2014 - December: Interesting Articles & Links

* Hand Warmers: How do they work?  -- http://www.wired.com/2014/12/whats-inside-hot-hands/

* China's appetite for pork - http://www.economist.com/news/christmas-specials/21636507-chinas-insatiable-appetite-pork-symbol-countrys-rise-it-also

* In defence of poetry -- http://www.outlookindia.com/article/A-Lovely-Strangeness/292942

* Cortez -- http://www.economist.com/news/christmas-specials/21636686-journey-past-most-mexicans-would-rather-forget-trail-hern-n?fsrc=scn%2Ffb%2Fte%2Fed%2Fpe

* On Evernote -- http://www.labnol.org/software/evernote-tips/18077/
- https://evernote.com/

* Photos - NASA - best from Space 2014 - http://www.wired.com/2014/12/nasa-best-earth-from-space-2014/

* Anti-microbial resistance in India -- http://www.indiaspend.com/cover-story/2-million-reasons-india-should-restrict-antibiotics-45573

* Labnol - Blogging tips -- http://www.labnol.org/internet/blogging/writing-successful-blog/1896/

* Ordinary things under an electron microscope -- http://www.sciencedump.com/content/putting-ordinary-things-under-electron-microscope

* New diagnostic platform - 600 diseases in 6 hrs -- http://www.iflscience.com/health-and-medicine/new-diagnostic-platform-can-detect-over-1000-pathogens-just-6-hours

* Chatterjee, Dev (2014): CIPLA: THE CRUSADER FOR AFFORDABLE DRUGS TAKES THE BATTLE TO MNCs, BS, 24Dec14 --- http://www.business-standard.com/article/companies/40-years-ago-and-now-cipla-the-crusader-for-affordable-drugs-takes-the-patent-battle-to-mncs-114122400009_1.html
- 2001 - Cipla started seelling AIDS drugs to Africa, undercutting MNCs - cost drops from $12,000/patient/yr to $800
- Today more than 8 million Africans are being treated with Cipla AIDS drugs
- Stomach cancer drug - MNCs sell it for $280,000 for 30 tabs -- Cipla sells the same for $6,500
- Yusuf Hamied argues that 70% of patented drugs sold worldwide  are not invented by the owning companies.
- MNCs kill competition with expensive litigation - Cipla paid $200,000/day for each case during court proceedings.
- When US was facing Anthrax and Bird-flu it was ready to break any patents....it was in national interest
- India is in perennial health crisis -- largest number of AIDS patients, diabetes, TB and malaria
- Patents for the TB drug is with an MNC
- Cipla earns 60% of its revenue from abroad -- new acquisitions - Medpro, South Africa ($512m), Yemeni co ($21m) and a drug distributor in Sri Lanka


* Sony's hackers - http://www.livemint.com/Consumer/F5uzgPGZlwIthi2IHzhJRN/Sony-hackers-snooped-for-months-before-planting-virus.html

* lifestyle Changing DNA - Methylation - http://www.financialexpress.com/article/lifestyle/health/how-exercise-changes-our-dna/21596/

* Atul Gawande interview - http://www.livemint.com/Opinion/ZZDSN3krwiyt09OIUy5nYI/The-art-of-living.html

* How Japan gave away its solar industry -- http://www.technologyreview.com/featuredstory/533451/can-japan-recapture-its-solar-power/
- According to METI, developers installed nearly 10 gigawatts of renewable generating capacity through the end of April 2014, including 9.6 gigawatts of photovoltaics. (The nuclear reactors at Fukushima Daiichi had 4.7 gigawatts of capacity; overall, the country has around 290 gigawatts of installed electricity-generating capacity.)
- Between 1985 and 2007, Japanese researchers filed for more than twice as many patents in solar technologies as rival U.S. and European inventors combined. Companies like Sharp, Sanyo Electric, Panasonic, and Kyocera became the clear leaders in solar technology.
- Japan’s 10 utilities were (and remain) vertical monopolies. Each controls power generation, transmission, and distribution in its respective region, and its grids are designed to deliver electricity from centralized power plants—including large nuclear reactors.
- The interconnection problem is further compounded by an artifact: two AC frequencies that split the country’s electrical system in half. Eastern Japan operates at 50 hertz, while western Japan uses 60-hertz power—a barrier that proved crippling in 2011, in the immediate aftermath of the Fukushima disaster
- HIT - heterojunction with intrinsic thin layer, the hybrid technology has become a mainstay of the company’s solar strategy.
- The Koriyama R&D facility boasts state-of-the-art labs for crystallizing, slicing, and patterning silicon wafers, and its production line can churn out up to 360 wafers an hour. Outside, a variety of photovoltaics are being tested, along with a modest-sized wind turbine and a large grid-connected battery. Its most ambitious program is directed by Makoto Konagai, one of Japan’s most celebrated solar scientists, who has moved to Koriyama from the Tokyo Institute of Technology.


* MSF - Single dose vaccine against Kala Azhar - http://www.msfindia.in/msf-supports-introduction-and-roll-out-single-dose-treatment-kala-azar-bihar


BS - Basu, Debasis (15Dec14): Make in India - Beyond the Slogan -- http://www.business-standard.com/article/opinion/debashis-basu-make-in-india-beyond-the-slogan-114121400577_1.html

* Anti-Microbial Resistance - http://www.project-syndicate.org/commentary/global-economics-drug-resistance-by-jim-o-neill-2014-12#
- We must encourage policymakers to support the development of the best diagnostics. Quicker, more accurate diagnoses will curb the current overreliance on antibiotics – a key requirement for combating resistance.

* 2000% return on Malaria investment -- http://www.indiaspend.com/cover-story/how-india-got-2000-return-on-anti-malaria-investment-94139

* Enadu and Chairman Rao - http://www.caravanmagazine.in/reportage/chairman-rao

* WSJ - Photos of the Year - http://graphics.wsj.com/Photos-of-the-Year/2014/en:date:January:1

* What is Fatigue? -- http://www.newyorker.com/tech/elements/what-is-fatigue


* Auletta, Ken (2014): BLOOD, SIMPLER, The New Yorker, 15Dec14, http://www.newyorker.com/magazine/2014/12/15/blood-simpler
- The plummeting costs of DNA-sequencing technology have made it possible for companies such as 23andme to provide individuals with their genetic information directly, rather than through doctors, empowering nerdy customers and self-motivated patients.
- Most other diagnostic labs, including Quest and Laboratory Corporation of America, perform blood tests on equipment that they buy from outside manufacturers, like Siemens and Roche Diagnostics. Before those devices can be sold, they must be approved by the F.D.A.

* Japan's ultra-nationalists 
- http://www.nytimes.com/2014/12/03/world/asia/japanese-right-attacks-newspaper-on-the-left-emboldening-war-revisionists.html
- NYT ed - http://www.nytimes.com/2014/12/04/opinion/whitewashing-history-in-japan.html?module=Search&mabReward=relbias&
- Rebuttal - http://www.nytimes.com/2014/12/15/opinion/japans-wartime-record.html

* What is the definition of a Good Life? -- http://www.huffingtonpost.com/smita-malhotra/redefining-happiness-in-india_b_6276642.html

* What you learn in your 40s -- http://www.nytimes.com/2014/03/01/opinion/sunday/what-you-learn-in-your-40s.html

* Gold in Diagnostics -- http://www.gold.org/advanced_by_gold/#!science-en
* Diagnostics -- http://www.health.harvard.edu/diagnostic-tests/

* Buildings - Architecture -- http://www.buzzfeed.com/autodeskeducation/the-most-unique-pieces-of-architecture-around-the-worl?b=1

* The geopolitical impact of cheap oil -- http://www.project-syndicate.org/commentary/oil-prices-geopolitical-stability-by-martin-feldstein-2014-11

* Plants vs Solar PVs -- http://www.economist.com/blogs/economist-explains/2014/12/economist-explains-1?fsrc=scn/tw/te/bl/ed/howplantsexploitsunlightsoefficiently

* Obituary - Justice Krishna Aiyer - http://scroll.in/article/693239/Justice-Krishna-Iyer-was-a-judge,-conscience-keeper,-legend,-enigma,-seeker

* The cost of a new drug -- http://www.economist.com/news/business/21635005-startling-new-cost-estimate-new-medicines-met-scepticism-price-failure?fsrc=scn/tw/te/ed/pe

* Economist - The Spy who hacked me -- http://www.economist.com/news/international/21635044-malicious-computer-code-making-spooks-job-easier-ever-spy-who-hacked-me

* Sony - Cybersecurity - Malware -- http://www.reuters.com/article/2014/12/02/us-sony-cybersecurity-malware-idUSKCN0JF3FE20141202
* SOny got hacked hard -- http://www.wired.com/2014/12/sony-hack-what-we-know/?mbid=social_twitter

Children of Gebelawi

It seems Egyptian author and Nobel laureate Naguib Mahfouz got stabbed in the neck for writing this book.

What was so offensive about "Children of Gebelawi"?

When I picked this book, I was hoping to come across the kind of stuff that riles up the zealots and fanatics. Instead of this, it seemed no more offensive than a stretched out narrative of a family patriarch who has a looming presence (just like the cover!) across five generations. It is about 'chiefs' who lord over their respective quarters, rebellious youngsters and murderous siblings.

It seems many folks in the Middle East were offended by the allegorical portrayal of God.

From what I could make out God and religion are not even marginal to the story-line.

So is it a case like "PK" in India where self-appointed guardians of religion went berserk, and seemed quite delighted to find an opportunity to get offended?

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Plants, Light & Excitons

Once in a while, the Economist publishes an article where the reader's comments turn out to be a lot more interesting than the original piece. Here is one  -

TE (3Dec14): HOW PLANTS EXPLOIT SUNLIGHT SO EFFICIENTLY - http://www.economist.com/blogs/economist-explains/2014/12/economist-explains-1?fsrc=scn/tw/te/bl/ed/howplantsexploitsunlightsoefficiently

The main point of contention is this claim by the TE author -

"The very best photovoltaic cells, the kind seen on many roofs, convert sunlight to electrical energy with an efficiency of around 35%; for more affordable cells the figure is closer to 20%. Plants accomplish the same process with about 90% efficiency during the first stage of photosynthesis."

Are plants really so efficient?

A reader contests this claim by quoting three articles:

• Scientific American (2011): http://www.scientificamerican.com/article/plants-versus-photovoltaics-at-capturing-sunlight/
• ScienceMag - http://www.sciencemag.org/content/332/6031/805.full
• Current Opinion in Biotech (2008): http://sippe.ac.cn/gh/2008%20Annual%20Report/Zhu%20X-G.pdf

He then reiterates the original question - where did TE source the '90% efficiency' figure?

No answers yet from the Economist.

Treating Nephrotic Syndrome in India

Last week we learnt the difference between a Syndrome and a Disease.

Our hyperactive, skinny four-year-old son, Aki,  had just recovered from a cough & cold, when he suddenly started looking a lot healthier. His cheeks filled out and his clothes started getting tighter. We were rather pleased at first -- until we realized that he had been putting on about 300g everyday without any significant change in his diet.

Our pediatrician recommended three tests (blood, urine and chest x-ray), and told us  to immediately cut down on Aki's salt and fat consumption while increasing his intake of proteins  - especially egg whites. The tests soon confirmed what he suspected:  loss of protein in urine (proteinuria), retention of water within the body (edema), high cholesterol and creatine levels -- a classic case of Nephrotic Syndrome (NS).

A syndrome is a set of symptoms or conditions that suggest the presence of a disease. In the case of Nephrotic Syndrome, all the symptoms do not even point to a disease but merely signal the onset of  a sudden change in the functioning of one set of cells within our kidneys, the nephrons.

The nephrons contain two parts - a wool-ball shaped Glomerulus, and a long, coiled Tubule. Blood is filtered by the glomerulus and the filterate goes down the tubule which  takes back useful stuff and excretes the harmful ones as urine. Under NS, the glomeruli - quite inexplicably - start removing protein molecules from the blood. This is unusual, not only because proteins are usually large, heavy molecules, but due to the fact that proteins are rarely wasted; the body needs them build and repair tissues.

Aki's body had swelled up from 14kg to 18.5kg in less than ten days. So the doctor prescribed diuretics to reduce accumulated body fluid, and, rather disconcertingly, an extended three-month dosage of steroids. Sensing our alarm, the doctor said that we had two options: Prednisolone, a corticosteroid that had been tried & tested for the past 35 years. Possible side-effects included stomach pain, high BP, change in body appearance, increased hair and retardation of growth. The alternative was to go for a more recently developed drug with possibly milder side-effects.

So the Rx was:

• Deflazacort - Defcort 18mg (twice a day * 7 days) - Glucocorticoid
• Lasix 20mg (once a day * 2 days) - Diuretic
• Multivitamins, calcium supplements, antacids

Two days later, when the swelling refused to subside, we went for a second-opinion to a specialist Pediatric Nephrologist at Apollo Hospital. The elderly doctor felt that the diagnosis was spot-on but the prescription had to be changed. He handed us a useful booklet titled "Nephrotic Syndrome in Children", and reverted to the tried-and-tested protocol:

• Prednisolone (Omnacortil / Wysolone - 20mg morning; 15mg evening) - Glucocorticoid
• Zylynix one 2.5mg  dose followed by Lasix 40mg (once day * 3 days)
• Continuation of the multivitamins (Zincovit), calcium (Ostocalcium) and antacid (Digene)

The effects were immediate. Almost overnight, Aki's body-weight came down from 18.5kg to 16kg. The side effects too were just as we were warned, especially the stomach aches, the tendency to be "excessively happy, quiet or abnormally active".

We are now one week down with the drugs, with five more to go...


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Unanswered Qs:

- How was NS treated before the discovery of steroids?
- Why are cortocosteroid tablets so cheap? (not that I'm complaining!) - The new corticosteroid, Defcort-18mg cost Rs.19/tab while the older formulation costs just few paise!
- How do the steroids plug the sieves in the Glomeruli? What else does it do within the body to other organs?
- What makes the tablets so bitter?

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LINKS & REFERENCES:

* Srivastava, RN (1975): Nephrotic Syndrome in Indian Children, Archives of Disease in Childhood, 1975 - url - http://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC1545499&blobtype=pdf
* Comparing Glucocorticoids: Prednisolone vs. Deflazacort - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763756/

The Beetles

Can't wait to get my hands on this -

Review: Wired - http://www.wired.com/2014/12/field-guide-strange-surprising-world-beetles/