Deal or no deal? At first glance, it may seem like greed is the only thing driving a contestant's answer to Howie Mandel's famous question. But new research shows that there may be more behind a game show contestant's decision than meets the eye.

Researchers at the University of Pittsburgh Medical Center have found that the brain controls an individual's preference for immediate or delayed rewards. The results appear in the Journal of Neuroscience.

In the small study, 45 adults were placed in a laboratory version of Deal or No Deal. Each participant was given a choice of immediately winning a prize that ranged from 10 cents to $105 or waiting anywhere from one week to five years to receive a guaranteed $100. The volunteer's decisions were scrutinized to determine how the brain makes reward-based decisions.

The study showed that an individual's decision to immediately take the reward or delay gratification could be determined by the level of activity in the person's ventral striatum — an important part of the brain's circuitry. The adults who were labeled as impulsive decision makers or exhibited delay discounting had more activity in the ventral striatum than adults who were willing to wait for the rewards.

What it means: Previous studies have shown that addiction disorders like substance abuse and gambling are associated with a more active ventral striatum. However, this study is the first to show that the brain's circuitry is also a factor in individuals who show delayed discounting. The findings offer additional insights into understanding and treating addiction disorders. Next step: the researchers will see if increased ventral striatum can predict if an individual will develop an addiction disorder.

From the Archive:

Jul. 25, 2005: When Gambling Becomes Obsessive
May 5, 1997: Addicted

Kids love toys that make noise — fire trucks with sirens, dolls that gurgle and keyboards that play music. But according to a new small study, parents may want to rethink what types of toys they put under their Christmas tree.

A new study from Deafness Research UK and the University College of London found that 14 out of 15 studied toys, had noise levels that are above the recommended level — 85dBA — when children held the toys 2.5 cm away from their ear. More than half of the toys produced noise levels above or near the safety limits when children held the toys at arm’s length — the normal distance that a child would hold a toy when playing.

The study examined 15 noise-emitting toys available for purchase this Christmas on children from 3 months old to 15 years-old. On average, noise levels below 80dBA are unlikely to cause damage, but prolonged exposure to levels over 80dBA could damage a child’s hearing and experiencing levels over 140dBA causes almost immediate injury to an unprotected ear. The researchers found that the most dangerous toys were mechanical toy guns, plastic tommy guns and cap guns — which had noise levels from 130 to 143dBC when held 2.5 cm from the ear and emitted levels ranging from 120 to 140dBC when held at arm’s length.

According to the researchers, toy guns can cause severe damage to a child’s ear that may potentially lead to hearing loss. The study concluded that toys — excluding guns — also have the potential to cause harm, but are less likely to cause damage if used safely for a limited period of time.

What it means: Noise-emitting toys could cause hearing damage in children. Although the results are admittedly from a very small study, it may be wise to keep children away from toy guns. For all other toys: parents should monitor their child’s use, make sure children don’t stick noisy toys close to their ears and be careful of prolonged exposure to any noise-emitting toy.

From the Archive:

Dec. 3, 2006: What’s Toxic in Toyland
Dec. 6, 2006: Tips for Safe Toys and other Household Products

There may be another use for the abortion pill — aside from stirring up controversy. Researchers from the University of California–Irvine have found that mifepristone, a chemical compound found in the abortion pill, helps thwart the growth of mammary tumors that often lead to breast and ovarian cancers.

The study, which will be published in Science, found that mifepristone prevents tumors by inhibiting progesterone — a female hormone involved in the menstrual cycle and pregnancy. Progesterone has been found to encourage mammary cells to spread in women that carry a breast cancer gene and in some cases, ultimately lead to cancer.

The researchers studied the affects of mifepristone, an anti-progesterone, on mice that had BRCA-1 — a mutated gene that significantly increases the risk of developing breast and ovarian cancers. More than half of women who have BRCA-1 will develop breast or ovarian cancer by age 70. The mice that were treated with mifepristone did not develop tumors by the time they were a year old, but the untreated mice all developed tumors by eight months of age.

What it means: Progesterone encourages tumors to develop when BRCA-1 is present by increasing the speed of cell division. But the researchers have discovered that when mifepristone is administered, it acts as a binding process and blocks progesterone. The discovery could lead to novel ways to prevent breast and ovarian cancer in women that have a genetic predisposition.

From the Archive:

Feb.18, 2002: Rethinking Breast Cancer
May. 28, 2001: New Hope for Cancer

Everyday millions of children suffer from nutritional deficiencies. With everything that modern science has to offer, scientists have long dreamed of a way to use cloning or genetic engineering to help solve this growing problem. New research from the University of California, the University of Haifa and the U.S. Department of Agriculture that will be published in the next issue of Science, comes one step closer to making that dream a reality by successfully cloning a gene from wild wheat.

The cloned wheat gene, dubbed GPC-B1, increases the amount of protein, zinc and iron content in grain by 10 to 15%. The researchers concluded that GPC-B1 was responsible for the changes by constructing genetically modified wheat lines with reduced levels of the gene. After several weeks, the genetically modified plants had 30% less grain, protein, zinc and iron.

Surprisingly, the study also found that cultivated wheat products like pasta and bread have a nonfunctional copy of GPC-B1. The researchers  think the gene was lost in the domestication process and surmise that reintroducing it into commercial wheat products could increase its nutritional value. 

Jorge Dubcovsky, a wheat breeder and lead scientist of the study, has begun to introduce GPC-B1 into 20 public wheat-breeding programs that are part of the Wheat Coordinated Agricultural Project. Research is still under way to determine if there are any negative implications caused by the genes.

What it Means: Wheat is one of the world’s largest crops and accounts for nearly one-fifth of all caloric intake. There are 2 billion people who are deficient in zinc and iron throughout the world and 160 million children who lack adequate proteins. Any increase in the amount of protein and micronutrients in grains could help curb this problem and increase overall health.

From the Archive:

Jun. 28, 2006: Good Harvests Don't Necessarily Ease Hunger

Marathon running is such a great form of exercise, it's hard to believe that it could have a negative impact on your health. It keeps you in shape. Helps control your blood pressure. And even elevates your mood. But according to a new study published in the Archives of Dermatology, marathon runners have a higher risk of developing atypical moles and skin lesions — which suggest a higher risk for skin cancer — than those who do not run.

The study evaluated 210 marathon runners for skin cancer risk factors by analyzing the intensity of their training, the type of clothing they wore and whether or not they applied sunscreen. Another control group of 210 non-runners of the same age and sex were also evaluated. Each of the 420 participants answered a questionnaire about their skin, family history and other physical characteristics.

The control group experienced a higher level of sun sensitivity, since many of the participants had blue, green or grey eyes. But the marathon runners were more likely to have atypical moles and solar lentigines (small, flat pigmented lesions) — which indicate a higher risk of malignant melanoma. The study also found that runners who trained harder were more likely to have skin problems.

The researchers think that two factors cause the marathon runners to have an increased risk for skin cancer. First, the marathon runners have more sun exposure. In fact, almost 97% of the runners wore shorts and short-sleeved shirts and only 56% regularly applied sunscreen when training. Second, endurance exercise may suppress the immune system.

What it means: More studies need to be done to determine the association between running and skin cancer. But in the meantime, take some precautions when running outside — make sure to apply sun and wear clothes that cover you.

From the Archive:

Jul. 31, 2006: Why Teens Are Obsessed With Tanning
Aug. 1, 2006: Should We All Run From the Sun?

“No bread for me, thanks. I’m watching my weight. But, could you pass the bacon?" If you are one of the 26 million Americans on a hard-core low-carb diet, like Atkins or South Beach — you’re probably all too familiar with that common dinner table sentiment. For years, conventional wisdom has told us that while low-carbohydrate diets may trim down our waste, they are not helping our heart.

In the largest study of its kind, new research from the Harvard School of Public Health (HSPH) found that diets low in carbohydrates and high in proteins and fats are not associated with increased risk of coronary heart disease in women — adding a compelling piece of evidence to the long debate over long-term safety effects in low-carb diets. “There has long been concern among many people about the long term effects of low-carb diets like Atkins,” said Frank Hu, co-author of the study and associate professor of nutrition and epidemiology at HSPH. “We did not see an association between low-carb diets and the risk of CHD. The diet is healthy.”

But the researchers aren’t advocating that you pile on the bacon — it just isn’t as bad as we thought and it certainly won’t make you healthier. What the study did find was an association between low-carbohydrate diets — that are high in fats and proteins from vegetable sources — had a 30% decreased risk of coronary heart disease. “If you want to follow a low-carb diet you should still pay attention and emphasize the healthy fats and proteins rather than just load your plate with bacon and stake,” Hu said.

The study — which will appear in the Nov. 9 issue of the New England Journal of Medicine — studied 82,802 women involved in the Nurse’s Health Study for a period of 20 years. Participants filled out semi-quantitative questionnaires every four years — reporting on what type and quantity of food they consume — and the researchers compiled data on the participant’s health and lifestyle every two years. Each participant was assigned a low-carbohydrate diet score ranging from 0 (lowest fat and protein, highest carbohydrate intake) to 30 (highest fat and protein, lowest carbohydrate intake) — which was calculating by measuring their intake of fat, protein, and carbohydrates. After 20 years, 1,994 of the women developed coronary heart disease. The researchers then compared those participants with their low-carbohydrate diet score and studied the association with their health condition.

What it means: The safety of low-carb diets has been debated for years without much scientific certainty. This is the first long-term study using a large sample size that has studied the long-term effects of low-carbohydrate diets on the development of coronary heart disease. While the researchers are not advocating diets that are high in fat and proteins and continue recommend eating healthy forms of fat and proteins, the study does show that low-carbohydrate diets are not harmful to your heart.

From the Archive:

May 3, 2004: The Low-Carb Frenzy

May 3, 2004: The Skinny on Low-Carbs

Americans shop around for everything these days, but many of them probably don’t think to shop around for hospitals. According to a recent study, however, there is more proof than ever than that is exactly what they should do.

The Ninth Annual HealthGrades Hospital Quality in American Study – the largest annual study of hospital performance ever – has found that the gap in quality between hospitals has continued to increase. In fact, the divide has become so wide that the average patient now has a 69% lower chance of dying - a 5% increase since last year - when treated at a hospital with a 5-star rating compared to a hospital with a rating of only 1-star.

While the study does note some improvements – there has been an overall 8% decrease in hospital risk-adjusted mortality rate since 2003 - the disconcerting trend is the widening gap between hospitals at the top and those at the bottom.  “The figure is concerning and alarming,” said Dr. Samantha Collier, the vice president of medical affairs at HealthGrades and author of the study. “We still haven’t closed the gap. The best hospitals are getting better at a faster rate than the bottom performers are improving.”

The study analyzed the records of 40.6 million Medicare discharge records in over 5,000 nonfederal hospitals from 2003 to 2005. Every hospital was assigned a quality rating of 1-star (poor), 3-star (as expected), or 5-stars (best) for 28 different diagnoses and procedures – the hospitals were not given one comprehensive rating in this report.

And there's a good reason for that. According to the report, some hospitals are better than others at different procedures, which is why the conventional wisdom should be to shop around. If you are curious how your hospital rates in anything from heart failure to hip replacements, check out HealthGrades Zagat-like guide to hospital care at www.healthgrades.com – where the company has posted a consumer guide to the study’s results. “Patients should do their homework,” Collier said. “Patients need to understand that there are real differences and there are hospitals that seem to be doing better at different things.”

The real unanswered question in the study is, what’s the secret to five star care? Staff changes? Funding? The study doesn’t given an answer – it just points out the problem and notes that 302,403 patients could have been saved from death between 2003 – 2005 if all hospitals had 5-star care.  “We have made improvements, but there are things that the top hospitals are doing that others are not,” collier said. “We need to understand what the top hospitals are doing and share that with other hospitals.”

What it means: The large study not only points out important issues plaguing hospitals – it also manages to assemble the data in a user-friendly free resource for consumers. The report, however, is not without limits. It fails to compare overall hospital ratings – though Collier notes the List of Distinguished Hospitals for 2007 that comes out in January will fill that void. The study also did not show what hospitals did and did not improve or answer the whys and hows about why certain hospitals are failing.

From the Archive:

Oct. 14, 2002: Business, Heal Thyself
Jun. 20, 2005: The e-Health Revolution

Smoking is a tough habit to kick, with 41% of smokers trying to quit ever year and only 10% of them actually succeeding. Wouldn’t it be great if you could just pop a pill and take away those unhealthy urges?

That may be a reality someday soon. Researchers at the University of Chicago have found that in a small double blind study a new drug – naltrexone, which blocks the effects of narcotics and has been used in the past to treat heroin addicts - used in conjunction with behavior therapy and nicotine patches helps stop women lighting up. The study found that the novel treatment combo increased success rates in women smokers by nearly 50%. The results will be published in the journal of Nicotine and Tobacco Research this month.

The study’s relatively small sample size examined 110 men and women who reported smoking a pack a day – approximately 20 cigarettes – for a period of 25 years and had unsuccessfully tried to quit several times. Half of the participants took 50 milligrams for a period of eight weeks – starting three days before they tried to quit – the other half was given placebos.

The researchers defined a successful cessation as “not smoking daily for one week and not smoking even a puff at least one day in each of two consecutive weeks at any point in the trial.”  After eight weeks the results were in - 62% of men and 58% of women on naltrexone stopped smoking – but in the group taking placebos 67% of men and 39% of women had quit. As a result, the research was only significant in women. In the study the drug helped assuage the women’s cravings and reduce their withdrawal symptoms.

What it means: It is unclear yet whether Naltrexone will be helpful in a larger population since the sample size was small. However, what is clear is that scientists are getting closer to developing one drug that really helps smokers quit. In July, a new drug – varenicline – was reported to help 40% of the study’s large sample size stop in nine weeks.

From the Archive:

Sept. 18, 2006: How Much Tobacco Is Safe?
July 6, 2006: A New Way to Kick the Habit

Pickles, ice cream, and late-night Chinese food are just some of the joys that pregnancy cravings can bring. But just because you’ve packed on a little baby fat, doesn’t mean you should keep it there. It could be harmful during your next pregnancy.

New research from the Harvard University of Public Health (HSPH) and the Karolinska Institute
in Stockholm, Sweden has found that an increase in body mass index (BMI)—a body fat measurement obtained by dividing weight by height—during a woman’s first and second pregnancies can cause complications, including pre-eclampsia, gestational diabetes, gestational hypertension, perinatal complications, still births, large-for-gestational-age birth, and caesarean deliveries. The results of the study will be published later this week in The Lancet.

The study analyzed over 150,000 Swedish women from 1992 to 2001 who were giving birth to their first and second child. The researchers tracked the difference between the participant’s BMI at the beginning and end of each pregnancy. They found that the women’s risk of experiencing pregnancy complications increased with their BMI. The women who gained one or two  BMI units—a unit is equivalent to approximately 6.6 lbs.—had a 20% to 40% higher chance of pregnancies complications. Those who gained three or more BMI units had a 63% increase of such complications when compared to those who increased less than one BMI unit. 

What it means: Obesity and pregnancy is an important public health issue—during the duration of the study the number of obese women in Sweden increased from 25% in 1992 to 36% in 2001. Several studies have found a link between pregnancy complications and obesity in the past few years. However, this study is the first evidence of a direct causal relationship.

From the Archive:

Jun. 7, 2004 America's Obesity Crisis
Apr. 20, 2006: The Long and Short of Pregnancy

It is often said that the early bird catches the worm. But what's the real reason behind the old wives' tale? Researchers from the Cold Spring Harbor Laboratory have discovered a genetic cause for familial advanced sleep phase syndrome (FASPS)—more commonly thought of as morning lark behavior—that causes people to have early sleeping and waking habits.

Everyone has an innate biological clock—or circadian clock—that regulates the body's schedule over 24 hours. The clock tells the body when it is time to wake up, eat dinner and go to sleep. In FASPS, the biological clock experiences a circadian rhythm disorder that causes the internal clock to run about four hours ahead of schedule.

Seven years ago, scientists discovered that the gene, PERIOD2 (PER2), is often mutated in people with FASPS. Now researchers have been able to take that discovery a step further using mathematical models to identify 21 phosphorylation sites—when a phosphate groups is added to a protein or small molecule—on PER2 protein in living cells. By mapping these sites, scientists have discovered that one site, Serine 659, is not phosphorylated during FASPS, which causes PER2 to destabilize and leave the nucleus early. The researchers say this is the first time that a complicated human behavior like FASPS has been linked to a genetic cause and molecular mechanism.

What it means: Genes really tell the tale. As researchers continue to study genetics, more societal phenomenon will continue to be linked to genes. Who knows what will be next. Next we might find out that a preference for vanilla or chocolate ice cream is genetic. So the next time you get hassled for staying up too late, tell them it's not your fault—it's genetic.

From the Archive:

Dec. 20, 2004: Why We Sleep
Jan. 8, 2006: Sleeping Your Way to the Top

In the largest diabetes prevention study ever, new research from the Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) has found that the drug, Avandia (rosiglitazone maleate) lowers the risk of developing type 2 diabetes and helps patients with abnormal glucose levels achieve normoglycemia – an even sugar level. The results of the study were presented at the 42nd Annual Meeting of the European Association for the Study of Diabetes and published in the Lancet.

Avandia is a drug that lowers the amount of glucose in the blood. In type 2 diabetes the cells in the body have trouble recognizing and producing the correct amount of insulin. When this happens, the insulin is unable to turn sugar into blood cells that are needed for energy. As a result, the sugar builds up in the blood instead of being put into the cells and causes the cells to starve for energy. 

Diabetes is not a small problem. “We are in the midst of an epidemic of type 2 diabetes with global implications,” Dr. Bernard Zinman, a steering committee member of DREAM, said during a live webcast from the conference on Friday. Type 2 diabetes affects approximately 5% of adults worldwide. And in the U.S. alone, 18 million people suffer from type 2 diabetes. Another 41 million people have pre-diabetes – a condition where blood sugar levels are elevated but not high even to be type 2.

The DREAM trial conducted by the Population Health Research Institute at McMaster University in Canada found that the incidence of developing type 2 diabetes was 62% lower when taking Avandia. The double blind study evaluated 5,269 participants with pre-diabetes for a period of three years and were assigned to take rosiglitazone, ramipril, or a placebo. The groups were then compared every six months for 3 – 5 years to determine if the two drugs affected the progression of type 2 diabetes. Only 10.6% of the patients taking rosiglitazone developed type 2 diabetes whereas 25% of the placebo group developed. In addition, 51% of the participants taking rosiglitazone had normal blood sugar levels after 3 years, while only 30% of the placebo group had the same affects. The trial also concluded that ramipril helps adults normalize their blood sugar. The results of ramipril will be published in a separate study in the New England Journal of Medicine.

What it means: Pre-diabetes is a serous problem that has not been addressed. Currently, there is not a single drug on the market that helps combat the progression of type 2 diabetes. With that in mind, between 29 and 55% of pre-diabetes cases will develop into type 2 diabetes within three years. Since rosiglitazone is already an approved medication for the treatment of type 2 diabetes, it can now be used for prevention to help stop diabetes before it stars.

From the Archive:

Dec. 8, 2003: Diabetes: Are You at Risk?
Jun. 6, 2006: Diabetes On The Move

Genes are the key to unlocking many mysteries. A few years ago, the completion of the human genome laid the foundation for unraveling several secrets in genetics. Today, genes are helping scientists put together yet another piece in the cancer puzzle.

In a new study published in Science Express researchers from John Hopkins Kimmel Cancer Center announced that they have finished drafting the first genetic code for breast and colon cancers. The researchers have identified 200 genes that are altered in the cancer genomes—the number of genes was previously thought to be much smaller.

The researchers used 11 breast and color cancer specimens that were taken post-operative from patients. In each tumor cell, there were billions of nucleotides that make up the structure of DNA. The study compared the nucleotides in the tumor specimens with normal samples of 13,000 well-defined sequences from the Human Genome Project to find the altered genes. In the end, the researchers examined approximately 465 million nucleotides, which is equal to the number of letters in an encyclopedia.

What it Means: While the research does not have immediate benefits, drafting the genetic code could be an important factor in the development of future treatments. In the past, gene alterations have led to helpful treatments like the breast cancer drug, Herceptin. However, others still criticize the research and believe scientists' efforts should be focused on developing treatments.

From the Archive:

Feb. 18, 2002: Rethinking Breast Cancer
Mar. 13, 2000: Katie's Crusade

Everyone knows that health care costs a fortune. Every year health-care costs continue to rise and the important question remains—how much bang are we getting for our buck?

In a new study that will appear in the New England Journal of Medicine, researchers at Harvard University and the University of Michigan have found that despite rising costs, the country’s health-care system has been cost effective and worthwhile. The study analyzed the average life expectancy and spending per capita from 1960 to 2000 in four different age groups by weighing two variables: increases in medical costs and overall health

The study found that 50% of the increases in life expectancy came from improvements in health care after taking into account non-medical factors. But we should be careful what we wish for. While the health-care system is producing results, it is also contributing to the increasing cost of caring for the country’s elderly population.  Since 1960, life expectancy has grown seven years from 69.90 to 76.87— adding a total of $19,900 per person each year. And for those over 65 years longevity has increased 3.5 years and added $84,700 per year.

What it Means: Health care is paying off, despite rising costs. However, researchers warn that when life expectancy reaches its threshold, healthcare costs may continue to increase without producing such valuable returns.

From the Archive:
Oct. 14, 2002: Business, Heal Thyself
Jun 20, 2005: The e-Health Revolution

Many of us are allergic to something—strawberries, dust, penicillin—you name it. Today, allergies are a real problem and children are catching the brunt of it.

According to new research, the prevalence of childhood allergies has been on the rise for a decade in many countries. From 2002 to 2003 scientists from the University of New Zealand replicated a study performed by the International Study of Asthma and Allergies in Childhood in 1991 to assess the global prevalence of hayfever (caused by an allergic reaction in the body to pollen or mold spores), eczema (a type of skin rash) and asthma. By repeating the study, scientists were able to accurately compare the rate of growth.

The study surveyed over 193,400 parents with children from ages 6 to 7 living in 37 countries and 304,680 children ages 13 to 14 living in 56 different countries. The scientists discussed the presence and frequency of asthmatic symptoms with interviewees.

The researchers found that the younger children were more likely to have eczema—whereas hayfever was equally as common in both groups. Also, asthma symptoms were more likely to decrease in the older children. In the United Kingdom approximately 1,700 children were surveyed and there was an increase in asthma from 18.4% to 20.9%, hayfever from 9.8% to 10.1%, and eczema from 13% to 16%.

What it means: While allergies are on the rise, your child’s discomfort doesn’t have to be. There are many ways to combat your child’s allergy symptoms. Parents should try to figure out what is causing the allergy and limit their contact with the source—if your child is allergic to dust mites, keep the house clean and stick that old teddy bear in the freezer for a few hours to kill the mites. Try to recognize the difference between an allergy and a cold. One rule of thumb is that allergies develop within minutes and typically do not last more than a few hours, but colds build over time and can last for days. While there are several over the counter medications, like Benadryl, that can assuage symptoms, if the problem becomes recurrent seek advice from an allergist.

From the Archive:

Aug. 7, 2005: Doctor's Orders
 Dec. 17, 2004: Asthma Alarm

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