Monday, May 28, 2012

Additional Forensic Investigation of 2001 Anthrax Attacks

From the University of Pittsburgh Center for Biosecurity comes this short report, a reiteration that the spores in the anthrax letters could not have come directly from those prepared by Bruce Ivins at Fort Detrick, as they lacked two substances contained in the RMR1029 anthrax spore collection. Thanks to Ross Getman for the citation.
Additional Forensic Investigation of 2001 Anthrax Attacks
By Amesh A. Adalja, MD, FACP, May 25, 2012 
The FBI’s conclusion that USAMRIID scientist Dr. Bruce Ivins perpetrated the anthrax attacks of 2001 is largely built on an extensive microbial forensics investigation. That investigation linked the spores found in recovered letters to material contained in a flask labeled “RMR-1029” that was under Dr. Ivins’ control. According to the FBI’s analysis, RMR-1029 contained anthrax spores of the Ames variety, with specific genetic features consistent with the letter attack materials. The results of research by the Chemical, Biological, Radiological and Nuclear Sciences Unit of the FBI just published in the Journal of Forensic Scientists provide additional data about the attack material.1
Evidence Based on Spore Purification Compounds. 
During the Amerithrax investigation, it was discovered that some laboratories that possessed the Ames strain were purifying the spores using a product that contained meglumine and diatrizoate. From lab records, it was determined that the spores contained in RMR-1029 were similarly purified using these compounds. This information gave rise to the question of whether the attack materials were taken directly from RMR-1029. To answer this question, the FBI developed a detection method that employed liquid chromatography and mass spectrometry to determine the presence of these compounds.1 As expected, the FBI investigators did find that anthrax spores taken directly from RMR-1029 contained both meglumine and diatrizoate. However, no evidence of these compounds was found when the spores from the anthrax letters were analyzed using the same method.1
          Source of Attack Material?
The major implication of this study, as the authors note, is “that the evidentiary spore material was not diverted directly from RMR-1029.” (1)  This fact means that if the anthrax spores used in the attack were taken from RMR-1029, their preparation would have required extra steps prior to mailing. That type of purification would have required specialized machinery and likely would have left traces of the material on machinery. No such material was found, though, and in a recently settled civil case in Florida, the U.S. Department of Justice acknowledged that the specialized machinery was not available at USAMRIID. (2) 
In the 2011 National Academy of Sciences report evaluating the FBI’s scientific conclusions in the Amerithrax case, this finding was cited in support of the report’s conclusion that “it is not possible to reach a definitive conclusion about the origin of the B. anthracis in the mailings based on the available scientific evidence alone.” (3) 
   1.   Swider C, Maguire K, Rickenbach M, et al. Trace detection of meglumine and diatrizoate from Bacillus spore samples using liquid chromatography/mass spectrometry. J Forensic Sci 2012; Accessed May 16, 2012.
   2.   Justice Dept. takes on itself in probe of 2001 anthrax attacks. Washington Post. January 27, 2012.
   3.   National Research Council. Review of the Scientific Approaches Used During the FBI's Investigation of the 2001 Anthrax Letters . Washington, DC: The National Academies Press; 2011.

Monday, May 21, 2012

SuperPACs: faster than a speeding bullet; able to leap tall buildings in a single bound. Is this even politics?/ NY Times

Why are Super PACs different than all other PACs?  [No, we are not discussing Passover tonight.]  See what the NY Times has to say.  But here is a quick summary:

  1. Super PACs can accept and spend donations throughout the year, not just during election periods
  2. Super PACs have few or maybe only one donor, and therefore no public accountability
  3. The donors set the agendas, not the candidates
  4. Funding is not limited by campaign spending limits on regular PACs
  5. It's fast cause you don't have to get contributions from lots of associates, then bundle them; instead, wealthy donors can just write one fat check for, well, the sky's the limit!
  6. The campaigns may be ethically and factually challenged
  7. There is unlimited gravy available for political consultants in advertising commissions 
Per the Times:
... Once seasonal affairs, campaigns from the presidential race down to House contests are becoming longer and more intense, driven by deep-pocketed donors eager to see incumbents pummeled throughout the political cycle. Decisions about attack ads and negative campaigning that once weighed on candidates are now made by consultants and donors with little or no accountability to the public.
“It’s not just easier to raise super PAC money — it’s dramatically easier,” Mr. Davis, a prominent Republican advertising strategist, said. “We raised more money than the Huntsman campaign, but we only had 20 or 30 donors.”

... With the primaries winding down, many consultants are turning to “boutique” super PACs, smaller outfits set up on behalf of a few donors — sometimes only one — to influence a few House and Senate races and other lower-profile campaigns. And some of the presidential super PACs are refashioning themselves as platforms for their vanquished candidates or as vehicles for general election spending. Mr. Schuman converted Americans for Rick Perry into the Restoring Prosperity Fund, with some of the same donors. The group will focus on Latino turnout and on efforts to help Mr. Romney in what Mr. Schuman called “second-tier” battleground states like Nevada and Colorado.
Super PACs offer advantages to the donors as well. Because they can give unlimited amounts to outside groups, they can have substantial influence without the hard work of raising money for a candidate, $2,500 check by $2,500 check, from other donors.
And super PACs allow them to spend on specific races or strategies, a development that could leave some candidates less dependent on party committees to decide whether they get the support they feel they need.
“You can’t roll into the National Republican Senatorial Committee and say: ‘Here is my check. I want it to go to these races,’ ” said one consultant who works with outside groups. “And you can with the super PAC.”

Friday, May 4, 2012

Are You Unwittingly Sharing Your Health Information?

The federal government has promised up to $27 billion in Medicare/Medicaid incentives for medical practices and hospitals to use electronic medical records, which are necessary to transfer health information electronically.  Many patients are not aware that their personal medical records are being shared and can be widely accessed. (In Maine, 75% of the population already has health information that has been uploaded to the system.) 

The reason given for health information exchanges is to improve healthcare quality.  The reason given for computerizing medical records is to improve the efficiency and cost of healthcare.  However, the electronic medical record systems used in the US tend to reduce physician efficiency, and increase costs, at least in the short-term.  My personal experience is that they increase errors and reduce patient safety, in addition to being inefficient.  But that's another story.

Our medical staff had several meetings about Maine's health information exchange, and our docs were wary of the concept, because we did not feel privacy was assured.  However, we were told that the exchange was an independent, state-based institution whose goal was to improve care through sharing of information from one Maine provider to another.  Information would not be "placed on the internet."  What I learned instead, through online searching, was that Maine's HealthInfoNet had received $6.6 million in federal grants, which was the major funding source and impetus for the program.  A federal agency coordinates all the state programs.

It was implied that information sharing would be limited to within Maine.  However, DHHS's goal is to share information nationwide, through the internet:
"On January 27, 2011, an additional $16 million was made available to states through ONC’s new Challenge Grants program. This program will provide funding to states to encourage breakthrough innovations for health information exchange that can be leveraged widely to support nationwide health information exchange and interoperability..."
We were told the new database would not collect information on HIV status or treatment by mental health professionals. What I learned from the HealthInfoNet website was different:  mental health records will be entered in the database.  HealthInfoNet got a $600,000 federal grant for this purpose inFebruary.  And it appears that local privacy safeguards for these records may erode as well, if one reads between the lines:  "many efforts are underway to integrate the treatment of mental illness into the general medical care structure."

Is another reason for computerizing and sharing medical records to allow the federal government to gain more personal information on US citizens in an era of increasing domestic surveillance?

According to today's C/NET:
The FBI is asking Internet companies not to oppose a controversial proposal that would require firms, including Microsoft, Facebook, Yahoo, and Google, to build in backdoors for government surveillance...  the White House, U.S. senators and senior FBI officials argue the dramatic shift in communication from the telephone system to the Internet has made it far more difficult for agents to wiretap Americans suspected of illegal activities, CNET has learned.
The FBI general counsel's office has drafted a proposed law that the bureau claims is the best solution: requiring that social-networking Web sites and providers of VoIP, instant messaging, and Web e-mail alter their code to ensure their products are wiretap-friendly...
James Bamford (author of The Puzzle Palace) tells us in WIRED that the feds have continued their Total Information Awareness project, supposedly cancelled by Congress in 2003, when it was run by the infamous John Poindexter, only now it has another name.  And we are the subjects of this federal surveillance:  those of us with credit cards, computers and mobile phones, not the unwashed and unwired terrorists.  The US government is building the largest data collection center in the world to collect info on everyone, and to break into encrypted information:
[The] Utah Data Center is being built for the National Security Agency. A project of immense secrecy, it is the final piece in a complex puzzle assembled over the past decade. Its purpose: to intercept, decipher, analyze, and store vast swaths of the world’s communications as they zap down from satellites and zip through the underground and undersea cables of international, foreign, and domestic networks. The heavily fortified $2 billion center should be up and running in September 2013. Flowing through its servers and routers and stored in near-bottomless databases will be all forms of communication, including the complete contents of private emails, cell phone calls, and Google searches, as well as all sorts of personal data trails—parking receipts, travel itineraries, bookstore purchases, and other digital “pocket litter.” It is, in some measure, the realization of the “total information awareness” program created during the first term of the Bush administration—an effort that was killed by Congress in 2003 after it caused an outcry over its potential for invading Americans’ privacy. 
But “this is more than just a data center,” says one senior intelligence official who until recently was involved with the program. The mammoth Bluffdale center will have another important and far more secret role that until now has gone unrevealed. It is also critical, he says, for breaking codes. And code-breaking is crucial, because much of the data that the center will handle—financial information, stock transactions, business deals, foreign military and diplomatic secrets, legal documents, confidential personal communications—will be heavily encrypted. According to another top official also involved with the program, the NSA made an enormous breakthrough several years ago in its ability to cryptanalyze, or break, unfathomably complex encryption systems employed by not only governments around the world but also many average computer users in the US. The upshot, according to this official: “Everybody’s a target; everybody with communication is a target.”
Has your health information been put in an electronic database without your consent?  In my state, the legislature voted for an "opt out" HealthInfoNet system rather than a system where citizens opt in:  Everyone in Maine is enrolled unless you opt out.  They say you can opt out by going to the HealthInfoNet website and unenrolling.  I wonder how well this works?  Since you opt out through the exchange, rather than through your local medical provider, it seems that medical information gets sent to the exchange on everybody, including those who opt out.