Quick Link: Maybe it’s time to take the plunge and become self-published like me

Quick links, bringing you great articles on writing from all over the web. After having some success with traditional publishing, author Denise Deegan decided to try out self-publishing. She writes up her experience on the Independent.ie site. ~ * ~ Maybe it’s time to take the plunge and become self-published like me by Denise Deegan […]

from Publetariat http://ift.tt/2aoM530

What is evolutionary medicine?

is the first of Ten Questions answered  by Randolph Nesse in an essay at http://evmedblog.org

from The Evolution and Medicine Review http://ift.tt/2an7Q61

Who's the most improved team this offseason?

from HoopsHype http://ift.tt/2aiVYOf

Deconstructing the Conspiracy of Deliberate Poisoning of Us Municipal Water

It takes more than a mass spectrometer, more than even a mass spectrometer and an ISO certification, to make you a scientist. Honesty helps too!

Heavy metals here, there, everywhere…

One of the key narratives among the supporters and practitioners of complementary and alternative medicine (CAM), particularly those with a conspiratorial world-view, is the claim that vast portions of the US general populous is being deliberately poisoned by certain corporations, special-interest groups, invested individuals, and the US government. Some of these supporters and practitioners go as far as to claim that this conspiracy is global in scope and not restricted solely to the USA. Among the supposed vectors of this poisoning is the claim of elevated and/or toxic levels of heavy-metals in such items as foods, vaccines, as well as municipal drinking water supplies; I will address the latter in this article.

One prolific web-based publication supporting this narrative is Natural News. Many of its writers, including its editor-in-chief Mr. Mike Adams (The Health Ranger), have added outspoken support to these claims of…someone…deliberately poisoning the drinking water. A brief search on Google using the appropriate keywords produces a large number of hits, with many of these hits being found on the Natural News website, and many have heavy-metal “detoxing” as a central theme. Titles of these Natural News articles include:

• “SHOCK FINDING: Oil and gas industry dumping toxic fracking waste into public water treatment plants incapable of filtering contaminants” [Internet Archive]
• “Don’t let heavy metals weigh you down; you can detox with some of the world’s greatest superfoods” [Internet Archive]
• “Health Ranger releases stunning infographic showing how heavy metals end up in the food supply due to industrial pollution” [Internet Archive]
• “Detox from heavy metals naturally by adding some cilantro to your sandwiches or salads” [Internet Archive]
• “China arrests thousands for environmental crimes as U.S. continues allowing heavy metals in food supply” [Internet Archive]
• “How to reduce your toxic heavy metal load simply and cheaply” [Internet Archive]

Of particular interest are three recent articles by Adams himself. In reference to his first article, during announcing the launch of his Natural Science Journal, Adams openly states that none of the existing science establishment (Academia, Corporate and Government) can be trusted [Internet Archive]. This is clearly illustrated in that announcement as follows:

In a world where nearly all so-called “science” is actually little more than corporate fraud and government malfeasance, nearly all mainstream science journals have been taken over by pharmaceutical and biotech interests. As a result, they destroy and suppress human knowledge rather than expanding it.

All the big science journals — Nature, The British Medical Journal, The Lancet and so on — function almost entirely as science prostitutes for corporate interests, spewing out a vomitous cascade of fraudulent, industry ghostwritten “doctored” studies that the industry pretends represent real science. This sad, filthy corruption of science harms the reputation of science itself and detracts from the valuable expansion of knowledge that can be achieved when science is practiced in the interests of humanity rather than corporate profits.

My aim is to rescue science from corporate prostitution and return science to the democratic, decentralized domain of the curious and the informed. (That means you.) This is why today, I have extraordinary news to unveil… a milestone for independent science conducted in the public interest… something that hasn’t happened before in the history of our world.

Today I’m announcing the launch of a new, independent, peer-reviewed science journal called the Natural Science Journal — a science journal that rejects all corporate money, government influence and all the blind, obedient “consensus” science narratives that only end in stupidity.

The actual first article itself, entitled: “ICP-MS analysis of toxic elements (heavy metals) in 100 municipal water samples from across the United States” [Internet Archive], is a simple laboratory report discussing the results obtained. It makes no remarkable claims and is written at the level of a laboratory analyst or technician. However, there is an attempt in the results and conclusion section by the author to make more of the actual observed heavy-metal levels measured than is warranted. The second article, however, is more direct and inflammatory. In it Adams openly claims [Internet Archive] that certain invested individuals and groups are deliberate poisoning the general US public using dangerously elevated levels of various heavy-metals in municipal and state drinking water sources. In this second article [Internet Archive] he referenced to further analytical results of US municipal and state drinking water undertaken by his CWC laboratory. Adams’ accusations are clearly demonstrated in both the title of the article (“Obama’s EPA caught covering up high heavy metals pollution across U.S. cities as federal government wages multi-faceted WAR against its own citizens”) and its content which states:

Our citizen-powered EPA Watch program has now resulted in the open source publishing of heavy metals contamination tests of 230 municipal water samples across America. The results show that two to three per cent of the U.S. water is highly contaminated with toxic heavy metals, poisoning an estimated 10 million Americans with brain-damaging contaminants that surpass EPA limits.

Yet the EPA has not alerted Americans to these toxic heavy metals in their water. Just as in the case of Flint, Michigan, the EPA is systematically covering up irrefutable scientific evidence of heavy metals water contamination across America.

The third article [Internet Archive], the most recent, is just a continuation of Adams’ accusations based on the data referenced in his second:

(NaturalNews) We’ve now published the water testing results for 239 water samples collected by our readers all across America.

As promised, this is part of our effort to conduct real science in the public interest and share the results publicly… even as the corrupt, criminal federal government conspires to hide these data from the public. (The EPA, like every agency of the government regime, has become a corrupt, anti-science front group that deliberately pollutes America’s waterways while covering up its crimes.)

Finally, in the last week Mr Adams has posted two new articles in which he promotes the opening of his CWC laboratory to the public for testing purposes. They reference the earlier articles containing data for the first 100 and, then, extended 239 water samples.

• “Health Ranger’s science lab announces water and soil testing services for the public: ICP-MS analysis reveals levels of 7 toxic metals, 3 major minerals and 10 trace elements” [Internet archive]
• “CWC Labs announces heavy metals water and soils testing services to the public; 20 toxic metals, minerals and trace elements analyzed via ICP-MS” [Internet archive]

… Or not

Fortunately, Adams did not only make the aforementioned claims, he also supplied the actual results measured by his Consumer Wellness Center Laboratory. Before diving into the raw data, there is one item that Adams must receive the appropriate due recognition for, namely the ISO/IEC 17025 accreditation recently achieved by his Consumer Wellness Center Laboratory. Having personally spent nearly two decades dealing with ISO/IEC 17025 accreditation for multiple laboratory analytical methods, I am fully aware of the large amount of effort and work required to achieve and maintain such an accreditation.

However, I believe that this accreditation will not provide Adams, his supporters, and those in the CAM arena with the “magic-bullet” they hoped for against the established sciences (academic, corporate and government). In fact, some of them may actually start to view it as a poisoned chalice in the near future.

Tilting at ISO 17025 accredited GC-MS wind-mills

The ISO/IEC 17025 standard is a lab-based quality system for the accurate, precise, and repeatable measurement of laboratory samples via internationally accepted standards, methodologies, procedures, and techniques to produce results that, when necessary, can be successfully used in any competent legal system. The standard itself is divided into two general sections, an Administrative section and a Technical section. Together they cover all aspects of running an accredited laboratory.

A key criteria underlining the entire ISO/IEC 17025 standard is traceability. Everything must be traceable back to its source/origin and/or to the international standards that the ISO/IEC 17025 standard is based on. This provides an accredited laboratory with a very capable system that is both international recognized and which generates reliable and trust-worthy results. Without the traceability, the entire quality system collapses.

The single weakness of the system is around sampling. Many accredited laboratories test samples that are provided by a third party rather than being collected by the accredited laboratory themselves. This is the situation Mr Adams’ Consumer Wellness Center Laboratory finds itself in with regards the Municipal and State water samples.

A Gas-Chromatography/Mass-Spectroscopy (GC-MS) is the combination of two useful analytical techniques: Gas-phase Chromatography and Mass-Spectroscopy. A GC-MS instrument is actually two analytical instruments linked together by an appropriate sample junction. The initial test sample is fed into the GC instrument which then separates the sample into its individual components (e.g. the individual types of heavy-metals ions) and delivers these, one molecule type at a time, to the MS instrument. The MS instrument then determines the type of molecule each component is, based on its measured molecular mass, as well as its concentration which can be referenced back to original sample and its make-up.

Another aspect of any analytical chemistry technique is the condition of the original sample and any associated preparation required before analysis. It can can be either a solid or liquid or gas, and may require specialized preparation depending on the type of analysis. For water samples, another aspect is whether the samples were supplied as a solution (complete dissolution of components) or a suspension/colloid (fine solid material floating/suspended within the water). For a suspension/colloid, the solid material is usually first separated from the water sample before analysis can commence, but for clear solutions — such as the water samples analyzed by Mr Adams’ Consumer Wellness Center Laboratory — sample preparation tends to be minimal.

And the raw data says …

So Mr Adams did us the favor of providing the analytical data for municipal and state water samples tested by his CWC laboratory. This allows not only a review of his data against his claims, but also a more thorough statistical interrogation of the data. A summary of this statistical interrogation is given in the table following (Table 1).

Table 1: Summary of CWC Laboratory analysis of 239 municipal and state water sources in the USA [Internet Archive]

	Aluminium (Al) ppb (µg/l)	Copper (Cu) ppb (µg/l)	Arsenic (As) ppb (µg/l)	Cadmium (Cd) ppb (µg/l)	Mercury (Hg) ppb (µg/l)	Lead (Pb) ppb (µg/l)	All Metals		As, Cd, Hg, Pb
							No.	(%)	No.	(%)
Variance (Ơ2)	2 730.10	35 369.63	1.34	0.08	0.00	79.56	n/a	n/a	n/a	n/a
Std. Deviation (Ơ)	52.25	188.07	1.16	0.29	0.00	8.92	n/a	n/a	n/a	n/a
No. samples with Z-Scores: >= 3ơ	8	5	5	5	0	3	23	9.6%	11	4.6%
AVE	28.69	101.01	0.80	0.08	0.00	1.49	n/a	n/a	n/a	n/a
EPA permitted max. (ppb)	500	1300	10	5	2	15	n/a	n/a	n/a	n/a
% of EPA max.	5.74	7.77	7.97	1.67	0.00	9.91	n/a	n/a	n/a	n/a
No. samples exceeding max. spec.	0	1	1	0	0	4	6	2.5%	5	2.1%

An initial review of the data provided by Adams indicated that few of the samples tested were outside the specifications stipulated by the EPA. When subjected to a Z-score analysis, a few interesting (but not unexpected) observations were made. For those unfamiliar with Z-Score statistics, it is a statistical method for determining whether each analytical data-point in a sample set is statistical similar or different for the sample set in question. This allows the reviewer of the data to note, with a given level of confidence, if an individual sample is significantly different from the others and, thus, which samples to take note of (ie. whether a particular sample approaches the maximum specifications set for it). Of the 239 samples analyzed, only 23 results were statistically different at a 99% confidence level (i.e. 3 sigma / 3ơ) based on a Z-Score analysis. That is equivalent to only 9.6% of the entire data set of all metals analyzed. If we remove aluminum and copper from the analysis, assuming that these elevated levels are coming from public water infrastructure that is old and/or in disrepair (ie. rusting water lines and pipes — a less scientific, but still reasonable assumption) and focus on the heavy-metals of considerably more concern (arsenic, cadmium, mercury, and lead, which are known for their severely toxic properties), then only 4.6% (i.e. 11 samples) are statistically different and thus are worth further investigation. However, the main finding behind the Z-Score is that the data sets for the water samples tested are mostly uniform, with most of the samples being statistically similar in that they generally have low levels of heavy-metal contamination.

Review of the averages (ie. the mean) across each heavy-metal indicated that all of the averages were below 10% of the maximum limit specified by the EPA, even when including the few elevated “outlier’ readings. That is to say, the average sample was well below the EPA levels of concern. Finally, of all 239 samples tested, only 2.5% (ie. 6 samples) exceeded the maximum limits specified by the EPA, and this drops to 2.1% when aluminum and copper are excluded from the average.

However, in Adams’ third article he states:

EPA limits, by the way, are much higher than what the United Nations requires for third world nations. So even water the EPA declares to be “safe” for Americans to drink may be considered unfit for human consumption in places like Somalia. (How’s that for a little factoid you didn’t expect?)

However Adams claims in this regards are without any merit as given by limits specified for drinking water by both the EU and WHO (Table 2).

Table 2: Heavy metal limits specified by the EPA, WHO and EU

	Aluminium (Al) ppb (µg/l)	Copper (Cu) ppb (µg/l)	Arsenic (As) ppb (µg/l)	Cadmium (Cd) ppb (µg/l)	Mercury (Hg) ppb (µg/l)	Lead (Pb) ppb (µg/l)
EPA (Permitted Maximum)	500	1 300	10	5	2	15
WHO (Permitted Maximum)	200	2 000	10	3	1	10
EU (Permitted Maximum)	200	100* / 3 000*	50	5	1	50

* EU Copper / guideline (no limit specified): 100 ppb running water / 3000ppb standing water

In general, the differences between the EPA, WHO and the EU are small. In some cases the EPA is a little less stringent, in other cases its limits are stricter, and for the rest they are essentially identical. In particular, for the four heavy metals of concern (arsenic, cadmium, mercury, and lead) the EPA is on par with both WHO (UN) and the EU. Adams attempted to create the impression that the EPA limits are significant higher than the UN (and dangerously so) but this is clearly not the case from the limits specified. This raises the question as to why Adams made such an accusation. One likely possibility is that Adams is aware that his own data does not strongly support the contention that there is a vast conspiracy to deliberately poison the US public en masse. Thus to create that impression he made the erroneous and deceptive claim about the UN limits for heavy metal contamination of drinking water being significantly lower than those used by the EPA — ie. In other words he was trying to forcibly create a crisis, a “phantom menace” if you will, where there actual was none. If true, this is action is to be condemned with the harshest censure as any individual that claims to be a scientist violates the main precept of science when he or she tries to force the data to fit a pre-existing hypothesis. The data tests the hypothesis, the hypothesis does not dictate the data.

Thus, instead of supporting Adams claims of mass heavy-metal poisoning through drinking water, Adams’ CWC laboratory results actually proven the complete opposite. If Adams, his supporters, and those of likeminded were correct in their speculation, the laboratory data would have shown significantly more samples with heavy-metal contamination above the EPA limits and much higher heavy-metals contents in almost all water samples for all metals tested in general.

If Adams was truly serious …

If Adams and his supporters were truly serious about the possibility of dangerously contaminated drinking water, then they should approach the entire issue much differently. For one, Adams should have designed a much better experiment, as his present design-of-experiment (DOE) is terribly weak. His “one-tap, one-sample, analyzed-once” approach is grossly inadequate. He should be sampling for each zip-code referenced in the data at more than one location and source, and at each source in triplicate. This would reduce any possible variation that typically arises when sampling a large system. Furthermore, this sampling should also be repeated multiple times over an extended time period, for example weekly or bi-weekly at each location and source over a period of about three months to a year. In addition, the overall analysis should not focus solely on single data points, as Adams present approach does, but rather on patterns in the data such as specific water supplies showing elevated heavy-metal repeatedly over long periods of time, with a particular emphasis on the much more dangerous elements of arsenic, cadmium, mercury, and lead. One further aspect of Adams’ DOE that must be addressed is that no attempt was made to account for the spread of population density in reference to the ZIP-codes tested. There is no way of knowing whether the water samples that demonstrated results above the maximum specified by the EPA were from small rural or town communities of a hundred or so people, or cities of millions. In light of this, making the claim that: “…poisoning an estimated 10 million Americans with brain-damaging contaminants …” is not scientifically justified as no attempt was made to account for population density.

In the end, it is easy for individuals or groups to make unfounded and pseudoscientific claims, but when people try to fit actual scientific fact and measurements — particularly using reliable and accurate analytical techniques — to the pseudoscience, then there is bound to be a conflict between the two. In that case, the well-executed science must always win.

---

CD “Tiger” Pearcey obtained his Master’s degree in Chemistry from the University of the Witwatersrand, South Africa. The title of his Masters dissertation was “Catalytic Oxidative Coupling of Methane with Consecutive Gas-Phase Reaction”. His original Bachelor of Science degree was a double major in Chemistry and Biochemistry. Pearcey has over 20 years’ experience in applied chemical research, most of which was obtained in service to his present employer who is a leading manufacturer in the paper, pulp, and dissolving pulp industry. Pearcey manages the laboratory with a speciality in bleaching technology at one of the company’s main research facilities.

The views expressed are those of the author, CD Pearcey, and do not reflect those of his employer on any topic in question.

 

 

from Science-Based Medicine http://ift.tt/2aTuWx8

Sergio Rodriguez comes back to the NBA a changed man

Six years later, Spanish guard Sergio Rodriguez returns to the NBA with three Spanish League titles, one Euroleague crown, a Euroleague MVP award, a Eurobasket championship, an Olympic medal and much-improved jump-shooting and playmaking skills. It’s going to happen with the Sixers, a far cry in terms of title contention compared to Real Madrid in Europe or the Spanish National Team in summer tournaments. But it’s all good, says Rodriguez, who never abandoned hope of making his way back to the NBA one day.

Why do you go back to the NBA this year instead of last year or next season?

Sergio Rodriguez: The situation I’ve had with Real Madrid over the past few years has been very good. It allowed me to grow both from a professional and a personal standpoint and I felt very comfortable. At the same time, going back to the NBA was always in the back of my mind, especially with all the titles we’ve won and all the things we’ve accomplished. But of course, I was going to do it in the right circumstances. It had to be a place where they really had faith in me. Otherwise, it would have been very complicated for me to give up on the good things going that I had in Madrid.

Walk me through the process of signing with Philadelphia. The season ends with Real Madrid… Then what happens until you agree to a deal with the Sixers?

SR: In the final stretch of the season, I didn’t want to think about anything other than winning the league title. Finishing the year with both the cup and league titles was very important. Once that was over with, I had five days off where there was contact with NBA teams, but obviously it was hard to evaluate the level of interest they had in me  and the real options out there before free agency actually began. When July 1 came, I was with the National Team and those were pretty intense days. I ended up having an offer that I really liked with Philadelphia and I think it can be a very good place for me to grow and fulfill my dream of returning to the NBA.

Were you more like, “I’m almost dead set on going to the NBA and will take the best offer” or “I’m only going if I have a really good option?”

SR: At my age, you can’t bet it all on whatever comes. Financially, it had to be a place where… I’m not even talking about making a lot of money, but more like a situation that wouldn’t hurt me money-wise [Rodriguez had a buyout to pay]. Once that was clear with the Sixers, I talked with management and the coach and felt really comfortable and confident that was the place for me. We had discussions with other teams, but from the get-go it was clear Philadelphia had a lot of interest and I established good rapport with Brett Brown and (Bryan) Colangelo.

I just wanted an opportunity to prove myself again in the States and enjoy basketball. I’ve always said this… Even though people might think differently, I enjoyed my first years in the NBA a lot. In hindsight, it feels even better. I went there when I was very young, I played a lot of games and a lot of minutes for my age and my skill level at that time. Now I go back a different man, more mature and with family and I want to enjoy it in a different manner.

Some players get cynical about the NBA when they go there and don’t have the playing time they hoped for. You say it was not your case and you enjoyed it. How was that?

SR: To each his own. My thing is I grew up playing at home always dreaming about playing in the NBA one day. That stays with you forever. Getting the chance to go there so early, it was big. I left Tenerife [the Spanish island where he was born] for Bilbao when I was 14, then I moved to Estudiantes and when I had a shot to make it in the league, I just took that chance. I feel very proud that I did that knowing it was a complicated thing to do, just playing against the best in an environment I was not familiar with. And anyway I did it and feel proud when I think about it. I can understand that some things are hard to swallow for some people, but that was not me. I just felt and feel happy knowing I did whatever I thought was best at each step of the way. I feel I was lucky too.

Looking at the kind of contracts that have been signed this summer, is it exciting to think about the financial compensation awaiting if you have one strong year in Philly?

SR: It is something you think about when you’re under contract for just another year because you don’t have that stabilty you find with a longer deal, but I’m thrilled about going there and proving myself. I’m perhaps going to be the most veteran player on the team, which didn’t come close to happening with any of the teams I’ve been with before. I just want to enjoy this season and not think too much about what may come afterwards. It’s about me growing as a player and us growing as a team. It’s exciting to be in a situation that’s different to the ones I’ve been through lately. I’m aware everything goes real fast. It’s been 10 years since I moved to the NBA for the first time and it’s been a blur.

Being a veteran on a team for the first time, how’s that going to be?

SR: It’s exciting. I think my experience can be useful to the team.

What do you know about the young guys on the team?

SR: It’s a situation akin to the one I had with the Blazers back in the day, especially my second year. Brandon Roy already had a great season under his belt, then you had LaMarcus Aldridge and it was a young group which was winning more and more. There was a lot of progress and we all grew together as a team. Plus the atmosphere there was really good. That gave us strength to improve. In Philly, I think it’s similar. Young guys are really looking forward to winning after a bunch of tough seasons and hoping to be important players in the NBA.

Is your wife happy with the move?  

SR: We’re all very happy. In 2006, I went to the States on my own with all my career ahead of me and it was a nice personal experience. Now it’s going to be a nice professional experience, but above all things a great personal experience for me, my wife and our daughter, who’s one year old. Not sure how much he will remember about the next few years, but it’s probably going to be something that stays with her for the rest of his life. Me and my wife can grow with this. She was with me late in my time in Portland, then Sacramento and New York. But it’s all different now. It’s not just about you and/or your couple. You have to take into consideration what’s best and most comfortable for the three of us. Back in the day, when you were looking for a place, it was about whatever you were into at the time, you wanted to live in certain areas. That changes now with the kid, it’s more difficult to make a choice, but it’s beautiful too.

Aside from the fact that you have won a lot, why do you think the Spanish National Team is disliked so much by so many people outside of Spain?

SR: It is?

Oh, you should see my Twitter mentions whenever I tweet during a Spanish National Team game.

SR: Nah, I don’t think it’s that bad. It’s true when you’re fortunate enough to win so many things you become the team to beat. This team has accomplished that with a lot of work and I think it’s been much deserved. Now we have the Olympic Games ahead of us and it’s a very good team again and we will be confident after winning the Eurobasket last year.

Is a bronze medal in Rio a success?

SR: That’s something you can only ask and think about after the fact. After making it to the final twice in the last two Olympic Games, we obviously have no other goal in mind than repeating and winning. But every tournament is different and we can only focus on the things we can control.

from HoopsHype http://ift.tt/2ayqRAV

Quick Links: What to Do When No One Shows Up To Your Reading

Quick links, bringing you great articles on writing from all over the web. A lot of prospective authors are held back by fears like “what if no one likes my work”. So what if you hold an author event, and no one show up? Embarrassing, right? How do you deal, besides with lots of wine […]

from Publetariat http://ift.tt/2ak3tmb

Quick Links: How to Prepare for Self-Publishing – Covers Design

Quick links, bringing you great articles on writing from all over the web. A great cover is like a great outfit for your book. And like a great outfit, the cover should look good close up as well as far away. It is also the first thing a potential reader will judge you on. In […]

from Publetariat http://ift.tt/2ax9OO3

Friday Links

– Portable desk divider Diplomate by Pierre-Emmanuel Vandeputte

– WSJ: Dyson vs. iRobot Roomba

– Kickstarter: Cora – All-in-one pour over coffee brewer

– Touchscreen monitor desk, anyone? Space Workspace from M33 Labs

– KickstarterThe Catalyst – Beer Fermentation Made Easy

– Recognize these emoji portraits of famous artists?

– Nice: Urban Travel Mugs

– Studio Job Loft in Antwerp

Enjoy your weekend!

from Better Living Through Design http://ift.tt/2awzmLc

2017 Scratchable Wall Calendar

May I suggest you sit down, take a sip of water, and prepare yourself? Because this is the first calendar of 2017 I’ve seen and it surprised the hell out of me. 2017!? It’s July, though, yes, just barely. It’ll soon be August, then September, October… you know the rest. The onslaught of holidays, etc. Ugh. Maybe you could get a jumpstart on the impending doom, or at least ease yourself into it, with this Scratchable Wall Calendar. The matte black PVC surface can be written on with chalk, then erased. You can also scratch off the white and silver ink, giving you ample opportunity to make the calendar more suited to your minimalist (or maximalist?) preferences.

Limited edition of 200.

Made in the United Kingdom
Dimensions: 27.5″h x 20″w

from Better Living Through Design http://ift.tt/2ajJGqf

15.0% Ice Cream Spoon

Before you roll your eyes at a $45 spoon, you need to know this is a special spoon, for ice cream. It uses your body heat to cut through frozen ice cream, which makes your “scooping experience” effortless. The solid aluminum spoon has a thermal conductivity of 237 W/mK (watts per meter kelvin), so you’ll be slicing through your favorite flavor with ease like a ice-cream-eating ninja.

“Comes in 3 different styles: 01.vanilla has the archetypal egg-shaped tip, 02.chocolate features an angular tip that allows easy reach to the corner of the ice cream cup, and 03.strawberry is ideal for drilling into your sorbet with its fork-shaped tip.”

Designer: Naoki Terada
Maker: Lemnos
Material: Polished Aluminum
Dimensions: 4.1 × 1 × 0.5 in. / 10.5 × 2.6 × 1.4 cm
Origin: Japan

from Better Living Through Design http://ift.tt/2ajAmTn

NBA A to Z: What Klay Thompson thinks of playing next to Kevin Durant

As much as any of the Golden State Warriors, Klay Thompson could feel the effect of Kevin Durant joining the team. USA TODAY Sports’ Sam Amick and Kevin Spain discuss how those two players’ games can co-exist.

Amick caught up with Thompson at a recent Team USA practice to get his thoughts on Durant joining the Warriors, how his game will be affected and how Durant’s agent grilled guys before the signing.

from HoopsHype http://ift.tt/2ahqpIZ

Separating Fact from Fiction in Pediatric Medicine: Facial Nerve Palsy

An infant with a left facial nerve palsy

There are numerous medical conditions that are seemingly designed to allow proponents of “irregular medicine” to proclaim their treatments to be effective. These conditions tend to be chronic and subjective in nature, or to have waxing and waning courses such that a parent or patient might easily be fooled into assigning a causal relationship between a bogus intervention and a clinical improvement. Brief, self-limited maladies are also quite convenient for people with nothing to offer but false information and false hope. After a recent encounter with a patient, I’ve added a new one to the list: idiopathic facial nerve palsy.

What is idiopathic facial nerve palsy?

Although not the first to do so, facial nerve dysfunction resulting in the sudden and unexplained weakness of all muscles on one side of the face was most famously described by Scottish neurophysiologist Sir Charles Bell in 1830. Hence it is commonly, if not always accurately, referred to as “Bell’s palsy.” Since then our understanding of the condition has progressed considerably, thanks to scientific investigation and improved diagnostic testing. In particular, we have learned that many cases are the result of infection, with ear infections, various human herpes viruses, and the spirochete responsible for Lyme disease being the most common culprits in children.

There are many other potential causes of facial nerve palsy in addition to infections, however. These include birth injury, congenital syndromes, cancer, metabolic and autoimmune diseases, and toxic exposures to name just a few. Bell’s palsy, which represents about half of all cases of facial nerve palsy in children, is the diagnosis given when symptoms appear to be idiopathic, meaning that they occur spontaneously and without an obvious cause. In reality, however, many of these cases are actually caused by viral infections or Lyme if the patient lives in an area where it is endemic.

Overall about 20-30 people out of every 100,000 are diagnosed with Bell’s palsy each year, with a predominance in the adult population. It is fairly uncommon in very young children and there is no particular increased risk based on race, gender, or location. It is not a reportable condition, so exact estimates are hard to determine, but roughly 40,000 people are believed to be diagnosed each year and you have about a 1 in 65 chance over your lifetime.

The key in sorting out these apparently idiopathic acute cases from those that may represent a more concerning underlying condition, like cancer or an aneurysm, is appropriate evaluation by a trained medical professional and judicious use of imaging and laboratory testing. It is not uncommon for pediatric neurologists to become involved, particularly in cases that are severe or persistent. Overall in children, the most common causes of facial nerve palsy are ear infections, Lyme disease (most common in endemic areas), idiopathic (Bell’s palsy), varicella (chicken pox) and herpes zoster (shingles).

What are the signs and symptoms of idiopathic facial nerve palsy?

In most cases of idiopathic facial nerve palsy, weakness of the facial muscles comes on suddenly. Patients or parents will notice decreased movement of the forehead, manifesting as difficulty raising the eyebrow as well as weakness in, if not complete inability to close the affected eyelid. One obvious sign is the disappearance of the nasolabial fold that runs between the cheek and the upper lip. The corner of the patient’s mouth typically droops at rest, and sufferers will have trouble smiling.

Because of the facial nerve’s complex anatomy and function, some patients will experience associated symptoms not related to muscular function. This can include a decreased ability to make tears on the involved side, loss of taste on the anterior two-thirds of the tongue, and increased sensitivity to sound. There is a very crude joke that I learned in medical school regarding one of these, but I won’t repeat it here. Those curious enough can practice their google-fu skills to find it.

An important aspect of the neurological examination of patients presenting with facial nerve palsy is careful attention to the muscles of the forehead. As previously mentioned, with idiopathic facial nerve palsy these muscles should be involved. But what if they aren’t?

We have two facial nerves exiting the brainstem, one for each half of the face, that travel through the skull to the various muscles of the face. The origins of most of each facial nerve’s motor functions lie in the cerebral cortex of the ipsilateral (same side) brain hemisphere. If injury occurs in these “upper motor” neurons, such as from a stroke, a patient will have facial paralysis on the same side.

But, because the division of the facial motor nucleus responsible for the forehead actually receives some input from the opposite hemisphere as well, those muscles are generally spared in the case of a stroke or other problem in the brain itself. Problems with the facial nerve distal to where these motor fibers combine, such as the classic idiopathic facial palsy, will result in total facial involvement. This is known as a peripheral palsy. If the forehead isn’t involved, we worry about something more sinister.

Along these same lines, activation of the facial nerve occurs both intentionally and automatically, such as during a spontaneous display of what humans call laughter. The peripheral facial nerve and the muscles innervated by its branches don’t know the difference between the two. If the problem occurs after the nerve emerges from the brainstem, nothing works.

But different areas of the brain are involved with these two aspects of facial movement. An injury in one will still allow the other to function. So if you can’t smile on command but watching Dane Cook elicits spontaneous laughter, you need neuroimaging and a better sense of humor.

How is idiopathic facial nerve palsy diagnosed and treated?

Idiopathic facial nerve palsy is a diagnosis of exclusion, requiring a thoughtful history and a thorough physical exam. We need to be even more careful in children because idiopathic palsy is less likely to occur compared to the adult population. All the muscles of the face must be involved to some degree and the onset must be fairly sudden. Weakness/paralysis should not continue to worsen after three weeks and recovery should begin no later than six months after the first sign of weakness.

Again, other causes must be ruled out to the best of our ability. This often includes laboratory testing for Lyme disease in children who may have come into contact with ticks capable of spreading the disease. Although many if not most patients don’t require additional studies, some may undergo electrodiagnostic studies, MRI or CT scanning, or lumbar puncture to obtain cerebrospinal fluid depending on the specifics of their presentation.

As with most conditions, treatment of facial nerve palsy in children is determined by the specific cause and the severity of the presentation. If there is a specific underlying etiology discovered, such as Lyme disease or a bacterial infection of the middle ear or surrounding bone, it should be treated. Congenital or severe acquired cases that result in permanent loss of movement may benefit from nerve grafting and/or muscle transplantation.

If no cause is discovered, and the diagnosis is idiopathic facial nerve palsy, the gold standard of therapy in adults is an oral steroid as early as possible in the course, and some experts recommend the addition of an antiviral medication that targets herpes simplex virus. The evidence of benefit from this is extremely meager, however. Physical therapy can also be helpful in some cases, serving to preserve function and avoid contracture of the involved muscles.

There is little evidence available to guide treatment in children with idiopathic facial nerve palsy. Based on adult data and expert consensus, steroids are commonly initiated when other causes, particularly leukemia, have been ruled out. In Lyme endemic regions, many children are empirically treated while studies are pending but there is not consensus on this approach. Antivirals, as with adults, aren’t well supported and are generally reserved for empiric treatment of the most severe cases or when the cause can be clearly attributed to shingles.

In addition to the cosmetic difficulties, one of the more distressing aspects of this condition is drying out of the affected eye and the possible development of corneal abrasions because of an inability to blink or close the eye. Artificial tears are generally prescribed and overnight use of a longer lasting lubricating ointment as well as patching are standard. Sometimes surgical intervention or the placement of a weight into the upper eyelid is necessary to avoid discomfort and injury.

What is the prognosis of idiopathic facial nerve palsy?

The overall prognosis for facial nerve palsy is challenging because such a variety of potential causes exist. Some, such as congenital cases associated with genetic syndromes, are very unlikely to resolve. In these cases, the facial nerve may not have even formed. Traumatic cases, such as after a forceps delivery, almost always demonstrate recovery because the nerve is simply swollen. With idiopathic facial nerve palsy, the prognosis is generally excellent, particularly if it never progresses to complete paralysis and recovery begins within three weeks of onset.

Close to 90% of patients with idiopathic facial nerve palsy will begin to experience recovery within three weeks even without treatment, with many seeing return of function within ten days. The earlier that recovery begins, the more likely it is to be complete. Nearly all patients who have early recovery will have no residual weakness. And most patients with late recovery will at least have moderate improvement. Cases that don’t demonstrate at least partial recovery by a few months were likely misdiagnosed.

Some “alternative” approaches to idiopathic facial nerve palsy

So now that you know the science-based medical understanding of idiopathic facial nerve palsy, it should be easy to see why so many practitioners of quackery CAM integrative medicine quackery claim treatment success, and why their patients might believe that an ineffective remedy worked. If diagnosed correctly, it is a largely self-limited condition and recovery begins fairly soon after onset in most cases. Of course the key is the “if diagnosed correctly” part. There are serious conditions that can present with facial palsy that may require specific treatment to prevent worsening. Imagine a child with leukemic infiltrate of the facial nerve or a brain tumor undergoing months of acupuncture before seeing a real doctor.

A quick online search reveals all the usual suspects. I’m not going to provide an exhaustive debunking of every implausible therapy, however. Maybe another time. Consider this more of a shallow yet fun dive into nonsense that might serve as inspiration for your own investigations, a frustrated laugh, or a cathartic primal scream.

Chiropractic

There is no shortage of chiropractic websites claiming success in treating this condition and making the expected claims about “removing nerve interference” we’ve all come to know and love. But the anatomical assumptions are a bit of a stretch. Each facial nerve leaves the brainstem and exits via a hole in the skull near the ear. It isn’t a spinal nerve and it would be very unlikely that a chiropractic subluxation of the upper vertebrae, if they even existed, would somehow interfere with it.

But they do love their case reports. There are two commonly used as justification for chiropractic care, both of which require a poor understanding of the natural course of the diagnosis to take seriously. In the first, a patient reported 70-80% improvement after a chiropractic adjustment and application of low level laser therapy at only 14 days after onset of weakness. Many patients see improvement this quickly plus he had been seen by his primary care doctor first and put on oral steroids. Must have been the chiropractic though. The second report, which sadly doesn’t involve any lasers, documents a patient that recovered steadily with chiropractic manipulation of multiple spinal segments and her skull…over a six month period.

TCM and acupuncture

Not to be outdone, proponents of Traditional Chinese Medicine and acupuncture claim to able to improve symptoms and reduce time to recovery without even accessing the spine. In addition to numerous herbs, vitamins, and a full body massage, they include the following helpful information on the etiology of idiopathic facial nerve palsy:

In traditional Chinese medicine (TCM), the diagnosis for Bell’s Palsy is termed “External Wind-Cold attacking the channels of the face”. According to TCM principles, one of the main implications of this condition is an underlying qi (a person’s inherent energy) deficiency. In China, acupuncture has been used for thousands of years to assist in Bell’s Palsy recovery, and the initial treatment goal according to TCM would be to expel Wind and resolve Damp, as well as to invigorate qi and promote blood circulation to the face. Consistent acupuncture treatments (usually recommended once or twice per week), can help soothe a patient, expedite the paralysis from dissipating, and enhance nerve function.

Of course, readers of Science-Based Medicine know that claims of ancient acupuncture are largely fictional. Modern acupuncture bears little resemblance to what was being done a hundred years ago let alone thousands. It was more akin to astrology based bloodletting with large spikes than the placement of stainless steel filiform needles gently into the skin while relaxing music plays.

Here is a video of “acupuncture” treatment involving running an electrical current into the muscles of a patient’s face. Electrical stimulation as a form of physical therapy is a treatment approach that has been tested and shown to not speed or induce recovery. Acupuncturists are simply taking advantage of the post hoc ergo propter hoc fallacy when they claim electroacupuncture, or any other flavor of acupuncture, helps. Here is non-electric acupuncture being used to treat facial palsy. Here is another example, which you know is fake because they are wearing sterile gloves.

In this video, which is actually a very interesting look into the thought process of an average person when faced with something like facial nerve palsy. You’ll notice her demonstrating many of the biases and logical fallacies we discuss on Science-Based Medicine. In the final video documenting the one month course of her weakness, she credits acupuncture as the most helpful intervention, not the steroids, time, or any of the many different interventions she tried, but she admits that she didn’t get needled until the tenth day.

Apparently acupuncture “works” better if you wiggle the needle. In a study that did not include sham acupuncture or a regular care group, patients whose needles were wiggled demonstrated statistically significant improvement in subjective outcomes compared to patients whose needles did not go wee wee wee all the way home. The only objective end point assessed revealed a tiny improvement that is likely clinically meaningless and represents noise in the data. My conclusion is that the patient’s having their needles wiggled knew they were getting “special” acupuncture.

For something a bit more academic, check out these guidelines for a prime example of the failure of EBM when it comes to alternative medicine. Notice all the “Grade A” recommendations. Garbage in, garbage out.

Homeopathy and more!

The University of Michigan Health System, one of many examples of academic medical centers choosing marketing over patient care, provides patients with this handy discussion of the use of homeopathy for Bell’s palsy.

Have you ever wondered which crystal is good for someone with facial nerve palsy? Well wonder no more! It’s obviously Lavender Jade, but be sure it has been freshly cleansed before each application.

If crystals aren’t your thing, practitioners of Face Reflexology claim to be able to reattach severed facial nerves years after the injury.

While perusing the internet looking into alternative remedies for idiopathic facial nerve palsy, I discovered Mudra therapy. This is an alternative practice that involves holding the fingers and hands in specific positions in order to “restore a state of balance in the body and raise the level of the performer’s resistance.” The fingers and thumb represent the “panchamahabhootas” that make up the entire universe: sky, air, fire, water, and earth. According to believers, holding specific finger positions in place can cure a variety of illnesses. Even facial palsy.

Here is a video of a hypnosis session on a patient with facial palsy. It does not appear to have helped despite the claim of amazing results.

Conclusion: Facial nerve palsy doesn’t need quackery

Idiopathic facial nerve palsy may not tend to be a life-threatening or even a serious medical condition in most cases, but it can be extremely distressing to patients and potentially very uncomfortable if appropriate care is not provided. Although there are no medical therapies that have been shown to significantly hasten recovery, it is important for the correct diagnosis to be made, particularly in children who are more likely than adults to have a more concerning etiology of their facial weakness. Rather than one of the many implausible and unproven alternatives, your best bet is science-based care from an appropriately trained medical professional.
 
 

from Science-Based Medicine http://ift.tt/2alVokM

Quick Link: What Happens After You Sign the Contract?

Quick links, bringing you great articles on writing from all over the web. Weina Dai Randel at Writers In The Storm gives us another peek behind the curtain with what happens after you sign the contract. Hint – it involves lots of edits… ~ * ~ What Happens After You Sign the Contract? May 30th, […]

from Publetariat http://ift.tt/2aCqLq5

Work ethic set Amare Stoudemire apart

Former NBA player Eddie Johnson breaks down the career of Amare Stoudemire, who recently announced his retirement from the league after 14 seasons.

from HoopsHype http://ift.tt/2ay7Kqc

Folded Vessel

Ah-ha! This proves that some designers are mercifully kind to those of us that can’t afford to just plonk down a thousand plus dollars for a beautiful book/magazine stand. Chen Chen & Kai Williams have designed the Folded Vessel for Good Thing, and it’s similar, though less expensive, to their Third Eye Vessel design. Three identical petals fasten together to form the floor-standing container, giving you an excellent spot to keep your records, books, and magazines. The matte-black is a no-brainer, but the pale pink or cobalt blue are also appealing options if you don’t mind a little color.

Designer: Chen Chen & Kai Williams

Material: Powder Coated Steel, Rubber, Aluminum
Dimensions: Length 19.5″, Width 17″, Height 14.5″

from Better Living Through Design http://ift.tt/2agrYAw

Chopping Blocks

Nice! These solid American Ash chopping boards are made from off-cuts. That means every circle, octagon, or square board you buy, you’re reducing the amount of wood that ends up in a landfill. Each block has a rope handle for convenient hanging for storage (or for swinging it around your head when you want to look crazy or dangerous).

All Douglas and Bec products are handmade in New Zealand by local artisians and have the qualities of small scale production.

Dimensions: Ø300 x h30mm

from Better Living Through Design http://ift.tt/2aePNPu

CARA: Integrating even more pseudoscience into veterans’ healthcare

 

The pixels were barely dry on David Gorski’s lament over the expansive integration of pseudoscience into the care of veterans when President Obama signed legislation that will exacerbate this very problem. The “Comprehensive Addiction and Recovery Act of 2016” (“CARA”) contains provisions that will undoubtedly keep Tracy Gaudet, MD, and her merry band of integrative medicine aficionados at the VA busy for the next few years integrating even more quackery into veterans’ medical care.

CARA is intended to address the serious prescription drug abuse problem in the U.S. It provides grants for local communities dealing with drug abuse crises and for drug abuse programs, improves access to overdose reversal medication and medication-assisted drug addiction, and assists in training first responders, among other things. It also includes provisions related to pain management, such as development of best practices to treat pain. None of that is the problem.

Deep in the Act, almost at the end, is “Subtitle C – Complementary and Integrative Health,” which begins with “Expansion of research and education on and delivery of complementary and integrative health to veterans.”  I am not sure who stuck this into the new law, but it is only tangentially related to addiction and recovery. It establishes the “Creating Options for Veterans’ Expedited Recovery” Commission or, in the acronym-rich language of government, “COVER.”

The COVER Commission is to examine the evidence-based therapy treatment models used by the VA for treating mental health conditions and “the potential benefits of incorporating complementary and integrative health treatments available in non-Department facilities.” This effort is to be directed at improving “wellness-based outcomes.”  Authority to use “non-Department facilities” means that complementary and integrative services not provided in house will be available to veterans, substantially expanding the opportunity to send them to questionable facilities.

And how is the VA to go about this? It is to examine the research on complementary and integrative health treatment therapies for mental health issues and identify what the benefit might be for including them. There’s a handy list of what Congress had in mind in the way of CIH (as it is now called) treatments: music therapy, equine therapy, training and caring for service dogs, yoga and meditation therapy (since when are yoga and meditation “therapies?”), outdoor sports therapy (same question), hyperbaric oxygen therapy, accelerated resolution therapy, art therapy, magnetic resonance therapy, and “other therapies the Commission determines appropriate.”  As always, there’s a blend of more or less conventional stuff (art and music therapy, dog training) with pseudoscience (acupuncture), although I note that many of the standards didn’t make it, like reiki, healing touch, guided imagery, reflexology dietary supplements, and tai chi. Of course, they could fall into the catchall “other therapies” if the Commission so chooses.

I was intrigued by the inclusion of hyperbaric oxygen therapy. How could that possibly benefit mental health issues? That feat appears to be the result of a series of lobbying efforts by proponents of HBOT for PTSD, although clinical trials to date have not supported its use, nor do experts in HBOT think it’s effective.   Behind this effort is a group of doctors of what appears to be the “brave maverick” variety, especially Dr. Paul Harch, who believes HBOT is an effective treatment for autism, if that tells you anything.

Accelerated resolution therapy (ART) is another new one. It is, according to the Substance Abuse and Mental Health Services Administration, (SAMSA),

a brief, exposure-based psychotherapy aimed at treating psychological trauma, depression, anxiety, phobias, obsessive–compulsive disorder, and substance use. The program is delivered in one to five, 60–75 minute sessions over 2 weeks. The program incorporates specific visualization techniques enhanced through the use of rapid eye movements (similar to the rapid eye movement stage of sleep) and a directive approach that reduces physical and emotional reactions to distressing memories and images stored in the brain.

SAMSA has concluded that ART is effective for reducing depression, improving personal resilience and self-concept and reducing trauma and stress-related disorders and is already in use in the military.  I am at a loss to see why this is in a list of complementary and integrative health practices.

Magnetic resonance therapy is an off-label use of transcranial magnetic stimulation, which is FDA-approved for drug -resistant major depression. It is now the subject of a clinical trial for PTSD. Again, it is hard to see why MRT is included in this category.

Eighteen months after the Commission’s first meeting, it is to issue a report on the VA’s evidence-based therapy model used for veteran’s with mental-health problems. As well, the report is to include

an examination of complementary and integrative health treatments [on the list] and the potential benefits of incorporating such treatments [in mental health therapy].

The VA must come up with an “action plan” for “improving wellness-based outcomes,” whatever that means.  If the Commission recommends a particular CIH therapy and the VA doesn’t incorporate it, the VA has to justify its decision to Congress.

How all of this plays out likely hinges on who is appointed to the Commission, which is to be selected by various members of Congress and the President. CARA specifies that half must be veterans and they must have a background in treating mental health and have experience working with the military and veteran population.  They cannot have a financial interest in the CIH treatments reviewed. They may seek out (but don’t have to) guidance from outside groups, such as foundations, nonprofit groups, institutions of higher education and “other organizations,” leaving open the distinct possibility that CIH proponents could have a say in the outcome.  If the Wayne Jonases of the world populate the Commission, we may well turn out to have another Whitehouse Commission on Complementary and Alternative Medicine on our hands.

Just what we need: more CAM research

CARA also says that, within 180 days of enactment (on July 22^nd), the VA

shall develop a plan to expand materially and substantially the scope of the effectiveness of research and education on, and delivery and integration of, complementary and integrative health services into the health care services provided to veterans.

Expanding “the scope of the effectiveness of research” sounds a little like Tom Harkin’s desire that NCCAM “validate” CAM instead of finding it doesn’t work, if it makes sense at all. How do you expand the scope of the effectiveness of something?

In any event, all pretense of having anything whatsoever to do with mental health issues or drug abuse is abandoned and there is no list of treatments Congress favors.  They mean all CAM/CIH for anything.

The plan must include research on the effectiveness of CIH health services, approaches to integrating CIH, and education and training for health care professionals in integrating CIH and “appropriate use of such services,” as well as “metrics and outcome measures to evaluate the effectiveness of integrating CIH.” In formulating the plan, the VA shall consult with, among others,

“institutions of higher education, private research institutes, and individual researchers with extensive experience in [CIH] and the integration of [CIH] into delivery of health care [and] nationally recognized providers of complementary and integrative health.”

Thus, CIH proponents will have an opportunity to influence the plan. No equal time for skeptics or SBM proponents is mandated.

Not only that, but the VA has to establish a pilot program at 15 VA medical centers to evaluate, among other things, whether CIH services are effective “in enhancing the quality of life of veterans” and in “increasing adherence to primary pain management and related services” and whether they “have an effect on the sense of well-being of veterans.” Note that this has nothing to do with effectiveness of the treatment per se, but basically looks at whether the CIH service makes the patient “feel better.”  As we know, a quack treatment can do absolutely nothing for the patient’s condition, but the patient will perceive improvement where there is none.

And who is to provide these services?

Professionals or other instructors with appropriate training and expertise in [CIH] services who are employees of the Department or with whom the Department enters into an agreement to provide such services.

In other words, the VA can contract with chiropractors, acupuncturists, reiki healers or what-have-you to handle the pseudoscience.

As far as I can tell, CARA does not give the VA any money to do any of these things, although perhaps these mandates will be funded in the next budget.

According to David’s post, much of this is already happening, or is about to happen at the VA anyway, according to a memo from top brass. CARA puts the imprimatur of Congress on the whole enterprise and ensures it is enshrined into law, giving any dissenters little chance of stemming the tide.

from Science-Based Medicine http://ift.tt/2aj8bkY

Quick Link: A Look at the Second Pinch Point in Stories

Quick links, bringing you great articles on writing from all over the web. Pinch points are important and I will admit a new idea for me. But basically they are where the action takes place that leads up to the main climax. It is something that I recognized intuitively but did not have a name […]

from Publetariat http://ift.tt/2adaPOq

The highest salary in the history of each NBA franchise

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

<p>.</p>

from HoopsHype http://ift.tt/2axXi3i

In The News – A brief look at how we read books today

In The News – Articles Of Interest For Authors A breakdown of American reader habits brought to you by the Staff at The Week. ~ * ~ A brief look at how we read books today The Week Staff E-books were supposed to spell the end of print, but Americans’ reading habits have taken a […]

from Publetariat http://ift.tt/2a5uRom

How good can the Timberwolves be this coming season?

Former NBA player Eddie Johnson sees a bright future ahead for the Minnesota Timberwolves.

from HoopsHype http://ift.tt/2awandN

Ile w153 Table Lamp by Wastberg

In love with a lamp… that should be a song title, shouldn’t it? The Ile w153 Table Lamp, designed by Inga Sempe, aims straight for our hearts, as it can be clamped to a ledge or tabletop, mounted on the wall, or set upon a flat surface. The shade moves smoothly, as it has a magnetic connection to the base. Now, the question is, just which color would be perfect for your bedside, reading chair, or desk? (Two grey/brown lamps are calling my name, I think.)

Designed by Inga Sempe
Manufactured by Wastberg

Materials: Aluminum Body With Steel Shade
Dimensions: 6.3″H x 7.5″ Shade Diameter

from Better Living Through Design http://ift.tt/2aw2HbL

Bambus Glass Carafe

How about another nice carafe to hold your hydration source? This handblown carafe was inspired by the bamboo of Zen gardens; it has an elegant handle and a drinking glass that fits perfectly on top. As stated before, a carafe lets you rely less on plastic bottles of water (hooray!) and more on your own two feet… to get water from the office cooler or your fridge’s filter. Perhaps while you walk to replenish said water you can be thankful that it’s clean and plentiful, and that you’re crossing a distance of yards instead of miles, unlike lots of other people in other parts of the world. Did you know you’d get a guilt trip while reading about why a carafe is so great? Surprise, and you’re welcome.

Designed by studio Sottovoce

Materials: Hand blown borosilicate glass

-Includes cup
-Hand wash only
-Made in Italy

from Better Living Through Design http://ift.tt/2aeYl5Z

The Public’s Love-Hate Relationship with Technology

There are many complex factors driving up the cost of healthcare, but one major factor is increasing medical technology. Often new expensive technologies provide incremental, or even questionable, additional benefits but can dramatically increase the cost of health care. This is especially true of in-hospital treatments.

There are also, of course, medical technologies that provide significant benefits, and others that improve our ability to make diagnoses. The public clearly wants and expects the latest and greatest medical technology when it comes to their health care or that of their loved-ones.

From this perspective the culture is definitely very pro-medical technology. Nothing it too invasive or heroic if it might save a loved-one. In fact, access to the latest medical miracles are considered a right, and even the suggestion that such technology might be futile is often met with hostility and anger.

At the same time, there is substantial fear in the culture toward some medical technologies, depending on context. A recent Pew survey found:

A majority of Americans would be ‘very’ or ‘somewhat’ worried about gene editing (68%); brain chips (69%); and synthetic blood (63%), while no more than half say they would be enthusiastic about each of these developments. While some people say they would be both enthusiastic and worried, overall, concern outpaces excitement.

People are both excited and worried at the same time.

Competing Narratives

It seems that there are two basic narratives at play here, and people will tend to adopt one or the other, but can flip between them depending on context.

The pro-technology narrative I think is more straightforward. People expect technology to make their lives progressively better. They have been sold on the “miracles of modern medicine” and want it. If something is broken about their body, they want it fixed.

There is a distinction to be made, however, between fixing a problem and enhancing human function. In general people are far more accepting of technology that is used to cure or treat a disease, or to fix or compensate for a missing or malfunctioning body part. I don’t think there would be much of an outcry if we were able to give patients completely bionic limbs to replace those that are lost or paralyzed.

If, however, you want to implant devices to enhance an otherwise completely healthy person, that is “meddling with nature.”

That brings us to the other narrative, one we discuss at SBM frequently, the appeal to nature narrative (or fallacy, depending on your perspective). People have a sense of what is “natural,” even if they cannot specifically define it, and they feel that anything that violates nature beyond some arbitrary and fuzzy point is morally wrong.

There appears to be some emotional calculus going on, with disgust at anything “unnatural” on one side of the equation, and appropriate health benefit on the other side. That sense of disgust is often translated into a moral position.

Messing with the brain, our genes, and our blood provokes these feelings in a majority of the public (at least according to this one survey). I don’t think such feeling are limited to these areas, however. Remember the girl with the baboon heart? People objected to transplanting animal organs, or even just animal protein, into a human (as if we are not animals).

This sense of disgust extends to our food, as is evidenced by popular objections to genetically modified food.

Nature is Amoral

While people are free to have whatever values and beliefs they wish, I am an unapologetic supporter of the notion that what is “natural” has no moral implications. I do think this is merely a manifestation of the emotion of disgust misplaced on technology.

There is also a strange combination of mutually incompatible beliefs at work. On the one hand, humans are viewed as part of nature and therefore we should not violate our nature – beyond some arbitrary point and depending on the purpose and details of the violation. In this view we should not alter our genes, or implant technology.

On the other hand, there is an implicit view that humans are somehow separate from nature. We are pure in some sense, and should not be contaminated with “animal proteins.” Some people would have less of a problem putting a mechanical heart into a patient than a baboon heart.

I don’t think any of these objections to medical or biological technology has a rational basis, or at least I have never heard one. There are often cost-benefit and risk-benefit issues with new technologies, and those are legitimate concerns, but they are rarely the basis for the actual objections. They are sometimes used as proxy issues, but are never the true cause of objections to the new technology.

The fact is, it is human nature to mess with nature. The primary adaptation of the human brain is that we use it to adapt our environment (nature) to us. Almost all of the food we eat has been altered beyond recognition to make it more palatable and nutritious for us. We can replace organs, swap out your blood, filter your blood, give you fake chemicals that bind to your cell’s receptors, remove diseased body parts, enhance your body’s defenses with germ-killing drugs, and replace body parts with artificial parts.

There is nothing “natural” about health care. What is natural is for humans to live short brutal lives.

Technology Advances

Despite the appeal to nature fallacy and the Luddites, acceptance of new technology slowly advances. Some people will object to the latest extension of our ability to alter, fix, and enhance our bodies, but then those technologies are quickly accepted as it becomes clear that there are no Frankenstein monsters or horrible consequences.

The classic example of this is in-vitro fertilization. There was a great deal of objection to “test-tube babies” when the technology was introduced, and now it is generally accepted without a thought (there are always some religious holdouts, but that is a separate issue).

The fact is – humans are animals, and our bodies are just complex biological machines. We all want long, healthy lives with good quality of life. We eventually will accept any technology that fulfills that desire, in fact we demand it. What was viewed previously as unacceptable meddling with nature will soon be seen as an inherent right of every person. Just try to deny IVF to a couple who want a baby, or talk to a family whose loved-one is in critical condition.

from Science-Based Medicine http://ift.tt/2a99u6s