Monthly Archives: March 2010

Researching at the edge of space | Bad Astronomy

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nsrc2010logo_cropI recently attended a conference in Boulder, and I have to admit that before I went I wasn’t sure what to make of it. Now I do, and I’m very glad I went.

The meeting was the Next-Generation Suborbital Researchers Conference 2010 (NSRC2010), and its goal was to figure out how best to exploit an upcoming revolution in space travel: private companies making suborbital launches to the very edge of space.

Space, in this case, is defined as being 100 km (62 miles) above the Earth’s surface. There, the atmosphere is incredibly thin, which has obvious benefits for astronomical observations (less turbulence blurring images, darker skies to see faint objects, less air to absorb ultraviolet and infrared light). But perhaps just as importantly, the planned flights will have up to three full minutes of microgravity — what is popularly but inaccurately called weightlessness or "zero g".

That’s where my initial skepticism came in. What can you do with only a few minutes of free fall? Well, it turns out you can do a lot. There are a host of biological, engineering, and astronomical experiments that can be run in this environment, ones that would be far too prohibitively expensive to do on, for example, a Shuttle mission.

virgingalactic_ss2

But this next generation of rockets from Virgin Galactic (Richard Branson’s effort with Space Ship 2, a model of which is pictured above), Blue Origin (Jeff Bezos from Amazon.com), and others will reach a height making a lot of this science possible. The region up to 100 km is too high to reach by balloon, and too low for orbital rockets, which is why it’s been dubbed "the ignorosphere". But it has its uses…

Observations of the Sun, for example, may not need much time to do because (you may have noticed) the Sun is pretty bright, so a three or four minute flight is enough to get some good data. The way incoming energy from the Sun couples with the Earth’s atmosphere is not hugely well understood, and a lot of it happens in this region high above the planet’s surface. Effects of low gravity on the human body can be tested, as well as on plants and other biological systems.

In fact, enough science can be done on these trips that the conference itself brought in 250 people interested in the topic. I was surprised at how many people came, as were the conference planners themselves: they were expecting half that many.

But there’s a lot of confidence here. Lori Garver, NASA Deputy Administrator, gave a keynote talk, saying that NASA will pledge $15 million per year to this new field of research in the new budget (pending approval by Congress). Alan Stern, an astronomer and conference organizer, announced that Southwest Research Institute, for whom he works, will put up $1 million of its own money for researchers to fly into space, too!

Given that each flight will cost something like $200,000, this is a pretty decent pool of money to investigate the ignorosphere. That may sound like a lot, but in fact a lot of scientific grants are in this range; a few years back I had my own personal research grant on Hubble that was for more than $40,000, and while I was at Sonoma State University our small team routinely applied for educational grants for $50k and more. Getting $200k for a flight is well within the reach of a lot of researchers. Of course, they’ll need more to cover equipment and such, but compare that to the millions upon millions needed for an orbital flight, or even several million for a sounding rocket, and you start to see that this is a pretty good deal.

NASA itself can use this sort of thing as well, testing equipment and new technology to see how it behaves. This is a whole lot cheaper than putting something up on the Space Shuttle (or on the next generation of orbital rockets).

It was exciting to sit and listen to all the buzz about this new, intermediate frontier. But as interesting as the science was, there was something more important going on at this conference. Something that, I suspect very strongly, will change the way we look at space travel.

And that will be the topic of my next post on this. Stay tuned.


A moment of Clarity. Some DTCG is not bad.

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Ok,

Here is the G-d's honest truth. Not all SNP/DTCG companies are bad. What do I mean by bad?

Not all SNP/DTCG companies misrepresented that which is not medically useful as medically useful.

I look at Pathway and Counsyl for example. Fast followers looking to say what they do and mean what they say.

Some of these DTCG tests could be clinically relevant and useful. The problem I have, is that there is no point at which I can say, "Hey I just want the clinically relevant stuff!" No ear wax please.

I need that as a clinician. If I want a huge panel of say CYP450 tests, where do I go? there are some labs that do this and charge and arm and a leg. One company, who I used charged the patient thousands of dollars because insurance wouldn't pick it up.

That cannot ever happen again.

With the addition of these tests with some clinical value, there must be a value add of inexpensive and RAPID TAT (Turn Around time)

A classic example is my last post. Provided these tests become validated clinically, in a patient who can't give me her Gail risk information (tough not to, but it could be a real case) I would use that other panel

The same is true for BRCA founder mutations. Provided you won't drop it in some google database that they get served up mastectomy ads, some patients are afraid of needles and that is a barrier.

There are some very good things here. These good things are getting drowned out by some very bad things.

We can work together if you are willing to bend.


"The lack of really effective clinical utility and the existence of commercial interests increases the confusion though. It’s hard to sell something that is interesting, “fun”(?), quite expensive, but not actually that useful to the majority right now. Hard to sell means sometimes over the top marketing."

What medicine cannot tolerate is Over the Top Marketing. It leads to inaccurate statements. This is something extremely forbidden in certain states. In fact, some states don't allow advertising to patients at all, or there laws are so strict you couldn't say anything than

"Dr Murphy, accepting new patients, take insurance"

Why is this? It is to prevent false claims and promises. Doctors can't make money back guarantees. They can't make statements which are not based on fact in advertising. A lot of companies in a rush to get out young science and feed the hype cycle for grants and whatever have been all too guilty of this hype.

So when I get a comment from one of my readers who says (paraphrased)

"Hey all this bashing you do on DTCG is making us in the science end of the SNP reseach look bad"

It prompted me to say, hey, I wouldn't have to throw so much cold water on it if it weren't being hyped so much by DTCG.......

So I guess my point is simple.

Hey DTCG, your opportunity is to leverage your amazing platforms to launch medical services, TO and WITH physicians.

Keep the nonmedical exactly that, NONMEDICAL

Keep the Medical EXACTLY that, MEDICAL

People can benefit by knowing their 2D6/2C19/2C9/VKORC1.

But there are some hurdles to be overcome

1. How can I trust your results?
You have started by enlisting or creating CLIA certified labs, that is a good start. Maybe FDA cert would be nice. Not needed, but nice. There currently is only AmpliChip that is FDA approved....Would like others.

2. How can I know your interpretation is correct?
By using board certified molecular pathologists, I can get a comfortable feel for the fact that the results have been vetted by your specialist. This is muy importante!

3. How can I integrate the results into my EMR/PHR/etc.?
This is going to be super important. How can I save these results linked to patient care? Sure, some would pull paper and put it in the chart, others would prefer a pull in and link. You have to think how to do this.

4. What if the interpretation changes?
Will you take responsibility to contact Either the ordering physician or patient when a result changed? This will be important as we learn more about the nature of these genetic changes.

Doctor's rely on these 4 things from most labs that they use. The depend on these services to be provided professionally and accurately.

These 4 things are EXTREMELY hard to do. But NEED to be done if you really want to be a part of the medical community. But even if you don't, I think your customers deserve this sort of validation and service. Don't you?
Take the jump, create a medical arm. Work with us.

The Sherpa Says: This is what is needed. Medicinally used DTCG that is "Allowed" to be of clinical use. A new Terms of Service, just for doctors, with a validation process that is transparent. And a Marketing process which is truthful.

Mainstream Media’s Sub-Par Health Coverage, Part 2

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I recently wrote about an experience that I had with a reporter (Erica Mitrano) who interviewed me about energy healing at Calvert Memorial Hospital in southern Maryland. Erica was very friendly and inquisitive, and we had a nice conversation about the lack of scientific evidence supporting any energy healing modality. I thought it would be fun to post what we had discussed at SBM, and then wait to see what trickled down into the finished piece.

When the final article appeared I was very disappointed. Not only was I not quoted, but there was no skeptical counter-point at all. The story read like an unquestioning endorsement of junk science, and I wondered if it was worth it to continue speaking to journalists to offer expert advice. It seemed to me that this experience was emblematic of all that’s wrong with health reporting these days. (Just ask Gary Schwitzer – who has recently given up on reviewing TV health stories in mainstream media since they are generally so inaccurate.)

But I want to apologize to Erica, because part of the problem in this case was her editors.  The online version of her story was substantially different from her printed version – and in this case the printed version was much more balanced. About 1/3 of an entire newspaper page (The Enterprise, Friday, February 19, 2010, St. Mary’s County, Maryland) was devoted to my counter arguments. Here’s a short excerpt:

“I’m honestly not aware of any scientific evidence that supports anything beyond the placebo effect with the energy healing modalities, including Reiki,” Jones said. “There is nothing we can measure that suggests there is a special force that needs to be balanced…”

Success stories are anecdotal and can generally be accounted for by a person getting better from something like an infection on his own. Patients tend to report success from energy work more often for subjective ailments, especially pain and emotional problems, she said…

Jones opposes untested therapies’ inclusion in hospitals.

“I think it’s misleading to the patients because they’re going to a hospital, they’re trusting the hospital will offer them treatments that have proof that they work and they don’t realize that these nurses are offering nonscientific therapies,” Jones said.

“I would rather that the nurses be given time to sit and talk to patients, go into the room and say, ‘Mrs. Smith, I’m sure you feel completely stressed out right now, and I don’t blame you.’ That would be more effective than concocting this pseudoscientific excuse for having nurses lay hands on people when really the patient needs a listening ear and a compassionate soul to talk to.”

But I think this case still serves as a reminder that traditional media’s approach to health story coverage can be flawed. Specifically, my concerns are these:

1. “Balance” – While I recognize the importance of impartiality in news reporting, the quest for balance can go too far. Some facts are incontrovertible, so regularly insisting that the truth is “somewhere in between” can be both misleading and dangerous.

2. Editing – Reporters can write an excellent piece of journalism that becomes nearly unrecognizable after their editors are finished with it.

3. Inability to crowd source – The advantage of blogs is that readers can correct the original article or add their valuable views. Without a community of virtual editors/contributors, any one news article is limited by the point of view and skills of the journalist.

4. Sensationalism – Mainstream media outlets are slaves to ratings and traffic. This means that they are under constant pressure to exaggerate the truth or misrepresent scientific research. Attention-grabbing headlines sell papers, and “good science makes bad television.” So readers must take what they read with a grain of salt.

5. Author credentials – Sadly, highly trained science journalists are being laid off in record numbers due to the economic realities of the failing newspaper business. Remaining writers often do not have the depth of experience to handle complicated health topics and do not represent important scientific nuances correctly.

In conclusion, I’d like to thank Erica for the opportunity to weigh in on energy healing and apologize for any distress that my blog post (expressing my frustration with the apparent bias revealed in the final online article) may have caused her. I know that Erica received a pointed letter of complaint regarding the story because of my post. I think it’s a good thing that people care enough about bias and misinformation to send formal complaints… because when those cease, we’ll be in serious trouble!


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Idaho Gov. Butch Otter emerges as leader of nationwide Repeal Obama Care States’ Rights movement

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Idaho Health Care Freedom Act

From Eric Dondero:

While in Congress Otter was considered a "conservative with a libertarian streak." (Source: Ballotpedia) He racked up one of the most consistently fiscally conservative records in the House. He even identified himself with the libertarian label on occasion. And well-known amongst movement libertarian, Otter was a keynote speaker and attendee at Libertarian Party of Idaho state conventions in the early 1990s. He was also friends with a great many libertarian activists in the State such as the well-known (Steve) Symms family.

One of the most "libertarian Republican" elected officials

But it was in 2006, when Otter really caught on with libertarians. The newly-elected Governor was given a front page feature story in Reason Magazine, "Butch Otter Rides Again: Idaho' next governor demonstrates the possibilities--and limits--of libertarian politics in the Republican Party." The piece was written by David Weigel, (now with the Washington Independent).

An excerpt:

Butch Otter is a study in contradictions. After Ron Paul of Texas, he’s the most libertarian Republican in the entire caucus. Unlike Paul, he has libertarian victories on his legislative scorecard. In June 2003 he shocked the Bush administration by sponsoring an amendment to a funding bill that stripped out the money the FBI needed to conduct sneak-and-peek searches— that is, raiding a target’s home without issuing a notice to the target. It passed with 309 votes. In 2004 he fought hard to amend the PATRIOT Act to bar the government from searching bookstore and library records. The amendment almost passed, until Otter’s own party leadership held the vote open for an extra 23 minutes to twist arms and get Republicans to vote against it. He was bitter about that vote. “You win some, and some get stolen,” he told reporters.

During three and a half decades in politics, Otter has had his decisions overruled by everyone from Idaho legislators (on obscenity laws they wanted to pass) to his fellow House Republicans (on medical marijuana they wanted to ban) to President Ronald Reagan (on the drinking age his administration wanted to raise).

Otter emerges in the National Spotlight

Since his election,he's had various legislative battles. But nationally, he's kept a very low profile until now.

Unexpectedly, and on virtualy nobody's radar, Otter has been immediately thrust into the middle of the national health care debate. Late Wednesday evening, word broke in the national media (Drudge Report, Fox News, ect...), that the Governor had signed a letter requiring the State Attorney General to sue the Federal Government if Idaho residents are forced to participate in Obama's health care measure.

All eyes have been on Virginia. Republican state legislators introduced a bill to exempt Virginians from participating. State AG Ken Cucinnelli held a press conference to announce that he would sue the Feds if they forced Virginians into the program. But Otter is the first to sign it into law.

From Google News (via AP):

BOISE, Idaho — Idaho took the lead in a growing, nationwide fight against health care overhaul Wednesday when its governor became the first to sign a measure requiring the state attorney general to sue the federal government if residents are forced to buy health insurance.

Similar legislation is pending in 37 other states... the state measures reflect a growing frustration with President President Barack Obama's health care overhaul.

Otter, a Republican, said he believes any future lawsuit from Idaho has a legitimate shot of winning, despite what the naysayers say.

"The ivory tower folks will tell you, 'No, they're not going anywhere,' " he told reporters. "But I'll tell you what, you get 36 states, that's a critical mass. That's a constitutional mass."

Last week, Virginia legislators passed a measure similar to Idaho's new law, but Otter was the first state chief executive to sign such a bill...

In a press conference announcing his signature on the legislation Otter made the following statement (from USA Today):

"What the Idaho Health Freedom Act says is that the citizens of our state won't be subject to another federal mandate or turn over another part of their life to government control," Otter said, adding, "I put a real high priority on the sovereignty of the state of Idaho."

Photo state capitol in Boise.

Commonwealth of Virginia, led by AG Cuccinelli, will challenge Obama Care on Constitutional grounds

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Supported by Libertarian Republicans in '09 race for AG

Fiscal libertarian and stalwart Constitutionalist Ken Cuccinelli said through a spokesman yesterday, that his office plans to move forward with plans to challenge Obama's Health Care proposal if passed by Congress. Further, he's warning Speaker Pelosi that if she tries to pass the legislation through "deem and pass" it would set in motion a major challenge by the Commonwealth and could lead to a full-blown Constitutional crisis.

From the Washington Post, March 17:

RICHMOND -- Virginia will file a legal challenge to the constitutionality of the Democratic health-care reform bill if Congress approves the measure, a spokesman for Attorney General Ken Cuccinelli II said Wednesday.

Cuccinelli (R), a social and fiscal conservative who has expressed deep skepticism about the growth of the federal government, has said since his fall election campaign that he was studying the legal issues involved in such a suit. His spokesman said Wednesday that Cuccinelli has decided he will challenge the measure.

The announcement came two days before President Obama is scheduled to visit Fairfax County to hold a final rally in support of the health-care bill before the congressional vote. Last week, Virginia became the first state to pass a bill declaring it illegal for the government to require individuals to purchase health insurance, a key component of the bills under consideration on Capitol Hill.

Cuccinelli was quoted in the American Spectator last week:

"Proponents of liberty must use all of the tools the Constitution provides to defend against this onslaught on our liberty..."

Note - Cuccinelli was endorsed by the Republican Liberty Caucus in his 2009 race. Virginia RLC at rlc.org

Libertarian Party member now serving as Virginia Republican AG Cuccinelli’s media spokesman

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Member, Roanoke Valley Libertarians

Brian Gottstein recently took over as media spokesman for libertarian-leaning Virginia Attorney General Ken Cuccinelli. Gottstein is well known downstate, as a hardline libertarian talk show host. Gottstein is a Tea Party activist, but also an active member of the Libertarian Party of Virginia.

Gottstein is the subject of a feature piece at the Roanoke Times website, "Metro columnist Dan Casey: Activist redirects spotlight onto new boss Cuccinelli." He is described in the piece as having gone from political activism to entering the "boiling political cauldron of state politics" particularly with his controversial new boss and now national media figure Cuccinelli.

From Roanoke.com March 18:

Brian Gottstein is a very busy guy these days.

For the first time ever, the less-government-is-always-better activist and Roanoke political consultant is on the government payroll.

Gottstein, 40, is communications director to Virginia's lightning rod attorney general, Ken Cuccinelli...

Gottstein also wrote a column for roanoke.com in which he regularly decried the growth of government and government spending and promoted free-market principles. Among the areas government should be out of, according to those columns, is public education.
He recently gave up a Sunday night Libertarian talk show on WFIR 960 and seven other Virginia stations because of his new position.

Gottstein is a member of the Libertarian Party of Virginia. From the Roanoke Valley Libertarians website:

The Libertarian Party had three speakers at the Roanoke Valley Independence Day Tea Party. Jeff Bowles (The Virginia State Central Committee Chairman), Jim Lark (former Libertarian National Committee Chairman & current Vice-Chair of the Libertarian Party of Virginia) and Brian Gottstein (LP member).

Penn medical school dean will step down | Philadelphia Inquirer | 03/18/2010 – Philadelphia Inquirer

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Penn medical school dean will step down | Philadelphia Inquirer | 03/18/2010
Philadelphia Inquirer
Arthur H. Rubenstein, a key figure in the renaissance of the University of Pennsylvania's medical school and health system, ...
University of Pennsylvania School of Medicine and AstraZeneca Working Together ...PR Newswire (press release)
Penn Med dean will step down in 2011Daily Pennsylvanian
University of Pennsylvania School of Medicine dean Rubenstein leaving next yearPhiladelphia Business Journal
MSN Money -Blinq (blog)
all 18 news articles »

WindWard Looks Seaward: Incremental Developments in Energy and Community

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Early in February, I met with Opalyn Brenger and Walt Patrick of WindWard, founders and caretakers of a sustainability research community in the middle of beautiful Washington State. They brought me to witness the final triumphant hours of an intensive weekend-long gasification workshop taking place at All Power Labs in Berkeley, California, where attendees and mentors were subverting modern diesel engines to the gasification techniques of the 1890s.

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Day 21

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The following morning was torture as I dealt with the effects of the previous nights drinking. I got up around 1030am and decided to brave the hike I'd agreed to do the previous night. As I grabbed breakfast and prepared my things Andy walked past on his way to bed looking like he'd smoked 20 joints in a row before pouring bleach into his eyes and then depriving himself of sleep for a week. I

Day 20

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The Wedding night

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