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Bret Stetka In a series of recent interviews, President Donald Trump's longtime personal physician Dr. Harold N. Bornstein told The New York Times that our new commander in chief has what amounts to a pretty unremarkable medical chart. Like about a quarter of American adults, Trump is on a statin for high cholesterol. He also takes a daily baby aspirin for heart health, an occasional antibiotic for rosacea, a skin condition, and Propecia, a pill to promote hair growth. Bornstein also told the Times that should he be appointed White House doctor, he probably wouldn't test the president for baseline dementia risk, something many doctors have argued should be mandatory. At 70, Trump is the oldest American president to ever take office. Couple his age with a family history of dementia — his father Fred developed Alzheimer's disease in his 80s — and one could argue that the question of baseline cognitive testing for the U.S. head of state has taken on new relevance. An assortment of fairly simple tests exist that can establish a reference point for cognitive capacity and detect early symptoms of mental decline. One of the most common such screens is the Mini-Mental Status Examination, a series of questions that gauges attention, orientation and short-term memory. It takes about five to 10 minutes to complete. Yet admitting vulnerability of any kind isn't something politicians have been keen to do. The true health of politicians has likely been cloaked in secrecy since the days of Mesopotamian kings, but definitely since the Wilson administration. © 2017 npr
Link ID: 23243 - Posted: 02.17.2017
By LISA SANDERS, M.D. The 3-year-old girl was having a very bad day — a bad week, really. She’d been angry and irritable, screaming and kicking at her mother over nothing. Her mother was embarrassed by this unusual behavior, because her husband’s sister, Amber Bard, was visiting. Bard, a third-year medical student at Michigan State, was staying in the guest room while working with a local medical practice in Grand Rapids so that she could spend a little time with her niece. The behavior was strange, but the mother was more concerned about her child’s left eye. A few days earlier it was red and bloodshot. It no longer was, but now the girl had little bumps near the eye. The mother asked Bard whether she could look at the eye. “I’m a third-year medical student,” Bard told her. “I know approximately nothing.” But Bard was happy to try. She turned to the girl, who immediately averted her face. “Can you show me your eye?” she asked. The girl shouted: “No! No, no, no!” Eventually Bard was able to coax her into allowing her a quick look at the eye. She saw a couple of tiny pimples along the lower lid, near the lashes, and a couple more just next to the eye. The eye itself wasn’t red; the lid wasn’t swollen. She couldn’t see any discharge. Once the child was in bed, Bard opened her laptop and turned to a database she’d been using for the past week when she started to see patients. Called VisualDx, it’s one of a dozen or so programs known as decision-support software, designed to help doctors make a diagnosis. This one focuses mostly on skin findings.
Link ID: 23242 - Posted: 02.17.2017
By Pallab Ghosh Scientists are appealing for more people to donate their brains for research after they die. They say they are lacking the brains of people with disorders such as depression and post-traumatic stress disorder. In part, this shortage results from a lack of awareness that such conditions are due to changes in brain wiring. The researchers' aim is to develop new treatments for mental and neurological disorders. The human brain is as beautiful as it is complex. Its wiring changes and grows as we do. The organ is a physical embodiment of our behaviour and who we are. In recent years, researchers have made links between the shape of the brain and mental and neurological disorders. Most of their specimens are from people with mental or neurological disorders. Samples are requested by scientists to find new treatments for Parkinson's, Alzheimer's and a whole host of psychiatric disorders. But there is a problem. Scientists at McLean Hospital and at brain banks across the world do not have enough specimens for the research community. According Dr Kerry Ressler, who is the chief scientific officer at McLean hospital, new treatments for many mental and neurological diseases are within the grasp of the research community. However, he says it is the lack of brain tissue that is holding back their development. © 2017 BBC.
Keyword: Brain imaging
Link ID: 23241 - Posted: 02.17.2017
Ewen Callaway Researchers have no way to tell whether young babies may later be diagnosed with autism. But brain scans could help, a small study suggests. By scanning the brains of babies whose siblings have autism, researchers say they have been able to make reasonably accurate forecasts about which of these high-risk infants will later develop autism themselves. The findings raise the prospect of diagnosing autism spectrum disorder (ASD) months before children develop symptoms, a goal that has proved elusive. Nature looks at the new study and its implications. Why has it been so tough to diagnose autism in infants? Children typically show symptoms of ASD, such as difficulty making eye contact, after the age of 2. Researchers believe that the brain changes underlying ASD begin much earlier — possibly even in the womb. But behavioural assessments haven't been helpful in predicting who will get autism, says Joseph Piven, a psychiatrist at the University of North Carolina (UNC) in Chapel Hill, who co-led the study, published online in Nature1. “Children who end up with autism at 2 or 3, they don’t look like they have autism in the first year," he says. Certain rare mutations are linked to ASD, but the vast majority of cases cannot be pinned to a single or even a handful of genetic risk factors. Beginning in the 1990s, Piven and other researchers noticed that children with autism tended to have larger brains than developmentally normal children, suggesting that brain growth could be a biomarker for ASD. But Piven and colleague Heather Cody Hazlett, a psychologist at UNC-Chapel Hill, say it had not been clear when overgrowth occurred. What did their latest study look at? © 2017 Macmillan Publishers Limited,
By Amy Ellis Nutt For the first time, scientists can point to substantial empirical evidence that people with attention-deficit/hyperactivity disorder have brain structures that differ from those of people without ADHD. The common disorder, they conclude, should be considered a problem of delayed brain maturation and not, as it is often portrayed, a problem of motivation or parenting. In conducting the largest brain imaging study of its kind, an international team of researchers found that ADHD involves decreased volume in key brain regions, in particular the amygdala, which is responsible for regulating the emotions. Although the study, published Wednesday in the Lancet Psychiatry, included children, adolescents and adults, the scientists said the greatest differences in brain volume appeared in the brains of children. Of seven subcortical brain regions targeted in the study, five, including the amygdala, were found to be smaller in those with ADHD, compared with those in a control group. The other regions that showed reductions in volume were: the caudate nucleus (which has been linked to goal-directed action), the putamen (involved in learning and responding to stimuli), the nucleus accumbens (which processes rewards and motivation) and the hippocampus (where memories are formed). © 1996-2017 The Washington Post
By John Carroll, Scratch yet another Phase III Alzheimer’s drug hopeful. Merck announced late Tuesday that it is shuttering its EPOCH trial for the BACE inhibitor verubecestat in mild-to-moderate Alzheimer’s after the external data monitoring committee concluded that the drug was a bust, with “virtually” no chance of success. A separate Phase III study in prodromal patients, set to read out in two years, will continue as investigators found no signs of safety issues. This is one of Merck’s top late-stage drugs, and news of the failure drove down the pharma giant’s shares in after-market trading by 2.45%. BACE drugs essentially seek to interfere in the process that creates amyloid beta, a toxic protein often found in the brains of Alzheimer’s patients. As the top amyloid beta drugs like bapineuzumab and solanezumab — which sought to extract existing amyloid beta loads — ground their way to repeated failures, developers in the field turned increasingly to BACE therapies as an alternative mechanism that could provide the key to slowing this disease down. Merck’s effort was the most advanced in the pipeline, but Eli Lilly and others are still in hot pursuit with their own persistent BACE efforts. Teams from Biogen/Eisai and Novartis/Amgen are also beavering away on BACE. “Alzheimer’s disease is one of the most pressing and daunting medical issues of our time, with inherent, substantial challenges to developing an effective disease-modifying therapy for people with mild-to-moderate disease. Studies such as EPOCH are critical, and we are indebted to the patients in this study and their caregivers,” said Dr. Roger M. Perlmutter, president, Merck Research Laboratories. © 2017 American Association for the Advancement of Science.
Link ID: 23238 - Posted: 02.16.2017
Jon Hamilton Scientists may have solved the mystery of nodding syndrome, a rare form of epilepsy that has disabled thousands of children in East Africa. The syndrome seems to be caused by the immune system's response to a parasitic worm, an international team reports in the journal Science Translational Medicine. And they think it's the same worm responsible for river blindness, an eye infection that's also found in East Africa. The finding means that current efforts to eliminate river blindness should also reduce nodding syndrome, says Avi Nath, an author of the study and chief of the section of infections of the nervous system at the National Institute of Neurological Disorders and Stroke. "We can prevent new infections even if we can't treat the ones who already have nodding syndrome," Nath says. Drugs can kill the parasite in its early stages. Nodding syndrome usually strikes children between 5 and 16 who live in rural areas of northern Uganda and South Sudan. Their bodies and brains stop growing. And they experience frequent seizures. "These are kids, young kids, you would expect that they should be running around playing," says Nath, who visited Uganda several years ago. "Instead, if you go to these villages they are just sitting there in groups," so villagers can keep an eye on them. © 2017 npr
By Mitch Leslie Fasting is all the rage. Self-help books promise it will incinerate excess fat, spruce up your DNA, and prolong your life. A new scientific study has backed up some health claims about eating less. The clinical trial reveals that cutting back on food for just 5 days a month could help prevent or treat age-related illnesses like diabetes and cardiovascular disease. “It’s not trivial to do this kind of study,” says circadian biologist Satchidananda Panda of the Salk Institute for Biological Studies in San Diego, California, who wasn’t connected to the research. “What they have done is commendable.” Previous studies in rodents and humans have suggested that periodic fasting can reduce body fat, cut insulin levels, and provide other benefits. But there are many ways to fast. One of the best known programs, the 5:2 diet, allows you to eat normally for 5 days a week. On each of the other 2 days, you restrict yourself to 500 to 600 calories, about one-fourth of what the average American consumes. An alternative is the so-called fasting-mimicking diet, devised by biochemist Valter Longo of the University of Southern California in Los Angeles and colleagues. For most of the month, participants eat as much of whatever they want. Then for five consecutive days they stick to a menu that includes chips, energy bars, and soups, consuming about 700 to 1100 calories a day. © 2017 American Association for the Advancement of Science
Link ID: 23236 - Posted: 02.16.2017
Laura Beil People who undergo gastric bypass surgery are more likely to experience a remission of their diabetes than patients who receive a gastric sleeve or intensive management of diet and exercise, according to a new study. Bypass surgery had already shown better results for diabetes than other weight-loss methods in the short term, but the new research followed patients for five years. “We knew that surgery had a powerful effect on diabetes,” says Philip Schauer of the Bariatric & Metabolic Institute at the Cleveland Clinic. “What this study says is that the effect of surgery is durable.” The results were published online February 15 in the New England Journal of Medicine. The study followed 134 people with type 2 diabetes for five years in a head-to-head comparison of weight-loss methods. At the end of that time, two of 38 patients who only followed intensive diet and exercise plans were no longer in need of insulin to manage blood sugar levels. For comparison, 11 of 47 patients who had a gastric sleeve, which reduces the size of the stomach, and 14 of 49 who underwent gastric bypass, a procedure that both makes the stomach smaller and shortens digestion time, did not need the insulin anymore. In general, patients who had been diabetic for fewer than eight years were more likely to be cured, Schauer says. Even those surgical patients who still needed to take insulin had greater weight loss and lower median glucose levels than others in the study. This study was also one of the few to show that bariatric surgery could help those with only mild obesity, defined as a body mass index between 27 and 34. How bariatric surgery might improve diabetes is still unknown, but scientists have pointed to effects on the body’s metabolism (SN: 8/24/13, p. 14) and gut microbes (SN: 9/5/15, p. 16). |© Society for Science & the Public 2000 - 2016.
Link ID: 23235 - Posted: 02.16.2017
Sarah Jane Tribble In response to outrage from patients and lawmakers, Marathon Pharmaceuticals has delayed the launch of an $89,000 drug for Duchenne muscular dystrophy. The company had announced the annual list price for Emflaza, which is a steroid, after the Food and Drug Administration approved the drug Thursday. Emflaza is approved as an orphan drug, which means it is intended to treat a rare disease. Duchenne is an inherited disorder that causes muscles to become weak. There is no cure for the condition, which mainly affects boys, but some drugs, including Emflaza, are used to lessen symptoms. For years, many American patients have imported deflazacort, the generic version of Emflaza, for about $1,200 a year. But because the medicine wasn't approved in the U.S., the cost of the medicine wasn't typically covered by insurers. That contrast in price between became a flash point Monday as Sen. Bernie Sanders, I-Vt., and Rep. Elijah Cummings, D-Md., sent a letter to Marathon on Monday morning demanding answers about the $89,000 price for a drug that isn't new. It has been used routinely by Duchenne patients in the U.S. since at least 2005. "We believe Marathon is abusing our nation's 'orphan drug' program, which grants companies seven years of market exclusivity to encourage research into new treatments for rare diseases — not to provide companies like Marathon with lucrative market exclusivity rights for drugs that have been available for decades," Sanders and Cummings wrote. Marathon said FDA approval would help more patients get the drug. © 2017 npr
Keyword: Movement Disorders
Link ID: 23234 - Posted: 02.15.2017
By Jesse Singal Those who advocate for sound, evidence-based research about autism are extremely alarmed about Donald Trump, and for good reason: In addition to Trump’s ties to Andrew Wakefield, the disgraced British doctor whose debunked research helped fuel the false idea of links between childhood vaccines and autism, Robert F. Kennedy Jr., a notorious anti-vaxxer himself, told reporters back in January that Trump planned to tap him as chair of a commission on “vaccine safety.” There is no question at this point that Trump has significant connections to a pseudoscientific medical movement that spreads dangerous, disproven ideas. Today, Trump gave nervous observers yet more reason to worry. It occurred at a White House event in which Trump and Secretary of Education Betsy DeVos met with a bunch of educators. Trump seemed to fixate, for a moment, on one educator named Jane (her last name is hard to make out) after she explained that she is the principal of a special education center in Virginia. The sequence starts at about 5:38 in this video: After Jane noted that many of her students have autism, Trump asked, “Have you seen a big increase in the autism, with the children?” Jane replied in the affirmative, but seemed to couch her response as being more about an increase in demand for services — she didn’t explicitly agree there’s been a big increase in the overall rate. Trump continued: “So what’s going on with autism? When you look at the tremendous increase, it’s really — it’s such an incredible — it’s really a horrible thing to watch, the tremendous amount of increase. Do you have any idea? And you’re seeing it in the school?” Jane replied — again, in a way that seems a bit noncommittal vis-à-vis Trump’s claim — that the rate of autism is something like 1-in-66 or 1-in-68 children. To which Trump responds: “Well now, it’s gotta be even lower [presumably meaning higher, rate-wise] than that, which is just amazing — well, maybe we can do something.” (Jane had the rate right, and Trump is incorrect that it has crept higher.) © 2017, New York Media LLC.
Link ID: 23233 - Posted: 02.15.2017
By Amitha Kalaichandran, When pain researcher Diane Gromala recounts how she started in the field of virtual reality, she seems reflective. She had been researching virtual reality for pain since the early 1990s, but her shift to focusing on how virtual reality could be used for chronic pain management began in 1999, when her own chronic pain became worse. Prior to that, her focus was on VR as entertainment. Gromala, 56, was diagnosed with chronic pain in 1984, but the left-sided pain that extended from her lower stomach to her left leg worsened over the next 15 years. "Taking care of my chronic pain became a full-time job. So at some point I had to make a choice — either stop working or charge full force ahead by making it a motivation for my research. You can guess what I chose," she said. Diane Gromala Pain researcher Diane Gromala found that taking care of her own chronic pain became 'a full-time job.' (Pain studies lab at Simon Fraser University) Now she's finding that immersive VR technology may offer another option for chronic pain, which affects at least one in five Canadians, according to a 2011 University of Alberta study. "We know that there is some evidence supporting immersive VR for acute pain, so it's reasonable to look into how it could help patients that suffer from chronic pain." Gromala has a PhD in human computer interaction and holds the Canada Research Chair in Computational Technologies for Transforming Pain. She also directs the pain studies lab and the Chronic Pain Research Institute at Simon Fraser University in Burnaby, B.C. ©2017 CBC/Radio-Canada.
By GINA KOLATA Dr. James Weinstein, a back pain specialist and chief executive of Dartmouth-Hitchcock Health System, has some advice for most people with lower back pain: Take two aspirin and don’t call me in the morning. On Monday, the American College of Physicians published updated guidelines that say much the same. In making the new recommendations for the treatment of most people with lower back pain, the group is bucking what many doctors do and changing its previous guidelines, which called for medication as first-line therapy. Dr. Nitin Damle, president of the group’s board of regents and a practicing internist, said pills, even over-the-counter pain relievers and anti-inflammatories, should not be the first choice. “We need to look at therapies that are nonpharmacological first,” he said. “That is a change.” The recommendations come as the United States is struggling with an epidemic of opioid addiction that often begins with a simple prescription for ailments like back pain. In recent years, a number of states have enacted measures aimed at curbing prescription painkillers. The problem has also led many doctors around the country to reassess prescribing practices. The group did not address surgery. Its focus was on noninvasive treatment.The new guidelines said that doctors should avoid prescribing opioid painkillers for relief of back pain and suggested that before patients try anti-inflammatories or muscle relaxants, they should try alternative therapies like exercise, acupuncture, massage therapy or yoga. Doctors should reassure their patients that they will get better no matter what treatment they try, the group said. The guidelines also said that steroid injections were not helpful, and neither was acetaminophen, like Tylenol, although other over-the-counter pain relievers like aspirin, naproxen or ibuprofen could provide some relief. © 2017 The New York Times Company
Keyword: Pain & Touch
Link ID: 23231 - Posted: 02.15.2017
Elizabeth Eaton A prehistoric marine reptile may have given birth to its young alive. A fossil from South China may be the first evidence of live birth in the animal group Archosauromorpha, scientists report February 14 in Nature Communications. Today Archosauromorpha is represented by birds and crocodiles — which both lay eggs. Whether this fossil really is the first evidence of live birth in Archosauromorpha depends on how another group of semiaquatic animals is classified, says Michael Caldwell, a vertebrate paleontologist with the University of Alberta in Canada. Placement of Choristodera, a now-extinct group that included a freshwater reptile that gave live birth, remains murky, with some researchers putting them with Archosauromorpha and others with a group that includes snakes and lizards. “Our discovery is the first of live birth in reptiles with undoubted archosauromorph affinity,” says Jun Liu, a paleontologist at Hefei University of Technology in China. Researchers have speculated that the biology of archosauromorphs prevented their reproductive traits from evolving, says study coauthor Chris Organ, an evolutionary biologist with Montana State University in Bozeman. This find may disprove that view. “Ancestrally, the science suggests that live birth is not absolutely prohibited,” Organ says. Even though birds and crocodiles haven’t yet evolved to give life birth, this discovery suggests that it’s possible. |© Society for Science & the Public 2000 - 2016
By Rachael Lallensack Goats know who their real friends are. A study published today in Royal Society Open Science shows that the animals can recognize what other goats look like and sound like, but only those they are closest with. Up until the late 1960s, the overwhelming assumption was that only humans could mentally keep track of how other individuals look, smell, and sound—what scientists call cross-modal recognition. We now know that many different kinds of animals can do this like horses, lions, crows, dogs, and certain primates. Instead of a lab, these researchers settled into Buttercups Sanctuary for Goats in Boughton Monchelsea, U.K., to find out whether goats had the ability to recognize each other. To do so, they first recorded the calls of individual goats. Then, they set up three pens in the shape of a triangle in the sanctuary’s pasture. Equidistant between the two pens at the base of the triangle was a stereo speaker, camouflaged as to not distract the goat participants. A “watcher” goat stood at the peak of the triangle, and the two remaining corners were filled with the watcher’s “stablemate” (they share a stall at night) and a random herd member. Then, the team would play either the stablemate’s or the random goat’s call over the speaker and time how long it took for the watcher to match the call with the correct goat. They repeated this test again, but with two random goats. The researchers found that the watcher goat would look at the goat that matched the call quickly and for a longer time, but only in the test that included their stablemate. The results indicate that goats are not only capable of cross-modal recognition, but that they might also be able to use inferential reasoning, in other words, process of elimination. Think back to the test: Perhaps when the goat heard a call that it knew was not its pal, it inferred that it must have been the other one. © 2017 American Association for the Advancement of Science.
Jon Hamilton Researchers have created mice that appear impervious to the lure of cocaine. Even after the genetically engineered animals were given the drug repeatedly, they did not appear to crave it the way typical mice do, a team reports in Nature Neuroscience. "They didn't keep going into the room where they received the cocaine and they seemed to be just as happy exploring all around the cage," says Shernaz Bamji, a professor in the Department of Cellular and Physiological Sciences at the University of British Columbia in Vancouver. "Addiction is a form of learning," Bamji says. And somehow, these mice never learned to associate the pleasurable feelings produced by cocaine with the place where they received the drug. The result was startling because the scientists thought these mice would be especially susceptible to addiction. "We repeated the experiment several times to see if we had made a mistake," Bamji says. The reason for the team's surprise had to do with proteins that affect learning. The animals had been genetically engineered to produce high levels of proteins called cadherins in the brain's "reward circuit," which plays an important role in addiction. And genetic studies have suggested that people with high levels of cadherins are more susceptible to drug addiction. Cadherins act a bit like glue, binding cells together. Usually this glue enhances learning by strengthening the connections, or synapses, between brain cells. © 2017 npr
Ian Sample Science editor Children who are born very prematurely are at greater risk of developing mental health and social problems that can persist well into adulthood, according to one of the largest reviews of evidence. Those with an extremely low birth weight, at less than a kilogram, are more likely to have attention disorders and social difficulties as children, and feel more shyness, anxiety and depression as adults, than those born a healthy weight. The review draws on findings from 41 published studies over the past 26 years and highlights the need for doctors to follow closely how children born very prematurely fare as they become teenagers and adults. “It is important that families and doctors be aware of the potential for these early-emerging mental health problems in children born at extremely low birth weight, since at least some of them endure into adulthood,” said Karen Mathewson, a psychologist at McMaster University in Ontario. Improvements in neonatal care in the past two decades mean that more children who are born very prematurely now survive. In a healthy pregnancy, a baby can reach 1kg (a little more than 2lbs) within 27 weeks, or the end of the second trimester. The study, which involves data from 13,000 children in 12 different countries, follows previous research that found a greater tendency for very low birth weight children to have lower IQs and autism and more trouble with relationships and careers as they reach adulthood and venture into the world. © 2017 Guardian News and Media Limited
By Andy Coghlan It’s as if a switch has been flicked. Evidence is mounting that chronic fatigue syndrome (CFS) is caused by the body swapping to less efficient ways of generating energy. Also known as ME or myalgic encephalomyelitis, CFS affects some 250,000 people in the UK. The main symptom is persistent physical and mental exhaustion that doesn’t improve with sleep or rest. It often begins after a mild infection, but its causes are unknown. Some have argued that CFS is a psychological condition, and that it is best treated through strategies like cognitive behavioural therapy. But several lines of investigation are now suggesting that the profound and painful lack of energy seen in the condition could in many cases be due to people losing their ability to burn carbohydrate sugars in the normal way to generate cellular energy. Instead, the cells of people with CFS stop making as much energy from sugar as usual, and start relying more on lower-yielding fuels, such as amino acids and fats. This kind of metabolic switch produces lactate, which can cause pain when it accumulates in muscles. Together, this would explain both the shortness of energy, and why even mild exercise can be exhausting and painful. © Copyright Reed Business Information Ltd.
Link ID: 23226 - Posted: 02.14.2017
By BENEDICT CAREY The number of retirement-age Americans taking at least three psychiatric drugs more than doubled between 2004 and 2013, even though almost half of them had no mental health diagnosis on record, researchers reported on Monday. The new analysis, based on data from doctors’ office visits, suggests that inappropriate prescribing to older people is more common than previously thought. Office visits are a close, if not exact, estimate of underlying patient numbers. The paper appears in the journal JAMA Internal Medicine. Geriatric medical organizations have long warned against overprescribing to older people, who are more susceptible to common side effects of psychotropic drugs, such as dizziness and confusion. For more than 20 years, the American Geriatrics Society has published the so-called Beers Criteria for potentially inappropriate use, listing dozens of drugs and their mutual interactions. In that time, prescription rates of drugs like antidepressants, sleeping pills and painkillers nonetheless generally increased in older people, previous studies have found. The new report captures one important dimension, the rise in so-called polypharmacy — three drugs or more — in primary care, where most of the prescribing happens. Earlier research has found that elderly people are more likely to be on at least one psychiatric drug long term than younger adults, even though the incidence of most mental disorders declines later in life. “I was stunned to see this, that despite all the talk about how polypharmacy is bad for older people, this rate has doubled,” said Dr. Dilip Jeste, a professor of psychiatry and neurosciences at the University of California, San Diego, who was not involved in the new work. © 2017 The New York Times Company
By Virginia Morell Strange as it might seem, not all animals can immediately recognize themselves in a mirror. Great apes, dolphins, Asian elephants, and Eurasian magpies can do this—as can human kids around age 2. Now, some scientists are welcoming another creature to this exclusive club: carefully trained rhesus monkeys. The findings suggest that with time and teaching, other animals can learn how mirrors work, and thus learn to recognize themselves—a key test of cognition. “It’s a really interesting paper because it shows not only what the monkeys can’t do, but what it takes for them to succeed,” says Diana Reiss, a cognitive psychologist at Hunter College in New York City, who has given the test to dolphins and Asian elephants in other experiments. The mirror self-recognition test (MSR) is revered as a means of testing self-awareness. A scientist places a colored, odorless mark on an animal where it can’t see it, usually the head or shoulder. If the animal looks in the mirror and spontaneously rubs the mark, it passes the exam. Successful species are said to understand the concept of “self” versus “other.” But some researchers wonder whether failure is simply a sign that the exam itself is inadequate, perhaps because some animals can’t understand how mirrors work. Some animals—like rhesus monkeys, dogs, and pigs—don’t recognize themselves in mirrors, but can use them to find food. That discrepancy puzzled Mu-ming Poo, a neurobiologist at the Shanghai Institutes for Biological Sciences in China, and one of the study’s authors. “There must be some transition between that simple mirror use and recognizing yourself,” he says. © 2017 American Association for the Advancement of Science.