Lifting the stem cell ban – was there any point?

President Obama has lifted the ban on embryonic stem cell research enacted by Bush, but I’m left feeling that this intervention came many years too late.

Pledging that his administration will “make scientific decisions based on facts, not ideology,” President Obama on Monday lifted the Bush administration’s strict limits on human embryonic stem cell research.

But Mr. Obama went on to say that the majority of Americans “have come to a consensus that we should pursue this research; that the potential it offers is great, and with proper guidelines and strict oversight the perils can be avoided.”

In making his announcement, Mr. Obama drew a strict line against human cloning, an issue that over the years has become entangled with the debate over human embryonic stem cell research.

As someone who works with stem cells I find this largely an empty, symbolic act, but one that needed to be done anyway. The reality is the damage was done by Bush already, and we’re fortunate that it was only a temporary delay in some of the most important research humans have developed to date.

What a lot of people don’t realize is that in 2006 a revolutionary result was discovered by Japanese scientists led by Shinya Yamanaka at Kyoto University. What they found was the reset button for mammalian cells, the genes that need to be expressed for a cell to revert to a pluripotent state. We wrote extensively about what results in these cells – induced Pluripotent Stem Cells or iPSC – mean for stem cell research and regenerative medicine overall. Basically, the ability to reprogram the cells of any individual to a totipotent state – one in which the cells may make any cell-type or tissue in the human body. Before some fool suggests this was due to Bush remember it was a Japanese group, the research started long before Bush, and it never would have been possible without ES cells from which they culled the critical genes for the transformation.

So why does it matter that Obama has reversed this policy? Not only are ES cells inferior compared to iPSC for human therapies, but wouldn’t it be easier not to upset the fundamentalists that would equate the value of our lives to that of a ball of undifferentiated cells?

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Rating your doctor online – is this a good idea?

I have just finished taking my last major exam of medical school – Step 2 of the boards (including Step 2 Clinical Skills, or CS, which costs 1200 bucks, requires you to travel to one of a few cities in the country hosting it, and is sealed by a EULA that forbids me from talking about what the test was like), and am winding down my medschool career in the next few weeks. It’s about 2 weeks from Match Day (the 19th), when I’ll find out for sure where I will spend the next 5 or so years of my life. I’ll be sure to have a post up a little after noon that day when I find out what the answer is. And then, around May 17th, graduation day, I’ll be a medical doctor, ready to start internship (also known as the hardest year of your life).

One of the things I’ve found universal to all medical students is that we really want to be good doctors when we are finished with our training. I don’t think I’ve ever met a medical student who was in this career for the money (you’d be crazy), or for other selfish reasons. They tend to be hard working, dedicated, humble people who, if anything, are sickeningly sincere about wanting to help other people. Maybe that’s just my school, but my experience is, these folks want to do good in the world.

But another universal is that not all doctors will be able to avoid making mistakes. Doctors are human, they all will eventually make errors, and the goal of any profession dedicated to improving the human condition should be constant self-reflection and efforts at self-improvement. This is not a simple thing to do however. Medicine is complex, and quality of medical treatment is very difficult to assess. We’ve discussed before, using metrics in medicine is challenging, and often rather than studying medical quality you end up merely assessing the social demographics of the physicians’ patients.

So it is with interest that I see reading boingboing that lots of people are upset because some doctors are forcing their patients not to rate them on sites like RateMD.com by having them sign a contract forbidding them from doing so.

The arguments for and against this practice are fascinating. We tread into the mucky waters of free speech, free enterprise, the practice of medicine, and the practical problem of assessing physician quality…

More below the fold…
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The editors of PLoS should read PLoS

ResearchBlogging.orgWhat do this cartoon and the latest edition of PLoS One have in common? Well, reading Bora’s blog this week I saw an article entitled, Risks for Central Nervous System Diseases among Mobile Phone Subscribers: A Danish Retrospective Cohort Study and my ears perked up. We have been mocking the idea that cell phones cause everything from brain cancer to colony collapse disorder and it’s always fun to see what cell phones are being blamed for based on weak associations and correlations.

In this article the authors identified more than four hundred thousand cell phone subscribers and linked their cell phone use to their medical records in the Danish Hospital Discharge Registry which has collected records of hospitalizations since 1977. They then tried to identify an association between cell phone use and various CNS disorders over the last few decades. These disorders include epilepsy, ALS, vertigo, migraines, MS, Parkinsons and dementia, a broad spectrum of diseases with a variety of pathologies and causes. Basically, they’re fishing. Well, what did they find?
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Rejecting Homosexual Children Results in Disastrous Health Outcomes – An Appeal to Parents

Blogging on Peer-Reviewed Research

Not infrequently, science butts heads with culture as the data scientists collect about issues of the day may conflict with cultural perceptions and deeply-held beliefs. Attitudes and perceptions about homosexuality are, not surprisingly, a source of denialism as certain overvalued ideas about sexuality are being challenged with our deeper understanding of human sexual desire. For one, homosexuality is not a choice, despite all attempts to reprogram or suppress homosexual desires, the desires do not go away. One might even hypothesize the attempts to repress or disparage such a fundamental aspect of someone’s identity might cause harm long term and result in negative health outcomes. Sure enough, this article published in the journal Pediatrics last week suggests this is in fact the case, and I believe we must begin to view the rejection of homosexuality by parents as not just as small-minded, but actively harmful, constituting child abuse that has long term implications on their childrens’ health.

The authors identified 224 gay and lesbian youths between 21 and 25 years of age and using surveys to evaluate for high risk behaviors, mental health and levels of rejection by family, they found some startling patterns…

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Hi, Mom!

i-717d70581118215cee135ee2f56bf332-DSCN0336.jpgIt’s another cold, snowy day in Michigan, and while I was busy stamping out disease, PalMom was looking out her window at the snow. Perching on a branch was this beauty, which I believe to be a red-tailed hawk. Please correct me if I’m wrong.

i-d9e2e5cef17eb7e6f31c4699c88e5893-DSCN0337.jpgThis raptor is no dummy. There’s a bird feeder a few yards away, which, in addition to attracting the LBJs, also brings the little mammals.

i-22d03b3632ac9af14b27ab1b478ec176-DSCN0339.jpgApparently the LBJs aren’t too stupid either. There were none at the feeder while brother hawk was there, but according to PalDad, the hawk is now gone, and the birds have returned to their feast.

The stupidest internal NIH memo ever – or why I can’t wait for the new administration

One of the great things about science is that it is open, international, and celebrates the free exchange of ideas. However, during the last 8 years we’ve seen some odd things at the National Institutes of Health – the premier governmental scientific institution in the world. The paranoia of the current administration has filtered down and contaminated day to day operations of what is essentially an academic health sciences campus.

For example, for some bizarre reason they decided to erect a 10 foot high iron fence around the entire campus:
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And at the entrances every car is searched, every day. And why? What makes the NIH campus different from any other medical campus in the country? We all work with the same radioactive isotopes, etc. They have a higher level infectious disease research lab which if you were really worried about could be fenced in rather than fencing in the entire 300 acre campus. What is the reason for this excess of security?

I happen to think there is no good reason and that the NIH security is run by paranoid idiots. The best evidence I have of this is a recent memo I’ve obtained that was sent to Health and Human Services employees about foreign visitors from the Deputy Secretary. Here is the relevant section:

i-7946a972cb4ab6b390962193dc8cb05c-NIH memo.jpg

Really? Now if an NIH investigator wants to bring a foreign speaker in to give a talk, not only can they not plug in their thumbdrives in the lecture hall computer to upload their powerpoint for fear of espionage, but they have to be followed into the bathroom too? Could you imagine? You invite some bigwig foreign scientist – like say any of this year’s Nobel Laureates in medicine – and when they have to make a pit stop you’d be forced to follow them in the bathroom for fear they’ll steal our lucky charms.

I hope in the next administration the first thing they do is tear down that stupid fence and treat the NIH like any other academic medical campus, and find whoever wrote this stupid memo and fire them. This type of paranoid security obsessiveness is uneccessary and counterproductive to the free exchange of ideas science needs in order to be open, international and collaborative.

Stop the RFK Jr. appointment NOW

I would beg everyone who reads the scienceblogs and cares about science to contact the transition team in the Obama administration as Orac has requested.

It should be clear by now to readers of this blog that pseudoscience is not a problem of just the right. The left wing areas of pseudoscience are just as cranky, just as wrong-headed about science, just as likely to use the tactics of denialism to advance a non-scientific agenda. We have been dealing with the denialism of the right more because they’ve been in control. Now is the time to nip the denialism of the left in the bud so it doesn’t take root in this new administration.

RFK Jr. is a crank (Orac for more), and one of the problems with cranks is Crank Magnetism. When people have one type of pseudoscientific belief it tends not to be isolated. Instead it reflects a general incompetence in understanding science, evaluating the quality of evidence, and what constitutes good science. RFK Jr.’s crankery will not be limited to vaccines and autism. He will undoubtably become the poster boy for all sorts of left wing crankery – be it environmental extremism, toxin/radiation paranoia (we’ll never get public wifi), or his already well known anti-vax crankery.

My letter to the transition team is below the fold. Please join me in trying to prevent this terrible error on the part of the Obama campaign.

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Science is politics

No, this isn’t some post-modernist rant on the inherent non-objectivity of science. On the contrary—this is a much simpler, grittier point, that science actually is the most accurate way of describing reality, and because of this, politics (the job of manipulating and controlling group’s social reality) and science will always be roommates.

This comes up because we get complaints—regular complaints about science blogging failing to stick to “science”. I gotta say that this complaint always seems to come from those who find reality to be a bit too liberal, but maybe that’s just my bias showing.

This intersection (if you’ll excuse the expression) is crudely obvious to working scientists writing grants—if you write the “wrong” thing (e.g. studying HIV in sex workers, stem cell research, etc.), your grant is history.

Less crudely, science informs political positions, such as how to deal with global warming (or whether or not it’s even a problem).

One such question came up in a comment recently. The question revolved around whether doctors should ask patients about firearms.
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Autism and Mitochondria

Prometheus brings us the best article I’ve seen to date on why the new push for a mitochondrial basis for autism is total nonsense.

Once I saw this push from denialists like David Kirby towards a link between mitochondria and autism I knew we were in for a world of trouble. If only because mitochondrial diseases are a relatively new area of study and there are enough unknowns that they’ll be able to milk this nonsense for a decade at least.

Prometheus, however, does an excellent job showing how the likelihood of a mitochondrial explanation for autism is prima facie absurd. This is not surprising given the clear absence of evidence for a maternal pattern of inheritance and the non-progressive nature of autism which is usually described as a “static encephalopathy”.

Keep the link handy for when you start hearing mito-woo from the DAN quacks.

DrPal, tell us more about HPV and cancer

OK, if you insist. This comes with the usual caveat directed at scientists that I know this is oversimplified, but I wish to reach the largest audience possible. Feel free to correct my mistakes, but please don’t bother me about oversimplification.

So here’s the deal. Several decades ago, it became scientifically fashionable to believe that most cancer had a viral cause. This belief coincided with the discovery that some viruses do cause cancer. And while it turns out that most cancers are not caused by viruses (probably), many of them are. Viruses can cause cancers in a number of ways, but since you said you were interested in HPV (human papilloma virus) we can use this as an example.

First, there is no scientific question about the causal relationship between HPV and cervical cancer (and certain oral cancers, anal cancers, and penile cancers, but we’ll use cervical cancer as shorthand for all of them). There is excellent epidemiologic evidence to support this, and virologic evidence that proves it.

Now that we’ve got that out of the way, how does this cancer virus thing work?
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