottom line, according to Dr. Paulus and others, is that mind and body are integrated in the insula. It provides unprecedented insight into the anatomy of human emotions.

Of course, like every important brain structure, the insula — there are actually two, one on each side of the brain — does not act alone. It is part of multiple circuits.

The insula itself is a sort of receiving zone that reads the physiological state of the entire body and then generates subjective feelings that can bring about actions, like eating, that keep the body in a state of internal balance. Information from the insula is relayed to other brain structures that appear to be involved in decision making, especially the anterior cingulate and prefrontal cortices.

The insula was long ignored for two reasons, researchers said. First, because it is folded and tucked deep within the brain, scientists could not probe it with shallow electrodes. It took the invention of brain imaging techniques, such as functional magnetic resonance imaging, or fMRI, to watch it in action.

Second, the insula was “assigned to the brain’s netherworld,” said John Allman, a neuroscientist at the California Institute of Technology. It was mistakenly defined as a primitive part of the brain involved only in functions like eating and sex. Ambitious scientists studied higher, more rational parts of the brain, he said.

The insula emerged from darkness a decade ago when Antonio Damasio, a neuroscientist now at the University of Southern California, developed the so-called somatic marker hypothesis, the idea that rational thinking cannot be separated from feelings and emotions. The insula, he said, plays a starring role.

Another neuroscientist, Arthur D. Craig at the Barrow Neurological Institute in Phoenix, went on to describe exactly the circuitry that connects the body to the insula.

According to Dr. Craig, the insula receives information from receptors in the skin and internal organs. Such receptors are nerve cells that specialize in different senses. Thus there are receptors that detect heat, cold, itch, pain, taste, hunger, thirst, muscle ache, visceral sensations and so-called air hunger, the need to breathe. The sense of touch and the sense of the body’s position in space are routed to different brain regions, he said.

All mammals have insulas that read their body condition, Dr. Craig said. Information about the status of the body’s tissues and organs is carried from the receptors along distinct spinal pathways, into the brain stem and up to the posterior insula in the higher brain or cortex.

As such, all mammals have emotions, defined as sensations that provoke motivations. If an animal is hot, it seeks shade. If hungry, it looks for food. If hurt, it licks the wound.

But animals are not thought to have subjective feelings in the way that humans do, Dr. Craig said. Humans, and to a lesser degree the great apes, have evolved two innovations to their insulas that take this system of reading body states to a new level.

In humans, information about the body’s state takes a slightly different route inside the brain, picking up even more signals from the gut, the heart, the lungs and other internal organs. Then the human brain takes an extra step, Dr. Craig said. The information on bodily sensations is further routed to the front part of the insula, especially on the right side, which has undergone a huge expansion in humans and apes.

It is in the frontal insula, Dr. Craig said, that simple body states or sensations are recast as social emotions. A bad taste or smell is sensed in the frontal insula as disgust. A sensual touch from a loved one is transformed into delight.

The frontal insula is where people sense love and hate, gratitude and resentment, self-confidence and embarrassment, trust and distrust, empathy and contempt, approval and disdain, pride and humiliation, truthfulness and deception, atonement and guilt.

People who are better at reading these sensations — a quickened heart beat, a flushed face, slow breathing — score higher on psychological tests of empathy, researchers have found. The second major modification to the insula is a type of cell found in only humans, great apes, whales and possibly elephants, Dr. Allman said. Humans have by far the greatest number of these cells, which are called VENs, short for Von Economo neurons, named for the scientist who first described them in 1925. VENs are large cigar-shaped cells tapered at each end, and they are found exclusively in the frontal insula and anterior cingulate cortex.

Exactly what VENs are doing within this critical circuit is not yet known, Dr. Allman said. But they are in the catbird seat for turning feelings and emotions into actions and intentions.

The human insula, with its souped-up anatomy, is also important for processing events that have yet to happen, Dr. Paulus said. “When you decide to go outside on a cold day, your body gets ready before you hit the cold air,” he said. “It starts pumping blood to where you need it and adjusts your metabolism. Your insula tells you what it will feel like before you step outside.”

The same goes for drug addicts. When an addict is confronted with sights, sounds, smells, situations or other stimuli associated with drug use, the insula is activated before using the drug.

“If you give cocaine to an addict, you are affecting their brain’s reward system, but this is not what drives the person to keep using cocaine,” Dr. Paulus said. The craving is what gets people to use.

For example, smokers enjoy whole-body effects, said Nasir Naqvi, a student at the University of Iowa Medical Scientist Training Program, who was the lead author of the recent article on smoking. It is not just nicotine binding to parts of the brain, he said, but sensations — heart rate, blood pressure, a tickle in the lungs, a taste in the mouth, the position of the hands, all the rituals.

The insula’s importance makes it an ideal target for many kinds of treatment, Dr. Paulus said, including drugs and sophisticated biofeedback. But methods to quell insular activity must be approached carefully, he said. People might lose the craving to smoke, drink alcohol or take other drugs, but they could simultaneously lose interest in sex, food and work.

As clinicians explore the possibilities, Dr. Craig is thinking about the insula in grander terms.

For example, lesions in the frontal insula can wipe out the ability to appreciate the emotional content of music. It may also be involved in the human sense of the progress of time, since it can create an anticipatory signal of how people may feel as opposed to how they feel now. Intensely emotional moments can affect our sense of time. It may stand still, and that may be happening in the insula, a crossroads of time and desire.

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Like a hole in the head: The return of trepanation

by Arran Frood

IN THE early 1960s, a young Russian neurophysiologist called Yuri Moskalenko travelled from the Soviet Union to the UK on a Royal Society exchange programme. During his stay, he co-authored a paper published in Nature. “Variation in blood volume and oxygen availability in the human brain” may not sound subversive, but it was the start of a radical idea.

Decades later, having worked in Soviet Russia and become president of the Sechenov Institute of Evolutionary Physiology and Biochemistry at the Russian Academy of Sciences in St Petersburg, Moskalenko is back in the UK. Now collaborating with researchers at the Beckley Foundation in Oxford, his work is bearing fruit.

And strange fruit it is. With funding from the foundation, he is exploring the idea that people with Alzheimer’s disease could be treated by drilling a hole in their skull. In fact, he is so convinced of the benefits of trepanation that he claims it may help anyone from their mid-40s onwards to slow or even reverse the process of age-related cognitive decline. Can he be serious?

For thousands of years, trepanation has been performed for quasi-medical reasons such as releasing evil spirits that were believed to cause schizophrenia or migraine. Today it is used to prevent brain injury by relieving intracranial pressure, particularly after accidents involving head trauma.

In the popular imagination, though, it is considered crude, if not downright barbaric. Yet such is the desperation for effective treatments for dementia that drilling a hole in the skull is not even the strangest game in town.

The problem is huge and growing. Alzheimer’s, the most common form of dementia, affects 700,000 people in the UK and nearly 5 million in the US. In addition, 1 in 5 Americans over the age of 75 have mild cognitive impairment, which often leads to Alzheimer’s. As people live longer, the numbers seem certain to grow. Yet we have few ideas about what causes dementia and even fewer about how to treat it. Most patients get a mixture of drugs and occupational therapy, which at best stalls the apparent progression of their illness by masking its symptoms.

The causes of dementia are many and poorly understood, but there is growing evidence that one factor is the flow of blood within the brain. As we age, cerebral blood flow decreases, and the earlier this happens the more likely someone is to develop early onset dementia. It remains unclear, however, whether declining cerebral blood flow is the cause, or an incidental effect of a more fundamental change. Moskalenko’s research indicates that cerebral blood flow is more closely correlated with age than with levels of dementia, so he decided to delve more deeply.

As well as delivering oxygen to the brain, cerebral blood flow has another vital role: the circulation and production of cerebrospinal fluid. This clear liquid surrounds the brain, carrying the nutrients that feed it and removing the waste it produces, including the tau and beta-amyloid proteins that have been implicated in the formation of plaques found in the brains of people with Alzheimer’s (Cerebrospinal Fluid Research, vol 5, p 10).

How blood flow influences cerebrospinal fluid flow can be gauged from something called “cranial compliance”, a measure of the elasticity of the brain’s vascular system. “The cranium is a bony cavity of fixed volume, with the brain taking up most of the space,” says Robin Kennett, a neurophysiologist from the Oxford Radcliffe Hospitals in the UK. “Every time the heart beats and sends blood into the cranium, something else has to come out to prevent the pressure rising to levels that would damage the brain.” So, as fresh blood flows into the brain’s blood vessels, cerebrospinal fluid flows out into the space around the spinal cord through a hole in the base of the skull called the foramen magnum.

As we age, the proteins in the brain harden, preventing this system from working as it should. As a result, the flow of both blood and cerebrospinal fluid is reduced, impairing the delivery of oxygen and nutrients as well as the removal of waste. Moskalenko’s research suggests that this normally begins between the ages of 40 and 50. Moreover, in a study of 42 elderly people with dementia, he found that the severity of their cognitive disorder was strongly correlated with cranial compliance: those with the severest dementia had the lowest compliance (International Journal of Psychophysiology, vol 69, p 307). “Cranial compliance is a significant component of the origin of certain cases of brain pathology,” he says.

This view gets qualified agreement from Conrad Johanson, a clinical neuroscientist at Brown University in Providence, Rhode Island. Although the link between low compliance and dementia has yet to be comprehensively shown, he says, “there’s a gestalt that it’s broadly true”.

So where does trepanation come into all this? “A hole made in the bony cavity would act as a pressure-release valve,” says Kennett, and this would alter the flow of fluids around the brain. This is exactly what Moskalenko observed when he carried out one of the first neurophysiological studies on trepanation.

Moskalenko studied 15 people who had undergone the procedure following head injuries. He found that their cranial compliance was around 20 per cent higher than the average for their age. Based on this, he calculates that a 4-square-centimetre hole increases cerebral blood flow by between 8 and 10 per cent, which is equivalent to 0.8 millilitres more blood per heartbeat (Human Physiology, vol 34, p 299). This, he says, shows that trepanation could be an effective treatment for Alzheimer’s, and he even goes so far as to suggest that it might provide a “significant” improvement in the mental functions of anyone from their mid-40s, when cranial compliance starts to decline. A 4-square-centimetre hole increases cerebral blood flow by between 8 and 10 per cent.

Surprisingly, his most vociferous critics do not challenge his support for trepanation. Instead they question his ideas about how it works. Gerald Silverberg at the Stanford School of Medicine in California points out that drilling a hole in the skull may temporarily drain the cranial cavity of cerebrospinal fluid together with any toxins that may have accumulated in it, effectively flushing out the system. “Metabolite clearance, or the lack of it, is felt to be an important factor in the development of age-related dementias,” he says. A similar intervention, known as a lumbar shunt or “spinal tap”, in which a needle is inserted into the spinal column to remove cerebrospinal fluid, can dramatically improve the cognitive performance of people who undergo the procedure, Silverberg says. Spinal taps are normally used as a treatment for hydrocephalus – water on the brain – but Silverberg is now trying it out on people with Alzheimer’s, and early studies suggest it helps (Neurology, vol 59, p 1139).

Olivier Baledent, a neurophysiologist based at the University Hospital of Amiens, France, also questions Moskalenko’s focus on cranial compliance (Journal of Cerebral Blood Flow & Metabolism, vol 27, p 1563). Like Silverberg, he believes cerebrospinal fluid itself is key. Baledent’s unpublished research shows that in people with mild cognitive impairment, there is reduced activity in a part of the brain called the choroid plexus, where cerebrospinal fluid is formed. He suspects this results in impaired fluid formation and reabsorption, leading to a build-up of toxins, and that a spinal tap may be able to stop or decrease dementia by improving fluid turnover. Trepanation could work in a similar way.

So will dementia patients and their families ever accept trepanation as a treatment for the condition? Johanson, who sees trepanation as no more alarming than a spinal tap, admits that it is always going to be a hard sell. “People think it’s witchcraft when you drill a hole in the skull and patients are improving.”
It is always going to be a hard sell – people think it’s witchcraft when you drill a hole in the skull and patients start improving

Harriet Millward, deputy chief executive of UK-based charity Alzheimer’s Research Trust, is keeping an open mind. “The procedure has been understudied so far and, until further research has been undertaken, the possibility of beneficial effects remains open,” she says. David Smith, a neuropharmacologist and head of the Oxford Project to Investigate Memory and Ageing, is even more receptive. “I think the observations look pretty robust,” he says. In the absence of drug treatments for dementia, “these rather drastic surgical ones are worth considering”, he says.

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Spinal Fluid Alzheimers Clues

Signs of Alzheimer’s disease show up in spinal fluid even as mild memory problems start to appear, according to new research.

Several substances known as biomarkers create a specific profile in the fluid, according researchers from Sahlgrenska Academy in Sweden.

“The earlier we can catch Alzheimer’s disease, the more we can do for the patient. The disease is one that progresses slowly, and the pharmaceuticals that are currently available are only able to alleviate the symptoms,” researcher Kaj Blennow said in a news release.

Blennow said that patients who showed the profile for Alzheimer’s disease were 27 times more likely to have mental deterioration than a control group. The study was based on samples from 168 patients.

“Our discovery that an analysis of biomarkers in the cerebrospinal fluid can reveal Alzheimer’s disease at a very early stage will have major significance if the new type of pharmaceutical that can directly slow the progression of the disease proves to have a clinical effect. It is important in this case to start treatment before the changes in the brain have become too severe,” said Blennow.

The results were published in the journal Lancet Neurology.

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Measuring Brain’s Memory Centers May Help Predict Alzheimer’s

Scientists at the University of California, San Diego School of Medicine have shown that a fully automated procedure called Volumetric MRI which measures the “memory centers” of the brain and compares them to expected size is effective in predicting the progression from mild cognitive impairment (MCI) to Alzheimer’s disease. The procedure can be readily used in clinics to measure brain atrophy, and may help physicians to predict decline in MCI patients. Their study has been published in the June issue of the journal Alzheimer Disease and Associated Disorders.

“Use of this procedure is like bringing the experience of an expert neuro-radiologist to any clinic that has the right software,” said James Brewer, MD, PhD, assistant professor in UC San Diego’s Departments of Radiology and Neurosciences. “These fully automated and rapid methods of measuring medial temporal lobe volumes may help clinicians predict cognitive decline in their patients, and have the potential to influence how neurology is practiced.”

Mild cognitive impairment (MCI) is considered a transitional stage between the forgetfulness associated with normal aging and Alzheimer’s disease. Yet, many patients with MCI do not progress to Alzheimer’s, and these individuals don’t need treatments targeted to prevent or slow down neuro-degeneration. Therefore, objective measures are necessarily to distinguish MCI patients who will clinically decline from those who will remain stable.

“Our goal was to find neuroimaging measures of change that reflected more than merely a person’s advancing age, but instead correlated tightly with how a person’s cognitive status worsens over time,” said co-author Michael Rafii, MD, PhD, assistant professor of neurosciences at UC San Diego. “It’s too early to draw a definitive comparison, but it appears that these early changes especially shrinking of the hippocampus may offer a robust biological marker for change.”

Medial temporal lobe atrophy has been associated with increased risk for conversion of MCI to Alzheimer’s disease. However, until now, studies have focused only on measurements of the brain’s hippocampus. The extent to which volumes of the amygdala the section of the brain associated with emotions and the nearby temporal horn could predict cognitive decline was unknown.

In addition, methods to measure these parts of the brain relied on subjective assessments of MRIs using a “tracing technique” that literally required a drawing of these portions of the brain a technique that isn’t practical or possible in most clinical settings.

For more than a year, researchers at the Memory Disorders Clinic at UC San Diego Medical Center have been successfully using a fully computerized procedure that takes images from the MRI scanner and translates them into quantitative values, according to Rafii, the clinic’s director. UC San Diego was the first clinic site to use this technology, which is now starting to be used in other clinical settings throughout the country.

The study looked at the fully automated volume measures of 269 MCI patients over a six-month interval. Baseline volume measurements of the hippocampus, amygdala and temporal horn were evaluated as predictors of cognitive change as measured by two commonly used instruments for screening cognitive function and dementia. Patients with smaller volumes of the hippocampus and amygdala showed more rapid clinical decline on these tests.

“These values objectively measure the hippocampus and amydala, and early data confirm previous findings that these brain areas may atrophy early in Alzheimer’s disease and can offer a clinical marker for change,” said Rafii. The fluid-filled temporal horn increases as the hippocampus shrinks, and these complementary measurements may correlate closely with how a patient’s cognitive status worsens over time, he added.

The study is part of the Alzheimer Disease Neuroimaging Initiative (ADNI), the largest Alzheimer’s disease study ever funded by the National Institutes of Health. Announced in October 2004 and set to run until 2010, this public-private consortium has engaged 59 research centers in the U.S. and Canada in a massive effort to follow 821 research volunteers for three years. One of its main goals is to develop biomarkers that can ultimately be approved by the FDA to substitute for cognitive measures in Alzheimer’s disease clinical trials.

Sanja Kovacevic, PhD, UC San Diego Department of Radiology, also contributed to this study, which was supported by the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health, and the Alzheimer’s Disease Neuroimaging Initiative, funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering and the Food and Drug Administration. Principle investigator of ADNI is Michael W. Weiner, MD, VA Medical Center and University of California, San Francisco.

Scanner images were processed using the NeuroQuant software package produced by CorTechs Labs, Inc. of La Jolla, California. Images were downloaded from the ADNI image depository at the Laboratory of Neuroimaging at UCLA.

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To Sleep, Perchance To Dream

WSJ

Twenty percent of Americans sleep less than six hours a night, and nearly one-third have lost sleep worrying about financial concerns, according to the National Sleep Foundation, which recommends that adults get seven to nine hours. “Our society thinks sleep is for slackers,” says Darrel Drobnich, the organization’s chief program officer.

Millions of Americans aren’t getting enough sleep, and even those that are may not be getting the most restful sleep possible. Health columnist Melinda Beck tries out the Zeo, a gadget that monitors and tracks brain waves during the different stages of sleep.
But all that lost sleep is taking an insidious toll. Chronic, inadequate sleep raises the risk of cardiovascular disease, depression, diabetes and obesity. It impairs cognitive function, memory and the immune system and causes more than 100,000 motor-vehicle accidents a year. Sleep deprivation also changes the body’s metabolism, making people eat more and feel less satisfied.

Studies presented at the American Association of Sleep Medicine’s annual meeting in Seattle this week also found that inadequate sleep is associated with lower GPAs among college students and with elevated levels of visfatin, a hormone secreted by belly fat that is associated with insulin resistance.

What many people don’t realize is that even if they log respectable time in bed (known as TIB among sleep researchers), they may be getting poor-quality sleep, with not enough of the restorative phases. REM, the Rapid Eye Movement phase in which dreaming occurs, is crucial for consolidating memories, learning, creativity, problem-solving and emotional balance. Deep, or slow-wave sleep, when the body secretes human growth hormone, is critical for development and physical repair. Both REM and deep sleep decline with age and are highly vulnerable to disruptions, from caffeine and alcohol to anxiety and a variety of sleep disorders.

One tip-off that you haven’t gotten enough restorative sleep is trouble waking up and excessive daytime sleepiness (a condition known as EDS). “People say, ‘Oh, I don’t have a sleep problem. I can fall asleep anywhere, anytime’ — but that means you are excessively sleepy,” says Charles Czeisler, a professor of sleep medicine at Harvard Medical School.

Other symptoms of sleep deprivation include mood changes, difficulty focusing or remembering and a chronic need for caffeine, which can then create a vicious circle of dependence and disruption. That would be me.

Finding out what’s going on in your sleep generally requires spending the night in a professional sleep lab hooked up to lots of wires and monitors. But I’ve been testing a new home-sleep monitor called the Zeo Personal Sleep Coach that lets people track their sleep patterns nightly in their own bedrooms.

You sleep wearing a soft headband with sensors that monitor your brain waves and send signals wirelessly to a device that looks like a sleek clock radio. It displays whether you are awake or in light sleep, deep sleep, or REM sleep, in real time, all through the night.

“If you can measure it, you can manage it,” says Stephan Fabregas, one of two recent Brown University graduates who invented the Zeo because they were looking for a way to wake up feeling less groggy after late nights.

Of course, not everyone needs a fancy gadget to tell them whether they are sleeping properly. But I was stunned by my results: The Zeo showed that I woke up numerous times and was awake for long stretches of the night, without having any recollection. (Perception of time is often distorted at night — many people with insomnia actually sleep more than they think they do.) Even though I was in bed for six or seven hours each night, I was averaging only about four hours of real sleep and very little REM or deep sleep. No wonder I feel so tired!

The Zeo stores the information on a memory card you can upload to a Web site, which helps track your sleep patterns and sends daily coaching tips for getting better sleep. The $399 device comes with six months of daily email coaching, which can be extended at a cost of $99 for each additional six months. (Currently, it’s available only online at www.myzeo.com.)

To help you keep track of your sleep, the Zeo also gives you a “ZQ” score every morning, based on the quantity and quality of your sleep the night before. There’s no ideal ZQ — you’re comparing your own score from night to night. But the average for people in their 20s is 86; for those in their 40s, it is 74; and for those in their 50s, it is 67, since sleep quality declines with age.

My ZQs bounced from the 40s to a dismal 15 the first week. Switching to decaf after 3 p.m. and making an effort to get to bed earlier helped me bring my score into the 50s the second week. (“Having caffeine even first thing in the morning can induce changes in brain activity during sleep,” says Kenneth Wright, director of the Sleep and Chronobiology Lab at the University of Colorado at Boulder and one of Zeo’s scientific advisers.) I also noticed that the nights when I had the longest stretches of wakefulness were those when my column was due — probably a sign that I was still thinking about it long after turning in.

Everybody’s sleep and sleep disruptors are different. Todd Johnson, a 40-year-old border-patrol agent in Caribou, Maine, and one of ZEO’s early testers, found that reading before he went to bed helped reduce his wake time and bring his ZQ from the 20s into the 60s. “You can try something that night and see the results in the morning,” he says. Another early tester, Tim Guirl, who teaches at a community college in Seattle, found that he had more restorative sleep if he didn’t exercise too close to bedtime and eliminated a large late-night snack.

Other recommendations from Zeo include reducing noise, light and disruptive influences like pets in the bedroom; having a “power-down” hour before bedtime with no email, no Internet use, no cellphones and no BlackBerrys; and keeping a consistent sleep schedule. And if you find yourself awake and worrying, Zeo recommends getting out of bed and writing down what you’re thinking about in a “worry journal.”

Zeo says its brain-wave results are similar to those from professional sleep labs — but only about 140 people have tested it so far. And the Zeo isn’t designed to diagnose actual sleep disorders, which plague an estimated 70 million Americans — you need to see a doctor for that.

To see if something besides drinking coffee and thinking great thoughts was affecting my sleep, I underwent a sleep study at the Sleep Health Center connected with Brigham and Women’s Hospital in Brighton, Mass. A polysomnography, as such tests are called, measures brain waves like the Zeo, but also heart rate, respiratory rate, oxygen saturation, body positions and movements. It took about 45 minutes to have all of the sensors and wires attached — and then a little longer to get comfortable enough to sleep.

To my surprise, the study found that I had a fairly severe case of Periodic Limb Movements, episodes of involuntary muscle movements in the night. About 10% of adults have PLMs. Many don’t even notice; sleep partners are often bothered more than the sleepers themselves. But PLMs can be very disruptive if they are accompanied by arousals from sleep. I was averaging 42 arousals per hour. According to David White, another Harvard sleep physician who prescribed the study for me, PLMs can be due to an iron deficiency or medication side effects, and they are often related to “restless-leg syndrome,” which causes an irresistible urge to move the legs, day or night. Medications like Requip can minimize the movements; I’m going to give them a try.

The study also showed I had some obstructive sleep apnea, in which the airway narrows, especially when the muscles relax in sleep. People with OSA stop breathing momentarily until a lack of oxygen alerts the brain, which wakes them up with a gasp. These mini arousals can occur as often as 70 times an hour, leaving the sufferer exhausted and at risk for heart disease, stroke and atherosclerosis. An estimated 4% of men and 2% of women have OSA. One telltale sign is having a shirt-collar size larger than 17 inches. Another sign is loud snoring, although I certainly don’t do that. (“Women never snore — they all deny it,” says Dr. White.)

Zeo
The Zeo sleep monitor lets people track their sleep patterns at home.
The most effective treatment is a Continuous Positive Airway Pressure machine, which blows air through the nose to keep the airway open. My OSA isn’t that bad — yet. Other remedies include a dental appliance that helps prop the airway open and losing weight, which helps reduce the airway blockage.

Dr. White is also chief medical officer for Philips Home Healthcare, which makes a watch-like monitor, called an Actiwatch, that tracks whether the wearer is moving or still, roughly corresponding with sleep. The Actiwatch doesn’t show sleep phases; it generally diagnoses problems with jet lag and body clocks. I wore one for a week, and although I’m still a night owl, it showed nothing amiss in that area.

All in all, “there are plenty of ways you can improve your sleep,” Jason Donahue, another Zeo founder, tells me cheerily. This week, I’m starting in on Zeo’s tips on keeping disturbances in the bedroom to a minimum. The dog may have to find a new place to sleep.

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Failure Of American Health Care Insurance Causes Bankruptcies

By Tara Parker-Pope

Nearly two out of three bankruptcies stem from medical bills, and even people with health insurance face financial disaster if they experience a serious illness, a new study shows.

The study data, published online Thursday in The American Journal of Medicine, likely understate the full scope of the problem because the data were collected before the current economic crisis. In 2007, medical problems contributed to 62.1 percent of all bankruptcies. Between 2001 and 2007, the proportion of all bankruptcies attributable to medical problems rose by about 50 percent.

“The U.S. health care financing system is broken, and not only for the poor and uninsured,” the study authors wrote. “Middle-class families frequently collapse under the strain of a health care system that treats physical wounds, but often inflicts fiscal ones.”

The data on medical bankruptcy, compiled by researchers at Harvard Law School, Harvard Medical School and Ohio University, is based on a survey of 2,314 randomly selected bankruptcy filers during early 2007.

Among families who were bankrupted by illness, those with private insurance reported average medical bills of $17,749 compared to those who were uninsured, who faced an average of $26,971 in medical costs. Those who had health insurance but lost it in the course of their illness reported average medical bills of $22,568.

Hospital costs accounted for about half the expenses (48 percent), followed by prescription drugs (18.6 percent), doctor’s bills (15.1 percent) and insurance premiums (4.1 percent). Medical equipment and nursing home care rounded out the list.

The health problems that left patients with the highest out-of-pocket expenses were ranked as follows:

Neurologic (i.e., multiple sclerosis): $34,167
Diabetes: $26,971
Injuries: 25,096
Stroke: $23,380
Mental illnesses: $23,178
Heart disease: $21,955

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You And The Sun

nyt

If we had lots of sun as children, and several minor burns, are we doomed no matter what we do now (in our 30s and up)?
A.W.

Dr. Steven Q. Wang, director of Dermatologic Surgery and Dermatology and Memorial Sloan-Kettering Cancer Center in Basking Ridge, N.J., replies:

Ultraviolet radiation from the sun plays a major role in the development of skin cancer. There is strong evidence that chronic, or long-term, UV exposure can induce the development of actinic keratosis (a precancerous condition) and two forms of skin cancer: basal cell cancer and squamous cell cancer.

In contrast, current evidence suggests that intermittent and intense UV exposure plays a major role in the development of most subtypes of melanoma. Lentigo maligna melanoma, a subtype of melanoma commonly found on the face and scalp of elderly men and women, is related to chronic UV exposure.

Severe sunburns as a child certainly increase an individual’s risk for developing skin cancer. However, this fact is by no means an excuse for adults to forgo protection from ongoing damage from ultraviolet rays. The body has an incredibly elaborate repair mechanism that can repair sun damage. It is also critical that everyone reduce the amount of future UV damage.

Is melanoma really sun-related? If so, then why do melanomas appear on places rarely exposed to the sun, like on the inner side of the arm or under a toenail?
Sam

In addition to sun exposure, genetic disposition and family risks of melanoma are important in assessing the risk of melanoma in any individual. Melanoma and other non-melanoma skin cancers can be found on parts of the body that are not routinely exposed to the sun. Hence, it is very important to examine the whole body, including the scalp and feet, during a total body skin exam.

Has it been established whether sunscreen helps to prevent skin cancer? Sunscreen clearly helps to prevent sunburn.
Michael

Sunscreen has been shown to block and absorb the UV spectrum from the sun, and a large body of evidence has demonstrated that sunscreen prevents sunburn. Furthermore, there is strong evidence showing the beneficial roles of sunscreens in reducing precancerous skin conditions like actinic keratosis and squamous cell cancer.

Sunscreen has also been shown to reduce the number of moles that develop in children. We know that having many moles is an independent risk factor for developing melanoma.

Current scientific evidence has not able to prove that sunscreen reduces the risk of developing melanoma. However, before jumping to any conclusions, it is important to point out that the older generation of sunscreens suffered a number of shortcomings.

First, these older sunscreens offered protection only against the shorter-wave UVB rays, but not the more deeply-penetrating UVA rays. UVA can induce indirect DNA damage in cells by producing oxygen radical species. Also, the older sunscreens were not photostable; many of them degraded after an hour of sun exposure. Current sunscreens have solved some of these technical problems.

There are a couple issues here. One is that the data linking skin cancer and sun exposure has traditionally been very poor. The medical community still maintains that sunscreen use is beneficial and limited sun exposure is best. The last I looked, about a year and a half ago, the United States Preventive Services Task Force consensus recommendation could find no definitive conclusion to recommend for or against sunscreen use in the prevention of skin cancer or the link between sun exposure and melanoma. There is some indication the the more benign skin cancers are influenced by sun exposure, but the bad form, melanoma, still has the jury out.
Jeremy

The comment that “data linking skin cancer and sun exposure has traditionally been very poor” is inaccurate. In fact, we have strong evidence attributing squamous cell cancer and basal cell cancer to excessive UV exposure.

The comment is correct, though, in stating that currently there is no definitive conclusion about the effects of sunscreens in protecting against melanoma. However, there are a number of reasons that could explain the ambiguous results. Let me elaborate on the points I made above.

First, the sunscreens used during the period when those studies were conducted had low SPF values, and in many cases, consumers did not regularly apply sufficient amounts, which would further reduce the effective SPF value. In some of the studies, then, the sunscreens had effective SPF values of only 2 to 4. In addition, all of those sunscreens provided no or very little protection against the more deeply penetrating UVA rays that can damage DNA. Finally, those older sunscreens were not photostable and tended to break down after an hour.

In contrast, today’s sunscreens have much higher effective SPF value, are photostable and offer broad UV spectrum protection. Like many sunscreen experts, I am optimistic that future studies may show the protective benefit of modern sunscreens in preventing melanoma. However, any definitive conclusion will not be available for at least 7 to 10 years. In the meantime, it is a good idea to continue to use sunscreens as a part of a photoprotective plan.

I am white, 60 years old, and as a child had two or three sunburns which caused my skin to peel. My father had a melanoma at 70 (upper back, was never in the sun). At 50, I had a basal cell carcinoma removed from my upper back. At 60, I had a 3 millimeter melanoma-in-situ removed from my upper back. I have also had several actinic keratoses removed (face, upper back).

How much of this can be attributed to genetics? What can I expect as to future problems? What can I do to reduce future occurrences (I wear a hat, long sleeved shirts, and use 45 SPF every day)? And at what interval do you recommend a visit to my dermatologist (currently every 3 months). Thank you
Victor Parker

In my clinic, I care for a large number of patients like you who had severe sunburns as a child and had a personal history of non-melanoma and melanoma skin cancers. To care for them, we use a number of noninvasive imaging modalities.

Most of those patients have routine total body skin exams every three to six months depending on their personal and family history and other risk factors. In addition, we often use dermoscopy, which uses a specialized hand-held microscope to examine moles, and total body photography. Both tools have dramatically improved the accuracy and confidence of detecting skin cancers.

Finally, our team emphasizes the need for rigorous and ongoing photoprotection. A number of studies have demonstrated that photoprotective actions like using sunscreen and wearing hats can reduce the risk for future skin cancers.

I would like to carry a sunscreen bottle in my car so as to have it available for reapplying. However, I am afraid what effect would high temp. in the car during summer have on the efficacy of any sunscreen?
MG

Carrying sunscreen in the car is a good idea. The high temperature will not severely impact the protective property of today’s sunscreens.

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Babies And TV

By Liz Szabo

A study released Monday adds to the debate over whether television impairs children’s language development.It found that parents and children virtually stop talking to each other when the TV is on, even if they’re in the same room.
For every hour in front of the TV, parents spoke 770 fewer words to children, according to a study of 329 children, ages 2 months to 4 years, in the June issue of Archives of Pediatrics & Adolescent Medicine. Adults usually speak about 941 words an hour.

Children vocalized less, too, says author Dimitri Christakis of the Seattle Children’s Research Institute. In some cases, parents may have spoken less because they sat a child in front of a TV and left the room, he says. In others, parents simply zoned out themselves while watching TV with a child. Researchers didn’t note the content of the TV shows.

Parents may not realize how little they interact with children when a TV is on, Christakis says. A mother may think she’s engaged with a baby because they’re both on the floor playing blocks. But if a TV is on in the background, the two of them talk much less, he says.

That may help explain earlier studies finding that babies who watch a lot of TV know fewer words, although they catch up to their peers by 16 months, Christakis says. “Babies learn language from hearing it spoken,” he says.

Christakis and his colleagues fitted children with digital devices that recorded everything they heard or said one day a month for an average of six months. A speech-recognition program, which could differentiate TV content from human voices, compared the number of words exchanged when televisions were on or off.

Victor Strasburger, a professor of pediatrics at the University of New Mexico, describes the latest report as “an excellent, creative study.”

It’s the seventh study to suggest that TV hurts children’s language development, Strasburger says. A March report from Harvard Medical School found that watching TV neither helped nor harmed children’s language skills.

Though Christakis acknowledges that there is still some debate about whether watching television is harmful, he says there’s no evidence to show that it’s helpful. That’s why the American Academy of Pediatrics recommends no TV for babies under age 2.

“We need to avoid parking babies in front of screens,” Strasburger says. “Parents need to realize they need to be the primary entertainment for their babies. Parents are movie stars when their kids are babies. It doesn’t last long.”

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Lappie on steroids

by Christopher Null

Today’s a big day for those of us obsessed with battery tech, with two new technologies in the works which promise to increase capacity for power packs — if they manage to make it to market.

Up first is a new spin on the traditional lithium battery, which uses sulfur as part of the cathode in the cell instead of the more traditional metal oxides used today. To solve a decades-old challenge, a nanoscale carbon structure is used to trap liquefied sulfur, keeping the sulfur in electrical contact in sufficient surface area to work as a component of the battery.

The upshot is that the new sulfur-based design can theoretically store three times the energy of a traditional lithium-ion battery of the same size. And since sulfur is in such abundance — sulfur is a by-product of oil and gas production and the stuff piles up in small mountains outside many refineries — there’s certainly no worry that we’ll run out of it in the foreseeable future. Patents have been filed.

Battery breakthrough #2 involves the use of technology that would allow batteries to be recharged by simple exposure to the air. Also using a carbon lattice like the lithium-sulfur cell described above, oxygen molecules are drawn from the air and become trapped in the matrix for use as part of the chemical reaction in the battery. When spent, the battery can draw in more oxygen, allowing a sort of natural recharging to occur as the battery operates and giving it a theoretical running time up to 10 times that of a non-air-based cell. And, because air is weightless, the battery cell is lighter than a typical chemical cell.

The so-called STAIR cell isn’t as far along as the lithium-sulfur cell, and prototypes are still being developed. However, if all goes well, it could be a suitable battery for many applications ranging from cell phones to electric cars — anywhere where reducing weight is of special concern.

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Brain Plasticity Returns To Favor

by Ian Sample

On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe’s leading science journal. It involved a group of people who took turns to sit in an old dentist’s chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people’s expressions and how they wore their hair. It was remarkable because all were completely blind.

The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain’s ability to adapt. The blind people had learned to “see” through the sensation of touch.

Here’s what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers’ brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera.

What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain’s power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain’s neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer’s disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits.

The idea of brain plasticity has been discovered and forgotten many times over the centuries. The ancient Greeks accepted the idea, with Socrates believing that people could train their brains the way gymnasts train their bodies. Around the time of Galileo, the idea fell out of favour, as scientists began to see the world mechanistically, with each object, organ and even parts of an organ being attributed well-defined, unchanging roles. It was these ideas that led to the notion of our brains being “hardwired”, an idea that today is steadily being overturned.

Norman Doidge, a psychiatrist at the University of Toronto and author of the New York Times bestseller, The Brain That Changes Itself, says our ongoing belief that our brains are hardwired has held up medical progress. “Our best and brightest neuroscientists thought our brains were structured like complex machines, with each part performing one function in one location, and that had implications. If you were born with a part that was defective, and say it gave you a learning disorder, it meant there was nothing you could do, you had to learn to live with it. If you sustained a brain injury or had a stroke and part of your brain broke down, there was nothing you could do. Brain exercises made no sense, and even more fundamentally, human nature was as fixed as the brain from which it emerged,” he says.

Neuroplasticity does not see the different regions of the brain as completely versatile and certainly not interchangeable. But it recognises that if part of the brain is damaged, it can be possible to train other areas to take on, at least to some extent, the job of the lost brain matter.

One of Doidge’s case studies, Cheryl Schiltz, demonstrates how brain plasticity can transform a damaged life. Her story began in 1997, when, at the age of 39, she picked up an infection after a routine operation. To clear it up, she was given a course of the antibiotic, gentamicin. When used in excess, the drug can sometimes destroy cells in the inner ear, causing hearing loss, but it is cheap and effective, so is widely used. In Schiltz’s case, gentamicin destroyed her vestibulary system, the looping canals of the inner ear that allow us to tell up from down. Tests showed she had only 2% of her vestibulary function left.

What happens to a person who cannot balance is striking. Schiltz felt as if she was constantly falling, and as a result, she usually did. When she hit the floor, the feeling didn’t go away. Sometimes, it was as if a trapdoor had opened and she was free-falling into an abyss.

Her doctor found an ingenious way to treat her. He fitted her with a bizarre-looking helmet fitted with motion sensors. These fed signals to a metal strip that she placed in her mouth. Now, as she tipped forward, she felt a tingle ripple to the tip of her tongue. As her head moved to the side, the tingle rolled sideways.

The first time Schiltz put the device on she began to cry. The wobbles subsided. She felt safe. She could stand up. Over time, her brain learned to turn the feeling in her tongue into a sense of balance. After prolonged training sessions, Schiltz needed the helmet less and less. Her doctor thinks her brain tuned into the tiny signals coming from what remained of her vestibulary system, and recruited other brain nerves to help out.

There is a darker side to brain plasticity that Doidge has seen in some of his own patients. He has treated several men whose relationships were in tatters because of what Doidge calls an “epidemic” of internet porn addiction. The men had spent so much time viewing pornographic images, they had become impotent with their partners, and some developed extreme sexual tastes. Doidge believes that neuroplasticity was at work here, with the men’s brains altered by an almost limitless supply of pictures, available any time at the click of a mouse. Most of the men recovered after being banned from using their computers and going cold turkey.

Some psychiatrists suspect that a common technique called cognitive behaviour therapy, which helps people to change their perspective on events in their lives, may work because of the brain’s plasticity.

In his book, Doidge uses ideas of neuro-plasticity to promote ways of overcoming conditions such as obsessive-compulsive disorder, and other common problems, such as persistent worries and anxieties. In some instances, he suggests that people force themselves to do a rewarding task as soon as they get the urge to worry or check whether the stove is off for the seventh time. “You have a real civil war for four to six weeks, because your brain is pulling you one way and you are pushing in another, but when it works, it is very powerful,” he says.

Doidge says he is not anti-medication, but wonders if therapies that tap into neuro-plasticity will soon replace drug treatments for certain conditions. “We can change our brains by sensing, imagining and acting in the world. It’s economical and mostly low-tech, and I’m very, very hopeful”.

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How Deep The Web?

By ALEX WRIGHT

One day last summer, Google’s search engine trundled quietly past a milestone. It added the one trillionth address to the list of Web pages it knows about. But as impossibly big as that number may seem, it represents only a fraction of the entire Web.

Beyond those trillion pages lies an even vaster Web of hidden data: financial information, shopping catalogs, flight schedules, medical research and all kinds of other material stored in databases that remain largely invisible to search engines.

The challenges that the major search engines face in penetrating this so-called Deep Web go a long way toward explaining why they still can’t provide satisfying answers to questions like “What’s the best fare from New York to London next Thursday?” The answers are readily available — if only the search engines knew how to find them.

Now a new breed of technologies is taking shape that will extend the reach of search engines into the Web’s hidden corners. When that happens, it will do more than just improve the quality of search results — it may ultimately reshape the way many companies do business online.

Search engines rely on programs known as crawlers (or spiders) that gather information by following the trails of hyperlinks that tie the Web together. While that approach works well for the pages that make up the surface Web, these programs have a harder time penetrating databases that are set up to respond to typed queries.

“The crawlable Web is the tip of the iceberg,” says Anand Rajaraman, co-founder of Kosmix (www.kosmix.com), a Deep Web search start-up whose investors include Jeffrey P. Bezos, chief executive of Amazon.com. Kosmix has developed software that matches searches with the databases most likely to yield relevant information, then returns an overview of the topic drawn from multiple sources.

“Most search engines try to help you find a needle in a haystack,” Mr. Rajaraman said, “but what we’re trying to do is help you explore the haystack.”

That haystack is infinitely large. With millions of databases connected to the Web, and endless possible permutations of search terms, there is simply no way for any search engine — no matter how powerful — to sift through every possible combination of data on the fly.

To extract meaningful data from the Deep Web, search engines have to analyze users’ search terms and figure out how to broker those queries to particular databases. For example, if a user types in “Rembrandt,” the search engine needs to know which databases are most likely to contain information about art ( say, museum catalogs or auction houses), and what kinds of queries those databases will accept.

That approach may sound straightforward in theory, but in practice the vast variety of database structures and possible search terms poses a thorny computational challenge.

“This is the most interesting data integration problem imaginable,” says Alon Halevy, a former computer science professor at the University of Washington who is now leading a team at Google that is trying to solve the Deep Web conundrum.

Google’s Deep Web search strategy involves sending out a program to analyze the contents of every database it encounters. For example, if the search engine finds a page with a form related to fine art, it starts guessing likely search terms — “Rembrandt,” “Picasso,” “Vermeer” and so on — until one of those terms returns a match. The search engine then analyzes the results and develops a predictive model of what the database contains.

In a similar vein, Prof. Juliana Freire at the University of Utah is working on an ambitious project called DeepPeep (www.deeppeep.org) that eventually aims to crawl and index every database on the public Web. Extracting the contents of so many far-flung data sets requires a sophisticated kind of computational guessing game.

“The naïve way would be to query all the words in the dictionary,” Ms. Freire said. Instead, DeepPeep starts by posing a small number of sample queries, “so we can then use that to build up our understanding of the databases and choose which words to search.”

Based on that analysis, the program then fires off automated search terms in an effort to dislodge as much data as possible. Ms. Freire claims that her approach retrieves better than 90 percent of the content stored in any given database. Ms. Freire’s work has recently attracted overtures from one of the major search engine companies.

As the major search engines start to experiment with incorporating Deep Web content into their search results, they must figure out how to present different kinds of data without overcomplicating their pages. This poses a particular quandary for Google, which has long resisted the temptation to make significant changes to its tried-and-true search results format.

“Google faces a real challenge,” said Chris Sherman, executive editor of the Web site Search Engine Land. “They want to make the experience better, but they have to be supercautious with making changes for fear of alienating their users.”

Beyond the realm of consumer searches, Deep Web technologies may eventually let businesses use data in new ways. For example, a health site could cross-reference data from pharmaceutical companies with the latest findings from medical researchers, or a local news site could extend its coverage by letting users tap into public records stored in government databases.

This level of data integration could eventually point the way toward something like the Semantic Web, the much-promoted — but so far unrealized — vision of a Web of interconnected data. Deep Web technologies hold the promise of achieving similar benefits at a much lower cost, by automating the process of analyzing database structures and cross-referencing the results.

“The huge thing is the ability to connect disparate data sources,” said Mike Bergman, a computer scientist and consultant who is credited with coining the term Deep Web. Mr. Bergman said the long-term impact of Deep Web search had more to do with transforming business than with satisfying the whims of Web surfers.

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Vitamin D Is Good For You

by Robin McKie

For any expectant mother, a brief stroll in the summer sunshine would seem a pleasant diversion from the rigours of pregnancy, a chance to relax in the warmth and to take in a little fresh air. It is a harmless – but unimportant – activity, it would seem.

But there is more to such walks than was previously realised, it emerged last week. In a new study, Bristol University researchers revealed they had found out that sunny strolls have striking, long-lasting effects. They discovered that children born to women in late summer or in early autumn are, on average, about 5mm taller, and have thicker bones, than those born in late winter and early spring.

Nor was it hard to see the causal link, said team leader Professor Jon Tobias. The growth of our bones, even in the womb, depends on vitamin D which, in turn, is manufactured in the skin when sunlight falls on it.

Thus children born after their mothers have enjoyed a summer of sunny walks will have been exposed to more vitamin D and will have stronger bones than those born in winter or early spring. “Wider bones are thought to be stronger and less prone to breaking as a result of osteoporosis in later life, so anything that affects early bone development is significant,” said Tobias.

The study is important, for it indicates that women should consider taking vitamin D supplements during pregnancy to ensure their children reach full stature. However, the Bristol team’s findings go beyond this straightforward conclusion, it should be noted. Their work adds critical support to a controversial health campaign that suggests most British people are being starved of sunshine, and vitamin D – a process that is putting their lives at risk.

These campaigners point to a series of studies, based mainly on epidemiological evidence, that have recently linked vitamin D deficiency to illnesses such as diabetes, breast cancer, prostate cancer, and tuberculosis. Last week also saw George Ebers, professor of clinical neurology at Oxford University, unveil evidence to suggest such a deficiency during pregnancy and childhood could increase the risk that a child would develop multiple sclerosis.

The studies require rigorous follow-up research, scientists admit – but they have nevertheless provoked considerable new interest in vitamin D. Indeed, for some health experts, the substance has virtually become a panacea for all human ills. Dietary supplements should be encouraged for the elderly, the young and the sick, while skin cancer awareness programmes that urge caution over sunbathing should be scrapped, they insist. We need to bring a lot more sunshine into our lives, it is claimed.

But this unbridled enthusiasm has gone down badly with health officials concerned about soaring rates of melanomas in Britain, the result of over-enthusiastic suntanning by holidaymakers decades ago. Existing, restrictive recommendations for limits on sunbathing must be rigorously maintained, they argue, or melanoma death rates will rise even further.

So just how much sunlight is safe for us? And which is the greater risk: skin cancer or diseases triggered by vitamin D deficiency? Answers for these questions now cause major divisions among health experts.

In fact, vitamin D is not strictly a vitamin. Vitamins are defined as nutrients which can only be obtained from the food we eat and which are vital to our health. For example, vitamin C, which wards off scurvy and helps the growth of cartilage, is found in citrus fruits, while broccoli and spinach are rich in vitamin K, which plays an important role in preventing our blood from clotting. And while it is true that vitamin D is found in oily fish, cod liver oil, eggs and butter, our principal source is sunlight.

“Vitamin D should really be thought of as a hormone,” said Dr Peter Berry-Ottaway, of the Institute of Food Science and Technology, and an adviser to the EU on food safety. “It forms under the skin in reaction to sunlight. We do get some from our food but our principal source is the sun.’

The key component in sunlight that stimulates vitamin D production in our bodies is ultra-violet light of wavelengths between 290 and 315 nanometres. Crucially, this component of sunlight only reaches Britain during the months between April and October. “The rest of the year, between November and March, the sun is low in the horizon. Its light has to pass through much more of the atmosphere than in summer and doesn’t reach the ground,” said Cambridge nutrition expert Dr Inez Schoenmakers. “For half the year we cannot make vitamin D from sunlight, so what we make in summer has to do us for the whole year.”

In relatively sunny southern England, this is not a problem but in the north and in the cloudier west, noticeable health problems build up – particularly among ethnic minorities. People with dark skin are less able to manufacture vitamin D than those with pale skin and in places with relatively gloomy skies – cities such as Bradford or Glasgow, for example – the impact can be severe.

In 2007, the Department of Health revealed that up to one in 100 children born to families from ethnic minorities now suffer from rickets, a condition triggered by lack of vitamin D in which children develop a pronounced bow-legged gait. The disease once blighted lives in Victorian Britain but was eradicated by improved diets. Now it is making a major resurgence, a problem that has been further exacerbated in ethnic communities by women wearing hijabs that cover all of their bodies and block out virtually every beam of vitamin-stimulating sunshine.

A major health campaign, offering dietary advice and vitamin D supplements has since been launched. But for many doctors, it is not enough. The nation’s health service needs to re-evaluate completely its approach to vitamin D as a matter of urgency; establish new guidelines for taking supplements; and scrap most of the limits on sunbathing currently proposed by health bodies.

These calls have been made not because of concerns about rickets, however. They follow the appearance of studies from across the globe that suggest vitamin D plays a key role in the fight against heart disease, cancer, tuberculosis, diabetes and multiple sclerosis. Vitamin D is not so much an important component of our diets as a miracle substance, they believe. It costs nothing to make, just some time in the sun, and lasts in the body for months.

A classic example of the potential of vitamin D was provided by a study published in a US journal, Proceedings of the National Academy of Sciences, last year. This revealed that people with higher levels of vitamin D were more likely to survive colon, breast and lung cancer. In the study, Richard Setlow, a biophysicist at the Brookhaven National Laboratory in the US and an expert on the link between solar radiation and skin cancer, calculated how much sunshine a person would get depending on the latitude on which they lived.

Setlow – who worked with colleagues at the Institute for Cancer Research in Oslo – also calculated the incidence and survival rates for various forms of internal cancers in people living at these different latitudes. Their results showed that in the northern hemisphere the incidence of colon, lung and breast cancer increased from south to north while people in southern latitudes were significantly less likely to die from these cancers than people in the north.

“Since vitamin D has been shown to play a protective role in a number of internal cancers and possibly a range of other diseases, it is important to study the relative risks to determine whether advice to avoid sun exposure may be causing more harm than good in some populations,” Setlow warned.

And then there is the impact of vitamin D levels on the heart. In a study published last year in the journal Circulation, scientists at the Harvard Medical School in Boston found that a deficiency of vitamin D increased people’s risk of developing cardiovascular disease. In addition, other studies have connected vitamin D deficiency to risks of succumbing to diabetes and TB.

And there was last week’s publication of the study by Professor Ebers which provided compelling evidence that lack of vitamin D triggers a rogue gene to turn against the body and attack nerve endings, a process that induces the disease multiple sclerosis. In each case, researchers urged that people ensure they take vitamin D supplements to help ward off such conditions.

But others believe such calls underestimate the problem. They point to a study, published in 2007, which indicates that more than 60 per cent of middle-aged British adults have less than optimal levels of vitamin D in their bodies in summer, while this figure rises to 90 per cent in winter. Given the links between deficiency and all those ailments, only a full-scale reappraisal of the vitamin’s role in British health will work, says Oliver Gillie, of the Health Research Forum.

In a report, Sunlight Robbery, he calls for the scrapping of Britain’s current SunSmart programme; the setting up of an international conference of doctors and specialists to establish vitamin D’s importance to health; promotion of the fortification of food with vitamin D: and the creation of a new committee whose membership would include representatives of groups of patients suffering from multiple sclerosis, cancer and other conditions linked to vitamin D.

But most controversial of all is his call for people to sunbathe far more frequently than currently advised. “It is time for the UK government to encourage people to sunbathe safely to reduce cancer risk,” he said.

Not surprisingly, the notion horrifies many health advisers. “There are now 9,000 new cases of melanoma in Britain every year and 2,000 deaths because people have sunbathed without proper care,” said Sara Hiom, director of health information for Cancer Research UK. “Figures have increased dramatically over the past 20 years and will continue to do so unless we are very careful.”

However, Hiom acknowledged that new studies did indicate that vitamin D deficiency was now linked to an increasing number of cancers and other diseases. “That is no excuse for behaving irresponsibly, however. People must avoided getting sunburned; stay out of the sun between 11am and 3pm even in this country in summer; and use factor 15 or stronger sunblock creams.”

In addition, other scientists cautioned that links between vitamin D deficiency with diseases like multiple sclerosis had yet to be proved. “People with low vitamin D may be more likely to have MS but that might simply happen because their condition makes it difficult to get out in the sunshine and make vitamin D in their bodies. We have yet to distinguish cause and effect in many of these cases,” said Dr Schoenmakers.

These points are crucial and suggest we need to be cautious about claims that vitamin D is capable of triggering miraculous cures. On the other hand, enough evidence is now emerging from laboratories round the world to indicate that a nutrient once thought to be a bit-player in the battle against disease, clearly has a key role to play in helping to maintain the general health of large numbers of the population of Britain.

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Up to 25% of People Have an Alzheimer’s Gene

by Carolyn Colwell

Middle-age people whose parents had Alzheimer’s and who carry the so-called Alzheimer’s gene might very well have the memory of someone 15 years older, a new study has found.

This memory decline was not detected in people of middle age whose parents had Alzheimer’s but who do not carry the gene, known as ApoE4, according to the study.

About 20 percent to 25 percent of the population have at least one copy of the ApoE4 gene, but not all people with the gene develop Alzheimer’s, said study co-author Dr. Sudha Seshadri, an associate professor of neurology at Boston University School of Medicine.

The study involved 715 participants in the ongoing Framingham Heart Study, including 282 whose parents, one or both, had been diagnosed with Alzheimer’s or other dementia. The participants averaged 59 years old and were healthy, with no memory complaints, said Seshadri, who is also a senior investigator with the Framingham study.

But when given a battery of cognitive tests, those who logged the lowest scores on verbal and visual memory tasks were people who were carriers of the ApoE4 gene and had parents with dementia.

Seshadri stressed that the neuropsychological tests and brain imaging conducted as part of the study offered a sensitive measurement of memory. The participants were “performing older than they’re expected,” she said, but added that there were “no memory symptoms associated with this.” Participants still tested within the normal range for memory and were living normal lives, she said.

The results suggest that the Alzheimer’s gene is facilitating the expression of some other gene, Seshadri said. “It’s just giving us a clue that whatever [other] gene we find is going to have an interaction with ApoE,” she said.

Finding other genes will require a sample of 10,000 to 20,000 people and the collaboration of several research groups, Seshadri said. But, she predicted that “within the next year or two, I think we are going to find more genes.”

The study, which was funded by the U.S. National Institutes of Health and released Wednesday, is to be presented at the American Academy of Neurology’s annual meeting, from April 25 to May 2, in Seattle.

But the findings should not send people scurrying for genetic testing, Seshadri and another expert said.

Alzheimer’s is “not like Huntington’s, where if you have the bad gene and you live long enough you’re going to get it,” Seshadri said. “E4 explains only part of the risk. Clearly there are other genes out there, but they probably have much smaller effects than ApoE4.”

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1709

By Stephanie Paine

People across Europe awoke on 6 January 1709 to find the temperature had plummeted. A three-week freeze was followed by a brief thaw – and then the mercury plunged again and stayed there. From Scandinavia in the north to Italy in the south, and from Czechoslovakia in the east to the west coast of France, everything turned to ice. The sea froze. Lakes and rivers froze, and the soil froze to a depth of a metre or more. Livestock died from cold in their barns, chicken’s combs froze and fell off, trees exploded and travellers froze to death on the roads. It was the coldest winter in 500 years.

IN ENGLAND they called the winter of 1709 the Great Frost. In France it entered legend as Le Grand Hiver, three months of deadly cold that ushered in a year of famine and food riots. In Scandinavia the Baltic froze so thoroughly that people could walk across the ice as late as April. In Switzerland hungry wolves crept into villages. Venetians skidded across their frozen lagoon, while off Italy’s west coast, sailors aboard English men-of-war died from the cold. “I believe the Frost was greater (if not more universal also) than any other within the Memory of Man,” wrote William Derham, one of England’s most meticulous meteorological observers. He was right. Three hundred years on, it holds the record as the coldest European winter of the past half-millennium.

Derham was the Rector of Upminster, a short ride north-east of London. He had been checking his thermometer and barometer three times a day since 1697. Similarly dedicated observers scattered across Europe did much the same and their records tally remarkably closely. On the night of 5 January, the temperature fell dramatically and kept on falling. On 10 January, Derham logged -12 °C, the lowest temperature he had ever measured. In France, the temperature dipped lower still. In Paris, it sank to -15 °C on 14 January and stayed there for 11 days. After a brief thaw at the end of that month the cold returned with a vengeance and stayed until mid-March.

Later that year, Derham wrote a detailed account of the freeze and the destruction it caused for the Royal Society’s Transactions. Fish froze in the rivers, game lay down in the fields and died, and small birds perished by the million. The loss of tender herbs and exotic fruit trees was no surprise, but even hardy native oaks and ash trees succumbed. The loss of the wheat crop was “a general calamity”. England’s troubles were trifling, however, compared to the suffering across the English Channel.

In France, the freeze gripped the whole country as far as the Mediterranean. Even the king and his courtiers at the sumptuous Palace of Versailles struggled to keep warm. The Duchess of Orleans wrote to her aunt in Germany: “I am sitting by a roaring fire, have a screen before the door, which is closed, so that I can sit here with a sable fur piece around my neck and my feet in a bearskin sack and I am still shivering with cold and can barely hold the pen. Never in my life have I seen a winter such as this one.”

In more humble homes, people went to bed and woke to find their nightcaps frozen to the bed-head. Bread froze so hard it took an axe to cut it. According to a canon from Beaune in Burgundy, “travellers died in the countryside, livestock in the stables, wild animals in the woods; nearly all the birds died, wine froze in barrels and public fires were lit to warm the poor”. From all over the country came reports of people found frozen to death. And with roads and rivers blocked by snow and ice, it was impossible to transport food to the cities. Paris waited three months for fresh supplies.
People went to bed and woke to find their nightcaps frozen to the bed-head

There was worse to come. Everywhere, fruit, nut and olive trees died. The winter wheat crop was destroyed. When spring finally arrived, the cold was replaced by worsening food shortages. In Paris, many survived only because the authorities, fearing an uprising, forced the rich to provide soup kitchens. With no grain to make bread, some country people made “flour” by grinding ferns, bulking out their loaves with nettles and thistles. By the summer, there were reports of starving people in the fields “eating grass like sheep”. Before the year was out more than a million had died from cold or starvation.

The fact that so many people left accounts of the freeze suggests the winter of 1708/1709 was unusually bad, but just how extraordinary was it?

In 2004, Jürg Luterbacher, a climatologist at the University of Bern in Switzerland, produced a month-by-month reconstruction of Europe’s climate since 1500, using a combination of direct measurements, proxy indicators of temperature such as tree rings and ice cores, and data gleaned from historical documents (Science, vol 303, p 1499). The winter of 1708-1709 was the coldest. Across large parts of Europe the temperature was as much as 7 °C below the average for 20th-century Europe.

Why it was quite so cold is harder to explain. The Little Ice Age was at its climax and Europe was experiencing climatically turbulent times: the 1690s saw a string of cold summers and failed harvests, while the summer of 1707 was so hot people died from heat exhaustion. Overall, the climate was colder, with the sun’s output at its lowest for millennia. There were some spectacular volcanic eruptions in 1707 and 1708, including Mount Fuji in Japan and Santorini and Vesuvius in Europe. These would have sent dust high into the atmosphere, forming a veil over Europe. Such dust veils normally lead to cooler summers and sometimes warmer winters, but climatologists think that during this persistent cold phase, dust may have depressed both summer and winter temperatures.

None of these things accounts for the extremity of that particular winter, however. “Something unusual seems to have been happening,” says Dennis Wheeler, a climatologist at the University of Sunderland, UK. As part of the European Union’s Millennium Project, which aims to reconstruct the past 1000 years of Europe’s climate, Wheeler is extracting data from Royal Navy logbooks, which provide daily observations of wind and weather. “With daily data you can produce very reliable monthly averages but you can also see what happened from one day to the next,” says Wheeler. He and his colleagues have now compiled a database of daily observations stretching back to 1685 from the English Channel area. “This is a key climatic zone. The weather there reflects wider conditions across the Atlantic, which is where in normal circumstances much European weather originates.”

The most immediate cause of cold winters in Europe is usually an icy wind from Siberia. “What you would expect would be long runs of easterly winds with a well-developed anticyclone over Scandinavia sucking in cold air from Siberia,” says Wheeler. Instead, his data show a predominance of southerly and westerly winds – which would normally bring warm air to Europe. “There were only occasional northerlies and easterlies and those were never for more than a few days,” says Wheeler. Another odd finding was that January was unusually stormy. Winter storms tend to bring milder, if wilder, weather to Europe. “This combination of cold, storms and westerlies suggests some other mechanism was responsible for that winter.”

There may be no easy explanation for the Great Frost of 1709, but unexpected weather patterns revealed by Wheeler’s data underline why climate reconstructions are so important. “We need to explain the natural variation in climate over past centuries so that we can tease apart all those factors that contribute to climate change. But before we can do that we need to nail down those changes in detail,” says Wheeler. “Climate doesn’t behave consistently and warmer and colder, drier and wetter periods can’t always be explained by the same mechanisms.” In the two decades after that terrible winter, the climate warmed very rapidly. “Some people point to that and say today’s warming is nothing new. But they are not comparable. The factors causing warming then were quite different from those operating now.”

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Look For A Thousand Years Of Global Warming

Global climate change will be “irreversible” for 1,000 years, scientists declared today.

Rising temperatures around the globe will be unstoppable despite attempts by millions of families to adopt greener lifestyles, researchers warned.

Contrary to popular opinion, halting carbon emissions will not see temperatures reduce before the year 3000, according to the US-based National Oceanic and Atmospheric Administration’s Earth System Research Laboratory.

Susan Solomon, who led the research, said cutting emissions remained important.

But she added: “People have imagined that if we stopped emitting carbon dioxide the climate would go back to normal in 100 years, 200 years – that’s not true.”

Ms Solomon is lead author of an international team’s paper reporting irreversible damage from climate change, published today in Proceedings of the National Academy of Sciences.

She defines irreversible as change that would remain for 1,000 years even if humans stopped adding carbon to the atmosphere immediately.

Ms Solomon said: “Climate change is slow, but it is unstoppable – all the more reason to act quickly, so the long-term situation does not get even worse.”

In recent years Britain has seen regular instances of flash flooding.

The latest findings were announced as US President Barack Obama ordered reviews that could lead to greater fuel efficiency and cleaner air, saying the Earth’s future depends on cutting air pollution.

Alan Robock, from Rutgers University in New Jersey, agreed with the research, adding: “It’s not like air pollution where if we turn off a smokestack, in a few days the air is clear.

“It means we have to try even harder to reduce emissions.”

In her paper Ms Solomon, a leader of the International Panel on Climate Change and one of the world’s best known researchers on the subject, noted that temperatures around the globe have risen and changes in rainfall patterns have been observed in areas around the Mediterranean, southern Africa and south-western North America.

Warmer climate also is causing expansion of the ocean, which is expected to increase with the melting of ice on Greenland and Antarctica, she said.

“I don’t think that the very long time scale of the persistence of these effects has been understood,” Ms Solomon added.

Global warming has been slowed by the ocean, but that good effect will wane over time with seas eventually helping keep the planet warmer, she said.

Climate change has been driven by gases in the atmosphere that trap heat from solar radiation and raise the planet’s temperature.

Carbon dioxide is the most important of those gases because it remains in the air for hundreds of years.

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Cannibalism is the Most Sincere Form of Flattery

By Philip Bethge

Were Europeans once cannibals? Research shows that up until the end of the 18th century, medicine routinely included stomach-churning ingredients like human flesh and blood.

According to the recipe, the meat was to be cut into small pieces or slices, sprinkled with “myrrh and at least a little bit of aloe” and then soaked in spirits of wine for a few days.

Finally, it was to be hung up “in a very dry and shady place.” In the end, the recipe notes, it would be “similar to smoke-cured meat” and would be without “any stench.”

Johann Schröder, a German pharmacologist, wrote these words in the 17th century. But the meat to which he was referring was not cured ham or beef tenderloin. The instructions specifically called for the “cadaver of a reddish man … of around 24 years old,” who had been “dead of a violent death but not an illness” and then laid out “exposed to the moon rays for one day and one night” with, he noted, “a clear sky.”

In 16th- and 17th-century Europe, recipes for remedies like this, which provided instructions on how to process human bodies, were almost as common as the use of herbs, roots and bark. Medical historian Richard Sugg of Britain’s Durham University, who is currently writing a book on the subject says that cadaver parts and blood were standard fare, available in every pharmacy. He even describes supply bottlenecks from the glory days of “medicinal cannibalism.” Sugg is convinced that avid cannibalism was not only found within the New World, but also in Europe.

In fact, there are countless sources that describe the morbid practices of early European healers. The Romans drank the blood of gladiators as a remedy against epilepsy. But it was not until the Renaissance that the use of cadaver parts in medicine became more commonplace. At first, powders made from shredded Egyptian mummies were sold as an “elixir of life,” says Sugg. In the early 17th century, healers turned their attention to the mortal remains of people who had been executed or even the corpses of beggars and lepers.

Paracelsus, the German-Swiss physician, was one of the most vehement proponents of body-stripping, which eventually gained popularity at even the highest levels of society. The “medicinal insanity,” as Sugg calls it, of British King Charles II was legendary. He paid 6,000 pounds for a recipe to liquefy the human brain. The regent applied the resulting distillate, which entered the history of medicine as “the king’s drop,” almost daily.

Scholars and noblemen, as well as ordinary people, swore by the healing powers of death. US anthropologist Beth Conklin, for example, quoting a 19th-century source, writes that in Denmark epileptics were reported to stand around the scaffold in crowds, cup in hand, ready to drink the red blood as it flows from the still quavering body. Skulls were used as medicine, as was the moss that tended to sprout from them. It was believed to staunch bleeding.

Human fat was supposed to alleviate rheumatism and arthritis, while a paste made from corpses was believed to help against contusions. Sugg even attributes religious significance to human flesh. For some Protestants, he writes, it served as a sort of substitute for the Eucharist, or the tasting of the body of Christ in Holy Communion. Some monks even cooked “a marmalade of sorts” from the blood of the dead.

“It was about the intrinsic vitality of the human organism,” says the historian. The assumption was that all organisms have a predetermined life span. If a body died in an unnatural way, the remainder of that person’s life could be harvested, as it were — hence the preference for the executed.

The practice was not always a success. In 1492, when Pope Innocent VIII was on his deathbed, his doctors bled three boys and had the pope drink their blood. The boys died, and so did the pope.

Was all of this cannibalism? Sugg has no doubt that it was. Like the cannibals of the New World, the Europeans were fundamentally interested in the consumption of vital energy. For anthropologist Conklin, the European form of cannibalism is especially remarkable. Outside Europe, she notes, the person who was eating almost always had a relationship with the person who was eaten. Europe’s cannibalism, on the other hand, was “distinctly asocial,” Conklin writes, adding that human body parts were treated as merchandise: bought and sold for a profit.

By the end of the 18th century, however, the appeal had worn off. “With the Enlightenment, physicians sought to shed their superstitious past,” says Sugg. In 1782, for example, William Black, a physician, wrote that he welcomed the demise of “loathsome and insignificant” medicines, like “dead men’s skulls pulverized.” These, “a farrago of such feculence” had fortunately disappeared from the pharmacies, Black remarked.

An era had come to an end, and with it the interest in recipes like those of Briton John Keogh. The preacher, who died in 1754, recommended pulverized human heart for “dizziness.” Keogh even provided a dose and instructions for use: “A dram in the morning — on an empty stomach.”

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Bureaucracies and Magic Numbers

by Mark Buchanan

IT IS 1944, and there is a war on. In a joint army and air force headquarters somewhere in England, Major Parkinson must oil the administrative wheels of the fight against Nazi Germany. The stream of vital paperwork from on high is more like a flood, perpetually threatening to engulf him.

Then disaster strikes. The chief of the base, the air vice-marshal, goes on leave. His deputy, an army colonel, falls sick. The colonel’s deputy, an air force wing commander, is called away on urgent business. Major Parkinson is left to soldier on alone.

At that point, an odd thing happens – nothing at all. The paper flood ceases; the war goes on regardless. As Major Parkinson later mused: “There had never been anything to do. We’d just been making work for each other.”

That feeling might be familiar to many working in large organisations, where decisions can seem to be bounced between layers of management in a whirl of consultation, circulation, deliberation and delegation. It led Major Parkinson – in civilian dress, C. Northcote Parkinson, naval historian, theorist of bureaucracy and humorist- to a seminal insight. This is “Parkinson’s law”, first published in an article of 1955, which states: work expands to fill the time available for its completion.

Is there anything more to that “law” than just a cynical slogan? Physicists Peter Klimek, Rudolf Hanel and Stefan Thurner of the Medical University of Vienna in Austria think so. They have recreated mathematically just the kind of bureaucratic dynamics that Parkinson described anecdotally 50 years ago. Their findings put Parkinson’s observations on a scientific footing, but also make productive reading for anyone in charge of organising… well, anything.

Parkinson based his ideas not just on his war experience, but also his historical research. Between 1914 and 1928, he noted, the number of administrators in the British Admiralty increased by almost 80 per cent, while the number of sailors they had to administer fell by a third, and the number of ships by two-thirds. Parkinson suggested a reason: in any hierarchical management structure, people in positions of authority need subordinates, and those extra bodies have to be occupied- regardless of how much there actually is to do.

Parkinson was crystallising, with tongue half in cheek, classic work done by the German sociologist Max Weber in the early 20th century. Weber described the attributes of an ideal bureaucracy and possible “degenerating” influences – such as any system of promotion not based wholly on merit. Parkinson’s own analysis spawned other, more po-faced and politically charged critiques of public bureaucracies from economists such as William Niskanen, who served on US President Ronald Reagan’s Council of Economic Advisers. Niskanen theorised that bureaucracies grow because officials seek to increase the budgets they control and so boost their own salary, power and standing. He and other conservatives used such arguments to push for smaller government – but they could not give any supporting quantitative insight into the growth of bureaucracies.

The new work aims to do just that. “Parkinson’s essays weren’t quantitative,” says Klimek, “but they’re so clear that it’s easy to cast them into specific mathematical models.” From a simple system of equations using quantities such as the promotion and drop-out rates within a hierarchical body, a “phase diagram” can be computed to show what conditions breed ever greater bureaucracy. A high probability of promotion coupled with the hiring of more subordinates – the scenario Parkinson described- is unsurprisingly a recipe for particularly fast growth.

Parkinson was also interested in other aspects of management dynamics, in particular the workings of committees. How many members can a committee have and still be effective? Parkinson’s own guess was based on the 700-year history of England’s highest council of state- in its modern incarnation, the UK cabinet. Five times in succession between 1257 and 1955, this council grew from small beginnings to a membership of just over 20. Each time it reached that point, it was replaced by a new, smaller body, which began growing again. This was no coincidence, Parkinson argued: beyond about 20 members, groups become structurally unable to come to consensus.

A look around the globe today, courtesy of data collected by the US Central Intelligence Agency, indicates that Parkinson might have been onto something. The highest executive bodies of most countries have between 13 and 20 members. “Cabinets are commonly constituted with memberships close to Parkinson’s limit,” says Thurner, “but not above it.” And that is not all, says Klimek: the size of the executive is also inversely correlated to measures of life expectancy, adult literacy, economic purchasing power and political stability. “The more members there are, the more likely a country is to be less stable politically, and less developed,” he says.

Why should this be? To find out, the researchers constructed a simple network model of a committee. They grouped the nodes of the network – the committee members- in tightly knit clusters with a few further links between clusters tying the overall network together, reflecting the clumping tendencies of like-minded people known to exist in human interactions. To start off, each person in the network had one of two opposing opinions, represented as a 0 or a 1. At each time step in the model, each member would adopt the opinion held by the majority of their immediate neighbours.

Such a process can have two outcomes: either the network will reach a consensus, with 0s or 1s throughout, or it will get stuck at an entrenched disagreement between two factions. A striking transition between these two possibilities emerged as the number of participants grew – around Parkinson’s magic number of 20. Groups with fewer than 20 members tend to reach agreement, whereas those larger than 20 generally splinter into subgroups that agree within themselves, but become frozen in permanent disagreement with each other. “With larger groups, there’s a combinatorial explosion in the number of ways to form factions,” says Thurner.

Santo Fortunato, a physicist who works on complex networks at the Institute for Scientific Interchange in Turin, Italy, thinks the result is convincing evidence for Parkinson’s conjecture. But he would like to see further testing. “The outcome might well change significantly if you change the shape of the social network, or the way people’s opinions influence one another,” he says.

So might this kind of work offer a rational way to optimise our decision-making bodies? One curious detail provides an intriguing slant on this question. In the computer simulations, there is a particular number of decision-makers that stands out from the trend as being truly, spectacularly bad, tending with alarmingly high probability to lead to deadlock: eight.

Where this effect comes from is unclear. But once again, Parkinson had anticipated it, noting in 1955 that no nation had a cabinet of eight members. Intriguingly, the same is true today, and other committees charged with making momentous decisions tend to fall either side of the bedevilled number: the Bank of England’s monetary policy committee, for example, has nine; the US National Security Council has six.

So perhaps we all subliminally know the kind of things that Parkinson highlighted and the computer simulations have confirmed. As Parkinson noted, we ignore them at our peril. Charles I was the only British monarch who favoured a council of state of eight members. His decision-making was so notoriously bad that he lost his head.

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Roots of Deception

By NATALIE ANGIER

When considering the behavior of putative scam operators like Bernard “Ponzi scheme” Madoff or Rod “Potty Mouth” Blagojevich, feel free to express a sense of outrage, indignation, disgust, despair, amusement, schadenfreude. But surprise? Don’t make me laugh.

Sure, Mr. Madoff may have bilked his clients of $50 billion, and Governor Blagojevich, of Illinois, stands accused of seeking personal gain through the illicit sale of public property — a United States Senate seat. Yet while the scale of their maneuvers may have been exceptional, their apparent willingness to lie, cheat, bluff and deceive most emphatically was not.

Deceitful behavior has a long and storied history in the evolution of social life, and the more sophisticated the animal, it seems, the more commonplace the con games, the more cunning their contours.

In a comparative survey of primate behavior, Richard Byrne and Nadia Corp of the University of St. Andrews in Scotland found a direct relationship between sneakiness and brain size. The larger the average volume of a primate species’ neocortex — the newest, “highest” region of the brain — the greater the chance that the monkey or ape would pull a stunt like this one described in The New Scientist: a young baboon being chased by an enraged mother intent on punishment suddenly stopped in midpursuit, stood up and began scanning the horizon intently, an act that conveniently distracted the entire baboon troop into preparing for nonexistent intruders.

Much evidence suggests that we humans, with our densely corrugated neocortex, lie to one another chronically and with aplomb. Investigating what they called “lying in day-to-day life,” Bella DePaulo, now a visiting professor of psychology at the University of California, Santa Barbara, and her colleagues asked 77 college students and 70 people from the community to keep anonymous diaries for a week and to note the hows and whys of every lie they told.

Tallying the results, the researchers found that the college students told an average of two lies a day, community members one a day, and that most of the lies fell into the minor fib category. “I told him I missed him and thought about him every day when I really don’t think about him at all,” wrote one participant. “Said I sent the check this morning,” wrote another.

In a follow-up study, the researchers asked participants to describe the worst lies they’d ever told, and then out came confessions of adultery, of defrauding an employer, of lying on a witness stand to protect an employer. When asked how they felt about their lies, many described being haunted with guilt, but others confessed that once they realized they’d gotten away with a whopper, why, they did it again, and again.

In truth, it’s all too easy to lie. In more than 100 studies, researchers have asked participants questions like, Is the person on the videotape lying or telling the truth? Subjects guess correctly about 54 percent of the time, which is barely better than they’d do by flipping a coin. Our lie blindness suggests to some researchers a human desire to be deceived, a preference for the stylishly accoutred fable over the naked truth.

“There’s a counterintuitive motivation not to detect lies, or we would have become much better at it,” said Angela Crossman, an assistant professor of psychology at the John Jay College of Criminal Justice. “But you may not really want to know that the dinner you just cooked stinks, or even that your spouse is cheating on you.”

The natural world is rife with humbug and fish tales, of things not being what they seem. Harmless viceroy butterflies mimic toxic monarch butterflies, parent birds draw predators away from the nest by feigning a broken wing, angler fish lure prey with appendages that wiggle like worms.

Biologists distinguish between such cases of innate or automatic deception, however, and so-called tactical deception, the use of a normal behavior in a novel situation, with the express purpose of misleading an observer. Tactical deception requires considerable behavioral suppleness, which is why it’s most often observed in the brainiest animals.

Great apes, for example, make great fakers. Frans B. M. de Waal, a professor at the Yerkes National Primate Research Center and Emory University, said chimpanzees or orangutans in captivity sometimes tried to lure human strangers over to their enclosure by holding out a piece of straw while putting on their friendliest face.

“People think, Oh, he likes me, and they approach,” Dr. de Waal said. “And before you know it, the ape has grabbed their ankle and is closing in for the bite. It’s a very dangerous situation.”

Apes wouldn’t try this on their own kind. “They know each other too well to get away with it,” Dr. de Waal said. “Holding out a straw with a sweet face is such a cheap trick, only a naïve human would fall for it.”

Apes do try to deceive one another. Chimpanzees grin when they’re nervous, and when rival adult males approach each other, they sometimes take a moment to turn away and close their grins with their hands. Similarly, should a young male be courting a female and spot the alpha male nearby, the subordinate chimpanzee will instantly try to cloak his amorous intentions by dropping his hands over his erection.

Rhesus monkeys are also artful dodgers. “There’s a long set of studies showing that the monkeys are very good at stealing from us,” said Laurie R. Santos, an associate professor of psychology at Yale University.

Reporting recently in Animal Behavior, Dr. Santos and her colleagues also showed that, after watching food being placed in two different boxes, one with merrily jingling bells on the lid and the other with bells from which the clappers had been removed, rhesus monkeys preferentially stole from the box with the silenced bells. “We’ve been hard-pressed to come up with an explanation that’s not mentalistic,” Dr. Santos said. “The monkeys have to make a generalization — I can hear these things, so they, the humans, can, too.”

One safe generalization seems to be that humans are real suckers. After dolphin trainers at the Institute for Marine Mammals Studies in Mississippi had taught the dolphins to clean the pools of trash by rewarding the mammals with a fish for every haul they brought in, one female dolphin figured out how to hide trash under a rock at the bottom of the pool and bring it up to the trainers one small piece at a time.

We’re desperate to believe that what our loved ones say is true. And now we find otherwise. Oh, Flipper, et tu?

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