Gulf War Syndrome Revisited How Seriously is Our Government Looking Out for the Troops?

As reported on Medscape News, researchers have found evidence of an abnormality in the functioning of the autonomic nervous system in a small group of patients with GWS. The abstract of the article -- Blunted circadian variation in autonomic regulation of sinus node function in veterans with Gulf War syndrome -- is here, and the news report about the research is here. They studied 22 veterans with GWS and 19 matched controls. They found a loss of normal functioning in the parasympathetic branch of the autonomic nervous system.

The autonomic nervous system (ANS) is a subset of the nervous system. It consists of two parts: the sympathetic and the parasympathetic systems. The ANS connects the brain with major organs, and is involved in regulation of such functions as heart rate and blood pressure.

In the veterans with GWS, there was a loss of functioning in the parasympathetic system. Normally, the heart rate slows during sleep. This did not happen in the GWS group. The findings are similar to that which is seen in early diabetic neuropathy.

Unfortunately, the findings do not suggest any particular course of treatment, nor do they provide much indication of the possible causes of GWS. The study is notable for two reasons, though. One is the very low P values recorded for the differences seen between the patients and the controls. This indicates that the investigators are on to something real, even if the significance is not entirely clear at this point. Second, the study shows that scientists are taking the issue seriously. That was not the case early on. If fact, as this Congressional record shows, the UK pursued this problem more aggressively that the US did. The UK testimony, given by one of the authors of the study on autonomic dysregulation, is here. This document provides a synopsis of the research on GWS, for the technically inclined. The author, Robert W. Haley, M.D., is less than pleased with the efforts of the US government:

Right now I am encouraged at the progress that has been made in understanding the new type of brain cell damage that appears to underlie Gulf War veterans’ symptoms. Up to a year or so ago, anyone who would give credence to anything other than stress as a cause of the problem was a pariah, but we are now seeing a broad change in viewpoint in the scientific community. Just last month I attended an NIH-sponsored meeting on responding to chemical terrorism, and the scientists in attendance were discussing the chronic brain effects of sarin nerve gas as a given. So the good news is that the bureaucratic resistance to research toward a biological explanation has finally been overcome, and the scientific world is poised to jump in and study the problem broadly. The bad news is that, just as clear directions are emerging for productive research to begin, funding for research on this problem has dried up.

I'm not quite sure what to make of his last point. One would think that, if the government is serious about its commitment to the health of our soldiers, the funding would not be cut. It seems especially surprising if there is evidence that the same research would have applications in the understanding of the effects of chemical weapons. Sure, if there is a chemical attack in the USA, using nerve gas, a lot of people could be killed; the research would not help them, but it could be extremely important to those who survive.

Meddling in peer review?

Members of Congress had a new opportunity to display how readily they will speak out on matters they know nothing about. They are supposed to be finalizing the budget for 2005 -- which start on Friday -- and have not done so. Have you ever wondered why these things take so long? At Biomedcentral, in The Scientist section, we see one of the things that has slowed them down:

Members of the US House of Representatives last week (Sept. 9) approved an amendment to the NIH fiscal year 2005 budget (HR 5006) that would prohibit NIMH from further funding grants "studying the decorations of dorm rooms and college students' Web pages" and "studying what makes for a meaningful day," as Rep. Randy Neugebauer (R-Tex.) characterized the grants last week.

The amendment is largely symbolic because the two grants already have been obligated. [...]

OK, they wrote and passed an amendment that does absolutely nothing. Meanwhile, we are all wondering when they will do something about the 9-11 Commission Report. What is taking so long? Oh, that's a rant tangent. Back to the point. I have to agree, it is not obvious immediately what value the studies will have. But that often is the case. For example, as I was writing this, I grabbed a journal that happened to be laying around. One study in the journal: Functional Magnetic Resonance Imaging of Macaque Monkeys Performing Visually Guided Saccade Tasks. Perhaps a few readers will know what made that study worth funding. Most will not. The fact is, most research is extremely obscure, and much of it seems pointless, taken out of context. In order to understand why it is important, it is necessary to understand what already has been done in the field, what else is being done currently, and how the proposed study will fit in among the rest. That is why we have peer review.

Survey of Health Care Professionals

Medscape, which may be the most popular of the health-care-professional websites, is conducting a poll of its readers regarding recent proposed legislation. 

Poll Results

Recently proposed state and federal legislation would expand the ability of healthcare providers, hospitals, and insurers to refuse to participate in sexual health and reproductive health services by claiming a moral or religious objection. Do you favor or oppose such legislation?
	33% (801)
	66% (1568)

Total Responses: 2369
Poll conducted 22-Sep-2004 - 30-Sep-2004

The results stratified by profession are as follows:  Physicians only: 40% favor, 59% oppose; nurses only: 38% favor, 61% oppose.  Obviously, some people who have registered as other professionals have voted, perhaps pharmacists, physician's assistants, etc. 

The poll was not scientific, obviously, because there is no attempt to survey a representative sample of potential respondents.  Still, it indicates that it is likely that a majority of health care porfessionals oppose the legislation. 

Military Veterans for Peace

There is no group called Military Veterans for Peace. But if there were, they would be voting...with their feet. As mentioned on Martini Republic, Hullabaloo, Moon of Alabama, et. al., many members of the Ready Reserve have not shown up for duty. Looking into this, I found an article on Slate Magazine that this is only one of many things that are not going well for the President of the United States of America. His post-convention bounce is nerfing out, the FBI has an enormous backlog of untranslated surveylance tapes, there is a growing terror campaign against government officials in Iraq, and the insurgency against the US military is growing stronger. Rodger A. Payne's Blog has some more detials on the deteriorating situation in Iraq.

The more I talk, the less I say

Another Slate article shows how the man uses a bizarre kind of logic to mislead the public.

Bush's arguments made the wisdom of cutting taxes unfalsifiable. In good times, tax cuts were affordable. In bad times, they were necessary. Whatever happened proved that tax cuts were good policy. When Congress approved the tax cuts, Bush said they would revive the economy. You'd know that the tax cuts had worked, because more people would be working. Three years later, more people aren't working. But in Bush's view, that, too, proves he was right. If more people aren't working, we just need more tax cuts.

But what about the jobs thing? Haven't we been told that employment is improving? Well, we do get numbers on that from time to time, but it turns out the numbers may not tell the whole truth. On Torgerson's Blog, we see that the conclusion that jobs are being created is a myth. If one looks at the data (observations are gold, after all) we see a different picture:

They [BLS] are claiming that over a million jobs have been created that have not EVER been detected by their actual sample surveys month after month. They make the claim based on a statistical device that has as it's core the assumption that for every job destroyed by a company gone bust or moving out of the country, another like job in the same community and the same industry mysteriously rises from the ashes to take it's place. Blind faith is necessary to believe this, because none of these jobs by definition have actually been detected. To be fair, this was a good assumption in years past when the model's mathematics were worked out. However, there has been no research from BLS or anywhere else that tests the validity of such assumptions during an era where so many jobs are outsourced, downsized or automated out of existence, OR in an era of generally contracting job opportunities.

Richard Torgeson shows what is learned when the assumtion is tested:

A better way would be to look at what the experts were saying the implications of those rosy job creation reports would be to the economy, and see if those predictions came true. Here's a representative comment of what was expected:

"I think this is something that can be sustained," William G. Cheney, chief economist at MFC Global Investment Management, said of the pace of job creation. The figures showed that the once-halting recovery has given way to a self-sustaining expansion, analysts said, as job growth drives up incomes, which fuels more spending, which begets more hiring, he said. "You create that many jobs and people go out and spend the money and it feeds on itself," Cheney said. Washington Post ("248,000 Jobs Added In May -Unemployment Rate Remains Unchanged", 6/5/04)

Yup, that's exactly what would have happened if over a million more people had jobs than was actually the case. So if it did not happen as predicted, that is clear empirical evidence that those jobs weren't really there. And of course, we know what happened since then.

June's rosy headlines gave way to July's gloom. "Job growth disappoints: Economy created just 112,000 jobs in June, less than half of forecasts; unemployment flat at 5.6%."

The day before, international business headlines screamed at US employers: "Outsource or Perish".

That expected retail spending fueled by those jobs also didn't happen: Retail sales suffered a larger than expected fall in June.

All told, there were virtually no economic indicators whatsoever that pointed to those jobs being real. Instead, we were told it was an unexpected "soft spot" in a strengthening economy. Right.

This all illustrates what I said yesterday, about how easily people are led to believe falsehoods, when they are shown the conclusions they want to believe, and don't look at the evidence for themselves.

Cyanotic and Cynical

The post for today is basically a rant. I start out with some loose associations about words, discuss an article about politics, show how the article illustrates some basic and annoying aspects of human psychology, and complain. Because it is long, I put it up at The Rest of the Story.

Hypocrisy 101

Nobody can make sure that 100% of his or her statements are mutually consistent. In fact, if you say a lot, you will contradict yourself from time to time. And if the news media watch you and report on everything you do and say, some of those inconsistencies will be reported.

That is why it is so important to be careful when making public negative judgments of others. You end up looking foolish when such things are pointed out.

Recently, the leader of a certian nation went on record with criticisms of his main political opponent. He accused the opponent of making unclear statements, undermining the authority of an allied leader. This caused indigant remarks to pop up around the Blogosphere like mushrooms in horse dung after a rainstorm.

People criticized the opponent (lets call him, say, John), some even going so far as to call his remarks treason. Yet, at the same time, we see this:

Commentary: Rumsfield's field day : The current confusion over the fate of election in Iraq
Posted on: September 24, 2004

By Jyoti Omi Chowdhury : If the fog of war has not confused the ordinary Iraqis yet, the current US administration's squabble about the fate of the Iraqi election is sure to put the confusion right back on the Iraqis and the world public.

In one of the most extraordinary and strange admission[s] to US failure in Iraq, Donald Rumsfield concluded that voting might not be possible in certain parts of war torn country due to the level of violence.

And then to make things more confusing for the general public, his deputy Richard Armitage, told reporters that the intial plan to hold elections in every part of Iraq is going to go ahead. So evidently, it is the tail that is wagging the dog.

[...] And according to Allawi and Bush, the only reason Iraq is seen as a quagmire because the “media” is reporting negative stories about the ongoing struggle of power.

Though it may come across as a flimsy excuse at best to shift the blame to the media, it also points out that this visit of the Iraqi prime minister, who has been hand picked by the current administration, is nothing but a election stunt, and a rather daft attempt to convince the general public that Iraq is somehow in a better state.

So how will this contradiction of position of Rumsfield and the administration about the current state of Iraq affect the election is yet to be seen.

But it is safe to say, the administration has followed a policy of “if you can’t win them, confuse them.” And this may be another ploy of an administration to do exactly just that.

So the bush administration is perhaps hoping that this policy of “hide and seek” may confuse the Americans enough to the extent that they might suffer denial and believe even with all the internal conflicts, suicide bombings, hostage takings, lack of funds for infrastructure, Iraq is somehow a better place, waiting for an election, just like America.

© The Bangladesh Journal

Presumably, English is a second language for the author, as the acticle is full of grammatical errors. Still, the author makes some good points. Blaming the media is a flimsy excuse. I don't agree that the visit of Allawi is "nothing but an election stunt," although certainly it was done with the election in mind.

The thing is, if it was treason for John to be critical of the situation in Iraq, is it not also treason for Rumsfeld to do so?

Health Care Policy as a Political Factor

The New England Journal of Medicine has published a Special Article, that they have posted on their website, with free access.  Normally, they provide free access only for items more than six months old; sometimes, though, the editors decide something is a great importance or interest to the public, and put it up for free. 

The Special Article, Health Care in the 2004 Presidential Election, provides the results of several national opinion surveys:

Results Voters ranked health care as the fourth most important issue in deciding their vote for president in 2004. The top health care issues for voters were the costs of health care and prescription drugs, prescription-drug benefits for the elderly, the uninsured, and Medicare. Bioterrorism and abortion were also important issues for voters. The voters most concerned about health care were older persons and those who identified themselves as Democrats. Four issues less salient to voters were racial disparities in health care, aid to developing countries to prevent and treat human immunodeficiency virus infection and the acquired immunodeficiency syndrome, medical malpractice, and the quality of care.

Conclusions Although health care ranks higher in importance among voters than most other domestic issues, it is only fourth in importance in deciding their vote for president. The health care issues of greatest concern are the affordability of health care and health care insurance. Health care issues do not appear likely to play a decisive role in the presidential election in 2004, but they might make a difference in some swing states if the race is close.
Note that people ranked the cost of health care as a greater concern than the quality of care.  I suspect that has to do with the context of the questions.  Probably most people think the quality is more important than the cost, but realize that the President can't do much about the quality, but can do something about the cost. 

The authors reviewed some background information pertaining to the current election situation:

The environment of the presidential election campaign of 2004 is very different from that of the past several elections. Since the election in 2000, the United States has experienced its first attack on American soil since Pearl Harbor, has participated in war in Afghanistan and Iraq, and was the object of an unresolved bioterrorist attack in which several persons in the nation's capital were infected with anthrax. Moreover, in 2000 there was a large federal budget surplus, whereas in 2004 the federal budget is in deficit.

In the field of health care, Congress enacted legislation in 2003 to provide a prescription-drug benefit for people receiving Medicare benefits that accounted for the largest expansion of the program since it began in 1965. Yet since 2000, the number of Americans without health insurance has risen from 39.8 million to 45.0 million.¹
---
¹Census Bureau. Income, poverty, and health insurance coverage in the United States: 2003. Table C-2: health insurance coverage by age: 1987 to 2003. (Accessed August 27, 2004, at http://www.census.gov/prod/2004pubs/p60-226.pdf.)
The three issues that people ranked as being more important than health care were: the economy, the wat in Iraq, and the campaign against terrorism.  The first two make sense, of course, but the third reflects a fundamental misunderstanding of the issues.  The accessibility of the health care system is an issue that is much more likely to have an impact on pepole's lives than the antiterrorism campaign.  We cannot predict the future, but we can say with confidence that inadequate access to health care is likely to have a much greater negative impact on public health, compared to the risk posed by terrorist attacks.  In my opinion, the public misunderstanding of the relative risks is a result of a failure of the leadership and the news media in this country to provide a realistic perspective of relative risks. 

I suppose that the leadership can be forgiven, to some extent, since it is in their best interest to have public concern focused on terrorism (instead of health care), but the news media should be able to retain and portray a rational understanding of the issues.  It is inexcusably short-sighted of them to focus on terrorism instead of health care.  Sure, terrorism makes for mmore compelling headlines, and such reporting no doubt boosts readershiip and viewership in the short run.  But in the long run, public health is what will determine how many people are alive to buy tomorrow's newspapers.  Politicians do not care how many  voters their are; their only concern is with the percentage  of voters who are on their side. 

Tangled Bank #12

The twelfth edition of Tangled Bank has been posted at the left-leaning Lean Left. Conservatives need not fear; there is really no political commentary, except for my own McDonald's-bland innocuous two cents' worth.

Unfortunately, when I went to read the articles, I made an error. I had set up a reverse talk-like-a-pirate translator for Pharyngula, since some of the more recent posts there were written in pirate-talk.

The error I made occurred when I accidentally changed the setting to talk-like-a-politician, and read his Tangled Bank submission. This was the result:

Ah, a faceful of poisonous spines—this President is getting more interesting already. It always seems that the closer you look at something in biology, the cooler it gets. Here are some closeups of the heads of conservatives:

These guys have a lot of potential to be great horror movie stars.

There’s another reason that the conservatives are fascinating, though: their financial relationships are very, very murky. All the evidence suggests that their lineage split off from that of more familiar animals long ago, well before the Cambrian, at about the time of the Union/Confederation split. They aren’t just monsters, they are primeval monsters, weird relics of an ancient world. Way cool!

Liberals, as they develop, turn the blastopore into their mouth opening. The term “democrat” means “people's mouth”, and refers to the fact that they use the first embryonic opening as the mouth opening. Neoconservatives instead use that first opening as their anus, and subsequently have to speak exclusively out of their anus (hence the name, which means “potty mouth”). The early body plans of Democrats and Republicans are both backwards and upside down relative to one another, which is why this is considered a primitive and fundamental distinction — wholesale reversals of the body plan are not something modern politicians can do lightly, and it had to have occurred way, way back when morphology was simpler and more ambiguous among our ancestral worms.

I think I prefer the pirate talk to the political stuff.

Millennium Challenge Account Update

On March 14, 2002, President George W. Bush announced the creation of the Millennium Challenge Account, a five billion dollar fund to promote economic development in developing nations. The nations have to meet certain criteria (i.e. they have to want to be like us) to be eligible. The criteria have been debated, but, actually, it probably is a good idea to have such criteria.

I was curious to see how our President is doing with his initiative. So I looked around on the 'net. I ignored disreputable sites, not wanting to aid in the dissemination of forged documents or anything like that. What I found is that the government has linked up with an entity called the Millennium Challenge Corporation. The MCC is responsible for administering the MCA. The have a website.

Because it is a corporation, it has all the advantages of corporate operations: speed, flexibility, freedom from govermnetal red tape, etc. It can get things done much more quickly than a ponderous bureaucracy ever could.

Their latest press release was issued on August 26, 2004. This details the process used for selecting countries to benefit in 2005. That is not what I really wanted to know. What I wanted to know is: how much aid actually has been provided since the time of the announcement, in early 2002?

Hmmmm. It looks as though the amount of aid they actually have contributed is, like, nothing.

New Option for Obstructive Sleep Apnea

Restore Medical is a company in St. Paul, MN, that has introduced a new treatment for obstructive sleep apnea. It is a simple, minimally-invasive, surgical procedure that can be done in the doctor's office.

OSA is a condition that results in temporary cessation of breathing during sleep. It disrupted the quality of sleep, such that daytime somnolence occurs. This has many adverse effects on health, and can lead to significant impairment of function. There are approximately 15 million affected patients in the USA, although it is likely that it is underdiagnosed.

The most common treatment is implemented by having the patient wear a mask at night, connected to a little pump that provides pressurized air. the increased pressure keeps the airway open. This does not cure the problem, but it effectively eliminates it by restoring quality of sleep. Some patients are not able, or not willing, to learn to sleep with the mask.

Various surgical options are available, but in general, they are not the preferred treatments. This is due to the frequency of complications that can arise from the surgery. Because of the fact that minimally-invasive surgery has a much lower rate of complications, any development in this area is noteworthy.

The Pillar Procedure is such a development. It involves the implantation of three polyethylene terephthalate (the same stuff used to make soda bottles) pillars to stiffen the soft palate. The pillars make it less likely that the soft palate will fall into the back of the throat when inspiratory effort creates a partial vacuum during inhalation. Of course, this will help only those patients whose apnea is caused by that particular anatomical problem.

Even so, a simple, safe procedure is welcome, even if it can be used only for a subset of patients.

Surprise, SurpriseUnintended Consequences of FDA Antidepressant Meeting

On CBS MarketWatch, we learn that the stocks of antidepressant drug makers went up after the FDA met to formulate recommendations for the use of their products in children and adolescents.  In this post, I comment on the meaning of the statements made by the FDA, try to explain why some panel members contradicted others, and get into the issue of risk-benefit decisions.  Although the recent FDA meeting only addressed the risk-benefit question in children and adolescents, the same concepts apply to adults.  Read the rest at The Rest of the Story.

FDA Panel Urges Stronger Warning on Antidepressants

Finally, like, a year later, the US Food and Drug Administration has come up with a recommendation regarding the use of antidepressant medication in children.  Two recommendations, actually.  Previous posts in this blog have documented the long strange trip it has been.  Years ago,  Hillary R. Clinton tried to get the FDA to mandate tougher testing requirements for pediatric medications.  There was all kinds of political flak, and it tooks years for anyhting to come of it.

Now, one year after the story about the possibility of antidepressant medication increasing the risk of suicide-related behavior in children, the FDA has made a clear statement, based upon careful analysis of the available data.  Although the data are limited, such that the most important questions still are not answered, at least we have enough clarity that doctors, parents, and patients can proceed with treatement decisions.  From the New York Times:

F.D.A. Panel Urges Stronger Warning on Antidepressants
September 15, 2004
By GARDINER HARRIS

BETHESDA, Md., Sept. 14 - Federal drug regulators should warn physicians and patients in the strongest possible terms that antidepressants not only cause some children and teenagers to become suicidal but most have also failed to cure their depression, a federal advisory committee voted Tuesday. [...]

"A black box is the strongest emphasis on warning information that we know how to do," said Dr. Robert Temple, director of the agency's office of medical policy.

After two days of testimony about the risks and benefits of the pills, the committee also agreed unanimously that the agency should require pharmaceutical manufacturers to attach a patient guide to the drugs' packaging that would describe the risks of suicide in plain language. Hundreds of approved drugs have black-box warnings, but fewer than 30 are required to have such patient attachments, F.D.A. officials said.

Also see this link  from FDAAdvisoryCommittee.com for more information. 

The patient attachment thing is a bit unusual.  This follows a finding, earlier this year, that a black box warning about the risk of QTc prolongation did little to change the prescribing behavior of physicians.  (See this link  for some background information on this and on the subject of black box labelling.  Note, though, that the article is not entirely accurate about some things.)  The use of an attachment that goes directly to the patient will reinforce the message. 

The complexity of the issue was illustrated by one of the committee members, who actually voted against the new requirements (from FDAAdvisoryCommittee.com):

The black box warning “won’t make prescribing [in children] more difficult,” Psychopharmacologic Drugs Advisory Committee Chair Wayne Goodman, MD, University of Florida McKnight Brain Institute, maintained. However, he added, “I anticipate there will be alarm from parents and the child.”

“I think that it is worth that complication because it will raise the threshold to prescribing and force an engagement of a discussion not only about the risk but the potential benefits and alternatives to medication,” Goodman said.

The committee members and consultants voted 15 to eight in favor of a black box warning.

Voting consultant Matthew Rudorfer, MD, National Institute of Mental Health, opposed the black box. “I believe that while we’re concerned about a 2%-3% increase of risk of suicidality, I think the underlying illness carries a 15% risk of suicide if left untreated and I fear that the black box will impede access to treatments,” he said.

“I think the appropriate warnings could be conveyed in bolded language that would more likely both be appreciated by prescribers without scaring off patients and families and clinicians,” Rudorfer added.

It will be interesting to see what popular and political responses arise from the latest FDA action. 

Brain Scans Show Hypnosis at Work

Another kind of neat science item: from news@Nature.com, here is a blurb about hypnosis. Hypnosis is a valid therapeutic method, although it has been besmirched somewhat by its use as a parlor or stage trick.

Gruzelier studied 24 subjects, half of whom were categorized as succumbing easily to hypnotism, and half of whom were resistant. He scanned the volunteers' brains while they tackled a problem called the Stroop task, a test of mental flexibility that requires subjects to categorize a list of colours presented in a different colour - the word 'green' printed in blue, say - depending either on the name or the actual colour.

Gruzelier tested the subjects before and after they underwent a standard procedure used by hypnotists to put their subjects into a trance. In resistant subjects, the anterior cingulate gyrus was less strongly activated after the procedure than before, showing that their brains were working less hard as they got better at planning how to complete the task.

But in hypnotized volunteers, the anterior cingulate, and the regions that govern it, were more strongly activated when they were in a trance, showing that they were struggling harder to plot their actions, Gruzelier reported. He suspects that this impaired ability to plan for oneself makes people more suggestible.

The article does not say what kind of scan was used, but I assume they used functional MRI scanning.

As a clinical aside, hypnosis can be used in psychotherapy, but in general, it has not been shown to be more effective than any other kind of psychotherapy. For specific uses, though, it may be more effective. Some people, for example, find it to work to help them quit smoking.

A Common Language for Penguins

A Common Language for Penguins
<> By Steve Hamm
09/13/04 2:47 PM PT

Up until now, Linux has been used primarily as an operating system for Web sites, search engines, e-mail systems, and complex number-crunching jobs. It has just a foothold in the realm of running corporate applications. "If the Linux industry can unite and pull this off, there's a real shot at a true open alternative to Microsoft," says Jim Simlin of the Free Standards Group.

Actually, using Linux is not difficult.  If you have an Intel or AMD box with relatively anemic innards, say, a 1GHz processor, a CD drive, and 128K of RAM, you can get reasonable performance and no setup hassles; all you need is with a "live CD" with a Linux operating system.  Knoppix (1  2) is the most famous, but there are many others.  You don't even have to install anything.  In fact, you don't even need a hard drive, although obviously it helps.  Put in the CD, boot from the CD (or a floppy, if the machine won't boot from CD) and you can surf the Internet, check your email, and do word processing, spreadsheets, etc..  You could also do photo editing, but it would be pretty slow.  If you have lots of RAM, and can install a home directory on the hard drive, it is pretty quick.  You can use Microsoft-formatted documents, if you want.  The point is, Linux already presents a real alternative to Windows.  The new standard is great, and will help increase the market share for Linux.  But even without it, Linux already is "a true open alternative to Microsoft."

Yadda National Guard Service Yadda Swift Boats Yadda Yadda

I heard an interview on NPR tonight, on Dick Gordon's The Connection. He interviewed a reporter with the Boston Globe. The reporter mentioned that there are actually TWO sets of documents. One set was reported upon by CBS; the other, by the Globe. He pointed out that the allegations of forgery were made about the CBS documents. So far, nobody has challenged the Globe documents.

The politicians befuddle. You decide.

Sorting Antidepressant Evidence is Tough

The US Food and Drug Administration started their review of the data regarding the risk of suicidal behavior in children and adolescents who are treated with antidepressant medication. The meeting started today and ends tomorrow (9/14/2004). I checked on the FDA site to see if they have posted any updated information, but apparently they don't have any bloggers on their staff, because there is nothing new yet -- ever though they adjourned for the day several hours ago.

Google lists 133 news articles already. The best title I saw was this one:

Sorting antidepressant evidence is tough
Dallas Morning News (subscription), TX - 2 hours ago
By KAREN PATTERSON / The Dallas Morning News. Drug regulators are ready to make hard decisions about the safety of antidepressant medicines. ...

Other article titles are : FDA Panel Debates Suicide Risk for Kids On Antidepressants; Mom Credits Prozac with Saving Child's Life; Reviewer Says Depression Drugs, Suicide Linked. Notice that the titles span a spectrum from "Yes, there is a risk;" to "The risks are debatable;" to "We can't tell if there is a risk;" up to "These drugs saved my child." The consumer, meanwhile, has to sort this out.

In this post, I do what I can to make sense of it, even though the data are not as straightforward as we would like.  Read the rest at The Rest of the Story.

>

Neuropeptide S and Me

This is a story of a medical career and a molecule, neuropeptide S. NPS is a small neuropeptide neurotransmitter that has the dual properties of both reducing anxiety and increasing alertness; this is rather unusual.  The stories are interwoven in order to illustrate some points about neuroscience and bioethics, with a couple of political jabs thrown in just for kicks.  Read the rest at The Rest of the Story.

Remember this Guy?

Remember how, before the war, he held a special election to confirm his legitimacy as ruler of Iraq? There was a 100% voter turnout, and Saddam got 100% of the vote. Remember the mass demonstrations that proved to the world how popular the guy was?

<>ﺔﻳﻭﺎﻤﻴﻛ ﺏﺮﺤﻟ ﻕﺍﺮﻌﻟﺍ ﺩﺍﺪﻌﺘﺳﺍ ﻦﻋ ءﺎﺒﻧﺃ

ﻲﻗﺍﺮﻌﻟﺍ ﺲﻴﺋﺮﻠﻟ ﺍﺪﻴﻳﺄﺗ ﺩﺍﺪﻐﺑ ﻲﻓ ﺖﻤﻈﻧ ﺓﺮﻫﺎﻈﻣ

Remember how we all were convinced that the demonstrations actually had been staged, a part of a carefully scripted political scheme, to make the guy appear more popular than he really was?

Remember how proud we all felt, here in the United States of America, that our politicians don't do that? That we are better than them, because we have the freedom to express ourselves, that we won't allow ourselves to be manipulated, that our leaders do not have to choreograph their public appearances?  Do you remember that pride is one of the deadly sins?

Do you remember all of those things? Good. Now read this:

Revolt of the Press Corps
By Dan Froomkin
Special to washingtonpost.com
Monday, August 16, 2004; 11:09 AM
The press corps appears to have had about enough of those hokey "Ask President Bush" events.

Instead of taking questions from reporters, President Bush has become increasingly partial to playing talk-show host to an audience of sycophantic fans. [...]

As John Harris writes in The Washington Post: "In loosening his style, Bush tightened his message. Fielding friendly questions at 'Ask President Bush' forums, or lathering up the crowds at pep rallies like the one here on Saturday afternoon, he presented his case for reelection with a force and fluency that sometimes eluded him at important moments over the past year."

There's never a nasty question, never a heckler, nothing but love. That makes for great imagery and great soundbytes. [...]

Bill Plante did a long report on the CBS Evening News on Friday, showing video of campaign wranglers trying to pump up the hand-picked crowd.

"The art of TV-friendly political stagecraft reaches new levels in this campaign," Plante says. "This tight control means that hecklers . . . are almost never seen at Bush events. . . .

"At events like these, it's all about getting the message without any distraction, and making sure that there's no public argument to spoil the party."

Elisabeth Bumiller writes in her White House Letter in the New York Times: "Bush campaign officials readily say that they carefully screen the crowds by distributing tickets through campaign volunteers. . . . [...]

Bumiller notes: "As of Wednesday in Wisconsin, Bush will have had 12 such campaign forums, which is one fewer than the number of solo news conferences he has had in three and a half years in the White House."

AFP writes: "President George W. Bush famously dislikes press conferences but has embraced 'Ask President Bush' sessions packed with supporters at least as eager to pay tribute to him as get an answer."

Here's the text of the most recent "Ask the President," in Beaverton, Ore. Here are the transcripts from previous events. [...]

There's more, but you get the idea.  Corpus Callosum connects.  You decide.

Medical Journals to Require Registration of Drug Trials

The recent controversy about the safety of antidepressant medication has brought another issue to the forefront. (Use the search function in the sidebar and search for "antidepressant" to see other posts on this subject.) For many years, there has been concern in the medical profession abut the selective publication of drug trials. What this means is that an experiment that shows that a drug works is more likely to be published than an experiment that shows no effect. Thus, it is possible for medical professionals to develop a false impression about the effectiveness of a particular treatment.

That such selective publication could occur is surprising to many people. However, it order to understand it, it is important to understand the circumstances in which many of these experiments are done.   In this post, I explain how this happened, what the medical profession is doing about it, and why it matters.  I also mention some unintended consequences that are likely to result.  Some are good; others not.  Read the rest at The Rest of the Story. 

I Forgot One...

The Corpus Callosum corrects errors of fact. Previously, I listed the members of Bush's team who should get a copy of Hooked on Phonics. The list inadvertently left out Dan Bartlett:

Bush fell short on duty at Guard
Records show pledges unmet
September 8, 2004

On July 30, 1973, shortly before he moved from Houston to Cambridge, Bush signed a document that declared, "It is my responsibility to locate and be assigned to another Reserve forces unit or mobilization augmentation position. If I fail to do so, I am subject to involuntary order to active duty for up to 24 months. . . " Under Guard regulations, Bush had 60 days to locate a new unit.

But Bush never signed up with a Boston-area unit. In 1999, Bush spokesman Dan Bartlett told the Washington Post that Bush finished his six-year commitment at a Boston area Air Force Reserve unit after he left Houston. Not so, Bartlett now concedes. "I must have misspoke," Bartlett, who is now the White House communications director, said in a recent interview.

"I must have misspoke"?  Ever time I have spoke something wrong, I have correct it. 

From Word Pirates

Misspoke

Used by politicians to imply they expressed themselves "imperfectly or incorrectly" (Websters) when in reality, they were lying through their teeth

submitted by Bob Morris

From The Columbia Guide to Standard American English, 1993:

Speak

This strong verb’s past tense is spoke, its past participle spoken. In Renaissance writing you’ll often see the now-obsolete past tense form spake. 

Just as the past participle of "speak" is "spoken," the past participle of "misspeak" is "misspoken."

The Corpus Callosum apologizes for the omission.

Prehistoric Family Values

Fossil hints at devoted parenting in dinosaurs
Michael Hopkin
Prehistoric familial care may explain instincts of modern birds and crocodiles.
Published online: 08 September 2004; | doi:10.1038/news040906-9

One adult dinosaur died surrounded by 34 young.

Ordinarily, I eschew the practice of posting something, just to say "this is cool." I try to post things that I have something to say about. Well, I don't have anything to say about this, except that it is pretty cool.

Fossil hunters in China have unearthed what looks like the final resting place of an adult dinosaur with 34 offspring. The unique discovery shows that at least some dinosaurs cared for their young after they hatched out, and suggests that the parental instincts of present-day birds and reptiles such as crocodiles may have a common evolutionary precursor.

In the fossilized group of horned dinosaurs called Psittacosaurus, a fully grown individual is surrounded by 34 youngsters, all huddled within an area of 0.5 square metres. It is almost certainly a family group rather than a happenstance collection of dead dinosaurs, says David Varricchio of Montana State University in Bozeman, part of the team who unearthed the bones in Liaoning, China.

"It does have that 'wow' aspect to it," he told news@nature.com. "It's more likely than not a family. It's hard to imagine [unrelated] whole skeletons being transported to the same place all together." [...]

"It is an amazing snapshot, a really nice, serendipitous finding," says Paul Barrett, a dinosaur expert at the Natural History Museum in London. But he cautions that the evidence for family life remains circumstantial at this stage.

Nevertheless, the arrangement is "very suggestive of post-hatching parental care", Barrett admits. The youngsters are all around 20-centimetres long, suggesting that they represent a single brood.

Scott McClellan Needs a Vocabulary Lesson

Today's online New York Times contains several articles on the tombstone milestone of the 1,000th US death in Iraq. One includes this quote:

Kerry: Iraq Death Tally a Tragic Milestone
By THE ASSOCIATED PRESS
Published: September 7, 2004
Filed at 5:53 p.m. ET

WASHINGTON (AP) -- Democratic presidential candidate John Kerry said Tuesday, as U.S. military deaths in Iraq passed 1,000, that it was a ``tragic milestone'' and the nation should honor its troops' sacrifice by continuing to ``fight for what they fought for'' and making right decisions in Iraq. [...]

Bush's spokesman, Scott McClellan, tied the Iraq deaths to losses in the Sept. 11, 2001, terrorist attacks.

``We remember and honor and mourn those who made the ultimate sacrifice in Iraq and Afghanistan. We also remember those who lost their lives on Sept. 11,'' McClellan said, noting that Bush has met with hundreds of relatives of fallen soldiers.

From Wordsmyth:

non sequitur Browse the words alphabetically around "non sequitur" See entries that contain "non sequitur"
	Syllables:		non sequitur
	Part of Speech		noun
	Pronunciation		nan seh kwih tEr
	Definition	1.	something such as a remark or a conclusion that does not logically follow from the premise, evidence, or preceding statement.
	Related Words		fallacy

New campaign idea: let's help the Republican presidential campaign by taking up a collection for several copies of Hooked on Phonics! Maybe we could get a quantity discount, getting one each for Bush, McClellan, Rove, and Rumsfeld. After they learn what "non sequitur" means, then maybe they will be able to understand that the war in Iraq has nothing to do with September 11, 2001.

The Truth About Drug Companies

The New York Times section, Books of the Times, contains a review of a new book by Dr. Marcia Angell: The Truth About Drug Companies. (Amazon link). The author now is a Senior Lecturer in the Department of Social Medicine, Harvard Medical School. Dr. Angell is no stranger to controversy.  Indeed, her first book essentially exonerated Dow-Corning, the makers of the silicone implants. I mention this to show that Dr. Angell does have credibility when writing about health care issues. She has a political bias, admits it, but still goes where the facts take her.

The publication of The Truth About Drug Companies has led to a great deal being written from pro- and anti-industry folks.  In this post, I collect the views from around the Blogosphere and provide my own views on the subjects raised in the book.  I agree with some of Dr. Angell's points, disagree with others, and make a few miscellaneous comments.  Read the rest at The Rest of the Story. 

Dual Head Setup Under Linux

I spent a couple of hours yesterday trying to get a two-monitor setup working under Linux (Fedora Core).  Today I figured it out.  In the BIOS (of the ASUS P4P800 Deluxe), there is a setting that prohibits the assignment of an IRQ to a video card on the PCI bus.  Since almost everyone uses the AGP slot for their video card, the setting in on by default.  But if you put a second video card in, it has to go in a PCI slot.  The default setting prevents it from getting an IRQ assigned.  Turning off the setting enabled Linux to use the second video card. 

Questions for Bush, During the Debates

What will you do if it turns out that global climate change is real, and we have catastrophic changes here in the United States of America?  Will you issue a public apology?  What regulatory changes will you propose, in order to repair the environmental damage?  What will you do to repair the damage to the country's economy?

Those of you who still are skeptical should read this article:

Eskimos Fret as Climate Shifts and Wildlife Changes
By CLIFFORD KRAUSS
Published: September 6, 2004

ANGNIRTUNG, Nunavut - At age 85, Inusiq Nasalik has seen some changes in his day.

Born in an old whaling settlement, he lived in igloos and sod houses as a child and drove a dog team to hunt on the tundra through much of his life. Now he lives in a comfortable house with a plush sofa in his living room, a Westinghouse range and microwave oven in his modern kitchen and a big stereo to play his favorite old Eskimo songs.

Life is good for him, he says, but he is worried about the changes he sees in the wildlife that surrounds this hamlet on the shores of an icy glacier fiord just below the Arctic circle.

He says the caribou are skinny, and so are the ringed seals, whose fur has become thin and patchy. The Arctic char that swim in local streams are covered with scratches, apparently from sharp rocks in waters that are becoming shallower because of climactic shifts. The beluga whales and seals do not come around Pangnirtung fiord as much anymore, perhaps because increased motorboat traffic is making too much noise. [...]

Scientists say the problems Mr. Nasalik observes result from climate change and the gradual increase in contaminants like pesticides and industrial compounds like mercury and PCB's that are transported by wind and currents from the industrialized south and accumulate in the fatty tissues of Arctic animals. The people who eat such animals are also affected, and high levels of contaminants have been found in the breast milk of Eskimo women. [...]

Arctic char, caribou and ringed seal are showing abnormally hard livers, according to a draft of the report that is to be released in September. Caribou have worms in their muscles and between their joints. The fat in Beluga whales is changing color. Hunters across the eastern Canadian Arctic are reporting that an increasing number of polar bears look emaciated, probably because their hunting season has been shortened by the shrinking ice cover. [...]

For Paulusie Veevee, a 75, an elder who started hunting with his grandfather when he was 10, the greatest tragedy of all is the changing habitat for the seals that depend on the ice for reproduction.

"The seals have their pups in dens on the ice," Mr. Veevee noted. "If there isn't enough ice, where will they have their babies - on land? That's the question I ask myself."

The SBVT Should Hang Their Heads in Shame,As Should All Bloggers Who Echo Their Lies

Never trust a group that includes the word "truth" in their name.  Via Raznor's Rants, here is a wee bit of an article published by the (Montana) Billings Gazette:

Columbus swift boat vet angry about letter
By LINDA HALSTEAD-ACHARYA
Of The Gazette Staff

COLUMBUS - Swift boat veteran Bob Anderson of Columbus is ticked.

It bothers him that Sen. John Kerry's swift boat history has become such a political hot potato. But he's even more irritated that his name was included - without his permission - on a letter used to discredit Kerry.

"I'm pretty nonpolitical," the 56-year-old Anderson said Tuesday. So, when he found out last week that his name was one of about 300 signed on a letter questioning Kerry's service, he was "flabbergasted."

"It's kind of like stealing my identity," said Anderson, who spent a year on a swift boat as an engine man and gunner.

The letter, which was posted on the Swift Boat Veter-ans for Truth Web site, claims the Demo-cratic presidential candidate has "grossly and knowingly distorted the conduct of the American soldiers, marines, sailors and airmen of that (Vietnam) war."

The letter also criticizes Kerry for trying to change his image from a critic of the war to a war hero.

"After reading the letter," Anderson said, "it kind of got under my skin. I had never come across a situation where someone used my name without my support or approval. It's not a very comforting feeling."

What's worse, he said, he disagrees with the letter. [...]

Can You Have Too Much Secrecy?

An article in the Washington Post shows that the federal government is going overboard when it comes to classification of documents:

'Secrets' Perplex Panel
Classified Data Growing to Include 'Comically Irrelevant'
By Michael J. Sniffen
Associated Press
Friday, September 3, 2004; Page A17

A former dictator's cocktail preferences and a facetious plot against Santa Claus were classified by the government to prevent public disclosure. [...]

These, as well as other examples of classification were cited last week by members of Congress and witnesses at a House subcommittee hearing into the Sept. 11 commission's conclusion that secrecy is undermining efforts to thwart terrorists.

Some classifications were made in error or to save face.

The CIA deleted the amount Iraqi agents paid for aluminum tubes from Page 96 of a Senate report on prewar intelligence. The report quoted the CIA as concluding that "their willingness to pay such costs suggests the tubes are intended for a special project of national interest."

That price turned out to be not so high. On Page 105 of the same Senate report, the same security reviewers let the CIA's figure -- as much as $17.50 each -- be printed along with other estimates that the Iraqis paid as little as $10 apiece.

"There are too many secrets" and maybe too many secret-makers, said Rep. Christopher Shays (R-Conn.), chairman of the House Government Reform Committee's national security panel. [...]

No one knows how much is classified, he said, and the system "often does not distinguish between the critically important and comically irrelevant." [...]

"This administration believes the less known, the better," added the Connecticut Republican, noting sadly he was speaking of a GOP administration. "I believe the more known, the better." [...]

Steven Aftergood, director of the Federation of American Scientists' project on secrecy, said some classification was designed to conceal illegality or avoid embarrassment, even though that is forbidden. [...]

Representative Shays is a Republican. One wonders why he would be so critical of the practices of his own party. Unless, perhaps, it is because the overzealous classification of government documents is contrary to the fundamental principles of the Republican Party. Could it be that the practice of classifying so many documents is fiscally irresponsible? A recent New York Times article sheds some light:

Government by, for and Secret From the People
By ERIC LICHTBLAU
September 5, 2004

THE capital’s worst-kept secret is out: the federal government is becoming even more secretive.

This will come as no surprise to anyone who has filed a Freedom of Information Act request in the post-Sept. 11 age or tried to find out why his name was put on a “no fly” list, only to be told the information was too sensitive to be shared. But a new study seeks to quantify the government’s interest in keeping material classified. It found that the administration protected some 14 million documents last year – a 60 percent increase since 2001.

The study, conducted by a coalition called openthegovernment.org, which favors greater access to government information, also found that it cost the federal government $6.5 billion last year to secure its classified information, an increase of 39 percent since 2001.

Classifying and maintaining the nation’s secrets amounted to $459 a memo – or $120 spent on maintaining secrets for each dollar spent to declassify and release them.

I don't think anyone would try to argue that he government should not be making more of an effort to secure classified information. But they need to remember that doing so costs money. Doing it unnecessarily is a waste of money.

Medical Ethicists Get it Wrong

In late August, information was published  regarding the role of US medical personnel in the abuse of detainees at Abu Ghraib.  At the time, I had not seen the article quoted below.  It is from BMC Medical Ethics, an open-access journal.  Reading it now, it seems to have been almost prescient.  Even so, I believe that the author made an error, when he concluded that international ethical principles superceed national interest.  Read the rest at The Rest of the Story. 

Economics is an Extension of Warfare by other Means

It is amusing to see Mr. Bush try to put a positive spin on the recent employment statistics. And even more amusing to see gullible Americans gobble it up like so much chicken feed.

The sound-bite numbers: 144,000 new jobs. Unemployment rate down from 5.5 to 5.4%

The meaningful numbers: The percentage of adults in the labor force is down from 66.2% to 66.0%. The growth rate of the labor force is down to 0.5%, compared to 1.5% last year. Looking at just the prime-age workers -- those between ages 25 and 54 -- the rate of growth dropped from 1.6% to 0.5%.

Part of the boost in new jobs reported came from workers returning to plants that shut down for retooling in July. Thus, those were not really new jobs. When you consider that growth in domestic automobile sales is declining, some of those jobs are not going to last.

Last month's wage increases almost, but not quite, kept up with inflation. Some workers were able to make up the difference by working extra hours, so the average weekly pay has kept up with inflation. Of course, with new overtime rules in effect, it will be harder to make up the difference by working more hours, and it will even more tempting for employers to squeeze extra hours out of workers, rather than hiring more workers.

This, of course, will increase the cost of health care:

Always on the Job, Employees Pay With Health
By JOHN SCHWARTZ
Published: September 5, 2004

American workers are stressed out, and in an unforgiving economy, they are becoming more so every day.

Sixty-two percent say their workload has increased over the last six months; 53 percent say work leaves them "overtired and overwhelmed." [...]

It is enough to make workers sick - and it does.

Decades of research have linked stress to everything from heart attacks and stroke to diabetes and a weakened immune system. Now, however, researchers are connecting the dots, finding that the growing stress and uncertainty of the office have a measurable impact on workers' health and, by extension, on companies' bottom lines.

Workplace stress costs the nation more than $300 billion each year in health care, missed work and the stress-reduction industry that has grown up to soothe workers and keep production high, according to estimates by the American Institute of Stress in New York. And workers who report that they are stressed, said Steven L. Sauter, chief of the Organizational Science and Human Factors Branch of the National Institute for Occupational Safety and Health, incur health care costs that are 46 percent higher, or an average of $600 more per person, than other employees.

"The costs are significant," Dr. Sauter said, adding, "Those are just the costs to the organization, and not the burden to individuals and to society." [...]

Imagine what we could do with that $300 billion dollars. If there were no workplace stress, we could afford to invade Iran!

The Toe Bone is Connected to the Head Bone

It always interests me to learn of some new medical finding that challenges the way we think about human physiology. Yesterday, there was a report in Medscape News about the role of leptin in the regulation of hypothalamic neurohormones. This advances our understanding of basic physiology, and reveals a treatment strategy for some forms of infertility. It also helps explain the infertility often seen in female patients with Anorexia Nervosa. I suspect the same holds true for men with Anorexia, but this was not studied specifically.

The Medscape article deals with the use of leptin as a possible treamtent for hypothalamic amenorrhea.   The possible use for treatment of Anorexia is not discussed in the original article.  The possibility raises some ethical questions, which I discuss briefly.  Read the rest at The Rest of the Story. 

China May Improve Honesty in Economic Data

If China goes ahead with this, it would make their economic reporting more honest than that used in the United States of America, in at least one respect:

Environmental damage to be counted in GDP
www.chinaview.cn 2004-09-02 07:50:01

BEIJING, Sept.2 (Xinhuanet) -- An experimental framework for calculating green GDP in China has been set up, vice-minister of the State Environmental Protection Administration Pan Yue said Wednesday.

The pilot system will be implemented in some regions as soon as possible, he said.

Green GDP (gross domestic products) is an amendment to GDP that deducts the cost of environmental damage caused by economic development.

As China's economy is growing rapidly but its environment has been worsened in turn, environment officials and experts have been calling for the adoption of green GDP in the country. [...]

Pollution, like an economic deficit, is just another way to shift taxes to future generations. Unlike an economic deficit, the effective interest rates tend to be quite high. As expensive as it is to prevent pollution, it always is cheaper that cleaning it up after the fact. Reporting economic growth, including an offset for pollution, would reflect this simple fact. It also would show that the economic growth in the USA is not as robust as has been claimed.