I have been writing blog posts and engaging in science communication long enough that I have a pretty good sense how much engagement I am going to get from a particular topic. Some topics are simply more divisive than others (although there is an unpredictable element from social media networks). I wish I could say that the more scientifically interesting topics garnered more attention and comments, but that is not the case. The overall pattern is that topics which have an ideological angle or affect people’s world-view inspire more passionate criticism or defense.  Timed drug release is an important topic, with implications for potentially anyone who has to take medication at some point in their lives. But it doesn’t challenge anyone’s world view. ESP, on the other hand, is a fringe topic likely to directly affect no one, but apparently is 70 times more interesting to my readers (using comments as a measure).

I also get e-mails, and my recent article on ESP research attracted a number of angry individuals who wanted to excoriate my closed minded “scientism”.  I think people care so much about ESP and other psi and paranormal phenomena because it gets at the heart of their beliefs about reality – do we live in a purely naturalistic and mechanistic world, or do we live in a world where the supernatural exists? Further, in my experience while many people are happy to praise the virtue of faith (believing without knowing) in reality they desperately want there to be objective evidence for their beliefs. Meanwhile, I think it’s fair to say that a dedicated naturalist would find it “disturbing” (if I can paraphrase Darth Vader) if there really were convincing evidence that contradicts naturalism. Both sides have an out, as it were. Believers in a supernatural universe can always say that the supernatural by definition is not provable by science. One can only have faith. This is a rationalization that has the virtue of being true, if properly formulated and utilized. Naturalists can also say that if you have actual scientific evidence of an alleged paranormal phenomenon, then by definition it’s not paranormal. It just reflects a deeper reality and points in the direction of new science. Yeah!

Regardless of what you believe deep down about the ultimate nature of reality (and honestly, I couldn’t care less, as long as you don’t think you have the right to impose that view on others), the science is the science. Science follows methodological naturalism, and is agnostic toward the supernatural question. It operates within a framework of naturalism, but recognizes this is a construct, and does not require philosophical naturalism. So you can have your faith, just don’t mess with science.

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Researchers recently published an extensive survey of almost 6,000 students across academic institution in Sweden. The results are not surprising, but they do give a snapshot of where we are with the recent introduction of large language model AIs.

Most students, 56%, reported that they use Chat GPT in their studies, and 35% regularly. More than half do not know if their school has guidelines on AI use in their classwork, and 62% believe that using a chatbot during an exam is cheating (so 38% do not think that). What this means is that most students are using AI for their classwork, but they don’t know what the rules are and are unclear on what would constitute cheating.  Also, almost half of students think that using AI makes them more efficient learners, and many commented that they feel it has improved their own language and thinking skills.

So – is the use of AI in education a bane or a boon? Of course, asking students is only one window into this question. Educators have concerns about AI creating a lazy student, that can serve up good-enough answers to get by. There are also concerns about outright cheating, although that has to be carefully defined. Some teachers don’t know how to react when students turn in essays that appear to have been written by a chat bot. But many also think there is tremendous potential is using AI as an educational tool.

Clearly the availability of the latest generation of large language model AIs is a disruptive technology. Schools are now scrambling to deal with it, but I think they have no choice. Students are moving fast, and if schools don’t keep up they will miss an opportunity and fail to mitigate the potential downsides. What is clear is that AI has the potential to significantly change education. Simplistic solutions like just banning the use of AI is not going to work.

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Does the lunar cycle affect human behavior? This seems to be a question that refuses to die, no matter how hard it is to confirm any actual effect. It’s now a cultural idea, deeply embedded and not going anywhere. A recent study, however, seems to show a correlation between suicide and the week of the full moon in a pre-Covid cohort of subjects from Marion County. What are we to make of this finding?

Specifically they show that:

We analyzed pre-COVID suicides from the Marion County Coroner’s Office (n = 776), and show that deaths by suicide are significantly increased during the week of the full moon (p = 0.037), with older individuals (age ≥ 55) showing a stronger effect (p = 0.019). We also examined in our dataset which hour of the day (3–4 pm, p = 0.035), and which month of the year (September, p = 0.09) show the most deaths by suicide.

They also found suicides were not significantly associated with the full moon for subjects <30. They did not give the p-value for those between 30 and 55, and I suspect, given the numbers, that group was either not significant or barely significant. The first question we should ask when confronted with data like this is – is this likely to be a real effect, or just a statistical false positive? We can think about prior plausibility, the statistical power of the study, and the degree of significance. But really there is one primary way this question is sorted out – replication.

In fact, studies like this are best done in at least two phases, an initial exploratory phases and a follow up internal replication to confirm the results of the first data set. But confirmation can also be done through subsequent replication, by the same group or others. A real effect should replicate, while a false positive should not. The authors note that they did a literature search and found the results “mixed”. In fact, this study is a replication (not exact replication, but still a replication) of earlier studies asking the same question. Did they replicate the results of previous studies? Let’s take a look. Continue Reading »

Yesterday’s post was the first in an exchange about the effects of climate change on public health. Today’s post is my response.

Part II

Climate change is a critically important topic for society today, and it’s important that the public have a working knowledge of the facts, causes, effects, and potential interventions regarding climate change, so I am always happy to discuss the topic. Unfortunately, it’s a very complex topic that has been highly politicized and polarized. The science often becomes wrapped up in ideology – the best indication of this is that one’s political affiliation is the strongest predictor of the public’s opinions regarding climate change. The media, as they do in general, is happy to sensationalize the topic and often does not provide good context or background. Scientists have gotten better communicating about climate change, but not enough to override political affiliation.

My sense is the core issue is that the complexity of climate change allows everyone to cherry pick those details that fit their narrative. You can find examples to support whatever narrative you want to believe. You don’t even have to be factually incorrect (although many people certainly are), you just have to be selective in your details and interpretation. Climate change is a Rorschach test of subjective validation and confirmation bias.

I say this all because I think Scott’s narrative comes through very clearly. He contacted me asking fervently for a debate on this specific topic, the health effects of climate change. I thought this was a little odd since I have never written or expressed an opinion about this topic before. It seems he assumed what my position was based on other things I have written about climate change – that I think it’s real, it is primarily being caused by humans, and the effects are likely to be bad for the environment and human civilization. This brings up another aspect of the climate change debate, that people generally take sides and think that everyone fits relatively cleanly into the “for or against” side. Once someone thinks they have detected what side you are on, they then ascribe the entire package of views to you.

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Some ideas never seem to die. There is something compelling about the narrative, perhaps because it fills some explanatory need. One of those narratives is that “they” have “the cure” to cancer but are keeping it hidden from the public in order to protect the profits that result from cancer treatment. I recently received the following e-mail (partly redacted):

“I read many articles by physicians like yourself that claim secrets cannot be kept about cancer cures.  I beg to differ.

Pharmaceutical firms require their associates to sign confidentiality agreements as a condition of employment.  If they breach it, it’s safe to assume that they risk grave consequences for doing so.

These companies could care less about sick people.  They only care about the health of their bottom line.  They make far more profit on lifetime treatments rather than one-shot cures.  After the patent expiration on a cure, the steady stream of revenue comes to a halt.

A cure eliminates the need for any new drug development unless the side effects are unpalatable.  I was even told as much by a retired employee of a pharmaceutical company.  She saw the private memos from their lobbyists.

In any case, the confidentiality contracts are why secrets are kept in the pharmaceutical industry.  It’s also why cancer cures can be kept hidden as it would be treated as a trade secret.  No one wants to be brought up on a felony charge of industrial espionage.  Nor do they wish to be sued for it by their former employer.

Ask yourself the following question: would you risk your family’s future under those circumstances?  No way!  If you signed one of those legal instruments, you would never divulge such information if you came across it.”

The notion that a pharmaceutical company could hide a cancer cure is, in my opinion, and from the perspective of an academic physician who has participated in clinical research for pharmaceutical companies, hopelessly naive. The belief comes partly from looking into a complex system from the outside, without any real idea how it actually works.  First let’s talk about the science and then we’ll turn to the logistics of the conspiracy itself.

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There are several viral videos spreading claiming to demonstrate a large electric charge stored in certain kinds of rocks in Africa. The most popular is this one which alleges to show electrically charged rocks from the Democratic Republic of Congo (DRC). When touched together the rocks give off large sparks which leave burn marks on the stones. The comments are mostly amusing and sad, reflecting the cultural turmoil of the region. A few figured out what is happening here.

We can start by evaluating the plausibility of the claim. The sparking is not a single event, as if there were static electricity in the rocks that discharged. They continue to discharge without diminishing. It is implausible that a natural ore (i.e. not a battery) would contain so much electricity. Also, where would the electricity come from? Some commenters through out the piezoelectric effect, the transformation of mechanical stress to current, but this only produces a tiny amount of electricity. Even if there were some small amount of static electricity in the material, this would not be a source of power, as some seem to believe.

What about the video itself? There are countless deceptive and fake videos on social media, so it’s good to have some basic idea how to recognize deception. I recommend Captain Disillusion’s Youtube channel – he is a digital effects expert who examines dubious videos and reveals their deception. On this video there are some immediately suspicious features. First, the video is very close-up. We are seeing just the rocks with little space around them. Close-cropping like this is a standard technique for hiding things out of view of the lens. An honest video documenting a phenomenon would show the environment and the setup, and show multiple angles and perspectives. It may zoom in at some point, but if all you see if a super close-up, be suspicious.

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What are the known factors that increase the risk of getting cancer? Most people know about smoking, but can probably only guess at other factors, and are likely to endorse things that do not contribute to cancer risk. The known contributors to cancer risk include: smoking, consuming alcohol, low levels of physical activity, getting sunburnt as a child, family history of cancer, HPV infection, and being overweight. But there are also a number of “mythic” causes that do not contribute to cancer risk but are widely believed to: artificial sweeteners or additives and genetically modified food; using microwave ovens, aerosol containers, mobile phones, and cleaning products; living near power lines and feeling stressed.

These are all lifestyle factors that people can influence by changing their behavior. Therefore there is a direct utility to informing the public about the true causes of cancer and identifying the factors that they should not worry about. I see the effects of misinformation and poor communication on a regular basis. Often my patients will express to me that they are highly motivated to get healthier by changing their lifestyle, and then they rattle off a list of things they are doing, most of which are useless or counterproductive. Forget all that – just stop smoking and let’s talk about a healthy and practical exercise routine for you.

A recent study seeks to shed light on why there is so much misinformation about the modifiable causes of cancer. This is a complex question, and any one study is only going to look at a tiny slice of potential contributing factors. Also, this is the type of question that is hard to look at in a controlled experiment, so we will have to make due with observational data that can have a lot of confounding factors. The authors did a survey of several English and Spanish language forums, assessing knowledge of true and mythic causes of cancer, and correlating them with belief in conspiracies, preference for alternative medicine, and lack of COVID-19 vaccination. The results are pretty much what you would expect, but let’s dive into some details.

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A panel of 386 experts from various disciplines and 122 countries have put together a consensus statement on how the world can best deal with the continued challenge of COVID-19. The statement contains 57 specific recommendations that had >95% consensus from the panel, with most having >99% consensus. This is like an M&M rounds for the world’s COVID response. In medicine we have morbidity and mortality rounds where we review both statistics and individual cases with bad outcomes. The point is to explore those cases and determine what went wrong, if anything, and how individually and systemically we can prevent or minimize future similar negative outcomes. This panel did the same thing for our COVID response.

Such endeavors are not about placing blame. We can leave that up to the politicians looking to score points. The purpose is to map out a future course, to take specific actions that will minimize future death and negative health outcomes from the COVID pandemic, which is (despite what you may want to believe) not over. The SARS-CoV-2 virus continues to spread throughout the population, and continues to mutate with variants and subvariants increasingly able to evade prior immunity (from infection or vaccination). As predicted the pandemic is slowly morphing into an endemic infection, like the flu, that will simply be with us indefinitely. But infections are still at pandemic levels.

The focus of the recommendations is on how governments can enact policy and allocate resources to better tamp down infections and reduce negative outcomes. This is needed, because government responses were mostly a failure. This doesn’t mean that the US and other governments didn’t do anything useful. They did. But from the perspective of what a fully prepared optimal response would have been, the actual response, in my opinion, was basically a failure. It’s not like we didn’t see it coming. Even now, after everything the world has been through, our preparedness and response is less than ideal.

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I get lots of e-mail, sometimes from people who want to convince me that their pet theory has merit – in explicit hope that I will champion their cause and spread their theory. They are always disappointed. The exchange is always the same, almost eerily so, as if they are all following the same script. I think to an extent they are – they are all absorbing the same narrative from the culture. So here is my generic response to all cranks, past and future.

Dear Crank,

I use that term not as a personal attack, but as an accurate description of your behavior. I want you to understand why that behavior is not serving you well, and what you can do the escape from a cycle of self-destructive, and frankly annoying, behavior. Hey – you e-mailed me, you jumped up in front of me waving your hands in order to get my attention. Well, you got it. And now I am going to do you a massive favor. I am going to give you a tiny slice of the attention you are so clearly desperate for and explain to you why you are a crank.

I understand you have a theory with which you are very impressed, and it includes a lot of math and facts and details. You may even have some scientific education and background. But if you think you have somehow seen through the fog, and have proven that the world’s scientists have all been hopelessly wrong for the last century or so, then you are likely suffering from not only a lack of proper humility, but overwhelming hubris. You may think that you have proven with one devastating argument that evolution is impossible, or global warming is not real, or that you have created free-energy, cured cancer, or changed everything we thought we knew about history (or whatever), but you haven’t.

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There is ongoing debate as to the extent that a skeptical outlook is natural vs learned in humans. There is no simple answer to this question, and human psychology is complex and multifaceted. People do demonstrate natural skepticism toward many claims, and yet seem to accept with abject gullibility other claims. For adults it can also be difficult to tease out how much skepticism is learned vs innate.

This is where developmental psychology comes in. We can examine children of various ages to see how they behave, and this may provide a window into natural human behavior. Of course, even young children are not free from cultural influences, but it at least can provide some interesting information. A recent study looked at two related questions – to children (ages 4-7) accept surprising claims from adults, and how do they react to those claims. A surprising claim is one that contradicts common knowledge that even a 4-year old should know.

In one study, for example, an adult showed the children a rock and a sponge and asked them if the rock was soft or hard. The children all believed the rock was hard. The adult then either told them that the rock was hard, or that the rock was soft (or in one iteration that the rock was softer than the sponge). When the adult confirmed the children’s beliefs, they continued in their belief. When the adult contradicted their belief, many children modified their belief. The adult then left the room under a pretense, and the children were observed through video. Unsurprisingly, they generally tested the surprising claims of the teacher through direct exploration.

This is not surprising – children generally like to explore and to touch things. However, the 6-7 year-old engaged in (or proposed during online versions of the testing) more appropriate and efficient methods of testing surprising claims than the 4-5 year-olds. For example, they wanted to directly compare the hardness of the sponge vs the rock.

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