Trump should be tested for a degenerative brain disease

I copy below a really scary article by Dr. Ford Vox who
is a medical journalist and commentator who practices brain injury medicine

When President Trump slurred his words during a news conference this week, some Trump watchers speculated that he was having a stroke. I watched the clip and, as a physician who specializes in brain function and disability, I don't think a stroke was behind the slurred words. But having evaluated the chief executive's remarkable behavior through my clinical lens for almost a year, I do believe he is displaying signs that could indicate a degenerative brain disorder.
As the president's demeanor and unusual decisions raise the potential for military conflict in two regions of the world, the questions surrounding his mental competence have become urgent and demand investigation.
Until now, most of the focus has been on the president's psychology. It's now time to think of the president's neurology - and the possibility of an organic brain disorder.
Every day of my working life, I evaluate people with brain injuries. It falls to me to make decisions about what is normal and what is not, what can improve and what will not, whether or not my patients can work, what kind of work they can do, and pretty much everything else.
In turning my attention to the president, I see worrisome symptoms that fall into three main categories: problems with language and executive function; problems with social cognition and behavior; and problems with memory, attention, and concentration. None of these are symptoms of being a bad or mean person. Nor do they require spelunking into the depths of his psyche to understand. Instead, they raise concern for a neurocognitive disease process in the same sense that wheezing raises the alarm for asthma.
Here's the evidence on which I base my conclusion that it would be prudent for the president to be tested for a brain disorder.

Language and executive dysfunction

Language is closely tied with cognition, and the president's speech patterns are increasingly repetitive, fragmented, devoid of content, and restricted in vocabulary. Trump's overuse of superlatives like tremendous, fantastic, and incredible are not merely elements of personal style. These filler words reflect reduced verbal fluency. Full transcripts of the president's interviews with outlets like the New York Times and Time reveal the extent of his disorganized thought patterns.
The problem becomes especially apparent in the transcript format, where his thinking is no longer camouflaged by visual accompaniments to communication like facial expressions and gesticulations. Some outlets have sought to protect the president, forgiving his lapses by declining to publish full transcripts. When Politico published a leaked transcript of the Wall Street Journal's July interview, we learned that the president's intellectual curiosity rises to the level of introductory geography: "You call places like Malaysia, Indonesia, and you say, you know, how many people do you have? And it's pretty amazing how many people they have."
The president made that remark in response to a question about the ideal corporate tax rate, demonstrating the degree to which his thinking drifts. The problems with language expression extend to language interpretation, the likely source of the president's gross misunderstanding of London Mayor Sadiq Khan's message to his city in the wake of a terror attack in June.

Dysfunction of social cognition and behavior

Some of the president's most concerning behaviors suggest a decline in social cognition: reduced insight and awareness into the thoughts and motivations of other people, coupled with symptoms like impulsivity and disinhibition that make him behave rudely and create needless controversy.
The decision to fire FBI Director James Comey in the middle of the investigation into Russian meddling in the 2016 election is an example of an impulsive decision that was greatly damaging to the president himself, assuming he was not actually trying to cover up his own complicity in the matter under investigation. Contradicting his own communications staff by disclosing that the Russia investigation was one reason he fired Comey is an example of disinhibited behavior. Rashly threatening Comey with a recording he did not have is reflective of poor emotional control.
Trump's easy Twitter trigger finger, most recently retweeting British far-right videos he apparently knew nothing about simply because the social media platform promoted these videos in his feed, reflects poor impulse control. Numerous problematic moments in the Trump presidency, such as his volunteering top secret Israeli intelligence to the Russian ambassador or volunteering that his immigration restrictions were indeed a "travel ban," reflect an inability to contain himself.
We saw this most recently with his inability to make it through a simple White House ceremony honoring Navajo code talkers without making an ethnically derogatory reference to an opposition political figure.
The president's decision to launch into a fight with a Gold Star wife and mother who lost their soldier in Niger is also reflective of impaired social cognition. It could also signal memory decline, since it seemed as though he had not learned from a similar imbroglio during the campaign.
Episodes like these often occur because of impaired frontal lobe brain systems. These typically provide some degree of restraint from saying the first thing that crosses your mind. In a healthy brain, these ideas must make their way through multiple layers of checks and balances that take into account the social propriety and appropriateness of the audience for a given remark. Such frontal impairment often does not stop at troublesome communication, but has physical manifestations such as childlike facial expressions and physical restlessness, both features we see in Trump.

Dysfunction in memory, attention and concentration

The integrity of other primary cognitive domains like memory, attention, and concentration are tied up in all of the problems I mention above. Memory impairment is specifically implicated in episodes like forgetting to sign orders - not once, but twice- that were the purposes of the press events the president was attending. Attention and focus are key to forming memory; the lack of either makes it more likely to forget why one was in a room in the first place.
The persistence of fixed beliefs about the crowd size at his inauguration, President Obama having a fraudulent birth certificate, or millions of undocumented people voting for Hillary Clinton suggest either a shocking willingness to lie, which falls into the behavioral dysregulation category, or a memory disorder that hobbles the president with fixed delusions that cannot be swayed by contradictory information. The New York Times opinion section has catalogued an astounding collection of the president's lies so extensive that such lying implicates the cognitive systems that undergird one's hold on what has happened in one's life.
If the president is questioning whether the "Access Hollywood" videotape of himself celebrating a lifestyle rife with misogyny and sexual assault is really him, that worries me more about a memory disorder than a particularly poor effort at gaslighting.

Moving forward

The clinical task is to distinguish the president's symptoms from normal aging. Typically, that's accomplished with standardized neuropsychological testing that would help compare the president to peers of similar age and education. It's perhaps useful to think of how many 71-year-olds in your life display similar behaviors, thoughts, and speech patterns as the ones we are witnessing in Trump.
If I were to make a differential diagnosis based on what I have observed, it would include mild cognitive impairment, also known as mild neurocognitive disorder or predementia. About 16 percent of people the president's age fall into this category. Mild cognitive impairment comes in various flavors as the precursor to a variety of different full-blown dementias. The key distinguishing characteristic between mild cognitive impairment and dementia is whether the decline is starting to interfere with essential daily functioning. In a billionaire typically surrounded by assistants, who is now the president surrounded by more assistants, whether Trump can perform his necessary daily tasks on his own may be difficult to assess.
The symptoms I've observed raise the concern for mild cognitive impairment preceding frontotemporal dementia, which is particularly heavy on the behavioral symptoms like those the president displays, as well as more typical Alzheimer's dementia, or dementia with Lewy bodies. Though advanced testing such as brain imaging, as well as genetic testing and cerebrospinal fluid analysis, are not required to make the diagnosis, all of this testing is warranted in the president's case if cognitive testing is consistent with mild cognitive impairment or dementia.
If an individual with these symptoms was in an average job in an average community surrounded by an average family, he or she would most likely be seen by a doctor. In the clinical evaluation of dementia, the concerns expressed by family members and the patient themselves are essential: They explain the changes observed over recent years, and that history is a prime ingredient in formulating the differential diagnosis.
The uniqueness of the megalomaniacal media personality that Trump has built himself into, followed by the presidency and its attendant cadre of fawning assistants, have most likely prevented him from getting proper assessment.
The president's apparent symptoms are advancing and warrant medical evaluation by relevant specialists. Given the sensitivity of his case, an independent panel would be appropriate. It's entirely possible that the president does not have predementia or is not progressing toward dementia. But he is definitely behaving as such. In either scenario, I do not think this is an individual who is fit to serve the office.

Why I wrote this article

The president is sick. That's the impression shared by a growing number of Americans - including me, as both a citizen and as a physician.
I am not a psychiatrist, and I have always taken some solace while writing about various public figures in the news that I am not governed by the Goldwater rule, which prohibits psychiatrists from dispensing free-form psychoanalysis about public figures they've never personally examined. But according to the American Medical Association, a variation of that rule now applies to all physicians. In a largely unreported addition to the AMA Code of Medical Ethics this fall, the AMA now has its own variation of the Goldwater rule: Physicians should refrain "from making clinical diagnoses about individuals (e.g., public officials, celebrities, persons in the news) they have not had the opportunity to personally examine."
The statement seems out of the blue, as the Goldwater rule has been around since 1973 without the rest of medicine ever joining in. The AMA has unfortunately chosen a time to issue its own prohibition precisely at a moment when physician insight into a public figure is needed more now than ever before.
I sought to better understand the source of this restriction, so I spoke with AMA media representative Robert Mills, who told me that the media ethics guidance derived from concern about Dr. Mehmet Oz. A medical student member, citing Oz's endorsement of fringe medical practices that seemed to be influencing Americans broadly, suggested that the association resolve to provide stricter media guidance to physicians that would help discourage them from portraying themselves as all-knowing media authorities.
That's a noble idea, but capping dialogue about public figures seems rather peripheral and worthy of deeper consideration than given by the paragraph in the broader statement. Dr. Matthew Wynia, who was formerly Director of the AMA Institute for Ethics and now directs the University of Colorado's Center for Bioethics and Humanities, told me that he considers the AMA's new position, emphasizing the importance of in-person examination, "misplaced" given the way medicine is practiced in 2017.
In Trump's case, we have no relevant testing to review. His personal physician issued a thoroughly unsatisfying letter before the election that didn't contain much in the way of hard data. That's a situation many people want to correct via an independent medical panel that can objectively evaluate the president's fitness to serve. But the prospects for getting Congress to use the 25th Amendment in this way seem poor at the moment.
What we do have are a growing array of signs and symptoms displayed in public for all to see. It's time to discuss these issues in a clinical context, even if this is a very atypical form of examination. It's all we have. And even if the president has a physical exam early next year and releases the records, as announced by the White House, what he really needs is thorough cognitive testing.

Before biting the bullet, I also spoke with Dr. Dennis Agliano, who chairs the AMA's Council on Ethical and Judicial Affairs, the panel that wrote the new ethical guidance. He advised me to be careful: "You can get yourself into hot water, since there are people who like Trump, and they may submit a complaint to the AMA," the Tampa otolaryngologist told me. Ultimately, he reassured me that I should just do what I think is right.
Which is to warn the president that he needs to be evaluated for a brain disease.

CRISPR and RNA editing

I find it somewhat satisfying that the field of RNA editing (in the broad sense) which I and my students worked on for so long is contributing, at least linguistically, to one of the most exciting gene modification techniques developed in recent years - CRISPR. Initially Doudna showed that joining two RNAs, one encoding a DNA nuclease and the other a short RNA sequence complementary to the site to be edited produced an RNA that could recognize and modify specific sites in genomic DNA. The mechanism of site specificity was simple base pairing and they used the term "guide RNA or gRNA" to describe this construct. This was the mechanism my lab had discovered in 1990 by which the insertion/deletion of uridine residues at precise sites in the cryptogenes encoded in maxicircle mitochondrial DNA of trypanosomatid parasites was achieved. We coined the term, guide RNA to describe short RNAs encoded mainly by the thousands of catenated minicircles in the kinetoplast mitochondria DNA which could recognize specific sites to be edited and recruit multiple protein complexes that precisely cleaved the mRNA, inserted uridines and then joined the two DNA fragments. Several additional “editing” phenomena were soon discovered that changed C to U in mammalian ApoB mRNA and changed encoded adenosine resides in multiple mammalian mRNAs to inosine, which behaved like guanosine. Again the site specificities, at least in ADAR editing, were determined by the mRNAs encoding complementary sequences in cis which acted by foldback to identify specific sites by base pairing and then recruiting ADAR adenosine deaminase enzymes. In fact, in our RNA editing Gordon Conferences at that time, the term “RNA editing” was used for both the trypanosomatid insertion/deletion of U’s and the method by which precise A’s were changed to G’s (functionally) or C’s to U. And now ADAR and APOBEC editing has solved one of the major problems of the CRISPR system by allowing the efficient production of specific nucleotide changes in mRNAs without non-specific changes elsewhere in the genome.
Truly, the incredible insight of Jim Watson and Francis Crick in their DNA double helix model in 1953 which was based on the base pairing of nucleotides in the two strands led to their understated ending comment in their Nature paper that it has not escaped their attention that this would lead to an elegant mechanism for DNA replication.

A New Old Drug Against an Old Disease - African Trypanosomiasis 

There has been a truly exciting drug development against African trypanosomiasis. The previous arsenical drugs used were either very toxic to the patient and the more recent (2009) combination of nifurtimox-eflornithine (NECT) had to administered as a combination of pills and 14 intravenous infusions. The NECT was not toxic and could kill parasites even after they entered the brain. The down side was that this treatment could not easily be used in rural African villages. The same organization that developed NECT in 2007 rediscovered fexinidazole, a compound that Sanofi had developed as an general antiparasitic drug but had  not pursued it any further. Researchers supported by the Drugs for Neglected Diseases initiative found both in animal models and in humans that this drug  taken orally cured 99% of people in the early bloodstream stage of the disease and 91% of people in  the tertiary stage where the trypanosomes had entered the brain!  The drug was taken through clinical trials and should be approved by the European Medicines Agency for use  in infected humans in the Democratic Republic of the Congo by the end of 2018. This may prove to be the magic bullet against this devastating disease in tropical Africa. I myself hope that resistance will not be rapidly developed. The best way to avoid development of resistance would be to combine another effective drug with fexinidazole, which unfortunately remains to be discovered.

An Interstellar Visitor

Astronomers have long speculated that debris from exoplanet formation could be ejected from another solar system but nothing so far has been observed (if we ignore the domestic molecules formed from elements created by supernova and kilonova explosions). On October 19 an unusual small object designated A/2017 was detected by the Panoramic Survey Telescope and Rapid Response System or Pan-STARRS 1 telescope in Hawaii by a postdoctoral fellow, Rob Weryk, while searching for near earth objects for NASA. The motion of this body could not be explained as a normal asteroid or comet since it did not follow the normal orbits of near-earth objects but was on a hyperbolic trajectory crossing the ecliptic (plane of the planets) inside Mercury’s orbit and then made a hairpin turn due to the gravity of the sun under the earth’s orbit at the rapid speed of 27 miles/sec. Weryk and Karen Meech, an astronomer who studies small bodies possibly involved in solar system formation, both realized that this object probably came from another solar system around another star. Davide Farnocchia and Matt Holman,  scientists at NASA's Center for Near-Earth Object Studies (CNEOS) at the agency's Jet Propulsion Laboratory also concluded that the evidence suggested an interstellar origin!!! A graph of the orbit is shown in the following  UTube video
https://www.youtube.com/watch?v=uYBYrFJoL2E.

If this is true, this asteroid must have spent millions  if not billions of years traveling from another solar system to the earth. I find this discovery fantastic and exciting.

An astronomer friend of mine, Ben Zuckerman, reminded me that this type  of astronomical phenomenon makes the suggestion  of "panspermia" or "lithopanspermia" - that life arrived on earth from other planets or even from exoplanets in other solar systems - in the realm of possibility.

The Nevada Massacre

The massacre of over 50 people in a Nevada hotel by one man with an automatic rifle is due entirely to the Nevada gun laws or lack thereof. Nevada has some of the most relaxed gun laws in the United States. Firearm owners there are not required to have a license, and do not have to register their weapons. The state does not prohibit the sale of assault rifles, and places no limits on the number of firearms an individual can possess and the capacity of ammunition magazines.

The second amendment to the US Constitution states: "A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed." Since there are no longer any militias in this country as in the days when the US Constitution was being written, this clearly does not allow people to "keep and bear arms" as was interpreted by the Supreme Court in 2008 in the Heller decision and is used by the right wing as justification for the unlimited ownership of guns in this country.

This however was not the worst Supreme Court decision in our history. That goes to the Dred Scott decision in 1857 by the Taney Court. It has been said that this decision was characterized by "convoluted logic, tortured misreadings of key constitutional provisions, contempt of precedent, distortion of history, and judicial activism on a world-historical scale". It led eventually to the Civil War.

The Heller decision has led to the modern day gun lobby headed by the National Rifle Association or NRA and to this country being the most violent civilized country in the world. The NRA has not yet made its normal soothing statements about the holy American gun rights after the Nevada massacre, since it must first wash the blood off its hands.

Guns must be banned from our country as is the case in England and every other civilized country. There will be enough death and destruction in our country and in the world as climate warming gets worse, but the absence of guns in private hands will decrease the killing of innocent people.

It is Time...

For the sake of this country and the entire world, Trump must be removed as President of the United States. He is Commander in Chief of the military forces in this country and has the sole authority to launch nuclear weapons. Ponder that for a moment. We are relentlessly moving towards a military confrontation (=war) with North Korea, and Trump’s response is to threaten “fire and fury” and call the North Korean dictator schoolyard names such as Rocket Man and Little Rocket Man. Very recently there was an exciting news story that the United States had a “back channel” with North Korea which could possibly be used for negotiation, and Trump tells the Secretary of State “Don’t waste time talking to Little Rocket Man” and “Save your energy, Rex, we’ll do what has to be done”, a Trumpian way of saying that we will attack North Korea, thereby initiating World War III which almost certainly would involve the use of nuclear weapons. This is in spite of both China and Russia saying that they would intervene if the US attacked first and this intervention would almost certainly be militarily. Ponder that for a moment.

Trump is clearly mentally incapable of the duties of the

Presidency and is too dangerous to be allowed to be ”doing what has to be done.” Meanwhile, Trump is planning to attend a Golf Trophy Ceremony while at the same time sending horrible tweets to the Mayor of San Juan who had the courage to tell Trump that her people have no houses to live in, potable water to drink, electric power to communicate and fuel to run trucks and cars (and generators) from the recent hurricane. She said that her people are dying and that the US and Trump are killing them by their inefficiency and bureaucracy. The ghost writer of Trump’s “Art of the Deal” says that he is “deeply disturbed” and utterly “untrustworthy”. Add to that - belligerent, thin-skinned, unable to apologize for anything, a sexual predator, anti-science and a climate denier. But these pale against his threatening nuclear war.

Congress should create a commission to examine if the 25th

amendment should be invoked to replace Trump with the Vice President, Mike Pence, who is a religious nut case and a disciple of the Republican mantra of tax cuts for the wealthy and repeal of Obama Care, but not crazy enough to attack North Korea and use nuclear weapons.

I urge the Congress to do this as soon as possible and hopefully

prevent a third world war.

The Power Emergency in Puerto Rico - an Idea

The Class 4 -5 Hurricane Maria has apparently cut off all electronic communication with the outside world. There is only a single cell phone service and this is very fragile. The Governor has warned people not to expect restoration of the island’s electric grid possibly for several months.  Puerto Rico’s electric grid is 44 years old and the only power company, the Puerto Rico Electric Power Authority (PREPA), has recently declared bankruptcy and for some time has prevented or limited the development of solar power in the island, even though Puerto Rico is a tropical island and has more than 10-fold the extent of sunlight as, e.g. Miami, ignoring cloud cover.  

I have a suggestion that may speed up the restoration of power to the island and also at the same time act as a model system for the use of solar power in a new type of decentralized electric grid in general. I suggest that solar power should be installed on or adjacent to every house and business together with appropriate Tesla-like storage batteries. Of course, reconstruction of the structures is required before the solar panels can be situated. So, this is definitely a non-trivial exercise, but the reconstruction of houses and businesses (and the grid) must proceed in any case. Of course a grid expert must be involved in devising a novel type of “micro-grid” that would of allow total decentralization as well as installation of devices at each set of panels for easily removing  the panels from the grid. The benefit of this proposal is that electric power will be restored much more rapidly than simply replicating the old electric grid system and relying on centralized fossil fuel generation of power. And the most important benefit is that this will be a test of the possibility of decentralization that could be  used in other island disasters or even in mainland cities after extreme destruction, natural or man-made. One possible man-made disaster could  be EMP pulses created by explosion of nuclear weapons in the atmosphere.

I just discovered that there is now a possible commercial solution (Novagen) to the problem of installation of solar power in sites as exist now in Puerto Rico.

Rapid Roll "I" - Under Development (http://www.renovagen.com/products/rapid-roll-i/)(http://www.renovagen.com/products/rapid-roll-t/)

The integration of the Rapid Roll technology into a side-opening ISO shipping container, combined with inverters and a larger battery bank, creates an easily transportable self-sufficient solar power system capable of generating 10 times more power than competitive products. Deploying a huge solar array measuring 5 metres (20 ft ISO) or 10 metres (40 ft ISO) in width and up to 200 metres in length, this represents by far the largest containerized deployable solar array yet conceived. At this scale a multi-MW solar power plant could be deployed in a matter of hours – city-scale power sufficient for a large mining site or military main operating base.

Renovagen envisages that this technology could revolutionize the cost-effective and environmentally-friendly provision of large amounts of off-grid power in remote locations across many industries – including military, disaster relief, mining, oil & gas, construction, events and telecommunications. Indeed it has the potential to save lives by – for example, reducing or eliminating the need for military fuel convoys or by powering medical facilities in disaster zones.

An ISO container form factor utilizes existing transportation and container-handling infrastructure, but it may be sufficiently light-weight to be air-lifted by transport aircraft or heavy-lift helicopter. By integrating more efficient solar cells in the future, systems of up to 600kWp may become possible – for the first time mobilizing truly industrial scale solar power.

Rapid Roll "T"

The Rapid Roll “T” trailer/tactical version provides an extremely mobile solution which can be airlifted by a wide range of medium and heavy-lift helicopters (gross weight from 1,500 kg) but packs enough power for energy intensive operations. Easily mounted on an on-road or off-road trailer or flat-bed truck, the Rapid Roll “T” provides many options for deployment to practically any global location imaginable. With simple deployment in just a few minutes without needing solar engineers onsite, it provides a practical solution for humanitarian and disaster relief, military, mining, events, film production and other temporary power-hungry operations in remote places which require equipment mobility. The size and weight of the Rapid Roll “T” when trailerised (2,000kg – 3,000kg total trailer weight) also makes it easy to tow with standard 4×4 vehicles and it fits on a number of commercial air freight pallets or 463L military pallet and also becomes extremely easy to transport internationally very quickly. Easy handling is facilitated with bi-directional forklift pockets and lifting rings.

The Dossier(s)?

The Dossier(s)?

The prison bars are slowly closing around Trump. I hope fast enough to prevent a war with North Korea. Following are two recent articles about the infamous dossier, including the salacious portion.  I myself have been closely following the dossier investigation. One nice thing about the dossier is that in the published version someone used a yellow highlighter to emphasize the best parts (Perhaps the use of a yellow highlighter is an “in joke”). Although it is possibly leaning towards a type of  “schadenfreude” (Translation: “the experience of pleasure, joy, or self-satisfaction that comes from learning of or witnessing the troubles, failures, or humiliation of another”) but I just can’t help it with this numbnut (Translation: The stupidest of the stupid. A complete dumbass, one whose intelligence quotient does not surpass that of the average rock), but I myself have been pushing for more on the salacious portion of the dossier.

And now for two recent articles about the dossier:

 How's THIS for a bombshell? It comes from BBC World News Correspondent Paul Wood (and was published in THE SPECTATOR, a weekly UK magazine):

"Steele is not the only source [on the infamous "pee tape]. I heard of Russian "Kompromat" - compromising material- on Trump from two sources months before the Steele Dossier came to light. That might be evidence for Trump's statement that Russian intelligence, as well as the US agencies, are out to get him. There are, though, reports of witnesses in the hotel who corroborate Steel's reporting. These include an American who's said to have seen a row with hotel security over whether the (alleged) hookers would be allowed up to Trump's suite. The dossier's account of hookers in a Moscow hotel room was the subject of gossip among a select group of  journalists, politicians, and intelligence people for months before it was published. Now claims are circulating of  more tapes showing an even more extreme behavior. Expect these allegations to emerge in due course."

And of course the following BBC-published report from Paul Wood can't possibly be retweeted enough times.....

"Former MI6 agent, Christopher Steele, is not the only source for the claim about Russian Kompromat on the president-elect. Back in August, a retired head of an East European intelligence agency told me he had been informed of its existence by the "head of an East European intelligence Agency." Later I  used an intermediary to pass some questions to active duty CIA officers dealing with the case file - they would not speak to me directly. I got a message back that there was "more than one tape", "audio and video", on "more than one date", "in more than one place" - in the Ritz-Carlton in Moscow and also in St. Petersberg - and that the material [in the Trump tape held by the Kremlin] was "of a sexual nature"."

WOW!

Don’t forget to call your Congressperson and push for impeachment. Treason alone just won’t do it, but an old-fashioned  sex scandal just might. 

Recent Major Non-Trump-related Advances in Science

In spite of the emotion and turmoil of my hearing Trump take the US out of the Paris Climate accord and also the storm of new information daily about Trump and the Russians ( I personally feel that these leaks are payback from Trump  having insulting the entire intelligence community), I want to calm myself and write a little about several recent exciting science discoveries. In spite of  having retired and closed my lab in 2014, I have tried (I admit with some difficulty) to keep up with papers and discussions in Nature and Science. And I also subscribe to a fascinating magazine for the educated layman (and retired molecular biologists) called The New Scientist.

Discovery of gravitational waves.

These are non-electromagnetic waves traveling at the speed of light produced by the deformation of space-time by massive accelerating gravitational objects. Einstein  had predicted these in  1916 in his General Theory of Relativity but it was thought that they were faint to be ever observed. In 1974  however, these waves were indirectly detected  by observing a binary neutron star system over a 2 year period by radio astronomy. Hulse and Taylor found that the period of rotation was decreasing exactly as predicted by Einstein’s theory if gravitational waves were being radiated.

               To actually detect gravitational waves requires an instrument that can measure a movement of 10^-19 meters (a distance of 1/10,000 of a proton)! The best way to measure small distances is still to  use interferometry, as used by Michelson in  1880  to show that the speed of light was constant in any direction and therefore a hypothetical medium in which light moved called the  “ether” did not exist.  This led directly to Einstein’s relativity theories. To detect  gravitational waves required a series of truly incredible engineering advances: production of an extremely powerful and stable 200 watt laser, seismic isolation systems that sense ground movements and make corrections, passive movement damping system involving pendulums supporting the 40 kg mirrors, production of extremely high quality vacuums in the two L-shaped 2.5 mile long tunnels in both the Hanford and Livingston sites, and finally a network of supercomputers to process and archive the terabytes of data produced every day. The project initiated in 1990 and was upgraded in 2010. The first detection of gravitational waves at both sites occurred in 2015, just a few days after the installation of upgraded detectors.

And suddenly there was a new window on the universe not based on electromagnetic waves! To date there have been three separate observations of gravitational waves.

In order to clear my head of  Trump nonsense, I plan to discuss several additional major advances in science in upcoming blogs.  These include:

1.      Entanglement.

2.      Dark matter

3.      Dark energy

4.      The multiverse and the quantum universe.

5.      Growth of brain organoids from stem cells.

6.      The role of micro RNAs in gene regulation

7.      Development of the CRISPR/Cas gene editing system

The Most Dangerous Organization in the World

Noah Chomsky is a famous American linguist, philosopher, cognitive scientist, historian and social critic. Recently he asked (clearly, rhetorically) ”…has there ever been an organization in human history that is dedicated with such commitment to the destruction of organized human life on Earth? Not that I’m aware of. Is the Republican organization—I hesitate to call it a party—committed to that? Overwhelmingly. There isn’t even any question about it.” 

As an example, he mentioned the UN-sponsored Conference on implementing the Paris Accord on Climate Change which took place in Morocco last November. As soon as the news came in that Donald Trump has been elected American President, the Conference abruptly terminated its discussion of Climate Change, leading Chomsky to say “Can the world survive when the richest, most powerful country in world history … not only is withdrawing from the effort to try to save the world from destruction, but is undertaking a dedicated commitment to race to the precipice as quickly as possible?”

Chomsky noted that President Trump wants an increase in the use of fossil fuels (including coal), removal of all regulations, termination of aid to developing countries trying to move to green energy and, most serious of all, destruction of the EPA and the Department of Energy by selecting climate deniers as directors and cutting their budgets by more than 30%.

Clearly, the Republican Party is the most dangerous organization in the world.

The rat lung worm is a nematode parasite that has snails as an intermediate host and can infect humans as incidental hosts and cause a fatal brain disease

Climate denial by Trump and Scott Pruit, the head of the Environmental Protection Agency, is not only stupid, but could turn out to be very dangerous for human health.

Angiostrongylus cantonensis is a nematode that lives in the lungs of rats and has snails as intermediate hosts.  It is endemic in humans and can cause an often fatal brain disease that is untreatable. The rat disease was discovered in 1935 and is found world-wide, and the first human case of the disease was recorded in Taiwan in 1944.  Recently, human cases have been identified in Hawaii, California, Alabama, Louisiana, Florida, and along the Gulf Coast. “It is a worm infection introduced into North America through globalization,” said Peter Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine. Transmission to humans occurs when people eat the intermediate hosts, which may even not be detectable on a leaf of lettuce that wasn’t washed. Even the slime left by an infected slug could transmit the disease and eating raw freshwater prawns, crabs, and frogs is also dangerous. In Maui there were six cases in a three month period.  The infected rats defecate worm larvae that are then eaten by snails, slugs and shrimp.  Humans are infected by eating contaminated food or even directly from handling infected snails. The parasites migrate to the brain meninges and can even penetrate into the brain. The disease is very difficult to diagnose.  Even though humans are not a true host, the presence of the worms causes a meningitis with severe headache, tremors, pain and inflammation caused by death of the worms and the host immune response. In fact, treatment with drugs used against other worm parasites can exacerbate the disease by killing the parasites and increasing inflammation.  

The rapid increase in the range of these parasites is almost certainly caused by climate change and globalization. There is an excellent recent paper entitled Geographic Range Expansion for Rat Lungworm in North America in Emerging Infectious Diseases (Volume 21, Number 7—July 2015) by Emily M. York, James P. Creecy, Wayne D. Lord, and William Caire.

Unfortunately, we are in the era of the fake-President Donald Trump, a climate denier, who is proposing a 30% decrease in the EPA budget. In fact, EPA workers are not allowed to even mention the term “climate change”. That reminds me of the king who once demanded that the ocean waves stop. I just hope that the FBI finishes its investigation and Trump and his crowd are indicted for treason and prosecuted. It should prove difficult for Trump to do more damage to our country when he is in jail.

But also unfortunately, this will certainly prove to be one of the least problems caused by climate change, and will pale in relation to the financial and ecological disasters caused by the rise in ocean level which will submerge major coastal cities worldwide, the expected mass migrations of people affected by the losses of water and food, and by the possibly nuclear wars caused by these migrations. In fact I doubt that our civilization will survive this tremendous damage to its infrastructure. 

Ah well, I have no children to suffer, but I am sure that the politicians such as Trump and the Republicans have children and grandchildren who will wonder why their ancestors let this happen to our world!

Republican talking Points and Fake News

There is a Fake News Republican talking point that Obamacare is in a “death spiral”. Unfortunately for their talking point, Obamacare is doing quite well, thank you.  Another talking point especially by the Lier in Chief, Donald Trump, was the repeated calling of Hilary especially in the debates, “crooked Hilary”. If  fake news is repeated enough times, it becomes a fact , whereas it is merely a “walking zombie”.  Reince Priebus said that Obama’s health care reform law is “imploding and exploding”. Speaker Paul Ryan  said many times that the ACA is in a “death spiral” and that “the law is collapsing”. Trump said that the ACA is “just about ready to implode” and “Obamacare is dead.”. He also said the immoral hope that after the failure of the new Republican Health Care law, Obamacare will collapse and he will pick up the pieces.

The CBO recently found that the health insurance “market would probably be stable in most areas.  And the New York Times pointed out that the healthcare market under Obamacare would probably be stable.  The death spiral lie was started when Aetna pulled out of 11 states and the CEO blamed this on a “death spiral”. This was actually done because Aetna was not allowed to merge with Humana and to avoid antitrust scrutiny. Another argument against a death spiral is that fewer young adults, who usually are more healthy, would buy policies through the exchanges, but in fact 85% of  the new policy members are protected from premium increases by subsidies. In 2017, 121.2 million people were signed up on Obamacare. There probably would have been more except that Trump stopped funding government adds reminding people of the deadlines for enrollment. The number will increase since four states people who started the enrollment before Jan. 31 to be enrolled. And Louisiana recently expanded Medicaid.  Experts agree that Obamacare would probably stabilize in the next few years. However, there are a few states where the markets are near collapse, but in Wisconsin, Idaho, Massachusetts, New Mexico, Arkansas and California, the markets have multiple insurance companies. New York has 17 insurance carriers and total enrollments increased 28% for 2017. Also fake news is that doctors are leaving due to Obamacare. But the total number of active physicians has increased 8% from 2010 and medical school applicants and students are at an all-time high. Finally the Medicaid expansion covers around 11 million people and has driven down the uninsured rate by around 7%.

There are definitely some problems in Obamacare, but most are due to Republican governors refusing to expand Medicare.  And a recent Trump executive order instructed agencies to relax Healthcare rules, and the IRS complied by refusing to enforce the individual mandate.

In 1897, the American writer, Mark Twain, said that “the report of my death was an exaggeration”. If the Republicans want Obamacare to die, they will have to do it themselves, which they are quite willing and capable of doing.  The only saving feature is that current users of Obamacare and Medicaid (Democrats and Republicans) have been filling the town hall meetings of their Congressmen and shouting down any signs of wanting to destroy Obamacare. This is something that Trump and friends can think about in their jail cells. The fact is that only the thing that is in a “death spiral” is the Republican Party. 

Too Good to be True?

A paper came out in Nature recently with the mind-numbing  title: “The antibody aducanumab reduces Ab plaques in Alzheimer’s disease.” But in perusal of the Abstract a statement jumped out to me: “In a transgenic mouse model of Alzheimer’s Disease (AD) aducanumab is shown to enter the brain, bind parenchymal Ab, and reduce soluble and insoluble Ab in a dose-dependent manner. In patients with prodromal or mild Ab, one year of monthly intravenous infusions of aducanumab reduces brain Ab in a dose-and time-dependent manner. This is accompanied by a slowing of clinical decline measured by Clinical Dementia Ratings-Sum of Boxes and Mini Mental State Examination scores.” They concluded that “..these results justify further development of aducanumab for the  treatment of AD.”

Now, I am not in the AD-amyloid field, but this appears very exciting. I know very well that there has been a great controversy whether amyloid-plaques and tangles have anything directly to do with the clinical development of AD, but these data show that this antibody reduces brain Ab plaques. It also provides preliminary evidence for an effect on the clinical development of AZ.

But before you run out and tell your mother about this, a larger Phase 3 clinical study with many more patients must be performed, but it already gives me a warm and fuzzy feeling. 

Computer viruses

I had written a blog entry recently about the possibility that the Kaspersky Antivirus Company could be involved with the Russian hacking of our election, but I never posted it, just in case it was wrong. The reason I thought that this was a possibility is that I had read that the CEO, Eugene Kaspersky, was a close friend of Putin. In addition, Kaspersky was the first company to forensically uncover the Stuxnet worm and its progeny, Duqu 2.0, that attacked the Iranian nuclear program as well as the entire Kaspersky computer network. This worm was presumably created by the NSA and the Israeli intelligence agencies.

So it was no great surprise that I read today that Ruslan Stoyanov, the Kaspersky Manager in charge of investigating computer hacking, was arrested in Russia and charged with Treason!  However, in view of all the recent publicity about Russian computer hacking, this has the definite smell of disinformation.

More to come, I presume.