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Medicinal Genomics Signs Tagaca SRL as Distribution Partner for its Genomic Breeding and Testing Platform in Uruguay. – PRNewswire
Posted: November 17, 2019 at 1:41 pm
BEVERLY,Mass., Nov. 15, 2019 /PRNewswire/ -- Medicinal Genomics Corp. (MGC), a pioneer in genomics and blockchain technology to improve the yield, safety and transparency of cannabis, today announced its partnership with Tagaca SRL as its distributor of record in Uruguay. Tagaca is the leading biotechnology distribution firm in Uruguay with product lines that span a broad spectrum of solutions, from laboratory systems and equipment to animal health.
"Uruguay is very serious about every aspect of the cannabis business as we have gone about this pioneering social experiment. And the potential for us to participate in the multibillion dollar global cannabis is clear," said Philip Goodwin, Tagaca's Director. "Our focus has always been to do things right from the beginning, in growing and testing, seed to sale tracking and retail supply. That's why our partnership with Medicinal Genomics is so important. We're not just building a cannabis market, we're building a reputation on a global scale, and for that, we want to work with the very best experts we can find."
Uruguay was the first country in the world to legalize cannabis in all its formsindustrial, medical and recreational in 2013. Today, more than 35,000 cannabis users avail themselves of government programs that control supply and licensing through pharmacies, a robust cadre of more than 7,000 home growers, and more than a hundred non-profit cannabis clubs growing supplying cannabis to nearly 3,500 registered members. There is also a burgeoning hemp market consisting of dozens of large-scale growers, and the government has recently opened the application process to increase the number of recreational commercial growers. The country is also attracting foreign investment and has created landmark export programs to supply cannabis to other countries as cannabis is legalized around the world.
"We couldn't be more pleased to partner with Tagaca in Uruguay. They have deep domain experience, and are one of the most respected biotech distributors in the country," said Brendan McKernan, CEO of Medicinal Genomics. "The Uruguayan market has tremendous potential and they've been building it from the ground up. That's why firms like Tagaca will play such an important role in their country's development in this global industry. We're honored and excited to be a part of that."
About Tagaca SRLFrom the beginning our goal was not to be another conventional company that imports scientific products.Our aspiration is to build a space of trust and advice for our clients, actively supporting their development and research processes, always focused on achieving successful results in all new ventures.We want science in Uruguay to grow and we work hard every day so that the Uruguayan scientist can discuss his ideas with us, knowing that our main objective is to ensure the quality of their results by working together on each idea, each new project or technical difficulty;facilitating, if necessary, contact with the person or company with the appropriate experience.Our advice will be fair and impartial, always trying to help with sincerity and humility. To achieve this, it is imperative that our service respects the times and needs of each person and their project, which is why we have been working with our suppliers for more than five years so that the logistics processes are effective.We explore all possible options to minimize the delivery times of our products, optimizing the operating procedures, and demanding the service and attention from the manufacturer that our customers deserve.
About Medicinal Genomics CorporationMedicinal Genomics Corporation is a pioneer in advancing the genomics of cannabis to build a stronger scientific foundation for cannabis-based products. The company's unmatched expertise in genetic science helps cultivators, dispensaries and testing laboratories characterize and understand the quality and consistency of cannabis to ensure patients and consumers have access to consistently safe, high quality cannabis. To support their mission, Medicinal Genomics also produces CannMed, an annual gathering of cannabis leaders, dedicated to the scientific advancement of the cannabis industry, and Kannapedia, the world's most complete public cannabis cultivar database.For more information, please visit http://www.medicinalgenomics.com.
MGC media contact:Ben Amiraultben.amirault@medicinalgenomics.com(617) 892-7243
SOURCE Medicinal Genomics Corporation
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Medicinal Genomics Signs Tagaca SRL as Distribution Partner for its Genomic Breeding and Testing Platform in Uruguay. - PRNewswire
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Rare native plants and mosses to yield DNA fingerprints – The Scotsman
Posted: at 1:41 pm
The genetic make-up of the iconic Scottish primrose, mosses from the countrys Celtic rainforests and rare plants from some of our highest mountains is to be laid bare in a ground-breaking new project that will act as a launchpad for global plans to sequence the genomes of all life on earth.
The internationally important native plants are among 2,000 across the UK that will have their DNA examined and documented in the first phase of the 9.4 million Darwin Tree of Life (DToL) project.
The initiative, funded by the Wellcome Sanger Institute, will eventually barcode around 8,000 key British species of plants, animals and fungi in the next two and a half years.
Scientists from the Royal Botanic Garden Edinburgh (RBGE) and the University of Edinburgh (UoE) are part of the UK-wide research team.
They say cataloguing the genomes of all Britains organisms will provide an unprecedented insight into the evolution of life on earth, while potentially identifying new treatments for diseases or solutions to future food security.
It will also increase understanding of how nature responds and adapts to environmental factors such as climate change, providing useful guidance for conservation.
The DToL will build the foundations to develop sequencing pipelines and sampling processes on a relatively well-known flora, and from that it can be expanded out to ultimately sequence everything on earth, said Dr Michelle Hart, who is heading up the RBGE team.
The teams work during the initial stage of the project will concentrate on important Scottish groups that are rare or of high conservation interest, particularly ferns, mosses, liverworts, lichens and rare flowering plants such as the primrose and twinflower.
She said: There are 1,000 bryophytes in the British Isles. Our bryophyte flora is an international botanical asset, because of its diversity and the global rarity of some of the habitats and species such as the snowbeds of the Cairngorm mountains.
And then there are lichens and mosses from the Atlantic woodlands of the Celtic rainforest this habitat is unique to Scotland.
The researchers will have access to the latest DNA-sequencing technology, but will also develop novel methods for analysing specimens.
To sequence whole genomes its crucial we obtain very high-quality DNA extractions from the organisms, in very long unbroken strands, Dr Hart said.
This means rethinking many of our techniques. We will explore gentle methodologies for breaking through plant cell walls and extracting their DNA without using harsh physical or chemical procedures.
RBGE science policy and impact officer Dr Alex Davey added: By fine-tuning our methodologies on the well-known flora and fauna of the British Isles we will be in an excellent position to extend this work in future to the genomes of lesser-known species from biodiversity hot-spots of the world.
The DToL is a foundational project, working towards the ultimate goal of sequencing all complex life on earth, as part of the Earth BioGenome project.
From the small fraction of the earths species whose genomes have already been sequenced, enormous advances have been made in knowledge and biomedicine. The DToL takes this to a whole new level.
Dr Alex Twyford, lecturer in botany at the University of Edinburgh, added: The Darwin Tree of Life Project will transform our understanding of the British fauna and flora, providing new insights from the level of the gene to the entire ecosystem. The Royal Botanic Garden Edinburgh and the University of Edinburgh will play an important role in collecting and analysing British plants and will use these data to inform our conservation science.
The Natural History Museum, University of Cambridge, Earlham Institute, EMBLs European Bioinformatics Institute, Marine Biological Association, Royal Botanic Gardens Kew and University of Oxford make up the rest of the DToL team.
All the information collected for DToL will be made publicly available.
Professor Mark Blaxter, leader of the DToL programme at the Wellcome Sanger Institute, said: The DToL project will change biology forever, delivering new insights into the numerous animals, plants, fungi and protists that call the British Isles home.
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Clear link between genetics and depressive symptoms uncovered – The Age
Posted: at 1:41 pm
"It has a whole bunch of other things surrounding it, but it creates depressive symptoms."
According to SANE Australia, up to 4 per cent of Australians will develop BPD at some point in their life, with the symptoms usually manifesting in late adolescence.
Sufferers have trouble managing their emotions and impulses, and can also struggle to maintain a stable self-image.
The causes of BPD are not well understood, although they are believed to be a combination of biological and lifestyle factors.
Ms Collett said despite her diagnosis being relatively simple compared to other mental health issues, it was "frustrating" that there still wasnt a clear diagnosis and treatment for many sufferers.
Its hoped that new research from QIMR Berghofer Medical Research Institute could help change that, with scientists there identifying key areas on the human genome with direct links to depressive symptoms.
Senior study investigator Professor Eske Derks said the research uncovered seven distinct regions on the human genome with links to symptoms.
"We identified, for the first time, three genetic regions related to sleep problems, two for anhedonia [a loss of interest or pleasure in life], one related to changes in appetite, and one for depressed mood," Professor Derks said.
Overall, about one in 11 people, or 9 per cent of Australians, reported having depression or depressed feelings in 2014-15, according to figures from the Australian Bureau of Statistics.
The QIMR findings provide insight into why the symptoms of depression can vary hugely between patients, and they point the way to more targeted therapies.
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"In some patients, depression will manifest as a reduced appetite, while for others, there will be increased appetite," Professor Derks said.
"So normally if youre looking for the genetic risk factors for depression, you tend to collapse all of these symptoms together, even though they can be quite different from patient to patient."
Professor Derks said being able to accurately assess exactly what genes were in play for individual patients meant they would be able to get tailored treatment instead of the current method of "trial and error", where patients are prescribed the most common medication and then put on other drugs if that fails.
Ms Collett said it would be a comfort going forward to have a more certain diagnosis.
"Im naturally curious about my own health situation, so it would be really good to know the underlying reason why I have it. Was it genetics? Was it something that happened when I was a kid? Who knows?" she said.
The study, which examined genetic data and self-reported symptoms from 150,000 people from the UK Biobank, has been published in the journal Psychological Medicine.
Stuart Layt covers health, science and technology for the Brisbane Times. He was formerly the Queensland political reporter for AAP.
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Genomic Predictions’ DNA test for embryos claims it can predict diseases and alert parents – Screen Shot
Posted: at 1:41 pm
Genomic Predictions DNA test for embryos claims it can predict diseases and alert parents
A New Jersey-based startup developed what it claims to be a genetic test capable of predicting a number of common diseases in embryos. The company, called Genomic Predictions, has been approached by dozens of parents-to-be from across the world in hopes of having the start-up help them weed out embryos more inclined to develop certain diseases later in life, such as cancer and diabetes. Although Genomic Predictions new test is in its infancy, the company has already come under fire by many in the academic and scientific communities, with some depicting the test as both impractical and unethical.
Genomic Predictions has been around for several years now, using various computing technologies, AI and machine learning to research genomes and discover novel ways of predicting phenotypes. Weve always thought that one of the best and earliest applications of this would be embryo selection because we can help families have a healthy child, said Stephen Hsu, the companys co-founder, in an interview for GEN.
Last month, Genomic Predictions finally unveiled a test which it claims can utilise DNA data to predict the likelihood of embryos from an IVF procedure to develop any of 11 types of diseases. As reported by MIT Review, the test, called LifeView, will measure IVF embryos DNA from hundreds of thousands of genetic positions and generate estimates regarding chances of having diseases such as diabetes, heart attacks, and five types of cancer. The test would also alert parents about how likely it is that their child will end up among the shortest 2 per cent of the population or the lowest 2 per cent in intelligence.
Genomic Predictions then hands parents report cards containing the testing results for each embryo so they could implant the ones they deem to be the healthiest out of the batch.
So far, the company reported that 12 clinics around the worldin Nigeria, Peru, Thailand, Taiwan, and the USwill order its new test. The few interested clients are mostly well-off professionals wanting to reduce their childs risk of having diseases that may run in the family. Genomic Predictions first set of clients, for instance, is a gay couple undergoing IVF with a surrogate mother who want to ensure their child wont have breast cancer. Another couple, who have two children with autism, want their third child to be neuro-typical; something they hope the LifeView test could help them achieve.
For the most part, however, clinics are extremely hesitant about ordering this new test, as many scientific experts and researchers voiced harsh criticism of it. It is irresponsible to suggest that the science is at the point where we could reliably predict which embryo to select to minimize the risk of disease. The science simply isnt there yet, tweeted Graham Coop, a geneticist at the University of California, Davis. A research by The Hebrew University of Jerusalem also concluded that attempting to predict the height and intelligence of an embryo is pretty much a futile attempt at this point in time. Others, such as Santiago Munne, an embryo testing expert and entrepreneur, suggest that the great uncertainty that comes with this type of testing would be off-putting for many doctors and client as well as a source for potential disappointment.
And lets not forget about the immense psychological strain such a test can place on children who find out theyve been selected out of a pool of embryos in order to be healthy. What if they do end up developing one of these diseases after all this money had been spent?
While a parents urge to do all in their power to prevent their child from being ill is understandable, this genetic selection process sets us on a very slippery slope. It seems that endeavours such as LifeView constitute a mere hop, skip and a jump away from genetically editing babies, and cater to our growing appetite to design what we perceive to be the perfect human. Naturally, we should support the scientific communitys efforts to find cures and solutions to prevent terrible diseases, but is phenotyping the answer? This approach all but ignores the slew of external and environmental factors that heavily impact someones chances of developing such diseases, including diet, lifestyle, stress, and someones mental state. It could be argued that no less attention should be placed on tackling the latter, as opposed to try and manufacture a flawless human being.
So far, tests like LifeView appeal only to couples using IVF, a process that is long, uncertain, invasive and prohibitively expensive. Some at Genomic Prediction, however, contend that IVF will be the future, claiming that even fertile couples would choose to undergo the process in order to reduce the chances of disease in their children. As such technologies proliferate, we must remain critical and alert of their application and the direction in which it takes our society. Crafting the perfect human and labouring to prevent any flaws in our children could cost us a great deal. Much more than an IVF treatment.
Genomic Predictions DNA test for embryos claims it can predict diseases and alert parents
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Here’s a better way to convert dog years to human years, scientists say – Science Magazine
Posted: November 16, 2019 at 9:49 am
A biological clock governs aging in dogs just as in humans.
By Virginia MorellNov. 15, 2019 , 3:42 PM
Our Scotch collie, Buckaroo, is just shy of 14 years old. Following the long-debunked but still popular idea that one dog year equals seven human years, hes almost a centenarian. (This formula may be based on average life spans of 10 and 70 years for dogs and people, respectively.) Now, researchers say they have a new formula (see calculator below)to convert dog years to human yearsone with some actual science behind it.
The work is based on a relatively new concept in aging research: that chemical modifications to a persons DNA over a lifetime create what is known as an epigenetic clock. Scientists have built a case that one such modification, the addition of methyl groups to specific DNA sequences, tracks human biological agethat is, the toll that disease, poor lifestyle, and genetics take on our bodies. As a result, some groups have converted a persons DNA methylation status to an age estimateor even a prediction of life expectancy (worrying ethicists, who say the data could be misused by forensic investigators and insurance companies).
Other species also undergo DNA methylation as they age. Mice, chimpanzees, wolves, and dogs, for example, all seem to have epigenetic clocks. To find out how those clocks differ from the human version, geneticist Trey Ideker of the University of California, San Diego, and colleagues started with dogs. Even though mans best friends diverged from humans early in mammalian evolution, theyre a good group for comparison because they live in the same environments and many receive similar healthcare and hospital treatments.
All dogsno matter the breedfollow a similar developmental trajectory, reaching puberty around 10 months and dying before age 20. But to increase their chances of finding genetic factors associated with aging, Idekers team focused on a single breed: Labrador retrievers.
They scanned DNA methylation patterns in the genomes of 104 dogs, ranging from 4 weeks to 16 years of age. Their analysis revealed that dogs (at least Labrador retrievers) and humans do have similar age-related methylation of certain genomic regions with high mutation rates; those similarities were most apparent when the scientists looked at young dogs and young humans or old dogs and old humans. Most importantly, they found that certain groups of genes involved in development are similarly methylated during aging in both species. That suggests at least some aspects of aging are a continuation of development rather than a distinct processand that at least some of these changes are evolutionarily conserved in mammals, Ideker and colleagues report in a preprint posted online at bioRxiv.
We already knew that dogs get the same diseases and functional declines of aging that humans do, and this work provides evidence that similar molecular changes are also occurring during aging, says Matt Kaeberlein, a biogerontologist at the University of Washington in Seattle, who was not involved with this research. Its a beautiful demonstration of the conserved features of the epigenetic age clocks shared by dogs and humans.
The research team also used the rate of the methylation changes in dogs to match it to the human epigenetic clock, although the resulting dog age conversion is a bit more complex than multiply by seven. The new formula says a canines human age = 16 ln(dog age) + 31. (Thats the natural logarithm of the dogs real age, multiplied by 16, with 31 added to the total.)
Calculate
(*Enter numbers whose value is 1 or greater)
If your dog were a human, it would be:
Using that formula, dogs and humans life stages seem to match up. For example, a 7-week-old puppy would be equivalent to a 9-month-old human baby, both of whom are just starting to sprout teeth. The formula also nicely matches up the average life span of Labrador retrievers (12 years) with the worldwide lifetime expectancy of humans (70 years).
Theyve shown that theres a gradual increase in DNA methylation in both species with age, says Steve Austad, an evolutionary biologist and aging expert at the University of Alabama in Birmingham. He doesnt find that especially surprising, but he thinks the technique could reveal far more interesting results if applied to issues like the different life spans among different dog breeds.
Thats one goal of Kaeberlein, whose groups new Dog Aging Project (open to all breeds) will include epigenetic profiles of its canine subjects. He hopes to find out why some dogs develop disease at younger ages or die earlier than normal, whereas others live long, disease-free lives.
So, how does our Buckaroo fare? Happily, the epigenetic clock calculation goes in his favor. Hes now only 73 in human yearsand a spry 73 at that.
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Here's a better way to convert dog years to human years, scientists say - Science Magazine
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Is sexual orientation genetic? Yes and no, an extensive study finds – Haaretz
Posted: at 9:49 am
The international group of scientists knew they were setting out to investigate an explosive subject: the hereditary basis of human same-sex behavior. Even so, the members of the prestigious Broad Institute in Cambridge, Massachusetts, may not have anticipated the magnitude of the public furor that erupted when they published their study, which identified several markers in certain genetic loci in the human genome related to same-sex sexual experience. The storm of reactions ranged from those who welcomed something seen as heralding significant progress in the field, to others who maintained that it would have been better if the scientists hadnt published anything.
The research results were published in full in the journal Science, at the end of August. This was the most extensive study of its kind ever conducted (there were about a half a million subjects), in which use was made of the GWAS (genome-wide association studies) method to analyze genetic big data. The researchers discovered five genetic markers (frequent, minor changes in the DNA segments of certain chromosomes) that appeared repeatedly among individuals who reported having had same-sex sexual experiences. Slight and frequent genetic variations were identified in both women and men, two others in men only and one more only in women.
No less important in the study, entitled Large-scale GWAS reveals insights into the genetic architecture of same-sex sexual behavior, is the scientists claim that a large number of genetic markers, perhaps even thousands, might operate simultaneously together although each in and of itself is of minuscule weight and influence ones same-sex orientation. Moreover, their study led the researchers to the conclusion that human genetics can explain up to 32 percent of same-sex sexual behavior.
What is at issue here, however, is not what the study contains but what it does not contain. As Melinda Mills, a sociology professor at Oxford, writes in the same issue of Science, there is no way that the researchers findings can be used as a tool to accurately predict same-sex behavior. Specifically, the fact that genetics can explain up to 32 percent of the fact that someone is gay or lesbian, does not mean that sexual identity is determined primarily by environmental factors not to mention social ones. This story is far more complex and has not yet been fully deciphered. Mills views are shared by Andrea Ganna, one of the chief authors of the new study.
What we basically do is statistical associations between having and not having these genetic markers and having or not having same-sex behavior, Ganna told Haaretz in a phone interview. Because we had this uniquely large study, he continued, which allowed us to have robust conclusions, and because we had the technology to measure the genetic markers of so many individuals, the time was right to confirm something that we expected: There is no one specific gay gene. Instead there are a lot of relatively common genetic markers, genetic mutations, that have a small effect on same-sex behavior.
At the same time, adds Ganna, a geneticist at Harvard Medical School and at Finlands Institute of Molecular Medicine, Not everyone is interpreting the fact that theres no single gay gene in the right way.
Gannas concern is shared by scientists around the world. Theyre worried that the researchers findings will fuel prejudice and discrimination against the LGBTQ community, and even spark calls for genetic engineering and genetic diagnosis among its members. So serious are these apprehensions that some have wondered whether the study would not do more harm than good.
As a queer person and a geneticist, I struggle to understand the motivations behind a genome-wide association study for non-heterosexual behavior, Joseph Vitti, a postdoctoral researcher at the Broad Institute, wrote on its blog, adding, I have yet to see a compelling argument that the potential benefits of this study outweigh its potential harms [T]he results presented not only oversimplify the question of biological causality, but also threaten direct damage by perpetuating the stereotype of LGBTQIA+ people as imprudent, while also likening same-sex attraction to a medical or psychological disorder.
Moreover, a website called The American Conservative posted an article entitled Not Born This Way After All? which wondered, skeptically: If the study proves that homosexuality is related to the environment, above all, and not to heredity why isnt it right and proper, in scientific terms, to allow those who so desire to undergo treatment in order to reduce their same-sex desires, which have now been shown not to be genetic?
That, however, is a simplistic reading of the studys findings. According to Michael Bailey, a professor of psychology at Northwestern University in Illinois, who was not involved in the study but has been conducting research on sexual orientation for 30 years, Its very important to understand that environment does not simply refer to social surroundings, like what your parents teach you and what kids you know, trauma and so on theres also a biological environment that begins right after conception.
Three years ago, Bailey and several colleagues published a survey of all the studies and professional literature in the field. The best studies have shown that genes are probably important but not overwhelmingly important, he tells Haaretz. We estimated in our 2016 review that 30 percent of the variation in sexual orientation is due to genetic variations. It may be this finding that led him to conclude that it is the biological environment that is mostly important. Bailey is convinced that men are born with their sexual orientation and that it is not subsequently acquired at any stage. He notes that there are several cases, I think there are seven throughout the professional literature, in which a baby boy was changed into a girl for medical reasons and was raised as a girl. When you follow these individuals through adulthood, you find that they are attracted to women and not to men.
In Baileys view, the best example of how biological-environmental factors can influence sexual orientation is the fraternal birth order effect. The phenomenon, whose existence is well established, he says, shows that the more older brothers a man has, the more likely he is to be homosexual. In practice, every older biological brother increases the probability that the youngest brother will be gay by about 33 percent. Thus, if the probability that a man with no older brothers will be gay is 2 percent, one older brother will increase the probability to 2.6 percent, and a second, third and fourth brother to 3.5 percent, 4.6 percent and 6 percent, respectively. Whats not yet clear is the reason for this.
In my mind, Bailey suggests, the best hypothesis as to why this happens is that a mothers immune system becomes increasingly active and produces antibodies against male proteins over successive births.
Fingers and hands
Behind this hypothesis is one of the most influential figures in the field, American-Canadian clinical psychologist and sexologist Ray Milton Blanchard. He was also among those who linked the fraternal birth order effect to another phenomenon of interest to scientists: the connection between being left-handed and having a same-sex orientation. The most extensive study in this regard was conducted in 2000, incorporating 20 different studies involving 7,000 gay male and female subjects and 16,000 heterosexual ones. It was found that gay men were 34 percent more likely to be left-handed. The situation was more extreme among lesbians: They were seen to have a 91 percent greater chance than straight women of writing with their left hand.
As a result, six years later, a research team led by Blanchard argued that the fraternal birth-order effect is relevant only among right-handed men. The reason is that, in any case, left-handed men who dont have older brothers already have a greater likelihood of being gay than right-handed men with such siblings.
A persons dominant hand turns out to be significant in another sense as well. An article published two years ago (about a study in which all the subjects had taken part in a gay pride parade in Toronto) found a connection between that hand and the gay persons role in bed: that is, the proportion of left-handed gays who defined their sexual behavior as passive or versatile (i.e., sometimes passive, sometimes not) was significantly higher than among those who described themselves as actives who clearly tended to be right-handed.
In research conducted over the years on the subject of the connection between sexual orientation and other attributes of the body, the hand holds a place of honor. But while Blanchard developed his theory on the basis of the whole hand, sometimes a few fingers are also enough: two, to be exact. In his 1998 study, British biologist John Manning confirmed a relatively old hypothesis, first put forward in Germany almost 150 years ago. Its gist is that the proportion between the length of index and ring fingers is, typically, different in men and women. Manning found that this phenomenon was detectable as early as age 2, which led to the observation that its source lies in the differences in testosterone and estrogen levels that already exist in the womb hereinafter: a biological-environmental factor.
Manning did not emphasize the element of sexual orientation in the two books and over 60 articles he wrote on this subject, but in the two decades that have elapsed since his study, more than 1,400 papers have been written on the ratio between the length of the second and fourth fingers (known as 2D:4D) and the connection between it and the level of risk of contracting certain diseases, as well as personality traits, cognitive and athletic abilities and sexual orientation.
One such study, published in 2010, maintained that straight and lesbian women are differentiated by the ratio between the length of the index and ring fingers, with lesbians tending to show a more masculine ratio i.e., closer to the average difference between the length of the fingers, among men. However, no such differences were found between gay and straight men.
Last year a team of scientists led by a British psychologist measured the fingers of 18 pairs of identical female twins, one lesbian, the other straight. Overall, differences in proportion were documented only in the lesbians and only in their left hand, and were comparable to the situation among men. This fact, the team concluded, could indicate a heightened exposure to testosterone in the womb but their study was based on a very small sample and drew much criticism. The critics charged that the conclusion was based on an overly simple means of measurement: of the way only two variables impacted each other. And, they added to bolster their argument, findings of studies involving those fingers have not been replicated in scientific experiments.
The field of gay science has been on a roll in recent years, but has a far longer history. Its modern phase dates to the early 1990s, when scientists began to publish increasing numbers of studies arguing that sexual orientation has a biological component. A leading scientist in this field is British-American neurobiologist Simon LeVay, who in 1990 performed autopsies on the bodies of 41 people: 19 gay men, 16 straight men and nine women. He discovered that the brain cells known as INAH-3 among the deceased gay men were relatively small, and closer in size to those of women than to heterosexual males.
In 1991, LeVay told Haaretz in a phone conversation, I published a study that got a lot of media attention, related to my observation that there was a region inside the hypothalamus that was different in size between men and women, and also between gay and straight men My additional finding was the difference in size between gay and straight men in this region inside the hypothalamus that is involved in the regulation of sexual behavior.
Adds LeVay, My general feeling is that there are certainly strong biological influences on peoples sexual orientation, but we cant say everything is genetic.
In the spirit of the period, and in light of the AIDS epidemic at the time, LeVay tried to be as cautious as possible about his conclusions. Its important to stress what I didnt find, he said in an interview to Discover magazine, in 1994. I did not prove that homosexuality is genetic, or find a genetic cause for being gay. I didnt show that gay men are born that way, [which is] the most common mistake people make in interpreting my work.
Three decades after publishing his study, he still thinks media coverage is doing an injustice to research even if its not his. Ive seen some headlines saying, basically, that this study [i.e., that of Ganna and his associates] shows its not genetic, or that are no gay genes, or something like that; and, of course, its not what the study shows at all.
Truly gay
In recent decades, scientific research (on men and women alike) in this realm has relied on an additional field: molecular genetics. The pioneer is geneticist Dean Hamer, who in 1993 conducted the first study of its kind.
We noticed that being gay, for males, tended to pass down through the mothers side of the family, he told Haaretz. And that is characteristic in genetics of something on the X chromosome because males get their X chromosomes from their moms That led us to look in families where there were gay brothers, to see if they shared anything on the X chromosome.
And thus, recalls Hamer, he and his team discovered Xq28: a genetic marker that plays a part in determining whether a person will be heterosexual or gay. He emphasizes that this is a factor, its not the factor and actually, overall, its not even the most important factor. He adds, Whats good about genetic studies, is that you know that whatever you find is a causal factor, because of course people are born with their genes, and its not something that changes over time.
LeVay, he explains, is looking directly at the brain, and were looking at what we think is building the brain and genes. Yet, its very difficult to know whether one was born with a brain like that, or whether that brain developed that way because of your behavior the causality is rather unknown.
At the same time, Hamer adds, That doesnt mean there arent specific pathways, because there has to be some sort of a pathway in the brain that controls sexual orientation. We know, for example, that the reason you become a male or a female is very simple: If you have a certain gene on the Y chromosome, you will produce male hormones, and if you have those you make a penis and scrotum and you become male. Accordingly, Theres probably some pathway in the brain that does same thing for sexual orientation, but were not going to discover it from genetics The answer will probably emerge from some sort of very sophisticated brain and developmental studies.
For 35 years, Hamer accumulated experience as a scientist at the National Institutes of Health in Bethesda, Maryland. That period is behind him. He doffed the white coat and now lives in Hawaii, where he makes films. But even if hes no longer occupied with research, it still occupies him.
Hamer: Back in the 1990s, I, along with all the scientists involved, believed that if we did good genetic studies wed find the important genes. For example, well find a gene that is responsible for the production of testosterone, and if its functioning was low, it would be possible to say that this is the cause of homosexuality in a particular person. But it turns out that it doesnt work that way. For every mental trait that has been studied everything you can imagine in the brain, for every single trait, theres a [vast number of] genes not to mention a host of complex societal and environmental factors.
For his part, Hamer has much praise for the Broad Institute study: The new GWAS study is really important, because for the very first time they used a huge sample and they mapped every inch of the genome. And this has never been done before. All the other studies were much smaller, or used many fewer genetic markers. But he also demurs: Whats very important is to look at what they actually analyzed. They didnt analyze people who were gay or lesbian, but anyone who had one single same-sex experience, which is quite different... They were measuring something more like openness to sexual experimentation.
As Hamer sees it, If you look for those five markers, or even just the three strongest markers, they are not necessarily found in people who actually identify as gay or lesbian. If you take people who are gay, like me, and look for those markers theyre not significantly there.
Hamer thinks that the whole field is lagging behind because of insufficient research, owing to the stigmas that plague the subject. I dont think sexuality is any more complicated than many other areas of human personality and individual differences, he observes, noting, We formally established that male sexuality is something that is deeply ingrained in people, its not any sort of choice really. It starts really early in life, and it has a major biological component to it. But, how it works? What the biological component is? Were completely unaware and dont know anything, and we barely know more than we did 25 years ago, or in the 1940s, when Kinsey did his work, to be honest.
Hamer was referring to biologist Alfred Kinsey, who in 1948 stunned the American public with his book, Sexual Behavior in the Human Male, which addressed previously taboo subjects, and challenged the traditional beliefs and existing knowledge about human sexuality. Kinsey had conducted a survey of men, which found that 37 percent of his subjects said they had undergone a homosexual experience of some kind, and 10 percent said they had been exclusively gay for three years of their adult life a statistic which to this day is generally said to represent the proportion of people engaging in same-sex behavior.
At the same time, subsequent studies reveal that the percentage of people who define themselves as exclusively homosexual is far lower, though it fluctuates from one article to the next. For example, a 2011 survey of nine different studies on the subject revealed that approximately 3.5 percent of Americans identify themselves as gays, lesbians or bisexuals. A poll involving 1,000 Jewish Israelis in 2012 found that 11.3 percent of the male respondents and 15.2 percent of the female ones said they felt an attraction to members of the same sex. However, only 8.2 percent of the men categorized themselves as gay or bisexual, while 4.8 percent of the women said they were lesbian or bisexual.
For his part, Ganna, of the Broad Institute, understands some of the criticism of his research. What we studied is not related directly to the biology, but to extended environmental factors related to it. Its not about our sample size once you have a lot of individuals, you can capture very small effects. But are these directly influencing same-sex behavior, or other things related to this topic? As a medical example, think about a study that looks for associations between genetic markers and lung cancer. In that example, what we found are genetic variants regarding how much you smoke, which is related to lung cancer.
One of the lessons, and one of the most interesting points arising from the study has to do, says Ganna, with the mode of measurement that had been in use since 1948, when Kinseys scale ranked individuals as being between 0 (totally heterosexual) and 6 (totally homosexual).
Ganna: Basically, the tendency is to locate individuals on a continuum. You can supposedly be anywhere between 100 percent heterosexual to 100 percent homosexual, which implies that the more youre homosexual, the less youre heterosexual, and vice versa. We show that this assumption actually doesnt hold water: When we look at the genetic data, its not that straightforward, theres no simple continuum of sexuality.
So, actually, you are refuting the Kinsey scale?
Ganna: Thats exactly one of our conclusions. What were now doing is, rather than asking people to put themselves on a scale somewhere between being exclusively heterosexual or exclusively homosexual, we ask them how much theyre attracted to men and women. You could be attracted to either of them, very attracted to both of them or to one more than the other. And that information will be crossmatched with genetic markers.
In the final analysis, he adds, We showed that this is just another natural human variation. Sexual orientation, similar to many other behavioral traits, is complicated and is composed of different factors. The interesting thing is how genetics and environment work together. If you think about how much more prevalent same-sex behavior has become lately, people engage in it more than in the past. And thats clearly not because our genetics are changing. Its because of the environment, because society is becoming more open and laws are changing.
Further research should focus on the relationship between environmental factors and genetics, Ganna says, and on how they interact. Its somewhat misleading to think of nature and nurture as separate aspects; they both contribute. So, it would be wrong to say that you can use only DNA to predict if someone will engage in same-sex behavior, but you also cant say its simply a [matter of] choice.
In summary, he says, I think that the more people who will understand that there are genetic and environmental components to sexual behavior, the better and this is a message that goes beyond just sexuality.
Choice and lifestyle
However, the relationship between science and the environment, and particularly the people living in it, is a complicated one. The subject definitely should be studied, but the social aspect of it is problematic, says LeVay, the neurobiologist. I am gay myself, and I feel strongly that gay people should be valued and accepted into society, regardless of what caused their sexual orientation. I dont think its vital for gay liberation to prove that gay people cant help but be gay there are plenty of other reasons [for accepting them], including basic human rights.
At the same time, he adds, this issue is socially relevant, because of traditional notions that see same-sex relations as a choice, a lifestyle or sinful behavior.
In recent years, there have been many studies showing that peoples attitudes toward homosexuality are closely tied to their beliefs about what makes people gay, says LeVay, citing a survey that showed there was a high probability that people who think homosexuality is a choice will object to a gay person being their childrens teacher which in a way might make sense, he adds: If you think being gay is something infectious, socially contagious, and you didnt want your kid to be gay, then you wouldnt want their teacher to be gay ... It follows that demonstrating that biological factors are involved, helps counter those ideas. Still, Im a bit ambivalent about the use of this type of research as some sort of a political weapon in the struggle for gay rights.
The Broad Institute study contains a reminder of the problems and stigmas that still exist with regard to the LGBTQ community. One of the parameters it considers are genetic correlations between genes that are ascribed to homosexuality, and certain psychological problems.
Bailey, the psychologist: One thing that was perceived as controversial, was to look for and find a genetic overlap between homosexual sex genes and genes associated with depression. Its not the same as saying all people who engage in homosexual sex are depressed for genetic reasons, but its also not something that can be easily ignored. There are assumptions that the higher rates of depression among gay men and lesbians is due to the way they are mistreated by society, but the evidence for that is not so overwhelming. There is also the fact, for example, that you have as high a rate of depression among homosexual men in the Netherlands, which is very tolerant, as you have in some less tolerant places, like the United States.
Ganna, for his part, tries to soften that criticism: Even if we see genetic overlap, or correlation, it is not set in stone that weve found a biological mechanism that causes depression and same-sex behavior, he says. There are many explanations for why this one genetic marker is associated with both things. But finding these correlations help us study human traits in general.
In the meantime, there is a price to be paid for conducting research in this realm, which all those involved must be aware of. Reminders of this abound, and are almost routine. In some cases whats at stake is not even a groundbreaking study or one of tremendous scientific importance. In 2017, for example, two researchers from Stanford published an article stating that gay men are predicted to have smaller jaws and chins, slimmer eyebrows, longer noses, and larger foreheads; the opposite should be true for lesbians. In the next stage, they created a facial-recognition program with the aid of more than 14,000 images taken from a singles site of straights and LGBTQs. The program was able to distinguish between gays and lesbians and heterosexuals with an accuracy of 81 percent for men and 71 percent for women, in contrast to an average rate of successful human guesses of 61 percent and 54 percent, respectively. Even though the program achieved relatively impressive results, the study as such drew widespread criticism not unusual for researchers engaged in such studies.
The Stanford gays identification program may be an extreme example, in this respect, but its also a byproduct of the considerable surge in studies in this field, a trend that began in the early 1990s. Together with the scientific community, media interest in the subject of same-sex orientation and its causes has contributed substantially to transmitting messages and shaping public opinion.
In the United States, this can be seen in a series of polls conducted by Gallup, Inc. The first one, conducted in 1977, found that only 13 percent of the respondents believed that homosexuality is an innate tendency, while 56 percent attributed it to environmental factors. This approach remained largely constant until the period between 1989 and 1996, when the rate of those supporting the innate thesis leaped from 19 percent to 31 percent; by 2001, it stood at 40 percent. Almost a decade and a half later, the annual poll produced, for the first time, a larger proportion who agreed with the innate argument. The latest survey, from the end of last year, showed this trend continuing: More than half of the American public believes that gay people are born with their sexual orientation, whereas only 30 percent attribute it to environmental factors (10 percent said both factors play a part, 4 percent cited other factors and 6 percent said they werent sure).
Changes in the perceptions of the origins of sexual orientation are having a pronounced effect on the struggle LGBTQ individuals are waging for equal rights. The latest Gallup poll shows that an absolutely majority (88 percent) of those who believe that homosexuality is an innate trait also support legitimizing same-sex marriages. In contrast, most of those who see this orientation as being environmentally driven (61 percent) are against.
When it comes to public opinion, which is very important, the born this way idea has been really resonant and has had a very positive impact on society, Hamer maintains. Public opinion polls asked people whether they think [gays] were born this way or not, and we know that believing that homosexuality is innate correlates with having positive feelings toward gay rights. Overall, its been important in educating the public about who we are, as gay people.
Such messages are reaching Israel as well. A poll conducted by the Dialog Institute for Haaretz at the end of 2013 found that 70 percent of those questioned favored full rights for same-sex couples, while 64 percent specifically backed their right to surrogacy. However, two polls conducted in the wake of the surrogacy law protest in July 2018 presented slightly lower numbers: About 57 percent of respondents expressed support for the right of same-sex male couples to surrogacy.
These polls did not ask Israelis whether they believe the origin of same-sex orientation is innate or environmental. If you ask Bailey, though, that doesnt really matter.
Ive gone to great lengths to try to persuade people not to base equal rights for gay people on the causal hypothesis, he says. Its a terrible idea to say gay people should have equal rights because they were born that way. Its terrible in part because some criminals might be born that way, and you dont want to them to have the same rights. Being gay doesnt harm anybody, other than people who are close-minded and easily offended. Preventing people from expressing their homosexuality is quite destructive for them. Thats true whether gay people are born that way or not.
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The American Heart Association’s Annual Conference Comes to Philly This Weekend – Philadelphia magazine
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Researcher Tom Cappola tells us about the latest clinical trials and medical breakthroughs to be announced during Scientific Sessions.
Chief of the cardiovascular medicine division in the Perelman School of Medicine at the University of Pennsylvania, Tom Cappola.
For the first time in its near 100-year history, the American Heart Association (AHA)will host its annual meeting in Philadelphia. AHAs Scientific Sessions is the largest cardiovascular meeting in the United States. On November 16-18, the meeting will attract nearly 18,000 attendees from more than 100 countries to the Pennsylvania Convention Center, and an additional two million medical professionals who will participate virtually in lectures and discussions about basic, translational, clinical and population science innovations aimed at reducing disability and deaths caused by cardiovascular disease and stroke.
The American Heart Association is excited to be in Philadelphia, said Michelle Kirkwood, director of National Science Media Relations for AHA. It has been on our wish list for some time, especially since the renovations at the Pennsylvania Convention Center and the citys landmark, robust nonsmoking laws that align directly with the American Heart Associations health and wellness goals. We are excited for our thousands of attendees to visit Philadelphia.
More than 610,000 people die of heart disease in the United States every year, according to the CDC. While heart disease is a leading cause of death for both men and women, it claims the lives of over 400,000 American women each year, or one death every 80 seconds. During the three-day meeting, more than 12,000 leading physicians, scientists, cardiologists and healthcare professionals in the global cardiovascular health community will host 850 educational sessions and more than 4,100 original research presentations to unveil the late-breaking science, clinical trials, and novel therapeutics and pathways that are shaping the future of cardiovascular care.
Its very fitting for Scientific Sessions to be here, chief of the cardiovascular medicine division in the Perelman School of Medicine at the University of Pennsylvania Tom Cappola said. We have the first medical school in the country and the first teaching hospital in the country. It makes sense that these new innovations would be presented in a place where theres already been so much innovation.
Cappola will be one of several Penn researchers leading the Cardiovascular Expert Theater, Innovations in Cardiovascular Therapies session during the meeting. Here are just a few big trends in heart care that Cappola says we can expect to learn more about during this weekends meeting:
Using artificial intelligence to monitor heart health
Artificial intelligence (AI) is having a big impact on cardiovascular care. Results from two preliminary studies to be presented this weekend will show AI can be used to accurately examine electrocardiogram (ECG) test results to possibly predict irregular heartbeat and risk of death. There will also be a presentation on the Apple Heart Study, which found that the Apple Watch and other wearable remote monitoring devices may be capable of detecting atrial fibrillation (aFib), an irregular and often rapid heartbeat that can lead to blood clots, stroke, heart failure and other complications.
Identifying new risk factors for aFib and stroke
George Mason University researchers will present results from two studies that found young people who smoke marijuana regularly have an increased risk of stroke. According to the study findings, young adults between the ages 18 and 44 who reported frequent use of marijuana, cigarettes and e-cigarettes were three times more likely to suffer stroke than young adults who did not smoke marijuana at all. The study also found that African-American males between the ages of 15 and 24 faced the highest risk of being hospitalized for arrhythmia.
In one Penn study to be presented this weekend, researchers found women who are diagnosed with peripartum cardiomyopathy (PPCM) during late pregnancy or within a month following delivery are more likely to experience restored cardiac function and improved outcomes compared to those who are diagnosed later in the postpartum period. The findings underscore the need for increased awareness and monitoring of heart failure symptoms, particularly among black women, who, on average, are diagnosed significantly later than white patients, according to study results.
Making advances in genetics and genomics
Another big trend at this years meeting will be the continued advancement in genetics and genomics, and how thats impacting cardiovascular care.
I think that genomic medicine has arrived and its arriving in waves, but it will ultimately affect all aspects of cardiovascular care, Cappola said. We have lots of people getting their 23andMe for sort of recreational purposes and they dont know what to do with it. But were starting to figure out what to do with that genetic information to improve care.
Another Penn Medicine study to be presented during the meeting will show why taller people may have an increased risk of developing atrial aFib. The research found a strong link between the genetic variants associated with height and ones risk for AFib, for the first time demonstrating that height may be a causal not correlated risk factor for the condition. Researchers hope insight from human genetics in large studies like this one will help them better understand causal risk factors for common disease.
It takes expertise to find links like this. Thats why researchers go to the American Heart Association meetings. You get all the experts together, they share their knowledge and this helps us to actually figure out what to do with this genetic information, Cappola said. Thats true across the board, but its particularly important for genomic medicine as it continues to advance.
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Taller People have Increased Risk of Irregular Heartbeat – News18
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Researchers have found that taller people have an increased risk of developing atrial fibrillation (AFib), an irregular and often rapid heartbeat that can lead to stroke, heart failure and other complications.
The research, which reveals a strong link between the genetic variants associated with height and one's risk for AFib, is the among the first to demonstrate that height may be a causal--not correlated--risk factor for AFib.
Researchers found that the risk for AFib climbed as one's height increased, with every one-inch increase in height translating to about a three percent increase in risk of Afib--independent of other clinical factors--as compared to those at average height (5 feet and 7 inches).
"Our findings suggest it may be beneficial to incorporate height into risk-prediction tools for AFib," said the study's lead author Michael Levin from University of Pennsylvania.
"While current guidelines advise against widespread screening for AFib, our findings show that a certain group of patients--specifically, very tall patients--may benefit from screening," Levin added.
AFib, which affects more than 33 million people worldwide, is a common, abnormal heart rhythm.
There are a number of clinical risk factors for developing AFib, including high blood pressure, heart disease, diabetes, and obesity.
Observational studies, examining population-level data, have found that taller individuals appear to have a higher risk of developing AFib.
To further examine the association between height and Afib, the research team leveraged data from the Genetic Investigation of Anthropometric Trials (GIANT) consortium, which studied more than 700,000 individuals to identify genetic variants associated with height.
They also examined data from the Atrial Fibrillation Genetics (AFGen) consortium, which studied more than 500,000 individuals to identify genetic variants associated with AFib.
The authors employed a statistical method which uses genetics to precisely estimate the relationship between two traits.
Their analysis revealed that genetic variants associated with height were also strongly associated with Afib, suggesting that increased height may be a cause of atrial fibrillation.
This relationship remained strong even after adjusting for traditional AFib risk factors, like heart disease, high blood pressure, and diabetes, among others.
From there, researchers used a similar statistical method to conduct an individual-level analysis of nearly 7,000 individuals enrolled in the Penn Medicine Biobank.
They found that height, and genetic variants associated with height, are strongly associated with an increased risk of AFib, independent from traditional clinical and echocardiographic risk factors.
"These analyses show how we can use human genetics to help us better understand causal risk factors for common disease," said the study's senior author Scott Damrauer.
The study is scheduled to be presented at American Heart Association 2019 Scientific Sessions in Pennsylvania, US.
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A new study hopes to prevent disease before it starts through genetics – KSL.com
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HURRICANE What would life be like if you knew you would get cancer one day, but could prevent it beforehand? Clinicians in Utah are hoping to accomplish just that through a new study.
One St. George man said he's participating for the health of his posterity.
Durward Wadsworth, 76, grew up on a farm in Southern Utah. He worked alongside his family tending to the fruits trees, horses, and other animals.
"We had to milk cows and bring hay in," he said.
The farm has remained, but things have changed.
"I have a brother that passed away. I have a sister that passed away, Wadsworth said.
They both died from cancer. Wadsworth was also diagnosed with colon cancer and finished chemo only a year ago.
It's not a fun treatment, he said. He went to the Dixie Regional Cancer Center for 12 rounds of chemo.
As a teenager Wadsworth was exposed to radiation during nuclear testing at the Nevada National Security Site.
"As kids, we didn't know any different, so we would go up on the hill and watch when one would explode and you could actually see the mushroom and hear the boom, he said.
Both his family history of cancer and heart disease, and his exposure to radiation, had him concerned.
His son encouraged him to participate in Intermountain Healthcare's HerediGene population study. Clinicians hope this study, in collaboration with deCODE Genetics of Iceland, will help them better understand the human genome.
Dr. Lincoln Nadauld, Chief of Precision Health at Intermountain Healthcare, said the study is unprecedented. He said it looks at the link between genes and human disease.
"This study is the largest of its kind. It's an attempt to map the genomes of 500,000 people over the next five years, Nadauld said. There is no genetic study in health care that has ever been reported or ever attempted that compares in size or scope.
Nadauld said this study will impact generations to come.
(It) will allow us and subsequent generations to better understand health and the origins of disease and health care-related issues, he said. It's going to change the way that we deliver health care for the better.
Nadauld hopes the study will help doctors better predict and prevent disease before someone is ill.
So let's intervene with either a medicine or a lifestyle change so that you never have to experience heart failure or heart attack or a stroke, he explained.
While this type of precision genomics started in oncology, Nadauld said his team has applied it to all of their medical disciplines, including cardiovascular and neurodegenerative disorders, metabolic issues and even mental illness.
This study could uncover the link between mental illness and genes, and could identify new treatments for mental illness, he said.
Even though Wadsworth still has a lot of life to live, he knows he probably won't personally benefit from the study by the time its completed. "But, you know, my posterity will benefit, he said.
That's enough motivation for him. Wadsworth said he doesn't want his five children and 18 grandchildren to suffer through cancer like he did.
"We want the best health care for them, he said. He also hopes they'll carry on the family farm.
Nadauld said the study isn't just for people who have been sick, but will include mostly healthy individuals.
He said it just takes a simple blood draw to participate. Nadauld said by the end of the year there will be 25 different walk-in clinics across the entire state.
Nadauld said he anticipates a very small percentage of the participants will be informed of a health issue, in which doctors and patients need to take action.
We expect that will happen in about 3% of our participants, he said.
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First Large-Scale Registry to Evaluate Real-World Lipid Management and Effectiveness of PCSK9 Inhibitors Announced – Cath Lab Digest
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New Registry, cvMOBIUS, Will Assess Lipid Therapies and Five-Year Cardiovascular Outcomes in 8,500 High-Risk Patients With a Recent Atherosclerotic Cardiovascular Disease Event
THOUSAND OAKS, Calif. (Nov. 15, 2019) Amgen in collaboration with the Duke Clinical Research Institute (DCRI) today announced plans to initiate theCardiovascularMulti-dimensionalObservationalInvestigation of theUse of PCSK9 inhibitors (cvMOBIUS) studythe first large-scale real-world study to assess lipid management and the impact of PCSK9 inhibitors on cardiovascular (CV) outcomes in clinical practice. While there is strong evidence demonstrating the efficacy of PCSK9 inhibitors from various randomized clinical trial studies, there is less information on the effectiveness of these medicines on cardiovascular outcomes in real-world practice.
The cvMOBIUS study will be conducted across the U.S. and Canada and will begin patient enrollment this month. A prospective observational registry of 8,500 adults eligible for treatment with a PCSK9 inhibitor will be followed for five years. In parallel, an electronic health record (EHR)-based registry will follow a broader population of adults hospitalized with atherosclerotic cardiovascular disease (ASCVD) at participating sites.
Cardiovascular disease is one of the most significant public health issues facing our country today. Gathering robust, large-scale data from diverse patients will better inform lipid management and help decrease the burden of cardiovascular disease in these high-risk patients, said Ann Marie Navar, M.D., Ph.D., assistant professor of medicine at the Duke University School of Medicine and member of the DCRI. The clinical evidence supporting the efficacy and safety of PCSK9 inhibitors in patients with cardiovascular disease is well established, but we still have a lot to learn about the benefits of these medicines in the real world.
Patients who have experienced a recent ASCVD event, including a myocardial infarction (MI), are at higher risk of experiencing another CV event, especially within the first year after.1,2Lipid lowering is one of the key approaches for reducing a patients risk for secondary events.1Based on large randomized trials, major professional cardiology societies, including the American Heart Association and the American College of Cardiology, acknowledge that lower is better when it comes to low density lipoprotein cholesterol (LDL-C) management in patients who have experienced an MI and other ASCVD events.3
LDL-C is one of the most important modifiable risk factors for cardiovascular disease, so lipid management is an essential element in reducing future CV events and improving clinical outcomes for high-risk patients, said Eric D. Peterson, M.D., MPH, distinguished professor of medicine at the Duke University School of Medicine and member of the DCRI. This large registry will examine how care is being delivered in clinical practice to patientswhether we are using the right medicines, whether we are reaching guideline-based LDL-C targets, and the degree to which achieving these goals impacts outcomes in real-world practice.
The cvMOBIUS study is important because it is one of the few instances that researchers will utilize data pulled directly from hospitals EHR systems for research. This should help set the stage for future big data analyses and pragmatic clinical trials, said Dr. Peterson.
Two large randomized outcomes trials, including the Repatha(evolocumab) cardiovascular outcomes (FOURIER) study, have demonstrated that innovative therapies like PCSK9 inhibitors lower LDL-C levels and can reduce the risk of heart attacks in high-risk patients with established cardiovascular disease. Additionally, the VESALIUS-CV trial, initiated in March 2019, is an ongoing randomized outcomes trial, designed to evaluate the long-term effects of Repatha in high-risk cardiovascular disease (CVD) patients without a prior heart attack or stroke. The study will be the first to investigate long-term outcomes in this population with Repatha for a minimum of four years.
Amgen is committed to building a vast body of evidence for Repathaclinical trial and real-world effectiveness data setsto advance the knowledge and treatment of cardiovascular disease, saidDavid M. Reese, M.D.,executive vice president of Research and Development at Amgen. This study will generate valuable real-world evidence to help us demonstrate that PCSK9 inhibitors, like Repatha, are an important treatment option for very high-risk patients and can help prevent recurrent cardiovascular events in the real world.
Drs. Navar and Peterson are co-primary investigators of the study.
About cvMOBIUS
cvMOBIUS is a multicenter prospective observational registry in the U.S. and Canada. The study will be comprised of two parallel arms: a multicenter, prospective observational arm that will include 8,500 patients who experienced an ASCVD event within 12 months, from 250 sites; and a parallel EHR-based registry of a larger cohort of patients hospitalized with an ASCVD event treated at participating centers. The primary endpoint includes time to death, any non-fatal MI and any non-fatal ischemic stroke (IS).
About the Duke Clinical Research Institute
The DCRI, part of the Duke University School of Medicine, is the largest academic research organization in the world. It delivers on its mission to develop and share knowledge that improves the care of patients through innovative clinical research by conducting groundbreaking multinational clinical trials, managing major national patient registries, and performing landmark outcomes research. DCRI research spans multiple disciplines, from pediatrics to geriatrics, primary care to subspecialty medicine, and genomics to proteomics. The DCRI also is home to the Duke Databank for Cardiovascular Diseases, the largest and oldest institutional cardiovascular database in the world, which continues to inform clinical decision-making 40 years after its founding.
About Repatha(evolocumab)
Repatha is a human monoclonal antibody that inhibits proprotein convertase subtilisin/kexin type 9 (PCSK9). Repatha binds to PCSK9 and inhibits circulating PCSK9 from binding to the low-density lipoprotein (LDL) receptor (LDLR), preventing PCSK9-mediated LDLR degradation and permitting LDLR to recycle back to the liver cell surface. By inhibiting the binding of PCSK9 to LDLR, Repatha increases the number of LDLRs available to clear LDL from the blood, thereby lowering LDL-C levels.4
Repatha is approved in more than 70 countries, including the U.S.,Japan,Canadaand in all 28 countries that are members of theEuropean Union. Applications in other countries are pending.
Repatha Cardiovascular Outcomes (FOURIER) Study Design
FOURIER (Further cardiovascularOUtcomesResearch with PCSK9Inhibition in Subjects withElevatedRisk), a multinational Phase 3 randomized, double-blind, placebo-controlled trial, was designed to evaluate whether treatment with Repatha in combination with statin therapy compared to placebo plus statin therapy reduces cardiovascular events. The primary endpoint was the time to cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. The key secondary endpoint was the time to cardiovascular death, MI or stroke.
Eligible patients with high cholesterol (LDL-C 70 mg/dL or non-high-density lipoprotein cholesterol [non-HDL-C] 100 mg/dL) and clinically evident ASCVD at more than 1,300 study locations around the world were randomized to receive Repatha subcutaneous 140 mg every two weeks or 420 mg monthly plus effective statin dose; or placebo subcutaneous every two weeks or monthly plus effective statin dose. Optimized statin therapy was defined as at least atorvastatin 20 mg or equivalent daily with a recommendation for at least atorvastatin 40 mg or equivalent daily where approved. The study was event-driven and continued until at least 1,630 patients experienced a key secondary endpoint.
Important U.S. Product Information
Repatha is a PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor antibody indicated:
to reduce the risk of myocardial infarction, stroke, and coronary revascularization in adults with established cardiovascular disease.
as an adjunct to diet, alone or in combination with other lipid-lowering therapies (e.g., statins, ezetimibe), for treatment of adults with primaryhyperlipidemia (including heterozygous familial hypercholesterolemia [HeFH]) to reduce low-density lipoprotein cholesterol (LDL-C).
as an adjunct to diet and other LDL-lowering therapies (e.g., statins, ezetimibe, LDL apheresis) in patients with homozygous familial hypercholesterolemia (HoFH) who require additional lowering of LDL-C.
The safety and effectiveness of Repathahave not been established in pediatric patients with HoFH who are younger than 13 years old or in pediatric patients with primary hyperlipidemia or HeFH.
Important U.S. Safety Information
Contraindication:Repatha is contraindicated in patients with a history of a serious hypersensitivity reaction to Repatha. Serious hypersensitivity reactions including angioedema have occurred in patients treated with Repatha.
Allergic reactions:Hypersensitivity reactions (e.g. angioedema, rash, urticaria) have been reported in patients treated with Repatha, including some that led to discontinuation of therapy. If signs or symptoms of serious allergic reactions occur, discontinue treatment with Repatha, treat according to the standard of care, and monitor until signs and symptoms resolve.
Adverse reactions:The most common adverse reactions (>5% of patients treated with Repatha and occurring more frequently than placebo) were: nasopharyngitis, upper respiratory tract infection, influenza, back pain, and injection site reactions.
From a pool of the 52-week trial and seven 12-week trials: Local injection site reactions occurred in 3.2% and 3.0% of Repatha-treated and placebo-treated patients, respectively. The most common injection site reactions were erythema, pain, and bruising.
Allergic reactions occurred in 5.1% and 4.7% of Repatha-treated and placebo-treated patients, respectively. The most common allergic reactions were rash (1.0% versus 0.5% for Repatha and placebo, respectively), eczema (0.4% versus 0.2%), erythema (0.4% versus 0.2%), and urticaria (0.4% versus 0.1%).
The most common adverse reactions in the Cardiovascular Outcomes Trial (>5% of patients treated with Repatha and occurring more frequently than placebo) were: diabetes mellitus (8.8% Repatha, 8.2% placebo), nasopharyngitis (7.8% Repatha, 7.4% placebo), and upper respiratory tract infection (5.1% Repatha, 4.8% placebo).
Among the 16,676 patients without diabetes mellitus at baseline, the incidence of new-onset diabetes mellitus during the trial was 8.1% in patients assigned to Repatha compared with 7.7% in those assigned to placebo.
Homozygous Familial Hypercholesterolemia (HoFH):The adverse reactions that occurred in at least two patients treated with Repatha and more frequently than placebo were: upper respiratory tract infection, influenza, gastroenteritis, and nasopharyngitis.
Immunogenicity:Repathais a human monoclonal antibody. As with all therapeutic proteins, there is a potential for immunogenicity with Repatha.
Please contact Amgen Medinfo at 800-77-AMGEN(800-772-6436) or 844-REPATHA (844-737-2842) regarding Repathaavailability or find more information, including fullPrescribing Information, atwww.amgen.comandwww.Repatha.com.
AboutAmgenin the Cardiovascular Therapeutic Area
Building on more than three decades of experience in developing biotechnology medicines for patients with serious illnesses,Amgenis dedicated to addressing important scientific questions to advance care and improve the lives of patients with cardiovascular disease, the leading cause of morbidity and mortality worldwide.5Amgen'sresearch into cardiovascular disease, and potential treatment options, is part of a growing competency atAmgenthat utilizes human genetics to identify and validate certain drug targets. Through its own research and development efforts, as well as partnerships,Amgenis building a robust cardiovascular portfolio consisting of several approved and investigational molecules in an effort to address a number of today's important unmet patient needs, such as high cholesterol and heart failure.
Amgen is committed to unlocking the potential of biology for patients suffering from serious illnesses by discovering, developing, manufacturing and delivering innovative human therapeutics. This approach begins by using tools like advanced human genetics to unravel the complexities of disease and understand the fundamentals of human biology.
Amgen focuses on areas of high unmet medical need and leverages its biologics manufacturing expertise to strive for solutions that improve health outcomes and dramatically improve peoples lives. A biotechnology pioneer since 1980, Amgen has grown to be the worlds largest independent biotechnology company, has reached millions of patients around the world and is developing a pipeline of medicines with breakaway potential.
For more information, visitwww.amgen.comand follow us onwww.twitter.com/amgen.
References
1.Yusuf S, et al. Lancet. 2004;364:937-952. 5. Ference BA, et al. EHJ. 2017;38:2459-2472.
2.Kuklina, EV. Centers for Disease Control and Prevention. Vital signs: prevalence, treatment, and control of high levels of low-density lipoprotein cholesterol. United States, 19992002 and 20052008. MMWR. 2011;60(4):10914.
3.Grundy SM, et al. JACC. 2018; 1-80.
4.Repatha Prescribing Information; Amgen, Thousand Oaks, CA, 2018.
5.World Health Organization. Cardiovascular diseases (CVDs) fact sheet.http://www.who.int/mediacentre/factsheets/fs317/en/.
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First Large-Scale Registry to Evaluate Real-World Lipid Management and Effectiveness of PCSK9 Inhibitors Announced - Cath Lab Digest
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