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South Dakota Could Provide Model For Medicare Reform
The Sioux Falls Argus Leader reports: "It might be only a footnote in health care reform this year, or perhaps a consolation prize. Either way, South Dakota ranks among the cheapest states in the nation for doing business through Medicare. The state is No. 47 with expenses averaging $6,253 for each person who uses the federal benefit to pay for health care. The U.S. average is $8,304. Officials attributed South Dakota"s results to local efficiencies and preventive health, and hope the good score might earn the state some benefit in proposed reforms. So far it hasn"t worked out that way, with Medicare cuts at this point appearing to apply evenly to all states. But researcher Elliott Fisher of the Dartmouth Institute for Health Policy and Clinical Practice, says the gap should be a tool in the debate as the government looks for ways to pay for reform."
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New Centre In London To Accelerate Personalized Mental Health Care
A powerful new research facility at the heart of King"s Health Partners Academic Health Sciences Centre has been launched by Professor Dame Sally C Davies, Director General of Research and Development and Chief Scientific Adviser, Department of Health. The Biomedical Research Centre (BRC) Nucleus is funded by a ÷£3M infrastructure grant from South London and Maudsley Charitable Funds (÷£1.8M) and Guy"s and St Thomas" Charity (÷£1.2M) to create a unique centre housing key translational initiatives to support the development of novel therapies and treatments for mental health and related disorders.
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Lawmakers Dilemma: Should Tax Increases Pay For Health Care Overhaul?
As lawmakers disagree over which taxes to raise to pay for health care reform, they "also face another problem: They"re confronting the fear that"s made it hard to raise taxes for more than 30 years. Republicans and moderate Democrats think that any tax increase is political poison back home," McClatchy Newspapers reports. "Republicans are pouncing on Democrats, charging that the party is eager to add a new tax burden to already-strapped constituents in the midst of a recession. ̣€¦ The current House Democratic plan would raise an estimated $543.9 billion over 10 years by imposing what it calls a "graduated surcharge" on higher-income earners." One criticism of the proposal is that "small businesses will be hurt. Surcharge backers cite data from Congress" Joint Committee on Taxation that indicate that 96 percent of small businesses wouldn"t be affected."
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Prostate Cancer Diagnosis, Treatment Could Be Improved By Protein That Suppresses Androgen Receptors

A protein that helps regulate expression of androgen receptors could prove a new focal point for staging and treating testosterone-fueled prostate cancer, Medical College of Georgia researchers say. Levels of the protein, í²arrestin2, are lower in some prostate cancer cells than in normal prostate cells while expression of testosterone-fed androgen receptors is higher, they report in Proceedings of the National Academy of Sciences Online Early Edition this week. "An increase in the number of androgen receptors is believed responsible for prostate cancer progression in men with advanced disease," says the study"s corresponding author, Dr. Yehia Daaka, Distinguished Chair in Oncologic Pathology in the MCG School of Medicine. With increased numbers of androgen receptors, prostate cancer can make use of the limited testosterone available after a diseased prostate gland is removed or after testosterone production is blocked by drug therapy. In fact, the increased number of androgen receptors may mutate so they can start feeding off other steroids or even growth factors, Dr. Daaka says. These wily skills help explain why cancer returns despite initially promising treatment results. "It is clear that signaling by the androgen receptor is paramount for not only the initiation but also the progression of the disease, including escape to a hormone-refractory disease," he says. Moves androgen receptors make to support cancer growth make it "unbeatable at this point," for some patients. However increased levels of í²arrestin2 appear to halt the potentially deadly increase in androgen receptor expression, the MCG research team has found. Androgen receptors have co-factors that can activate or repress their activity. "You could make the leap and say perhaps prostate cancer initiation and progression may be regulated by expression or non-expression of these co-factors," says Dr. Daaka, a Georgia Cancer Coalition Distinguished Cancer Scholar. Their studies in human tissue - both in culture and transplanted into mice - show this appears the case for í²arrestin2. First the team identified í²arrestin2 as cofactor for androgen receptors. Next they found a reciprocal relationship: androgen receptor expression is low when í²arrestin2 expression increases. That"s the scenario in healthy prostate cells while the exact opposite is true in some prostate cancer. When they forced increased expression of í²arrestin2, androgen receptor expression and activity went down. í²arrestin2 locks up an androgen receptor by binding to it, then the pair bind to yet another protein, ubiquitin ligase, which tags the receptor as waste and the trio make their way to the cell"s garbage dump. "The neat thing about it is í²arrestin2 inhibits or blunts the androgen receptor by promoting its degradation. So it disappears," Dr. Daaka says. His future studies include determining what happens when í²arrestin2 expression is further decreased in the face of prostate cancer. These studies will also help determine how big a player í²arrestin2 is in prostate cancer progression, says Dr. Daaka, noting that numerous other corepressors and activators of androgen receptors are known. Since all the happenings occur inside prostate cells, the findings don"t point toward a new blood or urine test for prostate cancer but could lead to new ways to stage prostate cancer from the first biopsy. In fact, Dr. Daaka and his team already are collecting samples from patients whose cancer has been staged to see if specific levels of í²arrestin2 expression correlate with different stages of disease. Another goal is to develop a small molecule that can get inside a patient"s cell and mimic í²arrestin2"s ability to suppress androgen receptor expression and so restore healthy levels found in prostate cells. Prostate cancer falls behind skin cancer as the second most common cancer in men and more than 192,000 new cases will be diagnosed this year in the United States, according to the American Cancer Society. Collaborators include Dr. Vijayabaskar Lakshmikanthan, postdoctoral fellow; Dr. Lin Zou, former postdoctoral fellow; Jae Kim, graduate student; Dr. Nidia C. Messias, assistant professor; and Dr. Zhongzhen Nie, assistant professor; from the MCG Department of Pathology; and Drs. Allison Michal and Jeffrey L. Benovic from Thomas Jefferson University. Toni Baker Medical College of Georgia


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