H. Pylori, Plausibility, and Greek Tragedy: the Quirky Case of Dr. John Lykoudis

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Mark Crislip is on vacation, but through an arduous series of shakings and succussions (beating his head against the wall?) we have channeled part of his essence: This post mostly concerns itself with infectious diseases, thanks to several recent posts on SBM that discussed the plausibility of health claims and that touched on the recent discovery that most peptic ulcer disease (PUD) is caused by a bacterium, Helicobacter pylori. Several comments and statements quoted in those posts reveal recurrent questions regarding both plausibility itself and the history of the H. pylori hypothesis. In this post I’ll attempt to answer some of those questions, but I’ll also insert some new confusion.

Plausibility ? Knowing the Mechanism

Let’s first dispense with a simple misunderstanding: We, by which I mean We Supreme Arbiters of Plausibility (We SAPs) here at SBM, do not require knowing the mechanism of some putative effect in order to deem it plausible. This seems so obvious that it ought not be necessary to repeat it over and over again, and yet the topic can’t be broached without some nebbishy South Park do-gooder chanting a litany of “just because you don’t know how it works doesn’t mean it can’t work,” as if that were a compelling or even relevant rebuttal. Let’s get this straight once and for all: IT ISN’T.

Steve Novella explained why at the Yale conference and again here. We talked about it at TAM7 last summer. For a particularly annoying example, read the three paragraphs beginning with “Mr. Gagnier’s understanding of biological plausibility” here.

OK, I’ll admit that I’m beginning to learn something from such frustration. Perhaps we’ve not been so good at explaining what we mean by plausibility. The point is not that we don’t know a particular mechanism for homeopathy, for example; the point is that any proposed mechanism would necessarily violate scientific principles that rest on far more solid ground than any number of equivocal, bias-and-error-prone clinical trials could hope to overturn. The same is true for “energy medicine” and for claims based on non-existent anatomical structures (iridology, reflexology, auricular acupuncture, meridians, chiropractic “subluxations”), non-existent physiologic functions (”craniosacral rhythms“), or non-existent anatomic-physiologic relations (”neurocranial restructuring,” “detoxification” with coffee enemas, dissolving tumors with orally administered pancreatic enzymes). The spectrum of implausible health claims euphemistically dubbed “CAM” is full of such nonsense.

Reader daedalus2u proposed a useful way to clarify the point:

I think the idea of prior plausibility should actually be reframed into one of a lack of prior implausibility. It isn’t that one should have reasons to positively think that something is plausible before testing it, but rather that one should not be able to come up with reasons (actually data) why it is fatally implausible.

Some of what We deem implausible will not be fatally so, of course. Implausibility can be based not only on established physical and biological knowledge, but also on studies, as is the case for sticking needles into people, injecting them with chelating agents, or claiming that autism is caused by childhood immunizations.

Plausibility and History

A second theme, though not as simple, concerns the historical role of plausibility. Reader anoopbal introduced the point:

am not sure if you can apply biological plausibility to every situation. It is usually considered as a weak criterion because it is limited by our knowledge.

If we used plausibility 300 years back, nobody would have used citrus fruits for scurvy nor people would have believed mosquitoes are linked with black water fever.

I think that daedalus’s “reframing” proposal deals with that objection to a large extent. I also don’t think that anoopbal’s examples are all that revealing. It seems to me that empiricism was the main source, other than myth, for plausibility at the time. Plausibility in the biomedical sense is not something that can be usefully discussed for the period prior to about the mid-19th century, when enough was finally known about biology and chemistry to hatch science-based medicine in its full form. Prior to that, most useful diagnostic and treatment methods had been discovered empirically (accidentally).

This is not to say that someone living before the mid-19th century could not have applied plausibility to a medical question—obviously that could happen at any time—but that to attempt to do so, when so much was still mysterious (how cowpox pus worked, microbiology, Avagadro’s number, energy flux in living organisms, physiology, pharmacology, etc.) or ‘explained’ by magic (the Vital Force, miasmas, sympathetic magic, the 4 humors, etc.) would have meant very little by today’s standards. And I do believe that there is a fundamental difference—not merely a foolish conceit about modernity—between what we know today and what we knew 300 years ago. Thus I don’t think that biological plausibility is a weak criterion now, even if it was then.

To give anoopbal his or her due, he seemed to partially agree when he later noted:

And that‘s exactly the limitation of biological plausibility. It is limited by what we currently know. Centuries back our knowledge about earth was limited, and you can’t blame them for believing the earth [was] a flat disc.

On to H. Pylori

Daedalus offered another interesting take on plausibility:

An idea does not have low prior plausibility if it does not agree with prior explanations, it has low prior plausibility if it does not agree with prior data.

Many (most?) scientists make this confusion too. That is because they are thinking on the level of the explanations, not on the level of the data that led to those explanations. The explanations may be wrong, the data that led to them is not.

Given the presumption that the data are accurate, we would all probably agree with this. Daedalus, however, then got a little tripped up:

The idea of using antibiotics to treat ulcers was incompatible with the idea that ulcers were due to too much acid. It was not incompatible with any of the data surrounding ulcer treatment.

So did Harriet Hall:

The idea of treating ulcers with antibiotics was not incompatible with any of the data about ulcers; it was only incompatible with the idea that ulcers were caused by too much acid.

At the time that Barry Marshall and Robin Warren proposed their bacterial hypothesis, there were data suggesting that ulcers were caused by too much acid: acid neutralization or suppression of acid formation resulted in better than 90% healing of peptic ulcers, compared with about 30% for placebo. If such therapies were discontinued after healing, the ulcers typically relapsed, only to be healed again by renewed acid suppression. This did not rule out the possibility of some other factor also being involved, of course, but it would seem to have come pretty close to throwing down the gauntlet of Ockham’s Razor.

Why not just Treat with Antibiotics?

What might it have taken prior to 1984, short of what was subsequently done, to convince the world that peptic ulcer disease could be effectively treated with antibacterial agents? A reader sent just such a question to Steve Novella:

What would Science Based Medicine do if H. pylori was not known, but a study showed that antibiotics given to patients with stomach ulcers eliminated symptoms? I assume that SBM wouldn’t dismiss it outright saying that it couldn’t possibly be helping because antibiotics don’t reduce stomach acid. I assume a SBM approach would do further studies trying to discover why antibiotics work. But, in the meantime, would a SBM practitioner refuse to give antibiotics to patients because he doesn’t have a scientific explanation as to why it works?

A straightforward answer is as follows. Although the question may raise an interesting general point about plausibility, the example is not a good one. Antibiotics are not one medicine but many. They all have side effects, some quite serious. Bacteria are also not one species but many; they have widely differing sensitivities to various antibiotics. Which antibiotic(s) would the study have used, and on what basis? Responsible MDs would not have accepted such a scheme for PUD, because they would have needed to know what they were treating and how to treat it (H. pylori turns out to require three different antibiotics given simultaneously).

A predictable rejoinder to this is that many physicians routinely treat upper respiratory tract infections, most commonly caused by viruses, with an antibiotic. Without going into detail, let me assure you that this does not refute my point: in many cases MDs should not be treating these URIs with antibiotics, and in cases where it makes a bit of sense to do so it is done with a single, short-term antibiotic with a benign risk/benefit profile, known to be effective against the most common community-acquired bacterial culprits of the respiratory tract. This is quite different from attempting to treat a mysterious bacterium that might not even exist, for a disease that already has effective treatments that are safer and have fewer side effects than antibiotics.

Mikerattlesnake got the point:

I think it’s a wise addendum to directly address the logical misstep in the question you received. Those who understand SBM would get the answer from the broad approach taken in your post, but those people aren’t the ones likely to parrot the fallacy.

To put it simply: finding that an antibiotic was effective against an ulcer would indicate a bacterial cause for ulcers that would warrant further study. The reason for that has entirely to do with prior plausibility. Antibiotics are known to fight bacteria. If an antibiotic cures ulcers, it gives us a plausible answer for the mechanism causing ulcers. The questioner makes the mistake of assuming that we would never abandon the assumed cause of ulcers, but SBM looks for mechanisms of action for ailments as well as cures.

So did BillyJoe, with the appropriate caveat:

I like it.

Only one thing though: this could never have happened. As I understand it, the treatment involves taking three different tablets – two antibiotics and an acid suppressing drug – twice a day for a week. How likely is that to have happened by chance?

Discoveries Require Context

Some might assume that Robin Warren and Barry Marshall were the first to discover bacteria apparently living in the human stomach and duodenum, and the first to propose that the bacteria might be involved in diseases of these tissues, but this isn’t the case. Such bacteria were first observed in the 19th century. Over subsequent decades there were sporadic reports of similar bacteria, but they were not necessarily associated with diseases and their presence could not be reliably reproduced. The table of contents of Helicobacter Pioneers: Firsthand Accounts from the Scientists who Discovered Helicobacters 1892 – 1982, edited by Barry Marshall, gives a hint of just how close some investigators came to the truth:

  1. Helicobacters were discovered in Italy in 1892: An episode in the scientific life of an eclectic pathlogist, Giulio Bizzozero. Natale Figura and Laura Bianciardi
  2. The discovery of Helicobacter pylori in Japan. Yoshihiro Fukuda, Tadashi Shimoyama, Takahashi Shimoyana and Barry J Marshall
  3. An early study of human stomach bacteria. A. Stone Freedberg
  4. Gastric urease in ulcer patients in the 1940’s: The Irish connection. Humphrey J O’Connor and Colm A O’Morian
  5. How it was discovered in Belgium and the USA (1955 -1976) that gastric urease was caused by a bacterial infection. Charles S Lieber
  6. A personal history of giving birth to the cohort phenomenon of peptic ulcer disease. Amnon Sonnenberg
  7. John Lykoudis: The general practitioner in Greece who in 1958 discovered the etiology and a treatment of peptic ulcer disease. Basil Rigas and Efstathios D Papavassiliou
  8. How I discovered helicobacters in Boston in 1967. Susumu Ito
  9. How we discovered in China in 1972 that antibiotics cure peptic ulcer. Shu-Dong Xiao, Yao Shi and Wen-Zheng Liu
  10. Helicobacter pylori was discovered in Russia in 1974. Igor A Morozov
  11. The discovery of Helicobacter pylori in England in the 1970’s. Howard W Steer
  12. We grew the first Helicobacter and didn’t even know it!. Adrian Lee, Michael Phillips and Jani O’Rourke
  13. The Dallas experience with acute Helicobacter pylori infection. Walter L Peterson, William Harford and Barry J Marshall
  14. The discovery of Helicobacter pylori in Perth, Western Australia. J Robin Warren
  15. The discovery of Helicobacter pylori, a spiral bacterium, caused peptic ulcer disease. Barry J Marshall
  16. Helicobacter pylori treatment in the past and in the 21st Century. Peter Unge

Prior to Marshall and Warren, human gastric bacteria were not only inconsistently seen, but were never cultured and hence never characterized in a useful way (for a more basic treatment of this topic, please see my 2004 essay in Skeptical Inquirer). At least two distinct technological advances were necessary to set the stage for the discovery and characterization of H. pylori in humans: first, a simple and safe method for obtaining gastric mucosa specimens from live patients had to be devised; second, the field of bacteriology had to appreciate the existence of highly fastidious organisms and devise methods for growing them in culture. The first of these requirements was satisfied only by the late 1970s, when flexible, fiberoptic endoscopy became widely available.

I am not enough of an historian of bacteriology to state, with certainty, when H. pylori might have first been cultured, if only its existence had been fully appreciated, but it is doubtful that it could have occurred much sooner than it did. Helicobacter Pioneers reports that the first successful culture of any helicobacter species—isolated from mice—occurred in 1968. Other examples of fastidious bacteria have also been characterized relatively recently: mycoplasma pneumoniae and chlamydophila pneumoniae, two organisms that cause atypical pneumonia, were still thought to be viruses until the 1960s; several new species of helicobacter and campylobacter, some of which are human pathogens, have been discovered only in the last 10-15 years.

The culture requirements of H. pylori, moreover, are esoteric: it grows best in an atmosphere of 5% oxygen and is helped by the presence of certain antibiotics to discourage overgrowth by more hardy contaminants, which are almost impossible to avoid when collecting specimens from the stomach via the mouth. Helicobacter takes much longer to grow than most bacteria, and but for serendipity Warren and Marshall almost missed it. They abandoned their first 34 culture attempts (or, more precisely, “junior microbiology staff” abandoned them) in spite of multiple variations of media and temperatures, after no growth had occurred within 48 hours. It was only after a five-day Easter vacation, during which the 35th attempt was left undisturbed, that tiny, transparent colonies appeared.

John Lykoudis: the Real Galileo of PUD?

An intriguing story in Helicobacter Pioneers is found in chapter 7: John Lykoudis: The general practitioner in Greece who in 1958 discovered the etiology and a treatment of peptic ulcer disease. You can read most of this chapter at the Google Books website. If it is accurate, it makes the answer to the question that the reader posed to Dr. Novella not so straightforward as Mikerattlesnake, BillyJoe, and I argued above: it inserts the “new confusion” that I promised at the beginning of this post. Lykoudis’s story has all the necessary tragic elements:

a general practitioner in a small, isolated town in Greece, prompted by a single clinical observation, developed on his own the concept that PUD and gastritis had an infectious etiology. As if this was not enough, this most unlikely student of PUD proceeded to devise an apparently effective treatment, based on the antibiotics of his time.

Lykoudis’s treatment, apparently developed by trial and error, consisted of 3 antibiotics (2 quinolines and streptomycin, for you microbiology/infectious disease enthusiasts out there) and vitamin A, taken orally. He patented this regimen in a pill that he named Elgaco, “from the Greek word for ulcer (= elkos), gastritis and colitis” (for which he also asserted that his treatment was effective). He eventually claimed to have treated 30,000 patients with nearly perfect results and no toxicity. According to the authors of the chapter,

The success of Elgaco cannot be quantified from extant notes on thousands of patients, because the outcome of each patient is not recorded. We have concluded, however, that his treatment was successful, based on the following considerations. First, our current understanding of the etiology and treatment of PUD makes it plausible that his treatment was effective. Second, there is the written testimony (some of it sworn, as explained later) of many of the patients who were treated by Lykoudis. All report prompt responses to his therapy. In some cases, patients even detail that radiographically proven ulcers were cured following treatment with Elgaco and that such cure was confirmed by repeat radiological series. Third, Lykoudis had a large following and despite fierce opposition from the establishment, patients flocked to him from all over Greece.

In spite of this, his attempts to make his discovery known to the world were rebuffed at every turn:

He encounter[ed] formidable obstacles in convincing the medical establishment, the Greek regulatory authorities and the pharmaceutical industry. In fact, Lykoudis spent the rest of his life engaged in incessant activity to propagate his treatment of PUD and gastritis. His archives, some made recently available by his family, make it clear that he was fully aware of the importance of his discoveries. They also convey an almost suffocating sense of frustration…

[He was] completely shunned by the medical establishment of his time, or at best, considered an eccentric provincial physician…

In 1966, Lykoudis attempted to publish his observations in the Journal of the American Medical Association, but his manuscript entitled “Ulcer of the Stomach and Duodenum” was rejected…Unfortunately, no copy of this manuscript survives for re-evaluation in the light of current knowledge.

Lykoudis did, however, publish his own booklet, “The Truth about Gastric and Duodenal Ulcer.” In it he wrote:

There is no doubt that gastritis and duodenitis, which have gastric and duodenal ulcer as their complication, are inflammations due to an infectious agent…

Lykoudis made numerous attempts to get his remedy approved by the Greek Drug and Pharmacies Administration, to no avail. He even managed to enlist the aid of influential politicians:

In 1967, Lykoudis succeeded in getting the attention of the Prime Minister’s office. His correspondence with the Minister of Health on 21 August, 1967, a sad document indeed, is revealing. He registers his frustration that medications with apparently no effect on PUD were approved, whereas Elgaco was repeatedly rejected. He proposes, in essence, a phase III trial: 100 PUD patients to be treated at a State hospital by the eminent professors, 50 with conventional treatment and 50 with Elgaco. ‘Their refusal to approve it is understandable, but their refusal to test it is not!’ he writes.

Lykoudis continued:

If the study proves them correct, they will be vindicated and I will become a laughing stock…It is dramatically urgent to clarify this issue…Too much, endless talking, which leads nowhere, while it is simple to resolve this in a practical way. Only facts constitute the truth.

Yet again he was refused. Lykoudis also tried, unsuccessfully, to interest several drug companies in his regimen. The final insults were these:

…he was referred for disciplinary action to the Athens Medical Association, of which he was a member, ‘because (a) he prepared and distributed an unapproved medicinal preparation…and (b) he made his method publicly known to attract patients’…On 6 November 1968…the Disciplinary Committee, presided over by a neurology professor, fined him 4000 drachmas…

A more serious problem for Lykoudis was his indictment in the Greek Courts…

In the latter instance numerous former patients came to his support; one of them testified that Lykoudis “treated also many poor ulcer patients free of charge.”  We are not told the outcome of the indictment.

Lykoudis died in 1980 without knowing that he would soon be vindicated. His story is disturbing because it is an almost perfect hybrid of two entirely different possibilities: on the one hand, a legitimate innovator who is unfairly rejected and persecuted, in spite of heroic efforts over more than 2 decades to prove his theory; on the other, a classical example of unwitting foolishness, bordering upon quackery or sociopathy.

It is only in hindsight that we can grant that there is a good chance that it wasn’t the latter. Consider the striking parallels, however, to Nicholas Gonzalez, whose main arguments have consisted of patient testimonials and case reports selected by himself, who claims that his regimen is nontoxic, who claims to treat some patients for free, who was hounded by regulatory boards for a time, who found political allies to help defend him, and who for years pleaded that all he wanted was a chance to test his regimen:

I believe in research. I don’t want this to be out there until we prove it works by the strictest standards of orthodox medicine. What I have wanted from the day I began researching this under Dr. Goode at Cornell in 1981, was to do appropriate clinical trials.

Again: Discoveries Require Context

My sense, reading the story of John Lykoudis, is that he was treated unfairly, and I think that most people would agree. A major caveat is that the authors of the chapter are clearly sympathetic to him, and it’s quite possible that another account would read differently.

Whether fair or not, it seems to me that the major weakness in Lykoudis’s case is that he never characterized the putative bacteria in any way: he didn’t see them, he didn’t provide direct evidence of them for others to examine, and he didn’t culture them.

Even his sympathetic biographers recognized this. Although they attributed his failure to “his lack of academic credentials” and even more to “his thesis [being] contrary to established, albeit unsubstantiated, dogma,” they also observed:

Unfortunately, when he was compelled to identify these elusive organisms, particularly when dealing with regulatory agencies, he meandered around known pathogens, unable to build a strong case for any of them. His main argument, and the strongest one he could marshal in all his writings in favor of the infectious etiology of these clinical entities, was the response to treatment that he had witnessed.

A good argument can be made that characterizing the “bug” not only is, but ought to be a sine qua non for treating a putative infectious disease with drugs. This is true because the drugs are not benign or universally effective, as argued above, but also because there are precedents suggesting that to do otherwise opens the door to mistreatments. Bacteria or viruses are frequently offered as potential etiologic agents for all sorts of diseases whose causes are poorly understood, particularly when there is an inflammatory component (that is one reason that the H. pylori hypothesis didn’t represent a new “paradigm”). Osteoarthritis and rheumatoid arthritis are examples, but these have, so far, eluded attempts at proof.

When I first learned about sarcoidosis and Crohn’s disease in medical school in the 1970s, I would have bet dollars-to-donuts that they, and rheumatoid arthritis and a few other diseases for that matter, would eventually be shown to have infectious etiologies. I would still almost make that bet, my only hesitation being that after 30+ more years of investigations and impressive advances in microbiology (including vastly more powerful methods of detecting well-veiled foreign invaders, from electron microscopy to nucleic acid amplification), no apparent culprits have feen found.

During that same time, moreover, not only peptic ulcer disease but also Lyme disease, Legionnaire’s disease, and Toxic Shock Syndrome were shown to have bacterial origins, and AIDS was shown to be caused by a virus. Thus on the basis of what has been learned about infectious diseases it can’t be argued, with a straight face, that biomedical progress is hampered by stodginess or petty jealousies or dogmatic thinking or conflicts of interest or any of the other usual suspects, even though they certainly all exist among individual scientists. What hampers progress, in cases such as Likoudis’s, is what hampers all scientific progress: the context is not prepared.

Instances in which at least some people have become convinced of a spurious infectious etiology, on the other hand, have not been pretty. In the early 20th century, prior to the discovery of antibiotics, some psychiatrists became convinced that “insanity” was caused by bacteria in the mouth and that the appropriate treatment was “surgical bacteriology”: tooth extractions, tonsillectomies, and in intractable cases removal of “testicles, ovaries, gall bladders, stomachs, spleens, cervixes, and especially colons.” More recently a putative bacterial cause of atherosclerosis has spawned a small quack industry.

Even if any of the diseases mentioned above is eventually found to be infectious in origin, this will not necessarily vindicate those whose premature exuberance put patients in harm’s way. Such exuberance ought to motivate legitimate investigations, not half-assed, ill-conceived treatments. Still, I seem to hear a ghostly voice in my ear, speaking Italian with a thick Greek accent…

E pur si muove!


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Machine Tools have become Uglier

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Why is it that no one can build a manual machine tool anymore that has some character and grace? Everything new I've seen lately is stark, cold junk, just barely good enough to do the job. Are we just too cheap to pay what it costs for a good machine tool anymore? Has the market responded to that

With Insurance Comes a New Need: More Primary-Care Doctors – New York Times

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With Insurance Comes a New Need: More Primary-Care Doctors
New York Times
It may urge goals of having 40 percent of the doctor work force in primary care, a 40 percent increase in their income and reforms in medical school ...
The future of med schoolMarketplace (blog)
Health-Care Reform's Major Hurdle: Doctor ShortagesCNBC
Health Care Bill Will Create Need For More DoctorsCBS2 Chicago
CBS News -News On 6 -WOAI
all 43 news articles »

minimum thickness for apply PWHT

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hai all,

i have a doubt with PWHT process. we are using asme ix and asme B31.1 for contruction code.

i already made prewps for this,

material P11 to P11 ( p no 4 and group no 1) and 6'' sch120 wall thickness 14.27mm.

my question is. what the minimum thickness for applying PWHT?

A Sensible – if Radical – Solution for Greece.

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 I'll offer my own, typically off-angle, view of the Health Care Bill and its implications for America's ongoing civil war, soon.  Till then, I just want to jot down a quick thought on another matter -- the current European economic crisis, precipitated by near bankruptcy of the nation of Greece.

But first, some announcements...

1) I've continued my series of ten-minute intellectual "YouTube Feasts." First concluding my series about spaceflight withPart V: The  Grand-scale reasons to explore space.  And then with the first part of a series about transparency, privacy and freedom. The Transparent Society: Part 1: the coming era of cameras everywhere. 

 2) The George Marshall Foundation has honoredme by prominently posting my 1999 essay touting George Marshall as the "Man of the 20th Century."

 Enjoy! (And spread the word.)

 

=== AND NOW... ABOUT THE GREEK/EUROPEAN CRISIS... ===

If you haven't been following this, it's pretty important. The "Club Med" countries of Europe -- Greece, Portugal, Spain and Italy -- seem to have gone on a spending binge, since joining the Euro-zone (using the Euro as currency) and now Greece, especially, is asking to be bailed out - big time - by the richest nations, especially Germany.  This seems unlikely.  But the alternative, draconian budget cuts, could stir major social unrest, as well as a national depression.

You know me, I always look for the most obvious thing that is going un-mentioned.  In the case of Greece, I am wondering why nobody mentions the blatant extent to which Greeks are notorious tax scofflaws.  Tax compliance rates in Greece are known to be dismal.  Isn't this an important side of any budget crisis?

I am wondering if Greece might be helped by a dose of radical transparency.  Tax evasion is mediated by corruption, which thrives in shadows.  Were the Greek economy radically opened to light, laws would be enforced, simply because citizens would spot their neighbors' evasions -- (yes I am talking radical transparency! So?) -- and therefore that side of the ledger should dramatically improve.  

This approach has an added advantage.  Radical transparency could be achieved with some simple changes in law, unleashing citizens and media to do the rest.  If combined with an amnesty for those who report and pay-up on past evasions, this approach could offer the poor and middle class something to counterbalance their own sacrifices in setting things right.

 This sort of thing could be a big piece in helping the "Club Med" countries transform their balance books and take up a new position of leadership in an era of change.

 

=== AND FINALLY... SOME SCIENCE...===

 Citizen news network with credibility ratings. (EARTH predictive hit?)

Mars Express buzzes Phobos, one of the Red Planet's two tiny moons.

Creatures found under 600 ft of Antarctic ice suggest possible life under Jovian moon surfaces.

Your next cool board game?

Researchers Turn Mosquitoes Into Flying Vaccinators.

Stop the Ug99 Fungus Before Its Spores Bring Starvation 

Well, it certainly is reciprocal accountability....

Wow re lunar ice.

A site that answers questions or computations.

Efficient, low-cost water treatment (membrane .02 microns) may be useful in third world countries.

F ive stellar ways to explore space using social media

Women and Posthumanity: The future looks large and sexy. The media is driving females to manipulate their bodies to increasingly unnatural idealized images. We've lost touch with what natural bodies look like; we have no acceptance of natural aging.


 

Obama "snubs and humiliates" Israel’s Prime Minister Benjamin Netanyahu on White House visit

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Walks out of meeting to go have dinner with the family

From Eric Dondero:

According to various reports, mostly from the foreign press, Obama snubbed Israeli President Bejamin Netanyahu on his two-day trip to Washington earlier this week. Half-way through the meeting Obama got up and announced he was leaving to have dinner with "Michelle and the girls."

At issue, Israeli settlements in East Jerusalem, and unwillingness of the Israelis to make further concessions to the Palestinian Authority as demanded by the White House.

The London Times quotes an un-named Congressman who witnessed the event:

"It was awful,” the congressman said. One Israeli newspaper called the meeting “a hazing in stages”, poisoned by such mistrust that the Israeli delegation eventually left rather than risk being eavesdropped on a White House telephone line. Another said that the Prime Minister had received “the treatment reserved for the President of Equatorial Guinea”.

Left to talk among themselves Mr Netanyahu and his aides retreated to the Roosevelt Room. He spent a further half-hour with Mr Obama and extended his stay for a day of emergency talks to try to restart peace negotiations. However, he left last night with no official statement from either side. He returned to Israel yesterday isolated after what Israeli media have called a White House ambush for which he is largely to blame.

Geller - American Jews can no longer ignore Obama's anti-Semitism

Liberty activist Pamela Geller of Atlas Shrugs had this response:

Obama shamed and humiliated the Jewish Prime Minister of Israel, while demanding we respect sharia and Islam. Jewish self-defense against virulent, genocidal Islamic anti-Semitism repels the leader of the free world.

Now here we are. Jews may then have tried to avoid Obama’s anti-Semitism, but they cannot now avoid the consequences of avoiding Obama’s anti-Semitism. He has unleashed an evil in this world the extent of which we are only now beginning to see. He has made the world safe for haters and killers.

The Jewish people, both in Israel and the diaspora, seem to be suffering from the Stockholm Syndrome. There can be no logical reason why an American Jew could intellectually excuse Obama’s twenty-year friendship and closeness with the anti-Semitic Farrakhan acolyte Jeremiah Wright.

There is no way an American Jew could explain away or rationalize Obama’s connections to Rashid Khalidi, Ali Abunimah, Bill Ayers, Bernardine Dohrn, and know about those connections without knowing what was coming. These Jews (and our history is plagued with them) love ideas, not people. They are so married to their dogma, their ideology, that they cannot, will not, see what is right in front of them. They worship at the church of human secularism. That is their religion. They have no G-d. They merely wearing a Jewish coat, but do not speak for Jews. It is the curse of the Jewish people historically to be betrayed by our own. This is the deepest cut of all.

Are we so broken a people that they shall have died in vain, for nothing? The six million looked like you, laughed like you, denied like you. The six million loved their country -- some were war heroes for Germany in World War I. They too thought the fringe would stay relegated to the margins of society. Fringe, meet White House.

On Thursday Geller had a piece published at Andrew Breitbart's BigJournalism.com titled "Obama's War on Israel."

Obama marching US towards Socialism; Netanyahu moves in free market direction

Since Netanyahu's election nearly 2 years ago, he's taken Israel on a decidedly different course. He is a considered an "ardent advocate" of the libertarian economic view, who has "championed welfare cuts and free-market practices."

From Ashbrook Center bio:

Benjamin Netanyahu became the youngest prime minister in Israeli history. He transferred the Israeli economy towards free market principles and brought recognition to Israel as one of the most sought after high-tech markets in the world. At the same time he drastically reduced the deficit, cut inflation to a 35-year low and brought foreign investment to Israel in unprecedented levels.

Aaron Korman of Israel Newsletter wrote on Netanyahu's practical implementation of free market ideals:

Netanyahu's economic plan... tax cuts and privatization taking a leading role... As the rest of the world is marching towards socialism, Israel appears to be headed in the other direction, embracing free market principals

Further info - "Netanyahu's free market reforms: Hong Kong in the desert" at WorldwideLiberty.

Gear Through

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This question is about cycle gas turbo-compressor fault diagnose and i have no idea of what gear through is . Is it a component or part? Thanks

Problem: bearing temperature at gear through is too high

Possible causes：

a. oil temperature is too high

Solar PV Installation and the SCE CREST Program

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Greetings all,

Does anybody have any experience using the CREST program through SCE (southern California Edison)? Getting a power purchase agreement and self installation? Does it pay enough to be profitable ona 250Kw-1.5Mw scale? Apx $.09/kw/hr Thanks for your consideration. Spacecannon

The Left’s Big Lie on Jefferson and Texas Board of Education

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Obama administration preparing to Nationalize Educational decision-making

Texas Board of Education stalwart member Cynthia Dunbar was a guest on the Bill Bennett in the Morning show on the Salem Network, Wednesday morning. Dunbar explained in detail how charges that the right-majority Board sought to remove Thomas Jefferson from the State curiculum were completely and utterly false. TPM, Daily Kos and other leftwing blogs spread this story last week, which was picked up by major media outlets.

Dunbar detailed how the Board recommended moving the main body of discussion of one of America's "greatest Founding Fathers," from the chapter on the Englightenment to the chapter on the founding of the Republic.

This has prompted some Texas Democrats into calling for the elimination of the elected board. Additionally, liberal Democrats are calling for the decision making process of educational curiculuum to be moved under the auspices of unelected bureacrats.

From a release by the libertarian-leaning Americans For Prosperity (AFP):

AUSTIN – The Texas chapter of Americans for Prosperity denounces the promise of State Sen. Juan “Chuy” Hinojosa (D-Dist. 20) to abolish the elected Texas State Board of Education.

"State Board of Education members are elected, and last election, while Rep. Hinojosa received 124,456 votes, the average number of votes cast for a single SBOE member was more than twice that – 335,207," said AFP Director Peggy Venable.

"To suggest eliminating an elected body because you don’t agree with their decisions is un-democratic,” said Venable.

Americans for Prosperity’s members are pleased with the SBOE’s decisions regarding the social studies curriculum standards. We are disappointed that Democratic Gubernatorial candidate Bill White and others on the left have grossly misrepresented the board’s actions,” said Venable. “Sen. Hinojosa apparently thinks that if the voter-elected Board makes rulings that don’t fit his liberal agenda, then the Board should be eliminated.

Sen. Hinojosa is attempting to defy our state constitution and deny voters their right to have an elected body represent their interests regarding the public education of our children," Venable said.

The Texas curriculum battle is very important nationally, for other States follow Texas's lead. Dunbar was asked by Bennett what she felt might be the next move by the Left. She responded that the Obama administration may now seek to nationalize the process and standardize curriculum selection as a result of the Texas controversy.

Obama encouraging Corporate Welfare-ism: Qwest to go for big stimulus grant in Colorado

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Melding industry with the State

Qwest is going for a healthy chunk of Obama stimulus funds. The large Rocky Mountain West firm is wanting the federal government assistance to extend its service into rural areas of Colorado.

The details from The Denver Business Journal bizjournals.com "Qwest seeks $350M from stimulus for rural broadband" March 25:

Qwest now will ask for the stimulus funds to cover 75 percent of the cost of a planned $467 million project to extend broadband service with download speeds of 12 to 40 megabits per second (Mbps) to more than half a million homes, schools, businesses and hospitals in rural communities in Qwest's 14-state service territory. Qwest would cover the remaining $117 million itself.

The stimulus funds would come from the "Broadband Initiatives Program" administered by the Rural Utilities Service, an agency of the U.S. Department of Agriculture. The $7.2 billion program's goal is to promote efforts to expand access to tens of millions of people who lack broadband and who live within 60 miles of a city or town.

Originally, Qwest would have been eligible to have only half of its broadband infrastructure expansion project funded. Now, in the second round of funding, stimulus funding would cover up to 75 percent of the project if Qwest's application is OK'd.

The Libertarian Party of Colorado issued a statement on their blog:

There is no reason that tax payers should be forced to subsidize rural internet services. It is nice for farmers and other rural dwellers, but it is not really fair that they should pay less than the cost of service to them at the expense of the taxpayer. If they want this service than the only fair and right thing for them to do is either pay a premium and make it worthwhile for providers like Qwest to provide service in their area or to create a community co-op type of arrangement to get service by pooling resources with other rural people living nearby. the answer is not to turn to welfare to subsidize relatively well off people, and relatively rich corporations like Qwest.

Qwest is one of the largest employers in Colorado. They also do business in Montana, Utah, Wyoming and Nevada.