I’ll confess, I don’t actually know what makes a Hot and Sour soup, but this particular soup (inspiration credit: Parna!) is hot and sour, so we’ll go with that for now. The baked tofu recipe from earlier makes for a great addition, either finely cubed (spoon friendly) or in thin strips. The recipe for the soup base follows:
2 14.5oz cans of low sodium vegetable stock
2 tbsp Hoisin sauce
2 tbsp low sodium soy sauce
1/2 – 1 tbsp wasabi paste (to taste)
1/2 – 2 tbsp sriracha chili paste (to taste)
1 tbsp balsamic vinegar
1/2 bunch chopped green onion
~4oz shitake mushroom, sliced (about 5 or 6 caps)
Heat the vegetable stock over medium heat until it starts to steam, lower heat to medium-low. Add all the liquid and paste ingredients, mix well. Just as the soup base begins to simmer, add the mushrooms, green onions, (optional) tofu and kill the heat. Serve steaming hot and enjoy!
A few disclaimers: adjust the amount of wasabi and sriracha paste you add based on your heat preference. I was shooting for enough kick to clear the sinuses but not enough to make my nose runny and used about 3/4 tbsp wasabi and 1 1/2 tbsp sriracha. I guess one’s supposed to be using rice wine vinegar or some nonsense like that in this type of dish, but I didn’t have any nor did I feel like getting any- the balsamic does just perfectly (can anyone even taste what kind of vinegar you used when its diluted by a factor of 60? The emphasis on low-sodium ingredients here isn’t just for your health- the soy sauce, stock and hoisin are already going to be chock full of salt, and your palate really just doesn’t need it.
The tale of the tale of TB is almost as intriguing as the history of the disease itself. Long a scourge forgotten in the first world, the increasing visibility of philanthropic and global funding to fight tropical diseases has brought fresh light to the world’s deadliest curable disease.
Unfortunately, the flurry of recent interest and coverage has brought with it a certain oversimplification of the issue as a whole in its journalistic treatment. As a consequence I was pleasantly surprised to see a piece on TB diagnostics (a field near and dear to my heart) in the New Yorker, one of the few media outlets I see consistently high quality journalism from.
On the whole Specter does a pretty decent job painting a picture of some of the major challenges faced in fighting the TB epidemic:
- Performance of current diagnostics: Smear microscopy, while a success story in and of itself faces limited sensitivity and even poorer performance in HIV+ and pediatric patients. Serology (blood tests) for TB antibodies is fundamentally flawed and at best useless in endemic countries where the majority of the population expresses TB antibodies.
- Medical “red light districts”: The unregulated sale of diagnostic testing services and pharmaceuticals is a significant problem facing efforts to control the TB epidemic. In many ways this is linked to the limitations of the public infrastructure which, while free and widely accessible, is often viewed as a burden by patients who are required to return to clinics every day for their treatment (itself a measure intended to prevent patient drop-out, this represents perhaps one of the most significant causes of it).
- The cost of new diagnostics: Commercial PCR platforms like Cepheid’s GeneXpert maintain proprietary control over every component of the diagnostic test- from the test reader to the cartridges that contain the chemical reagents specific to the disease each test is designed to detect. This enables manufacturers to avoid open competition and sell their cartridges with significant margins, raising their prices out of reach of most public health programs.
This last story really becomes the driving point of Specter’s essay, although he meanders quite a bit in reaching it. Unfortunately, those meanderings stumble over some extremely fundamental mistakes that detract from a message that really is quite on-target.
While many of Specter’s criticisms of smear microscopy are valid limitations, he fails to really address why it has become the single most powerful diagnostic tool in our arsenal. 1. It’s extremely cheap to deploy on massive scales 2. It’s pretty specific (meaning that if a patient tests positive, he or she almost definitely has TB). While these are both critical lessons to consider (cost and performance) when discussing the qualities of a new diagnostic test that would make it a valuable tool at global scales, lessons learned from attempting deploy both culture and PCR-based diagnostics have taught us over and over again that in the end cost will trump performance. In the developing world smear microscopy accounts for over half of all diagnostic tests performed for TB. In contrast culture and PCR account for about 12% and 0.1% of all tests, respectively.
Specter’s discussion of Cepheid’s GeneXpert system truly mystifies me. Not only does the section reads like a press release in its glowing praise of their accomplishments, it severely mangles a description of what GeneXpert is and how it’s related to “ a piece of equipment called a P.C.R.”. Specter misses the mark on two counts. First: PCR is not a type of equipment, but rather the chemical reaction that allows us to amplify any specific sequence of DNA in a sample (invented in 1983 by Kary Muller, the Nobel Prize in Chemistry was awarded to him for it in 1993). Second: PCR is the technology underlying the operation of the GeneXpert platform itself (a system which is, according to Cepheid’s website a “fully-integrated real-time PCR system.”). Specter’s description of the GeneXpert as a silver bullet aside, the history of PCR in TB diagnostics is a long one, none of which is alluded to in his essay. While the GeneXpert certainly has a great deal of novel functionality, the use of PCR to diagnose patients with TB was demonstrated at least twenty years prior to the GeneXpert’s introduction (the earliest citation of a PCR assay for TB I could find in a few minutes on Google Scholar was: Molec Microbiol 1989; 3:843-49).
These fundamental technical errors on Specter’s part do much to damage his credibility as a science writer, particularly when they underlie the very technology that lies at the center of his story.
This is unfortunate given that the story Specter is telling is a very accurate one: TB is a very treatable disease. Poor diagnostic performance hampers our ability to contain and eradicate it. Promising new diagnostics based on PCR have proven far too costly for widespread adoption. While he alludes to this idea briefly in his essay, it’s disappointing that he does not return to it: The way to lower the cost of PCR-based diagnostics is through open competition. This is a much more realistic point to make rather than endorsing the idea that the cost of platforms such as GeneXpert are validated by their potential impact (at 250x the cost of instrumentation and 20x the cost per test of microscopy, this is perhaps a moot point since widespread adoption is lacking not out of choice but simple economics).
Currently, the little competition that does exist in the PCR diagnostics market has failed to lower the price of testing much in the same way that competition between printer manufacturers has failed to lower the cost of printer ink cartridges, with one key difference: in the printer world, “generic” kits to refill cartridges made by printer manufacturers do exist. In the diagnostics world patent coverage would prevent the development of cartridges for competing manufacturers’ readers; however, this does not preclude the development of an entire “generic” platform consisting of a cartridge design and an associated reader. Specific strategies for achieving this need to be explored and tested; while the need for PCR-based diagnostics is felt in TB diagnostics, the potential impact of low-cost PCR extends far beyond.
I’ve always been dismayed by the relative cost of baked vs uncooked tofu at Trader Joe’s, so I’ve been working to produce something just as tasty at home. The key to the whole process is really properly squeezing the excess moisture out of your tofu before marinating. I cut my block in half, sandwich it between two plastic cutting boards and weigh it down with 4-5 cans of beans for about an hour. This makes the tofu extremely absorbent and lets it really suck in your marinade. On to the marinade itself:
1/4 cup soy sauce
1 tbsp peanut oil
1/2 tsp balsamic vinegar
3 cloves of garlic, finely chopped
After pressing the tofu for about an hour, pour the marinade over the two slices of tofu in a baking pan and let it sit for another hour at room temperature. A lot of recipes online seem to suggest marinading overnight, but you’ve done a good job pressing your tofu an hour is more than enough to get flavor into your tofu.
After marinading, bake the tofu for 35 minutes at 375, flip the pieces over, bake for another 10 minutes, let cool and enjoy! Baked tofu is delicious on its own, in a stir fry or, my favorite, in a tofu scramble with bell pepper, mushroom, diced tomato and onion.
The PPK is an amazing place and their recipes have never failed me. I’ve made these chocolate chip cookies for two groups of people (UAEMers and YJAers) and they were a smash hit both times. The ground flax seed is totally optional:
The best part about these cookies- eggless (vegan, duh) means you can munch on the delicious cookie dough as you bake!
This is a modification of a recipe I got from a book that seems similar to a type of German savory chocolate bun. Makes for a great breakfast bread and goes well with a cup of coffee.
2 1/4 cup all-purpose flour
1/2 tsp salt
2 tbsp sugar
3/4 tsp yeast
2 tbsp butter
2 heaping tbsp cornstarch
6 pieces of chocolate (I used 70% dark)
Mix all of the dry ingredients except the chocolate in a large bowl. Cut the butter into small pieces and work into the flour with your fingers, making sure there aren’t any large chunks of butter left. Slowly mix in warm milk until a dough forms- you want the dough to pull away from the walls of the bowl as you mix and becomes elastic. Adding too much milk will cause the dough to become overly sticky and instead of stretching when you pull it will simply come apart. Knead the dough well to make sure everything is incorporated and let rise for about 1-1.5 hours.
After the dough has roughly doubled in size, pull it out and knead it again on a floured surface. Roll the dough into a cylinder and cut it into 6 equal pieces. Flatten each piece down and roll 2 pieces of chocolate into the center. Pinch the joints shut and roll gently with your hands to smooth it into one continuous piece of dough. With a very sharp knife cut a shallow slit into the top of the dough.
Transfer each piece of dough onto a greased baking pan and bake for about 15 minutes at 400 degrees or until the dough starts to brown slightly. Cool on a rack, sprinkle with a little powdered sugar and enjoy!
To enjoy the buns after they’ve cooled as though they were fresh out of the oven place one on a plate in the microwave along with a cup with a little bit of water in it and microwave for 1 minute.
I’ll be honest, I have no idea what to call this stuff but it’s delicious so let’s just stick with that. Delicious. I first tasted this dish (or something like it) at my aunt’s place in India. My mom picked up the recipe and modified it a bit and it has since continued to evolve in my hands. The mix itself is super simple, but the frying technique is critical to the success of the dish and is something I haven’t quite mastered yet.
1 pound frozen or fresh corn kernels
3/4 cup water
3/4 cup corn meal
1/2 cup corn starch
2-3 thinly sliced Serrano chilies
1 tsp of salt or to taste
1 tsp of fresh black pepper to taste
Chaat masala to dust on finished product
- Bring some vegetable oil to frying temperature in a wok-type pan over high heat.
- Mix together all ingredients except the chaat masala (you can mix some in if you’d like, but I think its presence is better felt dusted onto the crisps)
- Spoon the mix into the oil once it’s hot and fry until medium / dark brown. The key is to get the corn to be in a single layer and all of the batter as light and crispy as possible, connecting the kernels together. Add too little and it tends to form clusters, add too much and you’ll get multilayer sheets of corn. I haven’t quite figured out how to get the monolayer every time, but even the clusters and sheets are still wonderfully crunchy and delicious.
- Dust off the fried mix liberally with chaat masala and enjoy hot!
I’ll keep playing with the batter recipe and will post a follow up eventually once I’ve figured things out a bit better.
As the world grows ever more complex and interwoven, it becomes progressively harder for any one individual, regardless of how technically they may be trained to stay completely on top of many of the issues facing us. It becomes necessary for us to take a step back sometimes and look at an issue not with our preconceptions about practices in a field, but by examining the data available that cuts to the heart of the issue.
The energy and environmental impact of agriculture is an excellent example of such an issue. This Times Op-Ed gives a wonderful counterpoint to the often emotional and chic movements growing around ideas like local food. There are definitely no shortage of good things about growing most foods locally, but there are worthwhile points to be made about the energy, land, labor and chemical savings that are possible by growing crops in areas they take well to and transporting them to consumers.
Much as the division of labor catapulted the world into and through the industrial revolution (we’re certainly still feeling the impact of many poor decisions made during that time, but the positive impact on quality of life is still difficult to contest) inexpensive transportation and the regional specialization in agriculture this allows has transformed the way we view agricultural efficiency.
Ultimately the decisions we make about the food we eat and where we get it should not be based solely on simplistic outlooks on the good and bad practices in food production and consumption. To really attack the inefficiencies and inequities in the system we need to take a closer look at where the faults lie rather than rallying behind self-applied labels.