A good science/engineering university library subscribes to hundreds of technical journals and keeps them in stacks going back decades.
Oh, but who has time to go there, find a place to park and then run around the stacks...?
Sometimes, you have to make sacrifices for your career instead of always whining about how things should be made better just for you. The journals charge money because they incur substantial expenses for providing an important service.
I went through that bullshit of trying to get access to university libraries.
First of all (at least in New York City), university libraries aren't open to the public. They charge their own students a $2,000 library fee so they don't let outsiders in for free.
Second, even when I did pull strings to get special accommodations to use a library on a guest basis, it was basically a day's work to look things up in the stacks when everybody else is getting them in 5 minutes online (as I do now with access to some academic databases).
Sometimes you have to find out what's going on in reality before you give sermons accusing people of "whining" when they're raising legitimate questions about what's being done with their tax money.
Your misinformation about journals is addressed here by somebody else.
I feel for her. I've been in the same situation as her and I've made the same arguments. Years ago it was even worse.
That said, I think she's exaggerating the situation somewhat. I think she should have a talk with a good reference librarian in her field.
(I do similar research, not in speech pathology but often in visual pathology, orthopedic handicaps, etc. She may have different needs, but I track down a lot of papers, with varying degrees of success.)
You might want to have access to 100 journals, but nobody reads 100 journals cover to cover. I read a half dozen core journals every week, and I got access to a good database and a few journals through a couple of professional organizations. The New York Public Library has a few good databases online free to its cardholders, and the EBSCO Academic (or whatever they call it) has some good journals too. Every week or so I come across a journal that isn't included, so I email the author, or ask my friends. It used to be easy to get into an academic library, but now that universities are monetizing, it's getting difficult (but not impossible). The public library has all kinds of arrangements for ordering papers from other libraries.
I think I know what Grove is doing. She's reading journal articles, looking at 200 footnotes, and she wants to read the ones that look interesting. I've done it myself. It's the sign (or maybe the vice) of a good scholar.
But there's a lot of redundancy. I used to collect a dozen articles, read them, and they all seemed to be saying about the same thing. A review article in the New England Journal of Medicine is about the same as a review article in The Lancet. If you've read one, you don't have to read the other (or the other six). If you can't read it in Topics in Language Disorders, you can probably read it in another dozen journals.
So (since she's not doing research in an academic institution) she probably doesn't need 100 articles. She needs a professor or librarian or somebody to steer her through the literature and give her a half dozen articles that she should read.
It's also an exaggeration to say that her clients won't get the benefit of the latest research. A practicing clinical speech therapist doesn't have to follow the basic research and theoretical arguments in the academic journals (although it's nice, and it's the sign of a good practitioner). You should be treating people according to consensus statements and guidelines. A lot of the latest stuff turns out to be wrong.
You should find everything you need for clinical practice in a half a dozen core journals and a few professional meetings. If you want to be up to date, you have to take continuing education -- no way out of it. And the people who give continuing education courses can guide you through the literature.
But if she takes the current research that seriously, she should have some academic affiliation, which would also give her library access. Admittedly, some charge exorbitant fees. But some universities used to give free library access to their alumnae, and even if they do charge
I very much doubt that a search warrant for guns prevents the police from taking files that very well might have to do with the purchase/maintenance/use of guns.
Yes, actually, it does. If a warrant says "search and seize guns", and you find something that's not a gun, you don't get to mess with it.
For example, a policeman who stops a motorist for a minor traffic violation and sees a handgun on the back seat may conclude that the driver is unlawfully in possession of the gun, and may enter the car to seize it.
Specific Bacteria That Precede Autoimmune Diabetes Identified: New Potential Avenues for Early Disease Detection and Prevention
Dec. 7, 2011 — A study led by Matej Orei from VTT Technical Research Centre of Finland suggests that autoimmune diabetes is preceded by diminished gut microbial diversity of the Clostridium leptum subgroup, elevated plasma leptin and enhanced glucose-stimulated insulin secretion.
In collaboration with the DIPP-Finnish Type 1 Diabetes and Prediction study, VTT researches have previously found that specific metabolic disturbances precede early -cell autoimmunity markers in children who subsequently progress to type 1 diabetes. However, the question remained what are the environmental causes and tissue-specific mechanisms leading to these disturbances?
Matej Orei from VTT Technical Research Centre of Finland and collaborators Eriika Savontaus from the University of Turku, Samuel Kaski from Aalto University and Mikael Knip from the University of Helsinki set out to address this question, and the results were published on October 27, 2011 in PLoS Computational Biology Journal.
The team carried out a study using non-obese diabetic (NOD) mice that recapitulated the protocol used in the DIPP clinical study, followed up by independent studies in which NOD mice were studied in relation to the risk of diabetes progression. Researchers found that young female NOD mice that later progress to autoimmune diabetes exhibit the same metabolic pattern as prediabetic children. These metabolic changes are accompanied by enhanced glucose-stimulated insulin secretion, upregulation of insulinotropic amino acids in islets, elevated plasma leptin and adiponectin, and diminished gut microbial diversity of the Clostridium leptum subgroup.
The elucidation of early metabolic pathways associated with progression to Type 1 diabetes points to novel avenues for early disease prevention. The ongoing efforts of VTT researchers are focused on the potential of specific bacteria from the C. leptum subgroup to help prevent Type 1 diabetes.
This study was supported by the Finnish Funding Agency for Technology and Innovation Tekes, the Seventh Framework Program of the European Community, and Juvenile Diabetes Research Foundation.
The environmental factors and molecular mechanisms leading to Type 1 diabetes are poorly understood and of great public health interest. The incidence of inflammatory and autoimmune diseases is rising faster than for any other major disease, and these diseases are affecting a wide spectrum of the population. The number of new cases of Type 1 diabetes in European children less than 5 years of age is expected to double between 2005 and 2020.
Journal Reference:
Marko Sysi-Aho, Andrey Ermolov, Peddinti V. Gopalacharyulu, Abhishek Tripathi, Tuulikki Seppänen-Laakso, Johanna Maukonen, Ismo Mattila, Suvi T. Ruohonen, Laura Vähätalo, Laxman Yetukuri, Taina Härkönen, Erno Lindfors, Janne Nikkilä, Jorma Ilonen, Olli Simell, Maria Saarela, Mikael Knip, Samuel Kaski, Eriika Savontaus, Matej Orei. Metabolic Regulation in Progression to Autoimmune Diabetes. PLoS Computational Biology, 2011; 7 (10): e1002257 DOI: 10.1371/journal.pcbi.1002257
That said, it's a mouse study. I always used to say, "Mice, humans, what's the difference? We're all mammals, right?"
Then a researcher at Rockefeller University clued me in. "Humans are not big mice."
As the saying goes, "We've cured cancer in mice a million times."
It's great to model a disease in mice. But the diabetes type I they model in mice might not be the same as type I diabetes in humans. Probably for every 10 mouse studies, 1 holds up in humans. And for every 10 human studies, 1 turns out to be actually useful against the disease.
But hey, this is immunology. When it comes down to what causes a disease like diabetes type I, nobody really knows, so 1 in 100 is pretty good odds.
If you have 100 researchers working on it, you've got a pretty good chance that somebody will get it.
Diabetes type I is an autoimmune disease. You get exposed to a trigger, your immune system goes after the trigger, but it also starts attacking other things. In diabetes type I, it attacks the beta cells of the pancreas, which produce insulin. https://en.wikipedia.org/wiki/Diabetes_Type_I The trigger might be a virus, or it might be something else. Hyöty thinks it's a virus, in fact group B coxsackievirus 1. If he can prove that it is a virus and he's identified it (in humans, not just mice), he'll be doing pretty good.
And if Hyöty can come up with a vaccine that will prevent coxsackievirus infection in humans, we can give it to kids and they'll never get diabetes type I. That will be great. I hope it works.
”We know that this vaccine is effective in mice,” noted Hyöty. ”It is important to test it in people, so that we can be sure that the vaccine prevents diabetes.
That's the important qualification. If he's ready to go to test it in humans, that's pretty good. But he's still got a long way to go. And a lot of vaccines don't make it.
Taking the vaccine through a clinical trial would cost some 700 million euros. Some funding is in place from the United States and from Europe, but more is required.
Oh, give him the money. We've wasted E700 million on a lot of stupider things that you could probably think of.
If this vaccine is promising, then the big pharmaceutical companies will probably spot him E700 million for clinical trials (although that does seem a bit high). If it really does prevent type I diabetes, it should be a successful vaccine.
By attacking America on 9/11, Al Qaeda hoped to lure America into a foolish overreaction that would alienate the West from the Islamic world, weaken America's will, and help spread Al Qaeda's message of extremism and violence.
Place the beginnings of Christianity in current times and you would have the same reaction. Scientology just seems silly because it's so recent and easy to disprove. Hard to argue with the founders of Christianity now...
And the NPR corespondent didn't hold his feet to the fire and ask, "Exactly what makes it unaffordable?"
That's exactly the problem. Of course if he did ask a question like that, the politician wouldn't have given NPR easy quotes any more. And that would mean the correspondent would have to work harder for a story.
Amy Goodman www.democracynow.org would have asked him. It can be done. Listen to her interview with Bill Clinton.
Or listen to Carole Coleman's interview with George W. Bush on Irish TV -- where she actually asked him substantive questions about the war in Iraq.
Exactly. I work in the media (radio), and you'd better believe it. But it doesn't only happen with "rich guys." (Or "gals.)
The classic example is that of a small local newspaper. The largest advertiser's son is arrested for drunk driving. The advertiser calls the paper and says, "please don't run that story." What does the paper do? If it agrees, it has compromised. If it doesn't, though, it loses its largest advertiser and (this example is based on a true story, can't remember the details now) goes out of business.
Classic example is Ms. magazine. Most of their advertising came from cigarettes. They ran stories about every cancer except lung cancer, every women's health problem except lung disease. An ad in Ms. magazine meant that their advertising acceptability department had approved it. Ms. was saying it was acceptable, even fashionable. They helped addict a generation of teenage girls to nicotine, and you can see it in the death rates in women from lung cancer, chronic obstructive pulmonary disease, heart disease, and strokes.
That's the George Seldes formula. If you want good news badly enough, pay for it yourself.
Fortunately Amy Goodman is a very good journalist. There's a reason people go to Harvard for their education. Like a lot of good small news organizations, it's heavily dependent on a single individual.
That's the general rule, but the exceptions are even more interesting. (And the exceptions are the ones that I read.)
Before Rupert Murdoch took it over, the Wall Street Journal was my choice for the best source of general news in the English language. The paper was very profitable and had a wide advertising base, so it wasn't dependent on any single advertiser. They were owned by a family, the Bancrofts, that were quite liberal, hired good journalists to run the paper, and left them alone, except when they had to stand behind them. The conservative editorial page gave them cover for a news department that was actually one of the most liberal in the country. I was struck by their no-sacred-cows coverage of the pharmaceutical industry, automobile safety, mining, and the Reagan-era welfare reforms. They had long, ongoing coverage of people with life-threatening diseases who couldn't afford to get treated in the health care system. One of their reporters in New York profiled a young woman who worked in a news stand near her house, who was blind in one eye, and going blind in the other eye, because she couldn't afford to pay her bills at New York Eye and Ear medical center, and couldn't afford the relatively cheap drugs for glaucoma.
The best account of the Wall Street Journal, I think, was in a couple of articles written by A. Kent Macdougal (in More and in the Monthly Review) after he retired to teach journalism. He said that in all his career, he never heard of pressure from an advertiser or a political favorite of the management or publisher. He was a socialist, and he could write whatever he wanted as long as he followed the formula of balanced, objective journalism with every statement backed up by facts.
Macdougal said that the Journal earned its credibility in the 1950s when they got photos of the next year's GM model cars, which were a big marketing secret. GM said that if the Journal published them, they would cancel all their advertising. The Journal published them, GM cancelled their ads, and when GM finally came back begging to let them advertise again, the Journal took a long time deciding whether to take them.
I think the formula for good news is a lot of money (from whatever source), and good journalists who know how to report, edit and manage news. Ralph Ingersol paid for PM and The Compass. George Seldes used to publish his newsletter In Fact, which published news that nobody else would (and had a network of reporters around the world who sent them stories they couldn't publish in their own newspapers), like racism in the South. In Fact was a model for American newsletters and dissident newspapers that followed, including I.F. Stone's Weekly. Seldes didn't know this until much later, but his main financial backer was a Communist who was getting money to pay for the newsletter from the Soviet Union. Dostoyevsky said, "We all came out from under Gogol's overcoat." Well, we all came out from under Seldes' In Fact.
So that's what it takes -- good journalists, and money with no strings attached, wherever you can get it. Let's see if Omidyar and Greenwald can do it.
"donating a small sum of money to an organization that the federal government considered terrorist in nature." Apparently Mr. Moalin once missed a telephone call from "Aden Hashi Ayrow, the senior al Shabaab leader," which makes it likely that a little more was going on than merely the donation of "a small sum of money." You may recall al Shabaab as the group behind the recent slaughter at the Westgate Mall in Nairobi. So to say "an organization that the federal government considered terrorist in nature" is to omit some rather important background. By any rational definition, al Shabaab is certainly a terror group.
If Moalin clearly knew that his money was going to pay for terrorist attacks, and people were killed as a result, and they can prove it by courtroom standards in a court of law, according to the rules of the Bill of Rights, then they can send him to jail for the rest of his life, and I would convict him if I were on the jury. He deserves as much sympathy as he gave his victims.
But if they have evidence that he wasn't knowingly involved in terror, which they did, then he's entitled to have it, and I want to know what it is before I come to any conclusions. And you should too.
It might be that they had 100 phone calls, all of which seemed to show that he had no intent of getting involved in terrorism, and one ambiguous call, which they interpret to mean that he was involved in terrorism. He's entitled to have the court look at all the evidence. We are too.
It is a hypothesis that collecting more data will find a pattern that will predict heart failure earlier, and that will lead to earlier interventions.
They haven't demonstrated that it works.
In order to demonstrate it, they have to do a controlled trial. They have to use these data collection systems in a group of 5,000 patients, and use the usual methods in another 5,000 similar patients, and see if there's any difference in a meaningful outcome. Do the patients live any longer? Are they any less likely to get strokes?
Sometimes it works, sometimes it doesn't. The New England Journal of Medicine just published a report on the use of a high-tech surgical intervention -- implanting cardiac resynchronizing devices in a new subset of heart failure patients. http://www.nejm.org/doi/full/10.1056/NEJMoa1306687 It turned out the resynchronization patients had more deaths than the control group, and they stopped the study early. You don't know until you've done the randomized, controlled trial. That's the method of science, the experimental method. You take your brilliant ideas and put them to a test.
That's science. Everything else is bullshit.
There was a study of using an electronic medical record in a pediatric intensive care unit. The patients with the EMR had a higher death rate than the control patients. The doctors said that when they needed to write a prescription in a hurry, they would just take out their Rx pad and write it. When they needed to write it with the EMR, they had to sign in, go through screens, and find what they were looking for.
EMR replaced a simple, effective system -- paper and pen -- with a more difficult system. What's the point?
There are systems that actually make it easier to treat patients. As I understand it, the Veterans Affairs and Kaiser Permanente have systems that actually collect useful data. The Scandinavians have great useful databases. http://www.bmj.com/content/347/bmj.f5906 But a lot of the new systems, particularly the ones that are merely being installed because they're required and subsidized under new federal regulations, are driving doctors crazy. They complain that they have to log in, go through screens, fill out checklist after checklist, and wind up with records that go on for hundreds of pages that nobody ever looks at again. Traditionally, on paper, they were forced to write a concise narrative for their colleagues and themselves, of useful information that got to the point and helped them make a decision about what to do next. These poorly-designed EMRs stopped forcing doctors to think. It simply forced them to collect a lot of data. Data isn't information. Useless data is noise.
And maybe most of all, they complain that instead of looking at their patients, they're looking at a computer screen. If you have to tell somebody that he's going to die in 6 months if he doesn't stop smoking, you shouldn't be looking at your computer screen. Maybe there's an element of human communication that computer nerds don't appreciate.
In any computerized records, there's a tradeoff between how much data you collect, and how much time you have to spend entering data. You can spend an extra hour a day just entering more data. Is this pill a tablet or a capsule?
And more important than time, when you write a medical record, you should be filtering information for just the important information. Otherwise you're just adding noise to the record, and making it harder for the humans to spot patterns.
If you want to prevent heart failure, the basic job is to stop smoking, lose weight, and exercise. When patients get outside of certain well-understood parameters, you can give the
For US society as a whole, social mobility is documented to be abysmally low. However, academia in the US is perhaps one exception to that --- places where people are doing the kinds of research likely to win Nobel Prizes are typically not run on the megacorporate model that dominates the rest of US society. Success in research does not generally come from being golfing buddies with some multi-millionaire executive, but from actually being good at what you do.
There have been studies of Nobel laureates, and Science had a News & Comments story on how they became Nobel laureates and what kind of background they came from. Unsurprisingly, they overwhelmingly came from wealthy, privileged families who were already accomplished in science. Arthur Kornberg was a Nobel laureate; his son Roger was also a Nobel laureate.
That just makes sense, and it's not necessarily bad. I had a friend whose father was a professor, and I learned more sitting around their dinner table than I did from his classes.
OTOH, if you come from a socially and economically deprived background, the barriers are overwhelming. http://www.ronsuskind.com/articles/000034.htmlhttp://www.ronsuskind.com/articles/000035.html One of the markers for social mobility is the number of black people I see. I go to medical conferences, and the number of black faces are few and far between. (It seems to be a little better in chemical engineering.)
Scientists would like to believe that they get ahead on merit, for the same reason that billionaires like to believe they got ahead on merit. But having a father who is a scientist is the strongest determinant of whether a son becomes a scientist.
But perhaps the most important of all: the US really does offer anyone a chance to earn their way solely on personal merit. And that's something very precious that's not available in many other countries where "who you know" counts for more than "what you know".
I'll disagree with you on that. There's a lot of economic and sociological literature that says that the U.S. has among the worst social mobility of any country in the world, along with the U.K. A son's income correlates more strongly with his father's income in the U.S. and U.K. than any other developed country. Excuse me for not looking up a citation, but I was particularly impressed by a few articles in Science about that.
This is in contrast, of course, to the myth that we have more opportunity and social mobility in the U.S. There are a few examples like Andrew Carnegie getting off the boat barefoot, but the typical situation is that children follow the family business.
There are many interesting reasons to perpetuate that myth. A lot of Americans like to say, "I made it on my own," but if you probe a little they say, "Yes, my father helped me out, but I made it on my own."
Unfortunately no therapy transacted over the internet or the telephone system can, these days, be said to abide by the confidentiality agreement the therapist is supposed to abide by.
What confidentiality agreement?
When Monica Lewinsky's therapist handed over her therapy notes to Kenneth Starr, that was the end of client-therapist confidentiality in the U.S.
HIPAA explicitly allows therapists to disclose information for law enforcement purposes.
Covered entities may disclose protected health information to law enforcement officials for law enforcement purposes as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests; or to identify or locate a suspect, fugitive, material witness, or missing person. https://en.wikipedia.org/wiki/Hipaa
Slashdot Mirror
A good science/engineering university library subscribes to hundreds of technical journals and keeps them in stacks going back decades.
Oh, but who has time to go there, find a place to park and then run around the stacks...?
Sometimes, you have to make sacrifices for your career instead of always whining about how things should be made better just for you. The journals charge money because they incur substantial expenses for providing an important service.
I went through that bullshit of trying to get access to university libraries.
First of all (at least in New York City), university libraries aren't open to the public. They charge their own students a $2,000 library fee so they don't let outsiders in for free.
Second, even when I did pull strings to get special accommodations to use a library on a guest basis, it was basically a day's work to look things up in the stacks when everybody else is getting them in 5 minutes online (as I do now with access to some academic databases).
Sometimes you have to find out what's going on in reality before you give sermons accusing people of "whining" when they're raising legitimate questions about what's being done with their tax money.
Your misinformation about journals is addressed here by somebody else.
That's right. The journal that Cortney Grove gave as an example, Topics in Language Disorders http://journals.lww.com/topicsinlanguagedisorders/pages/default.aspx , does provide free access to papers funded by NIH, Wellcome Trust and Howard Hughes http://journals.lww.com/topicsinlanguagedisorders/_layouts/oaks.journals/nih.aspx
I feel for her. I've been in the same situation as her and I've made the same arguments. Years ago it was even worse.
That said, I think she's exaggerating the situation somewhat. I think she should have a talk with a good reference librarian in her field.
(I do similar research, not in speech pathology but often in visual pathology, orthopedic handicaps, etc. She may have different needs, but I track down a lot of papers, with varying degrees of success.)
You might want to have access to 100 journals, but nobody reads 100 journals cover to cover. I read a half dozen core journals every week, and I got access to a good database and a few journals through a couple of professional organizations. The New York Public Library has a few good databases online free to its cardholders, and the EBSCO Academic (or whatever they call it) has some good journals too. Every week or so I come across a journal that isn't included, so I email the author, or ask my friends. It used to be easy to get into an academic library, but now that universities are monetizing, it's getting difficult (but not impossible). The public library has all kinds of arrangements for ordering papers from other libraries.
I think I know what Grove is doing. She's reading journal articles, looking at 200 footnotes, and she wants to read the ones that look interesting. I've done it myself. It's the sign (or maybe the vice) of a good scholar.
Just to get an idea of the kind of articles we're talking about, here's one of the free articles in
http://journals.lww.com/topicsinlanguagedisorders/Fulltext/2013/01000/Morphological_Awareness_Intervention_in_School_Age.4.aspx?WT.mc_id=HPxADx20100319xMP
But there's a lot of redundancy. I used to collect a dozen articles, read them, and they all seemed to be saying about the same thing. A review article in the New England Journal of Medicine is about the same as a review article in The Lancet. If you've read one, you don't have to read the other (or the other six). If you can't read it in Topics in Language Disorders, you can probably read it in another dozen journals.
So (since she's not doing research in an academic institution) she probably doesn't need 100 articles. She needs a professor or librarian or somebody to steer her through the literature and give her a half dozen articles that she should read.
It's also an exaggeration to say that her clients won't get the benefit of the latest research. A practicing clinical speech therapist doesn't have to follow the basic research and theoretical arguments in the academic journals (although it's nice, and it's the sign of a good practitioner). You should be treating people according to consensus statements and guidelines. A lot of the latest stuff turns out to be wrong.
You should find everything you need for clinical practice in a half a dozen core journals and a few professional meetings. If you want to be up to date, you have to take continuing education -- no way out of it. And the people who give continuing education courses can guide you through the literature.
But if she takes the current research that seriously, she should have some academic affiliation, which would also give her library access. Admittedly, some charge exorbitant fees. But some universities used to give free library access to their alumnae, and even if they do charge
You know about PubMed, right? http://www.ncbi.nlm.nih.gov/pubmed
How are we, the U.S., different from East Germany?
Easy. The US is using its national intelligence agencies to obtain intelligence on terrorists trying to kill people.
Except when they entrap people who are too stupid to find their way to the bathroom and lead them by the hand into a Hollywood terrorist plot that they never would have come up with on their own. http://www.nytimes.com/2010/06/16/nyregion/16terror.html http://www.theguardian.com/commentisfree/cifamerica/2011/dec/12/how-terrorist-entrapment-ensares-us-all
That's not the way the courts have decided it.
Yes, actually, it does. If a warrant says "search and seize guns", and you find something that's not a gun, you don't get to mess with it.
Unfortunately there is the plain sight doctrine or plain view doctrine. http://www.law.cornell.edu/wex/plain_view_doctrine
I'd rather have banner ads than have 3 or 4 ads at the top that are almost indistinguishable from the search results.
Or maybe it's a bacterium. Here's another one from the DIPP-Finnish Type 1 Diabetes and Prediction study:
http://www.sciencedaily.com/releases/2011/10/111028081949.htm
Specific Bacteria That Precede Autoimmune Diabetes Identified: New Potential Avenues for Early Disease Detection and Prevention
Dec. 7, 2011 — A study led by Matej Orei from VTT Technical Research Centre of Finland suggests that autoimmune diabetes is preceded by diminished gut microbial diversity of the Clostridium leptum subgroup, elevated plasma leptin and enhanced glucose-stimulated insulin secretion.
In collaboration with the DIPP-Finnish Type 1 Diabetes and Prediction study, VTT researches have previously found that specific metabolic disturbances precede early -cell autoimmunity markers in children who subsequently progress to type 1 diabetes. However, the question remained what are the environmental causes and tissue-specific mechanisms leading to these disturbances?
Matej Orei from VTT Technical Research Centre of Finland and collaborators Eriika Savontaus from the University of Turku, Samuel Kaski from Aalto University and Mikael Knip from the University of Helsinki set out to address this question, and the results were published on October 27, 2011 in PLoS Computational Biology Journal.
The team carried out a study using non-obese diabetic (NOD) mice that recapitulated the protocol used in the DIPP clinical study, followed up by independent studies in which NOD mice were studied in relation to the risk of diabetes progression. Researchers found that young female NOD mice that later progress to autoimmune diabetes exhibit the same metabolic pattern as prediabetic children. These metabolic changes are accompanied by enhanced glucose-stimulated insulin secretion, upregulation of insulinotropic amino acids in islets, elevated plasma leptin and adiponectin, and diminished gut microbial diversity of the Clostridium leptum subgroup.
The elucidation of early metabolic pathways associated with progression to Type 1 diabetes points to novel avenues for early disease prevention. The ongoing efforts of VTT researchers are focused on the potential of specific bacteria from the C. leptum subgroup to help prevent Type 1 diabetes.
This study was supported by the Finnish Funding Agency for Technology and Innovation Tekes, the Seventh Framework Program of the European Community, and Juvenile Diabetes Research Foundation.
The environmental factors and molecular mechanisms leading to Type 1 diabetes are poorly understood and of great public health interest. The incidence of inflammatory and autoimmune diseases is rising faster than for any other major disease, and these diseases are affecting a wide spectrum of the population. The number of new cases of Type 1 diabetes in European children less than 5 years of age is expected to double between 2005 and 2020.
Journal Reference:
Marko Sysi-Aho, Andrey Ermolov, Peddinti V. Gopalacharyulu, Abhishek Tripathi, Tuulikki Seppänen-Laakso, Johanna Maukonen, Ismo Mattila, Suvi T. Ruohonen, Laura Vähätalo, Laxman Yetukuri, Taina Härkönen, Erno Lindfors, Janne Nikkilä, Jorma Ilonen, Olli Simell, Maria Saarela, Mikael Knip, Samuel Kaski, Eriika Savontaus, Matej Orei. Metabolic Regulation in Progression to Autoimmune Diabetes. PLoS Computational Biology, 2011; 7 (10): e1002257 DOI: 10.1371/journal.pcbi.1002257
That's an interesting point.
The mouse vaccine doesn't cause diabetes I, so it should be OK.
I assume the vaccine attacks a different part of the virus than the part that is immunologically similar to beta cells.
But it's something to worry about.
it sounds legitimate.
I review stuff like this for a living. This does look like a legitimate, promising study.
The guy has done a lot of research. http://www.ncbi.nlm.nih.gov/pubmed/?term=Hy%C3%B6ty%2C+Heikki%5BAuthor+-+Full%5D
TFA doesn't say what the virus is, but I guess that it's group B coxsackievirus 1. https://en.wikipedia.org/wiki/Coxsackie_B_virus#Diabetes that Hyöty was working on.
That said, it's a mouse study. I always used to say, "Mice, humans, what's the difference? We're all mammals, right?"
Then a researcher at Rockefeller University clued me in. "Humans are not big mice."
As the saying goes, "We've cured cancer in mice a million times."
It's great to model a disease in mice. But the diabetes type I they model in mice might not be the same as type I diabetes in humans. Probably for every 10 mouse studies, 1 holds up in humans. And for every 10 human studies, 1 turns out to be actually useful against the disease.
But hey, this is immunology. When it comes down to what causes a disease like diabetes type I, nobody really knows, so 1 in 100 is pretty good odds.
If you have 100 researchers working on it, you've got a pretty good chance that somebody will get it.
Diabetes type I is an autoimmune disease. You get exposed to a trigger, your immune system goes after the trigger, but it also starts attacking other things. In diabetes type I, it attacks the beta cells of the pancreas, which produce insulin. https://en.wikipedia.org/wiki/Diabetes_Type_I The trigger might be a virus, or it might be something else. Hyöty thinks it's a virus, in fact group B coxsackievirus 1. If he can prove that it is a virus and he's identified it (in humans, not just mice), he'll be doing pretty good.
And if Hyöty can come up with a vaccine that will prevent coxsackievirus infection in humans, we can give it to kids and they'll never get diabetes type I. That will be great. I hope it works.
That's the important qualification. If he's ready to go to test it in humans, that's pretty good. But he's still got a long way to go. And a lot of vaccines don't make it.
Oh, give him the money. We've wasted E700 million on a lot of stupider things that you could probably think of.
If this vaccine is promising, then the big pharmaceutical companies will probably spot him E700 million for clinical trials (although that does seem a bit high). If it really does prevent type I diabetes, it should be a successful vaccine.
So how come I have to take off my shoes to get on a plane in the airport?
By attacking America on 9/11, Al Qaeda hoped to lure America into a foolish overreaction that would alienate the West from the Islamic world, weaken America's will, and help spread Al Qaeda's message of extremism and violence.
Good thing we're too smart to fall for that.
Place the beginnings of Christianity in current times and you would have the same reaction. Scientology just seems silly because it's so recent and easy to disprove. Hard to argue with the founders of Christianity now...
Two wrongs don't make a right.
And the NPR corespondent didn't hold his feet to the fire and ask, "Exactly what makes it unaffordable?"
That's exactly the problem. Of course if he did ask a question like that, the politician wouldn't have given NPR easy quotes any more. And that would mean the correspondent would have to work harder for a story.
Amy Goodman www.democracynow.org would have asked him. It can be done. Listen to her interview with Bill Clinton.
Or listen to Carole Coleman's interview with George W. Bush on Irish TV -- where she actually asked him substantive questions about the war in Iraq.
> .. always bends to business or advertisers.
Exactly. I work in the media (radio), and you'd better believe it. But it doesn't only happen with "rich guys." (Or "gals.)
The classic example is that of a small local newspaper. The largest advertiser's son is arrested for drunk driving. The advertiser calls the paper and says, "please don't run that story." What does the paper do? If it agrees, it has compromised. If it doesn't, though, it loses its largest advertiser and (this example is based on a true story, can't remember the details now) goes out of business.
Classic example is Ms. magazine. Most of their advertising came from cigarettes. They ran stories about every cancer except lung cancer, every women's health problem except lung disease. An ad in Ms. magazine meant that their advertising acceptability department had approved it. Ms. was saying it was acceptable, even fashionable. They helped addict a generation of teenage girls to nicotine, and you can see it in the death rates in women from lung cancer, chronic obstructive pulmonary disease, heart disease, and strokes.
http://www.democracynow.org/
I can't mod that up because I'm commenting.
That's the George Seldes formula. If you want good news badly enough, pay for it yourself.
Fortunately Amy Goodman is a very good journalist. There's a reason people go to Harvard for their education. Like a lot of good small news organizations, it's heavily dependent on a single individual.
This is essentially what we have now and it doesn't work.
Yeah, but it's the best you're going to get.
People tend to read and embrace what they already believe in, and ridicule & disparage what they do not believe in...
That's more the fault of the audience than the news media.
It would be nice if we could teach people to examine the different ideas before they make up their mind. That's what a liberal education used to do.
.. always bends to business or advertisers.
That's the general rule, but the exceptions are even more interesting. (And the exceptions are the ones that I read.)
Before Rupert Murdoch took it over, the Wall Street Journal was my choice for the best source of general news in the English language. The paper was very profitable and had a wide advertising base, so it wasn't dependent on any single advertiser. They were owned by a family, the Bancrofts, that were quite liberal, hired good journalists to run the paper, and left them alone, except when they had to stand behind them. The conservative editorial page gave them cover for a news department that was actually one of the most liberal in the country. I was struck by their no-sacred-cows coverage of the pharmaceutical industry, automobile safety, mining, and the Reagan-era welfare reforms. They had long, ongoing coverage of people with life-threatening diseases who couldn't afford to get treated in the health care system. One of their reporters in New York profiled a young woman who worked in a news stand near her house, who was blind in one eye, and going blind in the other eye, because she couldn't afford to pay her bills at New York Eye and Ear medical center, and couldn't afford the relatively cheap drugs for glaucoma.
The best account of the Wall Street Journal, I think, was in a couple of articles written by A. Kent Macdougal (in More and in the Monthly Review) after he retired to teach journalism. He said that in all his career, he never heard of pressure from an advertiser or a political favorite of the management or publisher. He was a socialist, and he could write whatever he wanted as long as he followed the formula of balanced, objective journalism with every statement backed up by facts.
Macdougal said that the Journal earned its credibility in the 1950s when they got photos of the next year's GM model cars, which were a big marketing secret. GM said that if the Journal published them, they would cancel all their advertising. The Journal published them, GM cancelled their ads, and when GM finally came back begging to let them advertise again, the Journal took a long time deciding whether to take them.
Now that Murdoch took over, he started using his pressure not on behalf of his advertisers, but on behalf of his political ideology http://www.nytimes.com/2009/12/14/business/media/14carr.html I guess he thinks he's Citizen Kane.
I think the formula for good news is a lot of money (from whatever source), and good journalists who know how to report, edit and manage news. Ralph Ingersol paid for PM and The Compass. George Seldes used to publish his newsletter In Fact, which published news that nobody else would (and had a network of reporters around the world who sent them stories they couldn't publish in their own newspapers), like racism in the South. In Fact was a model for American newsletters and dissident newspapers that followed, including I.F. Stone's Weekly. Seldes didn't know this until much later, but his main financial backer was a Communist who was getting money to pay for the newsletter from the Soviet Union. Dostoyevsky said, "We all came out from under Gogol's overcoat." Well, we all came out from under Seldes' In Fact.
So that's what it takes -- good journalists, and money with no strings attached, wherever you can get it. Let's see if Omidyar and Greenwald can do it.
"donating a small sum of money to an organization that the federal government considered terrorist in nature." Apparently Mr. Moalin once missed a telephone call from "Aden Hashi Ayrow, the senior al Shabaab leader," which makes it likely that a little more was going on than merely the donation of "a small sum of money." You may recall al Shabaab as the group behind the recent slaughter at the Westgate Mall in Nairobi. So to say "an organization that the federal government considered terrorist in nature" is to omit some rather important background. By any rational definition, al Shabaab is certainly a terror group.
Well, what's going on? You don't know, and I don't know, because the prosecutors never gave the exculpatory evidence. There's no clear evidence. Everything is inferred. http://www.fbi.gov/sandiego/press-releases/2013/san-diego-jury-convicts-four-somali-immigrants-of-providing-support-to-foreign-terrorists http://www.slate.com/articles/technology/future_tense/2013/09/basaaly_moalin_s_defense_team_takes_on_mass_nsa_telephone_surveillance.html
If Moalin clearly knew that his money was going to pay for terrorist attacks, and people were killed as a result, and they can prove it by courtroom standards in a court of law, according to the rules of the Bill of Rights, then they can send him to jail for the rest of his life, and I would convict him if I were on the jury. He deserves as much sympathy as he gave his victims.
But if they have evidence that he wasn't knowingly involved in terror, which they did, then he's entitled to have it, and I want to know what it is before I come to any conclusions. And you should too.
It might be that they had 100 phone calls, all of which seemed to show that he had no intent of getting involved in terrorism, and one ambiguous call, which they interpret to mean that he was involved in terrorism. He's entitled to have the court look at all the evidence. We are too.
Actually, most of the office systems were originally designed for insurance company billing. Then they tacked on the clinical applications.
Do you have a link to that? I would like to see it.
http://pediatrics.aappublications.org/content/116/6/1506.full
Unexpected Increased Mortality After Implementation of a Commercially Sold Computerized Physician Order Entry System
Pediatrics Vol. 116 No. 6
December 1, 2005
pp. 1506 -1512
doi: 10.1542/peds.2005-1287
It is a hypothesis that collecting more data will find a pattern that will predict heart failure earlier, and that will lead to earlier interventions.
They haven't demonstrated that it works.
In order to demonstrate it, they have to do a controlled trial. They have to use these data collection systems in a group of 5,000 patients, and use the usual methods in another 5,000 similar patients, and see if there's any difference in a meaningful outcome. Do the patients live any longer? Are they any less likely to get strokes?
Sometimes it works, sometimes it doesn't. The New England Journal of Medicine just published a report on the use of a high-tech surgical intervention -- implanting cardiac resynchronizing devices in a new subset of heart failure patients. http://www.nejm.org/doi/full/10.1056/NEJMoa1306687 It turned out the resynchronization patients had more deaths than the control group, and they stopped the study early. You don't know until you've done the randomized, controlled trial. That's the method of science, the experimental method. You take your brilliant ideas and put them to a test.
That's science. Everything else is bullshit.
There was a study of using an electronic medical record in a pediatric intensive care unit. The patients with the EMR had a higher death rate than the control patients. The doctors said that when they needed to write a prescription in a hurry, they would just take out their Rx pad and write it. When they needed to write it with the EMR, they had to sign in, go through screens, and find what they were looking for.
EMR replaced a simple, effective system -- paper and pen -- with a more difficult system. What's the point?
Read what doctors are actually saying about electronic medical records, http://www.kevinmd.com/blog/ http://www.nejm.org/
There are systems that actually make it easier to treat patients. As I understand it, the Veterans Affairs and Kaiser Permanente have systems that actually collect useful data. The Scandinavians have great useful databases. http://www.bmj.com/content/347/bmj.f5906 But a lot of the new systems, particularly the ones that are merely being installed because they're required and subsidized under new federal regulations, are driving doctors crazy. They complain that they have to log in, go through screens, fill out checklist after checklist, and wind up with records that go on for hundreds of pages that nobody ever looks at again. Traditionally, on paper, they were forced to write a concise narrative for their colleagues and themselves, of useful information that got to the point and helped them make a decision about what to do next. These poorly-designed EMRs stopped forcing doctors to think. It simply forced them to collect a lot of data. Data isn't information. Useless data is noise.
And maybe most of all, they complain that instead of looking at their patients, they're looking at a computer screen. If you have to tell somebody that he's going to die in 6 months if he doesn't stop smoking, you shouldn't be looking at your computer screen. Maybe there's an element of human communication that computer nerds don't appreciate.
In any computerized records, there's a tradeoff between how much data you collect, and how much time you have to spend entering data. You can spend an extra hour a day just entering more data. Is this pill a tablet or a capsule?
And more important than time, when you write a medical record, you should be filtering information for just the important information. Otherwise you're just adding noise to the record, and making it harder for the humans to spot patterns.
If you want to prevent heart failure, the basic job is to stop smoking, lose weight, and exercise. When patients get outside of certain well-understood parameters, you can give the
For US society as a whole, social mobility is documented to be abysmally low. However, academia in the US is perhaps one exception to that --- places where people are doing the kinds of research likely to win Nobel Prizes are typically not run on the megacorporate model that dominates the rest of US society. Success in research does not generally come from being golfing buddies with some multi-millionaire executive, but from actually being good at what you do.
There have been studies of Nobel laureates, and Science had a News & Comments story on how they became Nobel laureates and what kind of background they came from. Unsurprisingly, they overwhelmingly came from wealthy, privileged families who were already accomplished in science. Arthur Kornberg was a Nobel laureate; his son Roger was also a Nobel laureate.
That just makes sense, and it's not necessarily bad. I had a friend whose father was a professor, and I learned more sitting around their dinner table than I did from his classes.
OTOH, if you come from a socially and economically deprived background, the barriers are overwhelming. http://www.ronsuskind.com/articles/000034.html http://www.ronsuskind.com/articles/000035.html One of the markers for social mobility is the number of black people I see. I go to medical conferences, and the number of black faces are few and far between. (It seems to be a little better in chemical engineering.)
Scientists would like to believe that they get ahead on merit, for the same reason that billionaires like to believe they got ahead on merit. But having a father who is a scientist is the strongest determinant of whether a son becomes a scientist.
But perhaps the most important of all: the US really does offer anyone a chance to earn their way solely on personal merit. And that's something very precious that's not available in many other countries where "who you know" counts for more than "what you know".
I'll disagree with you on that. There's a lot of economic and sociological literature that says that the U.S. has among the worst social mobility of any country in the world, along with the U.K. A son's income correlates more strongly with his father's income in the U.S. and U.K. than any other developed country. Excuse me for not looking up a citation, but I was particularly impressed by a few articles in Science about that.
This is in contrast, of course, to the myth that we have more opportunity and social mobility in the U.S. There are a few examples like Andrew Carnegie getting off the boat barefoot, but the typical situation is that children follow the family business.
There are many interesting reasons to perpetuate that myth. A lot of Americans like to say, "I made it on my own," but if you probe a little they say, "Yes, my father helped me out, but I made it on my own."
Unfortunately no therapy transacted over the internet or the telephone system can, these days, be said to abide by the confidentiality agreement the therapist is supposed to abide by.
What confidentiality agreement?
When Monica Lewinsky's therapist handed over her therapy notes to Kenneth Starr, that was the end of client-therapist confidentiality in the U.S.
HIPAA explicitly allows therapists to disclose information for law enforcement purposes.
Covered entities may disclose protected health information to law enforcement officials for law enforcement purposes as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests; or to identify or locate a suspect, fugitive, material witness, or missing person. https://en.wikipedia.org/wiki/Hipaa