Intensive insulin provides survival benefit in patients with type 2 diabetes after heart attack

 

May 12, 2014

The Lancet

Intensive insulin treatment prolonged life by more than 2 years in patients with diabetes after a heart attack, compared with standard treatment for diabetes, a long term follow-up trial has shown. The trial, involving 620 patients with type 2 diabetes, began in 1990. Patients who were admitted to hospital with a suspected heart attack received either intensive insulin treatment, or standard glucose-lowering treatment for one year. The purpose of the study was to determine whether the difference in treatment affected all-cause mortality in the long-term.

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Long-term follow-up of the DIGAMI 1 trial -- a landmark study of type 2 diabetes in Sweden -- shows that intensive insulin treatment prolonged life by more than 2 years in patients with diabetes after a heart attack, compared with standard treatment for diabetes, reports Dr Viveca Ritsinger from the Unit of Cardiology of the Department of Medicine, Karolinska Institute, Stockholm, Sweden and colleagues in The Lancet Diabetes & Endocrinology.

The trial, involving 620 patients with type 2 diabetes, began in 1990. Patients who were admitted to hospital with a suspected heart attack received either intensive insulin treatment (an insulin-glucose infusion for at least 24 h, followed by insulin injection four times a day for at least 3 months) or standard glucose-lowering treatment (involving insulin only rarely) for one year. The purpose of the study was to determine whether the difference in treatment affected all-cause mortality in the long-term.

In the new study, patients were followed for up to 20 years, during which time most of them died. Those who received intensified insulin treatment during the trial survived an average (median) of 2·3 years longer compared with those who received standard treatment. The effect was apparent for at least 8 years after randomisation and thereafter leveled off. Patients who were at low cardiovascular risk (less than 70 years old, no history of heart attack or congestive heart failure) and had not previously had insulin therapy when the trial started seemed to benefit the most from intensive insulin treatment.

Although the results clearly show a benefit of intensive insulin treatment after a heart attack in patients with type 2 diabetes, the effect on survival seen is probably larger than would be seen if the trial was started today. Compared with 1990, when DIGAMI 1 began, there have been many advances in conventional treatment of patients with type 2 diabetes and cardiovascular complications, such as more frequent use of medication to lower cholesterol (statins) and blood pressure (angiotensin-converting-enzyme inhibitors).

According to Denise Bonds, of the National Institutes of Health, Bethesda, MD, USA, in an accompanying Comment, the new study "points to the benefit of good glucose control even when other risk factors such as lipids or blood pressure cannot be or are not modified…it provides an important reminder of how quickly medicine is advancing, something that is often forgotten in the busy day-to-day practice of medicine. In 20 years, we have gone from few glucose-lowering therapies to over half a dozen oral therapy drugs, plus insulin, plus effective treatments to reduce the risk of elevated lipids and blood pressure. Now, the challenge is choosing the best treatment option for our patients."

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Story Source:

The above story is based on materials provided by The Lancet. Note: Materials may be edited for content and length.

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Journal Reference:

1. Viveca Ritsinger, Klas Malmberg, Anton Mårtensson, Lars Rydén, Hans Wedel, Anna Norhammar. Intensified insulin-based glycaemic control after myocardial infarction: mortality during 20 year follow-up of the randomised Diabetes Mellitus Insulin Glucose Infusion in Acute Myocardial Infarction (DIGAMI 1) trial. Lancet Diabetes Endocrinol, May 2014 DOI: 10.1016/ S2213-8587(14)70088-9

Living near foreclosed property linked to higher blood pressure

 

May 12, 2014

American Heart Association

This study provides the first evidence that foreclosed properties may increase neighbors' blood pressure. Neighborhood environment is an important social determinant of cardiovascular health, including blood pressure. The scale of the recent U.S. housing crisis has prompted the public health community to seek a better understanding of how foreclosure activity might impact health. The number of foreclosures spiked in the United States in 2007-10 when more than 6 million homeowners fell behind on their mortgages and banks took ownership of the homes, or foreclosed.

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Living near foreclosed property may increase your risk of higher blood pressure, according to new research in the American Heart Association journal Circulation.

The study provides the first evidence that foreclosed property may affect neighbors' systolic blood pressure, the top number in a blood pressure reading.

Neighborhood environment is an important social determinant of cardiovascular health, including blood pressure. The scale of the recent U.S. housing crisis has prompted the public health community to seek a better understanding of how foreclosure activity might impact health. The number of foreclosures spiked in the United States in 2007-10 when more than 6 million homeowners fell behind on their mortgages and banks took ownership of the homes, or foreclosed.

Researchers reviewed data from 1,740 participants (mostly white, 53 percent women) in 1987-2008 in the Framingham (Massachusetts) Offspring Cohort, which is part of the Framingham Heart Study. The researchers distinguished between real-estate-owned foreclosures, which are owned by lenders and typically sit vacant, and foreclosures purchased by third-party buyers, which are generally put into productive use.

Researchers found each additional foreclosed property within 100 meters (328 feet) of participants' homes was associated with an average increase of 1.71 mm Hg in systolic blood pressure. The association only applied to properties that were real-estate owned and there was no effect from foreclosed properties more than 100 meters from participants' homes.

"The increases in blood pressure observed could be due in part to unhealthy stress from residents' perception that their own properties are less valuable, their streets less attractive or safe and their neighborhoods less stable," said Mariana Arcaya, Sc.D., M.C.P., study lead author and Yerby Postdoctoral Research Fellow at the Harvard Center for Population and Development Studies in Cambridge, Mass. "Safety could also be a concern that affects their ability to exercise in these neighborhoods."

"Healthcare providers, particularly those serving neighborhoods still recovering from the recent housing crisis, should be aware of foreclosure activity as a possible source of unhealthy stress for residents," Arcaya said.

Because the study involved predominately white, middle-class, suburban neighborhoods with single-family homes, research on different populations in urban and rural settings is needed, Arcaya said.

High blood pressure affects nearly 76 million people in the United States and is a major contributor to heart disease and stroke. Risk factors include genetics, advanced age, poor nutrition and excessive body weight and alcohol consumption. Stress and other factors may also contribute to high blood pressure.

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Story Source:

The above story is based on materials provided by American Heart Association. Note: Materials may be edited for content and length.

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Journal Reference:

1. Mariana Arcaya, M. Maria Glymour, Prabal Chakrabarti, Nicholas A. Christakis, Ichiro Kawachi, and S V Subramanian. Effects of Proximate Foreclosed Properties on Individuals' Systolic Blood Pressure in Massachusetts, 1987-2008. Circulation, May 2014 DOI: 10.1161/CIRCULATIONAHA.113.006205

Low rate of adverse events associated with male circumcision during first year of life, study finds

 

May 12, 2014

The JAMA Network Journals

A low rate of adverse events was associated with male circumcision when the procedure was performed during the first year of life, but the risk was 10 to 20 times higher when boys were circumcised after infancy. "Given the current debate about whether male circumcision should be delayed from infancy to adulthood for autonomy reasons, our results are timely and can help physicians counsel parents about circumcising their sons," the researchers concluded.

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A low rate of adverse events (AEs) was associated with male circumcision (MC) when the procedure was performed during the first year of life, but the risk was 10 to 20 times higher when boys were circumcised after infancy.

The American Academy of Pediatrics has updated its MC guidance to say that the benefits justify access to the procedure for families who choose it. There has been debate about whether MC should be considered a public health action because of its potential protective effect against acquisition of human immunodeficiency virus (HIV) as suggested in three randomized controlled trials. A part of the debate surrounds the rate of AEs.

The authors selected 41 possible AEs of MC based on a literature review and medical billing codes. They used data from a large administrative claims data set and records were available for about 1.4 million circumcised males (93.3 percent as newborns).

The rate of total AEs from MC was slightly less than 0.5 percent. The rates of potentially serious AEs from MC ranged from 0.76 per million MCs for stricture of the male genital organs to 703.23 per million for repair of an incomplete circumcision. Compared with boys circumcised at younger than 1 year of age, the incidence of probable AEs was 20-fold and 10-fold greater for boys circumcised at age 1 to 9 years and at 10 years or older.

"Given the current debate about whether MC should be delayed from infancy to adulthood for autonomy reasons, our results are timely and can help physicians counsel parents about circumcising their sons," the researchers concluded.

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Story Source:

The above story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.

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Journal Reference:

1. Charbel El Bcheraoui, Xinjian Zhang, Christopher S. Cooper, Charles E. Rose, Peter H. Kilmarx, Robert T. Chen. Rates of Adverse Events Associated With Male Circumcision in US Medical Settings, 2001 to 2010. JAMA Pediatrics, 2014; DOI: 10.1001/jamapediatrics.2013.5414

Diets rich in antioxidant resveratrol fail to reduce deaths, heart disease or cancer

 

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Grapes and red wine (stock image).

A study of Italians who consume a diet rich in resveratrol -- the compound found in red wine, dark chocolate and berries -- finds they live no longer than and are just as likely to develop cardiovascular disease or cancer as those who eat or drink smaller amounts of the antioxidant.

"The story of resveratrol turns out to be another case where you get a lot of hype about health benefits that doesn't stand the test of time," says Richard D. Semba, M.D., M.P.H., a professor of ophthalmology at the Johns Hopkins University School of Medicine and leader of the study described May 12 in JAMA Internal Medicine. "The thinking was that certain foods are good for you because they contain resveratrol. We didn't find that at all."

Despite the negative results, Semba says, studies have shown that consumption of red wine, dark chocolate and berries does reduce inflammation in some people and still appears to protect the heart. "It's just that the benefits, if they are there, must come from other polyphenols or substances found in those foodstuffs," he says. "These are complex foods, and all we really know from our study is that the benefits are probably not due to resveratrol."

The new study did not include people taking resveratrol supplements, though few studies thus far have found benefits associated with them.

Semba is part of an international team of researchers that for 15 years has studied the effects of aging in a group of people who live in the Chianti region of Italy. For the current study, the researchers analyzed 24 hours of urine samples from 783 people over the age of 65 for metabolites of resveratrol. After accounting for such factors as age and gender, the people with the highest concentration of resveratrol metabolites were no less likely to have died of any cause than those with no resveratrol found in their urine. The concentration of resveratrol was not associated with inflammatory markers, cardiovascular disease or cancer rates.

Semba and his colleagues used advanced mass spectrometry to analyze the urine samples.

The study participants make up a random group of people living in Tuscany where supplement use is uncommon and consumption of red wine -- a specialty of the region -- is the norm. The study participants were not on any prescribed diet.

Resveratrol is also found in relatively large amounts in grapes, peanuts and certain Asiatic plant roots. Excitement over its health benefits followed studies documenting anti-inflammatory effects in lower organisms and increased lifespan in mice fed a high-calorie diet rich in the compound.

The so-called "French paradox," in which a low incidence of coronary heart disease occurs in the presence of a high dietary intake of cholesterol and saturated fat in France, has been attributed to the regular consumption of resveratrol and other polyphenols found in red wine.

Association between small-vessel disease, Alzheimer pathology studied

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Cerebral small-vessel disease (SVD) and Alzheimer disease (AD) pathology appear to be associated.

AD is believed to be caused by the buildup of amyloid protein in the brain and tau tangles. Previous studies have suggested that SVD and vascular risk factors increase the risk of developing AD. In both SVD and vascular dementia (VaD), signs of AD pathology have been seen. But it remains unclear how the interaction between SVD and AD pathology leads to dementia.

Authors examined the association between SVD and AD pathology by looking at magnetic resonance imaging (MRI)-based microbleeds (MB), white matter hyperintensities (WMH) and lacunes (which are measures for SVD) along with certain protein levels in cerebrospinal fluid (CSF) which reflect AD pathophysiology in patients with AD, VaD and healthy control patients. The authors also examined the relationship of apolipoprotein E (APOE) Ɛ4 genotype, a well-known risk factor for AD.

The presence of both MBs and WMH was associated with lower CSF levels of Aβ42, suggesting a direct relationship between SVD and AD. Amyloid deposits also appear to be abnormal in patients with SVD, especially in (APOE) Ɛ4 carriers.

"Our study supports the hypothesis that the pathways of SVD and AD pathology are interconnected. Small-vessel disease could provoke amyloid pathology while AD-associated cerebral amyloid pathology may lead to auxiliary vascular damage," researchers conclude.

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Story Source:

The above story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.

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Journal Reference:

1. Maartje I. Kester, M.D., Ph.D. et al. Associations Between Cerebral Small-Vessel Disease and Alzheimer Disease Pathology as Measured by Cerebrospinal Fluid Biomarkers. JAMA Neurol., May 2014 DOI: 10.1001/.jamaneurol.2014.754

Out in the Open: The Tiny Box That Lets You Take Your Data Back From Google

 

The National Security Agency is scanning your email. Google and Facebook are hoarding your personal data. And online advertisers are selling your shopping habits to the highest bidder.

Today, more than ever, people are thinking about how to opt out of this madness without quitting the internet entirely. The obvious answer is to host your own web apps on your own computer server. And thanks to the burgeoning Indie Web Movement, there’s no shortage of open source alternatives to popular services like Google Calendar, Facebook’s photo albums, or Dropbox’s file sharing. The problem is that setting up and managing your own server is a pain in the neck–at least for the average consumer.

For open source developer Johannes Ernst, what the world really needs is a simple device that anyone can use to take their data back from the wilds of the internet. So he designed the Indie Box, a personal web server preloaded with open source software that lets you run your own web services from your home network–and run them with relative ease. Any system administrator will tell you that setting up a server is just the first step. Maintaining it is the other big problem. Indie Box seeks to simplify both, with an option to fully automate all updates and maintenance tasks, from operating system patches to routine database migrations.

Inside the Box

Image: The Indie Box Project

You can’t buy an Indie Box yet, but you can pre-order one through the crowdfunding site Indie GoGo. A completely assembled device costs $500. That may sound like a lot, but Ernst argues that the cost is in line with other machines equipped with similar hardware. And the prices could eventually come down if Ernst is successful in raising funds for the project. Eventually, the Indie Box software platform will be available to download, and that will let people install all its tools on their own hardware.

Plus, Ernst says, other developers will be free to build their own products atop Indie Box. “It’s not supposed to be one product from one company,” he explains. “It’s supposed to be a platform for lots of people to innovate on.”

The first Indie Box will run off an Intel Atom processor, 2GB of RAM, and two 1TB hard drives that mirror each other to help protect your data. Software will include ownCloud, which offers a calendar, address book, and Dropbox-style file sharing; the photo album apps mediagoblin and Trovebox; and the e-mail client Mailpile. For now, it won’t include an e-mail server since spam filters make it so hard to run one from home.

There’s also an app store that will let you add more tools. Although all apps in the store must be open source, developers will have the option of selling them for a fee, giving them the chance to actually make money from their projects. “What we find is that users have no problem paying if they don’t have to maintain the software,” Ernst says.

Eventually, he wants Indie Box to act as a hub for devices on the Internet of Things. He personally runs many devices that send data to a server across the internet, which then notifies him of something that happened on the device sitting just a few feet away from him. “There’s something wrong with that architecture,” he says. “I’m much more comfortable with having my thermostat communicating with a computer in my house over my own Wi-Fi than going through Google.”

A Box in Every Home

But the bigger aim is to put an Indie Box in every home. Running a home web server may sound ridiculously geeky, but keep in mind that personal computers, home internet connections, and smartphones were once the exclusive province of geeks. All are now mainstream, and Ernst says many people are already interested in the idea.

“Everyone we talked to wanted to be able to take their calendar data home from Google,” Ernst says. “People don’t necessarily want Google to know they have a doctor’s appointment, or what diseases they are being treated for.”

And he isn’t the only one building ready-made servers for the masses. Freedom Box Foundation is working on a similar appliance for activists in countries where the internet is heavily censored, and the French company Cozy Cloud is teaming with European telecommunications companies to bring its personal cloud servers to consumers. Perhaps the age of the personal web server is finally here.

Denmark: Three Deaths from Drug-Resistant “Pig MRSA”

 

Image: ICStefanescu (CC), Flickr

A troubling and also kind of odd story came out of Denmark this weekend. In a court proceeding, a microbiologist has disclosed that three residents of the country who had no known connection to farming died of MRSA infections caused by ST398, the livestock-associated strain of drug-resistant staph that first appeared among pig farmers in the Netherlands in 2004 and has since moved through Europe, Canada and the United States.

If the report is correct — and sources have told me it is, but I’ve seen no data to confirm it — it reinforces the concern that bacteria which become resistant because of antibiotic use on farms can move off farms and affect the health of people who have no connection to farming.

Livestock MRSA has always one of the best cases for establishing that, because the drug to which it showed the greatest resistance, tetracycline, wasn’t used against human MRSA in the Netherlands, but was used routinely on farms — so the only place the strain could have picked up its unique resistance pattern was in pigs. (Here’s my long archive of posts on pig MRSA, dating back to my book Superbug where the story was told for the first time.)
Just to get them high up, here are some Danish news sources; this sees to have been a widely covered story. Danish isn’t one of my languages, so I’ve relied on Google Translate — not the best practice, but there’s enough agreement among the stories that I am comfortable with it in this case.

• The Information: “Filthy use of antibiotics”
• Kvalls Posten: “Resistant swine bacterium has killed three Danes”
• DR DK: “Politicians are worried about swine bacteria”
• Avisen: “Three Danes die of swine bacteria”
• Ekstra Bladet: “Three died from killer bacteria from pigs”
• Fyens: “University hospital physician: Three died of swine bacteria”

The first way in which this is odd is that this story emerged not from government public health data but during the trial of two journalists, who in 2010 disclosed the names of farms that had been found to be harboring ST398 (alternatively called CC398). The names were published in a long, tough investigative article that accused the government of capitulating to the agricultural industry by gathering data on the presence of MRSA — which was very rare in Denmark — but not publishing it. The journalists, Kjeld Hansen and Nils Mulvad, are being prosecuted for violating the farmers’ privacy. (As a US journalist grateful every day for the First Amendment, the prosecution disturbs me greatly. William Heisel at Reporting on Health has also written about this.)

In trial testimony last week, Prof. Hans Jørn Kolmos of Odense Hospital said that he had one patient who died of a MRSA infection that turned out to be ST398, but who had no farm connection. When he asked the Statens Serum Institute (which performs Denmark’s infectious-disease research and tracking), he said, he learned there had been two more, also with no connection to farming. All three deaths occurred in 2012 and 2013.

It’s important to put those numbers in context. In 2013, according to the Institute, Denmark had 2,103 cases of MRSA; according to one of the news stories, 648 of those were ST398. We don’t even know how many MRSA cases we have in the US because it is not a disease  for which doctors have to notify someone — but in 2007, the estimate just of US deaths from MRSA was more than 18,000. We also don’t know how much of our MRSA is ST398, because the US does not track that strain. It’s possible that we have tons. It’s also possible we don’t have much. That’s not because we don’t use agricultural antibiotics, since we do, but because the ecological niche that “pig MRSA” would occupy might have already been filled up by other strains such as community MRSA (which on the other hand barely exists in Europe, leaving living space open for new strains to emerge into).

Finally, what’s also odd about this report is that Denmark, like the rest of Europe, has cracked down on farm-antibiotic use in a way that the US has not. Growth-promoter antibiotics have been banned throughout the European Union since January 2006 — so resistant bacteria coming off farms ought to be less likely. It is possible that Danish farmers are using essentially the same drugs for “disease prevention,” and thus still fostering the emergence of resistant bacteria. If true, that would be a cautionary tale for the US, since the Food and Drug Administration is instituting a growth-promoter ban, but not addressing preventive use. Also, to compensate for the loss of growth promoters, Danish farmers began using zinc and copper as feed additives; and it may be that those turn out to be driving the evolution of antibiotic resistance in similar ways that pharmaceuticals do.

That’s just a glimpse into how complex this situation is, and how many unanswered questions remain from this courtroom claim. But it’s also a reminder that agricultural antibiotic use has complex, potentially dangerous effects that extend far beyond a farm’s fences, and therefore deserves close scrutiny.

Active Learning Leads to Higher Grades and Fewer Failing Students in Science, Math, and Engineering

 

Image Credit: velkr0 / Flickr

Think back to when you learned how to ride a bike. You probably didn’t master this skill by listening to a series of riveting lectures on bike riding. Instead, you tried it out for yourself, made mistakes, fell down a few times, picked yourself back up, and tried again. When mastering an activity, there’s no substitute for the interaction and feedback that comes from practice.

What if classroom learning was a little more active? Would university instruction be more effective if students spent some of their class time on active forms of learning like activities, discussions, or group work, instead of spending all of their class time listening?

A new study in the Proceedings of the National Academy of Sciences addressed this question by conducting the largest and most comprehensive review of the effect of active learning on STEM (Science, Technology, Engineering and Mathematics) education. Their answer is a resounding yes. According to Scott Freeman, one of the authors of the new study, “The impact of these data should be like the Surgeon General’s report on “Smoking and Health” in 1964–they should put to rest any debate about whether active learning is more effective than lecturing.”

Before you study something quantitatively, you have to define it. The authors combined 338 different written responses to arrive at the following definition of active learning:

Active learning engages students in the process of learning through activities and/or discussion in class, as opposed to passively listening to an expert. It emphasizes higher-order thinking and often involves group work.

They then searched for classroom experiments where students in a STEM class were divided into two groups – one group engaged in some form of active learning, while the other group participated in a traditional lecture. At the end of the class, both groups took essentially identical exams.

The authors looked at studies where both groups were taught by the same instructor and the students were assigned at random to each group, as well as less ideal experimental conditions, where the instructors differed, or the students weren’t assigned to groups at random. They evaluated the performance of these studies using two metrics – their scores on identical exams, and the percentage of students that failed (receiving a D, F or withdrawing from the class). In all, they identified 228 studies matching their criteria, to analyze further.

Here’s what they found.

1. Students in a traditional lecture course are 1.5 times more likely to fail, compared to students in courses with active learning

The authors found that 34% of students failed their course under traditional lecturing, compared to 22% of students under active learning. This suggests that, just in the studies that they analyzed, 3,500 more students would have passed their courses if taught with active learning. By conservative estimates, this would have saved the students about 3.5 million dollars in tuition. The authors point out that, were this a medical study, an effect size this large and statistically significant would warrant stopping the study and administering the treatment to everyone in the study.

A comparison of how students performed in active learning and lecture courses. The horizontal axis is the failure rate, and the vertical axis is the relative number of courses with that failure rate. Under active learning, the average failure rate drops from 33.8% to 21.8%. Image Credit: Freeman et al, PNAS.

A large drop in the number of failing students meets a demonstrated need to increase the retention of STEM students, and should be taken very seriously. Nearly a third of all students entering US colleges and universities intend to major in STEM fields, and more than half of these students eventually either switch their majors to a non-STEM field or drop out of college without a degree. This attrition problem is particularly acute for minorities, as only 20% of under-represented minority students who are interested in the STEM fields finish university with a STEM degree.

2. Students in active learning classes outperform those in traditional lectures on identical exams

On average, students taught with active learning outperformed those taught by lectures by 6 percentage points on their exam. That’s the difference between bumping a B- to a B or a B to a B+. Here’s another way that the authors describe this result. Picture a student in a traditional lecture class who scored higher than 50% of the students on the exam. If the same student were taught with active learning instead, they would score higher than 68% of the students in this lecture class.

The increase in student grades (left, measured in standard deviations), and the percentage decrease in the failure rate (right), broken down by subject. Image Credit: Freeman et al, PNAS.

Both these results were incredibly robust. They held up for all of the STEM subjects for which there was sufficient data. They held in large and small classes (although the impact of active learning was larger in small classes), and they held in introductory as well as upper-level courses. The exam performance results also held up irrespective of how the students were split into the two groups – whether the groups had the same or different instructors, or whether the student were randomly assigned to courses or not. The authors were also careful to account for whether their study was affected by publication biases (the bias to publish positive results over negative ones) and they found that this did not significantly impact their findings.

I asked Scott Freeman whether star lectures with strong teaching evaluations should be interested in these findings as well. He responded,

“Most of the studies we analyzed were based on data from identical instructors teaching active learning v lecturing sections; some studies (e.g. Van Heuvelen in Am. J. Physics; Deslauriers et al. in Science) have purposely matched award-winning lecturers with inexperienced teachers who do active learning and found that the students did worse when given “brilliant lectures.” We’ve yet to see any evidence that celebrated lecturers can help students more than even 1st-generation active learning does.”

I’ll leave the last word with Scott, who makes a strong case for active learning.

“[Under active learning,] students learn more, which means we’re doing our job better. They get higher grades and fail less, meaning that they are more likely to stay in STEM majors, which should help solve a major national problem. Finally, there is a strong ethical component. There is a growing body of evidence showing that active learning differentially benefits students of color and/or students from disadvantaged backgrounds and/or women in male-dominated fields. It’s not a stretch to claim that lecturing actively discriminates against underrepresented students.”

References

Freeman et al. Active learning increases student performance in science, engineering, and mathematics. PNAS.

Data on STEM attrition rates from the Department of Education’s STEM attrition report and the President’s Council of Advisors on Science and Technology report.

Busca do Google no celular agora fala português e conversa em voz alta com você

 

Publicada em 12/05/2014 12:54

A partir de hoje, mais de 105 milhões de usuários de Internet no Brasil em qualquer dispositivo móvel com sistema operacional Android ou iOS e no navegador Chrome, já pode usar a voz para realizar pesquisas e também receber as informações desejadas, encadeando conversas com a ferramenta de busca do Google.

Perguntas simples podem ser feitas e respondidas em linguagem natural, graças a tecnologias como reconhecimento e síntese de voz (o processo de produção artificial de voz humana).

A ferramenta de busca do Google é capaz, agora, de entender o contexto e oferecer informações relevantes e instantâneas. É possível, inclusive, encadear um diálogo com o celular. Por exemplo: ao perguntar “Quem é Cléo Pires?”, após ouvir a resposta é possível perguntar, na sequência, “Quem são os pais dela?” e, depois, se “Ela tem irmãos”.  Todas as respostas serão relacionadas à atriz.

Fiz o teste perguntando quem é Pedro Collor de Melo e, depois, quando o irmão dele foi presidente. Obtive a primeira resposta, mas não a segunda, mostrando que ferramenta ainda precisa evoluir.

O mesmo aconteceu com as perguntas “O Flamengo ganhou ontem?” e “Quem fez os gols do Fluminense?” Obtive respostas para a primeira pergunta e até o complemente de quando será o próximo jogo do Flamengo e contra quem. Mas Não obtive uma resposta objetiva para a segunda pergunta. Apenas uma série de links para notícias onde poderia obter a informação.

As respostas por voz funcionam muito bem para perguntas objetivas: calorias de alimentos e previsão do tempo até informações de datas comemorativas ou curiosidades.

Experimente tocar no microfone da barra de busca e perguntar:

- Quantas calorias tem uma maçã?
- Como está o trânsito até o Pacaembu?
- Quem inventou o telefone?
- Vai chover amanhã?
- Qual é o elenco de Faroeste Caboclo?

Me empolguei e perguntei “Qual é o elenco de House of Cards?”. Em voz alta a voz sintetizada respondeu “Aqui está o elenco de House of Cards” e apresentou, na tela, uma série de links sobre a série, além de fotografias dos principais atores.

Já questões como “Qual é o melhor caminho para o Pacaembu?” são respondidas com frases do tipo “Calculando rotas para o Estádio Municipal Paulo Machado de Carvalho” e a apresentação da rota traçada no Google Maps.

O desenvolvimento das novas funcionalidades da busca nos dispositivos móveis foi todo feito aqui no Brasil, no centro de pesquisas do Google em Belo Horizonte, pela equipe coordenada por Bruno Possas, Engenheiro-Chefe de Buscas do Google, com quem converso ainda hoje, para explicar direitinho cada etapa: o reconhecimento de voz, o processamento da busca e leitura da resposta por síntese de voz (no caso, por transcrição fonética).

Detalhe importante: para usar a busca é preciso estar com uma conexão 3G, 4G ou WiFi ativa.

Aumenta o número de ataques phishing em aplicativos móveis

 

De acordo com um relatório recente da empresa de segurança Kaspersky Lab, os aplicativos móveis estão agora no topo da lista de vetores favoritos para ataques.

Quando se trata de ataques de spam ou phishing, os cibercriminosos se aproveitam principalmente do quesito "confiança". Se o cracker pode encontrar uma forma para que a mensagem pareça vir de alguma fonte conhecida, as chances de o usuário cair na armadilha são muito maiores.

Esse cenário levou a um aumento nas infecções por malware que têm acesso aos contatos e enviam e-mails maliciosos em nome da vítima para todo mundo que ela conhece. Algumas dessas técnicas, inclusive, foram adaptadas para mensagens instantâneas, redes sociais e até mesmo SMS. De acordo com um relatório recente da empresa de segurança Kaspersky Lab, os aplicativos móveis estão agora no topo da lista de vetores favoritos para ataques.

"Os gadgets se tornaram populares mesmo entre aqueles que não interagem muito com computadores e não possuem tanta familiaridade com segurança de PCs", disse, por e-mail, Darya Gudkova, chefe do departamento de análise de conteúdo e pesquisa da Kaspersky Lab. "Isso abriu as portas para novos vetores de ataques para spammers e phishers."

"Para se proteger, os usuários deveriam se lembrar de não abrir e-mails de remetentes desconhecidos e, especialmente, não clicar em qualquer link incorporado em tais e-mails - o que inevitavelmente representa um risco ao usuário", explicou Gudkova. "Clicar em links não seguros ameaça diretamente a segurança do usuário independente dos dispositivos usados - eles representam um perigo para desktops e dispositivos móveis da mesma forma."

Em outras palavras, as regras são as mesmas em qualquer caso. Só porque uma mensagem foi enviada pelo WhatsApp ou de algum outro aplicativo que você utiliza, isso não significa que é legítima.

A Kaspersky Lab identificou ataques de spam e phishing usando aplicativos móveis, como o WhatsApp

Você deve usar o mesmo bom senso e precaução para reconhecer se a mensagem parece verdadeira ou não, e ter disciplina para não abrir qualquer anexo desconhecido ou clicar em links suspeitos - não importa de onde ela aparentemente venha.

O relatório The Kaspersky 2014 Q1 Spam Report também mostra que mais de 70% das mensagens de spam pesam menos que 2KB em tamanho, e mais de 90% possuem 5KB ou menos.

Imagino que, se você manda uma porção de mensagens de spam, você quer que elas sejam enviadas rapidamente, sem que excedam a largura de banda do seu ISP (Internet Service Provider, ou provedor de Internet, em tradução). E mais importante ainda, já que a maioria dos spams são enviados a partir de máquinas comprometidas, você não quer chamar a atenção do provedor das vítimas. Viu o perigo?