How many, how old, how soon?

This article highlights the population projections for the UK to 2066 and their health implications. The changes in the demographic age structure of human populations have dual implications. Although they represent accomplishments in social and health development considering the fact that more individuals are able to live until old age, these changes also bring new demands that affect all aspects of society, including employment, taxation, pension, education, and health. Age specific population projections presented were obtained from the Office for National Statistics. It is projected that the total number of people aged 60 years and older will rise from 12 million in 2001 to 18.6 million in 2031 and the number of individuals suffering with chronic diseases and disabilities will see a three-fold increase. Although these projections rely on assumptions and are subject to some changes, it is made clear that the proportion of the population aged 65 and above will continue to increase substantially over the next decades. These population trends will have a large impact on the health and health care needs of the population. Thus, there is a need to develop and plan institutions and policies that address the demands of the aging population. Understanding and identification of the causes and prevention of conditions that could result to serious disabilities must be a high priority.     

Functional protein microarrays: just how functional are they?

Arrays of immobilized proteins have been developed for the discovery and characterization of protein functions ranging from molecular recognition to enzymatic activity. The success of these applications is highly dependent upon the maintenance of protein structure and function while in an immobilized state - a largely untested hypothesis. However, the immobilization of functional proteins is not without precedent. Active enzymes have been successfully immobilized for industrial applications for several decades. Furthermore, a survey of recent protein microarray literature reveals that an even wider range of proteins can maintain 'proper' function while immobilized. These reports help to validate the functionality of so-called functional protein microarrays.     

Gene therapy in the clinic: whose risks?

Current experience with gene therapy for X-linked severe combined immunodeficiency disorder (X-SCID) suggests that we might now be at the point where it can be considered the 'standard of care'. This therapy carries an unquantified risk of leukaemia, raising important questions for regulators. How dangerous does a potentially curative therapy for a fatal illness need to be before we call it unsafe. How uncertain does a risk need to be for us to regard a therapy as still 'experimental'? Whose interests should prevail? Here I argue that in X-SCID it is the parents and children whom we should listen to first and foremost. How far does this patient-centred approach to licensing therapies extend? Can it be given a rational basis?     

The evolution of noncoding DNA: how much junk, how much func?

Comparative sequence analysis on a genomic scale has opened the door for the systematic analysis of cis-acting regulatory DNA. It is now possible to begin to answer basic questions such as, how much meaningful noncoding sequence is in the genome? How strong is natural selection on functional noncoding sequences in different species? Two recent articles have capitalized on the comparative genomic approach in an attempt to answer these questions with surprising results.     

Oxygen uptake in heart failure: how much,how fast?

Patients with chronic heart failure (CHF) have limited exercise capacity. Exercise intolerance in CHF is associated with increased mortality; 1 moreover, several studies suggest that interventions that increase exercise capacity in CHF improve prognosis. 2–4 Therefore, as Kemps and colleagues state in this issue of the Netherlands Heart Journal, 5 exercise testing is an important tool for evaluating and monitoring heart failure.     

Cell division and DNA segregation in Streptomyces: how to build a septum in the middle of nowhere?

Streptomycetes are antibiotic-producing filamentous microorganisms that have a mycelial life style. In many ways streptomycetes are the odd ones out in terms of cell division. While the basic components of the cell division machinery are similar to those found in rod-shaped bacteria such as Escherichia coli and Bacillus subtilis, many aspects of the control of cell division and its co-ordination with chromosome segregation are remarkably different. The rather astonishing fact that cell division is not essential for growth makes these bacteria unique. The fundamental difference between the cross-walls produced during normal growth and sporulation septa formed in aerial hyphae, and the role of the divisome in their formation are discussed. We then take a closer look at the way septum site localization is regulated in the long and multinucleoid Streptomyces hyphae, with particular focus on actinomycete-specific proteins and the role of nucleoid segregation and condensation.     

Bacterial cooperation in the wild and in the clinic: Are pathogen social behaviours relevant outside the laboratory?

Individual bacterial cells can communicate via quorum sensing, cooperate to harvest nutrients from their environment, form multicellular biofilms, compete over resources and even kill one another. When the environment that bacteria inhabit is an animal host, these social behaviours mediate virulence. Over the last decade, much attention has focussed on the ecology, evolution and pathology of bacterial cooperation, and the possibility that it could be exploited or destabilised to treat infections. But how far can we really extrapolate from theoretical predictions and laboratory experiments to make inferences about ‘cooperative’ behaviours in hosts and reservoirs? To determine the likely importance and evolution of cooperation ‘in the wild’, several questions must be addressed. A recent paper that reports the dynamics of bacterial cooperation and virulence in a field experiment provides an excellent nucleus for bringing together key empirical and theoretical results which help us to frame – if not completely to answer – these questions.     

Do DNA microarrays have their future behind them?

The first report on DNA microarray technology appeared in Science in 1995. Starting from gene expression profiling, its application fields have considerably evolved and extend from microbiology to cancer study. DNA microarrays are now routinely used for the detection of single nucleotide polymorphisms, microRNAs analysis, study of copy number variation, CpG methylations detection.... Furthermore, the approval of DNA microarray technology by US Food and Drug Administration has opened the door to new applications in clinical diagnostics. At the same time, DNA arrays have to face the concurrence of the latest generation of very high throughput sequencing devices which are predicted to make the microarray technology obsolete. This review will discuss on this paradoxical situation.     

Neuroscience: how is three-dimensional space encoded in the brain?

A recent study in the rat has shown that hippocampal place cells and entorhinal grid cells exhibit vertically-elongated firing fields, indicating that the rat's brain may encode the animal's elevation less accurately than its horizontal position.     

The Mastodon in the room: how Darwinian is neo-Darwinism?

Failing to acknowledge substantial differences between Darwinism and neo-Darwinism impedes evolutionary biology. Darwin described evolution as the outcome of interactions between the nature of the organism and the nature of the conditions, each relatively autonomous but both historically and spatially intertwined. Furthermore, he postulated that the nature of the organism was more important than the nature of the conditions, leading to natural selection as an inevitable emergent product of biological systems. The neo-Darwinian tradition assumed a creative rather than selective view of natural selection, with the nature of the organism determined by the nature of the conditions, rendering the nature of the organism and temporal contingency unnecessary. Contemporary advances in biology, specifically the phylogenetics revolution and evo-devo, underscore the significance of history and the nature of the organism in biology. Darwinism explains more biology better, and better resolves apparent anomalies between living systems and more general natural laws, than does neo-Darwinism. The "extended" or "expanded" synthesis currently called for by neo-Darwinians is Darwinism.     

Grades in neural complexity: how large is the span?

The span of complexity in brains, between the simplest flatworms and the most advanced mammals is exceedingly great, measured by the number of different anatomical parts, physiological processes, sensory discriminations, and behavioral alternatives in the repertoire. Most evolution of brains has been adaptive radiation within the same grade of complexity. Distinct grades of complexity have appeared a dozen or more times and quite often in the retrograde direction. Advancement has not been inevitable or obviously advantageous in survival value but has happened-long before primates or mammals or vertebrates. Compare cuttlefish and the most advanced gastropods, bees and the best brine shrimp, primates and the most advanced reptiles known-all twigs with common branches. This repeated achievement of evolution has had all too little study in respect of the detailed listing of differences between major taxa of distinct grades of complexity. Connectivity at the level now known for the mammalian cortex is much needed in other classes, with estimates of reciprocity, intrinsic differentiation, dendritic parcellation and afferent and efferent connections, both locally and projecting to other centers, each done quantitatively to permit comparison. Physiological system organization, personality properties of neurons and circuits, proclivities and emergent phenomena at several integrative levels are sketchily known only for parts of a few systems. Examples are given of opportunities for new research that can more adequately characterize grades of brains.     

Xenotransplantation: from animal facility to the clinic?

Since 1960, clinical organ transplantation has evolved from an experimental procedure to highly successful ‘routine’, but as technical advances have extended eligibility to more victims of end-stage organ disease, the supply of donor organs has lagged behind. Urgency of need, probability of success and ability to pay are often used to limit waiting lists; without these, as many as 124 000 transplants per year could be performed in the USA alone. Although the supply of organs from human donors may well be assisted in future by increased public education and changes in donor laws, it is unlikely that the need for organs will ever be met by generosity and calamity alone — hence the enthusiasm for other sources of organs.     

Biofeedback in medicine: who,when, why and how?

Biofeedback is a mind-body technique in which individuals learn how to modify their physiology for the purpose of improving physical, mental, emotional and spiritual health. Much like physical therapy, biofeedback training requires active participation on the part of patients and often regular practice between training sessions. Clinical biofeedback may be used to manage disease symptoms as well as to improve overall health and wellness through stress management training. Research has shown that biofeedback interventions are efficacious in treating a variety of medical conditions, and many Americans are turning to biofeedback and other less traditional therapies for their routine healthcare.Clinical biofeedback training is growing increasingly popular in the USA, as many people are seeking out relatively new approaches to healthcare. This article provides an overview of clinical biofeedback training, outlines two models of training, details research which has established how effective biofeedback is in patients with a given disease, and describes who should be referred for biofeedback training.