A Malaria Treatment So Wacky It Just Might Work--Someday

The New York Times has a very interesting story today about a project that is being funded by the Gates Foundation to try to bring malaria under control. The idea is to treat patients (mice, to begin with) by placing them (or parts of them) in a very low wattage microwave. It will be some time before we know if this treatment will work to rid a body of malaria, but the article's main value is that in interviewing one of the method's co-inventors, Dr. Jose Stoute at Penn State, it provides a very nice summary of the complex biology of the malaria parasite, which helps us understand why this parasite has been a nemesis for thousands of years.

The idea, he said, is based on the fact that malaria parasites invade red blood cells and eat the hemoglobin inside them. Hemoglobin contains iron — and, as any bozo who’s ever tried to heat up a sandwich wrapped in tinfoil knows, it’s a bad idea to microwave metal.

Of course, the red cells containing parasites are floating along in arteries right next to healthy red cells, so whatever damage the microwave does to the parasites cannot be visited on the healthy cells, too.

And that, Dr. Stoute said, is where a crucial difference comes in: When a malaria parasite digests hemoglobin, it converts the iron into an inert crystalline pigment called hemozoin. The parasite must do that because free iron will tear oxygen atoms off things the parasite wants intact, like its cell membrane. The hemozoin crystals, packed with concentrated iron, are pushed into the parasite’s food vacuole — the empty space where a rudimentary creature that does not have a gut dumps its waste products. Drifting into an electromagnetic field with a vacuole full of hemozoin is about as brainy as stepping into a microwave with a stomach full of nails. But parasites don’t have brains, either.

Dr. Stoute and Dr. Spadafora [his co-inventor] have shown that they can fine-tune a custom-built microwave so that only the parasites are damaged. Their theory is that the heated-up hemozoin swells the vacuoles till they pop, unleashing an acid bath on the parasite’s innards. 

Even if the approach works in mice, all sorts of problems will have to be worked out before it is tested on humans, Dr. Stoute said. Hot spots like those that a microwave creates in liquids must be avoided. And any patient will undoubtedly need treatments for several days in a row, because the parasites hide in the brain, liver and spleen — and microwaving the head or abdomen is probably a bad idea.
“But eventually they have to come back out into the blood,” he said, “and that’s when we’ll get them.”

Since malaria parasites have shown an ability to develop resistance to all know drug therapies, we need to keep our fingers crossed for this idea, no matter how crazy it seems at first glance.

Women in Asia are Just Saying No to Marriage

The Economist's lengthy cover story this week is about the flight from marriage among women in Asia. Japan continues to be the prime example, but the story notes that the phenomenon is spreading to other Asian countries, including China and India. The basic story is a familiar one: women are increasingly better educated and in the labor force, but they are still expected to do the bulk of childcare, eldercare, and housework, while at the same time having little ability to divorce a man they no longer want to live with. This is pretty much a bad deal, and many women are rejecting it.

What is remarkable about the Asian experience is not that women are unmarried in their 30s—that happens in the West, too—but that they have never been married and have rarely cohabited. In Sweden, the proportion of women in their late 30s who are single is higher than in Asia, at 41%. But that is because marriage is disappearing as a norm. Swedish women are still setting up homes and having children, just outside wedlock. Not in Asia. Avoiding both illegitimacy and cohabitation, Asian women appear to be living a more celibate life than their Western sisters (admittedly, they could also be under-reporting rates of cohabitation and pre-marital sex). The conclusion is that East Asia’s growing cohorts of unmarried women reflect less the breakdown of marriage than the fact that they are avoiding it.

As women avoid marriage, men are forced to do the same even if they don't want to. In China, in particular, this is increasingly complicated by the distorted sex ratio at birth.

China has coined new terms to describe the two groups: sheng-nu (left-over women) and guang gun (bare branches, or men who will not add to the family tree). “Bare branches” is most commonly used in China to refer to men who will be unable to marry because of sex-selective abortion. And that encapsulates the biggest worry about Asia’s flight from marriage. If (when?) it spreads to China and India, it will combine with the surplus of bachelors to cause unheard-of strains. Prostitution could rise; brides could be traded like commodities, or women forced to “marry” several men; wives could be kept in purdah by jealous, fearful husbands.

The Economist notes that one solution to the bare branches problem is to bring in foreign brides, but that will only work as long as there is a supply of such women (usually through a deal brokered by their families), and the rise in the status of women is bound to bring that to an end.

Slave Maids in Lebanon

You have probably never have contemplated what the work of the Minister of Population in Madagascar might involve. Right? It turns out that one of her tasks is dealing with the tragedy of human trafficking. More specifically, dealing with the issue of poor women from Madagascar who are essentially sold into servitude in the middle east, including Saudi Arabia, Jordan, and in a story today from BBC News--in Lebanon.

Forced to work as a "slave maid" for wealthy families in Lebanon for 15 years, Abeline Baholiarisoa - a 59-year-old woman from Madagascar - finally achieved her freedom in March.
Madagascar's government chartered a plane to evacuate her and 85 other women.
The youngest of her four children, whom she left behind when he was six years old, played a key role in her evacuation, tracking her down via a welfare agency that rescues "slave maids", she says.
Ms Baholiarisoa says she was trapped in "a living hell" after being duped into going to Lebanon.
Madagascar's Minister of Population Nadine Ramaroson, the only government minister tackling the issue, says "a very organised network" involving senior government officials and businessmen emerged in the 1990s to engage in human trafficking.Ms Ramaroson says the government is trying to break the criminal networks, but it is not easy.Government officials provide fraudulent work permits, travel and identity document for around $5,000 per trafficked woman, social workers say.
While one job agency flew 300 women to Jordan last month with the government's approval, 43 women bound for Saudi Arabia and Kuwait were stopped from boarding planes.
Ms Ramaroson said all were recruited from remote rural areas with high illiteracy and poverty levels. Some 16-year-old girls were given forged identity papers showing their age as 21.

Sadly, this is not an isolated story and I have mentioned the situation of foreign women as domestics before in reference to Kuwait and more recently Jordan, although in the case of Jordan is was less obvious that women were in a virtual slave situation as was the women in Lebanon in this story.

Obama Administration Backs Off on Deportations

The Obama Administration has systematically been deporting a record number of undocumented immigrants, as I have noted before. Today, however, came an announcement that the policy would change and that only those who posed a threat to national security or public safety would be targeted for deportation (remember that being an undocumented immigrant is a misdemeanor, not a felony). The New York Times focuses on the benefit to non-US-born children of undocumented immigrants.

The new policy is expected to help thousands of illegal immigrants who came to the United States as young children, graduated from high school and want to go on to college or serve in the armed forces.Under the new policy, the secretary of homeland security, Janet Napolitano, can provide relief, on a case-by-case basis, to young people who are in the country illegally but pose no threat to national security or to the public safety.

The Associated Press looks at the bigger picture:

Laura Lichter, president-elect of the American Immigration Lawyers Association, said the devil was in the details of reviewing 300,000 cases.
But whatever the result, she said, the policy does bring administrative changes to the immigration system at a time when congressional action seems unlikely.
Many Republicans have long opposed any immigration overhaul, including the DREAM Act, characterizing such proposals as amnesty.
While the new policy does not provide illegal immigrants with a path to permanent residency, it does allow those whose cases are indefinitely stayed to apply for a work permit. The government could also reopen deportation cases if an immigrant is arrested or other circumstances in their case change.
"Congress is so stuck in its partisan politics, the immigration situation is getting worse and worse and worse," Lichter said. "This is the administration's only way, and frankly a very appropriate way, to come up with an interim fix."

A cynical view would be that President Obama sought originally to appeal to Republican voters by cracking down on undocumented immigration. Instead, it seemed only to antagonize people who had voted for him in 2008, and so a softer stance is being taken to bring those people back to the voting booth in 2012. 

Do You Think You Have Lung Cancer? Ask Your Dog

My wife and I have had German Shepherds for more than twenty years and we have always been impressed not just by how smart they are, but by the fact that they (like a lot of other animals) "see" things in the world that we can't. BBC News reports this week on an experiment at a hospital in Germany showing that dogs have a remarkable ability to diagnose lung cancer in a person by smelling their breath.

It is thought that tumours produce "volatile chemicals" which a dog can detect.
Researchers trained four dogs - two German shepherds, an Australian shepherd and a Labrador - to detect lung cancer.
Three groups of patients were tested: 110 healthy people, 60 with lung cancer and 50 with chronic obstructive pulmonary disease, a narrowing of the airways of the lungs.They all breathed into a fleece filled tube, which absorbed any smells.
The dogs sniffed the tubes and sat down in front of those in which they detected lung cancer smells.
They were successful 71% of the time. The researchers showed the dogs were not getting confused by chemicals associated with chronic obstructive pulmonary disease or smoking.
Dr Thorsten Walles, the report's author from Schillerhoehe Hospital, said: "In the breath of patients with lung cancer, there are likely to be different chemicals to normal breath samples and the dogs' keen sense of smell can detect this difference at an early stage of the disease.
"Our results confirm the presence of a stable marker for lung cancer. This is a big step forward."

Will this lead to new employment opportunities for dogs? Probably not, but it is nice when animals can help us improve our health without having to be harmed in the process.