Evolution of Cryptococcus gattii — from neurological disease agent in South America — to a pulmonary one in the American Pacific Northwest — demonstrates the kind of medical threat that biological change can pose

© 2014 Peter Free

Citation — to study

David M. Engelthaler, Nathan D. Hicks, John D. Gillece, Chandler C. Roe, James M. Schupp, Elizabeth M. Driebe, Felix Gilgado, Fabian Carriconde, Luciana Trilles, Carolina Firacative, Popchai Ngamskulrungroj, Elizabeth Castañeda, Marcia dos Santos Lazera, Marcia S. C. Melhem, Åsa Pérez-Bercoff, Gavin Huttley, Tania C. Sorrell, Kerstin Voelz, Robin C. May, Matthew C. Fisher, George R. Thompson III, Shawn R. Lockhart, Paul Keim, and Wieland Meyer, Cryptococcus gattii in North American Pacific Northwest: Whole-Population Genome Analysis Provides Insights into Species Evolution and Dispersal, mBio 5 (4): e01464-14, DOI: 10.1128/mBio.01464-14 (15 July 2014)

Citation — to press release

Steve Yozwiak, TGen-led international study finds likely origin of virulent lung fungus invading Pacific Northwest, Translational Genomics Research Institute (15 July 2014)

Citation — background article

Jennifer Frazer, Strange Fungi Now Stalk Healthy People, Scientific American 309 (6): ?? (01 December 2013)

Problem, method and findings

From the abstract:

The emergence of distinct populations of Cryptococcus gattii in the temperate North American Pacific Northwest (PNW) was surprising, as this species was previously thought to be confined to tropical and semitropical regions.

Beyond a new habitat niche, the dominant emergent population displayed increased virulence and caused primary pulmonary disease, as opposed to the predominantly neurologic disease seen previously elsewhere.

Whole-genome sequencing was performed on 118 C. gattii isolates, including the PNW subtypes and the global diversity of molecular type VGII, to better ascertain the natural source and genomic adaptations leading to the emergence of infection in the PNW.

Overall, the VGII population was highly diverse, demonstrating large numbers of mutational and recombinational events; however, the three dominant subtypes from the PNW were of low diversity and were completely clonal.

Although strains of VGII were found on at least five continents, all genetic subpopulations were represented or were most closely related to strains from South America.

The phylogenetic data are consistent with multiple dispersal events from South America to North America and elsewhere.

Numerous gene content differences were identified between the emergent clones and other VGII lineages, including genes potentially related to habitat adaptation, virulence, and pathology.

Evidence was also found for possible gene introgression from Cryptococcus neoformans var. grubii that is rarely seen in global C. gattii but that was present in all PNW populations.

These findings provide greater understanding of C. gattii evolution in North America and support extensive evolution in, and dispersal from, South America.

© 2014 David M. Engelthaler, Nathan D. Hicks, John D. Gillece, Chandler C. Roe, James M. Schupp, Elizabeth M. Driebe, Felix Gilgado, Fabian Carriconde, Luciana Trilles, Carolina Firacative, Popchai Ngamskulrungroj, Elizabeth Castañeda, Marcia dos Santos Lazera, Marcia S. C. Melhem, Åsa Pérez-Bercoff, Gavin Huttley, Tania C. Sorrell, Kerstin Voelz, Robin C. May, Matthew C. Fisher, George R. Thompson III, Shawn R. Lockhart, Paul Keim, and Wieland Meyer, Cryptococcus gattii in North American Pacific Northwest: Whole-Population Genome Analysis Provides Insights into Species Evolution and Dispersal, mBio 5 (4): e01464-14, DOI: 10.1128/mBio.01464-14 (15 July 2014) (paragraph split)

The moral? — A nasty reminder that (i) microbiological evolution, (ii) local ecology, and presumably (iii) modern travel occasionally combine to make significant trouble

If you read Jennifer Frazer’s Scientific American article about Cryptococcus gattii, you will see that the fungus (a) can be lethal (b) in people who are not apparently immuno-compromised.

Higher resolution NOAA climate model — suggests that southwestern Australia drying is due to anthropogenic greenhouse gases and ozone thinning — not volcanic emissions or changes in solar radiation

© 2014 Peter Free

Citation — to study

Thomas L. Delworth and Fanrong Zeng, Regional rainfall decline in Australia attributed to anthropogenic greenhouse gases and ozone levels, Nature Geoscience, DOI:10.1038/ngeo2201 (online, 13 July 2014)

Citation — to press release

Monica Allen, New NOAA climate model shows Australia’s long-term rainfall decline due to human-caused climate change, National Oceanic and Atmospheric Administration (14 July 2014)

Method and findings

From the abstract:

Precipitation in austral autumn and winter has declined over parts of southern and especially southwestern Australia in the past few decades.

According to observations and climate models, at least part of this decline is associated with changes in large-scale atmospheric circulation, including a poleward movement of the westerly winds and increasing atmospheric surface pressure over parts of southern Australia.

Here we use a high-resolution global climate model to analyse the causes of this rainfall decline.

In our simulations, many aspects of the observed regional rainfall decline over southern and southwest Australia are reproduced in response to anthropogenic changes in levels of greenhouse gases and ozone in the atmosphere, whereas anthropogenic aerosols do not contribute to the simulated precipitation decline.

Simulations of future climate with this model suggest amplified winter drying over most parts of southern Australia in the coming decades in response to a high-end scenario of changes in radiative forcing. The drying is most pronounced over southwest Australia, with total reductions in austral autumn and winter precipitation of approximately 40% by the late twenty-first century.

© 2014 Thomas L. Delworth and Fanrong Zeng, Regional rainfall decline in Australia attributed to anthropogenic greenhouse gases and ozone levels, Nature Geoscience, DOI:10.1038/ngeo2201 (online, 13 July 2014) (paragraph split)

NOAA adds:

Simulating natural and manmade climate drivers, scientists showed that the decline in rainfall is primarily a response to manmade increases in greenhouse gases as well as a thinning of the ozone caused by manmade aerosol emissions.

Several natural causes were tested with the model, including volcano eruptions and changes in the sun’s radiation. But none of these natural climate drivers reproduced the longS-term observed drying, indicating this trend is due to human activity.

© 2014 Monica Allen, New NOAA climate model shows Australia’s long-term rainfall decline due to human-caused climate change, National Oceanic and Atmospheric Administration (14 July 2014)

Caveat

Obviously a model might be skewed to show larger impacts from selected inputs.  If we are ignorant of the dynamic effects of various mixes of contributing variables, models will tend to be guesses, at best.

The moral? — Quasi-evidence, even with the caveat

Thomas Delworth noted that:

“The study of Australian drought helps to validate this new model, and thus builds confidence in this model for ongoing studies of North American drought.”

© 2014 Monica Allen, New NOAA climate model shows Australia’s long-term rainfall decline due to human-caused climate change, National Oceanic and Atmospheric Administration (14 July 2014)

Studying the southwestern US drought may benefit from more varied terrain and (presumably) numerically more and longer recorded data-collecting points.

Bolivian Andes atmospheric ultraviolet measurements set record high

© 2014 Peter Free

Citation — to study

Nathalie A. Cabrol, Uwe Feister, Donat-Peter Häder, Helmut Piazena, Edmond A. Grin, and Andreas Klein, Record solar UV irradiance in the tropical Andes, Frontiers in Environmental Science, DOI: 10.3389/fenvs.2014.00019 (08 July 2014)

Citation — to press release

Frontiers, Record levels of solar ultraviolet on Earth’s surface measured in South America, ScienceDaily (08 July 2014)

Findings and implications

From the well written abstract:

High elevation, thin ozone layer, and clear sky produce intense ultraviolet (UV) radiation in the tropical Andes.

Recent models suggest that tropical stratospheric ozone will slightly decrease in the coming decades, potentially resulting in more UV anomalies.

Data collected between 4300 and 5916 m above sea level (asl) in Bolivia show how this trend could dramatically impact surface solar irradiance.

During 61 days, two Eldonet dosimeters recorded extreme UV-B irradiance equivalent to a UV index (UVI) of 43.3, which is the highest ground value ever reported.

If they become more common, events of this magnitude may have societal and ecological implications, which make understanding the process leading to their generation critical.

© 2014 Nathalie A. Cabrol, Uwe Feister, Donat-Peter Häder, Helmut Piazena, Edmond A. Grin, and Andreas Klein, Record solar UV irradiance in the tropical Andes, Frontiers in Environmental Science, DOI: 10.3389/fenvs.2014.00019 (08 July 2014) (paragraph split)

Human health implication

From the press release:

“A UV index of 11 is considered extreme, and has reached up to 26 in nearby locations in recent years,” notes [Nathalie] Cabrol.

“But on December 29, 2003, we measured an index of 43.

If you’re at a beach in the U.S., you might experience an index of 8 or 9 during the summer, intense enough to warrant protection. You simply do not want to be outside when the index reaches 30 or 40.”

© 2014 Frontiers, Record levels of solar ultraviolet on Earth’s surface measured in South America, ScienceDaily (08 July 2014) (paragraph split)

A good example of a soundly presented abstract

The overview of the study:

(i) briefly names the elements that cause high ultraviolet levels on our planet,

(ii) what the team found in Bolivia,

(iiii) at what altitudes

and

(iv) why the findings might be important.

All in one short paragraph.

The moral? — Significance (as yet) uncertain

I doubt that Andean measurements of UV radiation are numerous over a noteworthy length of time.  Which means that it is difficult to put the team’s UV measurements into a reliable context, even in this one place.

Throw in the uncertainties regarding climate change and its effect on UV at Andean altitudes (or anywhere else) — and you have (scientifically speaking) little more than a valuable set of data points.

A recently gathered, more complete record of volcanic sulfate emissions for the last 2,000 years may improve climate models

© 2014 Peter Free

Citation — to study

Michael Sigl, Joseph R. McConnell, Matthew Toohey, Mark Curran, Sarah B. Das, Ross Edwards, Elisabeth Isaksson, Kenji Kawamura, Sepp Kipfstuhl, Kirstin Krüger, Lawrence Layman, Olivia J. Maselli, Yuko Motizuki, Hideaki Motoyama, Daniel R. Pasteris, and Mirko Severi, Insights from Antarctica on volcanic forcing during the Common Era, Nature Climate Change, DOI:10.1038/nclimate2293 (published online, 06 July 2014)

Citation — to press release

DHS News, Rewriting the history of volcanic forcing during the past 2000 years, Division of Hydrologic Sciences – Desert Research Institute (inexplicably not dated)

Context, method and findings

From the abstract:

Assessments of climate sensitivity to projected greenhouse gas concentrations underpin environmental policy decisions, with such assessments often based on model simulations of climate during recent centuries and millennia.

These simulations depend critically on accurate records of past aerosol forcing from global-scale volcanic eruptions, reconstructed from measurements of sulphate deposition in ice cores.

Non-uniform transport and deposition of volcanic fallout mean that multiple records from a wide array of ice cores must be combined to create accurate reconstructions.

Here we re-evaluated the record of volcanic sulphate deposition using a much more extensive array of Antarctic ice cores.

In our new reconstruction, many additional records have been added and dating of previously published records corrected through precise synchronization to the annually dated West Antarctic Ice Sheet Divide ice core, improving and extending the record throughout the Common Era.

Whereas agreement with existing reconstructions is excellent after 1500, we found a substantially different history of volcanic aerosol deposition before 1500;

for example, global aerosol forcing values from some of the largest eruptions (for example, 1257 and 1458) previously were overestimated by 20–30% and others underestimated by 20–50%.

© 2014 Michael Sigl, Joseph R. McConnell, Matthew Toohey, Mark Curran, Sarah B. Das, Ross Edwards, Elisabeth Isaksson, Kenji Kawamura, Sepp Kipfstuhl, Kirstin Krüger, Lawrence Layman, Olivia J. Maselli, Yuko Motizuki, Hideaki Motoyama, Daniel R. Pasteris, and Mirko Severi, Insights from Antarctica on volcanic forcing during the Common Era, Nature Climate Change, DOI:10.1038/nclimate2293 (published online, 06 July 2014) (paragraph split)

The press release adds:

In total, the study incorporated 26 precisely synchronized ice core records collected at an array of 19 sites from across Antarctica.

“This work is the culmination of more than a decade of collaborative ice core collection and analysis in our lab here at DRI,” said Joe McConnell, a research professor at DRI who developed the continuous-flow analysis system used to analyze the ice cores.

© 2014 DHS News, Rewriting the history of volcanic forcing during the past 2000 years, Division of Hydrologic Sciences – Desert Research Institute (inexplicably not dated)

The moral? — What we previously assumed (apparently) was not correct

Meaning that existing climate models almost certainly need revision — assuming (of course) that this team’s interpretations of their data are more accurate than previous ones.

Beryllium lung disease is apparently caused — not by the metal ion itself — but by a change in the shape of the HLA protein in which it lodges

© 2014 Peter Free

Citation — to study

Gina M. Clayton, Yang Wang, Frances Crawford, Andrey Novikov, Brian T. Wimberly, Jeffrey S. Kieft, Michael T. Falta, Natalie A. Bowerman, Philippa Marrack, Andrew P. Fontenot, Shaodong Daiemail, and John W. Kappler, Structural Basis of Chronic Beryllium Disease: Linking Allergic Hypersensitivity and Autoimmunity, Cell 158 (1): 132-142, DOI: 10.1016/j.cell.2014.04.048 (03 July 2014)

Citation — to press release

Newsroom, Researchers Learn How Beryllium Causes Deadly Lung Disease, National Jewish Health (03 July 2014)

Method and findings

From National Jewish Health’s well written explanation:

Using exquisitely detailed maps of molecular shapes and the electrical charges surrounding them, researchers at National Jewish Health have discovered how the metal beryllium triggers a deadly immune response in the lungs.

About 85 percent of people who develop chronic beryllium disease have an immune system protein known as HLA-DP2.

Cells throughout the body use this molecule to tell the immune system what is going on inside of them. HLA-DP2 sits on the cell surface holding small protein fragments taken from the cell’s interior. Immune system sentinels known as T cells bump against HLA-DP2 and its displayed protein fragment.

If the protein fragment is derived from the body’s own proteins, the T cell ignores it; if it is a foreign peptide, say from a bacterium, virus or other pathogen, the T cell sounds the alarm and triggers an immune response.

HLA-DP2 differs from most other peptide-presenting proteins by a single amino acid.

Dr. Kappler and his colleagues performed a series of highly detailed genetic, X-ray diffraction, molecular binding and electrostatic studies to show how this single amino acid can combine with other amino acids from HLA-DP2 and some of its bound self-peptides to create a unique molecular pocket that captures a single beryllium ion along with a sodium ion.

The peptides that bind to HLA-DP2 come from the body’s own tissues and normally elicit no immune response. With the beryllium and sodium firmly lodged in the molecular pocket, however, those peptides have a very slightly altered shape and electrical charge, which roving T cells recognize as foreign and dangerous. They initiate an immune response that causes inflammation and scarring in the lungs.

“This response resembles allergic hypersensitivity in that a metal ion causes an allergic reaction,” said Dr. Kappler.

“But it also resembles autoimmunity in that the immune system is mounting an attack against a self-peptide. It is a new form of immune response, and may lead to new therapeutic strategies to treat and prevent the disease.”

© 2014 Newsroom, Researchers Learn How Beryllium Causes Deadly Lung Disease, National Jewish Health (03 July 2014) (extracts)

The moral? — Shape and charge distribution matter

Which is why molecular biology is both understandable and challenging.

Brain appears to reroute auditory-induced emotional processing that occurs in tinnitus patients — from the amygdala to the insula and parahippocampus — a case of probably adaptive neural plasticity — that may help preserve neural processing times

© 2014 Peter Free

Citation — to study

Jake R. Carpenter-Thompson, Kwaku Akrofi, Sara A. Schmidt, Florin Dolcos, and Fatima T. Husain, Alterations of the emotional processing system may underlie preserved rapid reaction time in tinnitus, Brain Research 1567: 28-41, DOI: 10.1016/j.brainres.2014.04.024  (03 June 2014)

Citation — to press release

Chelsey B. Coombs, People with tinnitus process emotions differently from their peers, researchers report, News Bureau – University of Illinois (25 June 2013)

Method

Journalist Chelsey Coombs’ press release explains that:

Three groups of participants were used in the study:

people with mild-to-moderate hearing loss and mild tinnitus;

people with mild-to-moderate hearing loss without tinnitus;

and

a control group of age-matched people without hearing loss or tinnitus.

Each person was put in an fMRI machine and listened to a standardized set of 30 pleasant, 30 unpleasant and 30 emotionally neutral sounds (for example, a baby laughing, a woman screaming and a water bottle opening).

The participants pressed a button to categorize each sound as pleasant, unpleasant or neutral.

© 2014 Chelsey B. Coombs, People with tinnitus process emotions differently from their peers, researchers report, News Bureau – University of Illinois (25 June 2013) (reformatted)

Findings

From the abstract:

The TIN [tinnitus] and NH [normal hearing] groups, but not the HL [hearing loss without tinnitus] group, responded faster to affective sounds compared to neutral sounds.

The TIN group had elevated response in bilateral parahippocampus and right insula compared to the NH group, and left parahippocampus compared to HL controls for pleasant relative to neutral sounds.

A region-of-interest analysis detected increased activation for NH controls in the right amygdala when responding to affective stimuli, but failed to find a similar heightened response in the TIN and HL groups.

All three groups showed increased response in auditory cortices for the affective relative to neutral sounds comparisons.

Our results suggest that the emotional processing network is altered in tinnitus to rely on the parahippocampus and insula, rather than the amygdala, and this alteration may maintain a select advantage for the rapid processing of affective stimuli despite the hearing loss.

© 2014 Jake R. Carpenter-Thompson, Kwaku Akrofi, Sara A. Schmidt, Florin Dolcos, and Fatima T. Husain, Alterations of the emotional processing system may underlie preserved rapid reaction time in tinnitus, Brain Research 1567: 28-41, DOI: 10.1016/j.brainres.2014.04.024  (03 June 2014) (paragraph split)

Tentative conclusion phrased in lay terms

From the press release:

“We thought that because people with tinnitus constantly hear a bothersome, unpleasant stimulus, they would have an even higher amount of activity in the amygdala when hearing these sounds, but it was lesser,” [Fatima Husein] said.

“Because they’ve had to adjust to the sound, some plasticity in the brain has occurred. They have had to reduce this amygdala activity and reroute it to other parts of the brain because the amygdala cannot be active all the time due to this annoying sound.”

© 2014 Chelsey B. Coombs, People with tinnitus process emotions differently from their peers, researchers report, News Bureau – University of Illinois (25 June 2013) (paragraph split)

Caveat

One exceedingly obvious caveat is that neither the abstract nor the release says anything about the numbers of subjects or their demographic distribution.

The moral? — The overall effect of the fMRI-detected brain region rerouting is uncertain

The negative emotional effect of tinnitus appears to remain.  Coombs points out that:

Fatima Husain, who led the study, said previous studies showed that tinnitus is associated with increased stress, anxiety, irritability and depression, all of which are affiliated with the brain’s emotional processing systems.

© 2014 Chelsey B. Coombs, People with tinnitus process emotions differently from their peers, researchers report, News Bureau – University of Illinois (25 June 2013)

Changing toward a healthy lifestyle in young adults can moderately reduce the risk for cardiovascular disease in middle age — a study of 3,538 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) prospective cohort

© 2014 Peter Free

Citation — to study

Bonnie Spring, Arlen C. Moller, Laura A. Colangelo, Juned Siddique, Megan Roehrig, Martha L. Daviglus, Joseph F. Polak, Jared P. Reis, Stephen Sidney, and Kiang Liu, Healthy Lifestyle Change and Subclinical Atherosclerosis in Young Adults: Coronary Artery Risk Development in Young Adults (CARDIA) Study, Circulation 130 (1): 10-17, DOI:10.1161/CIRCULATIONAHA.113.005445 (July 2014)

Citation — to press release

Erin White, Adults Can Undo Heart Disease Risk, Northwestern University (30 June 2014)

Method and findings

From the abstract:

The Coronary Artery Risk Development in Young Adults (CARDIA) prospective cohort study (n=3538) assessed 5 healthy lifestyle factors (HLFs) among young adults aged 18 to 30 years (year 0 baseline) and 20 years later (year 20):

not overweight/obese,

low alcohol intake,

healthy diet,

physically active,

We tested whether change from year 0 to 20 in a continuous composite HLF score . . . is associated with subclinical atherosclerosis (coronary artery calcification and carotid intima-media thickness) at year 20, after adjustment for demographics, medications, and baseline HLFs.

By year 20, 25.3% of the sample improved . . . 40.4% deteriorated . . . 34.4% stayed the same; and 19.2% had coronary artery calcification.

Each increase in HLFs was associated with reduced odds of detectable coronary artery calcification (odds ratio=0.85 . . .) and lower intima-media thickness . . . and each decrease in HLFs was predictive to a similar degree of greater odds of coronary artery calcification (odds ratio=1.17 . . . ) and greater intima-media thickness . . . .

© 2014 Bonnie Spring, Arlen C. Moller, Laura A. Colangelo, Juned Siddique, Megan Roehrig, Martha L. Daviglus, Joseph F. Polak, Jared P. Reis, Stephen Sidney, and Kiang Liu, Healthy Lifestyle Change and Subclinical Atherosclerosis in Young Adults: Coronary Artery Risk Development in Young Adults (CARDIA) Study, Circulation 130 (1): 10-17, DOI:10.1161/CIRCULATIONAHA.113.005445 (July 2014) (paragraph split and reformatted)

Significance

From the press release:

“This finding is important because it helps to debunk two myths held by some health care professionals,” [Bonnie] Spring said.

“The first is that it’s nearly impossible to change patients’ behaviors. Yet, we found that 25 percent of adults made healthy lifestyle changes on their own.

“The second myth is that the damage has already been done — adulthood is too late for healthy lifestyle changes to reduce the risk of developing coronary artery disease. Clearly, that’s incorrect. Adulthood is not too late for healthy behavior changes to help the heart.”

The bad news is that 40 percent of this sample lost healthy lifestyle factors and acquired more bad habits as they aged.

“That loss of healthy habits had a measurable negative impact on their coronary arteries,” Spring said.

“Each decrease in healthy lifestyle factors led to greater odds of detectable coronary artery calcification and higher intima-media thickness.

“Adulthood isn’t a ‘safe period’ when one can abandon healthy habits without doing damage to the heart. A healthy lifestyle requires upkeep to be maintained.”

© 2014 Erin White, Adults Can Undo Heart Disease Risk, Northwestern University (30 June 2014) (paragraphs split)

The moral? — A cause for both pessimism and optimism

I think Dr. Spring may have been too harsh in regard to her negative evaluation of health care myths.  If 75 percent of a patient sample stays unhealthy or becomes even more so, it seems to me that the conventional pessimism is substantially upheld.  Loosely stated, three of four patients will ignore what health “authorities” tell them to do.

On the other hand, if 25 percent of a youthful sample does what is “good” for them, they will perhaps decrease their odds of developing atherosclerosis by 15 percent.  In healthcare, that is a substantial reduction in risk.

Recognizing BS when you read it — “Hitherto unrecognized feedback” salinity climate mechanism — from 2.6 million years ago — set out in a journal abstract absent the slightest supporting detail

Citation — to study

Junsheng Nie, Thomas Stevens, Yougui Song, John W. King, Rui Zhang, Shunchuan Ji, Lisha Gong and Danielle Cares, Pacific freshening drives Pliocene cooling and Asian monsoon intensification, Scientific Reports 4: 5474, DOI: 10.1038/srep05474 (27 June 2014)

Citation — to press release

Press Office, Research provides new theory on cause of ice age 2.6 million years ago, Royal Holloway University of London (27 June 2014)

The claim — in lay terms

From Royal Holloway University of London:

New research published today in the journal Nature Scientific Reports has provided a major new theory on the cause of the ice age that covered large parts of the Northern Hemisphere 2.6 million years ago.

The study, co-authored by Dr Thomas Stevens, from the Department of Geography at Royal Holloway, University of London, found a previously unknown mechanism by which the joining of North and South America changed the salinity of the Pacific Ocean and caused major ice sheet growth across the Northern Hemisphere.

©2014  Press Office, Research provides new theory on cause of ice age 2.6 million years ago, Royal Holloway University of London (27 June 2014)

The claim — in “scientific” terms

In its totality, as presented by the abstract:

The monsoon is a fundamental component of Earth’s climate. The Pliocene warm period is characterized by long-term global cooling yet concurrent monsoon dynamics are poorly known.

Here we present the first fully quantified and calibrated reconstructions of separate Pliocene air temperature and East Asian summer monsoon precipitation histories on the Chinese Loess Plateau through joint analysis of loess/red clay magnetic parameters with different sensitivities to air temperature and precipitation.

East Asian summer monsoon precipitation shows an intensified trend, paradoxically at the same time that climate cooled.

We propose a hitherto unrecognized feedback where persistently intensified East Asian summer monsoon during the late Pliocene, triggered by the gradual closure of the Panama Seaway, reinforced late Pliocene Pacific freshening, sea-ice development and ice volume increase, culminating in initiation of the extensive Northern Hemisphere glaciations of the Quaternary Ice Age.

This feedback mechanism represents a fundamental reinterpretation of the origin of the Quaternary glaciations and the impact of the monsoon.

Junsheng Nie, Thomas Stevens, Yougui Song, John W. King, Rui Zhang, Shunchuan Ji, Lisha Gong and Danielle Cares, Pacific freshening drives Pliocene cooling and Asian monsoon intensification, Scientific Reports 4: 5474, DOI: 10.1038/srep05474 (27 June 2014) (paragraph split)

This is not the way to present a new hypothesis in persuasive fashion

When speculating about something that happened 2.6 million years ago, based on (a) novel interpretations of (b) already proxy-derived climate data — the phrase “hitherto unrecognized feedback” is unlikely to inspire confident support.

Additionally, doing this is in an information-absent way weakens the already tenuous impression of credibility.

The moral? — New hypothesis or theory? — Give it a persuasive launch with a solidly reasoned abstract

My impression is that this proposed salinity-climate feedback connection — based on the merging of North and South America — is probably too absent in proven (or provable) data and mechanisms to be more than attention-seeking BS.

We do not understand how climate works today, so why would we think we can understand a different set of conditions 2.6 million years ago?

A study of 4,141 anaphylaxis registry patients in Austria, Germany and Switzerland appears to show that epinephrine is underused in emergency treatment

© 2014 Peter Free

Citation — to study

M Worm, M, O Eckermann, S Dölle, W Aberer, W, K Beyer, T Hawranek, S Hompes, A Koehli, V Mahler, K Nemat, B Niggemann, C Pföhler, U Rabe, A Reissig, E Rietschel, K Scherer, R Treudler, and F Ruëff, Triggers and Treatment of Anaphylaxis: An Analysis of 4000 Cases From Germany, Austria and Switzerland, Deutsche Artzeblatt International, 111 (21): 367-75, DOI: 10.3238/arztebl.2014.0367 (23 May 2014)

What is anaphylaxis?

From the paper’s first paragraphs:

Anaphylaxis is defined as an acute systemic reaction with the symptoms of an immediate allergic reaction that can affect the entire organism and is potentially life-threatening. Anaphylaxis can be fatal or lead to permanent damage.

Pathophysiologically, anaphylactic reactions—especially those triggered by foods or insect venom—are predominantly IgE-mediated, but in rare cases direct activation of the mast cells can be the cause.

At present no uniform worldwide definition of anaphylaxis exists. A mechanistic approach uses the term “anaphylaxis” for systemic generalized reactions of all degrees of severity.

The definition most often used today describes anaphylaxis as a severe generalized reaction with symptoms in various organ systems (skin and mucosa, respiratory tract, cardiovascular system, gastrointestinal tract).

© 2014 M Worm, M, O Eckermann, S Dölle, W Aberer, W, K Beyer, T Hawranek, S Hompes, A Koehli, V Mahler, K Nemat, B Niggemann, C Pföhler, U Rabe, A Reissig, E Rietschel, K Scherer, R Treudler, and F Ruëff, Triggers and Treatment of Anaphylaxis: An Analysis of 4000 Cases From Germany, Austria and Switzerland, Deutsche Artzeblatt International, 111 (21): 367-75, DOI: 10.3238/arztebl.2014.0367 (23 May 2014) (paragraphs split)

Method, findings and conclusion

Showing the utility of national health registries in retrieving pertinent data:

The study was carried out as a retrospective evaluation of data from the anaphylaxis registry (this records data about patients with severe allergic symptoms; that is, skin or mucosal symptoms and respiratory and/or cardiovascular symptoms in relation to triggers, symptoms, diagnostic procedures, concomitant diseases, and care) from 2006 to 2013, and from the documented callouts of the ADAC air rescue service from 2010 to 2011.

For severity grade III, the usage rate was 14.5% for the data from the anaphylaxis registry, 25% for the Berlin emergency physicians, and 19% for the air rescue service.

For severity grade IV, the usage rates were 43.9% for the anaphylaxis registry data, 100% for the Berlin emergency physicians, and 78% for the air rescue service.

Data on the emergency care of patients with severe allergic reactions show a discrepancy between the treatment recommendations given in current guidelines (epinephrine administration is recommended as a first line treatment from grade II upward) and the drugs actually given to patients.

© 2014 M Worm, M, O Eckermann, S Dölle, W Aberer, W, K Beyer, T Hawranek, S Hompes, A Koehli, V Mahler, K Nemat, B Niggemann, C Pföhler, U Rabe, A Reissig, E Rietschel, K Scherer, R Treudler, and F Ruëff, Triggers and Treatment of Anaphylaxis: An Analysis of 4000 Cases From Germany, Austria and Switzerland, Deutsche Artzeblatt International, 111 (21): 367-75, DOI: 10.3238/arztebl.2014.0367 (23 May 2014) (at Emergency Care and Discussion) (extracts)

Caveats

First, the authors note that the use of epinephrine in anaphylaxis rescue has not been definitively proven — meaning that it is possible that “dinging” practitioners for not using it for grade II reactions and up may be misguided:

The evidence that epinephrine administration has a positive influence on the survival of anaphylaxis patients is derived from earlier studies.

On the basis of these study results, epinephrine is recommended as the drug of choice in the guidelines for the acute treatment of severe allergic reactions, even though there are no prospective controlled studies of the efficacy and tolerability of epinephrine in the treatment of anaphylaxis.

It has been shown that patients who had received two doses of epinephrine before they reached the emergency room were less often hospitalized than patients who received the second or both doses in the emergency room. However, the case numbers in these cohorts were small (n = 58). Likewise, it was observed that persons who died as a result of an anaphylactic reaction had either received no or delayed epinephrine.

© 2014 M Worm, M, O Eckermann, S Dölle, W Aberer, W, K Beyer, T Hawranek, S Hompes, A Koehli, V Mahler, K Nemat, B Niggemann, C Pföhler, U Rabe, A Reissig, E Rietschel, K Scherer, R Treudler, and F Ruëff, Triggers and Treatment of Anaphylaxis: An Analysis of 4000 Cases From Germany, Austria and Switzerland, Deutsche Artzeblatt International, 111 (21): 367-75, DOI: 10.3238/arztebl.2014.0367 (23 May 2014) (at ninth paragraph under Discussion) (paragraph split)

Second, the data taken from Berlin practitioners was almost certainly slanted by the fact that they knew beforehand that epinephrine use was going to be tracked. Presumably, this group also knew that anaphylaxis treatment guidelines recommend epinephrine use.

Consequently, Berlin’s higher rates of epinephrine rescue cannot be taken as a reliable indicator of existing empirical practice, even among knowledgeable emergency providers.

The moral? — Medical treatment guidelines are (apparently) widely ignored, whether proven or not

This isn’t new information.  But, given the severity of grade IV analyphylaxis, it is slightly surprising.

One would think that in (a) life-threatening circumstances among (b) knowledgeable allergists and emergency practitioners, the presumed treatment of choice would dominate.

Patients beware.

Computer cloud data storage security issues — two predominant causes — both related to URL addresses

© 2014 Peter Free

Citation — to study

Cheng-Kang Chu, Wen-Tao Zhu, Jin Han, J K Liu,  Jia Xu, and Jianying Zhou, Security Concerns in Popular Cloud Storage Services, Pervasive Computing, IEEE 12 (4): 50-57, DOI: 10.1109/MPRV.2013.72 (October-Dec 2013)

Citation — to press release

Institute for Infocomm Research, Cracks emerge in the cloud, A*STAR Research (Singapore) (18 June 2014)

Method and findings

From the press release:

The A*STAR-led researchers analyzed the security of three well-known cloud service providers — Dropbox, Google Drive and Microsoft SkyDrive — and found that all three had vulnerabilities many users might encounter.

They uncovered several risks related to the sharing of secret URLs.

Because URLs are saved in various network-based servers, browser histories and Internet bookmarks, frequent opportunities exist for third parties to access private data.

Furthermore, the URL recipient may send the link to others without the data owner’s consent.

Another danger lies in the practice of URL shortening — reducing long web addresses to brief alphanumeric sequences for easier sharing on mobile devices.

Although the original URL may point to a privately shared file, shortening changes this address into plain text unprotected by encryption. [Jianying] Zhou also notes that because short URLs have very limited lengths, they are susceptible to brute-force attacks that can dig out supposedly secret files.

Zhou explains that the root cause of cloud security problems lies in the need to balance usability with privacy protection.

“Users should be careful when they share files in the cloud because no system is perfectly secure. The cloud industry, meanwhile, needs to constantly raise the bar against new attacks while keeping the service as functional as possible.”

© 2014 Institute for Infocomm Research, Cracks emerge in the cloud, A*STAR Research (Singapore) (18 June 2014) (paragraphs split)

The moral? — Be careful what you store in the cloud

. . . especially if you have a fiduciary duty to those whom the data concerns.