IAAPHO (I am a pediatric hematologist/oncologist), so take my comments for what they're worth...
TL;DR: This is a big freaking deal.
To address your points, ALL was the first drug that CAR-T treatment was approved for for several reasons. 1) It's common, so easier to do the trials. 2) It has good data to support the use of immunotherapy (see blinatumumab, inotuzumab ozogamycin), and this therapy is really just the next step in a long line of improvements in immunotherapy. 3) It's got a good target. Almost all Pre-B ALLs express CD19 and downregulation (the main resistance mechanism for immunotherapy) seems rare (but has been documented in relapsed cases). 4) The cure rate is nowhere near as high as you cite for older children and young adults (currently less than 80% for anyone over 13 years.). THIS is actually where most of the use for CAR-T therapy will come from.
The bigger news is that the TECHNOLOGY for this treatment has been FDA approved. Once you have perfected the cell harvesting/transfecting/culturing/infusing process, it's trivial to plug in a different antigen target into the cassette. And in fact, this is already happening on a large scale. Hop on over to clinicaltrials.gov and search for CAR... We've already got some results from GD2 targeting (neuroblastoma), HER2 targeting (breast cancer and osteosarcoma) and IL-13R2 (glioblastoma multiforme) with promising results. And remember, this is just the first generation of CAR-T therapy to make it to the market. As the technology matures the acceptable uses of it will broaden.
Your zero-sum game argument has been sufficiently debunked below. But suffice to say, this is a true breakthrough technology which will have a huge impact on the field for years to come. But you've gotta start somewhere.
(In bigger news, I think this is the first time in my 18+ years on/. that there's been a pediatric cancer article. That should tell you something...)
Put all these pieces together, and here's what we have: a rise in Chinese share prices in the last year that seemed to be driven more by investor psychology than by anything fundamental
Lately this seems to be how stock markets work.
It has nothing to do with actual value, just the psychotic glee of investors and speculators who envision doubling their money every six months.
The stock market has become separated from reality, with the people running the giant pyramid scheme feeling entitled to skim off the top with high-frequency trading.
In the long term, the assumptions used in the stock market seem to be irrational, unsustainable, and pretty much impossible. And corporations are often overvalued based on valuations which is more than the company will ever earn in the next few centuries.
Stock markets are going to fuck up our economies more than they seem to be helping. Because they stopped having anything to do with fundamentals and sane valuations a VERY long time ago.
The stock market is a reflection of mass delusion and wishful thinking.
Sorry, that's false. The stock market (rather accurately) reflects the earnings and intrinsic values of the underlying companies (at least in the US). Values are a little bit frothy right now as we're 6 years into a bull market, but well within historical norms. The Shiller price:earnings ratio is around 25 right now, with the historical average being around 16-18 depending on your timescale.
http://www.multpl.com/shiller-pe/
Sure, there are plenty of people making money off the stock market and investors do dumb things, but the fundamentals of the stock market haven't changed.
So I guess I still haven't been forced over to the dark side yet, but I went to try it out again to just see if it still sucks as bad as last time. And yup, it does. Completely unreadable, absurd amount of scrolling, ridiculous forced spacing, asinine column widths. Seriously, what's it going to take to make this die?
Any procedure like this, especially in sensitive areas like the brain and spine, are done with 3D MRI topography guidance ("Look ma, no glasses!"). Look up STEALTH MRI if you're interested. You basically take high res MRIs with multiple markers placed on the surface of the subjects' skin for reference, then the computer does some fancy math and says "Put needle here, go this deep, then stop".
Quit the radiation fear mongering. And yes, IAAMD.
Not quite. To put this into Slashdot friendly car analogy form, the pacemaker is more like a spark plug. It just starts off the reaction (myocardial contraction), much like the spark plug gets the piston moving, but it ain't doing the moving itself. You need an external fuel source (i.e. gasoline or oxygen/ATP) to do any real work. So yes, it's totally feasible to power a pacemaker by the blood it pumps, b/c it's not a closed circuit. Now an artificial heart would be a different matter, but I digress.
That is incorrect. The money is not "donated". There is a VAERS tax assessed on every single vaccine administered in the country. You can argue the definition of "tax" on this one, but it is a fee required by the government, so that's a tax to me. This cost is passed on to the patient/insurance company/Medicaid. I can assure you the pharma companies aren't taking it out of their bottom line. (IAAPediatrician, btw, if that adds any validity to my post).
It probably helps that you get a subscription to ESPN The Magazine with a subscription to their Insider section (or vice versa). It all goes back to added value.
I'm no fanboi, but seriously, how many people don't use a case for their iPhone? Probably 50% of my friends own one, and I can't think of a single one who goes "naked". This is a non-issue.
Because government funded information belongs to the people (sorry, I'm too lazy to format it):
Introduction
Autism spectrum disorders (ASD) represent a series of related highly complex socio-psychological and neurodevelopmental problems with associated metabolic and gastrointestinal abnormalities of poorly defined etiology. ASD typically develop during the first 3 years of life and are characterized by a myriad of deficits in language/communication skills, social detachment as well as repetitive and stereotypic behaviors.(1, 2) The etiopathology of ASD is multifactorial and has been linked to genetic abnormalities(3, 4) and inborn errors of metabolism but there are many postulated, largely ill-defined, triggers including infectious agents and environmental toxins.(5) Autism has been shown to have strong associations with various metabolic abnormalities, immunological function and gastrointestinal disturbances, although their mechanistic significance is unknown.(5-8)
In addition to the panel of neurodevelopmental problems associated with ASD, a range of gastrointestinal disorders have been reported, and recent studies have found that the condition is associated with abnormal gut microbiota.(9) There is also the possibility of previously unrecognized etiologic connections between microbiome disorder and childhood developmental problems, given the importance of the microbiome in mammalian metabolism, for example, bile acid metabolism.(10) Individuals with ASD are commonly exposed to repeated courses of multiple antibiotic therapies and this may contribute to the complex relationships between gastrointestinal dysbiosis and ASD by altering the composition or stability of their microbiota.(11-13) Abnormal sulfur metabolism has also been shown to typify individuals with ASD.(14) Waring et al. showed that individuals with autism have lower levels of plasma sulfate but considerably elevated levels of urinary sulfate, as compared to non-autistic individuals. These data suggest that autistic individuals may have impaired detoxification potential involving sulfation, as evidenced by their inability to sulfate the widely used drug acetaminophen.(14)
The prevalence of autism has increased from 4 in 10000 children before 1980(2, 15) to 99 in 10000 in 2009 in the United Kingdom(15) and 53 in 10000 in 2006 in the United States(16) alone, but this varies regionally and with ethnicity, and also some geographically localized areas have much higher incidences of ASD.(17) However, it is not clear whether the global increase is due to higher prevalence of the disorder, and/or improved early detection/diagnosis. Current diagnosis of ASD is subjective and depends on observations of a cluster of behaviors and fulfillment of multiple criteria set out in the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV-TR)(18) by a trained clinician. At present, there are no reliable biochemical- or genetic-screening tests for the disorder, and in some cases, particularly in late onset autism, childhood development can switch from being normal to showing a delay in acquisition of new skills, thus adding to the difficulty for diagnosing ASD. Thus, there is a pressing need for new diagnostic tools for ASD that are both sensitive and reliable, since early diagnosis can lead to timely interventions and optimized clinical management.
Metabonomic approaches offer the possibility of measuring metabolic end points (metabolic profiles) that are determined by genetic and environmental factors.(19, 20) The application of high throughput metabolic profiling methods using high resolution analytical platforms (nuclear magnetic resonance (NMR) spectroscopy and/or mass spectrometry (MS)) with subsequent multivariate statistical analyses now provides a well-established strategy for differential metabolic pathway profiling and disease diagnosis.(10, 20-22) Here we apply a metabolic profiling approach to capture the global biochemical signature of autistic individuals using NMR spectroscopy with multivariate statistical modeling to characterize indiv
Really? Insightful? Since the side effects of a completely novel class of drug "don't appear to significantly increase mortality" in mice, you would advocate completely skipping the Phase I (Human safety and pharmacokinetics) and phase II (Does it work at all in humans?) part of the tried and true drug trials? You, sir, are an idiot (or a lawyer, but I repeat myself).
Not so. My first three computers (circa 1992, 95, and 98) were all Gateways and all excellent machines that I had very few problems with. And on the rare occasions where I had problems, their service department was top-notch. You could call and speak to someone who spoke English, was knowledgeable and friendly.
This all changed about 8-20 years ago. I'm not sure if they just lost their way, had to cut too many corners to try and compete with Dell or just got too big for their britches, but it's simply not the same company it was back then. I have a Gateway laptop now that my med school supplies us all with, and it is the most horrid, evil machine I have ever had to deal with. Maybe Acer can turn them around, but I doubt it.
What a loss. He turned on an entire generation of kids to science. Surely I'm not the only one who used to wake up before school at 6 AM to watch Mr. Wizard on Nickelodeon before school? I know I wouldn't be where I am today (M.D.) without Mr. Wizard, and for that, I am eternally grateful.
Violation of ToS =! Theft. Say that over and over again until you get that absurd idea out of your head.
If they want to block access from the toolbar (probably impossible since the processing is done on the end-user's computer), let them go ahead. But the end user is under no obligation to stop using said toolbar.
Re:Makes a little bit of sense. . .
on
Treating the Dead
·
· Score: 1
30:2 is different than 15:1. You do 30 compressions, then two breaths. The whole point being, as I explained above, to maintain cardiac perfusion pressure. And as far as the breaths go, you basically want to give enough to make the chest rise an inch or so. Don't give too much or you'll end up insufflating their stomach and have them possibly vomit (which when you're doing rescue breaths is most unpleasant).
Re:Makes a little bit of sense. . .
on
Treating the Dead
·
· Score: 5, Informative
Wow, way too much pseduoinformation here. I'm ACLS certified, so take this to the bank:
First off, a public service announcement. The current guidelines (which are actually backed up by some pretty good science) are a ratio of 30:2 compressions to breaths. Another important thing to note is that the rate of compressions is 100/min. This is faster than you think and believe it or not is incredibly difficult to do. For the tempo, think "Another One Bites the Dust" (and pardon my irony).
Ok, now on to the reasoning behind the change. ("Well, I could explain it better, but I'd need charts, and graphs, and an easel.") Essentially, the flow of blood through the arteries and into the myocardium requires the creation and maintenance of a pressure head. Research has shown that it takes about 5-7 compressions to create that pressure head, and every time you stop pumping, you lose that pressure. Now only when this pressure head exists is oxygen being delivered to the myocardium, thus any time you stop pumping, you're creating a period of time in which oxygen is not being delivered. And apparently 30:2 was the best ratio for oxygenating blood in the lungs and delivering blood to the heart.
Have to disagree with your premise there... With the impeachment of Clinton and the rumbIlings among some of the more liberal Dems as wanting to impeach Bush, I'd say the balance of power is most decidedly tipped in Congress's favor. As you pointed out with your Bush 41 example, a President without a rubberstamping Congress isn't very effective.
My favorite "get into places where you shouldn't" tool? A stethescope. I'm a med student, and I'm fairly sure I could stroll into Fort Knox if I had a stethescope around my neck. Add in a white coat and it's all over but the crying.
Case in point: In the immediate aftermath of Hurricane Katrina, I was working at the Assembly Center on LSU's campus, where they were triaging patients coming out of New Orleans. There was some serious security here, including National Guard troops with AK-47s at most of the secured entrances. They were checking IDs on everybody that came in, but I was never once questioned. Just act like you belong, look like you're in a hurry, and stroll right on in.
Slashdot Mirror
The bigger news is that the TECHNOLOGY for this treatment has been FDA approved. Once you have perfected the cell harvesting/transfecting/culturing/infusing process, it's trivial to plug in a different antigen target into the cassette. And in fact, this is already happening on a large scale. Hop on over to clinicaltrials.gov and search for CAR... We've already got some results from GD2 targeting (neuroblastoma), HER2 targeting (breast cancer and osteosarcoma) and IL-13R2 (glioblastoma multiforme) with promising results. And remember, this is just the first generation of CAR-T therapy to make it to the market. As the technology matures the acceptable uses of it will broaden.
Your zero-sum game argument has been sufficiently debunked below. But suffice to say, this is a true breakthrough technology which will have a huge impact on the field for years to come. But you've gotta start somewhere.
(In bigger news, I think this is the first time in my 18+ years on /. that there's been a pediatric cancer article. That should tell you something...)
Lately this seems to be how stock markets work.
It has nothing to do with actual value, just the psychotic glee of investors and speculators who envision doubling their money every six months.
The stock market has become separated from reality, with the people running the giant pyramid scheme feeling entitled to skim off the top with high-frequency trading.
In the long term, the assumptions used in the stock market seem to be irrational, unsustainable, and pretty much impossible. And corporations are often overvalued based on valuations which is more than the company will ever earn in the next few centuries.
Stock markets are going to fuck up our economies more than they seem to be helping. Because they stopped having anything to do with fundamentals and sane valuations a VERY long time ago.
The stock market is a reflection of mass delusion and wishful thinking.
Sorry, that's false. The stock market (rather accurately) reflects the earnings and intrinsic values of the underlying companies (at least in the US). Values are a little bit frothy right now as we're 6 years into a bull market, but well within historical norms. The Shiller price:earnings ratio is around 25 right now, with the historical average being around 16-18 depending on your timescale.
http://www.multpl.com/shiller-pe/
Sure, there are plenty of people making money off the stock market and investors do dumb things, but the fundamentals of the stock market haven't changed.
Yet if you point this fact out, you lose a presidential election...
I'm confused. Can someone translate this into a car analogy for me?
So I guess I still haven't been forced over to the dark side yet, but I went to try it out again to just see if it still sucks as bad as last time. And yup, it does. Completely unreadable, absurd amount of scrolling, ridiculous forced spacing, asinine column widths. Seriously, what's it going to take to make this die?
Any procedure like this, especially in sensitive areas like the brain and spine, are done with 3D MRI topography guidance ("Look ma, no glasses!"). Look up STEALTH MRI if you're interested. You basically take high res MRIs with multiple markers placed on the surface of the subjects' skin for reference, then the computer does some fancy math and says "Put needle here, go this deep, then stop".
Quit the radiation fear mongering. And yes, IAAMD.
Not quite. To put this into Slashdot friendly car analogy form, the pacemaker is more like a spark plug. It just starts off the reaction (myocardial contraction), much like the spark plug gets the piston moving, but it ain't doing the moving itself. You need an external fuel source (i.e. gasoline or oxygen/ATP) to do any real work. So yes, it's totally feasible to power a pacemaker by the blood it pumps, b/c it's not a closed circuit. Now an artificial heart would be a different matter, but I digress.
You actually think they'll learn a lesson? That's cute.
That is incorrect. The money is not "donated". There is a VAERS tax assessed on every single vaccine administered in the country. You can argue the definition of "tax" on this one, but it is a fee required by the government, so that's a tax to me. This cost is passed on to the patient/insurance company/Medicaid. I can assure you the pharma companies aren't taking it out of their bottom line. (IAAPediatrician, btw, if that adds any validity to my post).
It probably helps that you get a subscription to ESPN The Magazine with a subscription to their Insider section (or vice versa). It all goes back to added value.
I'm no fanboi, but seriously, how many people don't use a case for their iPhone? Probably 50% of my friends own one, and I can't think of a single one who goes "naked". This is a non-issue.
Because government funded information belongs to the people (sorry, I'm too lazy to format it): Introduction Autism spectrum disorders (ASD) represent a series of related highly complex socio-psychological and neurodevelopmental problems with associated metabolic and gastrointestinal abnormalities of poorly defined etiology. ASD typically develop during the first 3 years of life and are characterized by a myriad of deficits in language/communication skills, social detachment as well as repetitive and stereotypic behaviors.(1, 2) The etiopathology of ASD is multifactorial and has been linked to genetic abnormalities(3, 4) and inborn errors of metabolism but there are many postulated, largely ill-defined, triggers including infectious agents and environmental toxins.(5) Autism has been shown to have strong associations with various metabolic abnormalities, immunological function and gastrointestinal disturbances, although their mechanistic significance is unknown.(5-8) In addition to the panel of neurodevelopmental problems associated with ASD, a range of gastrointestinal disorders have been reported, and recent studies have found that the condition is associated with abnormal gut microbiota.(9) There is also the possibility of previously unrecognized etiologic connections between microbiome disorder and childhood developmental problems, given the importance of the microbiome in mammalian metabolism, for example, bile acid metabolism.(10) Individuals with ASD are commonly exposed to repeated courses of multiple antibiotic therapies and this may contribute to the complex relationships between gastrointestinal dysbiosis and ASD by altering the composition or stability of their microbiota.(11-13) Abnormal sulfur metabolism has also been shown to typify individuals with ASD.(14) Waring et al. showed that individuals with autism have lower levels of plasma sulfate but considerably elevated levels of urinary sulfate, as compared to non-autistic individuals. These data suggest that autistic individuals may have impaired detoxification potential involving sulfation, as evidenced by their inability to sulfate the widely used drug acetaminophen.(14) The prevalence of autism has increased from 4 in 10000 children before 1980(2, 15) to 99 in 10000 in 2009 in the United Kingdom(15) and 53 in 10000 in 2006 in the United States(16) alone, but this varies regionally and with ethnicity, and also some geographically localized areas have much higher incidences of ASD.(17) However, it is not clear whether the global increase is due to higher prevalence of the disorder, and/or improved early detection/diagnosis. Current diagnosis of ASD is subjective and depends on observations of a cluster of behaviors and fulfillment of multiple criteria set out in the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV-TR)(18) by a trained clinician. At present, there are no reliable biochemical- or genetic-screening tests for the disorder, and in some cases, particularly in late onset autism, childhood development can switch from being normal to showing a delay in acquisition of new skills, thus adding to the difficulty for diagnosing ASD. Thus, there is a pressing need for new diagnostic tools for ASD that are both sensitive and reliable, since early diagnosis can lead to timely interventions and optimized clinical management. Metabonomic approaches offer the possibility of measuring metabolic end points (metabolic profiles) that are determined by genetic and environmental factors.(19, 20) The application of high throughput metabolic profiling methods using high resolution analytical platforms (nuclear magnetic resonance (NMR) spectroscopy and/or mass spectrometry (MS)) with subsequent multivariate statistical analyses now provides a well-established strategy for differential metabolic pathway profiling and disease diagnosis.(10, 20-22) Here we apply a metabolic profiling approach to capture the global biochemical signature of autistic individuals using NMR spectroscopy with multivariate statistical modeling to characterize indiv
Really? Insightful? Since the side effects of a completely novel class of drug "don't appear to significantly increase mortality" in mice, you would advocate completely skipping the Phase I (Human safety and pharmacokinetics) and phase II (Does it work at all in humans?) part of the tried and true drug trials? You, sir, are an idiot (or a lawyer, but I repeat myself).
Any sufficiently advanced malice is indistinguishable from stupidity.
Yeah, but you do win Nobel prizes and little things like that...
Kudos to you and the parent. Funniest /. comment I've read in years.
This all changed about 8-20 years ago. I'm not sure if they just lost their way, had to cut too many corners to try and compete with Dell or just got too big for their britches, but it's simply not the same company it was back then. I have a Gateway laptop now that my med school supplies us all with, and it is the most horrid, evil machine I have ever had to deal with. Maybe Acer can turn them around, but I doubt it.
What a loss. He turned on an entire generation of kids to science. Surely I'm not the only one who used to wake up before school at 6 AM to watch Mr. Wizard on Nickelodeon before school? I know I wouldn't be where I am today (M.D.) without Mr. Wizard, and for that, I am eternally grateful.
Violation of ToS =! Theft. Say that over and over again until you get that absurd idea out of your head.
If they want to block access from the toolbar (probably impossible since the processing is done on the end-user's computer), let them go ahead. But the end user is under no obligation to stop using said toolbar.
30:2 is different than 15:1. You do 30 compressions, then two breaths. The whole point being, as I explained above, to maintain cardiac perfusion pressure. And as far as the breaths go, you basically want to give enough to make the chest rise an inch or so. Don't give too much or you'll end up insufflating their stomach and have them possibly vomit (which when you're doing rescue breaths is most unpleasant).
First off, a public service announcement. The current guidelines (which are actually backed up by some pretty good science) are a ratio of 30:2 compressions to breaths. Another important thing to note is that the rate of compressions is 100/min. This is faster than you think and believe it or not is incredibly difficult to do. For the tempo, think "Another One Bites the Dust" (and pardon my irony).
Ok, now on to the reasoning behind the change. ("Well, I could explain it better, but I'd need charts, and graphs, and an easel.") Essentially, the flow of blood through the arteries and into the myocardium requires the creation and maintenance of a pressure head. Research has shown that it takes about 5-7 compressions to create that pressure head, and every time you stop pumping, you lose that pressure. Now only when this pressure head exists is oxygen being delivered to the myocardium, thus any time you stop pumping, you're creating a period of time in which oxygen is not being delivered. And apparently 30:2 was the best ratio for oxygenating blood in the lungs and delivering blood to the heart.
Here's the official guidelines and all the studies behind them in all their linky goodness. http://circ.ahajournals.org/content/vol112/24_supp l/
For the love of God, please mod parent down...
Have to disagree with your premise there... With the impeachment of Clinton and the rumbIlings among some of the more liberal Dems as wanting to impeach Bush, I'd say the balance of power is most decidedly tipped in Congress's favor. As you pointed out with your Bush 41 example, a President without a rubberstamping Congress isn't very effective.
Not sure how relevant that particular line of thinking is anymore... http://news.bbc.co.uk/2/hi/middle_east/3979887.stm
Case in point: In the immediate aftermath of Hurricane Katrina, I was working at the Assembly Center on LSU's campus, where they were triaging patients coming out of New Orleans. There was some serious security here, including National Guard troops with AK-47s at most of the secured entrances. They were checking IDs on everybody that came in, but I was never once questioned. Just act like you belong, look like you're in a hurry, and stroll right on in.