[History] One Hundred Year ago, when America was a haven for refugees…..the story of Abraham Haroutounian

With all these breaking news, I needed to clear my mind and went through my photo library. During my first visit in New York City during the summer 2008, I had a chance to hop in to attend the Ellis Island Immigration Museum and I still remember that travel document (see picture).
This is a document that resonate as today. This document tells the story of another Abraham. Abraham Haroutounian. By the name, you can recognize the Armenian origin of Abraham. Abraham was another refugee from another genocide. Abraham was Turkish citizen and Armenian national. Abraham was born in Marash (renamed Kahramanmaras), a village of Anatolia and lived through the Armenian genocide that took place from 1915 until 1923. We can speculate that following the march through Syria, Abraham found refuge in Aleppo.
After the World War I and the fall of the Ottoman Empire, Abraham likely settled, got married and founded a family. But Abraham was not anymore welcomed in his country and was surely considered a “guest” inside the newly formed Syrian state, a French protectorate. Abraham surely could not forget the horrible genocide he may have witnessed and felt no more secure in this land and seek refuge.
Abraham obtained a immigration visa to the US, with the aim to settle in New York. After obtaining his travel document from the French Administration taking care of Syria, Abraham and his family traveled by boat and landed in Ellis Island, waiting like many other immigrant his clearance and his first step in the United States. I try to imagine what this other Abraham felt when he arrived here in the US, staring at the Statue of the Liberty welcoming new comers as a symbol of democracy, freedom and justice for all.
But I also felt it, when I first came in the US over 7 years ago, with my carry-on, my check-in bag and my cardboard package in which I meticulously packed essential items to survive by my own (pair of sheets, some books, some kitchenwares and a pillow).
Now imagine if Abraham was planning to do the same. As today, Abraham would have been arriving by plane at JFK airport under an immigrant visa. Abraham however would have never leaved his American dream as by now he and his family would have denied entry into the US, on the motive of his Syrian origin.
Whenever you have a chance to visit New York, skip the line for the Statue of Liberty, instead hope in to the ferry taking you to Ellis Island and have a lesson of history. It is a great reminder that those pushing on the travel ban to refugees were also once a son or a daughter of a refugee or immigrant. Remember that any single President of the United States was a son of an immigrant that came in this country with a dream and reaped fruits of hard labor.

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[Junk Sciences] About that Nutella causes cancer news article…..a cautionary tale on credible science stretched into fake news

You have heard this sensational news about “Nutella causes cancer according to a study”. It initially came into my news feed from the Independent through an article with a “clickbait” headline such as “Nutella removed from shelves as it causes cancer”. The article was fairly alarmist, claiming a study linked contaminant in Nutella in causing cancer in children, such claims built on a EFSA (European Food Safety Agency) study but yet failed to specify a direct link to the official press release.  The original article has been removed or edited within hours and replaced with a more nuanced and realistic although the original HTML link still keep on the headlines (http://www.independent.co.uk/news/business/news/nutella-causes-cancer-palm-oil-supermarket-ban-italy-cadburys-a7522291.html).
That was not only bad science reporting but also bad journalism ethic, spinning an old press release into a twisted fake news that was surely attractive enough to call it “clickbait”.

1. What is all about Nutella causes cancer?

It all comes back to an press release from EFSA published on May 3, 2016, seven months before the #Nutellagate and available here: (https://www.efsa.europa.eu/en/press/news/160503a). If you read the press release, it involves any vegetable oils and any oils used in food processing. The release focused on certain oil byproducts called glycidyl fatty ester (GE), 2- and 3-monocholoroproanediol (2-MCPD and 3-MCPD) formed by heating process (200ºC). These compounds are classified as  “contaminants” (that means trace of these compounds were found in oils) and palm oil was among the different oils tested as one containing the highest amount of these contaminants. There are indication about a possible carcinogenicity of these compounds in rodents, in particular some form of kidney cancer in rats. The EFSA considers that is no safe levels of these contaminants. Yet, it is important to note that EFSA also noted the limitations of the current literature and further toxicity studies are needed. I don’t blame the EFSA of being overreactive, but also it is important than EFSA provides a clear picture and clearly establish an exhaustive “dose makes the poison” issue.
Now it is surprising that it took more than 7 months to associate that report with Nutella, considering that the report clearly and only mentioned “and in some cases ‘Chocolate spreads and similar’” (http://onlinelibrary.wiley.com/doi/10.2903/j.efsa.2016.4426/full). Does it means it is only the main source? Hell no but surprisingly, other food sources went under the rug. This is one of the most relevant paragraph:
For ‘Infants’, the food groups ‘Infant and follow-on formulae’, ‘Vegetable fats and oils’ and ‘Cookies’ were the major contributors to 3- and 2-MCPD and glycidol exposure. For ‘Toddlers’, the food groups ‘Vegetable fats and oils’, ‘Cookies’ and ‘Pastries and cakes’ were the major contributors to 3- and 2-MCPD and glycidol exposure. ‘Infant formula’ and follow-on formula’ were also important contributors to 3- and 2-MCPD exposure. For ‘Other children’, the food groups with highest contribution to exposure to 3- and 2-MCPD and glycidol were ‘Pastries and cakes’, ‘Margarine and similar’ and ‘Cookies’. For glycidol, ‘Fried or roast meat’ was an additional relevant contributor. ‘Vegetable fats and oils’ also contributed to 3- and 2-MCPD, and glycidol exposure. For ‘Adolescents’, ‘Adults’, ‘Elderly’ and ‘Very elderly’, the major sources of 3- and 2-MCPD and glycidol were ‘Margarine and similar’ and ‘Pastries and cakes’. Additionally, ‘Fried or baked potato products’ were important contributors to 3- and 2-MCPD exposure while ‘Fried or roast meat’ and in some cases ‘Chocolate spreads and similar’ were important contributors to glycidol exposure.”
Basically anything that contain vegetable oil is at possible danger of containing these compounds. However, the original source considering cherry-picking facts and falsely restricting to one food product highly popular in Europe was sounding like a nice way to generate traffic and revenues.
In this one they used a classical argument fallacy trope to build their narrative:
If A tells “palm oil contain carcinogens” and B tells “Nutella contains palm oil” we ended up with “Nutella contain carcinogens”.
Thats the goal of any “clickbait” article: to make revenues by generating high traffic to the link. Most of the time, these articles care little about facts and either use deceptive headlines, use far-stretched narrative, if not “fake news” as their claims are not based on verified information. Now, I expect a journalist to follow ethical rules that applies to academic publishing.
If I publish an article and I have noticed a mistake in my article, I can only fix it by notifying the editor and publishing an erratum in a follow up issue. In the case of an online  article, publishing an [Update] on top of the original article would also make the job. The Independent in my opinion showed some unethical journalism by just erasing their old stuff and replacing with the new stuff. Of course the damage is done and that was enough to spark some conspiracy theories.

2. So does it mean I can keep on splurging my Nutella jar?
Put down that tablespoon and  wait a minute. Lets look at the nutrition facts (https://www.nutella.com/en/uk/range).
nutella

Nutella is like any other spread, even a bit healthier than a tablespoon of peanut butter spread (190kcal)  but still much much than a strawberry jam spread (36kcal).
The problem of course comes from the amount of fat and sugar. They are both known to be important risk factors for obesity, Type II diabetes, cardiovascular diseases and cancer. Therefore, your main concern should be amount consuming in moderation. Moderation is key, even for a treat like Nutella.

[Metal] Therion – Gothic Kabbalah 10th Anniversary

Today is my birthday (turning 38, Yikes!), including some other celebs such as Rob Zombie. It also turns out this day marks the 10th Anniversary of Therion thirteenth album “Gothic Kabbalah”.
The interesting thing with Therion is their ability to scramble paths and make unexpected moves. You cannot simply expect to hear the same tunes and melodics over and over, ending you discovering the band with every single albums.
This is also the case with “Gothic Kabbalah”, a 2-CD release, with 17 titles and totaling a bit more of 83 minutes.
The album is a clear departure from their previous releases, leaving the symphonic and orchestral tones of “Vovin” and “Secrets of The Rune”, navigating more into a progressive and even incorporating heavy metal tones.
It starts with “Der Mitternachtsloewe” setting the artistic tone and guesting Hannah Holgersson. It is seamlessly followed by “Gothic Kabbalah”, “The Perennial Sophia”, “Wisdom of the Cage”. “Son of The Staves of Time” is one of the official videos from the album, allowing me to share and let you appreciate the tone of the album whereas “Tuna 1603″and “Trul” failed to inspire me.

https://youtu.be/YY-EOYJQMMY?list=PL6582FC6AD17B80E2

The second CD starts with “Wand of Abaris” is really sounding like a gothic metal song and that why this is one of my favorite of the album. “Three Treasure” brings on the operatics that was the trademark of their previous releases. “Path To Arcady” has this heavy-metal tone blending nicely with the tenor and sopranos lead vocals, making another one of my favorite. “TOF – The Trinity” gets more into classical metal, nice but not more. “Chain of Minerva” brings on more a Therion-like track, whereas “The Falling Stone” brings up something faster in its pace, almost inspired by some power metal songs. “Adulruna Rediviva” is another masterpiece, some Therion safe bet. A 13:38 track that makes what Therion is Therion. The two last tracks are live performance of “Seven Secrets of the Sphinx” and “To Mega Therion”.

[Junk Sciences] About that Dr. Neides article published in Cleveland.com

I am sure you have now heard about the infamous opinion article published by Dr. Daniel Neides, MD (Cleveland Clinic) titled “Make 2017 the year to avoid toxins (good luck) and master your domain: Words on Wellness” and published in Cleveland.com, the online site of “The Plain Dealer”, a local newspaper (http://www.cleveland.com/lyndhurst-south-euclid/index.ssf/2017/01/make_2017_the_year_to_avoid_to.html).
What was sounding first as a silly title just in time for the post-holiday “detox diets” and other scientific fallacy, quickly spinned into a conspiracy nightmare. I would not have been surprised if it came from some quack doctors that make a living on selling supplements, books and other premium services.
What was the most concerning was this article came from a medical director from a highly regarded US Health Institute, as the article was signed as “Dr. Daniel Neides is the Medical Director and Chief Operating Officer of the Cleveland Clinic Wellness Institute.
You can check for yourself but the content of this opinion article was simply frightening (I am commenting on the article as it was published on 1/8/17 at 10:52AM.
LYNDHURST, Ohio–I am tired of all the nonsense we as American citizens are being fed while big business – and the government – continue to ignore the health and well-being of the fine people in this country. Why am I all fired up, you ask?
I, like everyone else, took the advice of the Centers for Disease Control (CDC) – the government – and received a flu shot. I chose to receive the preservative free vaccine, thinking I did not want any thimerasol (i.e. mercury) that the “regular” flu vaccine contains.
Makes sense, right? Why would any of us want to be injected with mercury if it can potentially cause harm? However, what I did not realize is that the preservative-free vaccine contains formaldehyde.”
The article first sentence just set the tone: Dr. Neides has a grief about Big Gov and Big Business in general. I am mad on the government too, but not for the same reasons. We have been facing one of the most polarized election with the two parties trenched into their ideological trenches, with the average Joe in the cross-fire. We cannot have a ruling government without having a bipartisan consensus that help find a common ground to move on.
Then things gets sour as he is fingerpointing on the CDC, again using the allusion of Big Gov for his grief on this institution. It quickly turns into a anti-vaccine diatribe, with spelling errors (it is “thimerosal/thiomersal” not “thimerasol”). Not only Dr.Neides fail to name his grief correctly (and you cannot blame autocorrect on that one) but also makes a scientifically fallacy by associating “thimerasol” as mercury. As previously mentioned in my blog, there is a huge difference between mercury as an element (Hg) and the organomercury compounds such as methylmercury (CH3Hg) and ethylmercury (CH3CH2Hg). Considering organic chemistry part of the pre-requisite courses for any medical school, this type of mistake is not acceptable.
In a common anti-vaccine move, Dr. Neides quickly played the “goalpost moving” tactic. If you first argument failed following its refutation by facts, move to another target and play the same spiel. If it is not thimerosal, then it is the formaldehyde. If it is not the formaldehyde, then it is the aluminum……..
We are not yet at the end of the first paragraph and already Dr. Neides has taken a dangerous slippery slope in pseudoscientific claims. He will continue into the “appeal to authority” fallacy, claiming the government is condoning the global population health. This is why the government has agencies like the Department of Health and Human Services (DHHS), the Food and Drug Administration (FDA), the Center of Diseases Control (CDC) and the Environmental Protection Agency (EPA). They have doing their job, could be better but it could be worse. Considering our next government line-up, we will likely soon regret how “red tapes” is sometimes needed.
But lets go to the second part of his article with this very interesting quote:
We live in a toxic soup. There are over 80,000 chemicals used in various industries country-wide. There are over 2,000 new chemicals being introduced annually. We breathe in these chemicals through exhaust, eat them in our processed foods ( just look at the labels that have 20 or 30 ingredients and good luck pronouncing their names), textiles (clothing, bedding, furniture), and personal care products, including make-up, deodorant, shampoos, and soaps.“.
Of course we are living in a chemical soup, but not all of them are toxic. There are some that are neutral, some are toxic (this is what we refer as poisons and toxins and are extensively studied by a discipline called toxicology) and some are even beneficial (these are identified by a a discipline called pharmacology).
Authorities are constantly testing these chemicals for 40 years now and there is a huge effort from international agencies to provide a formidable toxicological database to document the toxicity of any existing chemical inventoried.
A side-note, the quote “good luck pronouncing their names” sounds eerily familiar to a quote from a certain Babe “If a third grader can’t pronounce it, don’t eat it“. I am guessing I should ditch the addition of “alpha-D-glucopyrannosyl-1,4-alpha-D-fructofurannoside” from my morning cup of Joe. Thats by the way the biochemical name for sugar.
It is followed by a mishmash of different terms that just sound like a nightmare for anyone teaching pharmacokinetics to healthcare professional.
Toxins accumulate in our fat cells if they are not eliminated and interrupt normal bodily functions. Your body should be a finely tuned machine with all of the organ systems working in concert together. But when toxins disrupt normal function, problems can occur. Those problems include cancers, auto-immune diseases, neurologic problems like autism, ADHD, and Parkinson’s disease, and the most prevalent chronic diseases like obesity, diabetes, and heart disease (note: so high blood pressure is not a chronic disease, then?).
Why are we so sick in 2017 despite the best access to healthcare? The body has wonderful built-in systems to help us detoxify. The liver and kidneys try to do an exceptional job keeping up with filtering out the “stuff” (toxins included) we don’t need. Our skin – the largest organ in the body – will release toxins in the form of perspiration (what did they teach you in med school? How did you graduated from your biochemistry class?). Our breath will release toxins with each exhalation (same “boingboing” moment). When our gut is healthy and our microbiome (100 trillion organisms that live in our intestinal tract, within our airway, and on our skin) intact, our bowel movements help rid unwanted toxins.
I like to think of our detoxification system as a big bucket. As long as the toxic soup stays within the bucket, our body can naturally eliminate what we don’t need and help us live at the highest quality of life. But what happens when the bucket starts to overflow – which is exactly what many of us have been facing our entire lives? The body may not have the capacity to eliminate our current exposures and THAT IS WHEN BAD THINGS START TO OCCUR.”
We, as animals, have evolved to deal with many chemicals in nature that can have a possible threat to use. In pharmacokinetics, we refer to ADME for Absorption, Distribution, Metabolism and Elimination.
Absorption of compounds is limited for water-soluble compounds, they need a special door (called solute carriers) to enter inside your body. Now some (and many drugs in general) are fat-soluble (we call them lipophilic compounds) and can diffuse passively through the intestinal barrier and get into the bloodstream. Even if these drugs can make it through the gut, they have to face a firs-pass metabolism by the liver (we will discuss later about it) and deactivate some if not all of them. Those who were not affected by the first-pass are ongoing a distribution phase. Distribution occurs by the spread of the compounds throughout the central compartment (blood circulation). From this compartment, compounds can diffuse into peripheral (tissue) compartments. One of this compartment is named the “deep storage compartment” (a nice word for your fat tissue) that can retain some lipophilic drugs. As long as you ingest them, you can accumulate these compounds. Once you stop, these compounds move from the periphery back into the central compartment. We know which compounds can store (the lipophilic ones) and such feature is considered in toxicological studies to define if a compound is toxic or not. After circulating, compounds are perfusing through the liver and undergo of series of chemical reactions called metabolism. Metabolism is ensured by a series of enzymes grouped into two phases: Phase I enzymes (called cytochrome P450s or CYPs) and Phase II (conjugating) enzymes. Phase I enzymes transform compounds from a fat-soluble into a water-soluble compounds. Phase II enzymes tag these compounds to ease their elimination. Finally, the elimination phase is the one by which the body get rid of these compounds. There are two major routes: hepatobiliary (liver via the bile duct and eliminated via feces) and renal (kidneys).
Again, the fallacious claim that skin and respiration are considered as major elimination routes is simply outrageously wrong, especially considering from a healthcare professional.
The third part is directly playing the classical anti vaccine tropes “vaccines cause autism” that have debunked again and again.  I will not into it, there are great resources about what this claim is purely wrong and not supported by science.
But I just wanted to add my take on Hepatitis B (HepB) and newborns vaccination. The general public has a global misconception about HepB being only an STD. Indeed it is not. HepB is the same type of virus than HIV when we talk about mode of transmission: a blood-borne pathogen (in addition to its sexual transmission). This is a vaccine we highly recommend to any staff working in lab research and handling any blood or blood-based products. Because there is always a risk of HepB transmission via accidental cut and exposure to blood, this is even supported by being an “healthy carrier” (you have circulating HepB in your blood but you are not having any liver condition). it is better safe than sorry, considering than HepB can lead to severe liver pathology such as cirrhosis.
Finally the fourth part was fairly alarming. You may have heard about Orac, a seasoned MD and oncologist that is doing a great job in his website “www.sciencebasedmedicine.org“. Orac has been raising his concern that pseudoscience and quackery has been percolating inside mainstream medicine, using names like “functional medicine”, “integrative medicine” or “holistic medicine” as a wolf with a sheep cloth, appearing harmless.
He cites then a quote from a colleague named Jessica Hutchins, MD and IFM-certified (certification from a certain Institute of Functional Medicine) as described as the following:
In a 2015 article in U.S. News and World Report (Link to her article), Jessica Hutchins, M.D., IFM certified practitioner, states , “Information on eating toxin-free food and pushing food manufacturers to stop using harmful ingredients can be found at foodbabe.com. When we vote with our dollars by choosing to buy products that are sustainably produced and chemical-free, we actively shape the market place. Help change the way [loved ones] nourish their precious bodies, starting with yourself as an example.
Using Vani Hari (aka the FoodBabe) as a source of information and as a reference for health advices, from an MD, is simply insane! “What did they teach you at the IFM?”. At first glance, the certification program provided by the IFM seems legitimate (https://www.functionalmedicine.org/certification_program/About/) however one single item appear intriguing:
Comprehensive assessment of the fundamental physiological systems that organize the key clinical imbalances and are affected by the mental-emotional-spiritual core: Assimilation, Communication, Defense and repair, Transport, Energy, Structural Integrity, Biotransformation and elimination
Until now, we have little or no evidence of prayers and thoughts work in healing someone, lesser than any evidence faith healer healed someone solely on their spiritual powers. Also the presence of chiropractors as instructors (and we know how well chiropractors have a scientific training) is also disturbing.

In conclusion, 2017 comes in with a bang as I feared: a year in which evidence, facts are discredited by gut-feeling, smooth talks and snake oil sellers.

Post-scriptum: when you have woo peddlers lauding your article, you know that our article is a complete #NaturalNonSense (courtesy: Chow Babe).
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[Neurosciences/Alzheimer] Structural variation in amyloid-β fibrils from Alzheimer’s disease clinical subtypes

Interesting study published in Nature about how differences in Abeta fibrils have an implication on the clinical symptoms.
A quick refresher for those not much familiar (it is also a bit of a headache as I just dive in the Alzheimer’s research). Alzheimer’s disease is characterized by the formation of senile plaques and tangles, such structures have been considered as the causative agents in neuronal cell death.
These plaques are clumps of a peptide called Abeta (for amyloid beta) peptides. We know how these peptides are formed (by cleavage of the amyloid precursor protein or APP) and we know there are different “flavors” of Abeta that have been described: Abeta 1-40, Abeta 1-42…..
We also know that these peptides are “sticky”. They are released as monomers (single peptide) and because they are hydrophobic (hates water, like oil hates water) they will try to bind together and form oligomers (think about little sticky balls). These oligomers then can form fibrils.
It is a very “dry” study because it is heavy on structural biology and computational biology but in the same time very interesting.
It shows us that plaque formation is not a linear processes, there are different combinations possible (imagine like comparing snowflakes) that have a direct impact on the clinical presentation and outcomes in patients.
That’s maybe providing another way of thinking in targeting Abeta that can help us learn from the failure of previous clinical trials.

Abstract and link to the original paper

Aggregation of amyloid-β peptides into fibrils or other self-assembled states is central to the pathogenesis of Alzheimer’s disease. Fibrils formed in vitro by 40- and 42-residue amyloid-β peptides (Aβ40 and Aβ42) are polymorphic, with variations in molecular structure that depend on fibril growth conditions. Recent experiments suggest that variations in amyloid-β fibril structure in vivo may correlate with variations in Alzheimer’s disease phenotype, in analogy to distinct prion strains that are associated with different clinical and pathological phenotypes. Here we investigate correlations between structural variation and Alzheimer’s disease phenotype using solid-state nuclear magnetic resonance (ssNMR) measurements on Aβ40 and Aβ42 fibrils prepared by seeded growth from extracts of Alzheimer’s disease brain cortex. We compared two atypical Alzheimer’s disease clinical subtypes—the rapidly progressive form (r-AD) and the posterior cortical atrophy variant (PCA-AD)—with a typical prolonged-duration form (t-AD). On the basis of ssNMR data from 37 cortical tissue samples from 18 individuals, we find that a single Aβ40 fibril structure is most abundant in samples from patients with t-AD and PCA-AD, whereas Aβ40 fibrils from r-AD samples exhibit a significantly greater proportion of additional structures. Data for Aβ42 fibrils indicate structural heterogeneity in most samples from all patient categories, with at least two prevalent structures. These results demonstrate the existence of a specific predominant Aβ40 fibril structure in t-AD and PCA-AD, suggest that r-AD may relate to additional fibril structures and indicate that there is a qualitative difference between Aβ40 and Aβ42 aggregates in the brain tissue of patients with Alzheimer’s disease.

Source: Structural variation in amyloid-β fibrils from Alzheimer’s disease clinical subtypes : Nature : Nature Research