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International Panel Releases New Recommendations For Concussion Treatment
In an article published in the June issue of The Physician and Sportsmedicine entitled "Consensus Statement on Concussion in Sport - The Third International Conference on Concussion in Sport Held in Zurich, November 2008," new information and guidelines on the definition and treatment of concussions in athletes are presented. This is a revised and updated statement of the recommendations developed following the 1st (Vienna) and 2nd (Prague) International Symposia on Concussion in Sport. By developing core questions on how to treat concussions and best "return-to-play" recommendations, the conference members worked to improve the current recommendations as well as aiming to make this information readily available to health care professionals.
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President Obama Picks New York City Health Commissioner Thomas Frieden For CDC Director
President Obama on Friday appointed New York City Health Commissioner Thomas Frieden as CDC director, according to Obama administration officials, the New York Times reports. According to the Times, Frieden, an infectious disease specialist, has "cut a high and sometimes contentious profile" in his seven years as health commissioner in New York City, during which time he has advocated for a smoking ban in restaurants and bars, made HIV testing part of routine medical exams and protected a program that distributes 35 million condoms a year. According to the Times, Frieden is expected to take office next month. The Times reports that he will "inherit a host of immediate and long-term problems," including questions surrounding a vaccine for the H1N1 influenza virus, also known as swine flu, health care reform and organizational issues at CDC.The Times reports that a potential advantage for Frieden is a positive relationship with likely FDA Commissioner Margaret Hamburg, who also was New York City health commissioner. Frieden would work with Hamburg to combat the H1N1 flu virus and to re-evaluate the U.S. food safety system (Harris/Hartocollis, New York Times, 5/15).
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Incyte Provides Update On Special Protocol Assessment For INCB18424 As A New Treatment For Myelofibrosis
Incyte Corporation (Nasdaq:INCY) announced that based on recent input from the U.S. Food and Drug Administration (FDA) regarding Incyte"s request for a Special Protocol Assessment (SPA) for INCB18424 for patients with primary myelofibrosis (PMF), post-polycythemia vera myelofibrosis (PPV-MF) and post-essential thrombocythemia myelofibrosis (PET-MF), it is clear that the most appropriate single primary endpoint for Incyte"s U.S. Phase III trial is the proportion of treated patients achieving a 35% reduction in spleen volume as compared to patients receiving placebo.
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First Evidence That Monkeys Wonder What Might Have Been

Monkeys playing a game similar to "Let"s Make A Deal" have revealed that their brains register missed opportunities and learn from their mistakes. "This is the first evidence that monkeys, like people, have "would-have, could-have, should-have" thoughts," said Ben Hayden, a researcher at the Duke University Medical Center and lead author of the study published in the journal Science. The researchers watched individual neurons in a region of the brain called the anterior cingulate cortex (ACC) that monitors the consequences of actions and mediates resulting changes in behavior. The monkeys were making choices that resulted in different amounts of juice as a reward. Their task was like the TV show "Let"s Make a Deal" with the experimenters offering monkeys choices from an array of hidden rewards. During each trial, the monkeys chose from one of eight identical white squares arranged in a circle. A color beneath the white square was revealed and the monkey received the corresponding reward. Over many weeks, the monkeys were trained to associate a high-value reward with the color green and the low-value rewards with other colors. After receiving a reward, the monkey was also shown the prizes he missed. What the researchers saw was that neurons in the ACC responded in proportion to the reward -- a greater reward caused a higher response. They also found that these same neurons responded when monkeys saw what they missed. Most of these ACC neurons responded the same way to a real or imagined reward. To measure how these responses might help the monkey to learn, the researchers kept the high reward in the same position 60 percent of the time, or moved it one position clockwise, so that a monkey could possibly notice and adapt to that pattern. The monkeys chose targets next to potential high-value targets more often than those next to low-value targets, (37.7 percent to 16.7 percent), which suggested that they understood the relationship between the high value target on the current trial and its likely location on the next trial. The monkeys learned the pattern and chose the high value more often than by a chance. "It is significant to learn that the neurons have a dual role, because the monkey can only adapt his behavior when he gets information on both of those events, real and missed," said Michael Platt, Duke professor of neurobiology and evolutionary anthropology and senior author of the study. People are much more likely to gamble if they see they could have won big by gambling in the past. Thus the researchers hypothesized that the monkeys would also select the target if it had offered a large reward on the previous trial and the monkey had missed it, and indeed, they observed this pattern. The effect may have reflected an increased willingness to switch to a new target, because the likelihood of switching increased with larger missed rewards, they noted. "This was not merely a function of the high-value targets holding a positive association for the monkey," Platt said. The monkeys" ACC neurons signaled missed reward information, and used a coding scheme in the brain that was similar to the coding used to signal real outcomes, Platt said. The researchers suspect that these neurons actually helped the monkeys to make better choices in the future. John M. Pearson, Ph.D., of Duke Neurobiology was also an author of the paper. The study was supported by a post-doctoral fellowship from the National Institute on Drug Abuse, a Neuroscience Education Institute grant, and the Duke Institute for Brain Sciences. Mary Jane Gore Duke University Medical Center


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