Archive for June, 2012

Jun 29 2012

Causeway Killer Mystery

Published by under Neuroscience

I wrote previously about the case of Rudy Eugene, the “Causeway Cannibal” who was found by police naked chewing on the face of a homeless man. At the time I felt the most plausible hypothesis for this bizarre and violent behavior was drugs, especially given that Eugene had no history of violence. It was therefore a little surprising when the official toxicology report came out Wednesday showing only marijuana in Eugene’s system, and no other known street or prescription psychoactive drugs – no LSD, bath salts, cocaine, narcotics, benzodiazepines, or barbiturates.

So what are we to make of this? We now have a neuropsychiatric mystery – what can cause a man with no history of violence to do what Eugene did. According to reports he parked his car on the beach, then walked back to Miami, stripping off his clothes along the way. He had his bible with him and he tore out pages leaving them along the road as well. At one point he was seen swinging naked from a light post. He then came upon Ronald Poppo, subdued him, tore off his clothes, and then proceeded to chew off his face (but not swallow the tissue). When confronted by an armed police officer Eugene refused to stop his behavior and was then shot four times until he was dead.

If we treat this as a medical history, then what is our differential diagnosis? Before we discuss cause (etiology) we should discuss phenomenology – what kind of behavior is this?  There are two phenomena to consider, psychosis vs delerium. Delerium or encephalopathy refers to an acute process that causes the higher cognitive functions of the brain to be compromised leading to a “clouded sensorium,” meaning that the person has difficulty attending to sensory information. They interact intermittently with their environment and usually also have a waxing and waning level of consciousness. They are confused as to their situation. They may hallucinate, and may become violent, but that violence is usually not directed or purposeful, just a non-specific lashing out at things around them.

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Jun 28 2012

Anti-Science as a Political Platform

This came to my attention through Orac at Respectful Insolence and I thought I would pig-pile on – the platform of the Texas Republican party. Mine is not a political blog and I will try to refrain from expressing any purely political opinion. Rather I do often address the science that informs politics and the intrusion of politics into science or the denial of science by political activists – all of which is evident in the platform.

Orac does his usual great job of addressing the evolution denial, anti-vaccine sentiments, and promotion of alternative medicine in the platform. Unfortunately, promoters of unscientific medicine and opponents of science-based medicine find allies on both sides of the political aisle. On the left they tend to appeal to anti-corporate and new age sentiments. On the right it’s all about freedom – health care freedom, freedom from mandates, and freedom from regulation. The platform specifically opposes regulation of vitamins and supplements, stating: “We support the rights of all adults to their choice of nutritional products, and alternative health care choices.”

I have written about the health care freedom movement before.  Essentially it is an attempt to undermine rational and reasonable measures to establish a minimum standard of care in medicine. You can’t have a standard without some criteria and some method of enforcing the criteria. The current standard is largely science-based, transparent, and fair, but proponents of unscientific methods that fall below the reasonable standard want to abolish it so they will be free to practice witchcraft as medicine. Health care freedom is presented as consumer freedom, but it is really anti-consumer and all about the freedom to sell pseudoscience and bad medicine.

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Jun 26 2012

Protoscience vs Pseudoscience

I was recently pointed toward an upcoming conference called, “1st Global Conference: Protoscience, Health and Well-Being.” The e-mailer was concerned, correctly, that the conference represents the tendency within the humanities for, “positioning the sciences as just one of the possible world views that is not ‘privileged’ over any other world view.” I completely agree that there is this persistent post-modernist view in some corners of the humanities. Further, this view has been enthusiastically adopted by some proponents of sectarian health methods (so-called CAM). Anything that undercuts the role of science in determining the legitimacy of a medical intervention is welcome to those who wish to promote unscientific methods.

Here is part of the introduction of the conference:

The popular experiences of alternative healing, DIY and free and open source technology are everyday experiences of the contemporary individual. These experiences are being conceptualised by Fuller (2010) as ‘anti-establishment science movements’ which tacitly challenge the highly socially positioned ‘scientific expert’, the social agent of the establishment science. In the field of health, these movements are challenging the biomedical domination in the field. One of the responses to deal with the authority challenges has been the absorption of selective alternative healing practices (such as acupuncture, homeopathy) into the established health systems while reasserting the central place of biomedicine with continued usage of the referents ‘alternative’ and ‘complementary’.

There is a tremendous amount of spin and historical revisionism in this short paragraph. First, I disagree that homeopathy and acupuncture are being absorbed into mainstream medicine. (Homeopathy remains firmly on the fringe, while acupuncture is making some headway.) Rather, these and other modalities are being pushed into mainstream medicine by political maneuvering and general deception. Advocates in influential positions, like Senator Tom Harkin, and pushing their agenda past individuals who are largely uninformed and apathetic. In the last century homeopathy was pushed through for FDA approval by Senator Royal Copeland, a lone advocate. Acupuncture is being pushed into the US military by one or two vocal and tireless advocates. There is no movement among mainstream scientists or physicians to absorb any of these methods – they are just being effectively promoted by advocates while the mainstream reaction is mainly that of the “shruggie.”

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Jun 25 2012

Diagnosis by Applied Kinesiology

Those of us promoting the application of scientific skepticism to medical claims deal with a very broad range of claims, from just at the edge of acceptable science to abject magical thinking. It is useful, and unfortunately necessary, to deal with the full range of pseudoscience, but I admit a particular fascination with the pure magic end of the spectrum. What thought process is going on in people who casually accept the impossible as true?

Take, for example, a recent news report of a Canadian man who apparently has suffered from pain for years. The reporting in the article, not surprisingly, is horrific. There isn’t a hint of journalistic skepticism, no consultation with a medical expert, and not even a token attempt at balance. I have learned that this means the journalist, Doug Hempstead, likely approached the article as a “human interest” story, which means there is no apparent need for any journalistic integrity, accuracy, balance, or important background or story details. All that matters is that there is a human interest and some sensational element.

The core of the story is that Eric Bertrand, who has suffered muscle pain for years despite treatment from real doctors, was finally pressured by his family to consult an alternative practitioner. The article mentions naturopathy – naturopathy, essentially, is medicine without science (or even basic reason and common sense, in my opinion). Naturopaths use a hodge podge of prescientific, fanciful, unproven or even disproved modalities. There is no real theme or consistency to what they use – anything goes.

However, Bertrand consulted Ottawa practitioner, Tony Brunelle, who is a chiropractor. (Brunelle now proudly displays his mention in the Ottawa Sun – nice free advertising).  Brunelle used a technique known as applied kinesiology to diagnose Bertrand’s problem.

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Jun 21 2012

In Praise of Confusion

Published by under Skepticism

A new study (yet to be published) apparently suggests that productive confusion can enhance learning. I find this conclusion to be highly plausible, but before I get to my thoughts on the matter let me summarize the study (or at least the press release).

Sidney D’Mello of the University of Notre Dame conducted a series of experiments in which subjects watched animated figures explain how to analyze scientific studies and discover any flaws. They were then tested on what they learned and their ability to analyze new studies. In some versions of the lessons the animated figures disagreed with each other and gave contradictory information, in order to generate confusion in the student. Students subjected to this confusion then performed better on later testing.

I cannot analyze the study itself as it is not yet published. I did, however, want to discuss the topic of confusion as it relates to learning and understanding. Taken at face value, the results of this study make sense to me and comport with my personal experience. In fact, they align with one of the core principles of the skeptical movement.

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Jun 18 2012

Facial Processing

Published by under Neuroscience

When you see a person for the first time your eyes quickly scan their face and in less than a second your brain has gathered a tremendous amount of information about this person, processed that information, and come to many simultaneous conclusions. Think about all the different kinds of information we quickly and simultaneously process – the age and gender of the person, their race (or more generally, the genetic group with which they belong), their personality and mood, their attractiveness, the status of their health, and whether or not we have ever seen them before (do we know them).

Our brains perform this processing quickly, efficiently, and subconsciously, and so we tend to take it for granted. There are regions of the brain dedicated to processing sensory information about human faces. We are still teasing apart all the various aspects of this subconscious processing, which not surprisingly is very complex and involves multiple layers.

It also always fascinates me to find that there is a scientific community and robust research, complete with ongoing controversies, about the smallest area of knowledge – how we process facial information. Modern science has drilled down deeply on even narrow questions, which I feel is part of its strength.

It is not surprising that humans are so good at facial processing. We are social creatures who live in cooperative groups. The information gained from another’s face can be critical to survival. Since humans are essentially tribal it makes sense that we would specifically process facial information to recognize when someone belongs to our group vs another group – and not just some other group, but which other group. Are they a member of a tribe with which we are currently hostile or friendly? This is apparently the root of stereotyping. When we are not familiar with a specific individual we judge them based upon the only available information that we have, the group with which they appear to belong.

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Jun 14 2012

Forces of Quackery

I get a lot of press releases in my inbox. I’m not sure why – I suspect it’s because of this blog. I actually find it helpful for the occasional blog topic, even though most of it is self-promotional fluff that’s little more than spam. Although, I find spam useful too. I keep a separate folder for all my spam and track the themes as sociological data. It’s also interesting to track the strategies that spam marketers and con artists are using the exploit the unwary.

Recently I found a press release in my e-mail that I thought I would have some fun with. This is one of those commercial press releases, just selling a new company or product. Here’s the opening paragraph:

SONOMA, CA – Forces of Nature® is singlehandedly changing the over-the-counter medicines industry by introducing the world’s first and only FDA Registered remedies that are 100% Certified Organicby the United States Department of Agriculture. Combining homeopathic materials with medicinal botanicals, the extensive line of all-natural, chemical-free treatments are guaranteed to heal warts, nail fungus, acne, eczema, psoriasis, varicose veins, athlete’s foot and many other ailments.

This is essentially the modern version of the snake oil salesman barking out of the back of their wagon selling their latest magic elixir. Let’s play find the logical fallacy. The first one is contained in the name, a clear example of the naturalistic fallacy. This theme is obviously central to the marketing of this company. The notion that something is magically safe and/or effective simply because it’s natural is a common logical fallacy in our culture, carefully cultivated by the supplement and other industries to remarkable success. There is, however, no operational definition of what constitutes “natural” and there is no scientific reason to think that a substance that occurs in nature should be safe for human consumption or have any medical qualities. Most natural substances are deadly poisons.

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Jun 12 2012

The Science of Prometheus

I’m a huge fan of science fiction, especially hard science fiction, and also of scientific deconstructions of popular works of science fiction. I also enjoy other forms of speculative fiction – I don’t require scientific accuracy, or even plausibility, to enjoy a good book or movie. I’m perfectly willing to suspend disbelief or allow for “gimmies” – OK, there’s subspace and you can travel faster than light. I’m good with that. I appreciate, however, when sci fi writers try to work within the scientific framework as much as possible, to minimize “gimmies”, and to extrapolate thoughtfully from established science. What I am not tolerant of, however, is gratuitous errors in science. There’s just no excuse for that in science fiction.

I saw Ridley Scott’s Alien prequel, Prometheus, over the weekend. What follows is a sequence of spoilers, so be warned. I will try not to discuss plot points unnecessarily, but if you don’t want any spoilers wait until after you see the movie to read further. This is also not going to be a movie review, just a discussion of some of the science in the movie.

Let me start with something that I really enjoyed. The planet that the ship Prometheus and its crew visit in the movie is actually a moon of a gas giant. I find this idea fascinating, and have speculated about this before myself. We are in the midst of an explosion of exoplanet discoveries. We are just now starting to get some data about what the typical configuration of other stellar systems is likely to be. We still don’t have enough data to answer this question, and our methods of finding exoplanets are biased toward large planets close to their suns. But we are starting to find smaller Earth-sized worlds far enough out to be in the goldilocks zone where liquid water can exist on the surface.

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Jun 11 2012

Sleep and Weight

Published by under Neuroscience

Recent evidence suggests there is a link between sleep quality and weight control – poor sleep correlates with risk of obesity. The possible causal connection goes both ways. Obesity increases the risk for sleep apnea and other conditions that may interfere with sleep, such as back pain. Recent studies also suggest that sleep deprivation increases appetite and decreases energy ependiture. A recent review summarizes the evidence:

On this basis, the present review examines the role of sleepcurtailment in the metabolic and endocrine alterations, including decreased glucose tolerance and insulin sensitivity, increased evening concentrations of cortisol, increased levels of ghrelin, decreased levels of leptin and increased hunger and appetite. It will be discussed how sleeprestriction may lead to increase in food intake and result in greater fatigue, which may favour decreased energy expenditure.

All of the hormonal factors listed above would tend to increase hunger and fat storage and decrease satiety. Fatigue also decreases energy output. Resulting weight gain may further worsen sleep, leading to a vicious cycle.

A new study adds another element to the mix. Researchers looked at 23 healthy subjects over two sessions, one with normal sleep and one with sleep deprivation. They then exposed them to various food choices while in an fMRI scanner. They found that the sleep deprived subjects had decreased activity in their frontal lobes while making food choices.

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Jun 07 2012

Boiron Settlement – Homeopathic Active Ingredients are Neither

At the end of April a federal court approved a settlement against Boiron – the world’s largest manufacturer of homeopathic products.

A federal court has preliminarily approved a class action lawsuit settlement with Boiron, Inc. that will provide up to $5 million in refunds to consumers who purchased certain Boiron homeopathic products, including Oscillo, Arnicare, Chestal and Coldcalm.

This is the result of a class action lawsuit against against Boiron alleging that they sold the above named products with false claims they knew they could not support. Jann Bellamy at Science-Based Medicine gives a good overview of the relevant law and the testimony given during the trial.

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