Archives For health

statistical analysis

As on every other day that ends in “y,” every plausible, implausible, and grasping-at-straws-to-keep-it-alive association between vaccines and autism was ruled out by a mountain rage worth of studies. But for anti-vaxxers, like for any ideological movement, not finding proof of their core belief only means that no one is looking hard enough because if scientists and doctors who did those studies weren’t all on the take from Big Pharma or the alien lizards who secretly ruled our world for thousands of years, they would’ve found that vaccines are nothing but a soup of brain melting toxins. And so, with that general approach in mind, an anti-vaccine group funded a very thorough study of vaccine schedules on macaques which looked for any difference in the brains of vaccinated and non-vaccinated monkeys. Every hypothesis they had was thrown in, from the different vaccination schedules, to thimerosal-containing shots, and any the brain tissues of the test subjects was going to be examined for even the slightest sign of possible abnormalities.

After observing the behaviors of all the monkeys as they grew, learned new skills, and studying the brains of some 36 of those with the most extreme vaccination application differences, there was absolutely no trace of anything abnormal in their neurons. None. Zip. Zilch. Which, if you’re paying attention to the science, is exactly what you’d expect unless the blood-brain barrier in all complex organisms simply vanished overnight. The only difference between a vaccinated and a non-vaccinated child is the likelihood of catching some diseases because we’re now pretty sure that the key causes of autism are genetic and affect the development of inhibitory neurons, not trace amounts of chemicals that yuppies who refuse to understand the concept of dosage think are toxic because some greedy, scientifically illiterate internet cranks told them so. There have been cases where vaccines had medically significant adverse effects but those cases are quite literally fewer than one in a million, and they have nothing to do with mental development.

But if you think that SafeMinds, the anti-vaccine think tank that funded this study is going to just shrug and accept it, you would be wrong. Instead, it’s adamantly claiming that it was mislead by reports from the team and accusing the researchers of cherry-picking their data, demanding to do its own statistical analysis on the findings. In other words, they didn’t get the study they really wanted and are now trying to save face by accusing the scientists of doing what they wanted to do in the first place: fake it ’till they make it and cherry-pick the data until they got the result they paid for. Far too many autism biomed cranks and quacks are depending on them being right to keep bilking parents to turn their kids into guinea pigs, and far too many parents are convinced that whatever is wrong with their child was caused by vaccines, SafeMinds and groups like it go to any lengths to keep the manufactroversy going. It must be the vaccines, it cannot not be the vaccines, they’ve invested too much time, money, and emotion for it not to be the vaccines. To them, this study is already “discredited” because wouldn’t give them what they needed.

little smartphone

Every few years, we seem to get paroxysms of warnings about how our smartphones are going to give us cancer one day. Despite being grounded in junk science, they cause a stir because a few people with the right credentials claiming that something they we every day is killing us is a good way to get a lot of attention very quickly. And with large contingents of people all too ready and willing to believe that a few cells in a lab are a good proxy for the human body, and that Big TelCo is just the next Big Tobacco in waiting, the City of Berkley accomplished a feat of quixotic justice that San Francisco and the state of Maine once failed to secure, and is trying to force all stores that sell phones within the city’s limits to carry a vague, scary warning about cell phones emitting radiation and implying that users may be at risk of something malignant if they don’t go through their phone’s manual to find a safe way to use it while shielding their fragile bodies. No scientific work dealing with in vivo studies says this, but hey, there’s pandering to be done so a little something like, say, the medical community disagreeing with you should’t get in the way.

Really, it’s not often that siding with a large industry trade group, such as CTIA, which fought in court to stop the mandate, is the scientifically correct thing to do. Usually trade groups will jump on a junk science bandwagon if it benefits them in a heartbeat and twist facts to suit the desires for higher profit, as in the case of the anti-GMO lobby for example. But in this rare case, CITA’s objections really did have the science on their side and it would’ve been a way more interesting case if science was actually invoked. Despite having the ability to prove that the City of Berkley was simply ascribing to Luddism and anti-scientific fallacies to cast cell phones as evil, cancer-emitting boxes of death, the modern equivalents to a pack of cigarettes in the 1950s, it decided to argue that the mandate just violated their members’ free speech rights. Please join me for a minute of facepalming at this legal equivalent of snatching a defeat from the jaws of victory. It’s yet another example why court decisions should be inadmissible in debates about science.

But hold on, you might say, what’s so bad about the City of Berkley only giving its citizens what they wanted? After all, shouldn’t people be free to make their own informed decisions and this disclaimer only gives them the tools to make up their minds after considering both sides? Well, yes, that would be the case in a scientifically hyperliterate utopia, or when there’s a real debate about an issue in the scientific community. But there’s a reason why we don’t slap labels on the astronomy books sold at Barnes and Noble warning readers that it contains descriptions of the theory of heliocentrism and features multiple references to the Big Bang, or on a medical book to warn readers that it does not consider the theory of the four humors and miasmas alongside germ theory. There are no current scientific debates about whether the universe is static, or the Earth orbits the sun, or that microorganisms invading our bodies are the origin of disease. Why would we want to give the public erroneous information because a special interest group really, really wanted to shout its ill-informed ideas no matter what the experts actually told them?

Make no mistake, this is not about a really lefty anti-establishment city defying corporate villains in court as a victory for the little guy, as the Luddite lobby spins it. It’s not about helping a public at risk make up its own mind on a case by case basis. This is about promoting misinformation a small but vocal group of technophobes believes to be true in order to similarly scare others and using the city to do the dirty legal work. This time they managed to get lucky because the trade group defending the science abdicated its responsibility to wander off into the tenuous lands of free speech where factual standards are non-existent unless you’re lying to damage careers or imply that someone innocent committed a crime while obviously knowing he or she didn’t. All of the labeling and warning the anti-science activists really want aren’t giving people some sort of valuable information they desperately need, but about putting their propaganda right in front of their faces through court-assisted arm twisting, which is why we shouldn’t so much be laughing and joking about them, but actively pointing out what they are and publicly opposing them.

[ illustration by Eric Motang ]


When you’re in business for yourself, or are a part owner of a venture, nothing sounds sweeter than being told that your business is profitable. What you don’t want to hear is that your artificial manipulation of supply for short term gain is actually profiteering, because people who relied on your product get angry. And if you’re a small pharmaceutical company, you wouldn’t like it when those people get angry. This is currently the case with Turin Pharmaceuticals, which owns what was once an accessible treatment for a dangerous parasitic infection in developing nations. Not content with selling it for a mere $13.50 per pill, its new owner, a hedge fund manager who has been investigated for campaigning the FDA to stymie companies whose stocks he was shorting, and fired from another drug maker for borderline embezzlement, jacked the price up by 5,500% to an absurd $750 per pill. Bizarrely though, reports from the field say that he’s not getting that kind of money and is delivering a lot of doses at no charge and at close to original prices.

But he’s not the only one that’s trying to profiteer from relatively rarely used drugs. Other small pharma companies like Rodelis, Valeant, and CorePharma have drastically increased prices for their old, but in demand medications. It’s become an entirely new business model. Instead of a new treatment superior to older drugs, their companies are being bought, prices for medication long paid off and covered by insurance plans are being doubled, tripled, and more, and when a reporter, customer, or a government agency asks why the sudden rate hike, they’re told it’s for funding R&D without anything in the pipeline to show as benefiting form the new cash. Yes, the process of making a new drug is very complex and expensive, which is why many companies in need of a steady pipeline of them to survive will do all sorts of unethical and questionable things to get them approved and sold; testing against placebos rather than a current standard, paying for fake journal articles, and even promoting off label uses for them, even though it’s illegal. But at least for all their glaring flaws in generating sales, these companies do have new drugs.

We should encourage competition among businesses to develop new ideas in medical care, it’s better for us as both customers and patients when we have choices and companies have really strong incentives to innovate. But the key word here is innovation, and just jacking up the prices of old drugs to bring in more cash is not innovating in any other way than sarcastically when we try to inject a little gallows humor into the conversation. And this isn’t even a good strategy. The PR is awful and the companies either look like Dickensian villains, or cave and ship the drugs to where they’re needed free of charge or for the typical rate. Competitors can easily undercut the newly overpriced drugs with something generic or better. Doctors balk and either negotiate new discounts to knock the price back down to what it was, or refuse to buy and go to competitors to make sure the treatment is covered. On top of that, with no new drugs and existing ones sold at the same price or given away to the needy, investors don’t get their money’s worth anyway. It’s just another example of how trying to hold medicine hostage in an advanced economy with very string regulations is a game one can’t win. And for their own good, really shouldn’t want to…

human heart

When it comes to preserving donated organs for transplantation, the last several decades gave doctors only one choice to keep them alive long enough to be useful. Chilled and transported to the recipients as quickly as possible to avoid spoilage. But a new generation of technology built with a much better understanding of organ structure and function is giving us a new option. Say goodbye to coolers and hello to sterile biospheres where organs are kept warm, fed, and with a private circulatory system until they’re ready to be transplanted. All of the surgeries done using warm, functioning organs have been a successes thus far, and the companies who make these organ-preserving devices are already eyeing improvements in sustaining organs using nutrient and temperature settings the donor organs need for their unique conditions, sizes, and shapes, instead of a general treatment for their organ type. Think of it as the donated organ getting first class transportation to its new home. But that’s making some people feel a bit uneasy…

According to reactions covered by MIT’s Technology Review, and repeated elsewhere, organs being restored to full function may be blurring the line between life and death, and not waiting a proper period of time means that instead of donating organs of a deceased patient, doctors are actually killing someone by harvesting his or her organs so others can live. In some respect, we do expect that sort of triage in hospital settings because after all, there’s only so much even the best medical techniques and devices can do to help patients and if doctors know that all efforts will be in vain, it only makes sense to save time, money, and resources, and give others a shot with the organs they need, something always in short supply. Wait too long to harvest the heart, liver, and kidneys, and they’ll start to die putting the would-be recipient at risk of life-threatening complications or outright transplant failure. However, if you don’t wait long enough, are you just helping death do its job and killing a doomed patient while her family watches? The fuzzier and fuzzier lines between life and death make this a very complicated legal and ethical matter.

But even considering this complex matter, the objections against refined organ harvesting miss something very important. Doctors are not taking patients who can make a full recovery into the operating room, extracting vital organs, putting them in these bio-domes, and sending them out to people in need of a transplant. These organs come from those who are dead or would die as soon as the life support systems are shut off with no possibility of recovery. Revive hearts which stopped after a patient died of circulatory disease and the patient will die again. Support organs inside the body of someone who is brain dead, or so severely brain damaged that recovery just can’t happen, and all you’re doing is extending the inevitable. It takes a lot more than a beating heart or working liver to actually live and these new preservation devices are not giving doctors an incentive to let someone die, much less speed up a patient’s death. They’re giving us a very necessary bridge towards the artificial or stem-cell grown organs we are still trying to create as thousands die of organ failure we can fix if only we could get them the organs they need…

flu virus

Scientists are now raising the dead and enslaving them to serve the needs of the living. This is not really much of an exaggeration because that’s exactly what happened when researchers in need of a suitable virus for gene therapy applications decided to create an extinct version of a modern virus by reverse-engineering its evolution and printing the now lost DNA into an empty capsid waiting to be activated. Let’s pause for a second and consider that this is the world that we now occupy. We can traverse the evolutionary tree of an organism and order up the DNA of its ancestors to be 3D printed on command. Beyond being basically horror movie fodder in real life though, this experiment isn’t just an exploration into seeing what’s possible. No, this turning back of the clock might become wildly effective cures for diseases and conditions for which the current treatment just isn’t enough or doesn’t really exist by producing a virus that our immune systems haven’t seen yet, and which repairs our genomes to fix what may one day kill us.

Now, I’ve talked about gene therapy and its promise before. It could combat complex disorders like cystic fibrosis, shrink, or at least arrest the growth of cancers, and eliminate problems that can be traced to single genes by altering them once and for all. While the very first human tests did get off to a rocky start, the technology is now much safer and much better understood, and has been showing some promise. In one inspiring trial, the engineered HIV virus sent an acute strain of pediatric leukemia into remission and showed evidence that precise targeting for gene therapy was definitely possible. However, current approaches have a major limitation before we can get really consistent results and that limitation is us. To be more specific, our immune cells pick up on the viruses’ signatures and attack them before they can do any good. This means a lot of good engineering that would have worked never makes it to its target and the patient just doesn’t react to the therapy. Considering that out immune systems have faced at least some of the strains we can use as therapeutic vectors, there’s not much else we can throw at them.

Or at least not much else that exists, thought the researchers in question here. Our bodies had not seen the viruses they brought back through their modern evolutionary history, so bringing a long lost ancestor back from the dead by identifying which mutations happened over the many generations and reversing them, would find our bodies defenseless. Which is exactly what we’d want for gene therapy. Before our bodies can mount a defense, the infection has spread so far and wide that the therapeutic edits should have had their intended macro effect. Just think of it as sending high altitude stealth bombers and special operations teams instead of flying enough conventional fighter planes and tanks against formidable defenses to get at least some through enemy lines. Just far cooler because it involves resurrecting extinct genomes. But rest easy for now if you’re worried about scientists trying to create a real Jurassic Park with this method. The technology we have now can’t just create mammoth and dinosaur DNA we can use to grow full creatures. Well, at least not yet, though we may have to revisit that question soon enough…

blood bag

Generally, when skeptics or popular science writers talk about medicine and money, it’s to ward off something one could call an argument ad-shillium, or rejecting scientific studies outright with declarations that anyone who sticks up for doctors and pharmaceutical companies over the hot and trendy snake oil salesperson of the month must be a paid shill. Shilling certainly happens in both the real world and online, but when one’s argument rests in basic science, money is not a topic relevant to the conversation. However, that doesn’t mean that it’s not important when new ideas come along and gain some serious traction. Case in point, Theranos, a company which a lot of people rightly suspect can shake up healthcare in the United States by offering dozens of blood using just a drop of blood at your corner pharmacy, is facing a barrage of questions as to how exactly its tests work and seems to be unwilling to tell anyone about their lab on a chip.

Ordinarily, this is where an experienced skeptic would look for signs of quackery. Useless tests, pseudoscientifc mumbo-jumbo on the website, avoidance of the FDA, and special pleading for the enigmatic technology which offers vague benefits that don’t run afoul of the agency’s rules for the same of pharmaceuticals and medical devices. But that’s not the case with Theranos. In fact, the company recently got a nod from the FDA to continue its work and is seeking approval of its technology and testing methods, and scientists who have tried to parse how it can test for so many things with so little blood say that it’s more than likely upgrading old technology into a new, compact toolkit. There’s no voodoo or snake oil here, just good old fashioned science and faster, better computers and machinery. Furthermore, the fees for each test are posted openly, and they’re a lot less than what’s offered by its competitors, whose pricing is opaque at best.

So if there’s nothing amiss at Theranos, why all the secrecy? Well, after many millions spent on research, development, and testing, the company wants to expand significantly and if it shares how it does what it does with the world, especially if it’s just an overhaul of existing methodology with better machinery, its competitors can quickly catch up and limit its growth. I’m sure it’s also trying to avoid getting patent trolled and bogged down in expensive litigation, more than likely of the frivolous, made to line lawyers’ pockets variety, since there’s no shortage of people with an abandoned medical testing device patent from which a troll can manufacture an infringement or two and file in East Texas. Perhaps this is unfair to scientists, and to some degree patients who may want a second opinion after Theranos’ tests show something alarming, but this is the result of setting up a healthcare system with opaque pricing and strict regulation, and legal minefields in the technology world through easy to obtain and vaguely worded frivolous patents.


Anti-vaccine activists would have us believe that autism is the result of some sort of undefined, or scary sounding toxicity and should be cured by a gluten-free diet and detoxification typically conducted by a profiteering quack. However, the real scientific evidence points to genetics and brain development, meaning that no one develops autism or turns autistic, but is born this way and will fall at some point along the spectrum when the condition can be diagnosed. Recently, another study provided additional evidence for this theory by comparing how modified skin cell cultures taken from those with autism, reverted into stem cells, and induced to grow into micro brains developed to skin cells from their non-autistic parents, subjected to the same treatment. Right away, the researchers noted an over-abundance of inhibitory neurons which created the roadblocks to forming necessary connections for sensory and social input processing.

While this isn’t confirmation that this is in fact what causes autism, it’s a substantial step toward identifying the culprits. It also narrowed down the gene responsible and gave the researchers a good idea for how to control its expression. While some pop sci outlets trumpet this as work we can use to develop a cure for autism, I’m not so sure that it’s so simple. After all, autism isn’t a structural disorder in which an excess of inhibitory neurons blocks important functions and pills or even gene therapy would suddenly turn autistic individuals into neuro-typical ones. With their brains affected from birth, their lives have been built around their neurons compensating for all the neurotransmitter dead ends. It would take many years for their brains to re-wire themselves and fashion a new personality. And while those with severe autism would greatly benefit, would this be a desired, or even an ethical treatment for high functioning autistic people?

If autism shapes how you see the world and you have always had it, yes, it can make life really confusing and difficult. But when one learns to overcome, to recognize one’s problems and find coping mechanisms, the journey has made this person who he or she is today. It’s tempting, in the words of autism quacks to “fix” them, but considering how integral autism has been to how they became who they are, the “fix” in question would mean undoing a lifetime of learning, and in some way undoing what they are today for the ability to better process certain stimuli, social interactions, and better emotional coping skills. Again, for low functioning autistic people, there are arguments in favor of the benefits outweighing the risk, but for those who’ve learned to see this condition as a part of who they are and can easily function on their own, even benefiting a little from some of its positive side effects, being “cured” won’t always be the best choice…

old man with pipe

When someone dies young, we say that this person’s death is tragic, that he or she died before his or her time. When someone dies in advanced age, we say that the deceased has lived a full life and it must have been their time to go as if age alone was the culprit. Both stances are very problematic form a scientific standpoint because, you see, nowhere does our biological makeup have a kill switch. There is not one gene or one process that acts like a ticking clock and once it runs out, we die. In fact there are creatures that seem to be near-immortal in this regard, weird jellyfish and microbes that can regenerate themselves when their bodies become worn and frail as if to start their lives anew. To blindly submit to mortality as if it’s somehow ordained by some force from above is to neglect the complete lack of any scientific basis for “our time to go” and ascribe to the frequently repeated misnomer that people die from old age when it’s not the old age that kills the person, but simply makes him or her very easy prey for numerous diseases.

Considering aging a disease or a medical condition is actually a lot more important than it might sound because at stake is government approval for anti-aging drug trials, with researchers able to communicate that their work is valid despite the fact that it fights something doctors don’t see as a disease. In reality, aging is a complex degenerative condition that needs to be treated like one and while there is no one switch we can flip to stop it, there are things we can do to slow it, partially reverse some of its effects, and allow for a longer period of life in good health and with fewer aches and pains. If the worst thing that comes out of these drug trials are treatments that don’t actually extend our lifespans but drastically improve our physical and mental fitness, that’s already a huge net gain because not only are people better off, but we’d also save trillions with less acute treatment for typical physical and cognitive problems of old age being necessary. It’s also a very realistic goal over the next 15 years provided that the funding is there, of course.

We should think of aging much the same way we think of HIV and AIDS. Left untreated, it won’t kill us by itself, but it will open enough doors for something to come along to do that dirty work, and so we should fight it with an arsenal of lifestyle changes. It’s going to be many years before we see rousing successes, but we already have promising pathways desperately in need of the funding and scientific rigor and legitimacy to be taken to their full potential. Convincing those in charge of the purse strings and regulatory approvals that they’re fighting a real problem, rather than just messing around with something nature has preordained, will be crucial because when they don’t think a valid problem is being fought or a valid question is being asked, they’re rather unlikely to keep writing the checks and giving green lights. There’s a cultural battle to be fought here because history is replete with those who claimed to know how to beat aging or death with potions and rituals which yielded nothing or even killed their patients. But armed with the basic understanding of how biology actually works, today’s scientists have a real shot at it.

old cyborg

Over all the posts I’ve written about brain-machine interfaces and their promise for an everyday person, one the key takeaways was that while the idea was great, the implementation would be problematic because doctors would be loath to perform invasive and risky surgery on a patient who didn’t necessarily need said surgery. But what if when you want to link your brain to a new, complex, and powerful device, you could just get an injection of electrodes that unfurl into a thin mesh which surrounds your neurons and allows you to beam a potent signal out? Sounds like a premise for a science fiction novel, doesn’t it? Maybe something down the cyberpunk alley that was explored by Ghost In The Shell and The Matrix? Amazingly, no. It’s real, and it’s now being tested in rats with extremely positive results. Just 30 minutes after injection, the mesh unwound itself around the rats’ brains and retained some 80% of its ideal functionality. True, it’s not quite perfect yet, but this is a massive leap towards fusing our minds with machinery.

Honestly, I could write an entire book about all the things easy access this technology can do in the long run because the possibilities are almost truly endless. We could manipulate a machine miles away from ourselves as if we inhabited it, Avatar style, give locked in stroke victims a way to communicate and control their environment, extend our nervous systems into artificial limbs which can be fused with our existing bodies, and perhaps even challenge what it means to be a human and become a truly space faring species at some point down the line. Or we could use it to make video games really badass because that’s where the big money will be after medicine, after which we’ll quickly diversify into porn. But I digress. The very idea that we’re slowly but oh so surely coming closer and closer towards easy to implant brain-machine interfaces is enough to make me feel all warm and fuzzy from seeing science fiction turn into science fact, and twitch with anticipation of what could be done when it’s finally ready for human trials. Oh the software I could write and the things it could do with the power of the human brain and a cloud app…

[ illustration by Martin Lisec ]

lab mouse

Let me start this post with something seldom seen on this blog, a personal story. Just a couple of years ago, yours truly was doing a mixed martial arts drill. My opponent had at least 100 lbs. on me and as he tried tackling me, as was his job, physics and gravity let him power through a stance that was supposed to stop him from flipping me onto my back. Felling myself slide, I did what I was trained to do and improvised. Digging in my toes and dropping my weight as low as possible, I slipped out of his grip, pivoted, and managed to flip him over my shoulder and on his back. As he quickly rolled to get up, I managed to catch him with one hand digging into his neck and the other tearing at a tricep, setting myself up for a knee to his jaw. The trainer called time, we let each other go, and he stood up as I straightened myself out. Less than a minute later, it hit me. Every other drill would have to be done with a vicious, shooting pain in my back. After a long, exceedingly painful hour, I was laying face down on an urgent care exam table.

Movies often make feats of superhuman strength look easy, and although I had just pulled off a movie-worthy move, reality quickly stepped in to show me my place. On rainy days, my back is whiny, and if I walked around all day, I have to grin, bear it, and try not to reach for painkillers. I absolutely love doing MMA, but the last several months until I was urged to stop for a while had been supported by compression gear, Vicodin, and muscle relaxers. One of these days, I hope that my back heals up just enough to get back to fighting and if there was a therapy which could fix my back with little more than a 30 minute IV drip and one injection, I’d happily sign up for it, much like journalist Tyler Graham did when receiving stem cell therapy for his shoulder. There was a catch of course. The procedure Graham tried is still unproven, and the evidence of what it’s able to do is purely anecdotal. Patients are paying a lot of money to go to SoCal, have their fat processed by a doctor to induce it to turn into adult stem cells, and have it injected back into the site of tissue damage to seemingly miraculously fix whatever’s torn or worn out.

And that’s really the problem here. How do stem cells do what they do? We don’t know. There are plenty of ideas and trials are ongoing to figure out just how to control these cells’ restorative powers because the potential is revolutionary, to put it mildly. But because stem cell therapies a lot of doctors offer today are a crapshoot, it’s not entirely impossible that your treatment will do nothing at all as it’s attacked by your immune system as dangerous mutant cells to be killed for the sake of your health, or, even worse, result in a painful, malignant tumor. Both scenarios are known to have happened in the lab and in the field, and until scientists get a really good handle on how to perform stem cell treatments, it’s probably not a good idea to have one. This is really a textbook case for why we need basic science rather than maverick doctors willing to turn you into a human guinea pig for a substantial fee. Personally, I’m glad that Graham feels better and hope that he’s one of the lucky ones who’ve been helped. And while I understand his decisions, and appreciate that he was very lucid and skeptical of the whole thing, I won’t follow suit.