A Blue View

Sunday Afternoon Relaxation

The History of the Internet:

An amusing, and surprisingly accurate, 1969 view of what the Internet would be like:

Maybe You Can't Patent DNA After All

Patenting a diagnostic test I understand. Patenting the gene that is being tested for, seems contrary to patent law (where's the "invention"?).  Now, at least one District Court judge agrees with me. From the NY Times:

On Monday, Mr. Sweet, a United States district judge in Manhattan, ruled that parts of patents held by Myriad Genetics covering two breast cancer genes, known as BRCA1 and BRCA2, were invalid.

Myriad analyzes those genes in an expensive test that predicts whether a woman is at a high risk of getting breast or ovarian cancer. The plaintiffs in the case, which included various medical groups and the American Civil Liberties Union, said the patents on DNA were illegal and impeded access to the testing.

The decision invalidating the gene patents stunned many lawyers who follow such issues.

“It’s really quite a dramatic holding that would have the effect of invalidating many, many patents on which the biotechnology industry has invested considerable money,” said Rebecca S. Eisenberg, a law professor at the University of Michigan who has written widely on gene patents.

The Genomics Law Report, an Internet journal, called the decision “radical and astonishing in its sweep.” It headlined its article, “Pigs Fly.”

Although patents are not granted on things found in nature, the DNA being patented had long been considered a chemical that was isolated from, and different from, what was found in nature. But Judge Sweet ruled that the distinguishing feature of DNA is its information content, its conveyance of the genetic code. And in that regard, he wrote, the isolated DNA “is not markedly different from native DNA as it exists in nature.”

The immediate impact will be limited in part because the decision, made in a district court, does not apply to gene patents other than the ones it considered, and its value as precedent for other courts is limited.

Moreover, Myriad said Tuesday that it would appeal, and several lawyers said they expected the ruling to be overturned. Professor Eisenberg said “there isn’t a whole lot of doctrinal support” for considering DNA as information rather than as a chemical.

Even before an appeal is decided, the landscape could change in a way that would render the Myriad case moot. A ruling is expected soon from the Supreme Court in the so-called Bilski case. That case does not directly concern gene patents — it is about a fight over a method of hedging risk in commodities trading — but it gives the Supreme Court a chance to set new standards on what is patentable.

“We are still waiting, holding our breath for the Bilski case,” said Kari Stefansson, head of research at DeCode Genetics, which sells disease risk tests similar to those sold by Myriad.

If Judge Sweet’s decision were upheld on appeal, the impact could be more far-reaching. The biggest impact would be on companies like Myriad and Athena Diagnostics that offer diagnostic tests based on genes.

Some biotechnology investors and executives say that lack of patent protection for DNA could diminish investment and remove incentives to develop tests. That could slow the move toward so-called personalized medicine, in which genetic tests are used to determine which drugs are best for which patients.

James P. Evans, a professor of genetics at the University of North Carolina, said that would not necessarily be the case. There is thriving competition in areas like testing for mutations that cause cystic fibrosis or Huntington’s disease, even though no company has exclusivity.

“It’s quite demonstrable that in the diagnostic area, one does not need gene patents in order to see robust development of these tests,” he said.

Coexisting With Neanderthals & Humans 40K Years Ago, Third Type Of Human Ancestor Identified

Wash Post:

A team of European researchers has identified a new lineage of proto-human that left Africa about a million years ago, traveling as far as Siberia and then dying out -- a discovery that raises new questions about early human history.

The existence of the new lineage was discovered by analyzing DNA extracted from a single bone fragment, according to a study published Wednesday in the journal Nature. What the beings looked like, how they lived and what happened to them are a mystery. All that's known is that they existed as recently as 40,000 years ago, which is the approximate age of the bone.

"Whoever carried this DNA out of Africa is some new creature that hasn't been on our radar screen so far," said Johannes Krause, a researcher at the Max Planck Institute for Evolutionary Anthropology in Germany, who helped lead the research team.

The new lineage, which has not yet been declared a separate species, occupied Russia's Altai Mountains during a long period when early modern humans and Neanderthals were also there. Whether its members had contact with those other early people -- or might have interbred with them -- isn't known.

Nevertheless, the possible cohabitation of the three groups gives rise to at least two narratives of the first chapter of Eurasian history.

Climate Change Opponents Join With Anti-Evolution Creationists To Spur American's Idiotic Attachment To Denialism

NY Times (For more, see A Blue View's Denialism category and/or buy the book that named the phenomenon: Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives):

Critics of the teaching of evolution in the nation’s classrooms are gaining ground in some states by linking the issue to global warming, arguing that dissenting views on both scientific subjects should be taught in public schools.

In Kentucky, a bill recently introduced in the Legislature would encourage teachers to discuss “the advantages and disadvantages of scientific theories,” including “evolution, the origins of life, global warming and human cloning.”

The bill, which has yet to be voted on, is patterned on even more aggressive efforts in other states to fuse such issues. In Louisiana, a law passed in 2008 says the state board of education may assist teachers in promoting “critical thinking” on all of those subjects.

Last year, the Texas Board of Education adopted language requiring that teachers present all sides of the evidence on evolution and global warming.

Oklahoma introduced a bill with similar goals in 2009, although it was not enacted.

The linkage of evolution and global warming is partly a legal strategy: courts have found that singling out evolution for criticism in public schools is a violation of the separation of church and state. By insisting that global warming also be debated, deniers of evolution can argue that they are simply championing academic freedom in general.

Yet they are also capitalizing on rising public resistance in some quarters to accepting the science of global warming, particularly among political conservatives who oppose efforts to rein in emissions of greenhouse gases.

In South Dakota, a resolution calling for the “balanced teaching of global warming in public schools” passed the Legislature this week.

“Carbon dioxide is not a pollutant,” the resolution said, “but rather a highly beneficial ingredient for all plant life.”

The measure made no mention of evolution, but opponents of efforts to dilute the teaching of evolution noted that the language was similar to that of bills in other states that had included both. The vote split almost entirely along partisan lines in both houses, with Republican voting for it and Democrats voting against.

For mainstream scientists, there is no credible challenge to evolutionary theory. They oppose the teaching of alternative views like intelligent design, the proposition that life is so complex that it must be the design of an intelligent being. And there is wide agreement among scientists that global warming is occurring and that human activities are probably driving it. Yet many conservative evangelical Christians assert that both are examples of scientists’ overstepping their bounds.

John G. West, a senior fellow with the Discovery Institute in Seattle, a group that advocates intelligent design and has led the campaign for teaching critiques of evolution in the schools, said that the institute was not specifically promoting opposition to accepted science on climate change. Still, Mr. West said, he is sympathetic to that cause.

“There is a lot of similar dogmatism on this issue,” he said, “with scientists being persecuted for findings that are not in keeping with the orthodoxy. We think analyzing and evaluating scientific evidence is a good thing, whether that is about global warming or evolution.”

Lawrence M. Krauss, a physicist who directs the Origins Initiative at Arizona State University and has spoken against efforts to water down the teaching of evolution to school boards in Texas and Ohio, described the move toward climate-change skepticism as a predictable offshoot of creationism.

“Wherever there is a battle over evolution now,” he said, “there is a secondary battle to diminish other hot-button issues like Big Bang and, increasingly, climate change. It is all about casting doubt on the veracity of science — to say it is just one view of the world, just another story, no better or more valid than fundamentalism.”

Not all evangelical Christians reject the notion of climate change, of course. There is a budding green evangelical movement in the country driven partly by a belief that because God created the earth, humans are obligated to care for it.

Yet there is little doubt that the skepticism about global warming resonates more strongly among conservatives, and Christian conservatives in particular. A survey published in October by the Pew Research Center for the People and the Press found that white evangelical Protestants were among those least likely to believe that there was “solid evidence” that the Earth was warming because of human activity.

Only 23 percent of those surveyed accepted that idea, compared with 36 percent of the American population as a whole. [For more see New Poll Shows Fewer Americans "Believe" Global Warming]

Majority Of Texans Don't Think Humans Evolved From Other Species; 30% Think We Walked With The Dinosaurs

 

Read the depressing Texas Tribune story.

"Think Twice: How the Gut's "Second Brain" Influences Mood and Well-Being"

Scientitific American:

As Olympians go for the gold in Vancouver, even the steeliest are likely to experience that familiar feeling of "butterflies" in the stomach. Underlying this sensation is an often-overlooked network of neurons lining our guts that is so extensive some scientists have nicknamed it our "second brain".

A deeper understanding of this mass of neural tissue, filled with important neurotransmitters, is revealing that it does much more than merely handle digestion or inflict the occasional nervous pang. The little brain in our innards, in connection with the big one in our skulls, partly determines our mental state and plays key roles in certain diseases throughout the body.

Although its influence is far-reaching, the second brain is not the seat of any conscious thoughts or decision-making.

"The second brain doesn't help with the great thought processes…religion, philosophy and poetry is left to the brain in the head," says Michael Gershon, chairman of the Department of Anatomy and Cell Biology at New York–Presbyterian Hospital/Columbia University Medical Center, an expert in the nascent field of neurogastroenterology and author of the 1998 book The Second Brain (HarperCollins).

Technically known as the enteric nervous system, the second brain consists of sheaths of neurons embedded in the walls of the long tube of our gut, or alimentary canal, which measures about nine meters end to end from the esophagus to the anus. The second brain contains some 100 million neurons, more than in either the spinal cord or the peripheral nervous system, Gershon says.

This multitude of neurons in the enteric nervous system enables us to "feel" the inner world of our gut and its contents. Much of this neural firepower comes to bear in the elaborate daily grind of digestion. Breaking down food, absorbing nutrients, and expelling of waste requires chemical processing, mechanical mixing and rhythmic muscle contractions that move everything on down the line.

Thus equipped with its own reflexes and senses, the second brain can control gut behavior independently of the brain, Gershon says. We likely evolved this intricate web of nerves to perform digestion and excretion "on site," rather than remotely from our brains through the middleman of the spinal cord. "The brain in the head doesn't need to get its hands dirty with the messy business of digestion, which is delegated to the brain in the gut," Gershon says. He and other researchers explain, however, that the second brain's complexity likely cannot be interpreted through this process alone.

"The system is way too complicated to have evolved only to make sure things move out of your colon," says Emeran Mayer, professor of physiology, psychiatry and biobehavioral sciences at the David Geffen School of Medicine at the University of California, Los Angeles (U.C.L.A.). For example, scientists were shocked to learn that about 90 percent of the fibers in the primary visceral nerve, the vagus, carry information from the gut to the brain and not the other way around. "Some of that info is decidedly unpleasant," Gershon says.

The second brain informs our state of mind in other more obscure ways, as well. "A big part of our emotions are probably influenced by the nerves in our gut," Mayer says. Butterflies in the stomach—signaling in the gut as part of our physiological stress response, Gershon says—is but one example. Although gastrointestinal (GI) turmoil can sour one's moods, everyday emotional well-being may rely on messages from the brain below to the brain above. For example, electrical stimulation of the vagus nerve—a useful treatment for depression—may mimic these signals, Gershon says. <Continue reading.>

"For Human Spaceflight, Can Measured Beat Bold?"

NY Times:

President George W. Bush ... After the shuttle Columbia’s disaster in 2003, he introduced a “new vision” to revive the floundering space program. It included post-shuttle propulsion systems and crew-carrying vehicles. The goal was a return of astronauts to the Moon by 2020. Sometime after, to Mars.

But the costs of fighting wars while cutting taxes left little money to support the undertaking. Although several billion dollars have already been invested in advanced hardware, the goals seem illusory, and public support seems thin.

Once again, experience brought reminders, so often overlooked, that Apollo was not a realistic model for future endeavors in space exploration. Going to the Moon had been, above all, a campaign in the cold war. The Soviet Union was the feared adversary, even more so after the Sputnik surprise and after Yuri Gagarin’s flight made him the first man in space, in spring 1961.

Early on, the political scientist John M. Logsdon at George Washington University made a study of the decision-making process leading to Apollo. Dr. Logsdon concluded that Apollo was “a product of a specific time in history” and a singular crash program responding to a perceived threat to the country. It did not represent a firm commitment by society to open-ended space exploration.

Norman R. Augustine, an aerospace industry executive, acknowledged as much when he led a task force that contributed to the first President Bush’s proposals. “The heavy driver for the space program used to be competition with the Soviets,” Mr. Augustine said at the time. “Today, there is not that clear competition but the fundamental values of exploration that drive us. They are less tangible, but no less important.”

If one thing is clear and encouraging in President Obama’s proposals, it is the recognition of Apollo’s exceptionality. Mr. Augustine also served on the committee that advised Mr. Obama, and his point about the changing political matrix has apparently sunk in.

“We’ve been trying to relive Apollo for 40 years, unsuccessfully,” NASA’s deputy administrator, Lori B. Garver, said in an interview with editors and reporters of The New York Times. “For too long NASA overpromised and underdelivered, and now we will be doing things differently.”

That remains to be seen. Congressional committees have not begun to examine the proposals and the modest budget increases for NASA. The administration’s plan may be “bold and game-changing,” in Ms. Garver’s words, but several aspects are likely to stir controversy or at least call for closer study.

In contrast to the past, the new plan sets no definite timetables, cost estimates or destinations. Nor is there extravagant rhetoric about knowledge and adventure. The Kennedy eloquence about sailing “this new ocean” was effective primarily because the nation felt the need to demonstrate its technological superiority in war and peace.

Denialist Alert: Swine Flu Has Killed 1,000 American Children So Far

If 20 school buses worth of kids were to die in a traffic accident, it would be all over the news for weeks. Yet, when 1,000 unvaccinated children are killed by ignorance, irrational fear or neglect, the news is buried within a minor story in the NY Times health section:

Most Americans do not intend to get the swine flu vaccine, assume the pandemic is over and think the flu threat was overblown, according to a poll released Friday by the Harvard School of Public Health.

As of the end of January, only about a fifth of all Americans had had swine flu shots, according to that poll and data released separately by the Centers for Disease Control and Prevention.

And, even though this flu hit children and teenagers the hardest, only about 40 percent of them have had the shots. That figure could improve because 13 percent of adults surveyed by Harvard told pollsters that they still intended to get their children vaccinated. If they do so, slightly more than half of all the country’s children will have been vaccinated, though many young ones who should have had two shots got only one.

Most parents who did not get shots said they felt the threat had passed. The second-most-common reason was fear of the vaccine, even though monitoring of the first 60 million doses showed no unusual rate of side effects ...

Nine children died of confirmed swine flu in the last week of January, according to weekly data released Friday. The C.D.C. estimates that about 1,000 children have succumbed to it since April.

NADA Moon Cartoon

 
 

Increased Money For Science In Obama's Budget

NY Times:

Calming fears that scientific research would be hurt by the Obama administration, the budget request for the Department of Health and Human Services was $81.3 billion, up from $79.6 billion a year ago. And the National Institutes of Health saw its budget request rise by $1 billion, to $32 billion, more than was requested last year.

The proposed budget, announced on Monday, now includes $6 billion for cancer research, intended to allow the agency to start 30 new drug trials and double the number of drugs and vaccines in clinical trials by 2016.

The first priority noted by the Office of Management and Budget was to support health insurance reform by strengthening policy on the use of computerized records, financing research to compare the effectiveness of different medical treatments and creating health centers to get more care to populations that lack it, like the uninsured and American Indians.

In other science-related budget requests, the National Science Foundation would get $7.4 billion, a nearly 8 percent increase from the budget last year.

Scientists had feared that budgets would be frozen and that stimulus financing that had been directed toward science would dry up in the coming fiscal year.

Separately, the State Department, through its own budget and that of the United States Agency for International Development, pours billions of dollars into global health. That money increased nearly 9 percent in the Mr. Obama’s budget request, rising to $8.5 billion this year from $7.8 billion, according to the department’s budget summary.

In her own preliminary analysis, Jennifer Kates, a vice president of the Kaiser Family Foundation, which specializes in health policy, said the amount of money devoted to programs in the president’s Global Health Initiative, which is split among several agencies, appeared to have risen about 8 percent to $9.6 billion, from $8.8 billion in fiscal 2010.

The key areas that were getting increases, Ms. Kates said, were the health of mothers and children, malaria, family planning and neglected tropical diseases. Financing for AIDS appears to be rising but not nearly as rapidly as it did during the Bush administration, which created the president’s Emergency Plan for AIDS Relief.

“It’s what they’ve been talking about,” she said.

While scientists concentrating on domestic problems had worried about deep cuts, global health appears to have been sheltered by Mr. Obama’s promise to exempt international affairs and global security.

"Obama Budget Freezes Much Domestic Spending"

NY Times:

President Obama will send a $3.8 trillion budget to Congress on Monday for the coming fiscal year that would increase financing for education and for civilian research programs by more than 6 percent and provide $25 billion for cash-starved states, even as he seeks to freeze much domestic spending for the rest of his term.

The budget for the 2011 fiscal year, which begins in October, will identify the winners and losers behind Mr. Obama’s proposal for a three-year freeze of a portion of the budget. Many programs at the National Institutes of Health, the National Science Foundation and the Energy Department are in line for increases, along with the Census Bureau.

Among the losers would be some public works projects of the Army Corps of Engineers, two historic preservation programs and NASA’s mission to return to the Moon, which would be ended as the administration seeks to reorient the space program to use private companies for launchings. Mr. Obama is recycling some proposals from last year, including one to end redundant payments for land restoration at abandoned coal mines; Western lawmakers blocked it in 2009. Mr. Obama will propose a total of $20 billion in such savings for the coming fiscal year.

Exempted from the cuts, however, are national security, veterans programs, Medicare, Medicaid and Social Security — the most expensive and fastest-growing areas of the budget.

By filling in the details behind the freeze, the administration hopes to show critics that it used a scalpel rather than an ax to keep spending for the targeted domestic agencies to $447 billion through 2013.

The three-year freeze would save $250 billion over the coming decade, assuming the overall spending on the domestic programs is permitted to rise no more than the inflation rate for the remainder of the decade — an austerity that neither party has ever achieved in Washington. Even so, the $250 billion in savings would be less than 3 percent of the total deficits projected through 2020.

Criticism of the spending plan has ranged from arguments among liberals in Mr. Obama’s party and some economists that he should not be cutting spending when the economy needs hundreds of billions of dollars more in stimulus money, to complaints from Republicans that the savings are too paltry when annual trillion-dollar deficits are the largest since World War II.

The debate reflects the conflicting imperatives underlying the administration’s fiscal policies — between the demands to help a struggling economy create jobs and the need for long-term efforts to address the huge buildup of debt that threatens the nation’s future prosperity.

“There is a huge tension” between the goals, said Robert D. Reischauer, a former director of the Congressional Budget Office.

Example Images From Full Body Scanners

Which is more intrusive, some TSA official you can't see looking at images like this or a TSA official right in front of you putting their hands all over your body? It's not clear to me which is the bigger invasion of privacy. Is it to you?

 

Learn how these full-body scanners work.

"Scientists are poorly equipped ... to respond when science comes under attack"

Whether it's the hacked climate emails or evolution, as discussed in this Wash Post article, or mammogram recommendations and vaccine phobia as posted often in A Blue View (for instance, here, here and here), it is clear that scientists need to become better, more effective advocates when they are in the public square.

The battle over the science of global warming has long been a street fight between mainstream researchers and skeptics. But never have the scientists received such a deep wound as when, in late November, a large trove of e-mails and documents stolen from the Climatic Research Unit at Britain's University of East Anglia were released onto the Web.

In the ensuing "Climategate" scandal, scientists were accused of withholding information, suppressing dissent, manipulating data and more. But while the controversy has receded, it may have done lasting damage to science's reputation: Last month, a Washington Post-ABC News poll found that 40 percent of Americans distrust what scientists say about the environment, a considerable increase from April 2007. Meanwhile, public belief in the science of global warming is in decline.

The central lesson of Climategate is not that climate science is corrupt. The leaked e-mails do nothing to disprove the scientific consensus on global warming. Instead, the controversy highlights that in a world of blogs, cable news and talk radio, scientists are poorly equipped to communicate their knowledge and, especially, to respond when science comes under attack.

A few scientists answered the Climategate charges almost instantly. Michael Mann of Pennsylvania State University, whose e-mails were among those made public, made a number of television and radio appearances. A blog to which Mann contributes, RealClimate.org, also launched a quick response showing that the e-mails had been taken out of context. But they were largely alone. "I haven't had all that many other scientists helping in that effort," Mann told me recently.

This isn't a new problem. As far back as the late 1990s, before the news cycle hit such a frenetic pace, some science officials were lamenting that scientists had never been trained in how to talk to the public and were therefore hesitant to face the media.

"For 45 years or so, we didn't suggest that it was very important," Neal Lane, a former Clinton administration science adviser and Rice University physicist, told the authors of a landmark 1997 report on the gap between scientists and journalists. ". . . In fact, we said quite the other thing."

The scientist's job description had long been to conduct research and to teach, Lane noted; conveying findings to the public was largely left to science journalists. Unfortunately, despite a few innovations, that broad reality hasn't changed much in the past decade.

Scientific training continues to turn out researchers who speak in careful nuances and with many caveats, in a language aimed at their peers, not at the media or the public. Many scientists can scarcely contemplate framing a simple media message for maximum impact; the very idea sounds unbecoming. And many of them don't trust the public or the press: According to a recent Pew study, 85 percent of U.S. scientists say it's a "major problem" that the public doesn't know much about science, and 76 percent say the same about what they see as the media's inability to distinguish between well-supported science and less-than-scientific claims. Rather than spurring greater efforts at communication, such mistrust and resignation have further motivated some scientists to avoid talking to reporters and going on television.

They no longer have that luxury. After all, global-warming skeptics suffer no such compunctions. What's more, amid the current upheaval in the media industry, the traditional science journalists who have long sought to bridge the gap between scientists and the public are losing their jobs en masse. As New York Times science writer Natalie Angier recently observed, her profession is "basically going out of existence." If scientists don't take a central communications role, nobody else with the same expertise and credibility will do it for them.

Meanwhile, the task of translating science for the public is ever more difficult: Information sources are multiplying, partisan news outlets are replacing more objective media, and the news cycle is spinning ever faster ...

Swine Flu A "Victory" Over The Denialist, Antivaccine Movement?

In a NY Times article about the government's successful fight against swine flu--thanks to good decision making and a bit of good luck--there was this interesting assessment about it's potential impact on Denialists:

One real triumph, several experts said, was how little damage misinformation did. In 1976, many people refused shots after three elderly Pittsburgh residents died shortly after getting theirs; it took the C.D.C. five days to explain that it was just a coincidence.

This time, many rumors arose but were quickly debunked: That thousands had died in Mexico. That the virus had circulated in the Midwest for a decade, undetected. That it had escaped from a laboratory. That seasonal flu shots made catching swine flu more likely. That flu shots did not work or caused autism. That the administration would make them mandatory. That Tamiflu resistance was widespread in Northern California. That a flu shot had disabled a Washington Redskins cheerleader, or that she was cured by chelation therapy by a doctor associated with the antivaccine movement. That mutant killer flu strains were circulating in Argentina or Ukraine or North Carolina.

The debunking succeeded, Dr. Osterholm said, “despite the fact that there are many fewer reporters who understand medical issues than there used to be.”

This time, both the C.D.C. and the World Health Organization responded quickly to almost every rumor. At the epidemic’s height, they held several news conferences a week, taking questions by phone from all over the world.

They also invited dozens of reporters to daylong seminars on influenza at C.D.C. headquarters in Atlanta and to exercises around the country led by the former anchorman Forrest Sawyer, at which they debated, for example, whether a miscarriage by one woman after getting a flu shot was a big scoop or a nonstory.

Remaining to be seen is what effect the pandemic has had on Americans’ feelings about vaccines.

Dr. Frieden said he thought a victory over the antivaccine movement had been scored. Nearly 60 million people have been vaccinated, including many pregnant women and children, with no surge in side effects.

John P. Moore, an AIDS researcher at Weill Cornell Medical College, was less sure. Dr. Moore, who spent years fighting AIDS denialism, has called skepticism about flu vaccine “an unholy alliance of the left and right” because it joined the liberal natural-medicine proponents with anti-big-government conservatives.

“It’s hard to say if it hurt or helped,” Dr. Moore said, pointing out that polls still show a large minority of Americans rejecting the vaccine. “As with AIDS, people have to die before others understand the consequences of ignoring science-based medicine.”

“It’s unfortunate that ... science can’t just be science’’

Boston Globe:

For Judy Ockene, a University of Massachusetts scientist, breast cancer is not some academic abstraction. It is personal . As a daughter, she watched her mother be diagnosed with the disease at the age of 44 - and survive. As a mother, she has two daughters of her own, one who is 42, another who just turned 40 - the very age when many women first undergo screening for breast cancer.

And now, with an air of dismay, she finds herself swept up in the controversy generated by new guidelines governing mammograms. Ockene, as a member of the US Preventive Services Task Force, helped draft recommendations that advised against routine screening for women in their 40s, which proved so inflammatory that the board’s top officials were summoned before a Congressional committee.

There was, Ockene said, never any contest between personal experience and scientific evaluation as she weighed the evidence on mammograms. Nor, she added, should there be.

“We all have our own stories about cancer,’’ said Ockene, a disease prevention specialist at the UMass Medical School. “But evidence is extremely important in all the work we do in health care. Does it mean it’s more important than all of the personal experiences? Well, I think it does. The evidence has to speak for itself.’’

But for the public, personal experience is often paramount. After the breast screening guidelines were released last month, media coverage overflowed with stories of women in their 40s whose tumors had been found with mammography, and who credited the scans with saving their lives.

Their consternation offers both a cautionary tale and a foreshadowing. “comparative effectiveness research,’’ promising to exhaustively assess the strengths and weaknesses of medical treatments. With money from the economic stimulus package, and possibly from the pending health care overhaul legislation, the federal government is expanding its use of

“If we’re really going to do comparative effectiveness research, there are going to be studies that show the tried-and-true things that we think are right aren’t really as good as we thought,’’ said Dr. Laura Esserman, a breast cancer specialist at the University of California, San Francisco.

“There’s a cultural acceptance that more is always better, and that explains why our health care costs get out of control,’’ Esserman said. “We have to understand there are limits to what we can do.’’

Ockene has been down this road before: She helped direct a study that drastically altered attitudes toward use of hormones in women after menopause. It was a reminder that science is rarely a linear pursuit. The medical landscape is pocked with reversals, yesterday’s panacea branded as today’s poison.

Mammograms themselves have been subject to course corrections: In 2002, the Preventive Services Task Force advised that screening start at 40. The panel updates its advice every five years, and so, in 2007, it enlisted a separate group of scientists to analyze eight mammogram studies. When that review failed to answer all of the task force’s questions, the panel commissioned elaborate statistical models to further assess benefit and risk.

“It’s unfortunate that things like this become so politicized, that science can’t just be science,’’ Ockene said.

Surprise: The Senate Compromise Might Actually Be Better At Containing Costs. Denialists Beware!

Karen Tumulty's analysis indicates the final bill will be better at containing costs than the original Senate version: principally by strengthening a Federal medical oversight board that will make decisions based on science not politics:

Given the drama and suspense of the past few weeks, it's understandable that the first round of commentary about the new Senate health bill would focus on the deals that Majority Leader Harry Reid had to make to bring aboard all 60 of the votes that he will need to beat a Republican filibuster ...

But while you might think that all this horsetrading would produce a weaker and more bloated bill, it appears that, by some measures at least, the opposite may have happened. The preliminary analysis suggests that the new bill would actually be more effective than the previous version in reining in health care costs in the long term. To use the current Washington cliche, it would do a better job "bending the curve." Congressional Budget Office Director Douglas Elmendorf put it this way in his blog:

Relative to the legislation as originally proposed, the expected reduction in deficits during the 2020–2029 period is larger for the legislation incorporating the manager's amendment. Most of that difference arises because the manager's amendment would lower the threshold for Medicare spending growth that would trigger recommendations for spending reductions by the Independent Payment Advisory Board.

What Elmendorf is talking about is this: As I had written a couple of weeks ago, Reid's earlier bill had taken the teeth out of one of the proposals that economists had considered a "game changer." It is a new board that would come up with proposals to bring down Medicare costs, largely taking the job out of Congress' hands. (Medicare is such a big player in the overall health market, spending more than $450 billion a year, that the private industry often follow its lead.)

Reid's earlier version would not have allowed the board to act unless Medicare spending grew faster than overall health care spending--something that pretty much doesn't happen these days. The new version is signficantly stronger, thanks in no small part to pressure from the Obama White House and a group of reform-minded freshman Senators. It would trigger action from the board if growth in health care spending exceeds that of Medicare spending, which is pretty much guaranteed to be the case.

All of that sounds pretty technical, but getting the details right is the difference between a health care bill that will work and one that won't, economists say. And many experts have been worried about the direction the bill appeared to be headed.

There's also another potentially significant improvement buried down in fine print of the bill:

"Why not monthly mammograms beginning at age 15?"

John Allen Paulos mounts the defense I've been waiting to see for evidence-based medicine. I particularly like his reductio ad absurdum, argument as it's the anti-Denialism one I've been privately making for weeks:

In his inaugural address, Barack Obama promised to restore science to its “rightful place.” This has partly occurred, as evidenced by this month’s release of 13 new human embryonic stem-cell lines. The recent brouhaha over the guidelines put forth by the government task force on breast-cancer screening, however, illustrates how tricky it can be to deliver on this promise. One big reason is that people may not like or even understand what scientists say, especially when what they say is complex, counterintuitive or ambiguous.

As we now know, the panel of scientists advised that routine screening for asymptomatic women in their 40s was not warranted and that mammograms for women 50 or over should be given biennially rather than annually. The response was furious. Fortunately, both the panel’s concerns and the public’s reaction to its recommendations may be better understood by delving into the murky area between mathematics and psychology.

Much of our discomfort with the panel’s findings stems from a basic intuition: since earlier and more frequent screening increases the likelihood of detecting a possibly fatal cancer, it is always desirable. But is this really so? Consider the technique mathematicians call a reductio ad absurdum, taking a statement to an extreme in order to refute it. Applying it to the contention that more screening is always better leads us to note that if screening catches the breast cancers of some asymptomatic women in their 40s, then it would also catch those of some asymptomatic women in their 30s. But why stop there? Why not monthly mammograms beginning at age 15?

The answer, of course, is that they would cause more harm than good. Alas, it’s not easy to weigh the dangers of breast cancer against the cumulative effects of radiation from dozens of mammograms, the invasiveness of biopsies (some of them minor operations) and the aggressive and debilitating treatment of slow-growing tumors that would never prove fatal.

The exact weight the panel gave to these considerations is unclear, but one factor that was clearly relevant was the problem of frequent false positives when testing for a relatively rare condition. A little vignette with made-up numbers may shed some light. Assume there is a screening test for a certain cancer that is 95 percent accurate; that is, if someone has the cancer, the test will be positive 95 percent of the time. Let’s also assume that if someone doesn’t have the cancer, the test will be positive just 1 percent of the time. Assume further that 0.5 percent — one out of 200 people — actually have this type of cancer. Now imagine that you’ve taken the test and that your doctor somberly intones that you’ve tested positive. Does this mean you’re likely to have the cancer? Surprisingly, the answer is no.

To see why, let’s suppose 100,000 screenings for this cancer are conducted.

Another Interview With Denialism's Author

Not the best explanation of Denialism, but interesting given the forum (for more, check out the A Blue View category Denialism or buy the book):

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Michael Specter
www.thedailyshow.com
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Gay AND Straight Identical Twins: National Geographic Discusses Possible Bases For Orientation

Timothy Kincaid:

Sexual orientation is genetic… but not fully genetic.

Each person has about a 4-6% chance of being same-sex attracted. If, however, one has a twin brother that’s gay, the odds increase to about 12%. Make it an identical twin and you have a 50/50 chance that you too will be gay.

Anti-gay activists irrationally declare that this proves that “there is no gay gene.” In a sense they are correct, if orientation were entirely determined by purely genetic composition, then identical twins (who have the same genes) would always have the same orientation.

But the increase in odd with the increase in genetic similarity does show that genes play a part, and a big part. Which leaves the question, how does one twin end up gay and the other straight? The answer may be in how epigenetics triggers genes and can cause identical genes to respond differently.

In the following National Geographic video, the narrator discusses what might cause identical twins to have non-identical orientation.

The Copenhagen Diagnosis: "Updating the world on the Latest Climate Science"

A new report has been released that "serves as a handbook of science updates ... in time for Copenhagen in December 2009, and any national or international climate change policy negotiations that follow ... The report has been purposefully written with a target readership of policy-makers, stakeholders, the media and the broader public." From their press release:

Climate change accelerating beyond expectations, urgent emissions reductions required, say leading scientists

Global ice-sheets are melting at an increased rate; Arctic sea-ice is disappearing much faster than recently projected, and future sea-level rise is now expected to be much higher than previously forecast, according to a new global scientific synthesis prepared by some of the world’s top climate scientists.

In a special report called ‘The Copenhagen Diagnosis’, the 26 researchers, most of whom are authors of published IPCC reports, conclude that several important aspects of climate change are occurring at the high end or even beyond the expectations of only a few years ago.  

The report also notes that global warming continues to track early IPCC projections based on greenhouse gas increases.  Without significant mitigation, the report says global mean warming could reach as high as 7 degrees Celsius by 2100.

The Copenhagen Diagnosis, which was a year in the making, documents the key findings in climate change science since the publication of the landmark Intergovernmental Panel on Climate Change (IPCC) Fourth Assessment Report in 2007.

The new evidence to have emerged includes:

• Satellite and direct measurements now demonstrate that both the Greenland and Antarctic ice-sheets are losing mass and contributing to sea level rise at an increasing rate.
• Arctic sea-ice has melted far beyond the expectations of climate models. For example, the area of summer sea-ice melt during 2007-2009 was about 40% greater than the average projection from the 2007 IPCC Fourth Assessment Report.
• Sea level has risen more than 5 centimeters over the past 15 years, about 80% higher than IPCC projections from 2001. Accounting for ice-sheets and glaciers, global sea-level rise may exceed 1 meter by 2100, with a rise of up to 2 meters considered an upper limit by this time.  This is much higher than previously projected by the IPCC.  Furthermore, beyond 2100, sea level rise of several meters must be expected over the next few centuries.
• In 2008 carbon dioxide emissions from fossil fuels were ~40% higher than those in 1990. Even if emissions do not grow beyond today’s levels, within just 20 years the world will have used up the allowable emissions to have a reasonable chance of limiting warming to less than 2 degrees Celsius.

The report concludes that global emissions must peak then decline rapidly within the next five to ten years for the world to have a reasonable chance of avoiding the very worst impacts of climate change.

To stabilize climate, global emissions of carbon dioxide and other long-lived greenhouse gases need to reach near-zero well within this century, the report states.

Read the summary or full report.

The Mammography Firestorm Makes It "blindingly obvious: health-care reform that actually controls costs--rather than just pretending to do so--would be virtually impossible to achieve"

Eugene Robinson:

The uproar over the on-again, off-again guidelines on when women should have mammograms is proof of the blindingly obvious: Health-care reform that actually controls costs -- rather than just pretending to do so -- would be virtually impossible to achieve.

I say "would be" because none of the voluminous reform bills being shuttled around the Capitol on hand trucks even tries to address a central factor that sends costs spiraling out of control, which is that each of us wants the best shot at a long, healthy life that medical science can offer. Just as all politics is local, all health care is personal. Skimping on somebody else's tests and procedures may be worth debating, but don't mess with mine.

Intellectually, it's simple to understand why it might make sense for women -- those who have no special risk factors for breast cancer -- to wait until they're 50, rather than 40, to start getting mammograms. The analysis by the U.S. Preventive Services Task Force, which made the recommendation, looks sound. According to the panel, a whopping 10 percent of mammograms result in false-positive readings that can lead to unjustified worry and unneeded procedures, such as biopsies. In a small number of cases, women are subjected to cancer treatment or even a mastectomy they didn't need.

This harm, the task force reasoned, outweighs the benefits of discovering relatively few cases of fast-growing, life-threatening breast cancer in women in their 40s through annual mammography. It is also true that waiting to begin regular mammograms until a woman reaches 50 -- and reducing the frequency to once every two years, as the task force recommended -- would save a portion of the more than $5 billion spent on mammography in the United States each year.

The problem lies in those relatively few instances when a mammogram does find that a woman in her 40s has a life-threatening tumor, and when early detection saves her life. This scenario may be fairly rare, but it happens. Given the option, many women would rather be safe than sorry -- and safe costs money ....

Each of us should ask ourselves: How much expensive, unnecessary, high-tech testing and treatment am I willing to have our out-of-control health system pay for to save one life, if the life in question might be mine or that of a loved one? The honest answer, I think, is: a whole bunch.

The honest solution is a word that cannot be spoken: rationing. Our system already rations health care based on the individual's ability to pay. Insurance companies ration some tests and procedures based on age, risk factors and what often seems like whim. This ad hoc rationing doesn't work very well, and nothing in any of the reform bills even tries to address the basic consensus that makes spending continue to rise: Put a lid on everybody else's costs, but don't touch mine.

Dr. Nancy Sneiderman: A Clear, Powerful Opponent Of Denialism

Dr. Nancy makes a compelling case for the scientific method and against knee jerk, pre-judged reactions, on yesterday's Meet The Press:

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"Cancer Overdiagnosis" Is A Problem Experts Are Increasingly Recognizing, But Is New To The Public

NY Times:

A few years ago, an independent group that issues guidelines on cancer screening decided to review its recommendations for breast cancer. It had last issued guidelines in 2002, but things had changed — there was new science and researchers had become more sophisticated in analyzing existing data.

So the group, the U.S. Preventive Services Task Force, started what it thought would be a straightforward job: gathering the newest science and asking about the benefits and risks of breast cancer screening, the best time to start and how often women should be screened.

The group ended up recommending that most women forgo routine mammograms in their 40s and test every other year instead of every year.

The response was swift and angry. Professional groups, like the American College of Radiology, advocacy groups, like the American Cancer Society, and politicians said the guidelines would deprive women of a life-saving test. And some said the guidelines were politically motivated to save money.

Panel members have been taken aback by the response. Their work seemed almost mundane, they say, just an effort to gather and evaluate the best possible evidence.

The task force, a 16-member panel of experts appointed by the Department of Health and Human Services, began its work as usual. It went to an academic center, in this case the Evidence-Based Practice Center at the Oregon Health and Science University, and asked for an extensive review of all the relevant papers published on breast cancer screening, including ones used in the last review. At that time, the task force recommended routine screening starting at 40, saying that there were benefits although they became greater as age increased. The Oregon group had done similar reviews for the panel, including a review for the 2002 guidelines.

This time, the panel hoped that it could get missing pieces of the puzzle. New studies allowed scientists to zero in on benefits and harms for women in their 40s and to evaluate with far more certainty not just whether women should be screened but also how often.

The Oregon scientists began by combing the literature. By November 2007, the researchers, led by Dr. Heidi D. Nelson, a professor of medicine, medical informatics and clinical epidemiology at the university, had finished its review and sent its work to 15 outside scientists for review, then sent it to the panel. Finally, the researchers were ready to make their first full presentation to the panel members.

Part of that evidence, which Dr. Nelson’s group included, was new results from a huge study in England of mammograms for women in their 40s. This study, published in 2006, compared 54,000 women offered mammograms starting at age 40 with 107,00 women the same age who were not offered them. Previous studies of women in their 40s had them starting at various times in that decade of their lives and so were less useful.

But the British study saw only a small decline in the breast cancer death rate after 10 years, and it was not statistically significant, meaning it could have occurred by chance. Previous studies also failed to find a statistically significant effect for women in their 40s.

Dr. Nelson’s group did a new analysis combining all the studies. By adding up all the small benefits, the researchers concluded that there was a slight benefit of screening, a statistically significant 15 percent decline in the death rate from breast cancer for women in their 40s.

That means, they said, that 1,900 women ages 40 to 50 must be screened to prevent one death from breast cancer up to 20 years later. At the same time, even with the screening, five deaths would have occurred anyway, probably because many of those cancers grew so fast that no matter how early they were found it was impossible to cure the women. So in the end, 1 out of 6 deaths would have been prevented.

The task force wanted more information. What about the harms of screenings for women in their 40s, it asked?

One harm is excess tests, like biopsies. But there was not much published data.

Dr. Nelson’s group drew upon a National Cancer Institute database of eight million mammograms in the United States telling what sort of mammogram — digital or film — the women got, when they got it, and whether they had follow-up tests. Analyzing those data, she concluded that women in their 40s have about a 10 percent chance of a false positive and a 1 percent chance of having a biopsy each time they have a mammogram. While those risks are small, they gain more significance when weighed against the relatively small risk of cancer for women in their 40s — a risk of 1.5 per of 1,000 women.

The serious harm, panel members said, is overdiagnosis, finding cancers that are better off not being found.

In 2002, when the group last reviewed breast cancer screening studies, the idea of overdiagnosis was not well formed. It has been hard for many people, even scientists, to believe that some cancers start then stop or even regress. But researchers all over the world have been finding overdiagnosis in studies of all sorts of cancers.

We Will Not Get A Handle On Medical Costs Until We Acknowledge We're All Going To Die

Last year, the government spent $50 billion in the last two months of a patients life: more than it spends on the Dept of Education or Homeland Security. Much of this money is wasted in futile attempts to keep the natural, inevitable result at bay. Medicare, for instance, will spend $40,000 on a drug that extends breast cancer victims lives by one month (I wonder how many vaccines $40k would buy?).

How much is too much, when is enough enough, and what should our priorities be -- these are the fundamental, rational questions we need to be asking ourselves if we truly want to reform our health care system. Unfortunately, after weeks like the last one, rational, evidence-based discussion of what's appropriate, for whom and when seems even less likely than before. From 60 Minutes:

The Cost of Dying:

Many Americans spend their last days in an intensive care unit, subjected to uncomfortable machines or surgeries to prolong their lives at enormous cost.

Watch CBS News Videos Online

At Home, At Peace:

Dr. Herb Maurer has made a decision about where he will spend his final days.

Watch CBS News Videos Online

Comfort and Costs:

According to oncologist Letha Mills, whose 70-year-old husband Dr. Herb Maurer is terminally ill with cancer, helping people die at home might increase their comfort and create savings in our healthcare system.

Watch CBS News Videos Online

An Interview With Denialism's Author

As regular A Blue View readers know, I'm reading, and have been greatly effected by, Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives.  Here's an interview with the author:

"White House Pushes Science and Math Education"

NY Times:

To improve science and mathematics education for American children, the White House is recruiting Elmo and Big Bird, video game programmers and thousands of scientists.

President Obama will announce a campaign Monday to enlist companies and nonprofit groups to spend money, time and volunteer effort to encourage students, especially in middle and high school, to pursue science, technology, engineering and math, officials say.

The campaign, called Educate to Innovate, will focus mainly on activities outside the classroom. For example, Discovery Communications has promised to use two hours of the afternoon schedule on its Science Channel cable network for commercial-free programming geared toward middle school students.

Science and engineering societies are promising to provide volunteers to work with students in the classroom, culminating in a National Lab Day in May.

The MacArthur Foundation and technology industry organizations are giving out prizes in a contest to develop video games that teach science and math.

“The different sectors are responding to the president’s call for all hands on deck,” John P. Holdren, the White House science adviser, said in an interview.

The other parts of the campaign include a two-year focus on science on “Sesame Street,” the venerable public television children’s show, and a Web site, connectamillionminds.com, set up by Time Warner Cable, that provides a searchable directory of local science activities. The cable system will contribute television time and advertising to promote the site.

The White House has also recruited Sally K. Ride, the first American woman in space, and corporate executives like Craig R. Barrett, a former chairman of Intel, and Ursula M. Burns, chief executive of Xerox, to champion the cause of science and math education to corporations and philanthropists.

Denialism: The Mammography Furor Is "a Rorschach test of where we are when it comes to the health-care system and health-care reform"

Wash Post:

President Obama's vision for making health care in America more effective and efficient collided for the first time last week with the realities and peculiarities of the nation's health-care system.

As the Senate moved toward its first floor vote on the health-care reform bill, two independent expert groups coincidentally released new guidelines for mammograms and Pap tests aimed at improving treatment for two forms of cancer in women.

Although neither set of recommendations was aimed at cutting costs, both were based on the kind of objective analysis of scientific research that the Obama administration has embraced in its bid to make care better and more economical.

But after the recommendations unleashed fierce criticism, controversy and debate, the administration appeared to quickly distance itself from the mammography guidelines to try to prevent the uproar from endangering a domestic priority.

"This tells us an awful lot more about where we are as a country in terms of our relationship to the health-care system and health-care reform than they do provide new information about how often women should get screened," said John Abramson, a clinical instructor at Harvard Medical School and a leading proponent of eliminating unnecessary care. "It's like a Rorschach test of where we are when it comes to the health-care system and health-care reform."

Nancy-Ann DeParle, director of the White House Office for Health Reform, said Saturday that the debate over the guidelines goes to the heart of "the unique doctor-patient relationship in the American health-care system and the desire to preserve that."

"Today many of these decisions are being made by insurance companies and bureaucrats, and we want to make sure those decisions are made by doctors," DeParle said.

'Evidence-based' care

The recommendations about mammograms and Pap tests are the latest in a series of guidelines that have been emerging as part of "evidence-based" medicine. The seemingly obvious idea behind the movement is to base medical decisions on the best available scientific evidence, including "comparative effectiveness" studies, instead of relying on tradition, intuition or personal experience.

"One of the things I think you're seeing is the maturation of the concept of evidence-based medicine," said Ned Calonge, chairman of the U.S. Preventive Services Task Force, the federally appointed panel that issued the new mammography guidelines.

Yesterday's Medical Test Whose Use Is Being Decided By A Popularity Contest: The Right & Wrong Ways To Debate The Mammogram Recs

Here's a perfect example of Denialism from the Chris Mathews show. Notice how no doctors or scientists are presented, very few scientific/medical objections are raised to the new mammogram recommendation and the few that are, are generally wrong (sorry Bazell, risk reward analysis is science). And while I generally like Congresswoman Debbie Wasserman-Schulz, having been a breast cancer patient does not make you an oncologist and its therefore wildly inappropriate of her to be offering medical advice (especially when she has the power to codify her personal opinions into law):

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Now contrast that approach with this one presented on another MSNBC show, one actually hosted by a medical doctor, Dr Nancy Sneiderman. Perhaps not surprisingly, she sets the entire debate between medical professionals and they focus their comments on the science. It's also worth noting how the American Cancer Society rep seems to have an agenda designed to scare people (any chance so it's they keep donating to his group?). Notice how Dr. Nancy and the other expert both strongly object to the misleading way he presents the statistical data. 

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We need to be seeing more of Dr. Nancy's approach and less of Chris Mathews: the only valid way to rebut the new mammogram & pap smear recommendations is a debate of their scientific & medical merits.

My point about Denialism is that the way the panel's recommendations are generally being rebutted in the media--by talking heads expressing their personal opinions, beliefs & preconceived biases--is not the way to do it. That's not science, that's religion.

"Sebelius's cave-in on mammograms is a setback for health-care reform"

Steven Pearlstein:

Health and Human Services Secretary Kathleen Sebelius did a marvelous job this week of undermining the move toward evidence-based medicine with her hasty and cowardly disavowal of a recommendation from her department's own task force that women under 50 are probably better off not getting routine annual mammograms.

This is an old issue that has not only sharply divided the medical community for more than 20 years, but also taps into deep resentments among women who, over the years, have felt neglected by a male-dominated medical establishment. And there's no doubt that the advisory panel's recommendation came at a politically inconvenient time, just as Congress enters the crucial final phase in a health reform debate in which opponents have successfully stoked fears of medical rationing.

But rather than showing the leadership necessary to lead a grown-up national discussion on how to eliminate unnecessary or wasteful procedures, Sebelius simply disowned the task force and ran for political cover. Just as the hysteria over "death panels" killed any chance that Medicare recipients and their patients might be encouraged to engage in an intelligent conversation about end-of-life care before it becomes an issue, the mammogram brouhaha is likely to set back efforts to dramatically increase research into what really works and what doesn't, and use the results to revamp the way medical care is delivered and paid for.

I should acknowledge that I have no idea who should and should not get routine mammograms. But I know enough about statistics to say that the issue is not settled just because you know of someone in her 40s whose breast cancer was detected by a mammogram and cured. As economists and medical researchers are fond of saying, the plural of anecdote is data.

To make a valid scientific finding of who should be screened and how often, you'd have to take into consideration how big the risk is that women are likely to develop cancer at any particular age; how fast tumors are likely to grow and how likely they are to be cured once they are caught; what is the likelihood that a tumor detected by mammogram might be found some other way; what is the probability that a suspected tumor turns out not to be pre-cancerous, or that doing a biopsy on it will actually increase the chance that it could become dangerous later. You'd also have to weigh the benefits of routine screening -- deaths avoided and years of life extended -- against the medical problems caused by complications that arise from biopsies, along with the mental anguish that goes along with the large number of false positives that crop up on mammographies of women in their 40s.

All that, of course, is exactly what the task force did, based on numerous studies done in different countries using different methodologies. In the end, it found that while some lives might be saved each year, the benefits of annual screening of women in their 40s were outweighed by the costs -- and that's without even getting into the financial costs, which run to several billion dollars a year.

As is often the case in such matters, those raising the most fuss were those with greatest financial interest in mammography (the radiologists and the makers of mammography machines) and the disease groups (in this case, the American Cancer Society), which tend to resist recognizing limits on how much time, money and attention is devoted to their cause.

"How many mothers, sisters, aunts, grandmothers, daughters and friends are we willing to lose to breast cancer while the debate goes on about the limitations of mammography?" Otis Brawley, chief medical officer of the American Cancer Society, asked in an op-ed article in Thursday's Washington Post. Dr. Brawley cleverly didn't answer his own question, but the clear implication of his question was that the only acceptable number should be zero. And it is that very attitude, applied across the board to every patient and every disease, which goes a long way in explaining why ours is the most expensive, and one of the least effective, health-care systems in the industrialized world.

The political argument from the White House was that it was necessary to duck this fight over evidence-based medicine in order to save it. The better approach would have been to see this as one of those teachable moments that could be used to reaffirm the entire rationale for reform. For while debate continues over whether some women may be getting too many mammograms, there is evidence that there are women who, because they lack insurance, are getting too few -- and dying unnecessarily as a result. What health reform is about is correcting that imbalance while devising new mechanisms for improving health outcomes and getting better control over costs.

Put in that context, it would have been perfectly reasonable for Sebelius to have announced that she was delaying implementation of the task force recommendation for a year in order to give it more time to seek a broader consensus among researchers, doctors and patients. That would have made clear that the administration remained committed to a health-care system driven by the best medical evidence but one that is also sensitive to broad public opinion. This is a tough-love message the country, and the Congress, need to hear.

Today's Health Care Cartoons

Time To Adjust Our Thinking: Sometimes Doing Less Is Best For You

NY Times:

This week, the science of medicine bumped up against the foundations of American medical consumerism: that more is better, that saving a life is worth any sacrifice, that health care is a birthright.

Two new recommendations, calling for delaying the start and reducing the frequency of screening for breast and cervical cancer [see The Next Medical Test Whose Use Will Be Decided By A Popularity Contest], have been met with anger and confusion from some corners, not to mention a measure of political posturing.

The backers of science-driven medicine, with its dual focus on risks and benefits, have cheered the elevation of data in the setting of standards. But many patients — and organizations of doctors and disease specialists — find themselves unready to accept the counterintuitive notion that more testing can be bad for your health.

“People are being asked to think differently about risk,” said Sheila M. Rothman, a professor of public health at Columbia University. “The public state of mind right now is that they’re frightened that evidence-based medicine is going to be equated with rationing. They don’t see it in a scientific perspective.”

For decades, the medical establishment, the government and the news media have preached the mantra of early detection, spending untold millions of dollars to spread the word. Now, the hypothesis that screening is vital to health and longevity is being turned on its head, with researchers asserting that mammograms and Pap smears can cause more harm than good for women of certain ages.

On Monday, the United States Preventive Services Task Force, a federally appointed advisory panel, recommended that most women delay the start of routine mammograms until they are 50, rather than 40, as the group suggested in 2002. It also recommended that women receive the test every two years rather than annually, and that physicians not train women to perform breast self-examination.

The task force, whose recommendations are not binding on insurers or physicians, concluded after surveying the latest research that the risks caused by over-diagnosis, anxiety, false-positive test results and excess biopsies outweighed the benefits of screening for women in their 40s. It found that one cancer death is prevented for every 1,904 women ages 40 to 49 who are screened for 10 years, compared with one death for every 1,339 women from 50 to 74, and one death for every 377 women from 60 to 69.

On Friday, the American College of Obstetricians and Gynecologists plans to announce a similar revision to its screening guidelines for cervical cancer [see The Next Medical Test Whose Use Will Be Decided By A Popularity Contest] ...

“A review of the evidence to date shows that screening at less frequent intervals prevents cervical cancer just as well, has decreased costs and avoids unnecessary interventions that could be harmful,” said Dr. Alan G. Waxman, a professor at the University of New Mexico who directed the process.

The challenge of persuading patients and doctors to accept such standards requires a transformational shift in thinking, particularly when the disease involved is as prevalent, as deadly, and as potentially curable as cancer. How do you convince them that it is in their best interest to play the odds when they have been conditioned for so long to not gamble on health? After all, for the one in 1,904 women in their 40s whose life would be saved by early detection of breast cancer, taking the risk would in retrospect seem a bad choice.

“This represents a broader understanding that the efforts to detect cancer early can be a two-edged sword,” said Dr. H. Gilbert Welch, a professor of medicine at Dartmouth who is among the pioneers of research into the negative effects of early detection. “Yes, it helps some people, but it harms others.”

Dr. Welch said this week’s recommendations could mark a turning point in public acceptance of that notion. “Now we’re trying to negotiate that balance,” he said. “There’s no right answer, but I can tell you that the right answer is not always to start earlier, look harder and look more frequently.”

That concept is proving easier to swallow in the halls of Dartmouth Medical School than in the halls of Congress. Coming as they did at the height of debate over a sweeping health care overhaul, the recommendations have provided fresh ammunition for those who warn that greater government involvement in medical decision-making would lead to rationing of health care. It has not mattered that the breast cancer screening recommendation is only advisory, and that the federal government, the American Cancer Society, and numerous private insurers have said they will not adopt it.

Senator Kay Bailey Hutchison, a Republican who is running for governor of Texas, cited the task force’s screening statistics in a floor speech on Thursday. “One life out of 1,904 to be saved,” Ms. Hutchison said, “but the choice is not going to be yours. It’s going to be someone else that has never met you, that does not know family history.” She added, “This is not the American way of looking at our health care coverage.”

The health care bills in both the House and the Senate would establish commissions to encourage research into the effectiveness of medical tests and procedures, but would not require that the findings be translated into practice or reimbursement policies.

As throughout history, it may take decades for medical culture to catch up to medical science. Dr. Rothman pointed out that it took 20 years for the public to accept the discovery in 1882 that tuberculosis was caused by a bacterium and not by heredity or behavior ...

“It’s going to take time, there’s no doubt about it,” said Louise B. Russell, a research professor at the Rutgers University Institute of Health who has studied whether prevention necessarily saves money (and found it does not always do so). “It’s going to take time in part because too many people in this country have had a health insurer say no, and it’s not for a good reason. So they’re not used to having a group come out and say we ought to do less, and it’s because it’s best for you.”

Today's Medical Test Whose Use Will Be Decided By A Popularity Contest: Pap Smears

There's another medical procedure that we'll use a popularity contest to decide how often, and on whom, it is done. At least that's the likely result of this NY Times report:

New guidelines for cervical cancer screening say women should delay their first Pap test until age 21, and be screened less often than recommended in the past.

The advice, from the American College of Obstetricians and Gynecologists, is meant to decrease unnecessary testing and potentially harmful treatment, particularly in teenagers and young women. The group’s previous guidelines had recommended yearly testing for young women, starting within three years of their first sexual intercourse, but no later than age 21.

Arriving on the heels of hotly disputed guidelines calling for less use of mammography, the new recommendations might seem like part of a larger plan to slash cancer screening for women. But the timing was coincidental, said Dr. Cheryl B. Iglesia, the chairwoman of a panel in the obstetricians’ group that developed the Pap smear guidelines. The group updates its advice regularly based on new medical information, and Dr. Iglesia said the latest recommendations had been in the works for several years, “long before the Obama health plan came into existence.”

She called the timing crazy, uncanny and “an unfortunate perfect storm,” adding, “There’s no political agenda with regard to these recommendations.”

Dr. Iglesia said the argument for changing Pap screening was more compelling than that for cutting back on mammography — which the obstetricians’ group has staunchly opposed — because there is more potential for harm from the overuse of Pap tests. The reason is that young women are especially prone to develop abnormalities in the cervix that appear to be precancerous, but that will go away if left alone. But when Pap tests find the growths, doctors often remove them, with procedures that can injure the cervix and lead to problems later when a woman becomes pregnant, including premature birth and an increased risk of needing a Caesarean.

Still, the new recommendations for Pap tests are likely to feed a political debate in Washington over health care overhaul proposals. The mammogram advice led some Republicans to predict that such recommendations would lead to rationing.

Senator Tom Coburn, a Republican from Oklahoma who is also a physician, said in an interview that he would continue to offer Pap smears to sexually active young women. Democratic proposals to involve the government more deeply in the nation’s health care system, he said, would lead the new mammography, Pap smear and other guidelines to be adopted without regard to patient differences, hurting many people.

“These are going to be set in stone,” Mr. Coburn said.

Senator Arlen Specter, a Pennsylvania Democrat and longtime advocate for cancer screening, said in an interview: “And this Pap smear guideline is yet another cut back in screening? That is curious.” Mr. Specter, who was treated for Hodgkin’s lymphoma in 2005 and 2008, said Congress was committed to increasing cancer screenings, not limiting them.

Representative Rosa DeLauro, Democrat of Connecticut, said that the new guidelines would have no effect on federal policy and that “Republicans are using these new recommendations as a distraction.”

“Making such arguments, especially at this critical point in the debate, merely clouds the very simple issue that our health reform bill would increase access to care for millions of women across the country,” she said.

There are 11,270 new cases of cervical cancer and 4,070 deaths per year in the United States. One to 2 cases occur per 1,000,000 girls ages 15 to 19 — a low incidence that convinces many doctors that it is safe to wait until 21 to screen.

The doctors’ group also felt it was safe to test women less often because cervical cancer grows slowly, so there is time to catch precancerous growths. Cervical cancer is caused by a sexually transmitted virus, human papillomavirus, or HPV, that is practically ubiquitous. Only some people who are exposed to it develop cancer; in most, the immune system fights off the virus. If cancer does develop, it can take 10 to 20 years after exposure to the virus.

The new guidelines say women 30 and older who have three consecutive Pap tests that were normal, and who have no history of seriously abnormal findings, can stretch the interval between screenings to three years.

In addition, women who have a total hysterectomy (which removes the uterus and cervix) for a noncancerous condition, and who had no severe abnormalities on previous Pap tests, can quit having the tests entirely.

The guidelines also say that women can stop having Pap tests between 65 and 70 if they have three or more negative tests in a row and no abnormal test results in the last 10 years.

The changes do not apply to women with certain health problems that could make them more prone to aggressive cervical cancer, including H.I.V. infection or having an organ transplant or other condition that would lead to a suppressed immune system.

It is by no means clear that doctors or patients will follow the new guidelines. Medical groups, including the American Cancer Society, have been suggesting for years that women with repeated normal Pap tests could begin to have the test less frequently, but many have gone on to have them year after year anyway.

Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society ... said, doctors in this country have been performing 15 million Pap tests a year to look for cervical cancer in women who have no cervix, because they have had hysterectomies.

Dr. Carol L. Brown, a gynecologic oncologist and surgeon at Memorial Sloan-Kettering Cancer Center, said the new guidelines should probably not be applied to all women, because there are some girls who begin having sex at 12 or 13 and may be prone to develop cervical cancer at an early age.

“I’m concerned that whenever you send a message out to the public to do less, the most vulnerable people at highest risk might take the message and not get screened at all,” Dr. Brown said.

Dr. Kevin M. Holcomb, an associate professor of clinical obstetrics and gynecology at NewYork-Presbyterian/Weill Cornell hospital, said that when he heard the advice to delay Pap testing until 21, “My emotional response is ‘Wow, that seems dangerous,’ and yet I know the chances of an adolescent getting cervical cancer are really low.”

Denialism: The Mammogram Firestorm Shows How Hard It Will Be To "reduce costs, by using science-based protocols to minimize unnecessary procedures and tests"

An amazing report from the NY Times that can be summarized as: the politicians in Washington intend to use public opinion polls to determine medical policy, not objective, rational science (read Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives).

The Obama administration distanced itself Wednesday from new standards on breast cancer screening that were recommended this week by a federally appointed task force, saying government insurance programs would continue to cover routine mammograms for women starting at age 40.

As the task force recommendations stirred concern among women, and came under fire from lawmakers of both parties, the White House emphasized that they were not binding on either physicians or insurers. Administration officials also fired back against Republicans who argued that the recommendations illustrated the dangers of an expanded government role in medical decision making.

Democrats on Capitol Hill acknowledged that the recommendations, in the midst of negotiations over a health care overhaul, had handed Republicans a vivid new way to raise the specter of rationing.

The issue underscored the political sensitivity of revamping the health care system, and trying to reduce costs, by using science-based protocols to minimize unnecessary procedures and tests. Even as the White House tried to reassure women that the recommendations would have no immediate force, a group of doctors that analyzes new research for the National Cancer Institute said it would include the new guidelines in the information it provides to doctors and the public.

Kathleen Sebelius, the secretary of health and human services, acknowledged in a statement that the recommendations, by the U.S. Preventive Services Task Force, had “caused a great deal of confusion and worry.” Ms. Sebelius then stressed that the task force “is an outside independent panel of doctors and scientists who make recommendations” and who neither “set federal policy” nor “determine what services are covered by the federal government.”

“The task force has presented some new evidence for consideration,” she added, “but our policies remain unchanged. Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action.”

On the White House blog, Dan Pfeiffer, the deputy communications director, wrote that “women who are currently getting mammograms under Medicare will continue to be able to get them.”

“There are no plans to change that,” Mr. Pfeiffer said ...

Neither Ms. Sebelius nor Mr. Pfeiffer explained why the government would not embrace the recommendations from the task force, which is appointed by Ms. Sebelius’s department. She said only that “there has been debate in this country for years” about the proper age and interval for breast cancer screening.

The task force advised on Monday that most women should not start routine screening until they are 50, as opposed to the current standard of 40. The reason, according to the task force, is that studies show that “the additional benefit gained by starting screening at age 40 years rather than at age 50 years is small, and that moderate harms from screening remain at any age.”

While the downsides of mammography have not received much attention, cancer researchers say they are real and include excess biopsies, unnecessary anxiety and the discovery and treatment of tumors that would not cause problems if let alone.

Denialism & The Mammogram Debate: To Ignore Science & Go With Your Preconceived Biases, Or Not

I'm in the process of reading the excellent new book by Michael Specter Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives and will have more on it later. The reaction to the recent scientific panel's pronouncement no longer recommending mammograms to women under 40, nor self-exams to any woman, as reported by the Wash Post below, is, however, a near perfect proof of Specter's argument: far too many people only support scientific conclusions that suit their preconceived biases while rejecting those that don't.

In 1997, a federal committee of medical experts recommended against routine mammograms for women in their 40s, sparking a political uproar that led to congressional hearings and a unanimous Senate vote challenging the findings.

Now, 12 years later, a similar drama is playing out around a different federal medical panel, which this week recommended against routine mammograms for women younger than 50, saying it is not worth subjecting some patients to unnecessary biopsies, radiation and stress.

The independent panel, the U.S. Preventive Services Task Force, also recommended against teaching women to do regular self-exams and concluded that there is insufficient evidence to recommend that doctors do exams.

The findings underscore a decades-long debate in the medical community about the benefits and risks of routine breast cancer screening for younger women. The conclusions also plunge the nonpartisan, nonpolitical advisory panel into the middle of a strident Washington discussion about health care, which has included allegations from Republicans that the Democrats' proposed reforms would lead to reduced care for patients.

Rep. Frank Pallone Jr. (D-N.J.) announced Tuesday that his House health subcommittee will hold hearings on the mammogram issue next month. Other lawmakers from both parties suggested that the task force had been swayed by insurance companies that stand to save money if fewer screenings are performed.

"We can't allow the insurance industry to continue to drive health-care decisions," said Rep. Debbie Wasserman Schultz (D-Fla.), who said earlier this year that she had undergone treatment for breast cancer.

The recommendations also garnered harsh criticism from powerful medical groups including the American Cancer Society -- which says it will continue to recommend regular mammograms for women older than 40 -- and the Access to Medical Imaging Coalition, which warned that the findings would "turn back the clock on the war on breast cancer."

Many patient advocacy groups and breast cancer experts, however, praised the decision, arguing that politics have too often interfered with science when it comes to mammograms. Maryann Napoli, associate director of the Center for Medical Consumers, said breast cancer screening is frequently "used by politicians as a way to say they are for women," whether or not the underlying policy makes sense.

Water Found On The Moon

Remember the oft derided Lcross mission last month ("Obama shot the moon!")? Well the NY Times reports it succeeded:

There is water on the Moon, scientists stated unequivocally on Friday.

“Indeed yes, we found water,” Anthony Colaprete, the principal investigator for NASA’s Lunar Crater Observation and Sensing Satellite, said in a news conference. “And we didn’t find just a little bit. We found a significant amount.”

The confirmation of scientists’ suspicions is welcome news to explorers who might set up home on the lunar surface and to scientists who hope that the water, in the form of ice accumulated over billions of years, holds a record of the solar system’s history.

The satellite, known as Lcross (pronounced L-cross), crashed into a crater near the Moon’s south pole a month ago. The 5,600-miles-per-hour impact carved out a hole 60 to 100 feet wide and kicked up at least 26 gallons of water ...

For more than a decade, planetary scientists have seen tantalizing hints of water ice at the bottom of these cold craters where the sun never shines. The Lcross mission, intended to look for water, was made up of two pieces — an empty rocket stage to slam into the floor of Cabeus, a crater 60 miles wide and 2 miles deep, and a small spacecraft to measure what was kicked up.

For space enthusiasts who stayed up, or woke up early, to watch the impact on Oct. 9, the event was anticlimactic, even disappointing, as they failed to see the anticipated debris plume. Even some high-powered telescopes on Earth like the Palomar Observatory in California did not see anything.

The National Aeronautics and Space Administration later said that Lcross did indeed photograph a plume but that the live video stream was not properly attuned to pick out the details.

The water findings came through an analysis of the slight shifts in color after the impact, showing telltale signs of water molecules that had absorbed specific wavelengths of light. “We got good fits,” Dr. Colaprete said. “It was a unique fit.”

The scientists also saw colors of ultraviolet light associated with molecules of hydroxyl, consisting of one hydrogen and one oxygen, presumably water molecules that had been broken apart by the impact and then glowed like neon signs.

In addition, there were squiggles in the data that indicated other molecules, possibly carbon dioxide, sulfur dioxide, methane or more complex carbon-based molecules. “All of those are possibilities,” Dr. Colaprete said, “but we really need to do the work to see which ones work best.”

Our World Changed Profoundly 40 Years Ago Yesterday: The Internet Was Born

I love the fact that the first message was not something profound like the ones Samuel Morse and Alexandar Graham Bell transmitted, but something far more prosaic: "login." From NPR (listen to story):

The Internet began with a whimper, not a bang. And not everyone agrees on when that whimper occurred. But 40 years ago Thursday, something called the ARPANET came into existence, and since then, communication hasn't been the same.

Charley Kline's moment in history unfolded inside a large, empty computer lab at the University of California, Los Angeles, at 10:30 p.m. on Oct. 29, 1969.

"I was 21 and a programmer who liked to program all hours of the day and night," Kline says.

Those hours were spent with the SDS Sigma 7 — a computer the size of a one-bedroom apartment.

On the night of Oct. 29, Kline sent an electronic message from the Sigma 7 to another computer at the Stanford Research Institute in Menlo Park.

That transmission would literally transform the way we communicate today. To tell the story of how it happened, you have to start with the context in which it happened.

A communication revolution was taking place — but it was happening over the telephone. Telephones were for communicating, while computers were built to process information — to do things like payroll and number-crunching.

The IBM 1401, a computer system about the size of a two-car garage, could process about as much information as your cell phone — your ratty old cell phone from the 1980s, that is.

On a recent afternoon at the Computer History Museum in Mountain View, Calif., a few old-timers got the IBM 1401 up and running. That computer is one of many in the museum's main exhibit hall — a space the size of four football fields.

But, says Bill Duvall, "It's fair to say that your BlackBerry has more computing power than all of the computers in this room combined."

Duvall was on the receiving end of Kline's first message.

Nearly four years before Duvall and Kline did the Internet equivalent of the moon landing, Bob Taylor was sitting in his office at the Pentagon, where he worked for the Advanced Research Projects Agency, or ARPA.

And he was frustrated.

Taylor had three computer terminals in his office. Each one connected to a different computer in a different part of the country.

"To get in touch with someone in Santa Monica through the computer, I'd sit in front of one terminal, but to do the same thing with someone in Massachusetts, I would have to get up and move over to another terminal," Taylor recalls. "You don't have to look at this very long to realize this is silly. This is stupid. So I decided, OK, I want to build a network that connects all of these."

So Taylor started to collect really smart people — people who could build that network, like Duvall, Len Kleinrock at UCLA and the young Kline.

Taylor also sent word to the biggest technology companies that they could bid on a contract to help build that network.

"IBM refused to bid, as did AT&T," Kline remembers. "They both said, 'Can't be done; it's useless.' They saw the future of computing as bigger and bigger mainframes."

So a smaller company, Bolt, Beranek and Newman, got the contract. It built a device called the IMP, the interface message processor. It was as big as two full-size gym lockers.

Kline explains how it worked: "I would type a character. It would go into my computer. My software would take it, wrap around it all the necessary software to send it to the IMP. The IMP would take it and say, 'Oh, this is supposed to go up to SRI.' "

Think about it like your home Internet router, only 100 times bigger.

A Message For The History Books

It took about a year for Bolt, Beranek and Newman to build several of these IMPs and get them into place at different locations in the country, including at UCLA and SRI.

"At some point, we were ready to test it," Kline says. "It wasn't like we had planned it."

So, late on that October night in 1969, Kline, sitting at the UCLA computer lab, placed a phone call to Duvall at Stanford.

"We didn't walk into a darkened room, turn on the lights, flip the switch and have it work," Duvall says. "This was something that we tried some number of times. ... We were hooked up with a telephone headset, and we were talking to each other."

Kline started to type the historic message — an online communication roughly equivalent to what the Neanderthal is to modern humans.

"We should have prepared a wonderful message," says Kleinrock, who headed UCLA's computer lab then. "Certainly Samuel Morse did, when he prepared 'What hath God wrought,' a beautiful Biblical quotation. Or Alexander Graham Bell: 'Come here, Watson. I need you.' Or Armstrong up in the moon — 'a giant leap for mankind.' These guys were smart. They understood public relations. They had quotes ready for history."

On Oct. 29, Kleinrock says, "All we wanted to do ... was to send a simple login capability from UCLA to SRI. We just wanted to log into the SRI machine from UCLA."

And so the first computer network communication was — well, it was supposed to be the word "login."

"The first thing I typed was an L," Kline says. Over the phone, Duvall told Kline he had gotten it. "I typed the O, and he got the O."

Then Kline typed the G. "And he had a bug and it crashed."

And that was it. The first-ever communication over a computer network was "lo." The ARPANET was born.

About an hour later, at 10:30, they got it to work — and successfully transmitted L-O-G-I-N. Kline scribbled some notes into a logbook and went home to bed.

A Viral Email Helps Put Life In Perspective (Hubble images)

There's an interesting viral email going around that inspired me to create this A Blue View post. The images in the email provide a useful perspective that we'd all do well to keep in mind. 

Impressive. But beyond our sun, it's a really big universe

Now try to wrap your mind around this ... the next one is a Hubble space telescope, ultra deep field infrared image of entire galaxies each of which is composed of billions of stars like the ones you see above.

And this is a close-up of one of the dark, "empty" regions above

Helps put your daily life and its issues in perspective no? And also, whether it's reasonable to think we're the only intelligent life in all this vast space.

If you'd like to see more Hubble images, check out After Hubble Repair, Amazing New Images From Space.

Bill O'Reilly Debates Atheist Richard Dawkins

Why Women Wear Makeup & Other Fascinating Facts From The Neuroscience Of Facial Perception

From a fascinating series of images at Scientific American that reveal much about how people process faces:

 

The Illusion of Sex, by Harvard psychologist Richard Russell, won Third Prize at the 2009 Best Visual Illusion of the Year Contest. The two side-by-side faces are perceived as male (right) and female (left). However, both of them are versions of the same androgynous face. The two images are exactly identical, except that the contrast between the eyes and mouth and the rest of the face is higher for the face on the left than for the face on the right. This illusion shows that contrast is an important cue for determining the sex of a face, with low-contrast faces appearing male and high-contrast faces appearing female. And it may also explain why females in many cultures darken their eyes and mouths with make-up. A made-up face looks more feminine than a fresh

Their other examples (Asian vs. caucasians, anger vs calm,  Mona Lisa's smile and more) are definitely worth seeing.

Ardipithecus ramidus' Importance (cartoon)

 

Read about the importance of the Ardi archeological find on understanding human evolution.

American Ignorance & Paranoia: 36K Die Each Year From Regular Flu, Yet Only 34% Plan On Vaccinations For More Deadly Swine Flu

American's scientific illiteracy and distrust of government could turn very deadly this year, based on this from the NY Times:

Last week, the Centers for Disease Control reported that 936 Americans had died of flu symptoms or of flu-associated pneumonia since Aug. 30, when it began a new count of deaths including some without lab-confirmed swine flu. That is few compared with the 36,000 that die annually of seasonal flu, but the deaths are concentrated in age groups that do not normally succumb, and the regular flu season will not arrive until November.

Confirming the centers’ anxiety that many Americans are reluctant to get swine flu shots, Consumer Reports released a poll late Wednesday showing that half of all parents surveyed said they were worried about the flu, but only 35 percent would definitely have their children vaccinated. About half were undecided, and of those, many said they feared that the vaccine was new and untested.

One worrying aspect, said Dr. John Santa, the director of health ratings at Consumer Reports, was that 69 percent of parents who were undecided or opposed to shots said they “wanted their children to build up their natural immunity.”

“Your body produces exactly the same antibodies, whether it’s from a ‘natural’ infection or from a vaccine,” Dr. Santa said. “If your child is the one that dies, you’ve paid a very high price for ‘natural’ immunity.” ...

Dr. Schuchat argued that the vaccine was neither new nor untested.

It is attached to the same “genetic backbone” of weakened flu virus as the 100 million seasonal flu injections given each year, grown in the same sterile eggs and purified in the same factories. And test injections done in September found that it had the same side effects, most of which were sore arms and mild fevers.

After Hubble Repair, Amazing New Images From Space

From the NY Times:

The new Wide Field Camera 3 aboard NASA's Hubble Space Telescope, took this image of hot gas fleeing a dying star 3,800 light-years away in the Scorpius constellation. A so-called planetary nebula, it is also known as the Bug Nebula or the Butterfly Nebula. What resemble dainty butterfly wings are actually roiling cauldrons of gas heated to more than 36,000 degrees Fahrenheit. The star itself, once about five times as massive as the Sun, is some 400,000 degrees Fahrenheit, making it one of the hottest known in the galaxy. In what amounts to a kind of galactic recycling, the lost gas, enriched by elements like oxygen, nitrogen and carbon produced by the formerly massive star, will form the stuff for future stars.

 

A clash among members of a famous galaxy quintet reveals an assortment of stars across a wide color range, from young, blue stars to aging, red stars. This photo of Stephan's Quintet, also known as Hickson Compact Group 92, was taken by the new Wide Field Camera 3. Stephan's Quintet, as the name implies, is a group of five galaxies. The name, however, is a bit of a misnomer. Studies have shown that group member NGC 7320, at upper left, is actually a foreground galaxy about seven times closer to Earth than the rest of the group. The image, taken in visible and infrared light, showcases the camera's broad wavelength range.

 

The Hubble's new Wide Field Camera 3 peered into one of the more crowded places in the universe in this view of a small region inside the globular cluster Omega Centauri, which has nearly 10 million stars. Globular clusters are ancient swarms of stars united by gravity. The stars in Omega Centauri are 10 billion to 12 billion years old. The cluster is about 16,000 light-years from Earth. The photograph showcases the new camera's color versatility by revealing a variety of stars in key stages of their life cycles.

See more photos.

Massachusetts "receiving a disproportionate share" Of Biomedical Stimulus Money

From the Boston Globe:

Massachusetts biomedical researchers are seeing a windfall from federal stimulus money, with the state receiving more in grants from the National Institutes of Health than all others but California.

With $178 million in extra federal funds already directed toward Massachusetts, research projects that had been dormant are being revived and others are accelerating.

By midweek, 660 new grants had been sprinkled across the state’s hospitals and university laboratories as part of the Obama administration’s campaign to kick-start a sputtering economy. More money is coming in daily, and researchers say they have begun hiring junior scientists and technicians and buying new equipment.

Massachusetts lags behind more populated states in overall stimulus funding, but scientists here are receiving a disproportionate share of the $10 billion the NIH plans to distribute. California has received 927 grants totaling $244 million, according to the Globe’s analysis of NIH data on funds awarded through the American Recovery and Reinvestment Act of 2009.

The volume of NIH stimulus funding reflects the region’s high concentration of research centers and its longstanding dominance in winning federal grants. The agency included geography as one of its criteria in distributing money, but said states with large research centers would get a higher share. The numbers are preliminary, and more grants are expected to be awarded between now and the end of the month.

The Upside Of Global Warming

We might skip the next scheduled Ice Age, according to a new scientific study reported on by the NY Times:

According to the study, after a slow cooling of less than half a degree Fahrenheit per millennium, driven by a cyclical change in the orientation of the North Pole and the Sun, the Artic region warmed 2.2 degrees just since 1900, with the decade from 1998 to 2008 the warmest in 2,000 years.

In theory, summer temperatures in the Arctic region would be expected to cool for at least 4,000 more years, given the growing distance between the Sun and the North Pole during the summer in the Northern Hemisphere, the study says.

But Jonathan T. Overpeck, a study author and climate specialist at the University of Arizona, said the rising concentration of long-lived greenhouse gases guaranteed warming at a pace that could stress ecosystems and cause rapid melting of Greenland’s great ice sheet.

“The fast rate of recent warming is the scary part,” Dr. Overpeck said. “It means that major impacts on Arctic ecosystems and global sea level might not be that far off unless we act fast to slow global warming.”

In the very long term, the ability to artificially warm the climate, particularly the Arctic, could be seen as a boon as the planet’s shifting orientation to the Sun enters a phase that could initiate the next ice age.

As a result of such periodic shifts, 17 ice ages are thought to have come and gone in two million years. The last ice age ended 11,000 years ago and the next one, according to recent research, could be 20,000 or 30,000 years off discounting any influence by humans. The last ice age buried much of the Northern Hemisphere under a mile or more of ice.

With humans’ clear and growing ability to alter the climate, Dr. Overpeck said, “we could easily skip the next opportunity altogether.”

René Descartes Meets Jonas Salk

The Aquatic Ape Theory Of Human Evolution

Like IHeartChaos, I'm also a sucker for anything about evolution (H/T A. Sullivan) but I was surprised that the Aquatic Ape Theory, which I first read about 30 years ago, is still being debated:

I'm a sucker for anything about evolution, especially anthropology and human evolution, so it's a gas to find this video from TED with Elaine Morgan discussing the aquatic ape theory of human evolution. The theory is that the reason Homo sapiens are naked and bipedal as opposed to all of our hairy quadroped great ape cousins is that we evolved on beaches to be sort of amphibious and that being naked, standing upright, having females with permanently enlarged breasts etc are adaptations that came about as being advantageous for shore-dwelling primates.

The problem is that beaches are the worst possible places for fossils to form, so no matter how much it makes sense, all we have to go on is phenotypal evidence, so it's one of those things that will probably always remain theoretical until we invent time travel.

Read an opposing view.

Things We Left On The Moon

The interesting list of things NASA has left on the moon, including these boots from Buzz Aldrin, can be found here.

The Earth Dodged A Bullet This Week: We Did Not All Die. And You Didn't Even Know.

Did you realize that every living thing on Earth, in fact the planet itself, dodged a bullet this week ... well, not actually a bullet but something far worse: a planet destroying, Armageddon producing asteroid?  Here's the the Lede blog:

NASA has confirmed the discovery of a new “scar” the size of the Earth in Jupiter’s atmosphere, apparently showing that the planet was hit by something large in recent days. The impact mark was first spotted on Monday morning by an amateur astronomer in Australia, who then drew the attention of scientists at NASA’s Jet Propulsion Laboratory to the change in Jupiter’s south polar region ...

Leigh Fletcher, an astronomer at the Jet Propulsion Lab told the magazine the impact scar “is about the size of the Earth.”

In Australia, the Sydney Morning Herald reported that the amateur astronomer, Anthony Wesley, a 44-year-old computer programmer from a village north of Canberra, made the discovery “using his backyard 14.5-inch reflecting telescope.”

Mr. Wesley told the Sydney Morning Herald that spotting the impact mark on Jupiter made him glad the huge planet is in Earth’s neighborhood: “If anything like that had hit the Earth it would have been curtains for us, so we can feel very happy that Jupiter is doing its vacuum-cleaner job and hoovering up all these large pieces before they come for us.”

It's important to keep life in perspective isn't it?

The Case For Exploring Mars

From The New Republic:

In 2004, TNR executive editor Peter Scoblic argued in favor of George W. Bush's proposal for a manned mission to Mars:

It's hard not to scoff at the president's call for a return to the moon, Mars, and "beyond" if for nothing other than its political transparency. The president's sudden dose of the vision thing immediately endeared him to the thousands of aerospace workers in Florida, while costing him almost nothing before he leaves office. But, despite its narrow opportunism, the president's plan is important, because it thrusts the prospect of a manned mission to Mars back into the public sphere.

One objection to a manned mission to Mars is that robotic craft could do the job just as well at a fraction of the cost--a compelling argument as we watch the Spirit rover successfully bound (or rather inch) over the surface of the Red Planet. On January 10, The Washington Post's editors wrote, "The success of NASA's latest Mars venture has proved the worth of unmanned missions, while manned space flight is exorbitantly expensive." The Los Angeles Times approvingly quoted physicist and space guru James Van Allen as saying that we could explore Mars with robots "at far less cost and far greater quantity and quality of results." Or, as Will Marshall, president of the Progressive Policy Institute, bluntly summed it up, "There's no real rationale for a manned space program."

Space-travel enthusiasts have always had trouble explaining why men must accompany their machines to other planets. As Hermann Oberth, a pioneer of rocketeering, observed, "For those who have never known the relentless urge to explore and discover, there is no answer. For those who have felt this urge, the answer is self-evident." In their attempt to articulate that urge, proponents of space travel often resort to platitudes. Last year, for example, after the shuttle Columbia disintegrated on reentry, President Bush said, "Mankind is led into the darkness beyond our world by the inspiration of discovery and the longing to understand. Our journey into space will go on." Such sentiments do nothing to sway Mars skeptics. As Anne Applebaum of The Washington Post asked in a January 7 column, "But why should it go on? Or at least why should the human travel part of it go on?" When Applebaum received a slew of angry e-mails from Mars buffs, she noted derisively that "most contained no rational arguments whatsoever. Instead, they cited the `religious awe' that space travel inspires, or the `human quest to explore and discover.'"

Applebaum mistakenly assumes that the benefits of a manned trip to Mars must be tangible if they are to be "rational." But it doesn't take a historian to know that the benefits of exploration are often impossible to forecast, nor does it take a philosopher to understand that those benefits can be affective, as well as cognitive. Exploration is valuable precisely because it is a "quest" that evokes "awe," precious not only for its visceral thrill but for the perspective it proffers. It forces us to question the future of our race, the maturation of civilization, and the reason for human existence. Such questions may seem indulgent, even silly, when contrasted with the immediate, practical demands of daily life, but that does not make them less important. If we do not ask them, we lose the opportunity to transcend the current and the mundane and imagine what we want the future to hold. <Continue reading.>

Apollo 11's 40th Anniversary

Neil Armstrong uttering those famous words as "a man" first stepped onto the moon (The video compares existing footage with new, partially restored video. The thumbnail image shows the new footage on the left and the old on the right.):

A two minute montage of Apollo 11 highlights:

See more Apollo 11 videos from NASA.

A photo slideshow from the Wash Post: