Who will win the Nobel in Medicine on Monday October 3rd

At 5:30 PM Perth Time (GMT+8) the Nobel Prize in Medicine or Physiology will be announced. Here is my shortlist. As well as scouring the internet, I chose some which might have helped people I know. I spent a few hours on this and we will have a little cocktail party starting 5 pm at the CHRO2024 conference in Perth to see if anyone can pick the winners (QR code below). Here goes!

GLP-1 based therapy for obesityJoel

Habener, Lotte Bjerre Knudsen, Svetlana Mojsov

Habener and Mojsov invented the drug, Knudsen put it into clinical practice. Glucagon-like-peptide-1 is part of glucagon. It is in the gut. It stimulates insulin. Knudsen changed the molecule which allowed long half-life making Semaglutide a once per week injection.

Discovery of TNF and then Anti-TNF therapy

Marc Feldmann and Ravinder Maini (ICL)

for ways to treat rheumatoid arthritis and other autoimmune diseases such as RA Crohn’s etc. (e.g. infliximab, Humira). UniMelb, WEHI, ICL Oxford)

Treatment of Haemoglobinopathies such as sickle cell disease and thalassaemia

Stuart Orkin

For the discovery of the molecular mechanism responsible for the switch from foetal to adult haemoglobin gene expression during human development and translating that knowledge into a novel treatment for the haemoglobin disorders – sickle cell disease and beta- thalassemia.

cGas the DNA sensing enzyme which detects foreign DNA.

Zhijian (James) Chen (Fujian / USA Texas)

Free foreign DNA in the body is detected via. cGAS cyglic-GMP-Amp-Synthase. This may be important for triggering interferons and innate immunity even relating to autoimmune diseases.

Drugs that repair the defective chloride channel protein in patients with cystic fibrosis.

Sabine Hadida, Frederick van Goor

For developing life-transforming drug combinations. Ivacaftor works by potentiating the CFTR channel, helping it open more often, which improves chloride ion flow. Vertex Pharmaceuticals etc. (Orkambi) and Tezacaftor/Ivacaftor (Symdeko).

Developed noninvasive prenatal testing (NIPT) using cell-free fetal DNA

Yuk Ming (Dennis) Lo

From The Chinese University of Hong Kong This innovation has revolutionized prenatal testing for mutations such as Down’s Syndrome.

The role of gut microbiota in human health and disease

Jeffrey I. Gordon

His research significantly advanced the understanding of how the community of trillions of microbes living in our digestive tract affects nutrition, metabolism, and overall health.

P.S. I have two tips for the Nobel Prize in Chemistry too! Suggested by Paige Bebee:

Metal-Organic Frameworks (MOFs) 

Omar M. Yaghi 

Yaghi’s work on MOFs has revolutionized materials science. MOFs are porous materials with vast applications, including gas storage, separation, catalysis, and drug delivery. Their tunable structure allows for highly specific functions, contributing to advancements in clean energy and environmental sustainability. 

Predicting 3D Protein Structures Using AI 

Demis Hassabis, John Jumper, David Baker 

AI-based protein structure prediction, highlighted by tools like AlphaFold, has transformed our ability to determine the shape of proteins. By addressing a long-standing biological challenge, this breakthrough enhances our understanding of protein function and accelerates drug discovery, biotechnology innovations, and disease research, pushing the boundaries of molecular biology.

Enjoy 🤞👍😁😁

Please say "new clear" when you read "nuclear"

 

In the 21^st Century, I have seen on TV, that some people in Australia have copied the George Bush and Scott Morrison's, incorrect pronunciation, of “nuclear”.  Here I explain why the correct pronunciation is “new-clear”.  The article in this this letter is taken from “The Big Book of Beastly Mispronunciations” by Charles Harrington Esler. 

Barry Marshall 2023
Twitter: @barjammar

See YouTube examples here

In summary, for “nuclear”, please say: “new-clear”
For practise, please say: new-clear three more times...

new-clear

new-clear

new-clear

From Esler’s Book

 

nuclear N(Y)OO-klee-ur. For Pete's sake, don't say NOO-kyuh-lur.

In his introduction to the fourth edition of the NBC Handbook of Pronunciation (1984), veteran broadcaster and language commentator Edwin Newman remarks that when the nuclear age began in August 1945, so did the nucular age as well.

Ever since nuclear entered the national vocabulary (a hundred years after entering English in the 1840s) it has been mispronounced by millions of educated and otherwise careful speakers, including scientists, lawyers, professors, and presidents of the United States. According to Newman, Dwight D. Eisenhower "could not get it right"; Jimmy Carter, who had been an officer aboard nuclear-powered submarines, pronounced it NOO­ kee-ur; and Walter Mondale, in his 1984 bid for the presidency, repeatedly said NOO-kyuh-lur. "The word, correctly pronounced," writes Newman, "somehow is too much for a fair part of the population, and education and experience seem to have nothing to do with it." In The Diabolical Dictionary of Modern English, R. W. Jackson dryly echoes that sentiment by defining nuclear simply as "nucyaler."

Newman's and Jackson's cynicism reminds me of a debate I once heard between William F. Buckley, Jr., and the philosopher Mortimer Adler on whether everyone is inherently "educable," or whether some people, by nature or by circumstance, are "ineducable." Of course, Adler, as a teacher, was of the former opinion, and Buckley, who earns his living trying to make his ideological opponents look hopelessly dull and impervious to illumination, was of the latter.

I choose to believe that anyone in possession of physiologically normal organs of speech and at least half a brain is capable of pronouncing nuclear correctly. As R. W. Burchfield (1996) points out, "the spectacular blunder of pronouncing [nuclear] as if it were spelled nuc-u-lar' is the result of a tempting misassociation with the many words ending in -ular (circular, particular, cellular, secular, molecular, jocular, avuncular, etc.).  This error is one of the ear and eye more than the tongue, and it has persisted not because it is too difficult for some to say N(Y)OO-klee-ur but because they do not heed the spelling and hear the difference between the proper and improper pronunciations ---which brings us to the matter of correction.

Those who do hear the mispronunciation and who say the word right (still a substantial majority of us, I think) are understandably reluctant to correct those who do not. Can you imagine, as Edwin Newman puts it, "how other and lesser members of the Carter administration found it tactful to pronounce [ nuclear ] during Cabinet meetings," when President Carter and Vice President Mondale were mangling the word, albeit unwittingly, at every turn?*see footnote In Shaw's Pygmalion, the arrogant dialectician Henry Higgins "experiments" without the slightest compunction on his social inferior, the "guttersnipe" Liza Doolittle, teaching her to speak Received Standard English so he can win a bet. But who else feels comfortable correcting the pronunciation of anyone but a child without being asked to do so?  It is a tricky matter even to correct family members and friends, and so with a neighbor, acquaintance, or coworker, most of us will not - and should not - presume to offer an unsolicited opinion. (Writing a book on the subject is different, for a book lays open its opinions only to those who freely choose to read it, and who are equally free to accept or reject the advice it contains without compromising their dignity.)

On the other hand, we should and do reserve the right, in matters of language, to speak as we see fit, to decide for ourselves what is acceptable and unacceptable, and to pass tacit judgment on our peers.  When I began writing this book nearly every person with whom I discussed its contents asked (and in some cases implored) me to decry NOO-kyuh-lur, which made me wonder whether it might be the Most Disdained and Detestable Beastly Mispronunciation in the language.  People who care at all about how words are pronounced (with the exception of linguists and lexicographers) seem to reserve their most vehement antipathy for NOO-kyuh-lur, and it comes as no surprise to me that a whopping 99 percent of the usage panel of Morris & Morris's Harper Dictionary of Contemporary Usage (1985) condemned it.  In usage notes devoted to a lame defense of the mispronunciation, M-W 10 (1993) and RHWC (1997) both admit that NOO-kyuh-lur is "disapproved of by many," yet by just how many it is impossible to determine. On behalf of the indeterminate many who pronounce the word correctly, then, I appeal to the inadvertent many who do not: listen, and be errant no longer. Molecular comes from molecule, and particular comes from particle, but there is no nucule to support nucular.  Nuclear comes from nucleus- N(Y)OO-klee-ys -which is almost never mispronounced. If you can say nucleus and you can say nuke (the informal verb meaning to attack with nuclear weapons or, humorously, to microwave), then the proper pronun­ ciation of nuclear is but a suffix away.

For more on correcting others' pronunciation, see gondola. Also see arctic, cupola, diminution, February, irrelevant, jewelry, Realtor.

*footnote:
* In I Must Say (1988), Newman writes, "Those who make it nucular must hear themselves saying it and must hear others who don't. How do they account for the difference? Do they think the others are wrong, and are they too polite to correct them?  Evidently they never look up the word in a dictionary.  Maybe the word 'muscular' leads them astray, or 'circular' or 'molecular.'  Only a fiend would distribute a circular written by a molecular biologist and recommending a muscular nuclear policy.  It is embarrassing to hear Russians and other foreigners snapping off the word as it should be when so many Americans cannot manage it"

Epson WF-7840 Scan to Email Settings for Apple

I have posted a document attached here about this.  I hope the Google search can find the information. It might help save a few hours for those trying.  The linked pdf has the same text as below, plus a set of screen shots showing some of the process and the end screen.  Here is the link again.  Except for this issue, I think the printer is really good and the setup was otherwise pretty automatic.  I have tried lots of these A3 printers and this one definitely leads the pack.  The software is very well done.

The issue is making the new Epson printer send the scan directly to email.  The trick with Apple is that you need an "app specific password" which is complicated if you are a novice because you also have to have "two factor authentication" and then use THAT special password for the EPSON login setup screen.  ** As an afterthought, I saw that the instructions from the Apple link I was given from Telstra Platinum Support includes the App Specific Password retrieval in the email RECEIVE instructions so if you don't receive (as in a printer setup) then you have skipped that part and the SMTP send is not set up!  At least that is my excuse, **

So here is some information about all that.  To speed you, here is a setup screen from the printer control panel:

DETAILED INSTRUCTIONS

Scan to Email from Epson WF-7840 Printer
(This might take an hour or so!!)

Date: 2020/11/08

Steps:

First, Install the Printer Completely

Then Get App Specific Password from your iCloud screen.

In Windows 10 I do these steps:

You need to have iCloud for Windows ( https://support.apple.com/kb/HT201391 )

You need to have TWO FACTOR AUTHENTICATION set up

go to iCloud.com and log in with your password and then with the authentication from your iPhone

Go to Security section and then generate an APP SPECIFIC PASSWORD, give it a name so you know what it is.

NOTE: THIS NUMBER IS GOING TO BE YOUR PASSWORD IN THE EPSON SCREEN

Have you Installed the Printer Completely?

Now, find the IP address of your printer ( mine is 192.168.0.125 ).  You can probably get this from printing out the network status on the printer maintenance sheets or on the control panel go to Settings/Network Settings/Network Status/Wired Lan Wifi Status

Now on the PC, log in to the printer and enter a username and password (these are blank initially).  If you change things from the PC, you might be timed out and you need to go back in and enter again. 

NOTE: But you can change these settings on the control panel too:

On the PC now log into the printer control at the IP address ( as I said, mine is http://192.168.0.125  Yours will be different. If you see a security warning don’t worry it is inside your own house.)

Now you should be in the printer administration screens

Go to the Tab “Network” and then on the left side column choose Email Server/Basic

Fill in the details and instead of your usual password, put in the “App Specific Password” which you see on the iCloud Screen.

Go into the printer administration or do this from the Printer Control Panel.

Fill in the screens as shown here:  The information is as follows:

(SEE LAST IMAGE ATTACHED ABOVE or in linked PDF)

SMTP AUTH / yourapplename@icloud.com / the app specific password / yourapplename@icloud.com / smtp.mail.me.com / 587 / STARTTLS / Disabled /

Mars in Opposition Photographed with iPhone XS Max Camera (real or artefact??)

This all started when I noticed Mars was very bright as I viewed it this month with the naked eye looking East from a location 10 km North of Gingin (-31°20'27.60" S 115°54'28.80").  Gingin is 100 km North of Perth Western Australia and it has very clear skies with hardly any light pollution.  I read that Mars was "in opposition" which means that it is in a direct line, on the same side of the sun as the Earth.  In this position it can be about 62 million km from Earth.  I took a photograph using 3.6x and posted it on Twitter.  It seemed pretty impressive with an orange disc visible.  After I posted it on Twitter I looked around and saw quite a few similar iPhone images on the web.  Then, some smart photography people claimed it was artefact and might be "bokeh" which is a kind of software interpretation.  I invited comments.  The authority on all things astrophysical is @thunderf00t and he came out with a quick answer that, through the telescope, "Mars is angularly about the size of a small crater on the moon." (thunderf00t link here)  Dave Jones checked it out and posted a couple more images showing how bad focus affects the digital camera image, increasing it about 5x (eevblog Tweet from Dave Jones).

I made some observations then, and sure enough, my iPhone could not see any small craters on the moon.  I tested the camera using a tape measure and ruler and discovered the resolution, using 3.6x, was 1 mm at 2 m.  This is an angle of about 0.03 degrees.  According to the laws of physics and trigonometry, the angular size of the moon is 0.524 degrees.  The Moon image from my iPhone was about 10 times bigger than the Mars image.  Thus the angular size of the Mars image was 0.0524 degrees.  From trig', allowing for a base of 6.2E10 meters away and a diameter of 6.7E6 meters, the actual angular size of Mars is 0.006.

Conclusion: iPhone has turned the Mars image into a circle 5x times bigger than it really is.  Clearly I need to upgrade my iPhone and purchase a long lens for it.  Thanks to all the experts.  I enjoyed refreshing my trig, and cosmology.  Its nice to know that some things have not changed since I finished high school 52 years ago.

Footnotes:

It was difficult to actually find the angular resolution of the iPhone, since most of the hype about "retina" really refers to the screen image rather than the camera.  But Wikipedia has good information.  Here is what I found out (see also my notes below).

The human eye has an angular resolution of 0.6 arcminutes.  There are 60 arcminutes in a degree so this is 1/100 of a degree. (0.01 degrees).

The iPhone has a resolution of the order of 300 pixels per degree (PPD) which is about 0.003 degrees. My measurement might not have been under ideal conditions.  Lighting, exposure, autofocus etc. seems to have worsened the result by a factor of 5-10.  So iPhone should be better than the eye.  It should be able to resolve mars as a single pixel, but not as a circle.

As an afterthought, I noted that the Jupiter image was about 2x the size of my Mars image and about 1/5 the size of the moon image.  Thus Jupiter had an angular size of 0.1 degrees.  According to trig', with the current distance to Jupiter of 782,905,474 km (7.82E11 m) and a diameter of 139,822 km (1.39E8 m), the actual angular size is tan-1((1.39E8)/(7.82E11)) = 0.01 degrees.  So it is (just) resolvable as more than a pixel but is also being magnified as it really is about 50 times smaller than the moon.

Further Information: Calculations and Image Data

My memory of the first steps on the moon 50 years ago.

On the 50th anniversary of the first step on the moon, I can add my experience that day, which was at 10:30 am Monday 21st of July in Perth (at 9:30 p.m. Houston time,  July 20, 1969). 

I was in first year medicine at the University of Western Australia. I attended math class, but at 10 am was free to watch the moon landing.

I joined a group of about 100 people in the Student Guild common room, and sat on the floor at the front, waiting for the first steps on the moon, watching a black and white 20 inch TV (no colour in those days).  Reception was poor as it had no real antenna, just a wire coat-hanger stuck into the broken antenna connection!  Being a person who likes to fix things, I didn’t want an intermittent antenna connection to fail at the crucial moment.  So I got up and adjusted the coat hanger.  To everyone’s dismay the picture deteriorated even more.  I was heckled and booed.  This got rather tense and I was not sure I could solve the problem.  Time was running out, 10 minutes to go!!  

In fear of being tarred and feathered, I noticed an open window so I climbed out into the garden, then ran about 500 meters across the grass of the Great Court to the Physics/computer science lecture theatre which had six, perfectly adjusted TV’s, on the side walls.  I made it with minutes to spare, in time to see a “perfect” transmission of John Armstrong’s first steps on the moon.  

50 years later, to the people I left in the Guild common room, I say “sorry about all that”.

My Acute Renal Failure Episode

UPDATE 23 July:(recovering)

In a nutshell...

Fell over

Sore knee +++

NSAID ++

?Staph cellulitis culture and aspirations negative

Admission to ER obs

24 hrs fluclox IV (renal status not yet checked)

Vomiting started but went home

36 hrs vomiting nil oral dehydrated

Readmit IV rehydration

Uhoh! Creatinine 450!!

Oliguric ATN

Renal U/S normal

eGFR 6! (Was 90 in January)

Creatinine peaks at 750 almost dialysed

Hypertension 190/110

Sinus Bradycardia HR30 monitored in CCU

Improved a bit, but caught severe cold ?flu

Deteriorated clinically can’t eat

Labs improving

Cold settling

22/07 feeling a bit better and eating a little (looking like Thai cave boy after no food for 12 days).

eGFR 15 (20% of normal)

Now: able to do a few emails, walk 100m, reading a book. Updating this blog.

😢🤮😬🥓🍳🥞🤞

23/07 

04/08 eGFR up to 35, Urea and Creatinine 2x normal.  Regaining strength.

Gastric Cooling for Bleeding Ulcers (in 1965)

I just uploaded a finished book written by Dr Wylie D. Gibbons, a 90 year old surgeon from Queensland Australia.  The title, as shown in the image below, is "Gastric Hypothermia for Major Haematemesis".

The book can be downloaded freely, even copied, at the clickable Dropbox web location here.

You can also view the several parts of the book by clicking here, which will make it faster to download.
If you cannot access Dropbox (e.g. from China) please use this link to my web server.

Background:

In the 1960's bleeding gastric and duodenal ulcers required emergency surgery.  Well, not exactly!  It was known that, in most cases, bleeding stopped before the patient bled to death.  So the strategy was to give "medical treatment" involving fasting, resting, washing out the stomach with a large bore tube, placing various solutions of drugs and antacids in the stomach, and waiting to see what happened.  All the while the patient was given blood transfusions.  After multiple transfusions, often completely replacing the patient's blood volume, surgery might be tried.  By this time the patient might be close to death and the anaesthesia itself could be fatal.

About then, a surgeon called Wangensteen at the University of Minnesota USA, on the basis of some animal experiments, introduced a machine to automatically lavage the stomach with ice water.  This process caught on and seemed to stop the bleeding in many cases.  At least it was better than nothing.

In this era, Wylie D. Gibbons learned the technique, critically evaluated then improved on it, and collected a series of patients in Rockhampton Queensland.  These formed the basis of his first thesis submitted in 1965 to the University of Queensland.  The thesis was rejected.  Read on if you are interested.

My comment on the back cover is as follows:

"In the absence of the true cause of peptic ulcer, patients faced a future of terrible suffering or death and clinicians were desperate to save them. In Rockhampton Queensland, the person who took on this heroic duty was the local surgeon, Dr Wylie Gibbons." 

Links to the Book:

The book is identified by ISBN-13:978-1974454174 and ISBN-10: 1974454177

Wylie D. Gibbons Publishing, 

Villa 240, 

60 Endeavour Boulevard, 

North Lakes, Queensland 4509, 

AUSTRALIA.

Hard cover copies are available (printed as required) for USD$100 from the author. 

The book can be downloaded freely, even copied or reproduced, at the clickable Dropbox web location here.

You can also view the several parts of the book by clicking here, which will make it faster to download.
If you cannot access Dropbox (e.g. from China) please use this link to my web server.