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PubMedDate not supplied

World hypotheses and the evolution of integrative medicine: combining categorical diagnoses and cause-effect interventions with whole systems research and nonvisualizable (seemingly "impossible") healing.

It has been proposed that to understand (1) the evolution of science and medicine, and (2) the integration of conventional, complementary and alternative medicine, it is essential to consider at least eight universal implicit meta-cognitive hypotheses. It has been suggested that these implicit "world" hypotheses can be applied in every discipline of science. The present paper reviews the eight world hypotheses and proposes an additional hypothesis, termed the nonvisualizable or "Nth" world hypothesis (adopting the mathematical concept of "N"; eg, as in N dimensional space). Drawing on contemporary mathematics and quantum physics, we propose that certain theories and data-by their inherent nature-can not be visualized, and therefore may seem "unimaginable" and "impossible" (if not "unbelievable"), even though they are real. Certain seemingly anomalous observations in mind-body and energy medicine, including areas historically labeled as parapsychology or spiritual energy healing, often elicit strongly skeptical and dismissive reactions. We propose that these skeptical and dismissive reactions to purportedly impossible (yet logical) theories and seemingly unbelievable (yet replicable) data can be tempered when the Nth world hypothesis is understood and incorporated. Integrity in evidence-based science and medicine may require that scientists and nonscientists alike develop comfort and humility in accepting the human mind's restricted ability to envision and imagine certain nonvisualizable-yet fundamental and real-concepts and effects, as illustrated in contemporary physics and complementary and alternative medicine.

Clinical Medicine↗
PubMed2005

Towards the world-wide ban of indoor cigarette smoking in public places.

In 1984, Dr. C. Everett Koop, then Surgeon General of the US, presented an important speech on the hazards of smoking. In his speech, he stated "The ultimate goal should be a smoke-free society by the year 2000." In addition, the World Health Organization (WHO) has initiated a process to ban smoking globally; on 21 May 2003, at the 56th World Health Assembly, WHO's 192 Member States unanimously adopted the world's first public health treaty, the WHO Framework Convention on Tobacco Control. Although good progress has been made, reaching the ultimate goal is far from certainty. Therefore, it is time to re-visit this crucial public health activity and re-energize the effort to reach this goal. Since numerous reports have been written on the ban of smoking based on benefits to the smokers, the emphasis of our report is on benefits to non-smokers from their exposure to environmental tobacco smoke (ETS). We provide a concise review of the impact of ETS on health and economy. In addition, we examined the different interest groups on supporting and opposing the ban, the role of the government, private citizens and medical professionals on this activity, and certain constraints on implementing the global ban. We also provide some recommendations on how to promote the ban globally. Since cigarette smoking is an unnecessary habit that has devastating consequences around the world, banning of cigarette smoking should be a global mission. A global ban on indoor smoking in public places is an important first step in an international effort to prevent morbidity and mortality caused by tobacco smoking and ETS.

Child↗
PubMed2005

The meaning of mammalian adult neurogenesis and the function of newly added neurons: the "small-world" network.

Adult neurogenesis has been observed in mammalian brain including human but a question remains: how do new neurons become functional in the adult brain? We propose that the random addition of only a few new neurons functions as a maintenance system for the brain's "small-world" networks. In popular parlance, the small-world network phenomenon is described by the concept of "six degrees of separation", which postulates that everyone in the world is connected to everyone else through a chain of at most six mutual acquaintances. Randomly added to an orderly network, new links enhance signal propagation speed and synchronizability. Newly generated neurons are ideally suited to become such links: they are immature, form more new connections compared to mature ones, and their number but not their precise location may be maintained by continuous proliferation and dying off. Similarly, we envisage that the treatment of brain pathologies by cell transplantation would also create new random links in small-world networks and that even a small number of successfully incorporated new neurons may be functionally important.

Adult↗
PubMed2006

Psychiatric agriculture: systemic nutritional modification and mental health in the developing world.

Modernization of agricultural systems to increase output causes changes to the nutritional content of food entire populations consume. Human nutritional needs differ from their "food", thus producing healthy agricultural products is not equivalent to providing agricultural products that are healthy for humans. Inclusion of the food production system as a factor in the increase of neuropsychiatric disorders and other chronic diseases helps explain negative trends in modern chronic diseases that remain unchecked despite stunning advances in modern medicine. Diseases in which our own technology plays a significant role include obesity and resulting disorders, such as diabetes, heart disease, hypertension, stroke and arthritis. Modernization's lure leads to importation of modern agricultural practices into a nutritionally vulnerable, malnourished and sometimes starving developing world. Wealthier nations hedge their food portfolio by having access to a wider variety of foods. The developing world's reliance on staple foods means even a minor widespread nutritional modification of one key food can have profound effects. New agricultural techniques may improve or exacerbate neuropsychiatric disorders through nutritional modification in regions where populations walk a nutritional tightrope with little margin for error. In most of the developing world western psychiatric interventions have failed to make inroads. People's consumption of fish has a demonstrated beneficial effect on their mental health and the omega-3 fatty acid content is a significant factor. Epidemiological, biological and agricultural studies implicate a lack of dietary omega-3s as a factor in certain mental disorders. Replenishing omega-3s has improved mental illnesses in controlled clinical trials. This article's detailed tilapia fish-farming model demonstrates how aquaculture/agriculture techniques can function as a public health intervention by increasing dietary omega-3s through creation of sustainable, economical and culturally appropriate food sources for the developing world.

Agriculture↗
PubMed2006

Are New World leishmaniases becoming anthroponoses?

In the New World, leishmaniases are originally wild exoanthropic zoonoses developing in sylvatic ecotopes. For a long time, Leishmania parasites have shown a remarkable plasticity to face modifications in their environment. Now, both geographical extension and numerical increase of leishmaniasis cases in the New World are giving cause for concern. These circumstances might have been provoked by the simple invasion of zoonotic foci by humans. However, dramatic evolutionary mechanisms are also at work in the New World: (i) the reduction of biodiversity associated with anthropogenic environmental changes (deforestation and urbanization); and (ii) the subsequent adaptations and interactions of new vectors and reservoir hosts at the interface with humans. This paper considers that these processes could result in new pathogenic complexes tending to synanthropic zoonoses, if not anthroponoses. Increasing man-made risk factors could thus possibly make leishmaniases a growing public health concern in the New World.

Animals↗
PubMed2004

Distinct neural substrates for the perception of real and virtual visual worlds.

Virtual environments have been frequently used for training and skill improvement. However, do real and virtual worlds engage the same brain states in human perceivers? We measured brain activity using functional magnetic resonance imaging (fMRI) while adults watched movie and cartoon clips, simulating real and virtual visual worlds, respectively. Relative to baselines using random static images, the medial prefrontal cortex (MPFC) and the cerebellum were activated only by movie clips of other humans. In contrast, cartoon clips of human and non-human agents activated the superior parietal lobes, while movie clips of animals also activated the superior parietal lobes. Our fMRI findings suggest that the perception of real-world humans is characterised by the involvement of MPFC and the cerebellum, most likely for on-line representation of the mental states of others, whereas the perception of virtual-world agents engages the parietal cortex in attention to actions.

Adult↗
PubMed2006

Chapter 15: HPV vaccine use in the developing world.

Human papillomavirus (HPV)-related morbidity and mortality from cervical cancer primarily occurs in the developing world, where, unfortunately, access to vaccines in general, and expensive newer vaccines in particular, is often more limited than in the industrialized world. In addition, secondary prevention methods such as HPV screening, Pap testing, or visual inspection are uncommon in the developing world. The HPV vaccine will be first introduced into the industrialized countries and it will then, over the course of time, become used in the developing countries. HPV vaccine should be introduced in the framework of comprehensive cervical cancer control, and offers an opportunity to bring together a wide range of constituents who have not to date worked closely on vaccination. Ultimately, the decision of whether and when a vaccine will be introduced will depend on individual countries. To prepare for decisions on HPV vaccine use, the sexual and reproductive health (SRH; including adolescent health), immunization, and cancer control communities need to work together to analyze the appropriate data and build international and national consensus. The timeframe for other newer vaccines, such as hepatitis B and Hib, has been measured in decades, and the challenge to the public sector is to greatly shorten the time needed to make HPV vaccines available and affordable for the developing world, where their impact will be greatest.

Developing Countries↗
PubMed2004

Old and New World arenaviruses share a highly conserved epitope in the fusion domain of the glycoprotein 2, which is recognized by Lassa virus-specific human CD4+ T-cell clones.

Data from human studies and animal experiments indicate a dominant role of T-cells over antibodies in controlling acute Lassa virus infection and providing immunity to reinfection. Knowledge of the epitopes recognized by T-cells may therefore be crucial to the development of a recombinant Lassa virus vaccine. In order to study human T-cell reactivity to the most conserved structural protein of Lassa virus, the glycoprotein 2 (GP2), seven GP2-specific CD4+ T-cell clones (TCCs) were generated from the lymphocytes of a Lassa antibody positive individual. All TCC displayed high specific proliferation, showed DR-restriction, and produced IFN-gamma upon stimulation with recombinant GP2. The epitope of four of the clones was localized to a short stretch of 13 amino acids located in the N-terminal part of GP2 (aa 289-301, numbering according to sequence of GPC). This epitope is conserved in all strains of Lassa virus and lymphocytic choriomeningitis virus (LCMV), shows >90% similarity in all New World arenaviruses of clade B, and overlaps with the proposed fusion domain of GP2. Peptides with conservative aa exchanges, as they naturally occur in the epitope 289-301 of the Old World arenavirus Mopeia and some New World arenaviruses, continued to effectively stimulate the Lassa-GP2-specific T-cell clones tested. The finding of a human T-helper cell epitope, which is highly conserved between Old and New World arenaviruses, is of importance for the design of arenavirus vaccines.

Amino Acid Sequence↗
PubMed2005

Biodiversity hotspots: evolutionary origins of biodiversity in wrasses (Halichoeres: Labridae) in the Indo-Pacific and new world tropics.

Halichoeres is a widely distributed coral reef fish genus with high levels of biodiversity in both the Indo-Pacific and New World tropics. This study employed molecular phylogenetic techniques and biogeographic analyses on 1700-1800 bp of mitochondrial CO1, 16s, and 12s to test competing hypotheses regarding the origins of biodiversity in this genus in these two biodiversity hotspots. Analyses indicate that Halichoeres is polyphyletic with distinct New World and Indo-Pacific Ocean components. The Halichoeres in the New World tropics formed a strongly supported clade (99% MP, 100% ML bootstrap values) that diverged 21.2-18.1 mya, suggesting that this lineage may represent a relictual fauna of the ancient Tethys Sea. The closure of the Isthmus of Panama contributed to the creation of Halichoeres biodiversity, but diversification across the Isthmus prior to its closure and within the W. Atlantic after the closure 3.1 mya were also important processes creating biodiversity in the New World tropics. Within the Indonesian Australian Archipelago (IAA) analysis of age vs. geographic distribution supported neither Center of Origin, Center of Accumulation or Center of Overlap hypotheses, and molecular clock estimates indicated that the role of Pleistocene sea level changes in the origins of IAA marine biodiversity may be less important than previously thought. Ancestral distribution reconstructions within the Indo-West Pacific (IWP) clade (99% ML bootstrap value) also failed to support these hypotheses as the reconstructions were highly sensitive to the inclusion of missing taxa. Results suggest plueralistic origins of biodiversity, but that vast amounts of habitat may favor the survival of biodiversity in the IAA biodiversity hotspot.

Animals↗
PubMed2003

The roads to and from the RNA world.

The historical existence of the RNA world, in which early life used RNA for both genetic information and catalytic ability, is widely accepted. However, there has been little discussion of whether protein synthesis arose before DNA or what preceded the RNA world (i.e. the pre-RNA world). We outline arguments of what route life may have taken out of the RNA world: whether DNA or protein followed. Metabolic arguments favor the possibility that RNA genomes preceded the use of DNA as the informational macromolecule. However, the opposite can also be argued based on the enhanced stability, reactivity, and solubility of 2-deoxyribose as compared to ribose. The possibility that DNA may have come before RNA is discussed, although it is a less parsimonious explanation than DNA following RNA.

Animals↗
PubMed1986

A putative non-cholinergic mechanism in urinary bladders of New but not Old World primates.

The effects of atropine on bladder contractions evoked by sacral ventral root stimulation were investigated in two species of New World monkey (marmoset and cebus) and in paraplegic man. The findings were then compared to those previously obtained for the cat and two species of Old World monkey (rhesus and baboon). The results show the marmoset and cebus to represent a transitional stage between the complete sensitivity of the bladders of Old World monkeys to atropine and the relative insensitivity of the cat bladder. The bladder response is shown to comprise two components, an atropine sensitive component which is slow in onset and an atropine resistant component which is easily fatigued. The experiments in paraplegic people confirm that the parasympathetic innervation of the bladder of man is, like that of Old World monkeys, exclusively cholinergic. A behavioural interpretation is tentatively offered to explain the two types of innervation.

Animals↗
PubMed1995

The outcome of suprapubic prostatectomy: a contemporary series in the developing world.

OBJECTIVES: To assess the appropriateness of the technique of suprapubic prostatectomy using a removable bladder neck partition suture for use in a developing world hospital and to provide contemporary open prostatectomy outcome data currently lacking in the world's literature. METHODS: From 1984 to 1994, 240 consecutive patients presenting to a developing world hospital with acute urinary retention underwent suprapubic prostatectomy using a removable bladder neck partition suture. The average length of time from bladder decompression until operation was 2.5 months. The outcome of these cases was retrospectively analyzed. RESULTS: The overall early complication rate was 19.6%. There were no deaths. The transfusion rate was 4.6%. Clot retention occurred in 6.7%, and 2.9% required return to the operating room for evaluation. For the second half of the series, the early complication rate decreased to 8.3%, the clot retention rate to 0.8%, and the transfusion rate to 1.7%. Other early and late complications were minimal. The length of delay from decompression until operation did not affect outcome. CONCLUSIONS: The technique of suprapubic prostatectomy using a removable bladder neck partition suture is appropriate for use in developing world hospitals because of its low morbidity and mortality rates. The outcome in this contemporary series of open prostatectomy cases compares favorably with the outcome from reported contemporary transurethral resection of the prostate (TURP) series. These data demonstrate that suprapubic prostatectomy is an acceptable option when the patient's anatomy or the state of local medical facilities precludes TURP.

Adenocarcinoma↗
PubMed1998

Ethics of cochlear implantation in young children: a review and reply from a Deaf-World perspective.

This article examines ethical dilemmas related to cochlear implant surgery in children. These dilemmas arise from the existence of a linguistic and cultural minority called the Deaf World. Organizations of culturally Deaf adults in the United States and abroad, as well as the World Federation of the Deaf, have, on ethical grounds, strongly criticized the practice of cochlear implant surgery in children. Three ethical dilemmas are examined. (1) The surgery is of unproven value for the main significant benefit sought, language acquisition, whereas the psychological, social, and linguistic risks have not been assessed. Thus the surgery appears to be innovative, but innovative surgery on children is ethically problematic. (2) It is now widely recognized that the signed languages of the world are full-fledged natural languages, and the communities that speak those languages have distinct social organizations and cultures. Deaf culture values lead to a different assessment of pediatric cochlear implant surgery than do mainstream (hearing) values, and both sets of values have standing. (3) The fields of otology and audiology want to provide cochlear implants to Deaf children but also, their leaders say, want to protect Deaf culture; those appear to be conflicting goals in principle because, if there were perfect implants, the ranks of the Deaf World would diminish.

Adult↗
PubMed1997

Using the World Wide Web--a new approach to risk identification of diabetes mellitus.

Diabetes mellitus is a major health problem with a rising tendency world-wide. A new strategy for risk evaluation and data collection of undiagnosed non-insulin-dependent diabetes mellitus (NIDDM) using the World Wide Web (WWW) is presented. An easy-to-handle questionnaire on typical risk factors was converted into an interactive WWW document. The Internet provides the suitable platform for the net-based distribution of the questionnaire form as well as the computer-assisted entering and interpretation of the data (http:(/)/www.uni-leipzig.de/-diabetes). The analysis program, installed on our WWW server, interprets the information and sends the assessment on-line back to the inquiring user PC. The data are also collected anonymously in a database for epidemiological studies. In the test period, 744 world-wide accesses were registered: 433 men, mean age 39.8 +/- 14.4 years (range 10-83) and 311 women, mean age 36.7 +/- 12.7 years (range 11-77). An increased risk for undiagnosed diabetes was identified to 43.6%. The risk profile of male and female users showed no significant gender-related differences. Using the WWW technology can support early detection and adequate treatment of undiagnosed diabetes. This innovative strategy to screen for a high risk profile is an useful, cost-effective and up-to-date tool for broad community health education and epidemiological studies world-wide.

Adolescent↗
PubMedDate not supplied

Ganglion cells of a short-wavelength-sensitive cone pathway in New World monkeys: morphology and physiology.

We have studied the morphology and physiology of retinal ganglion cells of a short-wavelength-sensitive cone (SWS-cone) pathway in dichromatic and trichromatic New World anthropoids, the capuchin monkey (Cebus apella) and tufted-ear marmoset (Callithrix jacchus). In Old World anthropoids, in which males and females are both trichromats, blue-ON/yellow-OFF retinal ganglion cells have excitatory SWS-cone and inhibitory middle- and long-wavelength-sensitive (MWS- and LWS-) cone inputs, and have been anatomically identified as small-field bistratified ganglion cells (SB-cells) (Dacey & Lee, 1994). Among retinal ganglion cells of New World monkeys, we find SB-cells which have very similar morphology to such cells in macaque and human; for example, the inner dendritic tree is larger and denser than the outer dendritic tree. We also find blue-on retinal ganglion cells of the capuchin to have physiological responses strongly resembling such cells of the macaque monkey retina; for example, responses were more sustained, with a gentler low frequency roll-off than MC-cells, and no evidence of contrast gain control. There was no difference between dichromatic and trichromatic individuals. The results support the view that SWS-cone pathways are similarly organized in New and Old World primates, consistent with the hypothesis that these pathways form a phylogenetically ancient color system.

Animals↗
PubMedDate not supplied

Spatial and temporal response properties of the major retino-geniculate pathways of Old and New World monkeys.

Old World monkeys, apes and humans all enjoy trichromatic colour vision, and the absorption spectra of the photopigments are very similar in all species and all individuals. Colour vision in New World monkeys however, is very heterogeneous. In many species, the majority of individuals is dichromatic. Recently, anatomical and electrophysiological studies revealed that the retinal organisation in Old World monkeys and New World monkeys is very similar, although the cells belonging to the parvocellular pathway do not show any colour opponency and their spectral sensitivity is similar to that of the magnocellular cells. Apparently, the magnocellular and parvocellular pathways in the retina and the LGN have not developed as an adaptation to luminance and chromatic processing. It is more likely that the two pathways originally evolved to cover different ranges in the spatio-temporal domain. In the present paper, several spatial and temporal properties of parvo- and magnocellular cells (which are identical for dichromatic and trichromatic animals) are compared.

Animals↗
PubMed2004

A third world international health elective for U.S. medical students: the 25-year experience of the State University of New York, Downstate Medical Center.

The Department of Preventive Medicine and Community Health at the State University of New York, Downstate Medical Center instituted a 6-8 weeks third world international health elective for fourth year medical students in 1980. Since that time, some 217 students have participated in a score of third world countries. However, the most popular sites have been India, Kenya and Thailand. The purposes of this elective are to provide fourth year medical students with an opportunity to observe and study the structure and functions of a health care delivery system in a third world country, to provide medical service, and to have a cross-cultural experience. The emphasis in this elective is on public health, preventive medicine and primary care. There are high levels of student competition for this elective. However, interest in it has been affected by world events such as the terrorist attacks of September 11, 2001 and the recent outbreak of Severe Acute Respiratory Syndrome (SARS) in Asia. Recent annual applications for this elective have been twenty-five and more out of a class of two hundred students. Annual acceptance rates vary considerably, ranging from as low as 27.2% in 1995-1996 to a high of 81.8% in 1987-1988. Careful screening, including an examination of academic records and personal interviews, has resulted in the selection of highly mature, adaptable, and dedicated students who overall have performed well at overseas sites. Student rated satisfaction levels with this elective are extremely high, with most rating it the best experience of their medical school years. Students undergo extensive preparation prior to going overseas. This includes individual health and safety issues, travel and lodging, and the nature of the host country culture, health care system, and assignment site. Our students are especially experienced in cross-cultural understanding because of the unusual diversity of the patients they treat in Brooklyn, and the ethnic diversity of local hospital staff and the medical school class. This Brooklyn experience in cross-cultural understanding has been cited by many participants as having been the best preparation for functioning in a foreign culture. In the late 1990s, we revised our procedures concerning health preparations so as to address the risk of HIV/AIDS and other blood borne diseases. In addition, we also adopted an Agreement and Release form containing 15 provisions requiring risk and responsibility assumption on the part of the student participants. The Alumni Fund of the College of Medicine has steadfastly supported this elective with both a philosophical commitment and financial grants to help defray travel costs. In 1998, Joshua H. Weiner of the class of 1941 created a sizeable endowment in the Alumni Fund of the College of Medicine to support students participating in this elective. In 2001, Sonja K. Binkhorst, Assistant Professor of Psychiatry at the Downstate Medical Center, arranged for some financial support for women medical students through the LSK Foundation and the American Medical Women's Association. During the years that this elective has been offered, overseas preceptors have willingly given of their time and institutional resources to make these experiences available and meaningful for students.

Delivery of Health Care↗
PubMed1999

Intronic sequence motifs of HLA-DQB1 are shared between humans, apes and Old World monkeys, but a retroviral LTR element (DQLTR3) is human specific.

Long terminal repeats (LTRs) of the human endogenous retrovirus K (HERV-K) family have been found at several sites within the human genome, of which one is located in the vicinity of HLA-DQB1. Since this DQLTR3 is only present on some haplotypes, we performed a linkage analysis in 130 Caucasian families. In order to date the integration event we also investigated the presence of this DQLTR3 in apes and Old World monkeys. Additionally, we sequenced the adjacent region of DQLTR3-positive and -negative haplotypes in humans, apes and old world monkeys to elucidate their evolution. Linkage analysis revealed a differential integration of DQLTR3 on specific HLA-DQ haploypes: there was a high frequency of this LTR on haplotypes containing HLA-DQB1*0302 (0.96) and a moderate frequency on HLA-DQB1*0402 (0.78), HLA-DQB1*0303 (0.44), HLA-DQB1*0502 (0.38) and HLA-DQB1*0301 (0.35). HLA-DQB1*0201 (0.18), HLA-DQB1*0503 (0.15), HLA-DQB1*0603 (0.15), HLA-DQB1*0602 (0.04), HLA-DQB1*0501 (0.03) and HLA-DQB1*0604 were rarely positive or devoid of DQLTR3. In apes and Old World primates there was no DQLTR3 rendering it a human specific insertion. Sequence analysis of the adjacent region showed two different motifs in humans corresponding to either presence or absence of DQLTR3. Two different motifs were observed within three sequences of Macaca mulatta: One motif is closely related to the sequence from Macaca nemestrina and Macaca fascicularis whereas the other sequence is more closely related with that of Papio papio and Cercopithecus aethiops. Therefore the analysis of retroviral elements as well as intronic sequences of MHC-DQB1 could help to clarify the evolution of this gene region as well the phylogenic relationship between humans, apes and Old World monkeys.

Animals↗