Thursday, December 31, 2015

"Hacking a board for more speed is not a good idea."

Hoverboards Under Fire



“These companies are marketing products to us based on perceptions of deficiencies."

Are vitamin supplements a waste of money?

 Could the coloured pills be doing more harm than good? 

Kashmira Gander 
The experts also didn’t mince words when it came to the supplement industry, which it said made £650million annually when they study was conducted at the expense of a public which was reacting to false anxieties about their health.
“These vitamins should not be used for chronic disease prevention. Enough is enough,” the experts concluded in the report.
Edgar Miller from the John Hopkins school of Medicine said at the time: “These companies are marketing products to us based on perceptions of deficiencies. They make us think our diet is unhealthy, and that they can help us make up for these deficiencies and stop chronic illnesses.”

An economics refresher for 2016: Hayek vs. Keynes. Rounds 1 and 2

ROUND 1

ROUND 2

"The media’s inability to resist a great narrative gives companies like Theranos a public relations boost that their science alone might not warrant."

The Theranos scandal should be a wake-up call. Here are 4 reasons it won’t be

Rebecca Robbins"The glowing corner-office profile is a tried-and-true genre in business journalism, and it’s easy to see why: The personal story of the latest “it” CEO can bring life to a boring world of valuations and financings.But there’s a downside, too: The media’s inability to resist a great narrative gives companies like Theranos a public relations boost that their science alone might not warrant."




Will Fast Food Die Before It Kills Us All?

Will Fast Food Die Before It Kills Us All?

"Printed books do more than furnish a room; they assume a real, vital presence in our lives."

The Future of the Humanities: Reading

As technology advances, doomsaying remains constant.

By Michael Dirda | HUMANITIES, November/December 2015 | Volume 36, Number 6

"Above all, no digital facsimile can ever replicate the mana, the glamour of a physical artifact. An online image of Van Gogh’s Starry Night hardly conveys the impact, the glory of the actual painting. In like fashion, first editions aren’t just a collector’s fetish: The dust jacket, the binding, the advertisements and blurbs, and even the misprints convey useful information. Printed books do more than furnish a room; they assume a real, vital presence in our lives. We can casually pluck a volume from a bookcase, reread a poem or a few pages of a novel, find ourselves comforted, refreshed."

Decline in Frozen Section Diagnosis for Axillary Sentinel Lymph Nodes as a Result of the American College of Surgeons Oncology Group Z0011 Trial

Julie Anne BishopMDJihong SunMDNicolas AjkayMDMary Ann G. SandersMD, PhD
From the Department of Pathology & Laboratory Medicine (Drs Sanders, Bishop, and Sun) Department of Surgery (Dr Ajkay), University of Louisville Hospital, Louisville, Kentucky. Dr Sun is now with the Department of Pathology, SUNY, University of Buffalo at Buffalo, New York.
Reprints: Mary Ann G. Sanders, MD, PhD, Department of Pathology & Laboratory Medicine, University of Louisville Hospital, 530 S Jackson St, Louisville, KY 40202 (e-mail: ).
Context.— Results of the American College of Surgeons Oncology Group Z0011 trial showed that patients with early-stage breast cancer and limited sentinel node metastasis treated with breast conservation and systemic therapy did not benefit from axillary lymph node dissection. Subsequently, most pathology departments have likely seen a decrease in frozen section diagnosis of sentinel lymph nodes.
Objective.— To determine the effect of the Z0011 trial on pathology practice and to examine the utility of intraoperative sentinel lymph node evaluation for this subset of patients.
Design.— Pathology reports from cases of primary breast cancer that met Z0011 clinical criteria and were initially treated with lumpectomy and sentinel lymph node biopsy from 2009 to 2015 were collected. Clinicopathologic data were recorded.
Results.— Sentinel lymph node biopsies sent for frozen section diagnosis occurred in 22 of 22 cases (100%) in 2009 and 15 of 22 cases (68%) in 2010 during the pre-Z0011 years, and in 3 of 151 cases (2%) collected in 2011 through 2015, considered to be post-Z0011 years. Of the 151 post-Z0011 cases, 28 (19%) had sentinel lymph nodes with metastasis, and 147 (97%) were spared axillary lymph node dissection.
Conclusions.— Following Z0011, intraoperative sentinel lymph node evaluation has significantly decreased at our institution. Prior to surgery, all patients had clinically node-negative disease. After sentinel lymph node evaluation, 97% (147 of 151) of the patients were spared axillary lymph node dissection. Therefore, routine frozen section diagnosis for sentinel lymph node biopsies can be avoided in these patients.

The Ethics of Radiological Protection

 2016 Feb;110(2):201-210.

FIRST THOMAS S. TENFORDE TOPICAL LECTURE: The Ethics of Radiological Protection.

Author information

  • 1*Centre d'√©tude sur l'Evaluation de la Protection dans le domaine Nucl√©aire (CEPN), 28 rue de la Redoute, 92260 Fontenay-aux-Roses, France.

Abstract

The International Commission on Radiological Protection system of radiological protection is based on three pillars: science, ethical and social values, and experience. As far as ethics and the protection of humans are concerned, the system combines the values of beneficence/non-maleficence, prudence, justice, and dignity. Beneficence and non-maleficence are directly related to the aim to prevent deterministic effects and to reduce the risk of stochastic effects. Prudence allows taking into account uncertainties concerning both the deterministic and stochastic effects of radiation on health. Justice is the way to ensure social equity and fairness in decisions related to protection. Over the past decade, the system has also integrated procedural values such as right to know, informed consent, stakeholder involvement and self-help protection, and reflecting the importance to properly inform and also preserve the autonomy and dignity of the individuals potentially or actually exposed to radiation. In practice, the search for reasonable levels of protection and tolerable exposure levels is a permanent questioning that depends on the prevailing circumstances in order to act wisely; i.e., with the desire to do more good than harm (beneficence/non-maleficence), to avoid unnecessary exposure (prudence), to seek fair distribution of exposures (justice), and to treat people with respect (dignity).

The College of American Pathologists' Archives of Pathology and Laboratory Medicine celebrates its 90th anniversary!

Philip T. CagleMD
From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
Reprints: Philip T. Cagle, MD, Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin St, Main Building, Room 227, Houston, TX 77030 (e-mail: ).
The authors have no relevant financial interest in the products or companies describ

Wednesday, December 30, 2015

Slightly elevated blood sugar linked to kidney damage risk

Slightly elevated blood sugar linked to kidney damage risk

Zombie allusions: They just keep on coming™: generating gravitational waves

Zombie stars: A source of gravitational waves?

Scientists have witnessed motions that would be predicted by Einstein’s general relativity

BY 
7:00AM, DECEMBER 28, 2015


GENEVA, Switzerland —  Pulsars are the dense cores of dead stars. But these zombies still communicate. They emit intense beams of radio waves with the regularity of a nearly perfect clock. A dancing pair of these cosmic radio beacons has just provided scientists with the best gauge that gravitational waves exist.

"...'people underestimate the happiness effect' of being outdoors."

Need a New Year’s resolution? How about spending more time outside than in a car.




“If you can have the experience of being in the moment for two or three days, it seems to produce a difference in qualitative thinking,” he said.
In the same article, Lisa Nisbet, a psychology professor at Canada’s Trent University, said that “people underestimate the happiness effect” of being outdoors.
“We don’t think of it as a way to increase happiness,” she said. “We think other things will, like shopping or TV. We evolved in nature. It’s strange we’d be so disconnected.”



Tuesday, December 29, 2015

Ethical Eating

 2015 Dec 28. doi: 10.1111/1750-3841.13191. [Epub ahead of print]

Genetically Modified (GM) Foods and Ethical Eating.

Author information

  • 11250 Bellflower Boulevard, Dept. Family and Consumer Sciences, California State Univ, Food Science and Nutrition Laboratory, Long Beach, Calif, 90840, U.S.A.

Abstract

The ability to manipulate and customize the genetic code of living organisms has brought forth the production of genetically modified organisms (GMOs) and consumption of genetically modified (GM) foods. The potential for GM foods to improve the efficiency of food production, increase customer satisfaction, and provide potential health benefits has contributed to the rapid incorporation of GM foods into the American diet. However, GM foods and GMOs are also a topic of ethical debate. The use of GM foods and GM technology is surrounded by ethical concerns and situational judgment, and should ideally adhere to the ethical standards placed upon food and nutrition professionals, such as: beneficence, nonmaleficence, justice and autonomy. The future of GM foods involves many aspects and trends, including enhanced nutritional value in foods, strict labeling laws, and potential beneficial economic conditions in developing nations. This paper briefly reviews the origin and background of GM foods, while delving thoroughly into 3 areas: (1) GMO labeling, (2) ethical concerns, and (3) health and industry applications. This paper also examines the relationship between the various applications of GM foods and their corresponding ethical issues. Ethical concerns were evaluated in the context of the code of ethics developed by the Academy of Nutrition and Dietetics (AND) that govern the work of food and nutrition professionals. Overall, there is a need to stay vigilant about the many ethical implications of producing and consuming GM foods and GMOs.

Pathologists and Liability: An Old Medical Story Needing a New Ending

 2015 Dec;144(6):828-9. doi: 10.1309/AJCP7R6XVXOEPFAH.

Pathologists and Liability: An Old Medical Story Needing a New Ending.


Reisch and colleagues’ study2 provides information that pathologists are like other physicians: they have great concerns over medical malpractice. The high percentage of pathologists matches general physician surveys on concerns regarding liability suits.
Of interest here is that pathologists, as the authors note, are low-frequency, high-severity defendants compared with other specialties traditionally associated with concerns of tort liability, such as neurosurgeons. So an important question is, do pathologists exhibit assurance behaviors that lead to defensive medicine?

Monday, December 28, 2015

Human embryos and eggs: from long-term storage to biobanking

 2015 Dec 23. [Epub ahead of print]

Human embryos and eggs: from long-term storage to biobanking.

Author information

  • 1Novel Tech Ethics, Faculty of Medicine, Dalhousie University, P.O. Box 15000, 1379 Seymour Street, Halifax, NS, B3H 4R2, Canada. francoise.baylis@dal.ca.
  • 2Centre for the Study of Global Ethics, Department of Philosophy, University of Birmingham, Birmingham, B15 2TT, UK. h.widdows@bham.ac.uk.

Abstract

Genetic relatedness poses significant challenges to traditional practices of medical ethics as concerns the biobanking of human biological samples. In this paper, we first outline the ethical challenges to informed consent and confidentiality as these apply to human biobanks, irrespective of the type of tissue being stored. We argue that the shared nature of genetic information has clear implications for informed consent, and the identifying nature of biological samples and information has clear implications for promises of confidentiality. Next, with regard to the special case of biobanking human embryos and eggs, we consider issues arising from: first, the type of tissues being stored; second, the use to which these tissues are put; and third, how this plays out given the shared and identifying nature of these tissues. Specifically, we examine the differences between human bodily tissues and human reproductive tissues focusing on the assumed potential of the reproductive tissues and on the possible greater emotional attachment to these tissues because of their real and imagined kinship. For some donors there may be a sense of family connection with embryos and eggs they once thought of as 'children-in-waiting'. Finally, we conclude by considering the implications for ethical practice.

"Eat food, not too much, mostly plants."

Weight-loss resolution? Watch ‘In Defense of Food’ first


"What diet to choose this time? Low-fat? Low-carb? Gluten-free or prehistoric? Or just throw out the scale and surrender to fate and French fries?
Stop, take a breath and consider instead a seven-word alternative offered by prominent food writer Michael Pollan that embraces clarity and shuns extremism.
Here goes: Eat food, not too much, mostly plants."

Weight discrimination persistent for women, adults with extreme obesity



Weight discrimination persistent for women, adults with extreme obesity


"Prevalence estimates of perceived discrimination varied across studies. Researchers found a pooled prevalence of perceived weight discrimination of 19.2% among adults with class I obesity (BMI 30-35 kg/m²; 95% CI, 11.7-29.8); 41.8% of adults with a BMI of at least 35 kg/m² experienced discrimination (95% CI, 36.9-46.9)."

The Cardiac Complications of Methamphetamines

 2015 Nov 28. pii: S1443-9506(15)01489-4. doi: 10.1016/j.hlc.2015.10.019. [Epub ahead of print]

The Cardiac Complications of Methamphetamines.

Author information

  • 1Cardiology Department, St Vincent's Hospital Melbourne, Vic, Australia. Electronic address: elizabeth.paratz@svha.org.au.
  • 2Emergency Department, St Vincent's Hospital Melbourne, Vic, Australia.
  • 3Cardiology Department, St Vincent's Hospital Melbourne, Vic, Australia.

Abstract

Methamphetamines are increasingly popular drugs of abuse in Australia, and are rising in purity. The rising popularity and purity of methamphetamines has notably increased demands upon Australian medical services. Methamphetamines are sympathomimetic amines with a range of adverse effects upon multiple organ systems. Cardiovascular complications are the second leading cause of death in methamphetamine abusers, and there appears to be a high prevalence of cardiac pathology. Cardiovascular pathology frequently seen in methamphetamine abusers includes hypertension, aortic dissection, acute coronary syndromes, pulmonary arterial hypertension and methamphetamine-associated cardiomyopathy. The rising prevalence of methamphetamine abuse is likely to increase the burden of cardiovascular pathology in Australians. A National Parliamentary Enquiry was opened in March 2015 to address concerns regarding the medical and social impacts of methamphetamine abuse. From April 2015, a National 'Ice Taskforce' was also created in parallel. Reversal of cardiac pathology appears to be achievable with abstinence from methamphetamines and initiation of appropriate treatment. It is key to appreciate that the pathogenesis of methamphetamine-induced cardiac complications arises as a result of the specific toxic effects of methamphetamines. Clinical management is hence individualised; suggested management approaches for methamphetamine-induced cardiac complications are detailed within this article.

"Obesity rates are twice as high among children whose parents lack a high school diploma, and such children are frequently off the medical grid."

Why can't America get its obesity crisis under control?


"Yet responding with treatment alone fails badly on equity grounds. The groups in the United States most likely to become obese are racial minorities, those without any education beyond high school and members of single-parent households; these are also the Americans least able to access quality medical care. Obesity rates are twice as high among children whose parents lack a high school diploma, and such children are frequently off the medical grid."

Long-term health effects of Vietnam-era military service: "Hearing and mental health appear to be particularly affected."

 2015 Dec 2;45:12-26. doi: 10.1016/j.jhealeco.2015.11.003. [Epub ahead of print]

Long-term health effects of Vietnam-era military service: A quasi-experiment using Australian conscription lotteries.

Author information

  • 1Centre for Health Economics, Monash University, Melbourne, Australia.
  • 2School of Accounting, Economics and Finance, University of Wollongong, Wollongong, Australia; IZA, Bonn, Germany. Electronic address: siminski@uow.edu.au.

Abstract

This paper estimates the long-term health effects of Vietnam-era military service using Australia's National conscription lotteries for identification. Our primary contribution is the quality and breadth of our health outcomes. We use several administrative sources, containing a near-universe of records on mortality (1994-2011), cancer diagnoses (1982-2008), and emergency hospital presentations (2005-2010). We also analyse a range of self-reported morbidity indicators (2006-2009). We find no significant long-term effects on mortality, cancer or emergency hospital visits. In contrast, we find significant detrimental effects on a number of morbidity measures. Hearing and mental health appear to be particularly affected.

Wednesday, December 23, 2015

Strong Public Health Recommendations from Weak Evidence? Lessons Learned in Developing Guidance on the Public Health Management of Meningococcal Disease

 2015;2015:569235. doi: 10.1155/2015/569235. Epub 2015 Nov 26.

Strong Public Health Recommendations from Weak Evidence? Lessons Learned in Developing Guidance on the Public Health Management of Meningococcal Disease.

Author information

  • 1Consultant Epidemiologist (Independent), 1081 Brussels, Belgium ; Department of Vaccinology, University of Antwerp, 2000 Antwerp, Belgium.
  • 2Division of Epidemiology, Norwegian Institute of Public Health, 0403 Oslo, Norway ; National Institute of Public Health-National Institute of Hygiene, 400-791 Warsaw, Poland.
  • 3Department of Infectious Disease Epidemiology, Immunization Unit, Robert Koch Institute, 13086 Berlin, Germany.
  • 4Meningococcal Reference Laboratory, Austrian Agency for Food and Health Safety, 8010 Graz, Austria.
  • 5Vaccine-Preventable Diseases Programme, European Centre for Disease Prevention and Control, 171 83 Stockholm, Sweden.
  • 6School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK ; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.

Abstract

The evidence underpinning public health policy is often of low quality, leading to inconsistencies in recommended interventions. One example is the divergence in national policies across Europe for managing contacts of invasive meningococcal disease. Aiming to develop consistent guidance at the European level, a group of experts reviewed the literature and formulated recommendations. The group defined eight priority research questions, searched the literature, and formulated recommendations using GRADE methodology. Five of the research questions are discussed in this paper. After taking into account quality of evidence, benefit, harm, value, preference, burden on patient of the intervention, and resource implications, we made four strong recommendations and five weak recommendations for intervention. Strong recommendations related not only to one question with very low quality of evidence as well as to two questions with moderate to high quality of evidence. The weak recommendations related to two questions with low and very low quality of evidence but also to one question with moderate quality of evidence. GRADE methodology ensures a transparent process and explicit recognition of additional factors that should be considered when making recommendations for policy. This approach can be usefully applied to many areas of public health policy where evidence quality is often low.

Exercise Found Less Helpful for the Obese

Exercise Found Less Helpful for the Obese

Benefit concentrated in normal-weight individuals in Swedish study.


"The new findings suggest it's more important to be a normal weight at a young age than it is to be fit, said senior author Peter Nordstrom, of Umea University in Sweden."

From the CAP: Template for Reporting Results of Biomarker Testing of Specimens From Patients With Myeloproliferative Neoplasms

Todd W. KelleyMDDaniel A. ArberMDChristine GibsonCTRDaniel JonesMD, PhDJoseph D. KhouryMDBruno C.MedeirosMDDennis P. O'MalleyMDKeyur P. PatelMD, PhDMonika PilichowskaMDMohammad A. VasefMDJeremyWallentineMDJames L. ZehnderMDfor the Members of the Cancer Biomarker Reporting Committee, College of American Pathologists

Ethics and Childhood Vaccination Policy in the United States

 2015 Dec 21:e1-e6. [Epub ahead of print]

Ethics and Childhood Vaccination Policy in the United States.

Author information

  • 1Kristin S. Hendrix, Lynne A. Sturm, and Gregory D. Zimet are with the Department of Pediatrics and Eric M. Meslin is with the Center for Bioethics, Indiana University School of Medicine, Indianapolis.

Abstract

Childhood immunization involves a balance between parents' autonomy in deciding whether to immunize their children and the benefits to public health from mandating vaccines. Ethical concerns about pediatric vaccination span several public health domains, including those of policymakers, clinicians, and other professionals. In light of ongoing developments and debates, we discuss several key ethical issues concerning childhood immunization in the United States and describe how they affect policy development and clinical practice. We focus onethical considerations pertaining to herd immunity as a community good, vaccine communication, dismissal of vaccine-refusing families from practice, and vaccine mandates. Clinicians and policymakers need to consider the nature and timing of vaccine-related discussions and invoke deliberative approaches to policymaking. 

Friday, December 18, 2015

"Positioning invented diseases prior to product launch, convincing physicians of ‘unmet needs’, expanding populations eligible for treatment..."

 2015 Dec 16. pii: medethics-2015-103131. doi: 10.1136/medethics-2015-103131. [Epub ahead of print]

CME stands for commercial medical education: and ACCME still won't address the issue.

Author information

  • 1Department of Pharmacology and Physiology, Georgetown University Medical Center, Washington, DC, USA.
"These exceptions cover just about everything that industry needs from CME, which is important to marketing precisely because it never directly promotes products.3 ,6 ,14–18 Positioning invented diseases prior to product launch, convincing physicians of ‘unmet needs’, expanding populations eligible for treatment (pre-diabetes, pre-hypertension), exaggerating adverse effects of competing therapies, minimising concerns about targeted drugs and identifying ‘emerging’ (ie, unproven or disproven) uses of drugs are all classic ways by which CME is used for marketing. Basic science presentations create buzz about new mechanisms of action—especially important for marketing when a new drug has no actual clinical advantages. And ‘processes/methodologies of research’ talks can be used against evidence-based medicine."

Byron York: What if Democrats had a national security debate?

Byron York: What if Democrats had a national security debate?


"Anyone not in the room might find it astonishing that in the midst of highly publicized terror attacks around the world and in the United States, not a single Democrat in the New Hampshire town hall brought up the subject. But that's what happened."

"Astrology relies so heavily on confirmation bias—the odds that you’ll identify enough with your sign to overlook its contradictions — that it’s hard to imagine getting anything out of it that you didn’t have going in."

Stars—They’re Just Like Us!



"BUT TOOLS FOR WHAT? Self-knowledge? Astrology relies so heavily on confirmation bias—the odds that you’ll identify enough with your sign to overlook its contradictions — that it’s hard to imagine getting anything out of it that you didn’t have going in. A better question might be why people like it, or whether it’s a problem to subscribe to something in which you don’t believe."

Await further prospective peer-reviewed studies: DNA Testing for Your Fitness Level

DNA Testing for Your Fitness Level: The Next Health Craze?