Thoughts on Delusions.

Been thinking about the differences in how one different mental delusion is treated compared to others. IF I thought I was Napoleon Bonaparte through excess wargaming or that I was a qualified airline pilot from reading Biggles Books nobody would let me rule France and invade Russia with a pan European army or pilot a 767 full of passengers. I would be treated for my delusions (I would hope) instead of being indulged in it.

There is one delusion which is pandered to by the psychological and medical establishment. Time was you had to be an adult and demonstrate the depth of your delusion before you got any treatment whether it being hormones with or without chemical castration then move towards surgery. But you had to show you were really serious about it.

Now we have bearded blokes demanding entrance to women’s safe spaces while declaring that they’re Lesbians and other Lesbians should let themselves be penetrated by them. No or little effort is made to conform to feminine norms (whatever they might be) let along feminine behaviour patterns. Sure women can be aggressive, but not like that.

Then there’s the issue of not just indulging but driving and encouraging children not old enough to consent into taking puberty blockers with horrendous effects to satisfy their distress, supposedly. Here we thought treatment should be about finding out the root cause of the distress, dealing with that and supporting the patient through normal development. Puberty is a big change for everyone.

As a Physiologist and Developmental Biologist the idea of giving pre-pubescent children puberty blockers with all the risks to their future fertility and health utterly abhors me. The irreversibility of many of the changes if taken for too long as happens a lot and the shutting off of the choice to go back ditto. Lots of kids change their minds. Treatment with puberty blockers takes away the choice or the possibility of choice.

Medical professionals are responsible for doing manifest harms to those in their care and the medical regulators look the other way. When we know that homophobic bullying is a prime cause of the desire to ‘change sex’ to pander to it is a terrible failure to look at or for root causes. When homophobic parents push their kids into it responsible medical professionals should say no and consider applications for wards of court. Instead they offer puberty blockers and fast track onto the Trans pipeline.

Children are being offered a solution they are not equipped to assess let alone consent to and which will harm them. The testimonies coming from de-Transitioners, the abuse they suffer from TRA’s should give anyone pause.

I’m struggling to think of an analogy from medicine and the only one I can think of is those poor people who conceive that one of their limbs is alien to them and asks the doctors to amputate it. They are not indulged and the courts side with the doctors. Can you imagine the furore if healthy limbs were being removed with the need for prostheses and treatment on the public purse? Especially if no psychological effort was made to ease the patient or research the cause and potential therapies.

My left leg is shorter than my right and the vast majority of muscle pulls and tendon strains have been on the left. But I’m not about to have it removed in favour of painful unresponsive prosthesis. I’ve read enough testimony from those trying to adapt to prostheses let along exercise with them to know I don’t want to go there. I’ve been at the track putting my spikes on next to people putting their running legs on. They have my admiration but I do not ache to join them.

Again, I’m not against Trans people, they need our sympathy and understanding but sometimes love has to be tough for the sake of the loved one.

The War on Women

Deep breath, it’s politics and science time on Muscleguy’s blog. I come at this issue as a Biomedical scientist and a brother, father and uncle worried sick about the increased risk to sisters, daughters, wives and nieces and of course cousins and aunts.

Firstly a disclaimer: I have nothing against Trans women or Trans men and wish them no harm whatsoever. The problem is you do not gain rights by trampling all over the rights and protections hard won by a still oppressed group in society. Doing that simply makes you an oppresser.

So by all means call me a TERF or other epthets. I have broad shoulders, I can take it.

This is in support of https://radfemrebecca.com a woman hounded unfairly off Twitter by Trans Rights Activists (TRA’s) wrongly laying complaints. It is also in support of @fairplaywomen and the new LGB Alliance formed because Stonewall is no longer campaigning for anyone other than TRA’s.

As a scientist I can tell you that you cannot change sex. Sex is determined by chromosomes (functioning normally) and there is no known or likely/possible mechanism to swap every Y chromosome for an X or vice versa. Doing so would also not diminish the increased size, muscle mass and bone density of a male body or turn a female body into Mr Universe. It would not make testes secrete oestrogen and progesterone or ovaries descend into a scrotum and just make testosterone. I’m sorry to be the bearer of such science but it is ineluctable and no amount of determined wishful thinking or self declaration will achieve this.

No amount of gender realignment surgery taking advantage of developmental leftovers can achieve this either (the lining of the scrotum is the tunica vaginallis which is a serosa which secretes fluid to stop the testes sticking together thus it can be used to line a ‘vagina’ which functions a bit like a real one. However it is much harder to turn a clitoris into a penis and a functioning one is not possible).

Stonewall spread lies and advice have caused councils to make changing rooms at baths and gyms unisex and turn women’s toilets unisex often leaving the male toilets alone. The Equal Rights Act 2010 makes the protection of women and their single sex spaces law. Legal challenges to this are being mounted in Scotland by civil society.

We are already seeing the downsides. A woman went into the unisex toilets on the ground floor of the Tron in Glasgow and was set upon by a man who admitted he was lying in wait for a woman to attack. A man has been convicted for filming a mother and daughter changing in the next door cubicle of unisex changing rooms. Ignoring the fact that bad actors will and are taking advantage of new unisex facilities to harass and attack women and girls is atrocious beyond words. This is happening and our sisters, daughters, wives, nieces, cousins, aunties are no longer safe.

What is the solution? Trans facilities. Women have had to campaign for decades to get things like public toilets. Active political campaigning and organising and lobbying. Not hounding people on twitter or calling them names. The first public toilets were male only and women had to fight to be included. TRA’s are freeloading on the efforts of women. Get out and raise money and lobby for separate facilities for Trans people. Women have shown you how to do it, the path is clear. Get going. I will support you.

We would all like to live in a perfect world but we don’t and until we get there we have to live in the real world. The real world where self declaration doesn’t trump biology. Where sex and gender are not interchangeable terms. One thing about being a scientist is using terms properly and understanding the need for them. Conflating sex and gender is simply wrong. You will not erase discrimination against Trans people by conflating the two. Those pesky chromosomes are still there, still as ineluctable as always. CRISPR/Cas9 will not rise to your rescue. It cannot do whole chromosomes and there’s a small delivery to every cell (good luck with postmitotic cells) problem. As well as that you cannot revert to an early embryo and go through development again as the ‘right’ sex.

I have had cause to describe myself as a molecular geneticist, no snigger at the back, a mountain of transgenic mice says otherwise. I am also a Developmental Biologist and i understand how male and female reproductive organs and genitals develop. I also understand various conditions lumped into ‘intersex’ and they do not validate anybody’s Trans identity except their own, if they choose. Stop co-opting them.

Stop hitting on the Lesbians and crowding them out of Pride marches. They are another ineluctable fact which no amount of wokeness or wishful thinking will make go away. They can also choose they have sex with and how. A penis is still a penis if you put ‘lady’ in front of it.

I think that’s about it for now. [girds loins for brickbats and epithets]

The Best Gluten Free Hamburger Buns

Right, recipe time on Muscleguy’s blog again. This one has been in development for a while: A gluten free hamburger bun which is the match of the contents. 

I’m sure all of us who are gluten intolerant or have Crohn’s who have been there, a toothsome looking GF burger which when you try and eat it results in the bun falling to bits, pieces of the patty, cheese, onions, pickles etc fall out, often all over your hands and fingers.

I have long had an excellent little book on Gluten Free Breadmaker recipes. It includes a most excellent Hot Cross Bun recipe, though I’ve never got the crosses to work the buns are fantastic, soft but firm, tasty and sliceable and able to be toasted to boot.

So I got to thinking about taking out the sugar and spices and making hamburger buns instead. This is the recipe I have been working on.

The result is a crusty bun which slices in half cleanly, the cut faces toast well (the better to resist the contents) and you can eat the whole burger as a burger should be eaten with only the juices escaping. You can put the part eaten burger down to partake of some chips etc without issue. The testing has been satisfied so it’s time to release the recipe and method.

But first, the book in question is by Carolyn Humphries and is titled Gluten Free Bread & Cakes from your breadmaker. A Foulsham imprint ISBN 978-0-572-03569-3. I can recommend the All Butter Croissants as well as the Hot Cross Buns.

Before we start I use the bread flour mix from the Dorling Kindersly Gluten Free Cookbook. It contains no xanthan gum since I use it mostly for sourdough bread where xg is contraindicated. It consists of 450g while rice flour, 115g potato starch, 60g tapioca flour and 60g cornflour mixed well together.

I have used Doves farm GF Bread Flour with reduced added XG for both sorts of bun and even the Doves farm General Purpose flour to make these so by all means try your own favourite mix.

Wet Ingredients

  • 1 large egg
  • 297g milk, warmed
  • 50g butter, melted

Dry Ingredients

  • 350g Flour mix
  • 5g ground linseeds (no more)
  • 1tsp psyllium husk powder (1Tbsp of ground husk)
  • 8g yeast, I use hand baking yeast but fastbake will do as well
  • large pinch of salt
  • 1Tbsp of Xanthan Gum (reduce of using xg containing flour mix)
  • 1/2 tsp of Guar Gum (to seal the crusts and keep the lifting gas in)

Method

  • Mix dry ingredients together in a large bowl, mix wet ingredients in a jug beating the egg well. 
  • Add wet to dry gradually while mixing. I use a stand mixer with a dough hook. 
  • Beat well until smooth and the yeast is well incorporated.
  • Scrape out onto a floured surface and using dough scrapers form into a sausage shape. Roll in the flour. 
  • Cut the sausage into 6 equal portions.
  • With oiled hands roll into balls and place on a prepared baking tray either greased or lined with paper. Flatten until a good diameter for burger buns.
  • Place in a warm place until well risen.
  • Risen buns can be egg or milk washed and dusted with sesame seeds. 
  • Bake at 200C/400F/180C Fan/gas 6 for 20-25 min.
Formed, flattened buns
Risen buns
Baked buns with sesame seeds
Cut buns showing crumb structure, note clean cut. Before toasting under grill.
Filled burger with chips
Half eaten still intact burger safely put down

So there you have it. The rest of the buns are cooled and in the freezer. To make full use of the oven I made pasties filled with my multi-bean chilli which will also be frozen for lunches etc.

If you want larger buns simply cut the ‘sausage’ into 4 instead of 6. The buns are flat bottomed and should lift easily off the tray.

You can of course fill these buns with whatever you choose. I have had them with cheese and pickle. You can taste the filling and the buns are delicious as well.

To make the hot cross buns, remove the ground linseeds and add 2-4tsp of spices of your choice (I mix it with the fruit), 50g of caster sugar and 100g of dried mixed fruit then make as above. Anyone with a working cross method is welcome to suggest it.

If you try these please let me know how you get on. Over and out.

A Cure For Chronic Fatigue?

Stimulated by kind words about this blog by someone on Scotgoespop here after a long lapse is a new post. Blogging on published research:

An article and editorial in New Scientist alerted me to the following research paper (free to view).

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0129898

From the labs of Øystein Fluge and Olave Mella in Bergen, Norway. It’s a good example of serendipity in research. They were treating a patient who had lymphoma and happened to also have Chronic Fatigue Syndrome (CFS) with a drug that lowers the numbers of a type of white blood cell that produces antibodies. This patient’s CFS improved markedly as a result. Intrigued they did a study in a small group of other CFS patients (without lymphoma). This paper describes the result of a phase II clinical trial. Phase I trials in humans test for toxicity and define the effective dose. Phase II test initial effectiveness.

CFS, also known as Myalgic Encephalomyolitis (ME) or more pejoratively as ‘yuppie flu’ is characterised by extreme loss of energy, vague flu like symptoms, muscle pains and a general malaise. Sufferers were often referred to psychiatrists with fitful results or derided as malingerers. My first encounter was because the woman now my wife had it in Halls at university. A neighbour of mine said she would appreciate some visits and company so I began to stop by and we became more and more friendly and 29 years later here we are. Seeing her collapse in the dinner queue and elsewhere convinced me it was more than a mirage. She had been a keen sportswoman, playing hockey and cricket. She got better, it seems pregnancy is an excellent gradual fitness program.

But back to the research. The hypothesis is that CFS/ME is as was suggested back in the ’80s a post viral syndrome, but not one caused by the virus hanging around but by rogue antibody producing cells attacking the body: an auto-immune syndrome. The treatment is with rituximab which is an antibody which removes CD20 antibody producing cells. The advantage of an antibody treatment is that it allows you to remove specific subsets of white blood cells. Removing all of them would open patients to opportunistic infections.

So, 29 patients were treated with infusions of the antibody two weeks apart then maintenance doses over 3, 6, 10 and 15 months. Patients were followed up over 36 months (3 years), no short term study this. They compared them to a saline infused control group from the phase I trial.

What did they find? 18/29 treated patients had both self reported decreases in fatigue score and showed clinically significant improvements. After the full 3 years 11 of the 18 were still in full remission. There were minor side effects but no toxicity of the treatment.

So it seems partially effective. It remains to be seen if the 7/18 who showed improvement but did not maintain it just need longer treatments or a repeat treatment cycle. Similarly with the 11/29 who showed no improvement. Or maybe their CD20 cells have a slight variant of the target protein and the antibody is thus less effective.

This is not a magic bullet, the quickest responders to treatment took 23 weeks to detect and improvement. Most took 32 weeks. This is also not a final word, more of a better proof of efficacy from their Phase I trial and working out doses. They seem to have done the best scientific job they could have within the constraints they have. And finally, it doesn’t work for everyone.

But the headline result is it a strong indication that CFS/ME is a real condition and that it is an auto-immune post viral syndrome. With any luck they will get funding for a larger Phase III trial and it will be approved for general release. People with CFS/ME are generally economically inactive and this costs society a lot, they also impact on the health service. So any treatment that gets them active again is likely to be cost effective. Especially as CFS/ME generally hits young adults. The good news is that since rituximab is already licensed for lymphoma rather than being a new compound rolling this out into clinics will be relatively quick.

As for my wife, the developing embryo and foetus, acting a bit like a parasite, dials down aspects of the mother’s immune system to avoid rejection. Important as the embryo/foetus is only half related to the mother. It thus seems likely that as well as the gradual fitness program that is pregnancy that this dialing down of the immune system cured her ME, as we knew it then.

Light at the end of the tunnel, one cheer for serendipity, one for the researchers and one for the patient guinea pigs.

International Information

Recent events have been rather revealing about true international allegiances. More in degree than surprise but it has still been instructive. Britain is a poodle to the US, that is a given but to the rank of lickspittle can now be revealed France, Spain, Portugal and Italy. Their reaction to the suggestion, source still unknown, that Edward Snowden was on Bolivian President Evo Morales’s plane was not questioning or thinking about the international niceties. Instead they acted to deny their airspace and demanded the right to search the presidental plane.

To the rank of independent entity must go Austria, though they didn’t have much choice.

The real surprise was France, so long not in Nato, with it’s properly independent nuclear deterrent (unlike Britain’s). They have since apologised and been shamefaced about it, suggesting they acted in haste and our now repenting at leisure.

We also now know that the outrage about US spying from France and Germany was not sincere and purely for public consumption to avoid angry citizens turning on their own governments.

So now we turn to Latin America and we see the countries that joined with Bolivia in support and condemnation of Europe and America: Venezuela, Ecuador, Argentina and Uruguay.

But who stayed away? Colombia, Chile and Peru. US Lickspittle status for those states then.

Cuba has now offered it’s support for Venezuela, Bolivia and Nicaragua at least suggesting Snowden transiting in Havana might not be a problem.

So it’s cack-handed  and kneejerk interference in Evo Morales’s plane based on some obviously wrong intelligence has resulted in a weakening of US influence in Latin America and could yet see Edward Snowden in safety. I call that an own goal.

Liberty and Equality March On in Fraternity and Sorority

The Supreme Court in the US has just struck down both California’s Propsition 8 banning gay marriage and the Federal DOMA Act signed into law, shamefully, by President Bill Clinton that denied Gay people married in states like Massachusetts the same inheritance, tax and next of kin rights as married Straight people.

A great day for sense and tolerance and a necessary blow against bigotry and ignorance.

Let joy be unconfined.

Delightful Fun

Been following the fun on the Guardian who are following the world’s media trying to track Edward Snowden down. An Aeroflot plane full of journalists are on a, dry, flight to Havana which Snowden is not on, unless he’s in drag as one of the stewardesses.

This is great fun. Go Ed, give them all the runaround and thanks a heap for the revelations. Pity they can’t winch Julian Assange out of the Ecuadorian Embassy in passing.

Book Review: The Serpent’s Promise

Image

Just finished reading this after my wife borrowed it from the library for me. I would agree with the reviews that say it’s a book for the converted to scepticism and is unlikely to appeal to believers unless they are already doubting their faith. It’s also rather scattergun and relates mainly to the first few books of the Old Testament. No attempted debunking of the feeding of the five thousand or the supposed water into wine incident.

But having said that it’s still a rollicking good read packed with interesting science. The bible is more for jumping off points than anything else. Jones will also as usual make you laugh several times.

Not one of his best but still well worth a look and a hat-tip from me for the reference to Göbekli Tepe site in SE Turkey, a further account here. A discovery that had past me by. A temple complex from 12,000 years ago, before agriculture in the fertile crescent. Demonstrating that social organisation and recruitment in hunter gatherers in the period before the agricultural revolution was more than we might have though. To put it into context there is twice as much time between the cities in Ancient Sumer and the present day as between Sumer and Göbekli Tepe.

Judging Risk, And Benefit

The Royal College of Obstetricians and Gynaecologists this last week released a report offering advice to pregnant women which advised mothers to be to avoid things like tinned food or food in plastic packaging because of unquantified and unidentified fears. This has got me thinking, not for the first time, about risk and how our society is ridiculously risk averse and has forgotten that we should assess risks in a risk-benefit analysis, something we are equipped to do naturally. Every time you approach a corner in the road in your car you are doing this in assessing how fast you should take it. Back in New Zealand corners on open roads in the countryside have speed advisory boards on them giving a suggested safe speed to help. It means when you see 20 (km/hr) you know the corner is a hairpin, and there are some.

What the RCOG report writers have forgotten is to factor in the benefits of food packaging and what life was like before we started to use it, especially for pregnant women. One risk in particular is Listeria which can cause miscarriages. Campylobacter and a new one E. coli 0157 which are both nasty. All of these, and more, can be caught from food. Packaging has not removed these risks entirely, which is why you should wash store bought salad leaves, but they have lowered them enormously. To the benefit of many, but especially the very young, the old, pregnant women and the immune compromised.

To ignore the benefits of the packaging, less handling from humans some of whom will carry viruses and bacteria. Remember the norovirus that causes winter vomiting needs just 9 virus particles to start an infection.

So if anything pregnant women are better off buying fresh veg, fruit and meat in plastic packaging than loose material that could have been handled by anyone.

We tend to live in a world where no risk can be accommodated just like nothing bad can happen without someone being held responsible.

And that is before we get to popular media reports of statistical scientific risks. They shout X doubles the risk of Y but often fail to point out that your risk of Y is a fraction of a percent.

Life is never risk free, you might choke on a pretzel, or just about anything but you have to eat. Too much water can kill as happens to some back markers in warm weather marathons who overestimate how much they are sweating and drink too much, yet we have to drink to stay alive. We must breathe but the air is full of microparticles and they don’t have to be viruses. Polluted air such as in London gives me asthma, yet when we lived there I had to breathe it. There were benefits from living where we lived, the jobs my wife and I did and the schools the kids went to. Having said that we were also happy to leave.

So next time some report, even from a Royal College tells you about a risk, think about benefits too, and ask what the absolute risk is and if it is some fraction per 1,000 people or whatever. Go about your life worry free.

My Tentacled Avatar

Dumbo Squid80X80

I’ve been asked about the origin of my tentacled orange avatar. So a quick explanation. It’s a screen grabbed and cropped still from The Deep episode of the BBC’s excellent Blue Planet series. I was given the DVD set for my birthday once. I have long had a fascination with cephalopods (octopus, squid and nautilus) ever since as a kid in Dunedin I saw a common octopus up close in the university’s Marin Aquarium. I found young ones in the local rock pools and in summer large dead ones washed up on the shores of Anderson’s Bay Inlet and stank in the sun. I now know they are probably females who have expired after protecting their eggs until they hatched. The females don’t eat and die of starvation.

In The Deep episode we meet Grimpoteuthis the Dumbo octopus. So named because it appears to have ears like Dumbo, Disney’s elephant which it uses to ‘fly’ through the water. What fascinated me was how it moved, like a fish’s fin or a bird’s wing: flat on the downstroke and rotated edge on on the upstroke. It will have evolved from the long fin which fringes the mantle of squid. Ripples in it help cuttlefish and the like to manoeuvre slowly and carefully. Grimpoteuthis has taken this basic design, reduced it and obviously added greater muscular and nervous control. It’s roughly equivalent to the evolution of fish fins from those of sharks and rays. A shark cannot swim with it’s pectoral fins (the ones at the front that stick out the side like stubby wings), it can only incline them like wing flaps on a plane. Rays can undulate their long fringing fins like a cuttlefish. Bony fish (teleosts) have pectoral fins that can be rotated and moved and used for propulsion. Some fish can swim backwards using them, useful for backing out of crevices that might contain food. Those fish fins became our legs and hands.

Dumbo octopus have made a similar evolutionary change. Taking a simple structure and elaborating it for further function.

But a picture is worth a thousand words so here are some videos of Grimpoteuthis in action.

You won’t find Grimpoteuthis in a rock pool though, they are creatures of the very deep, the deepest Octopus known, some living as far down as 7,000metres. About as far down as Everest is high. They hover over the seabed or in the water column eating polychaete worms and small arthropods.