Man Died When Pharmacist Refused to Give Him EpiPen Without the Mandated Prescription

(p. A15) Rates of hospital admissions for asthma, nut allergies in children, and prescriptions for EpiPens (used to treat extreme reactions) have all tripled in recent decades. Not only are food allergies now more common in children, but they are less likely to be outgrown with age than in years past.

The causes and consequences of this epidemic are the subject of “Allergic,” an important and deeply researched book by Theresa MacPhail, a medical anthropologist who memorably portrays the human face of disease.   . . .   Ms. MacPhail . . . has a personal connection to this subject: Her father died after being stung by a bee on the main street of the New Hampshire town where she grew up. (His girlfriend drove him to a drugstore instead of a hospital; even though he was in extremis, the pharmacist refused to dispense an EpiPen without a prescription.)

For the full review, see:

John J. Ross. “BOOKSHELF; Runny Noses, Itchy Eyes.” The Wall Street Journal (Wednesday, May 24, 2023): A15.

(Note: ellipses added.)

(Note: the online version of the review has the date May 23, 2023, and has the title “BOOKSHELF; ‘Allergic’ Review: Runny Noses, Itchy Eyes.”)

The book under review is:

MacPhail, Theresa. Allergic: Our Irritated Bodies in a Changing World. New York: Random House, 2023.

Even Environmentalists Face Trade-Offs: Plans to Refill the Salton Sea May Hasten an Overdue Large Earthquake

(p. A1) It has been about three centuries since the last great earthquake on the southern San Andreas Fault, the most treacherous seismic hazard in California. For decades researchers have puzzled over why it has been so long. The average interval of large earthquakes along that portion of the fault has been 180 years over the past 1,000 years.

While seismologists agree that Southern California is due for the Big One, a group of researchers published a paper on Wednesday [June 7, 2023] in the journal Nature that offers a reason for the period of seismic silence along the southern San Andreas, the tension-wracked meeting point of the North American and Pacific tectonic plates.

. . .

Mr. Hill and his co-authors found that major earthquakes along the southern San Andreas fault tended to happen when a large body of water, Lake Cahuilla, was filling or was full with water from the Colorado River in what are now the Coachella and Imperial valleys.

The lake has drained over the last three centuries and all that remains is the vestigial Salton Sea.

. . .

The research published in Nature, which builds on a paper on which Dr. Philibosian was a writer in 2011, raises questions about plans to rehabilitate parts of the Salton Sea, . . . .  . . .  As the sea dries out, toxic dust is left behind and blown into the air, posing a hazard for nearby residents.

. . .

Impounding more water in the Salton Sea could tamp down the dust.Impounding more water in the Salton Sea could tamp down the dust.  . . .  But a major change in the water level could also trigger seismic activity, according to Dr. Philibosian.

For the full story, see:

Thomas Fuller. “Scientists Offer Reason for a Sleepy San Andreas Fault.” The New York Times, First Section (Sunday, June 11, 2023): A20.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date June 7, 2023, and has the title “The San Andreas Fault Is Sleepy Near Los Angeles. Researchers Have an Idea Why.”)

The Nature article published online on June 7 and mentioned above is:

Hill, Ryley G., Matthew Weingarten, Thomas K. Rockwell, and Yuri Fialko. “Major Southern San Andreas Earthquakes Modulated by Lake-Filling Events.” Nature (2023) DOI: 10.1038/s41586-023-06058-9.

“They Just Invest in How to Navigate This Bureaucracy”

(p. A1) Capella Space, a San Francisco-based start-up, is building a fleet of small, inexpensive satellites that can track enemy troops as they move at night, or under cloud cover that traditional optical satellites cannot see through.

Fortem Technologies, a small aerospace company in Utah, wants to supply the Pentagon with a new type of unmanned aircraft that can disable enemy drones.

HawkEye 360, a Virginia-based firm, has used private equity funds to launch its own satellites that use radio waves emitted by communications equipment and other electronic devices to detect the presence of enemy troop concentrations.

Each of these systems is getting real-world testing in the war in Ukraine, earning praise from top government officials there and validating investors who have been pouring money into the field.

But they are facing a stiff challenge on another field of battle: the Pentagon’s slow-moving, risk-averse military procurement bureaucracy.

When it comes to drones, satellites, artificial intelligence and other fields, start-up companies frequently offer the Pentagon cheaper, faster and more flexible options than the weapons systems produced by the handful of giant contractors the Pentagon normally relies on.

But while the military has provided small grants and short-term contracts to many start-ups, those agreements often expire too quickly and are not large enough for young companies to meet their payrolls — or grow as rapidly as their venture capital investors expect. Several have been forced to lay people off, delaying progress on new technologies and war-fighting tools.

. . .

(p. A8) From the early months of the war, SpaceX’s Starlink, the Elon Musk-founded satellite internet service, had played a critical role for frontline Ukrainian troops. But small drones and a denser collection of satellites are also helping to provide the capacity for pervasive surveillance, allowing Ukraine to identify and track threats and targets constantly.

A new generation of cheaper and more precise attack drones carrying bombs can loiter in the air autonomously until they find their targets. Artificial intelligence-backed computer systems can fuse this collected data and other feeds to make targeting decisions, faster than any human.

The Ukrainians have also innovated a great deal themselves, impressing Pentagon officials as they have converted commercial drones, for example, into mini bombers.

Taken together, said Thomas X. Hammes, who studies war-fighting history at the Pentagon-backed National Defense University, the developments represent a “genuine military revolution,” and one that is happening much more quickly than the shift from infantry that traveled by foot in World War I to the motorized and mechanized armies of World War II.

. . .

(p. A9) Perhaps the most revolutionary use of American technology in Ukraine has been the application of software that uses artificial intelligence, made by Palantir, to help with targeting efforts. The company’s chief executive, Alex Karp, traveled to Ukraine last year to meet with President Volodymyr Zelensky.

“If you go into battle with old school technology,” Mr. Karp said this year at an event to discuss artificial intelligence tools in warfare, “and you have an adversary that knows how to install and implement digitalized targeting in A.I., you obviously are at a massive disadvantage.”

Some experts say that artificial intelligence, which has been used in Ukraine to help sift through the massive loads of data being accumulated from surveillance, will ultimately prove as disruptive to the nature of war-fighting as nuclear weapons.

. . .

For Primer, the small artificial-intelligence firm based in downtown San Francisco, it was a breakthrough moment.

Not long after the war in Ukraine started, its engineers, working with Western allies, tapped into a tidal wave of intercepted Russian radio communications. It used advanced software to clean up the crackly sound, automatically translated the conversations, and most importantly, isolated moments when Russian soldiers in Ukraine were discussing weapons systems, locations and other tactically important information.

This same work would have taken hundreds of intelligence analysts to identify the few relevant clues in the mass of radio traffic. Now it was happening in a matter of minutes.

The findings were quickly matched up with other so-called open source intelligence streams, like geolocation data pulled from social media accounts, giving updates on the location of troops or equipment, that could be matched with surveillance video from drones or images from satellites.

“It’s getting situational awareness,” said Sean Gourley, the founder of Primer.

Yet at the same time, the Pentagon was still deciding when to move ahead with major purchases of its technology. The company was burning through its cash reserves too quickly, so Mr. Gourley laid off engineers and other staff members.

“These engineers are great at creating solutions to solve these problems, which is what matters,” Mr. Gourley said. “But there is the uncertainty: When is this contract going to close? It’s very, very hard to justify that spend.”

Mr. Gourley said he decided instead to invest more money in a government relations push, hiring a former top aide to the Senate Armed Services Committee to help the company promote its business in Washington.

“The big defense companies, they don’t really kind of invest in the tech,” he said. “They just invest in how to navigate this bureaucracy. That kind of sucks, but that’s how you’ve got to play this game.”

In interviews, nearly a dozen top executives of technology-oriented companies shared stories of stalled efforts or frustration.

For the full story, see:

Eric Lipton. “Pentagon Is Slow At Signing Deals With Innovators.” The New York Times (Monday, May 22, 2023): A1 & A8-A9.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date May 21, 2023, and has the title “Start-Ups Bring Silicon Valley Ethos to a Lumbering Military-Industrial Complex.”)

Data Set Too Small to Support Claim of 250,000 Annual ER Deaths Due to Misdiagnosis

(p. A17) A shocking headline recently claimed that every year 250,000 people in the U.S. die after misdiagnosis in the emergency room. Even more shocking, the statistic was extrapolated from the death of one man—in a Canadian emergency room more than a decade ago.

. . .

The statistical methods used to arrive at the report’s estimate of 250,000 deaths are very bad, resulting in inaccurate findings that exaggerate potential harm in ERs. The estimate was derived from a single study that included only 503 patients discharged from two Canadian emergency rooms from August to December 2004. Researchers found that among the 503 patients, one person unexpectedly died related to a delay in diagnosis by an ER physician. The patient had signs of an aortic dissection—a tear in the major vessel that carries blood from the heart. For reasons we don’t know, the diagnosis was delayed for seven hours.

The goal of the Canadian study was to measure all kinds of medical errors, not to estimate the death rate from erroneous or late diagnoses. The sample size wasn’t big enough for that. Had nobody in the study sample died, would that mean that ERs never make fatal errors? Obviously not.

The AHRQ report misused this single death to estimate a death rate across the entire U.S. Dividing one death by 503 patients, the researchers estimate a death rate of 0.2%. They then multiply 0.2% by total annual ER visits in the U.S.—130 million—and come up with 250,000 deaths.

For the full commentary, see:

Kristen Panthagani. “A Study Sounds a False Alarm About America’s Emergency Rooms.” The Wall Street Journal (Friday, Dec. 30, 2022): A17.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date December 29, 2022, and has the same title as the print version.)

Milton Friedman Was a “Formative Intellectual Influence” to George Shultz

(p. A13) [George] Shultz, an unflamboyant personality once described by a college classmate as a “steady, plodding intellect,” reached the commanding heights of American government, holding four cabinet posts over his career from secretary of the Treasury to state. Shultz died in 2021 at the age of 100.

. . .

For a time Shultz was on track for a career in academia, working in the economics department at MIT and later the University of Chicago. “Chicago is what started me,” Shultz said. Milton Friedman, a formative intellectual influence and enduring friend, methodically deepened Shultz’s faith in free markets and his skepticism of government intervention in the economy. “Milton didn’t hit the tennis ball hard but it always came back,” Shultz once remarked, “which was reflective of the way he argued, too.”

. . .

. . . Shultz was hardly immune from being wrong. For example: Along with the rest of the State Department, he tried to talk Reagan out of using the line “Mr. Gorbachev, tear down this wall.” Shultz worried it was too provocative.

The cautionary tale is that many know Shultz from perhaps the biggest error in judgment he ever made, some 90 years into his life. That’s his association with Elizabeth Holmes, the Silicon Valley founder convicted of fraud in federal court. Shultz was one of Ms. Holmes’s first marks, and he helped her assemble a board for her blood-testing company from his Rolodex. Among the wreckage was Shultz’s relationship with his own grandson, Tyler, who early on discovered the company’s misrepresentations.

For the full review, see:

Kate Bachelder Odell. “BOOKSHELF; Subsume the Ego And Stay Loyal.” The Wall Street Journal (Tuesday, March 7, 2023): A13.

(Note: ellipses, and bracketed name, added.)

(Note: the online version of the review has the date March 6, 2023, and has the title “BOOKSHELF; ‘In the Nation’s Service’ Review: George Shultz’s Quiet Strength.”)

The book under review is:

Taubman, Philip. In the Nation’s Service: The Life and Times of George P. Shultz. Stanford, Cal.: Stanford University Press, 2023.

In 2021 Summers and Blanchard Worried That Biden’s Covid Stimulus Would Fuel Inflation

(p. A2) When Congress passed President Biden’s $1.9 trillion American Rescue Plan in early 2021, which included checks to households, enhanced jobless benefits and aid to state and local governments, inflation was around 2% and unemployment, though coming down, still above 6%.

At the time many forecasters thought the stimulus could push demand above the economy’s potential to supply goods and services and unemployment below its long-run natural rate of around 4%. Yet few thought this would meaningfully raise inflation. In previous decades unemployment had remained similarly low without raising price pressures.

A few disagreed, notably former Treasury Secretary Lawrence Summers and Blanchard. Both warned the stimulus was so large it would push the economy dangerously into overheating territory.

For the full commentary, see:

Greg Ip. “CAPITAL ACCOUNT; Why Did Inflation Take Off? Two Top Economists Answer.” The Wall Street Journal (Wednesday, May 24, 2023): A2.

(Note: the online version of the commentary has the date May 23, 2023, and has the title “CAPITAL ACCOUNT; Why Inflation Erupted: Two Top Economists Have the Answer.”)

A 2021 article that documented Summers’s and Blanchard’s worry that Biden’s huge stimulus might fuel inflation is:

Ip, Greg. “Inflation Risk: Little Now, but Some See Danger Ahead.” The Wall Street Journal (Tues., March 2, 2021).

Rice Farmers Adapt to Global Warming by Reviving Hardy Seed Breeds and Nimbly Adjusting Planting Rotations

(p. A1) Rice is in trouble as the Earth heats up, threatening the food and livelihood of billions of people. Sometimes there’s not enough rain when seedlings need water, or too much when the plants need to keep their heads above water. As the sea intrudes, salt ruins the crop. As nights warm, yields go down.

These hazards are forcing the world to find new ways to grow one of its most important crops. Rice farmers are shifting their planting calendars. Plant breeders are working on seeds to withstand high temperatures or salty soils. Hardy heirloom varieties are being resurrected.

. . .

The climate crisis is particularly distressing for small farmers with little land, which is the case for hundreds of millions of farmers in Asia. “They have to adapt,” said Pham Tan Dao, the irrigation chief for Soc Trang, a coastal province in Vietnam, one of the biggest rice-producing countries in the world. “Otherwise they can’t live.”

. . .

(p. A10) “We now accept that fast-rising salty water is normal,” said Mr. Pham, the irrigation chief. “We have to prepare to deal with it.” Where saltwater used to intrude 30 kilometers or so (about 19 miles) during the dry season, he said, it can now reach 70 kilometers inland.

Climate change brings other risks. You can no longer count on the monsoon season to start in May, as before. And so in dry years, farmers now rush to sow rice 10 to 30 days earlier than usual, researchers have found. In coastal areas, many rotate between rice and shrimp, which like a bit of saltwater.

But this requires reining in greed, said Dang Thanh Sang, 60, a lifelong rice farmer in Soc Trang. Shrimp bring in high profits, but also high risks. Disease sets in easily. The land becomes barren. He has seen it happen to other farmers.

So, on his seven acres, Mr. Dang plants rice when there’s freshwater in the canals, and shrimp when seawater seeps in. Rice cleans the water. Shrimp nourishes the soil. “It’s not a lot of money like growing only shrimp,” he said. “But it’s safer.”

Elsewhere, farmers will have to shift their calendars for rice and other staple grains, researchers concluded in a recent paper. Scientists are already trying to help them.

The cabinet of wonders in Argelia Lorence’s laboratory is filled with seeds of rice — 310 different kinds of rice.

Many are ancient, rarely grown now. But they hold genetic superpowers that Dr. Lorence, a plant biochemist at Arkansas State University, is trying to find, particularly those that enable rice plants to survive hot nights, one of the most acute hazards of climate change. She has found two such genes so far. They can be used to breed new hybrid varieties.

“I am convinced,” she said, “that decades from now, farmers are going to need very different kinds of seeds.”

Dr. Lorence is among an army of rice breeders developing new varieties for a hotter planet. Multinational seed companies are heavily invested. RiceTec, from which most rice growers in the southeastern United States buy seeds, backs Dr. Lorence’s research.

. . .

The new frontier of rice research involves Crispr, a gene-editing technology that U.S. scientists are using to create a seed that produces virtually no methane.

. . .

In Bangladesh, researchers have produced new varieties for the climate pressures that farmers are dealing with already. Some can grow when they’re submerged in floodwaters for a few days.

Others can grow in soils that have turned salty. In the future, researchers say, the country will need new rice varieties that can grow with less fertilizer, which is now heavily subsidized by the state. Or that must tolerate even higher salinity levels.

For the full story, see:

Somini Sengupta and Tran Le Thuy. “Reimagining Rice, a Crop That Feeds the World.” The New York Times (Monday, May 26, 2023): A1 & A10-A11.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date May 20, 2023, and has the title “Rice Gets Reimagined, From the Mississippi to the Mekong.”)

The “recent paper” by “researchers” mentioned above is:

Minoli, Sara, Jonas Jägermeyr, Senthold Asseng, Anton Urfels, and Christoph Müller. “Global Crop Yields Can Be Lifted by Timely Adaptation of Growing Periods to Climate Change.” Nature Communications 13, no. 1 (Nov. 18, 2022): article #7079.

Private Railroad Fuels South Florida Boom

We underestimate how well private entrepreneurs can efficiently provide the infrastructure that consumers want to buy.

(p. B6) South Florida housing values are still rising even as home prices in much of the country are starting to come down. Values for homes located near the region’s expanding rapid transit rail system are appreciating even faster.

Brightline, the privately owned and operated rail service, opened stations in Miami, Fort Lauderdale and West Palm Beach about five years ago, and more recently opened two more in Aventura and Boca Raton. Last week, Brightline started selling tickets for a new stop in Orlando, slated to open toward the end of the summer.

While mass transit systems throughout the U.S. are suffering from decreased business as more people work from home, Brightline reported a 68% increase in ridership in March of 2023, compared with the same month last year.

The popularity of the rail line is spilling over to the residential real-estate market, enabling home sellers to command higher prices for proximity to the transportation system, according to an analysis by the real-estate data and analytics firm Green Street.

For the full story, see:

Deborah Acosta. “South Florida Train Juices Home Values.” The Wall Street Journal (Wednesday, May 24, 2023): B6.

(Note: the online version of the story has the date May 23, 2023, and has the title “The Biggest South Florida Housing Boom Is Near the Rail Stations.”)

Longevity Proof of Concept–A Jellyfish That Can Return to a Younger Form

(p. A15) When Benjamin Franklin wrote that “nothing can be said to be certain, except death and taxes,” he must have thought he was stating an eternal truth. But if biotechnology researcher Nicklas Brendborg is to be believed, Franklin’s joke may need some updating. According to Mr. Brendborg, scientists have discovered a jellyfish the size of a fingernail that responds to stress by “ageing backwards,” reversing the normal direction of its development to become a bottom-dwelling polyp. This trick can be repeated over and over again with “no physiological recollection of having been older,” he explains, making this jellyfish “an example of the holy grail of ageing research—biological immortality.”

This tiny Methuselah is one of the striking examples in Mr. Brendborg’s breezy survey of the science of longevity, “Jellyfish Age Backwards,” which the author has translated from the Danish with Elizabeth DeNoma.

. . .

Short chapters built from short, declarative sentences combine with familiar material to give “Jellyfish Age Backwards” the feel of an introductory survey rather than a novel argument. Perhaps its piecewise construction is only a reflection of the disjointed state of the subject, where researchers are pulling on various threads but have not yet managed to knit them into a coherent whole. Mr. Brendborg finishes with a ringing declaration that the “noble” efforts of medical science will “eventually defeat” aging. But biology is complicated, as the author admits, and the strands of this multivariate and complex phenomenon may eventually prove to be tangled in some unresolvable knot.

For the full review, see:

Richard Lea. “BOOKSHELF; Dying Young At a Late Age.” The Wall Street Journal (Friday, Dec. 30, 2022): A15.

(Note: the online version of the review has the date December 29, 2022, and has the title “BOOKSHELF; ‘Jellyfish Age Backwards’ Review: Dying Young at a Late Age.”)

The book under review is:

Brendborg, Nicklas. Jellyfish Age Backwards: Nature’s Secrets to Longevity. Translated by Elizabeth DeNoma. New York: Little, Brown & Company, 2023.

Environmentalists Now Worry We Will Run Low on Squirrels

Really? Our dachshund, Walter Disney Diamond, would be happy to ship a few squirrels to whoever is worried. (His main activity is to dash outside to angrily defend our property rights in our fence against constantly interloping squirrels.)

(p. A19) Male Arctic ground squirrels go through puberty every year. As if that wasn’t hard enough, now the females have a problem, too.

According to a paper published on Thursday [May 25, 2023] in the journal Science, climate change appears to be making them emerge from hibernation earlier. That matters, because it could throw off the timing of the animals’ mating cycle.

. . .

Any decline in squirrel populations could disrupt the local food web. Almost all Arctic predators, from wolves to eagles, rely on them as a food source.

For the full story, see:

Mélissa Godin. “Squirrels Find Arctic Dating Scene a Bit Cold.” The New York Times (Saturday, May 26, 2023): A19.

(Note: ellipsis, and bracketed date, added.)

(Note: the online version of the story was updated May 25, 2023, and has the title “Just Between Us Squirrels, There Might Be Trouble in the Arctic Dating Scene.”)

Homo Sapiens’s Greater Genetic Diversity May Have Allowed Them to Adapt to Climate Change Faster than Neanderthals

(p. D5) Scientists have revealed a surprisingly complex origin of our species, rejecting the long-held argument that modern humans arose from one place in Africa during one period in time.

By analyzing the genomes of 290 living people, researchers concluded that modern humans descended from at least two populations that coexisted in Africa for a million years before merging in several independent events across the continent. The findings were published on Wednesday [May 24, 2023} in Nature.

“There is no single birthplace,” said Eleanor Scerri, an evolutionary archaeologist at the Max Planck Institute for Geoarchaeology in Jena, Germany, who was not involved in the new study. “It really puts a nail in the coffin of that idea.”

. . .

The researchers concluded that as far back as a million years ago, the ancestors of our species existed in two distinct populations. Dr. Henn and her colleagues call them Stem1 and Stem2.

About 600,000 years ago, a small group of humans budded off from Stem1 and went on to become the Neanderthals. But Stem1 endured in Africa for hundreds of thousands of years after that, as did Stem2.

If Stem1 and Stem2 had been entirely separate from each other, they would have accumulated a large number of distinct mutations in their DNA. Instead, Dr. Henn and her colleagues found that they had remained only moderately different — about as distinct as living Europeans and West Africans are today. The scientists concluded that people had moved between Stem1 and Stem2, pairing off to have children and mixing their DNA.

. . .

It’s possible that climate upheavals forced Stem1 and Stem2 people into the same regions, leading them to merge into single groups. Some bands of hunter-gatherers may have had to retreat from the coast as sea levels rose, for example. Some regions of Africa became arid, potentially sending people in search of new homes.

Even after these mergers 120,000 years ago, people with solely Stem1 or solely Stem2 ancestry appear to have survived. The DNA of the Mende people showed that their ancestors had interbred with Stem2 people just 25,000 years ago. “It does suggest to me that Stem2 was somewhere around West Africa,” Dr. Henn said.

. . .

Dr. Scerri speculated that living in a network of mingling populations across Africa might have allowed modern humans to survive while Neanderthals became extinct. In that arrangement, our ancestors could hold onto more genetic diversity, which in turn might have helped them endure shifts in the climate, or even evolve new adaptations.

“This diversity at the root of our species may have been ultimately the key to our success,” Dr. Scerri said.

For the full story, see:

Carl Zimmer. “A Study’s New Twist on How the First Humans Evolved.” The New York Times (Tuesday, May 30, 2023): D5.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story was updated May 24, 2023, and has the title “Study Offers New Twist in How the First Humans Evolved.”)

The article in Nature mentioned above is:

Ragsdale, Aaron P., Timothy D. Weaver, Elizabeth G. Atkinson, Eileen G. Hoal, Marlo Möller, Brenna M. Henn, and Simon Gravel. “A Weakly Structured Stem for Human Origins in Africa.” Nature 617, no. 7962 (May 25, 2023): 755-63.