Category: Health

The Absence of a Randomized Double-Blind Clinical Trial Is Used as an Excuse to Ignore an Emergency Procedure That Saves Lives

In an urgent emergency the son and wife of a man with a stopped heart, improvised the use of a toilet plunger to get his heart to start pumping again. In his wonderful account of the sources of insight, Gary Klein told a different example of urgent emergency improvisation: “Wag” Dodge saved himself from a massive wildfire racing toward him by lighting a match to the grass at his feet to pre-burn a patch he could lie down in. When the wildfire reached him, it passed on both sides, avoiding the patch that now had no fuel. Neither the son-and-mother, nor Wag Dodge, got their insight from collaboration or a randomized double-blind controlled trial.

(p. D5) In 1988, a 65-year-old man’s heart stopped at home. His wife and son didn’t know CPR, so in desperation they grabbed a toilet plunger to get his heart going until an ambulance showed up.

Later, after the man recovered at San Francisco General Hospital, his son gave the doctors there some advice: Put toilet plungers next to all of the beds in the coronary unit.

The hospital didn’t do that, but the idea got the doctors thinking about better ways to do CPR, or cardiopulmonary resuscitation, the conventional method for chest compressions after cardiac arrest. More than three decades later, at a meeting of emergency medical services directors this week in Hollywood, Fla., researchers presented data showing that using a plunger-like setup leads to remarkably better outcomes for reviving patients.

. . .

The new procedure, known as neuroprotective CPR, has three components. First, a silicone plunger forces the chest up and down, not only pushing blood out to the body, but drawing it back in to refill the heart. A plastic valve fits over a face mask or breathing tube to control pressure in the lungs.

The third piece is a body-positioning device sold by AdvancedCPR Solutions, a firm in Edina, Minn., that was founded by Dr. Lurie. A hinged support slowly elevates a supine patient into a partial sitting position. This allows oxygen-starved blood in the brain to drain more effectively and to be replenished more quickly with oxygenated blood.

. . .

. . ., a study carried out in four states found . . . [p]atients who received neuroprotective CPR within 11 minutes of a 911 call were about three times as likely to survive with good brain function as those who received conventional CPR.

. . .

Dr. Karen Hirsch, a neurologist at Stanford University and a member of the CPR standards committee for the American Heart Association, said that the new approach was interesting and made physiological sense, but that the committee needed to see more research on patients before it could formally recommend it as a treatment option.

“We’re limited to the available data,” she said, adding that the committee would like to see a clinical trial in which people undergoing cardiac arrests are randomly assigned to conventional CPR or neuroprotective CPR. No such trials are happening in the United States.

Dr. Joe Holley, the medical director for the emergency medical service that serves Memphis and several surrounding communities, isn’t waiting for a larger trial. Two of his teams, he said, were getting neurologically intact survival rates of about 7 percent with conventional CPR. With neuroprotective CPR, the rates rose to around 23 percent.

His crews are coming back from emergency calls much happier these days, too, and patients are even showing up at fire stations to thank them for their help.

“That was a rare occurrence,” Dr. Holley said. “Now it’s almost a regular thing.”

For the full story see:

Joanne Silberner. “How a Plunger Improved CPR.” The New York Times (Tuesday, June 27, 2023 [sic]): D5.

(Note: ellipses added.)

(Note: the online version of the story has the date June 15, 2023 [sic], and has the title “How a Toilet Plunger Improved CPR.”)

The Gary Klein book that I praised above is:

Klein, Gary. Seeing What Others Don’t: The Remarkable Ways We Gain Insights. Philadelphia, PA: PublicAffairs, 2013.

The “study carried out in four states,” and mentioned above, is:

Moore, Johanna C., Paul E. Pepe, Kenneth A. Scheppke, Charles Lick, Sue Duval, Joseph Holley, Bayert Salverda, Michael Jacobs, Paul Nystrom, Ryan Quinn, Paul J. Adams, Mack Hutchison, Charles Mason, Eduardo Martinez, Steven Mason, Armando Clift, Peter M. Antevy, Charles Coyle, Eric Grizzard, Sebastian Garay, Remle P. Crowe, Keith G. Lurie, Guillaume P. Debaty, and José Labarère. “Head and Thorax Elevation During Cardiopulmonary Resuscitation Using Circulatory Adjuncts Is Associated with Improved Survival.” Resuscitation 179 (2022): 9-17.

Some Variants of One Mitochondrial Gene Double Your Odds of Living to 100

(p. D3) . . . what made the great blooming of biodiversity possible? Dr. Lane, building on ideas developed with the evolutionary biologist William Martin, traces its origins to a freak accident billions of years ago, when one microbe took up residence inside another. This event was not a branching of the evolutionary tree but a fusion with, he argues, profound consequences.

The new tenant provided energy for its host, paying chemical rent in exchange for safe dwelling. With this additional income, the host cell could afford investments in more complex biological amenities. The pairing thrived, replicated and evolved.

Today we call these inner microbes mitochondria; nearly every cell in our body has thousands of these energy factories. Dr. Lane and Dr. Martin have argued that because of mitochondria, complex cells have nearly 200,000 times as much energy per gene, setting the stage for larger genomes and unfettered evolution.

. . .

With age, mitochondrial mutations accumulate. Elsewhere, Dr. Lane has pointed to research showing that variants in a single mitochondrial gene halved the prospect of being hospitalized for age-related disease in patients who have them, and doubled the prospect of living to 100. This finding, Dr. Lane believes, could lead to medical advances if we understood how to protect mitochondrial DNA.

“How can we hope to understand disease,” he asks, “if we have no idea why cells work the way they do?”

. . .

Whether research will bear him out remains to be seen, but Dr. Lane’s many predictions, however incredible they seem, are testable and could keep scientists busy for years. As Sherlock Holmes remarked, “When you have eliminated the impossible, then whatever remains, however improbable, must be the truth.”

For the full review see:

Tim Requarth. “Rethinking the Textbook on Life.” The New York Times (Tuesday, July 21, 2015 [sic]): D3.

(Note: ellipses added.)

(Note: the online version of the review was updated July 20, 2015 [sic], and has the title “Book Review: Taking on ‘The Vital Question’ About Life.”)

The book under review is:

Lane, Nick. The Vital Question: Energy, Evolution, and the Origins of Complex Life. New York: W. W. Norton & Company, 2015.

“People Will Die” from Blackouts Caused by Walz’s Net-Zero Climate Policies

(p. A13) Minnesota Gov. Tim Walz last year signed one of America’s most aggressive climate laws, mandating that 100% of the state’s electricity come from carbon-free sources by 2040. Even if he doesn’t ascend to national office, he may end up leaving not only Minnesota but other states in the dark. As we show in a new paper, politicians like Mr. Walz are destroying the electricity markets that are essential to economic success and even individual survival.

We analyzed seven Great Lakes states with connected electricity grids—Illinois, Indiana, Minnesota, Michigan, Ohio, Pennsylvania and Wisconsin. For decades, these states have bought and sold electricity in regional markets, benefiting from the abundance of reliable power generated from sources like coal, natural gas and nuclear. But through a combination of state mandates and utility company decisions, all of them are moving away from those reliable sources toward unreliable wind and solar power, in pursuit of net-zero greenhouse gas emissions.

. . .

When subzero temperatures sweep across the Great Lakes every January, states will increasingly ask each other for power that doesn’t exist. Ditto when heat waves crest in July and August. Factories will lose power—a death knell for competitiveness—while families will lose air conditioning or heat. In Michigan, we estimate that a wind-, solar- and battery-based grid will cause blackouts lasting as long as three days during extreme winter weather. People will die.

For the full commentary see:

Joshua Antonini and Jason Hayes. “Cross Country; Walz’s Climate Policies Could Leave the Midwest in the Dark.” The Wall Street Journal (Saturday, Aug. 10, 2024): A13.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date August 9, 2024, and has the same title as the print version.)

The “new paper” by Antonini and Hayes mentioned above is:

Antonini, Joshua, and Jason Hayes. “Shorting the Great Lakes Grid: How Net Zero Plans Risk Energy Reliability.” The Mackinac Center for Public Policy, 2024.

Orangutan Effectively Self-Medicates to Heal Facial Wound

The Food and Drug Administration (FDA) is currently investigating whether Rakus the orangutan conducted a randomized double-blind clinical trial to prove the safety and efficacy of akar kuning before he applied it to his wound.

(p. D3) Scientists observed a wild male orangutan repeatedly rubbing chewed-up leaves of a medicinal plant on a facial wound in a forest reserve in Indonesia.

. . .

“Once I heard about it, I got extremely excited,” said Isabelle Laumer, a primatologist with the Max Planck Institute of Animal Behavior in Germany, in part because records of animals medicating themselves are rare — even more so when it comes to treating injuries. She and colleagues detailed the discovery in a study published Thursday [May 2, 2024] in the journal Scientific Reports.

The plant Rakus used, known as akar kuning or yellow root, is also used by people throughout Southeast Asia to treat malaria, diabetes and other conditions. Research shows it has anti-inflammatory and antibacterial properties.

. . .

Orangutans rarely eat the plant. But in this case, Rakus ingested a small amount and also coated the wound several times. Five days after the wound was noticed, it had closed, and less than a month later “healed without any signs of infection,” Dr. Laumer said.

Michael Huffman, a visiting professor at the Institute of Tropical Medicine at Nagasaki University in Japan, who wasn’t involved in the study, said, “This is to the best of my knowledge the first published study to demonstrate an animal using a plant with known biomedical properties for the treatment of a wound.”

Primates have been observed appearing to treat wounds in the past, but not with plants. A group of more than two dozen chimpanzees in Gabon in Central Africa have been seen chewing up and applying flying insects to their wounds, said Simone Pika, an expert on animal cognition at Osnabrück University in Germany who documented that observation.

For the full story see:

Douglas Main. “Primate Self-Medicates To Heal His Wound.” The New York Times (Tuesday, May 7, 2024): D3.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date May 2, 2024, and has the title “Orangutan, Heal Thyself.”)

Laumer’s co-authored academic paper mentioned above is:

Laumer, Isabelle B., Arif Rahman, Tri Rahmaeti, Ulil Azhari, Hermansyah, Sri Suci Utami Atmoko, and Caroline Schuppli. “Active Self-Treatment of a Facial Wound with a Biologically Active Plant by a Male Sumatran Orangutan.” Scientific Reports 14, no. 1 (2024): article #8932.

Seeds of Plant Mostly Used for Pain Relief in Roman Era, Found Stashed in Buried Bone in “Far-Flung” Province

A couple of thousand years ago some humans had figured out how to use a medicinal plant for effective pain relief. And they did so without having conducted randomized double-blind clinical trials. And no agency of the government blocked them from easing their pain.

(p. D2) . . ., Mr. van Haasteren was cleaning the mud from yet another bone when something unexpected happened: Hundreds of black specks the size of poppy seeds came pouring out from one end.

The specks turned out to be seeds of black henbane, a potently poisonous member of the nightshade family that can be medicinal or hallucinogenic depending on the dosage.  . . .

This “very special” discovery provides the first definitive evidence that Indigenous people living in such a far-flung Roman province had knowledge of black henbane’s powerful properties, said Maaike Groot, an archaeozoologist at the Free University of Berlin and a co-author of a paper published in the journal Antiquity last month describing the finding.

The plant was mostly used during Roman times as an ointment for pain relief, although some sources also reference smoking its seeds or adding its leaves to wine.

For the full story see:

Rachel Nuwer. “Psychedelic Stash: Ancient Seeds Courtesy of a Doctor, or a Doctor Feel Good.” The New York Times (Tuesday, April 9, 2024): D2.

(Note: ellipses added.)

(Note: the online version of the story has the date March 21, 2024, and has the title “Long Before Amsterdam’s Coffee Shops, There Were Hallucinogenic Seeds.”)

The academic paper co-authored by Groot and mentioned above is:

Groot, Maaike, Martijn van Haasteren, and Laura I. Kooistra. “Evidence of the Intentional Use of Black Henbane (Hyoscyamus niger) in the Roman Netherlands.” Antiquity 98, no. 398 (2024): 470-85.

During Black Death Only 7 of 21 Regions of Europe Had Catastrophic Decline in Agricultural Activity

(p. D4) In the mid-1300s, a species of bacteria spread by fleas and rats swept across Asia and Europe, causing deadly cases of bubonic plague. The “Black Death” is one of the most notorious pandemics in historical memory, with many experts estimating that it killed roughly 50 million Europeans, the majority of people across the continent.

“The data is sufficiently widespread and numerous to make it likely that the Black Death swept away around 60 percent of Europe’s population,” Ole Benedictow, a Norwegian historian and one of the leading experts on the plague, wrote in 2005. When Dr. Benedictow published “The Complete History of the Black Death” in 2021, he raised that estimate to 65 percent.

But those figures, based on historical documents from the time, greatly overestimate the true toll of the plague, according to a study published on Thursday [Feb. 10, 2022]. By analyzing ancient deposits of pollen as markers of agricultural activity, researchers from Germany found that the Black Death caused a patchwork of destruction. Some regions of Europe did indeed suffer devastating losses, but other regions held stable, and some even boomed.

. . .

Losing half the population would have turned many farms fallow. Without enough herders to tend livestock, pastures would have become overgrown. Shrubs and trees would have taken over, eventually replaced by mature forests.

If the Black Death did indeed cause such a shift, Dr. Izdebski and his colleagues reasoned, they should be able to see it in the species of pollen that survived from the Middle Ages. Every year, plants release vast amounts of pollen into the air, and some of it ends up on the bottom of lakes and wetlands. Buried in the mud, the grains can survive sometimes for centuries.

To see what pollen had to say about the Black Death, Dr. Izdebski and his colleagues picked out 261 sites across Europe — from Ireland and Spain in the west to Greece and Lithuania in the east — that held grains preserved from around 1250 to 1450.

In some regions, such as Greece and central Italy, the pollen told a story of devastation. Pollen from crops like wheat dwindled. Dandelions and other flowers in pastureland faded. Fast-growing trees like birch appeared, followed by slow-growing ones like oaks.

But that was hardly the rule across Europe. In fact, just seven out of 21 regions the researchers studied underwent a catastrophic shift. In other places, the pollen registered little change at all.

. . .

Monica Green, an independent historian based in Phoenix, speculated that the Black Death might have been caused by two strains of the bacteria Yersinia pestis, which could have caused different levels of devastation. Yersinia DNA collected from medieval skeletons hints at this possibility, she said.

In their study, Dr. Izdebski and his colleagues did not examine that possibility, but they did consider a number of other factors, including the climate and density of populations in different parts of Europe. But none accounted for the pattern they found.

“There is no simple explanation behind that, or even a combination of simple explanations,” Dr. Izdebski said.

. . .

“What we show is that there are a number of factors, and it’s not easy to predict from the beginning which factors will matter,” he said, referring to how viruses can spread. “You cannot assume one mechanism to work everywhere the same way.”

For the full essay see:

Carl Zimmer. “Questioning the Toll Of a 1300s Pandemic.” The New York Times (Tuesday, February 15, 2022 [sic]): D4.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the essay was updated Feb. 15, 2022 [sic], and has the title “Did the ‘Black Death’ Really Kill Half of Europe? New Research Says No.”)

The book cited above as over-estimating the death toll of the Black Death is:

Benedictow, Ole J. The Complete History of the Black Death. Martlesham, UK: Boydell Press, 2021.

The academic article co-authored by Izdebski and mentioned above is:

Izdebski, A., P. Guzowski, R. Poniat, L. Masci, J. Palli, C. Vignola, M. Bauch, C. Cocozza, R. Fernandes, F. C. Ljungqvist, T. Newfield, A. Seim, D. Abel-Schaad, F. Alba-Sánchez, L. Björkman, A. Brauer, A. Brown, S. Czerwiński, A. Ejarque, M. Fiłoc, A. Florenzano, E. D. Fredh, R. Fyfe, N. Jasiunas, P. Kołaczek, K. Kouli, R. Kozáková, M. Kupryjanowicz, P. Lagerås, M. Lamentowicz, M. Lindbladh, J. A. López-Sáez, R. Luelmo-Lautenschlaeger, K. Marcisz, F. Mazier, S. Mensing, A. M. Mercuri, K. Milecka, Y. Miras, A. M. Noryśkiewicz, E. Novenko, M. Obremska, S. Panajiotidis, M. L. Papadopoulou, A. Pędziszewska, S. Pérez-Díaz, G. Piovesan, A. Pluskowski, P. Pokorny, A. Poska, T. Reitalu, M. Rösch, L. Sadori, C. Sá Ferreira, D. Sebag, M. Słowiński, M. Stančikaitė, N. Stivrins, I. Tunno, S. Veski, A. Wacnik, and A. Masi. “Palaeoecological Data Indicates Land-Use Changes across Europe Linked to Spatial Heterogeneity in Mortality During the Black Death Pandemic.” Nature Ecology & Evolution 6, no. 3 (March 2022): 297-306.

Governments Often Deliver “Horrible Ideas Executed Terribly”

(p. A15) After the $320 million floating fiasco ran aground, Ohio Sen. J.D. Vance tweeted: “The Gaza pier is a symbol of the Biden administration. A horrible idea executed terribly.”

. . .

Government is bad for your health. Whose idea was it to pay for gain-of-function research in Wuhan? Remember when the Food and Drug Administration delayed the rollout of Covid tests by, among other things, requiring applications on CD-ROMs? In 2020! The FDA interference, according to a Yale Law Journal 2020 Forum, was “possibly the deadliest regulatory overreach in U.S. history.”

. . .

Between the Covid-19 Economic Injury Disaster Loan, the Paycheck Protection Program and the Federal Pandemic Unemployment Compensation program, the FBI reports almost $300 billion in fraud. It was so easy, tens of thousands reportedly filed applications from jail.

. . .

Why are governments so bad at execution? Accountability and incentives. There are no prices or profits, just elusive cost benefits estimated in simple spreadsheets any first-year investment banker could fudge.

But these public-works projects are well intentioned, right? Hardly. Good luck finding all the hidden agendas, political back scratching and paid-off donors. Or, in the case of student loans, bribes to voters. Getting re-elected is how politicians measure the success of government work vs. private-sector profits.

Those profits from each private-sector project or product provide capital that pays for the next important project. In perpetuity. Profits also provide guidance to markets that fund great ideas and kill off bad ones. It’s Darwinism vs. kleptocracy. Sadly, politicians and industrial policy will always fund dumb things like electric-vehicle chargers, high-speed rail and Neom—horrible ideas executed terribly.

For the full commentary see:

Andy Kessler. “Your Government at Work.” The Wall Street Journal (Monday, June 10, 2024): A15.

(Note: ellipses added.)

(Note: the online version of the commentary has the date June 9, 2024, and has the same title as the print version.)

In “An Entrenched Echo Chamber” the Highly Credentialed Slow Progress Toward an Alzheimer’s Cure

Centralized research funding (often centralized by government agencies) reduces the pluralism of ideas and methods that often lead to breakthrough innovations. The story of Alzheimer’s research, quoted below, is a dramatic case-in-point.

A secondary related lesson from the story quoted below is that Dr. Thambisetty, one of the outsiders struggling to make a difference, is trying to evade the enormous costs of mandated phase 3 clinical trials, by only investigating drugs that already have been approved by the FDA for use against other conditions. With his severely limited funding, and the huge costs of mandated phase 3 clinical trials, this may be a shrewd strategy for Thambisetty, but notice that by following it, he will never explore all the as-yet-unapproved chemicals that might include the best magic bullet against Alzheimer’s.)

(p. A25) What if a preposterous failed treatment for Covid-19 — the arthritis drug hydroxychloroquine — could successfully treat another dreaded disease, Alzheimer’s?

Dr. Madhav Thambisetty, a neurologist at the National Institute on Aging, thinks the drug’s suppression of inflammation, commonly associated with neurodegenerative disorders, might provide surprising benefits for dementia.

It’s an intriguing idea. Unfortunately, we won’t know for quite a while, if ever, whether Dr. Thambisetty is right. That’s because unconventional ideas that do not offer fealty to the dominant approach to study and treat Alzheimer’s — what’s known as the amyloid hypothesis — often find themselves starved for funds and scientific mind share.

Such shortsighted rigidity may have slowed progress toward a cure — a tragedy for a disease projected to affect more than 11 million people in the United States by 2040.

. . .

. . ., in 2006, an animal experiment published in the journal Nature identified a specific type of amyloid protein as the first substance found in brain tissue to directly cause symptoms associated with Alzheimer’s. Top scientists called it a breakthrough that provided a key target for treatments. The paper became one of the most cited in the field, and funds to explore similar proteins skyrocketed.

. . .

In 2022, my investigation in Science showed evidence that the famous 2006 experiment that helped push forward the amyloid hypothesis used falsified data. On June 24 [2024], after most of its authors conceded technical images were doctored, the paper was finally retracted.

. . .

In reporting for my forthcoming book about the disturbing state of play in Alzheimer’s research, I’ve spoken to many scientists pursuing alternatives. Dr. Thambisetty, for example, compares brain tissues from people who died in their 30s or 40s with and without genetic risk factors for Alzheimer’s. He then compares these findings to tissues from deceased Alzheimer’s patients and people who didn’t have the disease. Where changes overlap, drug targets might emerge. Rather than develop new drugs through lab and animal testing, followed by clinical trials that cost vast sums — a process that can take decades — he examines treatments already approved as reasonably safe and effective for other conditions. Patent protections have lapsed for many, making them inexpensive.

Experiments have also begun to test the weight-loss drug semaglutide (sold as Wegovy, among other brands). Researchers hope that results due in 2026 will show that its anti-inflammatory effects — like Dr. Thambisetty’s idea about hydroxychloroquine — slow cognitive decline.

Ruth Itzhaki, a research scientist at the University of Oxford, stirred curiosity in the 1990s when she shared evidence tying Alzheimer’s to herpesvirus — a scourge spread by oral or genital contact and often resulting in painful infections. For years, powerful promoters of the amyloid hypothesis ignored or dismissed the infection hypothesis for Alzheimer’s, effectively rendering it invisible, Dr. Itzhaki said with exasperation. Research suggests that viruses may hide undetected in organs, including the brain, for years, causing symptoms divergent from the original infection.

. . .

Sometimes a disease stems from a single clear-cut origin, such as genetic mutations that cause deadly sickle cell disease. “But very few diseases of aging have just one cause. It’s just not logical,” said Dr. Matthew Schrag, a neurologist at Vanderbilt University Medical Center. Working independently of his university, he discovered the 2006 research image manipulations.

. . .

“There is an entrenched echo chamber that involves a lot of big names,” Dr. Schrag said. “It’s time for the field to move on.”

For the full commentary see:

Charles Piller. “All the Alzheimer’s Research We Didn’t Do.” The New York Times (Friday, July 12, 2024): A25.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the commentary has the date July 7, 2024, and has the same title as the print version. Where there are a couple of small differences in wording, the passages quoted above follow the online version.)

Piller’s paper in Science, mentioned above, is:

Piller, Charles. “Blots on a Field?” Science 377, no. 6604 (July 2022): 358-63.

Piller’s commentary is related to his forthcoming book:

Piller, Charles. Doctored: Fraud, Arrogance, and Tragedy in the Quest to Cure Alzheimer’s. New York: Atria/One Signal Publishers, Forthcoming on February 4, 2025.

Unlike DNA, RNA Has “Catalytic Power”

(p. 8) In the early 1980s, when I was much younger and most of the promise of RNA was still unimagined, I set up my lab at the University of Colorado, Boulder. After two years of false leads and frustration, my research group discovered that the RNA we’d been studying had catalytic power. This means that the RNA could cut and join biochemical bonds all by itself — the sort of activity that had been thought to be the sole purview of protein enzymes. This gave us a tantalizing glimpse at our deepest origins: If RNA could both hold information and orchestrate the assembly of molecules, it was very likely that the first living things to spring out of the primordial ooze were RNA-based organisms.

. . .

RNA discoveries have led to new therapies, such as the use of antisense RNA to help treat children afflicted with the devastating disease spinal muscular atrophy. The mRNA vaccines, which saved millions of lives during the Covid pandemic, are being reformulated to attack other diseases, including some cancers. RNA research may also be helping us rewrite the future; the genetic scissors that give CRISPR its breathtaking power to edit genes are guided to their sites of action by RNAs.

Although most scientists now agree on RNA’s bright promise, we are still only beginning to unlock its potential. Consider, for instance, that some 75 percent of the human genome consists of dark matter that is copied into RNAs of unknown function. While some researchers have dismissed this dark matter as junk or noise, I expect it will be the source of even more exciting breakthroughs.

For the full essay see:

Thomas Cech. “Move Aside, DNA. RNA Has Arrived.” The New York Times, SundayOpinion Section (Sunday, June 2, 2024): 8.

(Note: ellipses added.)

(Note: the online version of the essay has the date May 29, 2024, and has the title “The Long-Overlooked Molecule That Will Define a Generation of Science.”)

The essay quoted above was adapted from the author’s book:

Cech, Thomas R. The Catalyst: RNA and the Quest to Unlock Life’s Deepest Secrets. New York: W. W. Norton & Company, 2024.

A Dollar Spent on Medicaid Yields (at Most) 40 Cents of Value to Recipients

(p. C3) A . . . National Bureau of Economic Research study estimated the value of Medicaid to its recipients at between 20¢ and 40¢ per dollar of expenditure, with the majority of the value going to health-care providers like doctors and hospitals. By comparison, the Earned Income Tax Credit—a cash transfer program designed to enhance the incomes of the working poor—delivers around 90¢ of value to its recipients per dollar of expenditure. Given that more than half of Obamacare’s reduction in the numbers of the uninsured has been from its expansion of Medicaid, this makes the law look more like welfare for the medical-industrial complex than support for the needy.

For the full commentary see:

Daniel P. Kessler. “The Health of Obamacare.” The Wall Street Journal (Saturday, Dec. 12, 2015 [sic]): C3.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date Dec. 11, 2015 [sic], and has the same title as the print version.)

The NBER working paper mentioned above was later published in:

Finkelstein, Amy, Nathaniel Hendren, and Erzo F. P. Luttmer. “The Value of Medicaid: Interpreting Results from the Oregon Health Insurance Experiment.” Journal of Political Economy 127, no. 6 (Dec. 2019): 2836-74.

(Note: my title for this blog entry continues to be supported in the 2019 published version of the earlier NBER working paper.)

Pigeons Can Learn to Accurately Spot Cancerous Breast Cells

(p. C4) . . . researchers at the University of California, Davis, the University of Iowa and Emory University have demonstrated that pigeons are surprisingly good at detecting cancer as well. Using grain as a reward, the scientists managed to train hungry pigeons to reliably spot malignancies in images of human breast cells.

The birds achieved roughly 85% accuracy, which is probably better than beginning medical students, the scientists said, although it doesn’t approach the prowess of seasoned pathologists. On the other hand, the birds’ training only involved 24 slides at four times magnification (and they graduated debt-free). What’s more, when Edward A. Wasserman and his colleagues exploited the “wisdom of flocks” by combining the “votes” of four pigeons on each slide, the birds’ accuracy shot up to an astonishing 99%.

When confronted with mammograms, by contrast, the pigeons were flummoxed. After awhile, they seemed to learn to detect cancer on these images, but when shown new ones, they couldn’t do any better than chance, which implies that they had simply memorized the right calls on the initial images during repeated viewings. By contrast, birds that learned to pick out cancer from tissue samples could carry over their skills to new images.

Why so good with images of actual tissue yet so bad with mammograms? The former consist of breast cells seen under a microscope, while the latter are murkier images of overlapping elements (such as blood vessels) within the breast. Like physicians, pigeons find it easier to make the diagnosis by looking at cells, which is why biopsies are taken.

For the full commentary see:

Daniel Akst. “R&D; Pigeons That Spot Breast Cancer.” The Wall Street Journal (Saturday, Dec. 12, 2015 [sic]): C4.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date Dec. 11, 2015 [sic], and has the title “R&D; The Pigeons That Can Spot Breast Cancer.”)

The research summarized in the passages quoted above, was published in the academic article:

Levenson, Richard M., Elizabeth A. Krupinski, Victor M. Navarro, and Edward A. Wasserman. “Pigeons (Columba Livia) as Trainable Observers of Pathology and Radiology Breast Cancer Images.” PLOS ONE 10, no. 11 (2015): e0141357.