Most adults who tried to get swine flu vaccine for themselves or their children have been unable to find it, even if they fall into high-risk groups, according to a Harvard survey released today.

Flu is widespread in Massachusetts and 47 other states, but deliveries of vaccine against the swine flu virus have lagged behind both illnesses and supply projections. Manufacturers are struggling to produce both the new vaccine and seasonal flu vaccine at the same time.

A telephone survey conducted last weekend by the Harvard School of Public Health found that four out of 10 American parents and one out of five high-priority adults were looking for swine flu, or H1N1, vaccine. Slightly fewer than one out of five adults not in a high-risk category were also searching for vaccine.

High risk groups include pregnant women, adults caring for a baby less than six months old, health care workers and emergency personnel, and adults age 25 to 64 who have medical problems such as asthma or heart disease.

Two-thirds of parents looking for vaccine were unable to find it for their children. The same was true for high-priority adults. Seven out of 10 other adults seeking vaccine were also unable to get inoculated.

"These findings suggest that the nationwide H1N1 vaccine shortage is presenting a real challenge for those who have tried to get the vaccine," Robert J. Blendon, professor of health policy and political analysis at Harvard, said in a statement released with the poll.

Almost all people polled said they will keep looking for vaccine, for themselves or their children, the survey said.

The survey was conducted by calling 1,073 adults, on both landlines and cell phones, from October 30 through November 1. The margin of error is plus or minus 3.8 percentage points. It is the fifth survey done by the Harvard researchers since swine flu emerged in the spring.

Harvard Medical School's publishing arm has a new iPhone application for all things swine flu, pulling information from local and national health specialists, its own medical and business schools, and an outbreak locator, all downloadable from the iTunes Store.

Called the HMSMobile Swine Flu Center, it offers video guides for preventing infection, interactive tools to determine if an illness is likely to be swine flu, and advice for businesses dealing with illness, according to Harvard Health Publications. It also includes access to HealthMap's “Outbreaks Near Me” program, a real-time map of disease outbreaks developed by John Brownstein of Children's Hospital Boston and Clark Freifeld of MIT's Media Lab.

Several hundred Harvard students are taking part in an experiment that tests social networks as early warning systems for disease spread, the Harvard Crimson reports.

Dr. Nicholas A. Christakis, who is a Harvard Medical School professor as well as a house master at Harvard, is well known for his research into social networks as important influences on behavior. His work has linked the spread of happiness, quitting smoking, and obesity to circles of friends.

Now he is asking 650 randomly selected Harvard undergraduates to report twice a week for 12 weeks on whether they have flu symptoms, the story said. The students are also being asked to supply the names of three friends and to assess their own popularity.

"By looking both at whether you’ve had the flu and where you are in the social network, we think you can get an early warning of an epidemic," Christakis told the Crimson. "If this works, we’ll have invented a new method for attacking diseases, which could have broad relevance far outside Harvard."

By Carolyn Y. Johnson, Globe Staff

Harvard researchers have created a strip of pulsing heart muscle from mouse embryonic stem cells, a step toward the eventual goal of growing replacement parts for hearts damaged by cardiovascular disease.

The new work, to be published in the journal Science tomorrow, begins to confront what will be a major frontier for stem cell biology: translating recent basic science advances to meet the promise of regenerative medicine, by finding ways to make such cells functional and potentially useful for therapies.

"I think over the last five years or so, we’ve made great progress in being able to guide stem cells into whatever cell type we want -- in this case the heart," said Dr. Deepak Srivastava, director of the Gladstone Institute of Cardiovascular Disease at the University of California, San Francisco, who was not involved in the research. The new work "has begun to think about how to assemble these types of cardiac cells into a 3-D fashion, for future use within a heart. It’s a long way from that right now ... but it’s a first baby step toward that goal."

People with advanced dementia spend their last days suffering the same pain, complications, and poor prognosis as people with other terminal conditions, according to a new study that urges better care focused on providing comfort at the end of their lives.

Dr. Susan Mitchell of Hebrew SeniorLife Institute for Aging Research and Harvard Medical School led a study of 323 patients with end-stage dementia at 22 nursing homes near Boston. Writing in this week's New England Journal of Medicine, they report that the life expectancy for advanced dementia patients was close to what late-stage cancer or congestive heart failure patients might anticipate. Like dying cancer patients, the dementia patients also experienced infections, fever, and eating problems.

"Dementia is a terminal illness," Mitchell said in an interview. "When families understand this is the end stage, most of them will want comfort care as the goal."

Thirteen Massachusetts researchers and clinicians have been elected to the Institute of Medicine, a prestigious national body that makes recommendations on health and health-care policy.

The institute's 65 new members include:

Amy N. Finkelstein, professor of economics, MIT
Alfred L. Goldberg, professor of cell biology, Harvard Medical School
Dr. Sue J. Goldie, professor of public health, and director, Center for Health Decision Science, Harvard School of Public Health
Dr. Daniel A. Haber, professor of medicine, Harvard Medical School, and director, Massachusetts General Hospital Cancer Center
Tyler E. Jacks, professor of biology, and director, David H. Koch Institute for Integrative Cancer Research, MIT
Dr. Ichiro Kawachi, professor and chair, department of society, human development, and health, Harvard School of Public Health
Dr. Isaac S. Kohane, professor of pediatrics and health sciences and technology, Harvard Medical School; and chair, informatics program, Children's Hospital Boston
Dr. Joan Y. Reede, dean for diversity and community partnership and associate professor of medicine, Harvard Medical School
Gary Ruvkun, professor of genetics, Harvard Medical School and Massachusetts General Hospital
Dr. Clifford B. Saper, professor of neurology and neuroscience, Harvard Medical School, and professor and head, department of neurology, Beth Israel Deaconess Medical Center
Dr. Megan Sykes, associate director, Transplantation Biology Research Center, Massachusetts General Hospital, and professor of surgery and professor of medicine, Harvard Medical School
Dr. Bruce D. Walker, director, Ragon Institute of Massachusetts General Hospital, MIT, and Harvard University
Dr. Ralph Weissleder, professor of systems biology and radiology, Harvard Medical School, and director, Center for Systems Biology, Massachusetts General Hospital

By Liz Kowalczyk, Globe Staff

Many hospitals have been widely advertising robot-assisted surgery, especially for prostate cancer, marketing it as having shorter recovery times and fewer complications than standard operations.

But a nationwide study published today raises serious concerns about the wide use of robots in prostate operations, say Boston physicians who led the research team.

The Harvard Medical School researchers found that cancer patients who underwent minimally-invasive prostate removal -- now usually done with remote-controlled robots -- were more than twice as likely to experience incontinence or impotence a year and a half after their operations than patients who had traditional surgery using an open incision.

Success at controlling the cancer was about the same for both operations. Patients who had minimally invasive, or laparoscopic, surgery were able to go home from the hospital in two days on average, one day shorter than the comparision group, and had fewer post-surgery respiratory problems and other short-term complications.

Doctors in training are strictly bound by regulations governing how many hours they may work in a week and how much time off they must have between shifts, an outgrowth of research linking medical errors to a lack of sleep. Boston researchers have turned their attention to attending physicians, experienced doctors who perform emergency operations or deliver babies through the night and resume their workload the next day.

Dr. Jeffrey Rothschild of Brigham and Women's Hospital led an eight-year study comparing the rate of complications in procedures a physician performed the day after nighttime procedures to procedures the same physician performed after a night with no procedures.

The researchers found no statistically significant difference in the roughly 5 percent rate of complications, which included infection after surgery or blood loss after deliveries. But if the physician had less than a six-hour opportunity to sleep between the last nighttime procedure and the first one the next day, the complication rate was higher: 6.2 percent for less than six hours compared to 3.4 percent for more than six hours.

"These data suggest that attending physicians, like residents and nurses, may be at increased risk of making errors when sleep deprived or working extended shifts," the authors write in tomorrow's Journal of the American Medical Association.

In an interview, Rothschild said it would be premature to suggest policy changes before the issue is studied across all surgical specialties and in other hospitals. The study looked at a wide variety of specialties but it was conducted in a large, advanced-care, teaching hospital (not identified in the journal article) where resident physicians were available to assist attending physicians. But he said there are lessons that could be applied now.

"For physicians who find themselves in that situation, it's part of professionalism to ask for assistance or postpone a procedure if they feel they are fatigued," he said.

By Elizabeth Cooney, Globe Correspondent

Doctors who receive money from drug or medical device makers are expected to reveal those payments when speaking at professional meetings or submitting a manuscript to a medical journal. A new study led by Boston researchers found that the accuracy of physicians' disclosures fell short when compared to what orthopedic device makers reported.

Dr. Mininder Kocher of Children's Hospital Boston and his New England Journal of Medicine co-authors took a list of payments made to surgeons by five companies that develop and market knee and hip replacement implants. The information was published on company web sites in late 2007 as part of a settlement with the US Department of Justice, as this Globe story reported.

Before the March 2008 annual meeting of the Academy of American Orthopedic Surgeons, physicians who were making presentations or serving on committees for the meeting were asked to list payments they received that could indicate potential conflicts of interest. About seven out of 10 physicians disclosed financial relationships that the device manufacturers had already made public, the authors concluded.

"The thrust has been voluntary disclosure from the physicians," Kocher said in an interview. "Our study would suggest that that may not be so accurate and is difficult to validate."

By Carolyn Y. Johnson, Globe Staff

Jack W. Szostak, a professor of genetics at Harvard Medical School and Massachusetts General Hospital, is one of three winners of the Nobel Prize in Physiology or Medicine in 2009. He will share the $1.4 million prize with Elizabeth Blackburn of the University of California, San Francisco, and Carol W. Greider of Johns Hopkins University School of Medicine.

The three are being honored for discovering a mechanism that protects the genome from degrading, research that has had an impact on aging and cancer research. The trio discovered that the caps of chromosomes -- called telomeres -- protect DNA, and that an enzyme called telomerase builds the caps.

When Szostak arrived at his Mass. General laboratory this morning, colleagues had hung photocopies around the lab of his landmark 1982 journal article on telomeres, "Cloning Yeast Telomeres on Linear Plasmid Vectors," with the words "Congrats Jack!" scrawled over it. Balloons and streamers decorated the lab.

Szostak was later welcomed to a conference room with a long standing ovation. Smiling and shaking his head in what seemed like overwhelmed disbelief, he called the award "delightful" and said he was awakened by the call from the Nobel committee before 5 a.m.

"This is the highest scientific honor," Szostak said. "It's great to receive that kind of recognition."

In a press release early this morning, The Nobel Assembly at Karolinska Institutet said the scientists were honored for discoveries that "have added a new dimension to our understanding of the cell, shed light on disease mechanisms, and stimulated the development of potential new therapies."