Features

People who regularly eat a variety of nuts including walnuts, peanuts and tree nuts may be less likely to develop heart disease than individuals who rarely or never eat nuts, a US study suggests. 

Researchers examined information on medical history, lifestyle and eating habits for more than 210,000 healthcare workers. During an average follow-up of more than two decades, 14,136 people developed cardiovascular disease, including 8,390 coronary heart disease cases and 5,910 strokes. 

Compared to people who rarely, if ever, ate nuts, people who had one 28-gramme serving of nuts at least five times a week were 14 per cent less likely to develop cardiovascular disease, and 20 per cent less likely to develop coronary heart disease, the study found. 

“Consuming a variety of nuts at least a few times per week is beneficial to lowering risk of cardiovascular disease,” said senior study author Shilpa Bhupathiraju, a nutrition researcher at the Harvard T.H. Chan School of Public Health in Boston. 

But people should not overdo it, and they should avoid salted nuts. 

“Nuts are high in calories,” Bhupathiraju said by e-mail. “They should be eaten in small portions and used to replace other protein foods rather than being added to the diet.” 

Eating nuts has long been linked to a lower risk of heart disease, diabetes, and high blood pressure, but much of this research has focused on overall intake rather than identifying specific types of nuts that may have the biggest benefit. 

The current study looked at different types of nuts separately and found that people who ate walnuts at least once a week had a 19 per cent lower risk of cardiovascular disease and a 21 per cent lower risk of coronary heart disease than people who never at nuts. 

At least two weekly servings of peanuts, meanwhile, was associated with a 13 per cent lower risk of cardiovascular disease and a 15 per cent lower risk of coronary heart disease. 

Two servings or more of tree nuts such as almonds, cashews and pistachios were linked to a 15 per cent lower risk of cardiovascular disease and a 23 per cent lower risk of coronary heart disease. 

Researchers found no evidence of an association between total nut consumption and risk of stroke, but the risk of stroke was lower in people who consumed larger amounts of peanuts and walnuts. Peanut butter and tree nuts were not associated with stroke risk. 

The study, reported online November 13 in the Journal of the American College of Cardiology, was not a controlled experiment designed to prove whether or how eating nuts might lower the risk of heart disease. 

And it focused mainly on whites, which may mean the results do not apply to people of other racial or ethnic groups. 

Even so, the results add to the large and growing body of evidence pointing to heart benefits of nuts, said Dr Emilio Ros, author of an accompanying editorial and researcher at Instituto de Salud Carlos III in Spain. 

“What’s new is the pinpointing of the risk associated with eating particular nuts, such as walnuts and peanuts,” Ros said by e-mail. 

“Obviously the overall diet is very important for prevention of heart disease,” Ros added. “It should be plant-based with abundant veggies, legumes and fruit, whole cereals, fermented dairies and fish and seafood and it should have little salt, meat and meat products, and wine in moderation with meals [the Mediterranean way].” 

LONDON — A driverless, electric car is only a swipe away in the cities of the future, where pollution clampdowns and rapid advances in technology will transform the way we travel, despite lagging infrastructure.

As more and more countries announce a phasing-out of pure petrol and diesel cars, early versions of tomorrow’s models are already on the streets: hybrid cars, fully electric motors and vehicles that can partially drive themselves.

Attitudes to vehicle ownership in cities are changing as smartphone apps make a ride available in minutes.

David Metz, of the Centre for Transport Studies at University College London, believes developed cities have reached “peak car”, with ownership no longer associated with increasing prosperity.

Metz said city planning was changing to temper the vehicle access once thought vital.

“We now see high-density urban areas are more successful with less traffic,” he said, citing London’s car-free Leicester Square entertainment district and the Canary Wharf financial hub.

Cars could be phased out of city centres altogether, as urban planners ditch the 20th-century, car-focused grid-plan model for city streets.

Private cars, sitting idle for 23 hours a day, might be eclipsed by car-pool clubs, journey-sharing apps or one-trip rental cars as seen in cities around the world from Berlin to Istanbul to Vancouver.

‘Driving everywhere by themselves’

Driverless technology also looks set to revolutionise urban road travel, according to industry figures.

Graeme Smith, chief executive of Oxbotica, a British company developing autonomous vehicle software, said new cities being planned in China envision all vehicles being electric, autonomous and publicly-owned.

“In those cities, your life would be fundamentally different,” he told AFP.

“50 years into the future, maybe these things will be driving everywhere by themselves — but there’s a progression to go through.”

Driverless technology faces the challenge, over time, of bringing down the cost of sensors while improving their performance — and there is currently no standard operating methodology.

Some cars with levels two and three autonomy are already on the roads.

Britain’s Transport Secretary Chris Grayling said he expected the first level four self-driving cars to reach the UK market by 2021, bringing the world closer to level five, or total autonomy.

Fully driverless cars could help ease gridlock by driving closer together in convoy and avoid traffic by exchanging real-time information.

‘The final destination’

The switch to electric vehicles (EVs), meanwhile, is already well under way.

Volvo will no longer sell solely diesel or petrol cars from 2019, while Volkswagen’s Audi brand is gearing up to offer an electric version of every one of its models. 

“We think it is really the final destination for the auto industry,” said Eric Feunteun, Renault’s electric vehicle programme director, told journalists in Utrecht in the Netherlands earlier this month at an event where the French carmaker unveiled partnerships with renewable energy companies.

Britain and France intend to ban the sale of fully petrol or diesel cars from 2040, while smog-plagued India wants to sell only electric cars by 2030.

Besides legislation on a pan-European and a national level, cities themselves are taking action on pollution.

London is set to introduce an ultra-low emissions zone in the city centre in 2019, with charges for more polluting vehicles, and hopes to extend it to the inner London ring road by 2021.

‘Woeful lack’ of charging points

Manufacturers said they feel up to the challenge.

“We’ll supersede the sale of petrol/diesel cars way before 2040,” said Jonny Berry, Renault’s regional electric vehicles fleet sales manager.

Berry was speaking at a car show in Regent Street in the heart of London’s shopping district, where electric models were the focus of attention.

“I think it’s a very easy target for us to reach. More and more people are coming round to the idea.”

While some countries like Norway have a high take-up of electric vehicles, in many world cities, the charging infrastructure is patchy.

Some commentators see a future of wireless charging base pads laid under city streets, underground car trains or drone car flights; others are more sceptical.

Expert motoring journalist Matt Robinson said a “woeful lack” of suitable charging points remained a big problem for electric car users.

“London is the best place in Britain to own an electric car but the infrastructure lags behind the uptake of early adopters,” he said.

Robinson is also sceptical about the distance ranges given by EV manufacturers for their batteries, saying they are almost “impossible to obtain in the real world”.

Driverless cars also face overcoming the “public fear factor”, he said.

“Do you ever trust your safety to something doing 115 kilometres per hour without human control?”

The Muse

Jessie Burton

London: Picador, 2016

Pp. 445

The drama in Jessie Burton’s novel, “The Muse”, has many sources: The Spanish Civil War is brewing, while there are ominous signs of fascism’s forward march in other parts of Europe. The passion for art on the part of several characters drives them to extraordinary behaviour. Illicit affairs, including a mother and daughter loving the same man, have dangerous potential, while many characters harbour explosive secrets. There is much romance and many betrayals, some intentional, some accidental.

Yet, at the beginning, one doesn’t sense this degree of drama as the narrative shifts between two young women, three decades apart. Odelle Bastien, who immigrated to London from Trinidad five years before, describes her frustrations. Everywhere she goes, she is met by preconceived notions, some outright racist, which keep her from fitting in and from getting jobs for which she is qualified. 

Well-educated and an aspiring writer, she has trouble finding British citizens who are as well versed in English literature as she is. All in all, London is not the paradise that she was raised to expect, but in typical immigrant fashion, she does not write about her disappointments to her mother back in Trinidad, who did all she could to send her daughter to a better life in Britain.

However, just as the story opens in 1967, Odelle lands a job as a secretary in an art gallery and meets the eccentric Marjorie Quick who recognises her talent. This opens up new opportunities for her, but in basic ways, her outlook on life is already set. “I was — both by circumstance and nature — a migrant in this world, and my lived experience had long become a state of mind.” (p. 171)

As the novel progresses, one discovers that several of the characters could claim the same.

While Odelle has been held back by racism, Olive Schloss, the subject of the counterpoised narrative, suffers from sexism. She is an aspiring painter, but her talent is ignored by her father, Harold, an Austrian art dealer who goes to great lengths to promote male artists, but views women as lacking in the needed vision. Ironically, his blindness to his daughter’s talent unleashes a series of events that drive the plot in unexpected directions. 

The Schloss family left London for a Spanish village in 1936, hoping that the change will heal Olive’s English mother, Sarah, who suffers from chronic depression to the point of being suicidal. Though signs of the violent outbreak of the civil war to come are mounting, the members of the Schloss family all find their own reasons to stay. Harold thinks he has discovered a great painter, Isaac Robles, in the village. Sarah also seems to have found a purpose in life, and Olive feels she has found herself in Spain, which becomes more than geography to the family. 

Both Odelle and Olive are children of the empire, hailing from its opposite poles. Linking their narratives, which unfold in alternating chapters, is art, one painting in particular, and one character who is only identified at the end. Suspense builds in both plots as does one’s curiosity about what links the two. 

Mystery also stems from the fact that several characters reinvent themselves. With her own talents unrecognised, Olive choses to be Robles’s muse, and eventually passes off her paintings as his, imagining she is supporting Spain’s workers and poor for whom Robles advocates. Robles and his sister are emblematic of the contradictions between the conservative rich and the radicalised poor in Spain at that time. As the illegitimate offspring of a man who is loyal to the nobility, they live on the margins of society. When Robles is targeted by the right wing for his political acts, his sister is forced to flee and assume a new identity.

“The Muse” is an exceptional novel in terms of writing technique and themes. Author Jessie Burton has a lot to say about empire, about art and history, about art and love, about women’s situation, about the link between the personal and the political, and about the depth and unpredictability of human emotions, but she weaves her observations into the story so subtly that one does not know one is being instructed. The intricate way in which she structures the story to preserve the mystery and connect the two plots is brilliant, as is her character development. Above all, one learns that there is never a single story, and some things may remain ambiguous for a lifetime or more.

Below a certain starting threshold, using medication to reduce blood pressure in otherwise healthy people does not provide a clear survival benefit for most, a research review suggests. 

Researchers examined data from 74 previously published clinical trials that randomly selected a total of more than 306,000 people to take blood pressure drugs or placebo. 

Treatment to lower blood pressure only appeared to help prevent heart disease and boost survival odds for people who started out with systolic blood pressure above 140 mmHg. 

The exception was people with heart disease who took medication to reduce blood pressure below 140 mmHg, who did have a lower risk of cardiovascular events like heart attacks or strokes, the researchers report online November 13 in JAMA Internal Medicine. 

“Our results support a very simple strategy where everyone with a blood pressure above 140 mmHg should receive treatment, whereas most people below that level will have no further benefit from additional medications,” said study co-author Dr Mattias Brunstrom of Umea University in Sweden. 

“Patients with previous heart disease may benefit from lower blood pressure goals, and an individual goal should be established together with the patient´s physician,” Brunstrom said by e-mail. 

Setting the right goal for blood pressure has been a matter of intense debate in the medical community in recent years because research to date has offered a mixed picture of which patients may benefit from treatment, Brunstrom added. 

Complicating matters, many patients with dangerously high blood pressure do not take drugs to treat it or commit to lifestyle changes that could achieve the same goal like improving their diet and exercise habits. 

New recommendations announced this week at the American Heart Association conference in Anaheim, California, set a systolic target of 130 mmHg as a goal for lowering high blood pressure. For decades, the goal had been 140 mmHg in the US, and this is still the target in Europe. In Canada and Australia, however, the goal is 120 mmHg. 

“There is an ongoing controversy about setting strict guidelines about blood pressure levels and in which setting it is safe or justified to treat elevated blood pressure,” said Dr Costantino Iadecola, director of the Feil Family Brain and Mind Research Institute at Weill Cornell Medicine in New York. 

The results of the current study suggest that the right blood pressure goal may not be one size fits all, Iadecola said. 

“The message here is that there is no universal number good for everyone,” added Iadecola, who was not involved in the study. 

When people had blood pressure of at least 160 mmHg, medication to reduce it was associated with a 7 per cent lower risk of death across all of the studies in the analysis, as well as 22 per cent lower odds of events like heart attacks and strokes. 

Between 140 mmHg and 159 mmHg, the reduction in mortality risk was similar, but there was a smaller 12 per cent decrease in the chances of cardiovascular events like heart attacks or strokes. 

Healthy people didn’t appear to benefit from medication if they already had blood pressure below 140 mmHg. 

But with a history of heart disease and average blood pressure of 138 mmHg, medication was associated with a 10 per cent lower risk of events like heart attacks and strokes. Medication did not appear to influence survival odds for these people, however. 

Because the study only examined lowering blood pressure with medication, it is not clear if the results would be the same for other strategies such as changes in diet and exercise habits. 

“We have no reason to think it should be any different with lifestyle modifications, but the scientific evidence supporting that lifestyle modifications cause less heart disease and stroke is weaker,” Brunstrom said. 

Washing apples in water with a dash of baking soda is the most effective way to remove pesticide residue, new research shows. 

The mix outperformed Clorox-spiked water for getting rid of the chemicals, and also worked better than plain water, Dr Lili He of the University of Massachusetts in Amherst and her colleagues found. They reported their findings October 25 in the Journal of Agricultural and Food Chemistry. 

Pesticides are widely used in agriculture to kill bugs, fungi and other produce-plaguing pests. They can hurt humans, too, but most of us are exposed to amounts so tiny that they don’t pose a risk, according to the Environmental Protection Agency (EPA). 

Many people try to limit their exposure to pesticides by washing produce, but whether or not this does anything to remove them has not been studied, Dr He and her team note. They coated apples with thiabendazole, a fungicide, or phosmet, which is used to kill a variety of pests, and washed them with water or water mixed with bleach or baking soda. The researchers used Gala apples because they are widely consumed and also likely to contain a wide variety of pesticides. 

Using super-sensitive, high-tech tests, the researchers checked on and within the apple for pesticides and measured pesticide concentration within plant tissue. Rinsing the fruit in the baking soda solution for 12 minutes was most effective for removing thiabendazole, they found, while a 15-minute baking soda rinse was most effective for getting rid of phosmet. 

Some of the pesticide passed beyond the apple’s surface, with thiabendazole going four times deeper than phosmet. None of the washing methods could fully remove the residue. 

After harvest, the EPA requires apple producers to soak the fruit for two minutes in bleach mixed with water. The quick dip is intended to remove bacteria and other organic matter, not to wash off pesticides, Dr He noted in a telephone interview with Reuters Health, but it would be ideal to find a post-harvest treatment that would do both. 

The baking soda solution is likely more effective because it can help break apart pesticide molecules, the researcher said, and can be used for washing other types of produce.

Professional photographers and amateurs for whom photography is more than just candid snapshots taken with an average smartphone or camera are familiar with the uncompressed RAW photo format. For a good reason: only RAW allows extensive and almost unlimited manipulation without affecting when not destroying the photo quality. Without a computer, however, or good software to do the job, RAW is practically useless, often a burden.

Processing pictures after they have been taken has become very common. Most smartphones feature a built-in app that lets you play with the shot this way. And of course, there is software for real computers that lets you do extraordinary post-processing work, with Adobe Photoshop in the lead.

Regardless of why you should or should not post-process photos, of the debate about cheating by making you look better in the picture, about intentional deception in the media, and other ethical or non-ethical reasons, being able to correct and improve a shot is legitimate. It is justified if only for the fundamental settings that allow to you adjust brightness, exposure and contrast, white balance, to apply cooling or warming filters, and to crop the image for better, more pleasant presentation.

Typically your photos would be in the universal jpg compressed format. This is especially true if you take them with a smartphone. When you apply a change to a jpg photo you reduce its quality at the same time. Colours, tones, sharpness, resolution, clarity, and overall realism are altered, and not for better. The stronger the changes and the more the quality loss. Moreover, each time you save it, and then reopen it for more manipulation, it loses more of its original quality. The “save” operation in itself is destructive, for it has to compress the picture again.

Enter RAW. The format presents the major, the invaluable advantage of allowing you to manipulate photos time and again without affecting their original quality, this is mainly, but not only, because it preserves the original file-size and quality of the shot, and does not compress it in any way.

Cameras and software makers use different RAW types. Nikon for example uses NEF, whereas Samsung goes for DNG. Adobe Photoshop is able to read and work with all of them. These differences and this terminology do not matter, they all are native, lossless, non-compressed formats and present the same advantages.

Virtually all full-size dedicated DSLR cameras can shoot RAW, in addition to jpg of course. The shooting mode is user-selectable, for convenience. On the other hand few smartphones can perform the trick. Samsung’s top of the line Galaxy S8 is one of the few smartphones on the market that come with RAW photography ability. Is it necessarily a good thing for a handset?

It is, certainly, provided you know what this entails. Firstly it creates very large file size. If a jpg is say 4 MB, its equivalent RAW would be about 30 MB. Secondly, if you like to post-process a RAW picture taken with a smartphone, you must copy it to a computer and use an application programme like Photoshop, GIMP, or the like. Smartphones just cannot do it – but there is an exception!

Google’s Snapseed app for smartphones is made to open and process RAW pictures. As at this date it is the only professional photo editing software for smartphones. It is free and does a decent job. Still, its power cannot be compared to Photoshop’s, simply because a smartphone processing power cannot be compared to that of a full-fledged computer. Snapseed does not have a fraction of Photoshop functionality, but it does the essential settings and adjustments very well, and again, you can edit your picture a hundred times, the original quality will be preserved.

Some would argue that even if a great software app were available to edit RAW photos using a smartphone, the screen size would still be a limitation. Proper, professional photo editing is better done on a large screen. Most users go for 22”, 24” or 26” computer monitors for that. To say the least, it is just more comfortable doing it this way.

The first Chip Talk story was published in this newspaper exactly 25 years ago, in November 1992. It has since been published continuously, every week, written by the same writer. This article is the 1265th in the series.

The best way to get teens to play sports may be to let them sample a variety of different athletic pursuits earlier in childhood, a Canadian study suggests. 

Researchers followed 756 kids starting when they were 10 or 11 years old, giving them quarterly questionnaires for five years to see what sports they were playing. 

Kids who dabbled in several sports at the start of the study were 55 per cent more likely to participate in recreational athletics five years later than children who did not start out playing any sports or who specialised in only one, the study found. 

“Children have a lot to gain from engaging in a wide variety of sports,” said senior study author Mathieu Belanger of the University of Sherbrooke in New Brunswick. 

“Through sport diversification children get to develop a wider variety of skills which will contribute to their feeling of competence in sports, which increases the chances that children enjoy their experiences in sports,” Belanger said by email. 

The findings come as a growing number of children are specialising in a single sport at younger ages and participating in it year round to pursue spots on elite teams that may boost their chances of college scholarships down the line. 

Children who specialised in one sport at the start of the study were 65 per cent more likely to participate in sports during adolescence than other kids, the study found. But the early specialists did not have lower odds of nonparticipation as teens. 

“If children specialise in only one sport and happen to drop out from that activity at one point, they risk having no other sport to fall to since they have not been exposed to them and have not developed complementary skills required to fully engage in them,” Belanger said. “Parents should therefore seek opportunities for their children to try different physical activities and also avoid having their children take part in any given sport year-round.” 

In the first year of the study, 147 kids, or 19 per cent, specialised in just one sport. Another 506 kids, or 67 per cent, sampled a variety of sports and 103 children, or 14 per cent, did not participate in sports at all, the researchers reported online November 13 in Pediatrics. 

Children who specialised in a single sport also tended to spend more time participating in organised physical activity as opposed to informal pickup games with friends. 

With specialisation, kids were also more likely to play sports competitively, with specific performance goals, and less likely to be involved in recreational sports as teens. 

The study was not a controlled experiment designed to prove whether or how sports habits in childhood influence how much physical activity kids get in adolescence. Researchers also did not look at the total number of hours kids participated in practices and competitions or examine whether youth played sports as adults. 

Even so, the findings add to evidence that early sports specialisation may not have health benefits in the long run, said Jennifer Sacheck, a researcher at the Friedman School of Nutrition Science and Policy at Tufts University in Boston who wasn’t involved in the study. 

“Put simply, specialising at a young age puts a child at an added risk for injuries, burn-out and emotional stress,” Sacheck said by email. “Cross-training is known to be a good thing for functional movement skills and motivation should be equally cherished in kids.” 

For the kids who are truly motivated and gifted athletes, specialisation needs to be handled with care, she advised. In particular, parents and coaches need to watch for signs of sports fatigue, such as when kids are not motivated in practice, get injuries or struggle to sleep well or to do well in school. 

“Too much of a good thing can sometimes not be a good thing,” Sacheck said. “If a child has strong desire to specialise in a particular sport at an early age, parents should still try to maintain engagement in other complementary sports activities throughout the year, and this could be on a much less competitive level like intramurals.” 

Through my expatriate experience of more than two decades, I have had the opportunity of living in plenty of commonwealth countries, which were all part of the British Empire, and therefore Anglophone. But I got to set foot on Francophone soil for the first time only when I reached Mauritius.

This island was colonised by the Dutch, the French and the British, in that order. France seized Mauritius in the early 18th century, but later lost it to Britain in 1810, during the Napoleonic Wars. Still, this tiny nation retained the French language and French law, despite being under British occupation. 

The country won independence from Britain in 1968 but even though it was British for nearly a hundred and fifty years, French influence from the early 19th century continued to dominate its society and culture. The two official languages here are English and French, with the latter one spoken almost universally. Creole, which is a curious mix of French with a spattering of Portuguese, Spanish, South African, Swahili, Tamil and English — is the informal lingua franca. 

So, one has to master a bit of French to function in this place, and Mauritians start your training process from the moment they set eyes on you. Believe me, it’s true. 

Now, where learning a foreign language is concerned, French is right at the top in the most difficult category. It might seem like child’s play because there are little kids in this world who speak it fluently, but those are French children, you see. They are introduced to the strange sounding intonations of this complicated dialect from birth, but the real challenge arises when you try deciphering it at my ripe old age.

Since French is not a phonetic language, each letter does not have a single corresponding sound, so the spelling does not match the pronunciation. Also, a lot of letters are silent, which can make pronunciation and spelling a most exasperating exercise. Finally, the less said about the nasal consonants at the end of a word, which are not pronounced as consonants but the vowel that precedes them, the better. 

Moreover, the letter “R” is one of the most difficult sounds in French. It is a kind of raspy resonance produced in the back of the throat that has no equivalent in English, therefore for this letter more than any other, it is essential to get help from a native French speaker. 

I do not have to look far to find one, because the housekeeping lady who tidies my room, has been dropping hints about teaching me French. She is called “Rani” which I managed to figure out quite recently. For an entire week I call her “Khani” because that is how she pronounces the word. It is only when I ask her the meaning of her name (it translates into Queen in Hindi) that I finally understand my inability to decipher the French “R”.

Rani tells me that each time I have to grapple with this difficult consonant I must speak from the bottom of my throat.

“As if you are about to spit,” she instructs me.

“How will you say the khrane is coming?” she asks.

She points at the raindrops falling on my head as a hint.

“The rain is coming,” I answer. 

“Kh, not R, use your epiglottis,” she insists.

 “So rat becomes khat?” I question.

“Oui! Excellente!” she exclaims.

“Wow! It’s all French to me,” says the voice in my head.

Nothing in the soft-spoken bearded man clad in salwar kameez gives an inkling that he is famous, but Pakistani artist, social worker, philanthropist and stamp designer Jimmy Engineer is an international artist and a global citizen who loves and cares for fellow human beings, especially the less fortunate.

But, above all, he is a “servant of Pakistan”, a name by which he does not mind going. And a being striving for excellence.

“All my life I wanted to achieve excellence. I wanted to show that Pakistan can be as positive and creative as any other nation. I served for over 40 years my country. In all exhibitions I promoted the positive side of Pakistan.”

And many are the countries and the exhibitions he held in the course of his life as an artist, so far: over 80 exhibitions in both his native country and abroad. 

His works are in private collections in 28 countries; the themes are historical, philosophical, land and seascapes, architectural and cultural compositions, both figurative and abstract, calligraphy, portraits and miniatures.

The artist’s name is the result of a Zoroastrian tradition whereby the profession becomes the name. Both his father and grandfather were engineers, a tradition he did not follow, having different inclinations early in life.

“I started drawing and using powder colours when I was 4,” he says giving an overview of his life and work at the Jordan National Gallery of Fine Arts where he is exhibiting paper prints of his original oils on canvas and original drawings on paper.

His teacher? 

“Nature.”

And when you learn from a perfect mentor, “you will always remain a student”, he says with sincere humility.

When he was six, in 1960, doctors gave him three months to live because his kidneys were failing. He defied medicine and nature — subsequent X-ray showed he had “two new kidneys” — in an act he considers a “second chance”. And because he was given this second chance, he believes he has to give back. 

He does, generously.

“Nearly all my proceeds go to charities dealing with blind children, orphans, prisoners, widows, homeless and sick people.”

It makes this altruistic artist who lives in a two-room rented house happy to give.

“For me it is important to be a good human being. To serve humanity.”

Which he does through his art.

His charity work, including the many walks for different causes, is all about changing perceptions: of his country, Pakistan, when he exhibited in the US or Europe, of children with special needs when he took them to public spaces — zoos, 5-star hotels, restaurants — of inmates, particularly juvenile, for he believes “nobody is born a criminal. Society makes them what they are”.

His dedication has contributed to the bettering of the lives of hundreds of people, in his home country and elsewhere. But he also wishes to spread the message of peace and raise awareness about problems plaguing people, for which, besides painting, he would walk: for cancer, leprosy, education, law and order.

In one instance, in 1994, he went on an arduous 4,000-km walk on foot, sleeping in villages, “seeing what people need”. In 2001 he walked for peace between India and Pakistan, “daring” to pin the flags of both countries on the long white shirt he walked in — “now in the Peace Museum in Beijing” — an act of courage and peril.

Spreading harmony and peace seems to be his mission in life. 

In 2009, after an exhibition in Houston, Texas, the mayor made Engineer an honorary citizen of the city and a goodwill ambassador.

His good deeds are too many to mention. Talking to this unassuming man one would not guess that Mother Theresa knew and embraced him, that personalities far and wide court him, that he received accolades, travelled the world over and received over 70 Shields of Honour from various Pakistani and foreign organisations.

The prolific artist spent three years at the National College of Arts. He left without waiting for his degree, a paper validating an obvious talent, and has been living in Karachi ever since. 

His works count over 3,000 paintings, more than 1,000 calligraphic works, over 1,500 drawings and 700,000 prints in private collections.

He paints in different styles, always claiming to be the disciple of a perfect master, nature, and, as such, having to perpetually learn more.

Seeing his works, it is difficult not to find him modest.

The drawings, original, are mostly magnified details of the bigger paintings. The lines flow easily, masterfully, meeting and separating to form images of tender parent-child love, caring beings helping or consoling each other, sadness and desolation, or peaceful animals from some bucolic landscape the artist must have seen in his many walks.

The exhibition could not have had a more apt title, “Lines That Talk”, because Engineer’s lines do indeed tell stories of myriad people.

Like in the prints of his oil paintings — which must be a wonder to behold — which tell the story of the 1947 partition of India and Pakistan, with all the accompanying human dispossession, misery and tragedy.

They are also a “tribute to the struggle and sacrifices of the hundreds of thousands of men, women and children who created Pakistan”.

The images show masses in flight from burning villages, caravans, huddled people under a tree, the story of refugees everywhere, maybe more poignant here, where the narrative of dispossessed Palestinians is so familiar.

The colours, earthen with much reddish-maroon tint, are warm, soothing, almost belying the images they create.

Engineer’s architectural compositions are a labour of love. Painstaking details, layered, rich, images reflect Pakistani architecture, but also structures from India, Yemen, China and several other countries.

The compositions are such that “no building is off balance, jumping around”. Dense, yet with each image enjoying primacy, the filigree details of mosques, churches, buildings keep the eye prisoner, hungry for more.

The idea, in the artist’s 58 architectural compositions is that “if architecture [of different countries] can be brought together, people can be brought together”. Not surprising for someone seeking peace, harmony and the wellbeing of fellow human beings.

The “lines” Engineer makes talk are mesmerising. A quick glance would not do. One needs time to take all the details in, and then go over the images again and discover, with surprise, so many overlooked.

The exhibition runs through November 25.

Robotic-assisted surgery is much more expensive than other minimally invasive surgeries, but it does not improve outcomes of surgery for kidney tumours and rectal cancers. 

”The rapid increase in costly robot surgery in lieu of laparoscopic surgery without a definite advantage for the patient is a problem that can be applied not only to the urological field but also to the entire surgical field,” Dr In Gab Jeong from University of Ulsan College of Medicine, Seoul, Korea told Reuters Health by e-mail. “This may lead to a huge increase in the cost of medical care that can be a significant burden on the healthcare system.” 

In robotic-assisted surgery, the same instruments used in laparoscopic surgery are connected to a robotic device that allows for 3-dimensional visualisation, greater range of motion of the instruments, and improved ergonomics for the surgeon. 

Extensive marketing and competition among hospitals have led to widespread use of robotic surgery for a broad range of procedures, but it remains controversial because of its increased costs and lack of evidence of improved outcomes compared with non-robotic minimally invasive approaches. 

In a study reported in the Journal of the American Medical Association, Jeong’s team used a US database to compare outcomes and costs of robotic-assisted surgery versus laparoscopic surgery for extensive kidney surgery. 

In 2003, robotic-assisted surgery accounted for 1.5 per cent of operations in this setting; by 2015, it accounted for 27 per cent of surgeries. Laparoscopic surgeries declined in parallel during that period. 

After taking a variety of factors into account, robotic-assisted surgery had similar rates of major complications, blood transfusions, and prolonged hospital stays as laparoscopic surgery. 

But robotic-assisted surgery costs averaged $2678 (2272.67 euros) more than those associated with laparoscopic surgery, mainly as a result of longer operating room times and higher supply costs. 

“The development and use of robotic platforms might be helpful in patient care,” Jeong said. “However, scientific research on cost-effectiveness and safety has sometimes not been sufficiently conducted, and it is rapidly spreading in the medical field due to various reasons, such as marketing of the company, patient’s preference for the latest technology, and recommendations of the hospital/doctors.” 

In a second study in the same issue of the journal, Dr David Jayne from St James’s University Hospital, Leeds, UK and colleagues from 29 centres in 10 countries investigated whether robotic-assisted surgery was less likely to require conversion to open surgery, compared with conventional laparoscopic surgery, in 471 patients who were having rectal cancers removed. 

The average surgery time was 37.5 minutes longer in the robotic-assisted group than in the conventional laparoscopic group, but the robotic devices did not reduce the need to convert some of the operations to open surgery. 

Nor did the robotic devices reduce complication rates, either during the procedure or within 30 days after the procedure. 

As in the kidney surgery study, healthcare costs were significantly higher with robotic-assisted surgery than with conventional laparoscopic surgery, by an average $1132 (961.32 euros). 

“Robotic surgery is a technical advance in minimally invasive surgery, but the current robotic system is too expensive to justify its unselected use in rectal cancer,” Jayne told Reuters Health by e-mail. “There is a need for robotic systems to be competitively priced to enable advanced surgeries, such as rectal cancer surgery, to be cost-effective.” 

“The area of robotic surgery will change appreciably in the near future as other manufacturers bring robotic surgical systems onto the market,” he said. “This will open up competition and should push costs down.” 

“Whether robotic-assisted surgery for some procedures represents ‘value’ for either the individual patient or the health care system is unlikely,” writes Dr Jason D. Wright from Columbia University College of Physicians and Surgeons, New York in a related editorial. 

“From a policy perspective, robotic-assisted surgery exemplifies the difficulty of balancing surgical innovation with evidence-based medicine,” he concludes. “Both the generation of high-quality evidence evaluating new procedures and then the utilisation of this evidence to guide practice should remain priorities for surgical disciplines.”