Saturday, August 31, 2013

Health : The Atlantic: The Neuroscience of War

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thumbnail The Neuroscience of War
Aug 31st 2013, 22:31, by James Hamblin

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That's an update from Sarah Palin's Facebook page yesterday. One could find it confusing, as she is quoting herself. The answers to Palin's questions, respectively, seem to be no and yes. I won't touch the invocation of Allah.

In the discussion of the significance of chemical warfare and the importance of the U.S. red line, Atlantic correspondent James Fallows remains unconvinced that military intervention in Syria is advisable. As does much of the world. Fallows noted today, "The United States has not acted previously as if chemical-weapons use was an end-of-history, line-drawing occasion," referring to the 1988 use of nerve gas on civilians by Saddam Hussein during the Iran-Iraq war. As he put it, "Nerve gas was hideous then. Chemical weapons are hideous now." 

President Obama called on the U.S. Congress today to authorize a strike against the Assad regime. While as a nation we wait for that, let's talk about hideousness—what John Kerry yesterday called "moral obscenity." The United Nations estimated that more than 100,000 people have died in the Syrian civil war thus far. Chemical attacks have been estimated to involve something on the order of 355 to 1400 of those deaths. As Dominic Tierney wrote for The Atlantic in December 2012, "Blowing your people up with high explosives is allowable, as is shooting them, or torturing them. But woe betide the Syrian regime if it even thinks about using chemical weapons! A woman and her child under fire in Aleppo might miss this distinction." 

In May I wrote about the physiology of nerve gas, which I'll excerpt in the following paragraphs (like Palin, quoting myself), because it's worth being on the same page about this distinction what "nerve agents" are; why many consider it defensible to land a bullet in someone's spine or to force-feed detainees, but not to gas. There are a few agents that could be called "nerve agents," "nerve gas," or "chemical weapons," like sarin, soman, and taubun. Based on the symptoms reported in Syria, the leading suspect is sarin. All are banned by a 189-country international convention.


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Inspecting gas masks during manufacture, c1941 (Argus Newspaper Collection, State Library of Victoria)

On April 22, 1915 in Belgium, the German army killed or injured 5,000 Allied soldiers by releasing 150 tons of chlorine gas. That is regarded as the first modern use of large-scale chemical warfare, though the concept goes back to snake-venom-tipped arrows in the Stone Age. By 1937, German chemist Gerhard Schrader had developed an insecticide that the Nazis soon realized was a more toxic agent than chlorine gas: sarin. They did not use it in World War II, though, reportedly because they understood its potential and feared retaliation in kind.

In 1988, around 5,000 Kurds died at Halahbja after Iraq used both sarin and sulfur mustard. Sarin further became a household name after the 1995 Tokyo subway attack in which the religious cult Aum Shinrykio used sarin to kill 12 people and harm thousands more.

So, what does sarin do to our bodies?

SHARK300200.jpgEffect of sarin on the left eye of a rabbit (pupil constriction) [Journal of Medical, Chemical, Biological, and Radiological Defense]


Sarin is unique in potency but not in mechanism. There are other drugs, pesticides, and plants that work the same way. They are called cholinesterase inhibitors.

Our nerves talk to each other by releasing chemicals called neurotransmitters. The amount of a particular neurotransmitter helps determine whether a nerve fires or not. What so-called nerve agents do is alter those neurotransmitters. They kink the signaling between our nerves, telling them to do things they normally do, but with altered frequency.

After a neurotransmitter has done its job, delivered its message, an enzyme usually comes along and demolishes it. But nerve agents block those enzymes. The enzyme can't break down the neurotransmitter, so the neurotransmitter stays around and keeps giving its message. If that message was, say, to release a little water onto your eye because your eye was dry, now the repeated message becomes "make your eyes water uncontrollably." 

Here is a drawing of that reaction, just like in organic chemistry class (still a requisite for all U.S. doctors). The big block is the enzyme (acetylcholinesterase). In the top image, it's working normally: breaking down the neurotransmitter (acetylcholine) into smaller parts. In the bottom images you can see how the "nerve agent" (sarin in our case) just kind of hangs out in the "esteric site," so then the enzyme cannot do its job.

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Screen Shot 2013-05-06 at 10.59.36 AM.pngScreen Shot 2013-05-06 at 10.59.44 AM.png

 

As acetylcholine builds up in our bodies, we become extremely uncomfortable and die. We are killed by the accumulation of our own normal neurotransmitter telling our own nerves to do the normal things they normally do, just in excess. One could draw an analogy to cancer. In this case, though, neurotransmitters live and die on an order of milliseconds, so it happens in a flash.

Within seconds of exposure to sarin gas (or liquid, which evaporates easily), we start to notice the immediate effects of acetylcholine buildup. First, our smooth muscles and secretions go crazy. The nerves to those areas keep firing, keep telling them to go. The nose runs, the eyes cry, the mouth drools and vomits, and bowels and bladder evacuate themselves. It is not a dignified state.

Since sarin has no smell or taste, the person may very well have no idea what's going on. Their chest tightens, vision blurs. If the exposure was great enough, that can progress to convulsions, paralysis, and death within 1 to 10 minutes.

If the exposure was not enough to kill them, though, the person should recover pretty quickly and completely. It is not the sort of agent that leaves people blind and infertile and glowing green. The U.S. military also has a lotion that can be applied immediately after exposure, Reactive Skin Decontamination Lotion, to good effect, among other antidotes. Most people exposed to sarin do not die. A large exposure is not a death sentence.


Richard M. Price, a professor at the University of British Columbia and author of The Chemical Weapons Taboo and spoke with CBS News recently about what he considers the two factors that perpetuate the taboo of nerve agents:

1.   "They were banned before they existed in any serious form, in the 1899 Hague Declaration concerning the prohibition of the use of projectiles with the sole object to spread asphyxiating poisonous gases. That ban, he said, held more weight because the weapon in question was not already in use. (The 1925 Geneva Protocol and a 1997 international treaty also banned the weapons.)"

2. A "tradition of non-use ... made their use anomalous, so it's continued to raise the threshold that you would only use them under really dire circumstances. Even Adolf Hitler declined to use chemical weapons on the battlefield in World War II." (Though he did use gas chambers.) 

Beyond the physiology—and debate over whether gruesome death by paralysis and asphyxiation is a greater human rights abuse than, say, gruesome death by being shot in the neck—the questions will come to the use of chemical weapons as a symbol of willful defiance and escalation, as a precedent, and as a threat to the United States' credibility as a nation that stands by its red lines. Among other contextual theories. Price called it "really puzzling" that Assad would deploy chemical weapons, and that was echoed by Vladimir Putin today, since the Syrian army is not in a desperate position. Putin said he is "convinced that [the chemical attack] is nothing more than a provocation by those who want to drag other countries into the Syrian conflict, and who want to win the support of powerful members of the international arena, especially the United States."

Then another angle to consider is one Tierney described in December: Washington is sometimes willing to cast a blind eye against the use of chemical weapons, as long as its in our interests [referring to Hussein's use in 1988]... Baghdad was seen as a secular bulwark against the more threatening Iraniansthe classic lesser of two evils ... Strip away the moralistic opposition to chemical weapons and you often find strategic self-interest lying underneath. Powerful countries like the United States cultivate a taboo against using WMD partly because they have a vast advantage in conventional arms. We want to draw stark lines around acceptable and unacceptable kinds of warfare because the terrain that we carve out is strategically favorable."


    






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U.S. News - Health: Anticlotting Drugs: What You Need to Know

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Aug 31st 2013, 12:00

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Friday, August 30, 2013

U.S. News - Health: CDC: 4 Percent of Adults Using Sleep Aids

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Aug 30th 2013, 08:12

Celebrity trainer Vinnie Tortorich on what works for weight loss; 5 healthy comfort foods from the experts

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U.S. News - Health: ACA and Health Insurance: Which "Metal" Tier is Right for You?

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ACA and Health Insurance: Which "Metal" Tier is Right for You?
Aug 30th 2013, 20:15

Planning to buy health insurance on the state-based marketplaces? Find out which "metal" tier is right for you.

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U.S. News - Health: Hospitals Try New Ways to Lower Premature Birth Rates

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Aug 29th 2013, 18:05

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U.S. News - Health: Why Get Health Insurance in the State Marketplaces?

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Aug 30th 2013, 17:10

Pros and cons to buying health insurance on the new state marketplaces.

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U.S. News - Health: Why Iodine is Important During Pregnancy

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Aug 30th 2013, 16:31

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U.S. News - Health: How to Save Money on Fitness

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Aug 30th 2013, 15:50

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Health : The Atlantic: Study: Boyfriends Insecure, Wish to Hoard Success for Themselves

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thumbnail Study: Boyfriends Insecure, Wish to Hoard Success for Themselves
Aug 30th 2013, 14:45, by Julie Beck

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Problem: It's hard to remember that other peoples' successes do not diminish your own, to choke down the bile of jealousy that rises in your throat whenever anyone in your peripheral vision is doing a better job of being a person than you are.  But you'd think you could swallow the evil green demon that lives inside your unhappy heart long enough to muster up a little genuine pleasure when the person succeeding is your partner, whom you claim to love. Or, at least not let it make you think worse of yourself. A study in the Journal of Personality and Social Psychology tested that ability in men and women.

Methodology: Researchers studied a total of 896 people in heterosexual relationships over the course of five experiments, testing the theory that men's implicit self-esteem would be affected more by the success of their partners than women's would.

In the first experiment, participants completed a social intelligence test and then were told their partners performed either in the top or bottom 12 percent. They didn't find out their own scores. Then they measured their own self-esteem, both implicit and explicit—the test for implicit, or subconscious, self-esteem involved measuring how quickly they associated positive or negative words with the word "me."

Other studies asked people to write about a time their partner either succeeded or failed (sometimes generally, sometimes within a specific category such as intellectual or social successes/failures), then measure their self-esteem, their predictions about the future of their relationships, and their relationship satisfaction. The final experiment rubbed a little more salt in the wound, asking them to think about a time when their partner succeeded, and they failed (or vice versa).

Results: It didn't seem to matter to men what the circumstances of their girlfriends' success was. Whether the success was social or intellectual, whether it related to the boyfriend's failure or was just something the woman achieved independent of anything the boyfriend did, the men still tended to feel worse about themselves when their girlfriends succeeded. This only goes for implicit (subconscious) self-esteem, though—men didn't explicitly report feeling worse about themselves, whether because they didn't consciously notice or because they didn't want to portray themselves as insecure jerks, we cannot say.

"The lack of difference lends some support to the idea that men interpret 'my partner is successful' as 'my partner is more successful than me,'" the study reads.

In the face of a partner's success, women felt better about the future of their relationship, and men felt worse. Men felt better about the future of their relationship when their partner had just failed.

Implications: The researchers bandy about some theories as to why men were made more insecure by female partners' successes, but women didn't feel the same about their male partners' successes. One is that studies have shown that women care more about communal behavior. Another is the idea that men are more competitive than women, and therefore more likely to see a partner's success as a sign that they are not as good as their partner. Because behind every great relationship is a scoreboard.


The study, Gender Differences in Implicit Self-Esteem Following a Romantic Partner's Success or Failure, appears in the Journal of Personality and Social Psychology.


    






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