Mar 06 2017

Terraforming Mars

MarsTransitionVHow high a priority should we have for sending people to Mars? This seems to be a big question these days. NASA is developing the Space Launch System (SLS) and the Orion capsule specifically to have the capacity to send people to Mars. Elon Musk has stated that the real purpose of SpaceX is to colonize Mars.

The public imagination has also been sparked by movies such as The Martian (which was excellent). I also recommend National Geographics’ series “Mars” which is a combination of interviews with current scientists and engineers about the problems that a Mars colony would face, with a narrative about a future colonization mission.

The one fact that everyone agrees on is that colonizing Mars will be extremely difficult. Mars has an atmosphere about 1% that of Earth. This makes it just thick enough to be a problem but not thick enough to help with breaking while landing on Mars, and not thick enough to make the surface any more livable. A 1% atmosphere is effectively a vacuum, but it is enough to cause planet-wide dust storms that would make life on Mars challenging.

Transfer to Mars would take about 8 months with current rocket technology. Depending on the relative position of the planets and the transfer speed, 130-260 days are the figures most often cited. That means supply lines would be very difficult, and don’t expect any rescue missions.

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Mar 03 2017

Trump’s Dangerous Plan to Deregulate Pharmaceuticals

Trump-FDADuring Trump’s recent address to Congress he referred to 20 year-old Megan Crowley who has Pompe’s disease.

“Megan’s story is about the unbounded power of a father’s love for a daughter,” Trump said. “But our slow and burdensome approval process at the Food and Drug Administration keeps too many advances, like the one that saved Megan’s life, from reaching those in need.”

This statement, an unwarranted and factually-challenged attack on the FDA is all the more frightening when put into context. He has appointed to the FDA Jim O’Neill, who said in 2014:

“We should reform FDA so there is approving drugs after their sponsors have demonstrated safety—and let people start using them, at their own risk, but not much risk of safety. Let’s prove efficacy after they’ve been legalized.”

Not requiring evidence for efficacy for drugs would be an unmitigated disaster. It also makes not sense – the concept of “safety” cannot be entirely separated from efficacy. Drugs are evaluated and their use determined by risk vs benefit. You cannot do a risk vs benefit assessment if there is no data on benefit.

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Mar 02 2017

Tucker Carlson vs Bill Nye on Climate Change

Nye vs CarlsonTucker Carlson of Fox News recently had Bill Nye on as a guest to discuss climate change. The entire interview is worth a listen because it nicely illustrates the strategies employed by denialists.

Here are some highlights:

Carlson pushes what is a very common denialist narrative, that they are skeptics who are just asking honest questions. Meanwhile the proponents of global warming are trying to shout them down, call them names, and are doing a disservice to science by trying to shut down debate.

The problem with this narrative (other than not being true) is that you can apply it to any position that denies established science. Flat-Earthers are just skeptics, stop shouting them down. Answer their honest questions.

The devil, of course, is in the details. Are climate change denier just asking honest questions? Ironically, Carlson himself demonstrates in the interview that he isn’t. He is playing rhetorical games to cast doubt on climate science.

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Feb 28 2017

De-Extinction

Recently Harvard University geneticist Prof George Church announced that he and his team are close to making a mammoth-elephant hybrid. They have been reconstructing mammoth DNA from frozen remains.

They will not be able to make a 100% mammoth clone, but rather they are splicing mammoth genes into Indian elephant DNA and hope to grow a hybrid. The result would have, they hope, enough mammoth traits to be adapted to a colder environment, and therefore essentially spread the range of the Indian elephant north.

Such programs raise two question – can we actually achieve de-extinction with such techniques, and should we?

The answer to the first question is – we’re not even close yet. The reporting of Church’s announcement was highly sensationalized, with many outlets reporting that we will have mammoths in two year. The reality is that Church’s team has made 45 mammoth DNA inserts into the Indian elephant genome. This is insignificant.

Estimates of the differences between mammoth and elephant DNA indicate that several thousand genes are involved. In addition, there may be even more regulatory changes in the DNA outside of genes. You can make a lot of evolutionary change by turning on or off, or up or down, the expression of genes without changing the genes themselves.

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Feb 27 2017

The Death of Expertise

fox-globalwarmingTom Nichols’ book, “The Death of Expertise: The Campaign Against Established Knowledge and Why it Matters,” is currently on the Amazon bestsellers list. The book discusses a topic I have delved into many times here – what are the current general attitudes of the public toward experts and expertise, and how did we get here?

He mentions various aspects to this war against experts:

“The United States is now a country obsessed with the worship of its own ignorance. Many citizens today are proud of not knowing things. Americans have reached a point where ignorance, especially of anything related to public policy, is an actual virtue.”

The culture and our educational system have created a generation that has little experience being told they are objectively wrong. Everyone feels they are entitled to be right. Combine this with the illusion of knowledge provided by Google, and everyone thinks they are their own expert in anything.

Interestingly, as Nichols also points out, people are arbitrarily selective in which experts they respect. Sports is a great example. No one really thinks they should play for the NFL and begrudges recognizing that NFL players are the result of a combination of natural talent and years of developing physical ability and specific skills.

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Feb 24 2017

Practicing Evidence-Based Medicine

SBM-coverAn excellent article in ProPublica by David Epstein discusses the problem of doctors not adhering to the best evidence-based standards. The full article is worth a read, and I won’t just repeat it here, but I do want to highlight a few points which align well with what I have been writing here and at SBM for years.

The essential problem is that there is a disconnect between the best evidence-based standards and what is actually practiced out in the world. There are actually two problems here. The first is the scientific evidence itself. The second is the alignment of practice to this evidence.

Scientific evidence in medicine has a few challenges. There is publication bias, researcher bias, p-hacking, the decline effect, and problems with replication. What all of this adds up to is that there is a lot of published preliminary evidence, most of which is wrong in the false positive direction. There is a tendency, in my opinion, of adopting treatments prematurely.

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Feb 23 2017

Natural News Delisted from Google

natural-news-pseudoscienceIt appears that Google has removed all Natural News content from their indexing. This means that Natural News pages will not appear in organic Google searches.

This is big news for skeptics, but it is also complicated and sure to spark vigorous discussion.

For those who may not know, Mike Adams, who runs Natural News, is a crank conspiracy theorist supreme. He hawks snake oil on his site that he markets partly by spreading the worst medical misinformation on the net. He also routinely personally attacks his critics. He has launched a smear-campaign against my colleague, David Gorski, for example.

A few years ago Adams put up a post in which he listed people who support the science of GMOs to the public, comparing them to Nazis and arguing that it would be ethical (even a moral obligation) to kill them. So he essentially made a kill-list for his conspiracy-addled followers. Mine was one of the names on that list, as were other journalists and science-communicators.

In short Adams is a dangerous loon spreading misinformation and harmful conspiracy theories in order to sell snake oil, and will smear and threaten those who call him out. He is an active menace to the health of the public.

Adams is a good example of the dark underbelly of social media. It makes it possible to build a massive empire out of click-bait and sensationalism.

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Comments: 126

Feb 21 2017

Potential New Pain Drug from Snail Venom

Cone-SnailResearchers have published in PNAS promising results from a snail venom analogue used in the treatment of pain. This is exciting for a number of reasons, even if the current compounds under study do not pan out.

Pain is a difficult clinical problem. There are limited options for treating chronic pain and we can quickly run out of options if patients cannot tolerate certain classes of drugs. What we really need are entirely new classes of pain medication, and that is what this new approach promises.

There are essentially two neurological components to pain: there is the physical sensation, and then there is the emotional component. It is interesting to ask the question, why does pain hurt? There is nothing about the sensation itself that is inherently painful. Any sensation is just nerve cells firing and carrying signals to areas of the brain that interpret those signals. Pain hurts because pain pathways specifically connect to the emotional centers in the brain to create a negative experience.

For further background, clinically it is helpful to distinguish different types of pain. There is nociceptive pain, which is the nervous system appropriately sensing damage and generating protective painful sensations. There is also neuropathic pain, which is the nervous system malfunctioning and producing inappropriate pain that is not protective. We further divide pain into acute and chronic. Finally, we consider the context of the patient, such as whether or not they are terminal.

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Feb 20 2017

Human Gene Editing

CRISPR-human editingThe recent rapid development of CRISPR technology, which has made gene editing fast, affordable, and accurate, has rekindled the ethical debate about human gene editing. Last week a special panel put together by the National Academy of Sciences gave a “yellow light” to human germline gene editing – saying that such editing might be ethical once the risks were properly assessed.

Germline editing means that the changes would be part of the gametes, the sperm or egg, and would therefore be passed down to offspring. If gene editing were done to a fertilized then this would affect all cells, including the germ cells.

By contrast somatic cell editing would affect only adult cells and not be passed down to the next generation. Such editing would only affect the individual.

The ethical controversy over germline editing is that such changes essentially can become a permanent part of the human population.

What Changes are Acceptable?

The NAS report essentially lays out two criteria for human germline editing. The first is that research shows that such editing is safe in humans without any unintended consequences. They want to make sure that dangerous changes to the human genome will not enter the human population. This is, of course, a perfectly reasonable criterion.

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Comments: 21

Feb 17 2017

The Science of Smoking Bans

smoking-banIn a recent article for Slate, Jacob Grier argues that the science used to justify widespread bans on smoking in public places was flawed. Recent more robust research has show little to no health benefit from such laws, he argues. While he has a point regarding the arc of scientific evidence, I think he is going too far in the other direction in his conclusions about the science.

Second Hand Smoke

The current consensus of evidence is that there are health risks to second hand smoke, although they are statistically small. Debate centers around the magnitude of the effect, with few doubting that there is a negative health effect. Negative health effects include heart attacks, lung cancer, stroke, and exacerbation of asthma. On a population level, even small increased risks result in large numbers of excess deaths and negative health outcomes. The CDC estimates, for example, that second-hand smoke exposure results in 34,000 excess cardiac deaths each year.

Increased recognition of the health risks of passive smoke exposure lent significant political weight to anti-smoking efforts, resulting in a cultural shift over the last 30 years. As a result smoking has largely been banned in most indoor public places and many work places.

The empirical question on which Grier focuses is the impact of those smoking bans on health outcomes. He does a fairly thorough review of the literature, although I think his review is biased to make his point, that the health benefits of such bans have been overplayed and maybe don’t exist.

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