Medicine https://scienceblogs.com/ en Should A Doctor Prescribe A Walk In The Park? https://scienceblogs.com/sb-admin/2020/07/24/should-doctor-prescribe-walk-park-151452 <span>Should A Doctor Prescribe A Walk In The Park?</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>Has your doctor recommended you go for regular jogs in the park, countryside walks, community food growing sessions, or some other nature-based activity? These so-called “green prescriptions” are typically given alongside conventional therapies and have existed in various forms for a number of years.</p> <p>In recognition of the potential health benefits of green prescriptions, the UK government has <a href="https://www.gov.uk/government/speeches/george-eustice-speech-on-environmental-recovery-20-july-2020">just announced</a> a £4 million investment in a two-year pilot as part of its post-COVID-19 recovery plan, with plans to scale up in the future.</p> <p>There is increasing evidence of the benefits of contact with nature, and the World Health Organization has identified ten ways in which nature impacts positively on <a href="https://www.euro.who.int/en/health-topics/environment-and-health/urban-health/publications/2016/urban-green-spaces-and-health-a-review-of-evidence-2016">our physical and mental health</a>. When parks and other greenspaces are accessible and inclusive they can promote physical activity, psychological relaxation and social cohesion.</p> <p>There is even evidence to suggest that contact with microbes in the environment can <a href="https://www.pnas.org/content/110/46/18360">“train” our immune systems</a> and reinforce the microbial communities on our skin, and in our airways and guts. These “microbiomes” could play a role in how our bodies respond to infectious diseases such as COVID-19 and to secondary infections. Microbes from the environment could also potentially supplement our bodies with <a href="https://www.sciencedirect.com/science/article/pii/S0048969719346753">fatty acids such as butyrate</a>, which are linked to reduced inflammation and may promote mental health.</p> <p>Green prescriptions therefore have huge potential. But if they are to work, they need to be seen as the start of a much more holistic mode of health and social care delivery: part of a post-COVID “new normal”. This would chime strongly both with the renewed appreciation of nature and the surge in community mobilization and action we saw under the lockdown.</p> <p>This needs to go beyond simply substituting green for conventional prescriptions. Instead we should provide greener, more natural settings and practices for health, social care, education, transport and active travel. A good example is the GoGoGreen project at a primary school we have worked with in Sheffield. There, greening a school playground not only created a barrier against air pollution from vehicle emissions but also provided multiple other benefits to the school community and started a conversation about cleaner modes of travel.</p> <p>Green prescribing cannot be seen as a low-cost alternative to conventional treatments. To be effective it still demands investment and resources. The two year pilot is welcome, but if it is to be successful in the long-run the government must make a firm commitment to scaling-up while also addressing systemic issues such as social inequality. All this will take time, and if this holistic approach is not adopted then people in crisis with more immediate priorities will be less likely to go on that prescribed walk in the woods.</p> <p>Our own research on <a href="http://iwun.uk/">improving wellbeing through urban nature</a> in Sheffield confirms that people in more deprived communities, with <a href="https://drive.google.com/file/d/1rflfQx73wUOhjWnohht4KbDFef9ySGR2/view">poorer health and shorter life expectancies</a>, don’t have the same levels of access to high quality, <a href="https://doi.org/10.1016/j.geoforum.2019.04.016">well-maintained greenspaces</a>. These are the people that arguably most need green prescriptions, but if they don’t have the basic access then those prescriptions are unlikely to be effective. What’s more, many <a href="https://doi.org/10.3390/ijerph17103460">doctors are not aware of green prescribing</a>, nor do they have a firm understanding of the benefits or know how to get involved.</p> <p>Our research also reveals that context is critical and green prescriptions need to be <a href="https://doi.org/10.3390/su11185029">rooted in their</a> local area and closely related to the people and places who are going to use them. A wealthy white pensioner in a rural area is likely to have very different experience of and access to nature compared with a young working class person of color in an inner city. A formulaic top-down approach is unlikely to work for both these people.</p> <h2>Recommendations</h2> <p>To sum up, this is what we need to make green prescriptions a success.</p> <p>They have to be part of a systemic approach to incorporating nature-based interventions and <a href="https://doi.org/10.1007/s11252-020-00964-w">nature-based thinking</a> in urban infrastructure and service provision.</p> <p>The prescribing process needs to be made easy, for doctors, social care professionals and patients. GPs often lack time and resources, while patients may lack motivation and confidence, or have little previous positive experiences of nature.</p> <p>Green prescribing also needs to be seen as one part of a holistic health-promotion strategy based on a planetary health perspective. In order to care for ourselves, we also need to care for our environments.</p> <p>Finally, we need new ways of working with local organisations and communities to understand what’s needed in local contexts, and to build skills and capacity.</p> <p><span>By <a href="https://www.sheffield.ac.uk/landscape/people/academic/anna-jorgensen">Anna Jorgensen</a>, Chair in Urban Natural Environments, Health and Wellbeing, University of Sheffield and <a href="https://www.researchgate.net/profile/Jake_M_Robinson">Jake M. Robinson</a>, PhD Researcher, Department of Landscape, University of Sheffield. Jorgensen receives funding from the British Academy and the European Commission. Robinson receives funding from the Economic and Social Research Council (ESRC). He is affiliated with inVIVO Planetary Health, the Healthy Urban Microbiome Initiative and Greener Practice. This article is republished from The Conversation under a Creative Commons license. Read the <a href="https://theconversation.com/green-prescriptions-should-your-doctor-send-you-for-a-walk-in-the-park-143231">original article</a>. <img alt="The Conversation" height="1" src="https://counter.theconversation.com/content/143231/count.gif?distributor=republish-lightbox-basic" width="1" /></span></p></div> <span><a title="View user profile." href="/author/sb-admin" lang="" about="/author/sb-admin" typeof="schema:Person" property="schema:name" datatype="">sb admin</a></span> <span>Fri, 07/24/2020 - 15:39</span> <div class="field field--name-field-blog-categories field--type-entity-reference field--label-inline"> <div class="field--label">Categories</div> <div class="field--items"> <div class="field--item"><a href="/channel/medicine" hreflang="en">Medicine</a></div> </div> </div> <section> </section> Fri, 24 Jul 2020 19:39:42 +0000 sb admin 151452 at https://scienceblogs.com NVX-CoV2373: Here's How The Coronavirus Vaccine Based On A Flu Shot Works https://scienceblogs.com/sb-admin/2020/05/27/nvx-cov2373-heres-how-coronavirus-vaccine-based-flu-shot-works-151450 <span>NVX-CoV2373: Here&#039;s How The Coronavirus Vaccine Based On A Flu Shot Works</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>A new trial has begun in Victoria <a href="https://www.abc.net.au/news/2020-05-26/coronavirus-vaccine-trial-begins-in-melbourne-brisbane/12286028">this week</a> to evaluate a potential vaccine against COVID-19.</p> <p>The vaccine is called NVX-CoV2373 and is from a US biotech company, Novavax.</p> <p>The trial will be carried out across Melbourne and Brisbane, and is the first human trial of a vaccine specifically for COVID-19 to take place in Australia.</p> <p>This vaccine is actually based on a vaccine that was already in development for influenza. But how might it work against SARS-CoV-2, the coronavirus that causes COVID-19?</p> <h2>What’s in the mix?</h2> <p>Vaccines trigger an immune response by introducing the cells of our immune system to a virus in a safe way, without any exposure to the pathogen itself.</p> <p>All vaccines have to do two things. The first is make our immune cells bind to and “eat up” the vaccine. The second is to activate these immune cells so they’re prepared to fight the current and any subsequent threats from the virus in question.</p> <p>We often add molecules called adjuvants to vaccines to deliver a danger signal to the immune system, activate immune cells and trigger a strong immune response.</p> <p>The Novavax vaccine is what we call a “subunit” vaccine because, instead of delivering the whole virus, it delivers only part of it. The element of SARS-CoV-2 in this vaccine is the spike protein, which is found on the surface of the virus.</p> <p>By targeting a particular protein, a subunit vaccine is a great way to focus the immune response.</p> <p>However, protein by itself is not very good at binding to and activating the cells of our immune system. Proteins are generally soluble, which doesn’t appeal to immune cells. They like something <a href="https://www.sciencedirect.com/science/article/pii/S0952791520300091?via%3Dihub">they can chew on</a>.</p> <p>So instead of soluble protein, Novavax has assembled the SARS-CoV-2 spike protein into very small particles, called nanoparticles. To immune cells, these nanoparticles look like little viruses, so immune cells can bind to these pre-packaged chunks of protein, rapidly engulfing them and becoming activated.</p> <p>The Novavax vaccine also contains an <a href="https://www.tandfonline.com/doi/full/10.1586/erv.11.25">adjuvant called Matrix-M</a>. While the nanoparticles deliver a modest danger signal, Matrix-M can be added to deliver a much stronger danger signal and really wake up the immune system.</p> <p><img alt="The spike protein is formed into nanoparticles to attract immune cells, and Matrix-M is added as an adjuvant to further activate immune cells." data-entity-type="file" data-entity-uuid="c42655cf-72d9-44e4-a4b0-2408e941ada9" src="/files/inline-images/coronavirus%20protein%20spike_0.jpg" /></p> <p><span>The spike protein is formed into nanoparticles to attract immune cells, and Matrix-M is added as an adjuvant to further activate immune cells.</span> <span><span>Author provided</span></span></p> <h2>Rethinking an influenza vaccine</h2> <p>The Novavax vaccine for SARS-CoV-2 is based on a vaccine the company was already developing for influenza, called NanoFlu.</p> <p>The NanoFlu vaccine contains similar parts – nanoparticles with the Matrix-M adjuvant. But it uses a different protein in the nanoparticle (hemagglutinin, which is on the outside of the influenza virus).</p> <p>In October last year, Novavax started testing NanoFlu in a <a href="https://clinicaltrials.gov/ct2/show/NCT04120194">phase III clinical trial</a>, the last level of clinical testing before a vaccine can be licensed. This trial had 2,650 volunteers and researchers were comparing whether NanoFlu performed as well as Fluzone, a standard influenza vaccine.</p> <p>An important feature of this trial is participants were over the age of 65. Older people tend to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657521/">poorer responses</a> to vaccines, because immune cells become more difficult to activate as we age.</p> <p>This trial is ongoing, with volunteers to be followed until the end of the year. However, <a href="https://ir.novavax.com/news-releases/news-release-details/novavax-nanoflu-achieves-all-primary-endpoints-phase-3-clinical">early results</a> suggest NanoFlu can generate significantly higher levels of antibodies than Fluzone – even given the older people in the trial.</p> <p>Antibodies are small proteins made by our immune cells which bind strongly to viruses and can stop them from infecting cells in the nose and lungs. So increased antibodies with NanoFlu should result in lower rates of infection with influenza.</p> <p>These results were similar to those released after the <a href="https://www.nejm.org/doi/full/10.1056/NEJMc1803554">phase I trial</a> of NanoFlu, and suggest NanoFlu would be the superior vaccine for influenza.</p> <p>So the big question is – will the same strategy work for SARS-CoV-2?</p> <p><img alt="The Novavax vaccine is one of several potential COVID-19 vaccines being trialled around the world." data-entity-type="file" data-entity-uuid="65bfbd37-4f72-4ee2-bef0-d5d70dd1e74c" height="263" src="/files/inline-images/coronavirus%20vaccines%20worldwide.jpg" width="394" /></p> <p><em><span>The Novavax vaccine is one of several potential COVID-19 vaccines being trialed around the world.</span> <span><span>Shutterstock</span></span></em></p> <h2>The Australian clinical trial</h2> <p>The <a href="https://clinicaltrials.gov/ct2/show/record/NCT04368988?term=novavax&amp;recrs=ab&amp;draw=2&amp;rank=1&amp;view=record">new phase I/II trial</a> will enrol around 131 healthy volunteers aged between 18 and 59 to assess the vaccine’s safety and measure how it affects the body’s immune response.</p> <p>Some volunteers will not receive the vaccine, as a placebo control. The rest will receive the vaccine, in a few different forms.</p> <p>The trial will test two doses of protein nanoparticles – a low (5 microgram) or a high (25 microgram) dose. Both doses will be delivered with Matrix-M adjuvant but the higher dose will also be tested without Matrix-M.</p> <p>All groups will receive two shots of the vaccine 21 days apart, except one group that will just get one shot.</p> <p>This design enables researchers to ask four important questions:</p> <ol><li> <p>can the vaccine induce an immune response?</p> </li> <li> <p>if so, what dose of nanoparticle is best?</p> </li> <li> <p>do you need adjuvant or are nanoparticles enough?</p> </li> <li> <p>do you need two shots or is one enough?</p> </li> </ol><p>While it’s not yet clear how the vaccine will perform for SARS-CoV-2, Novavax has <a href="https://novavax.com/download/files/2020-05-13WVCWebinarCOVID19v3.pdf">reported</a> it generated strong immune responses in animals.</p> <p>And we know NanoFlu performed well and had a good safety profile for influenza. NanoFlu also seemed to work well in older adults, which would be essential for a vaccine for COVID-19.</p> <p>We eagerly await the first set of results, expected in a <a href="https://novavax.com/download/files/2020-05-13WVCWebinarCOVID19v3.pdf">couple of months</a> – an impressive turnaround time for a clinical trial. If this initial study is successful, the phase II portion of the trial will begin, with more participants.</p> <p>The Novavax vaccine joins <a href="https://www.who.int/who-documents-detail/draft-landscape-of-covid-19-candidate-vaccines">at least nine other vaccine candidates</a> for SARS-CoV-2 currently in clinical testing around the world.</p> <p><span>By <a href="https://theconversation.com/profiles/kylie-quinn-1008550">Kylie Quinn</a>, Vice-Chancellor's Research Fellow, School of Health and Biomedical Sciences, RMIT University and <a href="https://theconversation.com/profiles/kirsty-wilson-1103649">Kirsty Wilson</a>, Postdoctoral Research Fellow, RMIT University. This article is republished from The Conversation under a Creative Commons license. Read the <a href="https://theconversation.com/the-vaccine-were-testing-in-australia-is-based-on-a-flu-shot-heres-how-it-could-work-against-coronavirus-139380">original article</a>.<img alt="The Conversation" height="1" src="https://counter.theconversation.com/content/139380/count.gif?distributor=republish-lightbox-basic" width="1" /></span></p></div> <span><a title="View user profile." href="/author/sb-admin" lang="" about="/author/sb-admin" typeof="schema:Person" property="schema:name" datatype="">sb admin</a></span> <span>Wed, 05/27/2020 - 10:18</span> <div class="field field--name-field-blog-categories field--type-entity-reference field--label-inline"> <div class="field--label">Categories</div> <div class="field--items"> <div class="field--item"><a href="/channel/medicine" hreflang="en">Medicine</a></div> </div> </div> <section> </section> Wed, 27 May 2020 14:18:04 +0000 sb admin 151450 at https://scienceblogs.com COVID-19: The Downside To More Testing Could Be Overflowing Hospitals https://scienceblogs.com/conversation/2020/03/30/covid-19-downside-more-testing-could-be-overflowing-hospitals-151446 <span>COVID-19: The Downside To More Testing Could Be Overflowing Hospitals</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>"You can’t fight a virus if you don’t know where it is."</p> <p>These were the words of Director General of the World Health Organisation (WHO), Dr Tedros Adhanom Ghebreyesus, at his <a href="https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-mission-briefing-on-covid-19---12-march-2020">briefing</a> on the COVID-19 pandemic in mid-March.</p> <p>He made the statement in a bid to underscore the need to test many more people as key to containing the spread of the disease.</p> <p>Ordinarily, that makes sense and I would agree with it. It is the right thing to do in the face of a disease which would show mild to no symptoms in the majority of those that are infected but does not inhibit their ability to infect others.</p> <p>Countries that follow the <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/laboratory-guidance">WHO view</a> have sought to buy test kits and increase the number of tests conducted daily. Others have been more cautious and have set up guidelines to ensure that they only test people with significant history of risk for COVID-19 or symptoms of the disease.</p> <figure role="group"><img alt="Lagos treatment camp" data-entity-type="file" data-entity-uuid="c675c966-9ea7-44bd-a11f-971063782f61" src="/files/inline-images/Lagos%20treatment.JPG" /><figcaption><em>An aerial view of a new isolation and treatment centre established by the Lagos State government at the main bowl of the state-owned Stadium. Pius Utomi Ekpei/AFP via Getty Images via The Conversation</em></figcaption></figure><p> </p> <p>Looking at the various models and the progression of the pandemic, I wish to offer some views on testing and the attendant issues and challenges.</p> <p>I believe that there are a myriad of factors to consider and that, particularly in Africa, countries have to take them all on board when making their decisions to curtail the spread of the virus.</p> <p>The factors include the dangers posed by false test results, the fact that testing data is being badly communicated leading to a rise in panic levels and the fact that testing capacity is limited in many countries.</p> <h2>The fear factor</h2> <p>It is quite clear that the world is now dealing with two pandemics instead of one. The first is the virus. The second is fear and, in many cases, outright panic. That is why landlords are <a href="https://www.irrawaddy.com/news/burma/myanmars-nurses-doctors-face-eviction-landlords-panic-covid-19.html">kicking out</a> health workers from their houses. That is why we get reports of <a href="https://edition.cnn.com/2020/03/23/africa/chloroquine-trump-nigeria-intl/index.html">chloroquine toxicity</a> within 24 hours of US President Donald Trump saying that might be the treatment for COVID-19.</p> <p>What has panic got to do with testing? Panic is being driven by the way in which the outcome of testing is being communicated. For example, most countries are releasing data about how many more cases there are. But they are not telling their citizens how many of these people have no symptoms at all, or have mild ones.</p> <p>Knowing how many of those who tested positive were not considered to be in a critical state would be helpful.</p> <p>The other area in which data is being badly handled, and adding to panic levels, is that countries are reporting new cases on a daily basis. These aren’t necessarily new infections but, rather, new <em>detections</em>. Most are people who already had it and (for whatever reason were able to get tested) were found to be positive. They are people who, just the day before, did not know they had the virus and therefore weren’t provoking fear in others. Also, the number of new confirmed cases alone may not be the best indicator for the challenge the disease poses in a country or community.</p> <p>Knowing their status now should not cause panic. It should simply inform about the importance of the preventive measures, including testing, to prevent spread of the disease.</p> <h2>Limited resources</h2> <p>Countries are being urged to test as many people as possible in the face of limited test resources. The mainstay polymerase chain reaction test is quite limited and relatively slow. It is also expensive given the requirements even of staff and laboratories.</p> <p>Enter rapid test kits to the rescue. But there aren’t enough. Even the US <a href="https://www.pulse.ng/bi/tech/the-us-is-struggling-to-test-more-people-for-coronavirus-now-its-facing-a-shortage-of/82647n6">doesn’t</a> have enough test kits to meet the demand.</p> <p>In addition, not all the kits in use have been tested properly. For example, there are reports that thousands of test kits imported by the Spanish health authorities were found to be <a href="https://www.express.co.uk/news/world/1260805/spain-coronavirus-tests-chinese-testing-kits-false-results">faulty</a>.</p> <p>The challenge of a test kit giving false negatives is that the people are told, erroneously, that they do not have the virus. They go away and continue to infect others freely. In the event that they have any symptoms, they are likely to ignore these, and some may become severely ill before seeking care. If they do seek care early, the health care workers may be exposed to COVID-19 thinking that this person had tested negative and could only have some other disease.</p> <p>A false positive, on the other hand, means that the number of cases reported continues to rise along with the panic created and attendant socio-economic disruption.</p> <p>The Jack Ma Foundation has donated 20,000 <a href="https://economictimes.indiatimes.com/magazines/panache/jack-mas-coronavirus-testing-kits-reach-nigeria/articleshow/74829029.cms">test kits </a>to Nigeria. But what are these among so many? Consider two statistics alongside this number. The <a href="https://www.worldometers.info/world-population/nigeria-population/">population</a> of the country – about 200 million people. And the fact that with 65 confirmed cases (as at the time of writing this), Nigeria is tracking over <a href="http://apanews.net/en/pays/nigeria/news/six-covid-19-patients-well-as-nigeria-trails-4000-contacts">4,000 contacts</a> already.</p> <p>A further complication in Nigeria is that the allocation of available tests kits could become subject to social and political whims. Government officials are scrambling to get tested along with their families and wealthy friends. Unfortunately, the guidelines for determining who to test won’t apply to this category of people. This means that limited resources will be used up.</p> <p> </p> <h2>Overwhelming hospitals</h2> <p> </p> <p>The fatality rate for COVID-19 has not yet been <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30244-9/fulltext?rss=yes">definitively established</a>. Nevertheless, the fatality rate – particularly among older people – has been one of the major factors stoking fear. It is also one of the reasons hospitals are overwhelmed with COVID-19 positive cases.</p> <p>This is why the decision to increase testing needs to be made along with ensuring that the facilities are in place to manage the increase in numbers of people identified with COVID-19. Without additional measures, hospitals will simply become overwhelmed, as has <a href="https://www.washingtonpost.com/opinions/2020/03/15/hospitals-are-overwhelmed-because-coronavirus-heres-how-help/">happened in the US</a>.</p> <p><a href="https://www.pulse.ng/bi/politics/a-construction-expert-broke-down-how-china-built-an-emergency-hospital-to-treat-wuhan/260wvrz">In China,</a> for example, several new health facilities were built in just a few weeks along with the deployment of thousands of health workers to Wuhan, the epicentre of the outbreak in that country. For its part the <a href="https://www.bbc.com/news/uk-51969104">UK recalled</a> about 10,000 retired health workers and the US is <a href="https://www.channelstv.com/2020/03/27/us-asks-health-workers-to-apply-for-visas-amid-covid-19-pandemic/">offering visas</a> to health workers who might want to come and work there.</p> <p>In Nigeria, the approach being taken is similar to that of China. <a href="https://businessday.ng/coronavirus/article/lagos-island-coronavirus-isolation-centre-now-ready-for-use-sanwo-olu/">New facilities </a>are being established and equipped to handle COVID-19 cases.</p> <p>But the strain on the health system must not be underestimated. Admission of a case of a highly infectious disease, like COVID-19, stretches the health system many times over and increases the risk of health care workers being infected. Of course, as the numbers rise, the health care workers are soon <a href="https://www.pulse.ng/bi/tech/thousands-of-chinese-doctors-volunteered-for-the-front-line-of-the-coronavirus/83jtyw5">overwhelmed </a>and the fatalities could rise along.</p> <p> </p> <h2>What needs to be done</h2> <p> </p> <p>I would argue that we should not just follow the admonition of the WHO to “test, test, test” without examining it in the context of our local peculiarities. Testing is important but countries should adapt guidelines for testing that work for them, knowing also the dangers of having asymptomatic disease spreaders – that is those who have the virus but aren’t showing any symptoms.</p> <p>They should also consider reporting confirmed cases along with their clinical status as well as recoveries and discharges (all to encourage reporting of possible cases). The bigger worry is the fatalities and that is what countries must work to avoid.</p> <p>Lastly, lock downs must be considered – the socio-economic challenges weighed into it – as a means to minimise the spread in the face of limited facilities. This would allow those who might require hospital admissions to show up, while those who don’t will stop spreading the disease while they recover on their own.</p> <p><span>By <a href="https://theconversation.com/profiles/doyin-odubanjo-667074">Doyin Odubanjo</a>, Executive Secretary, <a href="https://theconversation.com/institutions/nigerian-academy-of-science-2114">Nigerian Academy of Science</a>. This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/covid-19-to-test-or-not-to-test-134934">original article</a>.</span></p> <p><img alt="The Conversation" height="1" src="https://counter.theconversation.com/content/134934/count.gif?distributor=republish-lightbox-basic" width="1" /></p></div> <span><a title="View user profile." href="/author/conversation" lang="" about="/author/conversation" typeof="schema:Person" property="schema:name" datatype="">The Conversation</a></span> <span>Mon, 03/30/2020 - 22:25</span> <div class="field field--name-field-blog-categories field--type-entity-reference field--label-inline"> <div class="field--label">Categories</div> <div class="field--items"> <div class="field--item"><a href="/channel/medicine" hreflang="en">Medicine</a></div> </div> </div> <section> </section> Tue, 31 Mar 2020 02:25:10 +0000 The Conversation 151446 at https://scienceblogs.com Coronavirus Isn't a Pandemic, But That Doesn't Change Its Relative Risk https://scienceblogs.com/conversation/2020/02/14/coronavirus-isnt-pandemic-doesnt-change-its-relative-risk-151437 <span>Coronavirus Isn&#039;t a Pandemic, But That Doesn&#039;t Change Its Relative Risk</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>Is the coronavirus a pandemic, and does that matter? 4 questions answered</p> <p>The new coronavirus has now <a href="https://www.nytimes.com/2020/02/04/world/asia/coronavirus-china.html?action=click&amp;module=Top%20Stories&amp;pgtype=Homepage">affected more than 20,000 people</a> in China and claimed more lives as of Feb. 4 than the SARS epidemic from 2002 to 2004. Hong Kong has reported its <a href="https://www.wsj.com/articles/coronavirus-cases-rise-above-20-000-in-china-as-hong-kong-reports-first-death-11580799736">first death</a>. Some public health officials have said the outbreak is <a href="https://www.nytimes.com/2020/02/02/health/coronavirus-pandemic-china.html">likely to soon be a pandemic</a>, but the <a href="https://www.bbc.com/news/world-asia-china-51368873">World Health Organization</a> said Feb. 4 that it isn’t, yet.</p> <p>Just what is a pandemic anyway? An epidemiologist and public health researcher explains.</p> <h2>1. What is a pandemic?</h2> <p>When a disease outbreak, or epidemic, crosses international boarders and spreads across a wide region, we public health professionals typically call it a <a href="https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section11.html">pandemic</a>. The term “pandemic” tells us that the outbreak is occurring in many places but says nothing about its severity.</p> <p>Because of their wide geographic distribution, pandemics usually affect a large number of people. While we usually think of pandemics in relation to <a href="https://www.who.int/csr/disease/swineflu/en/">serious</a>, life-threatening diseases, even outbreaks of mild diseases could cross borders and become pandemics.</p> <h2>2. Does it matter if it is or isn’t called a pandemic?</h2> <p>Calling an outbreak a pandemic is simply a reflection of where the disease is spreading. The terminology doesn’t change anything about the severity of the disease or how we are responding.</p> <p>Since the day the outbreak was identified, health officials worldwide have been taking steps to <a href="https://emergency.cdc.gov/han/han00424.asp">isolate ill people to try and prevent any spread</a> and <a href="https://www.whitehouse.gov/briefings-statements/press-briefing-members-presidents-coronavirus-task-force/">quarantine people who have traveled to certain areas of China</a>. The World Health Organization <a href="https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)">declared it to be a Public Health Emergency of International Concern</a> Jan. 30, which improves information sharing and coordination throughout the world.</p> <p>These actions will continue no matter what it is called.</p> <p><img alt="Flight attendants check temperatures of passengers aboard an Air China flight from Melbourne to Beijing on Feb. 4, 2020. AP Photo/Andy Wong" data-entity-type="file" data-entity-uuid="48275465-29d2-4d85-b6dc-1fa212527111" src="/files/inline-images/coronavirus%20pandemic.jpg" width="500" /></p> <p><em>Flight attendants check temperatures of passengers aboard an Air China flight from Melbourne to Beijing on Feb. 4, 2020. <a href="http://www.apimages.com/metadata/Index/APTOPIX-China-Outbreak/50184f4d18db47c7933892aa1b538c24/2/0">AP Photo/Andy Wong</a></em></p> <h2>3. Would it being a pandemic put me at greater risk?</h2> <p>Your risk wouldn’t changed simply because of a change in terminology. Though the virus has been identified in <a href="https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200204-sitrep-15-ncov.pdf">23 countries</a> as of Feb. 4, over 99% of the cases have occurred in China.</p> <p>Local transmission outside of China has generally been limited to people who had direct contact with ill travelers from China. In a <a href="https://www.nytimes.com/reuters/2020/02/03/business/31reuters-china-health-germany.html">cluster reported from Germany</a>, several employees of a company were infected by a co-worker who returned from travel to China, and one of the employees infected one of their children. This clearly shows that person-to-person spread is possible, but it doesn’t mean that the disease is spreading extensively in the community.</p> <p>Even if an outbreak is spreading worldwide, how it is spreading locally and how people respond is what determines your risk.</p> <h2>4. So what happens next?</h2> <p>Public and global health experts and health care workers will continue to respond to this outbreak as they have for the last month. Doctors and nurses in the community will continue to quickly identify ill people and test them for the coronavirus. Sick people will be isolated so that they don’t spread their illness to their family, friends or co-workers. Public health officials will track the spread of this outbreak and will use that information to prevent the spread of the disease in the community.</p> <p>The next move is up to the virus.</p> <p><span>By <a href="https://theconversation.com/profiles/brian-labus-788583">Brian Labus</a>, Assistant Professor of Epidemiology and Biostatistics, University of Nevada, Las Vegas. Labus received past funding from the Centers for Disease Control and Prevention for disease surveillance activities while working at the local health department. This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-the-coronavirus-a-pandemic-and-does-that-matter-4-questions-answered-131128">original article</a>.</span></p> <p><img alt="The Conversation" height="1" src="https://counter.theconversation.com/content/131128/count.gif?distributor=republish-lightbox-basic" width="1" /></p> <p> </p></div> <span><a title="View user profile." href="/author/conversation" lang="" about="/author/conversation" typeof="schema:Person" property="schema:name" datatype="">The Conversation</a></span> <span>Fri, 02/14/2020 - 10:41</span> <div class="field field--name-field-blog-categories field--type-entity-reference field--label-inline"> <div class="field--label">Categories</div> <div class="field--items"> <div class="field--item"><a href="/channel/medicine" hreflang="en">Medicine</a></div> </div> </div> <section> </section> Fri, 14 Feb 2020 15:41:58 +0000 The Conversation 151437 at https://scienceblogs.com To Reduce Risk of Coronavirus and Flu, Wash Your Hands https://scienceblogs.com/sb-admin/2020/02/11/reduce-risk-coronavirus-and-flu-wash-your-hands-151441 <span>To Reduce Risk of Coronavirus and Flu, Wash Your Hands</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>A new study finds an easy way to reduce the spread of many infectious diseases, from coronavirus to influenza; washing hands more frequently in just 10 airports. </p> <p>Though <a href="https://doi.org/10.1111/risa.13438">the findings</a> were published in late December, just before the recent coronavirus outbreak in Wuhan, China, the study's authors say that its results would apply to any such disease and are relevant to the current outbreak. The methods included epidemiological and data-based simulations.</p> <p>People can be surprisingly casual about washing their hands, even in crowded locations like airports where people from many different locations are touching surfaces such as chair armrests, check-in kiosks, security checkpoint trays, and restroom doorknobs and faucets. Based on data from previous research, the team estimates that on average, only about 20 percent of people in airports have clean hands -- meaning that they have been washed with soap and water, for at least 15 seconds, within the last hour or so. The other 80 percent are potentially contaminating everything they touch with whatever germs they may be carrying.</p> <figure role="group"><img alt="Wash those hands " data-entity-type="file" data-entity-uuid="2f0262ef-dcb8-4165-bfda-bf33d1da6de9" src="/files/inline-images/image-040915_golden_staph.jpg" /><figcaption>Use soap and water in airports. And everywhere else. </figcaption></figure><p> </p> <p>"Seventy percent of the people who go to the toilet wash their hands afterwards, and of those that do, only 50 percent use soap. Others just rinse briefly in some water. That figure, combined with estimates of exposure to the many potentially contaminated surfaces that people come into contact with in an airport, leads to the team's estimate that about 20 percent of travelers in an airport have clean hands.</p> <p>Improving handwashing at all of the world's airports to triple that rate, so that 60 percent of travelers to have clean hands at any given time, would have the greatest impact, potentially slowing global disease spread by almost 70 percent, the researchers found. Deploying such measures at so many airports and reaching such a high level of compliance may be impractical, but the new study suggests that a significant reduction in disease spread could still be achieved by just picking the 10 most significant airports based on the initial location of a viral outbreak. Focusing handwashing messaging in those 10 airports could potentially slow the disease spread by as much as 37 percent, the researchers estimate.</p> <p>They arrived at these estimates using detailed epidemiological computer models that involved data on worldwide flights including duration, distance, and interconnections; estimates of wait times at airports; and studies on typical rates of interactions of people with various elements of their surroundings and with other people.</p> <p>Even small improvements in hygiene could make a noticeable dent. Increasing the prevalence of clean hands in all airports worldwide by just 10 percent, which the researchers think could potentially be accomplished through education, posters, public announcements, and perhaps improved access to handwashing facilities, could slow the global rate of the spread of a disease by about 24 percent, they found.</p> <p>The researchers used data from previous studies on the effectiveness of handwashing in controlling transmission of disease, so these data would have to be calibrated in the field to obtain refined estimates of the slow-down in spreading of a specific outbreak.</p></div> <span><a title="View user profile." href="/author/sb-admin" lang="" about="/author/sb-admin" typeof="schema:Person" property="schema:name" datatype="">sb admin</a></span> <span>Tue, 02/11/2020 - 21:03</span> <div class="field field--name-field-blog-categories field--type-entity-reference field--label-inline"> <div class="field--label">Categories</div> <div class="field--items"> <div class="field--item"><a href="/channel/medicine" hreflang="en">Medicine</a></div> </div> </div> <section> </section> Wed, 12 Feb 2020 02:03:09 +0000 sb admin 151441 at https://scienceblogs.com Rural health report card - three reasons for higher mortality https://scienceblogs.com/sb-admin/2020/02/05/rural-health-report-card-three-reasons-higher-mortality-151435 <span>Rural health report card - three reasons for higher mortality</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>A <a href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2019.00722">recent paper</a>, "Higher U.S. Rural Mortality Rates Linked To Socioeconomic Status, Physician Shortages, And Lack Of Health Insurance," published in Health Affairs Journal, seeks to explain differences in rural and urban people when it comes to mortality, but also rank states using county level data on outcomes and health care access.</p> <p>The study focused on five explanatory variables within each county: socioeconomic (e.g., poverty status, access to housing and education, employment), uninsured rates, the supply of and access to primary care physicians, the percentage of racial or ethnic groups and the number of rural and urban residents.</p> <p>However, after compiling all of the data, the researchers believed that only three of their explanatory variables were applicable: socioeconomic deprivation, percentage of uninsured and the primary care physician supply. Those three variables were linked to 81.8% of the total variance of mortality. Correlation is not necessarily causation but it is well known that people who claim their supplements and organic food and fitness crazes led to their better health often leave out that a lot of issues correlate with greater wealth. It isn't the special label on the food making people live longer, it is the other trappings of wealth. The percentage of racial and ethnic groups and the number of rural or urban residents were not significantly associated with mortality even though the percentage of African Americans was positively associated with mortality. After adjustments for socioeconomic deprivation, uninsured rates and supply-access to primary care physicians were factored in, the percentage of African Americans was no longer significantly associated with mortality. They used the rural-urban continuum codes put out by the USDA to break down and divide by counties, and because the health data tends to be by counties, they feel like the data are better matched.</p> <p><img src="https://scienceblogs.com/files/blogs/mortality%20rural%20areas.JPG" /></p> <p>"We're not saying that African Americans across the country don't have higher rates of mortality because they absolutely do," said Scott Phillips, editor in chief for theTexas Tech University Health Sciences Center Rural Health Quarterly magazine and a co-author to the study. "What we are saying, and what we discovered with this study, is that other disparities that African Americans face, particularly socioeconomic status and access to care, account for the higher African American mortality rates across the country."</p> <p>The study also showed the percentage of Hispanic Americans is negatively associated with mortality, another facet of the "Hispanic paradox", an epidemiological confounder showing that Hispanic Americans tend to have health outcomes that are comparable to or better than whites even though Hispanic Americans on average tend to have lower socioeconomic status.</p> <p> </p> <p><strong>Rural residency does not negatively affect mortality but it does favor lower mortality - except in these western states</strong></p> <p>The results indicate that rural dwellers would have lived <em>longer</em> than their urban counterparts had their socioeconomic conditions and access to health care been similar. </p> <p>Now the authors want to further analyze the three states that proved to be exceptions to those findings: Colorado, Montana and Wyoming. Those three contiguous states in the Mountain West have higher urban mortality than rural mortality.</p></div> <span><a title="View user profile." href="/author/sb-admin" lang="" about="/author/sb-admin" typeof="schema:Person" property="schema:name" datatype="">sb admin</a></span> <span>Wed, 02/05/2020 - 10:38</span> <div class="field field--name-field-blog-categories field--type-entity-reference field--label-inline"> <div class="field--label">Categories</div> <div class="field--items"> <div class="field--item"><a href="/channel/medicine" hreflang="en">Medicine</a></div> </div> </div> <section> </section> Wed, 05 Feb 2020 15:38:35 +0000 sb admin 151435 at https://scienceblogs.com Coronavirus: Less Hype, More Perspective, Worry About The Flu Instead https://scienceblogs.com/conversation/2020/02/04/coronavirus-less-hype-more-perspective-worry-about-flu-instead-151431 <span>Coronavirus: Less Hype, More Perspective, Worry About The Flu Instead</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>With a new infectious disease outbreak on our doorstep, we might ask ourselves: are we reacting to the coronavirus in a way that is proportional to the threat?</p> <p>The problem is that when it comes to infectious disease epidemics, we have a strong tendency to overreact emotionally and under-react behaviorally. The overreaction aspect may be attributable to the fact that we are primed to fear infectious diseases appearing suddenly within our population, in the same way that <a href="https://doi.org/10.1016/S0006-3223(02)01669-4">we are evolutionarily prepared to fear snakes and spiders</a>.</p> <p>Most of us fear snakes and spiders without ever having been harmed by them. Compare that with automobiles, which harm many more of us, yet are only feared by a small number who have been in accidents themselves. In the same way, we fear infectious disease outbreaks much more readily and intensely than we fear diabetes epidemics.</p> <figure role="group"><img alt="Amygdala in red is where we fear" data-entity-type="file" data-entity-uuid="0b98f57c-71ab-4046-b2e1-d1ca734fb5f6" src="/files/inline-images/amygdala%20fear.JPG" /><figcaption>The amygdala (in red) is largely responsible for fear learning. <a href="https://www.shutterstock.com/image-illustration/amygdala-female-brain-anatomy-lateral-view-134423381">(Shutterstock)</a></figcaption></figure><p>From the perspective of the brain, <a href="https://doi.org/10.1146/annurev.neuro.24.1.897">the amygdala is largely responsible for fear learning</a>, a process by which fear responses become attached to formerly neutral cues that are now viewed as signifying something genuinely threatening.</p> <p>This explains fearful emotional responses to a formerly innocuous sneezing sound in a crowded subway train. Such amygdala-driven learning more readily occurs when the threat in question is an infectious disease than, say, a chronic disease epidemic of a much larger scale that poses an authentic personal threat.</p> <h2>Déjà vu</h2> <p>In 2003, SARS infected more than 8,000 people worldwide and caused <a href="https://www.cdc.gov/sars/about/fs-SARS.pdf">774 deaths</a>. In Canada, <a href="https://www.canada.ca/content/dam/phac-aspc/migration/phac-aspc/publicat/sars-sras/pdf/sars-e.pdf">438 people were infected and 44 died</a>. Those figures yield about a 10 per cent death rate for SARS. To be sure, it was a lethal virus, and it spread at an alarming rate with tragic consequences, particularly in places where infection protocols were not enacted quickly and decisively.</p> <p>Now, 17 years later, we are facing a very similar-looking threat from another coronavirus, again originating in China, and quickly spreading around the globe. The mortality rate is difficult to estimate so early, but signs so far suggest a mortality rate similar to or lower than SARS.</p> <figure role="group"><img alt="It's not SARS" data-entity-type="file" data-entity-uuid="55d0f255-d34b-4861-9300-cb8b407584a0" src="/files/inline-images/SARS%20mask.JPG" /><figcaption>A man wearing a protective mask carries flowers at Women’s College Hospital in Toronto during the SARS outbreak in March 2003. THE CANADIAN PRESS/Kevin Frayer</figcaption></figure><p>In just over a week, mass travel restrictions are been enacted overseas, and governments (appropriately) are <a href="https://travel.gc.ca/destinations/china">advising against travelling to the epicentre of the outbreak</a>, the city of Wuhan, China.</p> <p>Highly alarming stories and images are <a href="https://www.bloomberg.com/news/articles/2020-01-29/coronavirus-misinformation-is-incubating-all-over-social-media">circulating on social media</a> depicting an epidemic out of control, about to overtake North America. Netflix even just launched a (very) hastily prepared docu-series on the horrors of infectious disease epidemics (just like coronavirus). If that isn’t a sign of the coming apocalypse, I’m not sure what is.</p> <h2>Viral information</h2> <p>The world seems riveted to media content pertaining to the coronavirus outbreak. From many perspectives, this is not surprising.</p> <p>We respond quickly and intensely to information about infectious disease threats, even in faraway places or if they’re unlikely to have an impact on us. A reader’s attention is captured by the topic even when the coverage itself is intentionally not sensationalistic. I would read a responsibly written Ebola article over an excitingly written heart disease article any day.</p> <p>In this age of social media, sharing is an individual choice and one made almost reflexively. In our brains, this relatively unconscious level of processing is disproportionately in the domain of the amygdala and largely unimpeded by <a href="https://doi.org/10.1146/annurev.neuro.24.1.167">higher cortical centres</a> known to be implicated in thoughtful deliberation.</p> <figure role="group"><img alt="Surprise, media is hyping coronavirus" data-entity-type="file" data-entity-uuid="16f186d5-7a2d-4f28-9e7b-ca6c7b568ac8" src="/files/inline-images/coronavirus%20media.JPG" /><figcaption>Sensationalized news and misinformation about infectious diseases can spread quickly through social media. <a href="https://www.shutterstock.com/image-photo/person-hoodie-laptop-hacking-creative-digital-1466220044">(Shutterstock)</a></figcaption></figure><p>The tendency to share emotionally evocative images and text is even more unchecked than in conventional media. This results in selective spread of highly sensationalistic content via social media, and motivation for media outlets to shape their offerings to be more sensational. An old dynamic on steroids.</p> <p>There is also a trend evident in some media outlets to intentionally <a href="https://j-source.ca/article/tips-for-journalists-and-media-organizations-in-canada-covering-the-coronavirus/">counter this</a>. All of us, when we catch ourselves, can recognize and limit our indulgence of overly sensationalistic content and reactions, including when it comes to infectious disease outbreaks.</p> <h2>Word to the wise</h2> <p>What should we do while we wait for things to unfold? My advice, if I were a physician dispensing it, would be to encourage people to pay attention to official information as much as possible, the <a href="https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html">Public Health Agency of Canada</a>, for example, or its provincial counterparts. It will be there, and will be up to date and accurate for the most part.</p> <p>The behavioural advice is relatively straightforward: wash your hands often, cover your mouth (with your arm) when you cough, avoid touching your face (surprisingly difficult to do consistently) and, for now, avoid travelling to Wuhan.</p> <p><em><strong>Read more: <a href="https://theconversation.com/coronavirus-fear-of-a-pandemic-or-a-pandemic-of-fear-130934">Coronavirus: Fear of a pandemic, or a pandemic of fear?</a> </strong> </em></p> <p>The situation is more complicated in mainland China, where the state-controlled media is struggling to compete with social media sharing, in part because of lack of trust. One advantage that the Chinese government does enjoy, however, is the ability to quickly and decisively implement <a href="https://theconversation.com/coronavirus-fear-of-a-pandemic-or-a-pandemic-of-fear-130934">top-down actions to limit disease spread</a>.</p> <p>So really, there are very different challenges for <a href="https://www.thestar.com/news/canada/2020/01/28/to-stop-coronavirus-we-could-learn-from-how-vancouver-handled-sars.html">capitalist</a> and communist countries when attempting to stem the flow of infectious disease epidemics.</p> <h2>Food for thought</h2> <p>Long story short, don’t lose sight of the larger picture in terms of risks in everyday life.</p> <p>Spending too much time watching television while snacking on potato chips is probably riskier than shaking hands. But maybe avoid both for now, just to be safe.</p> <p>And to end where I began — recalling how SARS overtook our collective consciousness in 2003 — it’s important to also remember that <a href="https://doi.org/10.1371/journal.pone.0080481">five times more deaths are attributable to the seasonal flu every year</a>. If there is an infection we should fear, could it be that one? Or should we stop fearing infections altogether?</p> <p><span>By <a href="https://theconversation.com/profiles/peter-hall-952834">Peter Hall</a>, Professor, School of Public Health and Health Systems, University of Waterloo. Hall receives funding from the Natural Sciences and Engineering Research Council of Canada (NSERC), the Canadian Institutes of Health Research (CIHR) and the Social Sciences and Humanities Research Council of Canada (SSHRC). This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-coronavirus-should-we-take-a-deep-breath-130859">original article</a>.</span></p> <p><img alt="The Conversation" height="1" src="https://counter.theconversation.com/content/130859/count.gif?distributor=republish-lightbox-basic" width="1" /></p></div> <span><a title="View user profile." href="/author/conversation" lang="" about="/author/conversation" typeof="schema:Person" property="schema:name" datatype="">The Conversation</a></span> <span>Tue, 02/04/2020 - 13:05</span> <div class="field field--name-field-blog-categories field--type-entity-reference field--label-inline"> <div class="field--label">Categories</div> <div class="field--items"> <div class="field--item"><a href="/channel/medicine" hreflang="en">Medicine</a></div> </div> </div> <section> </section> Tue, 04 Feb 2020 18:05:50 +0000 The Conversation 151431 at https://scienceblogs.com “A gift to the construction industry”: catchy quotes from Court of Appeals argument on OSHA’s silica standard https://scienceblogs.com/thepumphandle/2017/10/14/a-gift-to-the-construction-industry-catchy-quotes-from-court-of-appeals-argument-on-oshas-silica-standard <span>“A gift to the construction industry”: catchy quotes from Court of Appeals argument on OSHA’s silica standard</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>OSHA <a href="http://scienceblogs.com/thepumphandle/2016/03/24/sorry-it-took-so-long-osha-issues-rule-to-protect-workers-exposed-to-silica-dust/">took the long road</a> to adopt a standard to address respirable crystalline silica. Although the final rule was issued in March 2016, it is being challenged by both industry and labor groups. The first says OSHA went too far, the other says OSHA didn’t go far enough.</p> <p>The long road, however may be coming close to end. The U.S. Court of Appeals for the District of Columbia Circuit heard oral arguments last week from parties that are challenging the rule. Judges Merrick Garland, David Tatel and Karen LeCraft Henderson spent more than two hours listening to arguments from the National Stone, Sand and Gravel Association (NSSGA), the Brick Industry Association (BIA), the U.S Chamber of Commerce, the North America Building Trades, the United Steelworkers and others.  Attorneys with the Department of Labor’s Office of the Solicitor were there, too, to defend the OSHA rule.</p> <p>I enjoyed listening (and relistening) to the <a href="https://www.cadc.uscourts.gov/recordings/recordings2018.nsf/FBB1D597702702BE852581A70057DDFE/$file/16-1105.mp3">court’s audio</a> of the oral argument. What made it particularly enjoyable was listening to the judges---they did their homework!</p> <p>Judges Garland and Tatel, in particular, probed, cajoled, and challenged the attorneys to clarify their arguments. The judges pressed the attorneys on issues concerning economic feasibility, health risks, and the legal standard for substantial evidence. There were plenty of references to prior litigation on OSHA health standards. They mentioned significant previous court decision on OSHA standards, such as for asbestos, lead and formaldehyde.  I felt a bit like an outsider, listening to the attorneys speak about those rulings. They described them as if they were old friends who remain relevant today. And like relationships with old friends, we don't always agree about what she said or remember events in the same way.</p> <p>There were times during the oral arguments that the presenting attorney rose to a judge’s challenge for a cogent response. But I cringe a few times when I heard nervous laughter from an industry attorney who knew he was stumped by the judge’s question.</p> <p>Below are just some of my favorite quotes and exchanges. The text doesn't capture the animation I heard in the audio from the courtroom or the commitment of the attorneys to their arguments. I've included a time stamp at each quote so you can listen for yourself. (I had difficulty distinguishing Judge Garland’s from Judge Tatel’s voice. If I incorrectly attribute the quotes, please leave a comment and I’ll correct it.)</p> <p>NSSGA and BIA argue that OSHA overstates the risk of health harm caused by exposure to respirable crystalline silica. Their attorney, William L. Wehrum, said:</p> <blockquote><p>“We assert that OSHA had a thumb on the scale. We believe the record makes clear that OSHA came to this rulemaking with a determined goal of reducing the level of the standard. We believe it clouded OSHA’s judgement and caused it to lose objectivity, which we believe permeates the entire proceeding." [00:02:36]</p></blockquote> <p>Judge Tatel chimed in:</p> <blockquote><p>"You say that OSHA had its thumb on the scale, which is a curious statement given our standard of review. The question is: is there significant evidence in the record to support OSHA’s position for what it did? <em>You</em> can certainly point to contrary evidence, but OSHA has explained <em>all</em> that. ...You have to make your argument in terms of our specific standard of review, which is the substantial evidence question. Our case law is very specific about that."</p></blockquote> <p>Sounding like a law professor Tatel added:</p> <blockquote><p>"What’s your <em>best</em> argument regarding the substantial evidence test?" [00:04:19]</p></blockquote> <p>Wehrum had difficulty providing a short and sweet and precise answer.</p> <p>Judge Garland addressed the problem for the court of dueling scientists. William Wehrum tried to describe the evidence from his side's experts, but Garland interrupted:</p> <blockquote><p>"We have scientists on both sides and the law here is quite clear. When there are scientists on both sides, OSHA is permitted to take the ones that are most likely to protect worker safety. There is <em>supposed</em> to be a thumb on the scale in terms of safety. ...That's what our own case says. It is perfectly appropriate for OSHA to weight in favor of worker safety. That's right, isn't it. [00:09:56]</p></blockquote> <p>William Wehrum: "Correct your honor to a point, but that dosen't insulate OSHA from review.</p> <p>Soundly a bit frustrated, Garland said:</p> <blockquote><p>"That's what we doing here, but it is not enough to say there is a plausible mechanism. You have to be able to show that OSHA's studies are not <em>themselves</em> substantial evidence."</p></blockquote> <p>The attorney representing the U.S. Chamber of Commerce was also schooled by Judge Garland. This time it was a math problem.</p> <p>Attorney Michael Connolly argued that there are so few deaths today is the U.S. from silicosis that OSHA has not met its burden of demonstrating that exposure to respirable silica poses a significant risk of harm to workers. Connolly pointed to the low number of silicosis deaths reported on death certificates and compared to the millions of workers in silica-related industries.</p> <p>Judge Garland asked [00:18:50]:</p> <blockquote><p>"Is that the right <em>division</em>? Dividing the total number of deaths that are reported on the death certificates by the total number of workers in <em>industry</em>? Or is the right number the total number of deaths at a certain level of exposure? That is, in terms of the 1 in 1,000 test.</p></blockquote> <p>(The "1 in 1,000" comes from a <a href="https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=preambles&amp;p_id=748">1980 Supreme Court ruling</a> about OSHA's benzene standard. The Supreme Court justices did not offer a specific ratio but indicated that the threshold likely fell somewhere between 1 death per 1 billion (which would not be considered significant) to 1 death per 1,000 (which would be significant.))</p> <p>Judge Garland continued:</p> <blockquote><p>"It's not supposed to be just 1 over the entire population of the United States, or 1 over everybody who works. It’s supposed to be 1 over 1,000 people who work at a certain exposure level, isn’t that right?"</p></blockquote> <p>Michael Connolly: "Sure. That’s correct."</p> <p>Judge Garland:</p> <blockquote><p>"Isn't it exposed to silica <em>at a certain exposure levels</em> that matters? Not all people who may have been exposed to silica? [20:03]</p></blockquote> <p>Score one for the judge.</p> <p>I wish I'd been in the courtroom for that exchange. I would have turned my head to see if Judge Garland's remark brought a smile to the attorneys who were defending OSHA's rule.</p> <p>Labor Department attorney Kristen Lindberg was charged with responding to some of the arguments raised by the industry petitioners. Among her excellent synopsis was this:</p> <blockquote><p>[00:35:00] "It's worthwhile to step back a little bit and review the support OSHA had in the record for its findings. Their risk assessment findings were supported by nearly all of the occupational health and medical organizations that commented on the rule, including NIOSH, the American Cancer Society, the American College of Occupational and Environmental Medicine, the American Thoracic Society, the Association of Occupational and Environmental Clinics, and the American Public Health Association."</p> <p>"... Industry petitioners want you to reject conclusions that have overwhelming support among scientists and that were supported by the independent peer reviewers who scrutinized OSHA’s risk assessment. They want you to reject this extensive body of scientific evidence on the flimsy basis that there are flaws in some of the studies that OSHA relied upon and that there is uncertainty in epidemiology. They want you to impose a legal burden on OSHA that the agency could never meet."</p> <p>[00:36:53] "The broad support for OSHA’s conclusions within the scientific community should increase the court’s confidence that OSHA’s analysis is sound. The courts understand that OSHA, in marshalling scientific evidence to support a risk assessment, cannot ever reach perfection because the science those risk assessments are based on is not perfect. There <em>will be</em> flaws in studies, there <em>will be</em> stronger and weaker studies, there may be some uncertainty, but what OSHA has done here, its extensive analysis based on a huge body of evidence conforms fully with the OSH Act and with the requirements of courts that have interpreted the OSH Act."</p></blockquote> <p>Bradford Hammock argued the case on behalf of the National Association of Home Builders and other industry groups. He tried to convince the judges that OSHA's requirements for the construction industry are not technological feasible.</p> <p>Victoria Bor, the counsel for North America’s Building Trades Unions dismissed Mr. Hammock's assertions. Her argument began with the following [00:67:40]</p> <blockquote><p>"By way of context, Table 1, which is the centerpiece of the construction standard, is a <em>gift to the construction industry</em>. Most OSHA standards set a permissible exposure limit and require employers to monitor their workplaces and devise their own strategies following the hierarchy of controls to bring exposures below the permissible exposure limit (PEL). The silica standard gives employers options. They can follow the traditional approach or they can follow Table 1, which is in effect is a manual that lists 19 of the 23 construction tasks that most commonly generate significant silica exposure, and specifies control strategies for each. Employers who fully and properly implement the controls listed on Table 1 are freed from monitoring their workplace and have a safe harbor for complying with the PEL.</p> <p>"...OSHA assumes that most employers will follow table, which is a completely reason assumption because it tells employers exactly what they have to do, frees them from monitoring, and gives them a safe harbor for complying with the PEL."</p> <p>"Now rather than accepting this gift, as Mr. Hammock already explained to you, the industry petitioners point to Table 1 and argue that to the extent it requires the use of respirators....OSHA is conceding that the standard isn't feasible. ...The petitioners’ argument completely ignores that Table 1 does not require employers to comply with the PEL. What it requires is for employers to implement the listed controls. So whether the PEL can be reached without the use of respirators---the question that the industry petitioners focus on--- is actually completely irrelevant."</p></blockquote> <p>Victoria Bor continued:</p> <blockquote><p>"What is relevant, as Ms. Goodman [of the Labor Department] said, is that the typical employer can comply with Table 1 most of the time. On this question, the petitioners argument on feasibility rests on vague assertions that in <em>certain</em> circumstances,<em> certain</em> employers may not be able to use <em>certain</em> of the wet methods listed in Table 1 at <em>some</em> time. …Petitioners point to <em>no</em> evidence that undermines OSHA’s conclusions that most employers will be able to comply with Table 1 by utilizing those controls most of the time."</p></blockquote> <p>There was dead silence after her rebuttal. None of the judges asked Victoria Bor to clarify or further defend her arguments. They seemed convinced.</p> <p>The excerpts above are just some of memorable moments from the oral argument. Another was a lengthy argument by the unions and rebuttal by the Labor Department about OSHA's provisions for medical surveillance and medical removal protections. It was the one time that the Labor Department's case seemed on shaky ground.</p> <p>If you  <a href="https://www.cadc.uscourts.gov/recordings/recordings2018.nsf/FBB1D597702702BE852581A70057DDFE/$file/16-1105.mp3">listen to the audio</a> for yourself you'll hear the word "grapple" used numerous times by attorneys for the unions. You'll hear the Labor Department attorneys repeat the phrase"de minimis benefit." You'll hear one judge say to an industry attorney "it's not your principle argument, it's your <em>only</em> argument" and another judge mention "a shopping list." You'll hear all the parties claim that OSHA's decisions are, or are not, "supported by the record." Finally you'll hear many references to previous Supreme Court and Appeals Court decisions on other OSHA standards.</p> <p>It's been many years since OSHA started down the road toward a comprehensive silica standard. People will disagree on when the agency actually hit the road, but they know that last week's stop at the U.S. Court of Appeals means the road may soon be coming to an end.</p> <p>Judges Garland, Henderson, and Tatel are now at the wheel. They will decide whether OSHA's rule will stand as is, or whether the agency needs to make a U-turn.</p> <p>I relished listening to the oral arguments. I'll be eager to read the judge's opinion when it's issued.</p> <p> </p> <p> </p> <p> </p> </div> <span><a title="View user profile." href="/author/cmonforton" lang="" about="/author/cmonforton" typeof="schema:Person" property="schema:name" datatype="">cmonforton</a></span> <span>Sat, 10/14/2017 - 11:19</span> <div class="field field--name-field-blog-tags field--type-entity-reference field--label-inline"> <div class="field--label">Tags</div> <div class="field--items"> <div class="field--item"><a href="/tag/crystalline-silica" hreflang="en">crystalline silica</a></div> <div class="field--item"><a href="/tag/occupational-health-safety" hreflang="en">Occupational Health &amp; Safety</a></div> <div class="field--item"><a href="/tag/osha" hreflang="en">OSHA</a></div> <div class="field--item"><a href="/tag/regulation" hreflang="en">regulation</a></div> <div class="field--item"><a href="/tag/silica" hreflang="en">silica</a></div> <div class="field--item"><a href="/tag/chamber-commerce" hreflang="en">Chamber of Commerce</a></div> <div class="field--item"><a href="/tag/david-tatel" hreflang="en">David Tatel</a></div> <div class="field--item"><a href="/tag/legal-challenge" hreflang="en">legal challenge</a></div> <div class="field--item"><a href="/tag/merrick-garland" hreflang="en">Merrick Garland</a></div> <div class="field--item"><a href="/tag/us-court-appeals-dc-circuit" hreflang="en">US Court of Appeals DC Circuit</a></div> <div class="field--item"><a href="/tag/regulation" hreflang="en">regulation</a></div> </div> </div> <div class="field field--name-field-blog-categories field--type-entity-reference field--label-inline"> <div class="field--label">Categories</div> <div class="field--items"> <div class="field--item"><a href="/channel/medicine" hreflang="en">Medicine</a></div> </div> </div> <section> </section> <ul class="links inline list-inline"><li class="comment-forbidden"><a href="/user/login?destination=/thepumphandle/2017/10/14/a-gift-to-the-construction-industry-catchy-quotes-from-court-of-appeals-argument-on-oshas-silica-standard%23comment-form">Log in</a> to post comments</li></ul> Sat, 14 Oct 2017 15:19:29 +0000 cmonforton 62941 at https://scienceblogs.com Gun control laws can impact death rates. But we need more research to find what works. https://scienceblogs.com/thepumphandle/2017/10/05/gun-control-laws-can-impact-deaths-rates-but-we-need-more-research-to-find-what-works <span>Gun control laws can impact death rates. But we need more research to find what works.</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>Guns are the third leading cause of injury-related death in the country. Every year, nearly 12,000 gun homicides happen in the U.S., and for every person killed, two more are injured. Whether Congress will do anything about this violence is a whole other (depressing) article. But there is evidence that change is possible.</p> <p>Last year, a <a href="https://academic.oup.com/epirev/article/38/1/140/2754868/What-Do-We-Know-About-the-Association-Between" target="_blank" rel="noopener noreferrer">study</a> published in <em>Epidemiologic Reviews</em> “systematically” reviewed studies examining the links between gun laws and gun-related homicides, suicides and unintentional injuries and deaths. Researchers eventually gathered evidence from 130 studies in 10 countries, finding that in certain places, gun restrictions are associated with declines in gun deaths. For instance, laws that restrict gun purchasing, such as background checks, are associated with lower rates of intimate partner homicide; while laws addressing access to guns, such as safe storage policies, are associated with lower rates of unintentional gun deaths among children. Study co-authors Julian Santaella-Tenorio, Magdalena Cerdá, Andrés Villaveces and Sandro Galea write:</p> <blockquote><p>This heterogeneity in approaches and implementation methods makes it critical to identify approaches that are less likely to be effective and to identify which strategies, looking forward, may be more likely to work. In addition, examining the associations between specific policies and firearm-related deaths across countries can improve our understanding about which types of laws are more likely to be successful in reducing firearm mortality rates in similar contexts or within diverse legal frameworks.</p></blockquote> <p>The study’s findings are a mixed bag — some of the gun laws studied seemed to reduce gun deaths, while others seemed to make no difference or increase deaths. For example, a number of studies examined found no association between concealed carry laws and gun homicides in the U.S. However, one study using injury data from southern Arizona found higher proportions of firearm injuries and deaths associated with concealed carry. Yet another study in Colombia examined the effects of laws banning the carrying of guns during weekends after paydays, holidays and elections days in two Colombian cities, Cali and Bogota. That study found a 14 percent reduction in homicide rates in Cali during no-carry days and a 13 percent reduction in Bogota.</p> <p>Studies on background checks and waiting periods came in mixed as well. For example, one study cited found no association between waiting periods and homicides and suicides. On the other hand, researchers have found that gun purchase bans for people with certain mental health conditions were associated with fewer homicides. One study found more stringent background checks were linked with fewer gun homicides. States with laws banning people with domestic violence restraining orders from owning and purchasing a gun also experienced reductions in intimate partner homicide. But one study found no homicide effect for laws that restricted gun access among those convicted of domestic violence.</p> <p>Two cross-sectional studies analyzed found that gun permits and licenses were associated with lower rates of gun suicide. In Missouri, researchers studied the effect of repealing requirements that people need a valid license to buy a gun, finding the repeal was associated with a 25 percent increase in homicide rates. On laws regulating gun storage, one study found that such child access prevention laws were associated with fewer unintentional gun deaths among children younger than 15, but not among older teens. Another found child access laws were linked to a reduction in all suicides among people ages 14 to 17. A study using hospital discharge data found that such storage laws were associated with lower nonfatal gun injuries among those younger than 18.</p> <p>The <em>Epidemiologic Reviews</em> study included research on particular laws as well. For example, a study on the U.S. Gun Control Act of 1968 — which restricted the sale of so-called <a href="https://en.wikipedia.org/wiki/Saturday_night_special" target="_blank" rel="noopener noreferrer">Saturday night specials</a>, among many other measures — did not find associated changes in homicide rates. But a study on Washington, D.C.’s 1976 law banning ownership of automatic and semiautomatic firearms and handguns found an “abrupt” reduction in homicide and suicide rates. Globally, Australia’s 1996 National Firearms Agreement, which banned certain kinds of firearms, was linked with a significant reduction in gun death rates. In addition, Australia has not experienced a mass shooting since the law was enacted. Control gun laws in Brazil, Austria and South Africa were also associated with fewer gun deaths.</p> <p>Overall, researchers were able to identify some “general observations” in combing through the 130 studies — most notably finding that the simultaneous enactment of laws targeting multiple gun regulations were associated with fewer gun deaths in certain countries. Another big finding: we simply need more research to understand what works and what doesn’t to prevent gun deaths. The researchers also noted that few studies have delved into the impact of gun safety laws on particular populations or whether such laws affect social attitudes, norms and behaviors. The authors write:</p> <blockquote><p>To conclude, we have provided an overview of national and international studies on the association between firearm-related laws and firearm injuries/deaths. High-quality research overcoming limitations of existing studies in this field would lead to a better understanding of what interventions are more likely to work given local contexts. This information is key for policy development aiming at reducing the burden posed to populations worldwide by violent and unintentional firearm injuries.</p></blockquote> <p>In more recent gun research, a <a href="http://content.healthaffairs.org/content/36/10/1729.abstract" target="_blank" rel="noopener noreferrer">study</a> published this month in <em>Health Affairs</em> set out to quantify the clinical and economic burden associated with emergency room visits for gun-related injuries in the U.S. Researchers examined data from the Nationwide Emergency Department Sample, identifying 150,930 people between 2006 and 2014 who showed up to an ER alive, but with a gun-related injury. That number represents a weighted estimate (that’s a fancy term for adjusting data to represent the greater population) of 704,916 patients.</p> <p>ER visits for gun injuries was lowest among those younger than 10 and highest among ages 15 to 29. Incidence of gun injury was about nine-fold higher for male patients — among men ages 20 to 24, more than 152 patients per 100,000 visited the ER for a gun injury. Most of the patients had been injured in an assault or unintentionally. The proportion injured in an attempted suicide was more than two-fold higher among Medicare beneficiaries. Handguns were the most common cause of the injury, followed by shotguns and hunting rifles.</p> <p>Among the more than 150,000 cases of gun injury at the ER, 48 percent were discharged home, 7.7 percent were discharged to other care facilities, about 37 percent were admitted to the hospital and just more than 5 percent died during their ER visits. Overall, 8.3 percent of the gun injury patients either died in the ER or as an inpatient. The average charge for gun injury in the ER was about $5,250; the average charge for those admitted was more than $95,000. Over the entire study period, gun-related injuries cost $2.9 billion in ER charges and $22 billion in inpatient care.</p> <p>Authors of the <em>Health Affairs</em> study also pointed out the need for more research, citing a 1996 federal measure known as the Dickey Amendment that said injury research funds at the Centers for Disease Control and Prevention could not be used to advocate or promote gun control. Co-authors Faiz Gani, Joseph Sakran and Joseph Canner write:</p> <blockquote><p>Researchers, politicians and government officials must work together to ensure that research funds are allocated to promote the understanding of the complex interplay between social, economic and medical factors associated with firearm-related injuries. Only through the adoption of an evidence-based public health approach can the resulting substantial medical and financial burden be reduced.</p></blockquote> <p>To request a full copy of the ER study, visit <a href="http://content.healthaffairs.org/content/36/10/1729.abstract" target="_blank" rel="noopener noreferrer"><em>Health Affairs</em></a>. For a copy of the gun policy study, visit <a href="https://academic.oup.com/epirev/article/38/1/140/2754868/What-Do-We-Know-About-the-Association-Between" target="_blank" rel="noopener noreferrer"><em>Epidemiologic Reviews</em></a>.</p> <p><em>Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for 15 years. Follow me on Twitter — <a href="http://www.twitter.com/kkrisberg" target="_blank" rel="noopener noreferrer">@kkrisberg</a>.</em></p> </div> <span><a title="View user profile." href="/author/kkrisberg" lang="" about="/author/kkrisberg" typeof="schema:Person" property="schema:name" datatype="">kkrisberg</a></span> <span>Thu, 10/05/2017 - 12:30</span> <div class="field field--name-field-blog-tags field--type-entity-reference field--label-inline"> <div class="field--label">Tags</div> <div class="field--items"> <div class="field--item"><a href="/tag/government" hreflang="en">government</a></div> <div class="field--item"><a href="/tag/gun-controlviolence" hreflang="en">Gun Control/Violence</a></div> <div class="field--item"><a href="/tag/healthcare" hreflang="en">healthcare</a></div> <div class="field--item"><a href="/tag/legal" hreflang="en">Legal</a></div> <div class="field--item"><a href="/tag/mental-health" hreflang="en">mental health</a></div> <div class="field--item"><a href="/tag/public-health-general" hreflang="en">Public Health - General</a></div> <div class="field--item"><a href="/tag/regulation" hreflang="en">regulation</a></div> <div class="field--item"><a href="/tag/research" hreflang="en">Research</a></div> <div class="field--item"><a href="/tag/safety" hreflang="en">safety</a></div> <div class="field--item"><a href="/tag/gun-control-0" hreflang="en">gun control</a></div> <div class="field--item"><a href="/tag/gun-deaths" hreflang="en">gun deaths</a></div> <div class="field--item"><a href="/tag/gun-injury" hreflang="en">gun injury</a></div> <div class="field--item"><a href="/tag/gun-safety" hreflang="en">gun safety</a></div> <div class="field--item"><a href="/tag/gun-violence" hreflang="en">gun violence</a></div> <div class="field--item"><a href="/tag/homicide" hreflang="en">homicide</a></div> <div class="field--item"><a href="/tag/injury-control" hreflang="en">injury control</a></div> <div class="field--item"><a href="/tag/prevention" hreflang="en">Prevention</a></div> <div class="field--item"><a href="/tag/public-health" hreflang="en">public health</a></div> <div class="field--item"><a href="/tag/suicide" hreflang="en">suicide</a></div> <div class="field--item"><a href="/tag/healthcare" hreflang="en">healthcare</a></div> <div class="field--item"><a href="/tag/mental-health" hreflang="en">mental health</a></div> <div class="field--item"><a href="/tag/regulation" hreflang="en">regulation</a></div> <div class="field--item"><a href="/tag/research" hreflang="en">Research</a></div> <div class="field--item"><a href="/tag/safety" hreflang="en">safety</a></div> </div> </div> <div class="field field--name-field-blog-categories field--type-entity-reference field--label-inline"> <div class="field--label">Categories</div> <div class="field--items"> <div class="field--item"><a href="/channel/medicine" hreflang="en">Medicine</a></div> </div> </div> <section> </section> <ul class="links inline list-inline"><li class="comment-forbidden"><a href="/user/login?destination=/thepumphandle/2017/10/05/gun-control-laws-can-impact-deaths-rates-but-we-need-more-research-to-find-what-works%23comment-form">Log in</a> to post comments</li></ul> Thu, 05 Oct 2017 16:30:31 +0000 kkrisberg 62938 at https://scienceblogs.com If Rigvir is effective "virotherapy" for cancer, why are quack clinics selling it and quackery promoters like Ty Bollinger promoting it? https://scienceblogs.com/insolence/2017/10/02/if-rigvir-is-effective-virotherapy-for-cancer-why-are-quack-clinics-selling-it-and-quackery-promoters-like-ty-bollinger-promoting-it <span>If Rigvir is effective &quot;virotherapy&quot; for cancer, why are quack clinics selling it and quackery promoters like Ty Bollinger promoting it?</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><em>Last week, I <a href="http://respectfulinsolence.com/2017/09/25/rigvir-a-cancer-cure-imported-from-latvia-that-cancer-patients-should-avoid/">wrote about Rigvir</a>, a highly dubious cancer therapy developed in Latvia. Rigvir is an oncolytic virus, and its proponents claim that it targets only cancer cells for destruction, leaving normal tissue alone. Its history and how it came to be approved in Latvia in 2004 and added to the Latvian Health Ministry's list of reimbursable medications in 2011 remain rather mysterious, but how it is being marketed does not. For example, Rigvir has become a new favorite treatment at a number of quack clinics, such as the Hope4Cancer Institute in Mexico, where Rigvir is offered along with <a href="https://sciencebasedmedicine.org/ask-the-science-based-pharmacist-what-are-the-benefits-of-coffee-enemas/">coffee enemas</a> and a wide variety of quackery. Moreover, as I described last week, there is a striking paucity of evidence supporting the efficacy of Rigvir against any cancer, even melanoma, the cancer for which Rigvir is approved in Latvia and for which there appears to be almost no published evidence at all. Certainly there is nothing resembling well-designed randomized clinical trials supporting the efficacy of Rigvir. Basically, few outside of Latvia and Eastern Europe had heard of Rigvir, as it had flown under the radar, most likely because Latvia is a small country. Then Ty Bollinger featured Rigvir in <a href="https://www.cancertutor.com/ttac-global-quest-cancer-killing-viruses-cancer-stem-cells-gmos-juicing/" rel="nofollow">Episode 3</a> of his alternative medicine propaganda video series <a href="https://www.cancertutor.com/global-cancer-documentary/" rel="nofollow"><cite>The Truth About Cancer</cite></a> (<cite>TTAC</cite>), complete with "miracle cure" testimonials, and suddenly Rigvir wasn't so obscure any more.</em></p> <!--more--><h2><cite>The Truth About Cancer</cite> promotes Rigvir</h2> <p>As I've discovered since last week, the people who run the International Virotherapy Center, where Rigvir is manufactured and sold, are not particularly happy about the increased level of attention directed at them. Indeed, within 15 hours of last week's post going live, I had received an e-mail from someone named Lelde Lapa, whose title was listed as Assistant of Business Development Department at the International Virotherapy Center (IVC). She was quite…unhappy with my post. Personally, I was amazed at how fast I received such a long e-mail after publishing my post. Clearly the IVC has many Google Alerts set for Rigvir and its name and is fast to act.</p> <p>As of this writing, the exchange is up to four e-mails, two from Ms. Lapa and two responses from me. One thing stood out, and that was how my charge that IVC irresponsibly markets Rigvir using patient testimonials seemed to produce the most defensive response. Based on that, I thought I would look a bit more at how Rigvir is actually marketed, starting with how Ty Bollinger featured it in Episode 3 of <cite>TTAC</cite>. (After all, Ty Bollinger's video series is where most cancer patients interested in alternative medicine learn about Rigvir.) Although I couldn't force myself to watch more than about the first half hour of the first episode of <cite>TTAC</cite> when it was first released, fortunately <a href="https://sciencebasedmedicine.org/the-truth-about-cancer-series-is-untruthful-about-cancer/">Harriet Hall could</a> and I did download all the episodes off of YouTube when they were briefly available for free. This allowed me to watch the segment on Rigvir, which starts at around the one hour mark and takes up most of the last half hour of the episode.</p> <p>The segment begins with an interview with Kaspars Losans, MD, IVC's medical director. Dr. Losans claims that Rigvir is a "very good" virus that specifically targets cancer cells and leaves normal cells alone. Next up, we meet Ivars Kalvins, PhD, who is the Director of the <a href="http://www.osi.lv" rel="nofollow">Latvian Institute of Organic Synthesis</a>, which is a "state research institute specializing in pharmaceutical research, organic chemistry, molecular biology and bioorganic chemistry." (The appearance of a scientist from a Latvian state research institute made me wonder a bit about collusion between the government and the IVC, for obvious reasons.) In his narration, Bolinger notes that Dr. Kalvins is a member of the European Academy of Sciences and <a href="http://www.independent.co.uk/news/science/european-inventor-award-can-a-british-inventor-win-in-the-oscars-of-innovation-10306192.html">one of three finalists for the European Medicine Award in 2015</a> and has many publications and patents. In contrast, he does not mention that Dr. Kalvins <a href="http://www.delfi.lv/bizness/uznemumi/vairakas-arstu-organizacijas-prasa-izvertet-rigvir-kompensesanu.d?id=48494303">owns a 3% stake in Rigvir</a>. Googling him, I found that he is best known for developing a heart medication, <a href="https://en.wikipedia.org/wiki/Meldonium">Mildronate</a> (generic name: meldonium). Interestingly, although Bollinger claims Kalvins has over 650 publications, I could only find ten in PubMed.</p> <p>In any case, my first thought was: If such a seemingly good "conventional" scientist is behind Rigvir, then why is it that the IVC has not published anything resembling good science supporting its claims for Rigvir? This is not a person who doesn't know how to publish. Oddly enough, he is not co-author of any of the few publications I could find in PubMed about Rigvir. Less oddly, given his support of Rigvir, he is not well-regarded outside of Latvia, basically because he makes claims for meldonium that are <a href="http://www.cnn.com/2016/03/08/health/sharapova-doping-meldonium-mildronate/">equally unsupported</a>. Indeed, meldonium was the alleged performance-enhancing drug that Russian tennis player Maria Sharapova was <a href="http://www.cnn.com/2016/03/08/health/sharapova-doping-meldonium-mildronate/">caught using last year</a>, leading to her suspension. Although it is approved in Latvia and several former Soviet Republics, it is not approved in the U.S. or European Union. Maybe Dr. Losans isn't quite the good conventional science that the first impression gave me.</p> <p>Be that as it may, Dr. Kalvins goes through the standard "history" of Rigvir, specifically about how Prof. Aina Muceniece discovered it. Interesting to me is Dr. Kalvins's claim that Rigvir is used "very, very successfully" to treat melanoma and "not only melanoma." I also wondered about his claim that Rigvir is a native, non-modified virus. That, of course, is likely true, as Rigvir is an Echovirus, specifically ECHO-7. As I mentioned last time, Echoviruses are RNA viruses that were thought to be orphan viruses (viruses with no known disease associated with them) but in fact do cause mostly (but not always) mild febrile diseases. In any case, Dr. Kalvins claims that Rigvir is a "non-mutating" virus, which, of course, also set my skeptical antennae a'twitching given that there is no such thing as a totally non-mutating virus. I suppose it's possible that he means the ECHO-7 strain used in Rigvir doesn't cause mutations in human cells, but who can tell for sure?</p> <p>We also meet another physician, Peteris Alberts, MD, PhD, who is IVC's Head of Research &amp; Development. After Bollinger says that Rigvir's activity was first demonstrated in mice, Dr. Alberts says:</p> <blockquote><p> <strong>Dr. Peteris Alberts:</strong> They found that if you take a tumor from a patient, put it into a hamster, then it will start growing, or something like that. If you put [it] on the virus, it will just fade away. Do you know who did that observation first? Ms. Garklava, the lady you saw this morning.</p> <p><strong>Ty:</strong> Really? </p> <p><strong>Dr. Peteris Alberts:</strong> Yeah. She did that. </p></blockquote> <p>There is a very brief shot of Bollinger interviewing an old woman, but none of the interview is heard, which I found odd.</p> <p>Indeed, there are a lot of claims made for Rigvir, none of which seem to be supported by any publications that I've been able to find indexed in PubMed. For example, Dr. Kalvins is shown saying:</p> <blockquote><p> There are at least ten different cancers, locations of cancer like renal cancer, like breast cancer, like stomach, lung, many others, also prostate cancer, which is very, very common for men. But, approved officially, it is only for melanoma now, but this is a very, very big success because we see that the people who use this virus for other indications of other types of cancers also can be healed. </p></blockquote> <p>If this is true, then the IVC should publish these results. One of the excuses that IVC makes for not having published clinical trials to support Rigvir's efficacy and safety against cancer is lack of finances. However, if the IVC has already done preclinical work that shows all this, there is absolutely nothing preventing it from publishing those results. It hasn't. Why is that? (I think I know the answer.)</p> <p>Another claim is made by Elita Shapovalova, MD, an oncologist at Riga East Clinical University Hospital:</p> <blockquote><p> In melanoma cases, in earlier stages when patients receive Rigvir, the percentage survived is 92 percent. And later stages, for example, if they receive Rigvir it's 60 percent. If they don't receive it, it's only 9 percent. There's no chemotherapy medicine that can treat melanoma, at least not found. In the beginning, we were using radiotherapy. But then, it got rejected. So we could not use it because it kills the immune system and it's very hard to fight. We come back to chemotherapy — the medicine in the chemotherapy field is not found to cure melanoma. And the second negative is that it has side effects, which simply destroys the immune system, which lowers the quality of life of the patient, and simply changes the whole life of the patient by these side effects. </p></blockquote> <p>Again, if this is true, then the IVC should publish these results. As I <a href="hhttp://respectfulinsolence.com/2017/09/25/rigvir-a-cancer-cure-imported-from-latvia-that-cancer-patients-should-avoid/">discussed last week</a>, the existing publications indexed in PubMed supporting the efficacy of Rigvir against melanoma are <em>very</em> unconvincing, and there are no randomized clinical trials to speak of, at least none to which I have access. (In actuality, in our e-mail exchanges, Ms. Lapa basically admitted that the IVC has no clinical trial results that meet modern standards.) For other cancers, the paucity of evidence is even more obvious.</p> <p>None of that stops Dr. Kaspars Losans from claiming:</p> <blockquote><p> Then comes the second mechanism of RIGVIR. Whenever those RIGVIRs are attracted to cancer cells, those cancer cells become visible for the human immune system. Until that time, they are invisible, they have the natural ability to be hiding from the immune system. And due to the RIGVIR guidance, because RIGVIR is attached, and attach to cancer, and RIGVIR is inside the cancer cell. So the immune system, due to RIGVIR, recognizes cancer and starts to react against this cancer. </p></blockquote> <p>One more time, if this is true, than IVC should publish these results. This is the sort of immunological mechanism that would take a lot of cell culture, animal, and clinical work to demonstrate properly. That's a detailed mechanism that Dr. Losans is claiming. If IVC has the experimental and clinical results to demonstrate such a mechanism, it should publish them. If it doesn't, it has no business making claims like this on a documentary by a well-known proponent of cancer quackery, or anywhere else, for that matter.</p> <p>Also, Dr. Alberts should stop making the ridiculous claim that prefaced Dr. Losan's description of Rigvir's mechanism of action that Rigvir is "the first real cancer therapy where you have an oncolytic virus which also has immunomodulating activity." There are lots of oncolytic viruses under study with immunomodulatory activity. <em><strong>That's the point!</strong></em> <a href="http://www.nature.com/nrd/journal/v14/n9/full/nrd4663.html?foxtrotcallback=true">That's the whole idea behind oncolytic viruses</a>, that they "promote anti-tumour responses through a dual mechanism of action that is dependent on selective tumour cell killing and the induction of systemic anti-tumour immunity." Seriously, even if everything the IVC and its minions say about Rigvir is true regarding its mechanism of action, Rigvir is not the only oncolytic virus with a dual mechanism of action!</p> <p>Finally, having Antonio Jimenez, the director of the Hope4Cancer Institute opining about how Rigvir boosts the immune system doesn't help the credibility of Rigvir:</p> <blockquote><p> Often times, in clinical practice, we focus on optimizing the immune system – getting the best immune system possible. And that's great. But still, cancer cells have now developed a way to bypass immune recognition. And the International Virotherapy Center here in Latvia, with the studies on RIGVIR, they have concluded that the RIGVIR is binding to the receptor site on the cancer cell surface, called the CD55. When it binds to this receptor, now the T-cells, the B-cells, the natural killer cells, will recognize the cancer cells and mount a specific immune response. </p></blockquote> <p>Again, that's a very specific mechanism that Jimenez is proposing. Where's the evidence to support it?</p> <p>Again, seriously, any truly scientific institute that had developed a drug would not want a quack like Ty Bollinger or Dr. Jimenez endorsing its discovery. That's the kiss of death as far as scientific credibility goes. Yet IVC embraces these quacks, sells to the Hope4Cancer Institute, and gladly lets its product be featured on a video documentary series designed to attack conventional oncology and promote alternative cancer quackery.</p> <p>I also can't help but scoff at the claims, made by several IVC boosters, that Rigvir has "no side effects." For one thing, there is no such thing as an effective medicine that has absolutely no side effects. It's clearly just not true. After all, even in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560272/"><cite>Melanoma Research</cite> paper from 2015</a> that I trashed last week as being so badly done, the authors noted that in previous clinical studies Rigvir had caused subfebrile temperature (37.5°C for a couple of days), pain in the tumour area, sleepiness, and diarrhea. Again, whenever anyone claims that an anti-cancer medication (or any medication, for that matter) is completely without side effects, I start becoming very suspicious.</p> <h2>But what about the testimonials?</h2> <p>A key part of <cite>TTAC</cite>'s segment on Rigvir consists of three testimonials. The first was from a woman named Khrystyna Yakovenko, who in 2012 was diagnosed with melanoma that had metastasized to the liver:</p> <blockquote><p> It all started in the end of 2012. When I contacted my doctor, he diagnosed melanoma of the fourth stage, with a metastasize of the liver. They prescribed the plan of chemotherapy and at that time, I even didn't understand what is what. I completely trusted our Ukrainian doctors and I trusted the methods they are using. I trusted this plan of chemotherapy. So I simply didn't realize — I didn't realize the effect of this diagnosis completely, entirely at that moment. </p></blockquote> <p>I can't help but note that here Bollinger invokes a typical trope used by quacks, that you have to "believe" in the therapy, saying, "one of the very important parts about a successful cancer treatment is that you believe in it and you're ready to fight to save your life." After that, Yakovenko relates:</p> <blockquote><p> I was not feeling afraid. I was not falling into panic. Simply, I understood that I had no right to leave it. I had to fight. When I first came to my therapy center, doctors didn't say, "Yes, we will do it." They said, "We will try." Because the stage was late. I think that sometimes on the earlier stages — on the initial stages people who have this very scary diagnosis, they sometimes are by themselves. They lose hope. They stop the fight. And they simply leave it. But, sometimes there are people who, even at late stages, they continue to fight, and continue to find the out of the situation. In this case, as the disease simply just is overwhelming. </p></blockquote> <p>So, basically, Ms. Yakovenko is a woman who was given a "maximum" of a couple of years to live, but was alive in late 2015 or early 2016, when this film was being made. That's about three years, which is very good but not evidence that Rigvir prolonged Ms. Yakovenko's life. Melanoma can have a highly variable course, and there are patients who survive with stage 4 melanoma for years. They are the outliers, of course, but there are too many of them to take someone who survived less than twice as long as predicted as slam dunk evidence that whatever cancer treatment she chose worked. I also can't help but notice that no scans are shown, and no mention is made of whether her cancer shrank, was stable, or progressed. Yes, this is yet another unconvincing <a href="http://oracknows.blogspot.com/2004/12/understanding-alternative-medicine.html">cancer cure testimonial</a>.</p> <p>A more recent interview, dated December 2016, is published on the <a href="https://virotherapy.blog/2016/12/05/i-have-personally-met-this-brave-lady-just-a-few-days-ago/">blog of the Virotherapy Foundation</a> (mentioned last week). Thus, Ms. Yakovenko's story is continuing to be used to promote Rigvir, with her saying, "I have already been alive for 2 years and 7 months thanks to Rigvir," which suggests that this interview occurred in the latter half of 2015, given that she started Rigvir in February 2013.</p> <p>The next testimonial is a man named Ruslan Isayev, who reports that he was only given seven months to live. In the interview, we are not even informed what kind of cancer Mr. Isayev had, other than that he had surgery for it. I presumed that he had melanoma, which turned out to be correct, as you will see, but it's very sloppy not to have specified the cancer. In any event, Mr. Isayev states that he tried chemotherapy after his surgery but couldn't take it and stopped, living "for one year more without chemotherapy," after which he decided to start Rigvir. Naturally, he credits the Rigvir with saving his life and even holds up a picture of his son, noting that he had been told that it would be very difficult for him to have any more children and that when he learned that his wife had become pregnant he vowed that "if were to be a girl, a daughter, I would name her after Aina Muceniece — after Professor Aina Muceniece, who was the discoverer, the great person, so Aina. And if it were to be a boy, then I would name him after the chairman of virotherapy, Jurgis, who is the grandson of Professor Aina Muceniece." It was a boy, and he named him Jurgis.</p> <p><a href="https://sites.google.com/a/njit.edu/yzs3portfolio/hum-102/research-paper">A little Googling revealed</a>, though:</p> <blockquote><p> In an interview on May 28, 2014, Ruslan Isayev gave a personal account of his experience with stage III skin melanoma. When he was diagnosed in 2010, the Chechen Republic doctors refused to operate on Ruslan. He went to Dagestan for surgery and after two weeks of lying in bed, the doctors gave Ruslan just seven months to live. He went to Grozny for chemotherapy, but after four doses he began to feel worse and worse. A local doctor then prescribed Interferon Alfa, a pharmaceutical drug meant to slow down tumor growth. Ruslan took this drug for one and a half years until a friend mentioned RigVir, an oncolytic virus created by the Latvian Academy of Sciences. After his third injection of RigVir, the doctors said his lymphonodus had shrunk and metastases disappeared. After a year of taking RigVir, Ruslan is alive and healthy. </p></blockquote> <p>Stage III melanoma is curable, I note. True, its survival rate is not great, but if the surgery is adequate long term survival is possible. I also note that Isayev received what sounds like considerable conventional therapy, including chemotherapy and a year and a half of interferon-alpha. As is the case with most such testimonials, it's very difficult to ascertain whether the treatment had anywhere near the effect claimed because too little information is given. <a href="http://es.allreadable.com/3160GnON">An account in Spanish</a> reveals a rather convoluted story in which Mr. Isayev had surgery, had a number of complications, briefly underwent chemotherapy, and then underwent treatment with interferon-alpha, during which time he claims that his disease did not progress but that it "didn't help me, either." (Stable disease is actually a desirable outcome.) He then claims that after he switched to Rigvir his lymph nodes shrank, his metastases disappearing. Overall, it's a convoluted story that does not really show that Rigvir is the reason why he's still alive. Again, most likely, it's the variable course of melanoma progression, the surgery, and interferon-alpha that have resulted in his continued survival.</p> <p>Finally, there is a Russian woman named Zoya Sokolova, who states that she was diagnosed with "third stage cancer." Again, the cancer isn't identified, and I assumed that it was melanoma as well. This time, I was incorrect. It was sarcoma, as you will see. (Google is my friend.) In any case, in <cite>TTAC</cite>, Ms. Sokolova reports:</p> <blockquote><p> It was— the diagnosis was very sudden for me. It was after a very strong stress, and then after a month and a half, I was diagnosed with a third stage cancer. Already after the surgery I had my chemotherapy, then they assigned another six chemotherapy and a full course of radiotherapy. My condition allowed only for chemotherapy to be handles, and after the fourth, I wasn’t able to stand up from the bed. I became a bed patient. Before these courses of chemotherapy I was told about a center, about a treatment, but I believed in our doctors and their treatment methods. So I decided to follow that path. </p></blockquote> <p>Then:</p> <blockquote><p> It seemed that they wanted it to be so for me, but they couldn’t give a warranty, they couldn’t say for sure that I would [beat] this disease. That moment when I couldn’t stand up from the bed on my own. I was so weak, and my relatives decided to take a van, to make a bed for me, and simply drive me to Riga, to the center. Before coming to Riga I made a blood test and a complete observation for the doctors here to have the full picture of my condition. When the doctor saw my blood test she was really astonished because all the blood tests was lower than for a live person. She was astonished how I managed to get here, staying alive. </p></blockquote> <p>Here's what it sounds like to me as a surgeon, based on the account above and the <a href="https://books.google.com/books?id=ktdKDQAAQBAJ&amp;pg=PT226"><cite>TTAC</cite> book</a> that told me she was being treated for sarcoma. <a href="https://www.cancer.org/cancer/soft-tissue-sarcoma/detection-diagnosis-staging/staging.html">Stage III sarcoma</a> means that either the cancer is larger than 5 cm in diameter and grade 3 histology or that it has spread to nearby lymph nodes. I note that stage III sarcomas are still potentially curable. Actually, even some cases of stage IV sarcoma are potentially curable if the distant metastases can be completely resected by surgery. Indeed, surgeons frequently resect lung and liver metastases from sarcoma, when they are few enough and small enough to be completely resected.</p> <p>My reconstruction of the testimonial is that Ms. Sokolova underwent radical surgery for her cancer, followed by chemotherapy and radiation, both of which are frequently used to treat sarcoma. She obviously had a very bad time of it, suffering multiple complications to the point where she was bedridden. After she began the Rigvir, she slowly recovered from the complications that she had suffered and, of course, attributed her recovery to Rigvir. At no point in this testimonial is any evidence provided that the Rigvir had any effect on her tumor. As far as I could tell from every description of her case, she was tumor-free at the time she chose to use Rigvir, just very ill from complications of surgery, radiation, and chemotherapy. Rigvir almost certainly did not save her, as much as Ms. Sokolava believes that it did, <a href="https://virotherapy.blog/2017/03/02/some-earlier-videos-from-zoya-sokolova/" rel="nofollow">tells the Virotherapy Foundation that it did</a>, and now uses virotherapy to "<a href="https://youtu.be/5InWy4_fVBo">strengthen her well-being</a>" and prevent recurrence. Again, there is no evidence that Rigvir prevents the recurrence of sarcoma.</p> <p>Not surprisingly, Bollinger laps up this story as evidence of how great Rigvir is as a cancer treatment.</p> <h2>A previously discussed testimonial revisited</h2> <p><a href="http://respectfulinsolence.com/2017/09/25/rigvir-a-cancer-cure-imported-from-latvia-that-cancer-patients-should-avoid/">In my post last week</a>, I briefly mentioned a testimonial that is featured on the <a href="https://www.virotherapy.eu/testimonials.php" rel="nofollow">International Virotherapy Center website</a>:</p> <iframe width="560" height="315" src="https://www.youtube.com/embed/yUdhf4rFqDY" frameborder="0" allowfullscreen=""></iframe><p> In brief, Nadine is a British woman who had melanoma in 1999 that recurred in 2009. We know that she's undergone surgery, radiation therapy, and chemotherapy, but that she still has cancer. She is portrayed in the video as doing well after having started Rigvir, even though she is not cancer-free. What I didn't know (but perhaps should have discovered through Googling) last week is that Nadine has a <a href="https://www.gofundme.com/nadineking">GoFundMe page</a> that paints a much more dire picture of her situation. It was last updated six months ago, which makes me worry about whether she is still alive:</p> <blockquote><p> Recently, she has seen huge success from a treatment she had at the Global Virotherapy Cancer Clinic in Latvia. The centre there offers holistic care and a course of virotherapy. Incredibly, just one week after returning from Latvia, Nadine's scan showed that the 2cm tumour on her lung had completely disappeared and all-but-two of her other tumours had shrunk significantly. This is a huge breakthrough and so now Nadine needs to obliterate all the other ones too and go back to Latvia every three months for further treatment at a cost of around £7,000 a time.</p> <p>Although this treatment isn't available in the UK, it is something that is now being trialled in the USA in combination with immunotherapy, which Nadine is receiving through our amazing NHS.</p> <p>This treatment is working amazingly well at keeping surface lumps and bumps at bay - a few injections at sites near them sees them shrinking and vanishing - so this must be kept going.</p> <p>Unfortunately though, the cancer has managed to take up residence in her lower intestine, making it impossible to eat or drink. Nadine, as resilient and incredible as ever, hasn't taken this lying down and has insisted the surgeons try to clear enough of her stomach to allow fluids to pass. As soon as this happens, she will be heading to Hungary for Gerson Therapy. This holistic therapy has been responsible for some fantastic results in other melanoma patients, and Nadine is determined to get out there and get this thing back under control. This therapy will cost around £7,000 too. So, Nadine really needs YOUR help! </p></blockquote> <p>Malignant small bowel obstruction due to melanoma is definitely not good. Fortunately, update #2 shows that she did undergo surgery for her bowel obstruction:</p> <blockquote><p> Just a little note to say Thank you to everyone who's checked in with me after my operation on Tuesday. </p> <p>I've been using the cannabis oil instead of morphine and codeine for pain relief, with the added bonus that I can't be bothered to speak or move.... My kids and sister are delighted!!!! Lol</p> <p>I am soooooo happy too, that with your help I'm almost at my target to help towards my next batch of treatment...I can't thank you enough.xxx<br /> I promise to send each of you a thank you message , bear with me... Xxxxx</p> <p>So next week once the shoulder starts to heal I have a full on week of getting back on track.</p> <p>Monday I'm meeting a lady to discuss Biomagnetism therapy, Tuesday follow up at the nutritionists, weds back to hospital for checks, Thursday we get back on the virotherapy injections.....and Saturday I start the spring mindfulness course, this is key in keeping my mind focused and living in the moment.xxxxxxxx</p> <p>Some times people ask me what I'm doing for work, as you can see, my full time job is trying to stay as well as possible and keep plugging away at trying to find why I've got this disease in the first place. </p></blockquote> <p>That was six months ago. It is unclear when the video featured on the IVC website was shot, but it's dated August 11, 2017. However, in it Nadine doesn't mention any surgery for a bowel obstruction; so either that was intentionally not mentioned, with the bowel surgery falling under the rubric of "many operations," or this video was recorded before her bowel obstruction, which, I note, happened while she was undergoing virotherapy, as was made clear to me reading her GoFundMe page. Obviously, the Rigvir didn't stop her tumor from progressing. Yet, the IVC is still using Nadine's testimonial in a deceptive—dare I say irresponsible—manner to sell Rigvir. Yes, I stand by my original assessment, and unfortunately that irresponsible and unethical use of patient testimonials to promote Rigvir is having an effect, particularly now that more and more alternative cancer clinics appear to be offering it.</p> <p>Meanwhile, Rigvir marketers appear to be using <a href="http://www.delfi.lv/news/national/politics/rigvir-versas-pret-rsu-asocieto-profesori-purvinu.d?id=49269519">using legal thuggery to try to silence Latvian critics</a>. For example, Riga Stradiņš University recently received a letter from Sorainen, a law firm representing Rigvir Holding, regarding Dr. Santa Purvina, who is faculty there. The letter asked whether Dr. Purviņa's <a href="http://www.delfi.lv/bizness/uznemumi/vairakas-arstu-organizacijas-prasa-izvertet-rigvir-kompensesanu.d?id=48494303">statement</a> that the studies upon which the approval of Rigvir were based were inadequate represented the view of the University. If that isn't an attempt at intimidation, I don't know what is.</p> <p>The more I learn about Rigvir and the International Virotherapy Center, the more I think the whole operation stinks to high heaven. It should be interesting to see what lands in my e-mail in box this week. Be assured that I do plan on publishing the entire e-mail exchange eventually. I merely held off because I was particularly interested in how the IVC will respond to the e-mail that I sent on Friday. In the meantime, the whole Rigvir operation is starting to remind me of the Burzynski Clinic, only worse given the marketing to alternative cancer clinics and the even more transparent than usual excuses for not doing clinical trials. What I do see is the marketing of Rigvir using the same methods that <a href="http://respectfulinsolence.com/2011/11/29/burzynski-the-movie-subtle-its-not/">Stanislaw</a> <a href="http://respectfulinsolence.com/2011/12/12/what-dr-stanislaw-burzynski-doesnt-want/">Burzynski</a> uses to market antineoplastons, patient testimonials and through alternative medicine-promoting hucksters like Ty Bollinger, whose documentary has <a href="http://respectfulinsolence.com/2017/06/05/cassandra-callenders-cancer-is-progressing-and-the-quackery-isnt-stopping-it/">persuaded cancer patients</a> to <a href="http://respectfulinsolence.com/2016/04/19/another-young-woman-with-cancer-lured-into-quackery-by-ty-bollinger/">eschew effective treatments</a> in <a href="http://respectfulinsolence.com/2016/05/27/yet-another-woman-with-breast-cancer-lured-into-quackery-by-ty-bollinger-and-holistic-medicine-advocates/">favor of quackery</a>.</p> <p>That's not a good strategy for a company marketing a science-based treatment. It is, however, a good strategy if you're marketing quackery. Which is it, Rigvir?</p> </div> <span><a title="View user profile." href="/oracknows" lang="" about="/oracknows" typeof="schema:Person" property="schema:name" datatype="">oracknows</a></span> <span>Sun, 10/01/2017 - 21:40</span> <div class="field field--name-field-blog-tags field--type-entity-reference field--label-inline"> <div class="field--label">Tags</div> <div class="field--items"> <div class="field--item"><a href="/tag/cancer" hreflang="en">cancer</a></div> <div class="field--item"><a href="/tag/complementary-and-alternative-medicine" hreflang="en">complementary and alternative medicine</a></div> <div class="field--item"><a href="/tag/medicine" hreflang="en">medicine</a></div> <div class="field--item"><a href="/tag/pseudoscience" hreflang="en">Pseudoscience</a></div> <div class="field--item"><a href="/tag/quackery-0" hreflang="en">Quackery</a></div> <div class="field--item"><a href="/tag/skepticismcritical-thinking" hreflang="en">Skepticism/Critical Thinking</a></div> <div class="field--item"><a href="/tag/aina-muceniece" hreflang="en">Aina Muceniece</a></div> <div class="field--item"><a href="/tag/antonio-jimenez" hreflang="en">Antonio Jimenez</a></div> <div class="field--item"><a href="/tag/coffee-enema" hreflang="en">coffee enema</a></div> <div class="field--item"><a href="/tag/echo-7" hreflang="en">ECHO-7</a></div> <div class="field--item"><a href="/tag/echovirus" hreflang="en">Echovirus</a></div> <div class="field--item"><a href="/tag/elita-shapovalova" hreflang="en">Elita Shapovalova</a></div> <div class="field--item"><a href="/tag/hope4cancer" hreflang="en">Hope4Cancer</a></div> <div class="field--item"><a href="/tag/international-virotherapy-center" hreflang="en">International Virotherapy Center</a></div> <div class="field--item"><a href="/tag/ivars-kalvins" hreflang="en">Ivars Kalvins</a></div> <div class="field--item"><a href="/tag/kaspars-losans" hreflang="en">Kaspars Losans</a></div> <div class="field--item"><a href="/tag/latvia" hreflang="en">Latvia</a></div> <div class="field--item"><a href="/tag/melanoma" hreflang="en">melanoma</a></div> <div class="field--item"><a href="/tag/nadine-king" hreflang="en">Nadine King</a></div> <div class="field--item"><a href="/tag/peteris-alberts" hreflang="en">Peteris Alberts</a></div> <div class="field--item"><a href="/tag/quackery" hreflang="en">quackery</a></div> <div class="field--item"><a href="/tag/riga-east-clinical-university-hospital" hreflang="en">Riga East Clinical University Hospital</a></div> <div class="field--item"><a href="/tag/rigvir" hreflang="en">Rigvir</a></div> <div class="field--item"><a href="/tag/ruslan-isayev" hreflang="en">Ruslan Isayev</a></div> <div class="field--item"><a href="/tag/sarcoma" hreflang="en">sarcoma</a></div> <div class="field--item"><a href="/tag/truth-about-cancer" hreflang="en">The Truth About Cancer</a></div> <div class="field--item"><a href="/tag/ty-bollinger" hreflang="en">Ty Bollinger</a></div> <div class="field--item"><a href="/tag/zoya-sokolova" hreflang="en">Zoya Sokolova</a></div> <div class="field--item"><a href="/tag/cancer" hreflang="en">cancer</a></div> <div class="field--item"><a href="/tag/complementary-and-alternative-medicine" hreflang="en">complementary and alternative medicine</a></div> <div class="field--item"><a href="/tag/medicine" hreflang="en">medicine</a></div> </div> </div> <div class="field field--name-field-blog-categories field--type-entity-reference field--label-inline"> <div class="field--label">Categories</div> <div class="field--items"> <div class="field--item"><a href="/channel/medicine" hreflang="en">Medicine</a></div> </div> </div> <section> <article data-comment-user-id="0" id="comment-1366521" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1506914282"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>Ah, so the Verita Life clinics have their snouts in the Rigvir trough! Dispositive proof that it is a worthless scam.</p> <p>Verita (the other buttock of the "Regenerasia" bum) started out working the stem-cell side of the street, back when stem-cells were the cure for everything. With a focus on harvesting their victims from newly-wealthy Asian markets. Then it was live-fetal-cell injections from sheep and such as, though I think they've moved on from that to the fetal-cell <b>extracts</b> -- processed to distill the Vital Essence -- with a side-line in placenta products. They leapt aboard the GcMAF scamwagon as it passed, too.</p> <p>For Medical Director they have recruited one 'Dr' Richard Deandrea, who does not seem to have attracted any Respectful Insolence in the past. You really should look him up.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366521&amp;1=default&amp;2=en&amp;3=" token="xtvtW2aCzntMHmQNoP5Jj-GgJTYCg87Gikd1B4j1tSw"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">herr doktor bimler (not verified)</span> on 01 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366521">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366522" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1506929037"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>Anytime someone tells you that you have to believe in something for it to work, you are guaranteed they are full of bovine feces. That is the best thing about science, no belief is necessary. Don't believe in gravity, you will still fall to your death when you step off a tall building. Don't believe in germ theory, Influenza will still lay you out, and Hemorrhagic fever will still liquefy your innards. </p> <p>As a wise man once pointed out: "Science, It works Biatches"</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366522&amp;1=default&amp;2=en&amp;3=" token="V4Ag6OjxKhuFI0ulehxydvxpX8S8XDQKMGgXeHYCIiU"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Anonymous Pseudonym (not verified)</span> on 02 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366522">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366523" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1506938070"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><blockquote><p>generic name: meldonium</p></blockquote> <p>If only meldonium would loosen up the meibomian, I'd be all in today.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366523&amp;1=default&amp;2=en&amp;3=" token="txHkUs-E_Bn4-OLQRtFXukmA87pJt6fZCJ4BBmgmDuY"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Narad (not verified)</span> on 02 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366523">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366524" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1506938526"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>The claim that Rigvir lacks side effects reminds me of my favorite fictional drug, Provasic (RDU-90), the miracle heart drug in "The Fugitive" (it also had no side effects whatsoever, except for wiping out patients' livers).</p> <p>An enjoyable list of fictional drugs (a good one is Hibernol, the cold and flu remedy that lets you sleep through the entire flu season):</p> <p><a href="https://en.wikipedia.org/wiki/List_of_fictional_medicines_and_drugs">https://en.wikipedia.org/wiki/List_of_fictional_medicines_and_drugs</a></p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366524&amp;1=default&amp;2=en&amp;3=" token="hNfVzRiP23tJa_4Qu3atUAyA5_P-_pfhPaZ-9s2uOeU"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Dangerous Bacon (not verified)</span> on 02 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366524">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366525" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1506945689"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>Wait, CD55 and the approval is for melanoma? I'm stuck on a phone, but this doesn't seem like an obvious starting point.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366525&amp;1=default&amp;2=en&amp;3=" token="2mddiFBd5om4lO-Ms0sBdyJvTbC3cLXmroy_1fIrBhI"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Narad (not verified)</span> on 02 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366525">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366526" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1506950795"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>Probably not the latest, but <a href="http://brianduriemd.myeloma.org/content/whatever-happened-measles-vaccine-therapy-status-report">here's</a> one item on what's been going on at Mayo since that whole curing multiple myeloma with measles vaccine thingamabob.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366526&amp;1=default&amp;2=en&amp;3=" token="19pHaWIcMeJMHfS0CBeJiLEuaGeRAvWHi79KNdxrCBc"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Narad (not verified)</span> on 02 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366526">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366527" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507015210"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>Aug. 15, 2017:<br /><a href="https://medicalxpress.com/news/2017-08-clinical-trial-genetically-virus-cancer.html">https://medicalxpress.com/news/2017-08-clinical-trial-genetically-virus…</a></p> <p>The Phase I immunotherapy trial is for those ages 18 and older with metastatic solid tumors that have not responded to standard treatments. The treatment injects an oncolytic (cancer-destroying) virus—vesicular stomatitis virus (VSV)—into the tumor. The virus is engineered to grow in cancer cells, destroy these tumors, and then spread to other cancer sites. During this process, it recruits the immune system to the area with the goal of triggering an immune response.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366527&amp;1=default&amp;2=en&amp;3=" token="durw8Y6h2RDyjc9XLsKGMSYVAsLGzW4goXH39t8Ea84"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Mike McCants (not verified)</span> on 03 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366527">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366528" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507050139"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>Wikipedia tells me the putative receptor for Rigvir, CD55, is distributed primarily in blood cell lineages, both red blood cells and lymphocyte lines, but also in lung and adrenal tissues. Not exactly a target one would expect to be free of collateral damage (side effects). </p> <p>Furthermore, human viruses such as coxsackie and enteroviruses that use this receptor in human diseases do not easily recognize the rodent version of CD55</p> <p> Spiller OB, Goodfellow IG, Evans DJ, Almond JW, Morgan BP (January 2000). "Echoviruses and coxsackie B viruses that use human decay-accelerating factor (DAF) as a receptor do not bind the rodent analogues of DAF". J. Infect. Dis. 181 (1): 340–3. </p> <p>This would seem to cast some doubt on the origin story for Rigvir. All the more reason that the lack of published research on preclinical work for this drug is a serious red flag. No legitimate government regulatory body would approve trials in humans with an infectious agent without a substantial body of published, peer reviewed in vitro and animal work. </p> <p>Logic therefore leads to the inescapable conclusion that the drug regulatory apparatus in Latvia is illegitimate. </p> <p>I know, I'm shocked:<br /><a href="https://www.youtube.com/watch?v=SjbPi00k_ME">https://www.youtube.com/watch?v=SjbPi00k_ME</a></p> <p>Capt</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366528&amp;1=default&amp;2=en&amp;3=" token="BUmDunou7DYmLYdpFs8zULHyagTONaAAJ3VEkvoHkc8"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">captian_a (not verified)</span> on 03 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366528">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366529" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507051372"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>Every time I look at the picture at the start of the article, I think they photo shopped Salmonberries as the Rigvir virus bodies. Then I think do they have salmonberries in Latvia? Maybe they are replacing coffee beans with salmonberries. </p> <p>I just needed something a little stupid to help get past the recent horror.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366529&amp;1=default&amp;2=en&amp;3=" token="YXatOq9xrvKx9UfoyoZfNl17eRIS2hJH2xHqzqoNR2M"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Rich Bly (not verified)</span> on 03 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366529">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366530" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507051770"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>Hope4Cancer's "Dr Tony" bangs-on at-length about Rigvir® here ... <a href="https://youtu.be/4Z0A2tR1EgQ?t=20m17s">https://youtu.be/4Z0A2tR1EgQ?t=20m17s</a> .<br /> This Rigvir® computer-animation shows virus-particles as big as red-blood-cells, &amp; virus multiplying like bacteria ... <a href="https://vimeo.com/178891587">https://vimeo.com/178891587</a></p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366530&amp;1=default&amp;2=en&amp;3=" token="6Tm5lOrnFdJ97DGUvEa5eKA4dHW8xt5UaYFGVvL5vQk"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">John Q. Public (not verified)</span> on 03 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366530">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366531" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507072710"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><blockquote><p>Wikipedia tells me the putative receptor for Rigvir, CD55, is distributed primarily in blood cell lineages, both red blood cells and lymphocyte lines, but also in lung and adrenal tissues.</p></blockquote> <p>What I was looking at before was <a href="https://www.proteinatlas.org/ENSG00000196352-CD55/pathology">from the Human Protein Atlas</a>.</p> <p>And no, I am not the slightest bit competent here.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366531&amp;1=default&amp;2=en&amp;3=" token="j-Mmg-wh51VnR1XuDBJLVTTTJUCHLLxb10Onqnsbn6s"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Narad (not verified)</span> on 03 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366531">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366532" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507116242"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>I have no opinion on the efficacy of this product (the fact that a given Bad person believes in it meaning nothing whatsoever). However, you are, let's assume accidentally, wrong in your assessment of the publication history of Ivars Kalvins. First, PubMed indexes primarily Western journals and is far from complete. A search of the less-limited Google Scholar makes it appear that he may well have hundreds of publications - especially when it quickly becomes apparent that the correct orthography of his name includes a number of diacritical marks, and that in many of his publications his last name is rendered as "Kalvinsh" to represent phonetically the modified S at the end of the name. And indeed, when I search PubMed for "Ivars Kalvinsh" it returns 50 publications.</p> <p>Those silly Easterners do not understand that when we say Science is universal, we really mean that they are to study only the hypotheses that Americans have already given the thumbs-up to, which means that they are always to be behind us intellectually, trailing in our wake, and not incidentally paying royalties and never collecting them. Rather like those pesky Cubans, having the nerve on a tenth the per-capita income to come up with a cancer treatment that white people had not already patented. Shame, really.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366532&amp;1=default&amp;2=en&amp;3=" token="Ad1CgFU-5weGVF2twJZyK5I2CjLPNkGIdTtrhs5bzKU"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">jane (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366532">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366533" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507118149"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>jane: "PubMed indexes primarily Western journals" and "Those silly Easterners do not understand"</p> <p>Please advice us which longitudes divides this planet between "East" and "West"? Does that mean Latvia is in the "East", and Japan with its DTaP and varicella vaccines is in the "West"?</p> <p>Or are you just being a clueless racist? Do you even know where Latvia is? (it is two countries away from where homeopathy was dreamed up a bit over two centuries ago)</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366533&amp;1=default&amp;2=en&amp;3=" token="qtkKYLd-1UDw87Y8OeaM-vAz2MOhej4OEMiU9dFBCo4"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Chris (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366533">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366534" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507120724"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>Oh, yay, the medical weeaboo is back.</p> <p>One quibble, jane, do you use "West" as a generic snarlword for all industrialized countries, or do you actually not know where Cuba and Latvia are located?</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366534&amp;1=default&amp;2=en&amp;3=" token="E86LYASsPJ8Jp4hsSzfLJoJMvERe2lPDDKJrsKbzGcU"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Politicalguineapig (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366534">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366535" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507123081"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>The divide between "East" and "West" is an interesting thing. It basically got its start as "Old World" views about "the Orient" (Asia Minor, the Middle East, Asia.) We definitely still talk about "Eastern philosophy" or "Eastern mysticism" as opposed to Western philosophy or mysticism.</p> <p>Then there was a divide between "Eastern Europe" and "Western Europe." (Russia has always had this interesting identity crisis about whether it is part of "the East" or "the West.") Nowadays, every former Eastern Bloc country is trying to distance itself from Russian hegemony and the whole notion of "Eastern Europe." So Poland very firmly defines itself as Central European, Lithuania is kind of riding Poland's coattails into "real Europe" by way of shared history. Estonia wants to be Nordic. Ukraine is kind of a mess, but Western Ukraine sort of looks up to Poland (or used to?) as "real Europe," positioning itself closer to Poland, despite many historical grievances. Latvia is essentially the odd man out. (Belarus seems perfectly happy to be Russia's little brother, or at least the Belarusian government.)</p> <p>And then there's "Western imperialism" in terms of colonialism, which has definitely been a real thing, and still is. (Hell, just look up the colonial history of <i>Belgium</i> even, it's awful.) Western Europeans have been screwing over the rest of the world for ages. They still do, just in a less overt way.</p> <p>And there's the "Western imperialism" of the Soviet era, which was also definitely real, although by that point, the US was in the forefront. (We essentially installed Pinochet; just one example among many.)</p> <p>Of course, Japanese imperialism and Russian imperialism have also been real things.</p> <p>Some people now prefer to talk about the "global north" vs. the "global south," but the geography of that is also weird, since a lot of former colonized nations are above the equator, and Australia and New Zealand are below it.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366535&amp;1=default&amp;2=en&amp;3=" token="p4lEApUuK6rKySopwujFqqdlfDFH1N4P6iXmY6qa1iU"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">JP (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366535">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366536" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507123186"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>^ the Cold War era would probably be a better phrase than "the Soviet era.'</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366536&amp;1=default&amp;2=en&amp;3=" token="Z-pasdm-sPJgOCXYnF5OT4Of-KWZlgyRNNbLt8__2xM"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">JP (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366536">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366537" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507135103"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>Narad,</p> <p>That is a great reference. </p> <p>I too am way out of my league on this topic. No worries. No qualifications required for commenting .</p> <p>Jane,<br /> If you think Orac has erred on his critique, namely there is a paucity of science to support this company's claims, the proper rebuttal is to present this hidden science. Your argument that there COULD BE supportive publications that he might find if only he weren't so biased toward "Western" science is basically akin to arguing that there could be intelligent life on the far side of the moon. </p> <p>I wont hold be holding my breath that the PR contact Orac has been emailing is filling his inbox with links to peer reviewed science supporting the use of Rigvir.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366537&amp;1=default&amp;2=en&amp;3=" token="VDZxTFUoxM30pqKPNgM6fusVOAzga7yT0Z_NRz-Vbo8"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Captian_a (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366537">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366538" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507140373"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>JP: "Ukraine is kind of a mess, but Western Ukraine sort of looks up to Poland (or used to?) as “real Europe,” positioning itself closer to Poland,"</p> <p>Where there are several areas where the border was moved in both directions. </p> <p>The way Jane was using "East" versus "West" is to suggest that magic actually works, and only certain cultures know about it. She neglects that magic does not work, and those "Eastern" cultures do not live in the past. They even use smartphones.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366538&amp;1=default&amp;2=en&amp;3=" token="cFV5nyUSTll7KMUC-BY9gjbTgVrkfe-SEX5xOY-e4-I"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Chris (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366538">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366539" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507142879"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>What I have learned from skimming the backstory:</p> <p>1. Ivars Kalviņš (of the USSR Latvia Institute of Organic Synthesis) and Rigvir's other enthusiasts were all well-placed in the old Soviet-era science establishment, and therefore it is totally above-board and respectable.</p> <p>2. Rigvir has always been marginalised and non-establishment and that's why its enthusiasts have never hard the resources to test it.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366539&amp;1=default&amp;2=en&amp;3=" token="zN0IfTCtvHVT5TnSlFrpqsLk-Uc379Yuho-KK3XZJiE"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">herr doktor bimler (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366539">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366540" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507143563"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p><i>Latvia is essentially the odd man out. </i></p> <p>I get the impression that Latvia is the Baltic country most thoroughly integrated into the Russian economy and Russian politics and Russian criminal circles (to the extent that these are separable). There's a Latvian resort, Jurmala, that's esentially a playground for Russian oligarchs and mafia types. They have the best money launderers in Europe.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366540&amp;1=default&amp;2=en&amp;3=" token="flTwi2Evw5LbxN0_uYKiTDsFp9qpxuSHNT-YHvXDC8E"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">herr doktor bimler (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366540">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366541" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507143663"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>Hemo. It's not just some red thing that fcks with your life anymore:</p> <blockquote><p>What makes this protein, called Hemo, so unusual is that it’s not made by the mother. Instead, it is made in her fetus and in the placenta, by a gene that originally came from a virus that infected our mammalian ancestors more than 100 million years ago...</p> <p>A team of French researchers engineered healthy human cells to make a viral protein found in many tumors and watched the cells grow in a petri dish.</p> <p>The protein caused the cells to behave in some suspiciously cancer-like ways. They changed shape, as cancer cells do, becoming long and skinny. And they also started to move across the dish.</p></blockquote> <p><a href="https://www.nytimes.com/2017/10/04/science/ancient-viruses-dna-genome.html">https://www.nytimes.com/2017/10/04/science/ancient-viruses-dna-genome.h…</a></p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366541&amp;1=default&amp;2=en&amp;3=" token="xQ08sjYr2-Qsn-cx_B2s83rUYxAtt2gJSpT62M3YO4Y"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Tim (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366541">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366542" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507145000"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>@HDB:</p> <p>The over mafia control of Russia has been suppressed; really it's just higher up, I guess.</p> <p>I haven't really spent much time in Latvia (just passing through on the train, so not at all I guess), but one of the people who [was] on my committee is from Riga. She definitely grew up in the Russian-Jewish-Soviet culture there. (She has said that it just doesn't feel like the holiday season without a "New Year's" tree." She is fluent in Latvian, though.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366542&amp;1=default&amp;2=en&amp;3=" token="2ezBUce24iB2tGxVr9kKtAYvp-eayOTl8z56nLvTxb0"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">JP (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366542">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366543" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507145034"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>*overt, not over.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366543&amp;1=default&amp;2=en&amp;3=" token="6tngkHYTa1WKPZqAwAfYEbW2tf-7kQvUe5Bnorvggts"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">JP (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366543">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366544" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507148187"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p><i>Estonia wants to be Nordic. </i></p> <p>In case anyone is all "[citation needed]", here is SATW:<br /><a href="https://satwcomic.com/party-crasher">https://satwcomic.com/party-crasher</a></p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366544&amp;1=default&amp;2=en&amp;3=" token="NfiR3D5kpRsIitOt_YcRGOtFTTwMz5z3o63W1rZZ8qM"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">herr doktor bimler (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366544">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366545" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507153886"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>What the hell, I made a comment and it disappeared.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366545&amp;1=default&amp;2=en&amp;3=" token="Lht0tdOCS6yvgYyMfJx4wLcdpWqjiO4K5jMWzd3HNcM"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">JP (not verified)</span> on 04 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366545">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366546" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507204625"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>@herr doktor bimler</p> <p>"There’s a Latvian resort, Jurmala, that’s esentially a playground for Russian oligarchs and mafia types. They have the best money launderers in Europe."</p> <p>True, politics are highly influenced by this and state institutions are lax in the oversight of many sectors, not just banks. You can also read the following article and related ones to realize how deeply integrated corruption and blatant scheming in highest echelons has been and still is: <a href="http://eng.lsm.lv/article/politics/politics/latest-oligarch-transcripts-reveal-media-manipulation.a241609/">http://eng.lsm.lv/article/politics/politics/latest-oligarch-transcripts…</a> </p> <p>Considering the fact that back in 2004 the situation was even worse, corruption in the process of registering Rigvir seems highely likely. </p> <p>As to Jurmala, that little Rigvir "family company" strangely had enough money to buy a fancy clinic there, in the most expensive real estate area in Latvia (imagine what the prices are if you can count on Russian oligarchs being interested in buying). To the average Latvian this would seem quite suspicious: <a href="https://www.virotherapyclinic.eu/">https://www.virotherapyclinic.eu/</a></p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366546&amp;1=default&amp;2=en&amp;3=" token="MsQOFrZdNHNfhtS8_fu-dbmn4SKSVkgh3F8tUHJzZ_c"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">z (not verified)</span> on 05 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366546">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> <article data-comment-user-id="0" id="comment-1366547" class="js-comment comment-wrapper clearfix"> <mark class="hidden" data-comment-timestamp="1507791057"></mark> <div class="well"> <strong></strong> <div class="field field--name-comment-body field--type-text-long field--label-hidden field--item"><p>Kalvins is not a director of Latvian Institute of Organic Synthesis (LIOS) for a few years. <a href="http://www.osi.lv/en/contacts/">http://www.osi.lv/en/contacts/</a></p> <p>Rigvir is neither developed or studied in LIOS. LIOS has never received any grant (esp from Latvian government) to study Rigvir. As you mentioned, Kalvins has shares in a company and is rather representative of Rigvir, not LIOS. </p> <p>I strongly agree that Rigvir has no published confirmation of activity either in preclinical and clinical studies. To my knowledge, Rigvir even doesn't have appropriate (if any) quality and batch to batch reproducibility control as well.</p> </div> <drupal-render-placeholder callback="comment.lazy_builders:renderLinks" arguments="0=1366547&amp;1=default&amp;2=en&amp;3=" token="rPLFfaNkdGBMUigU8YyGHX27xWsX0TliNjORQLV4ZPs"></drupal-render-placeholder> </div> <footer> <em>By <span lang="" typeof="schema:Person" property="schema:name" datatype="">Scientist from Riga (not verified)</span> on 12 Oct 2017 <a href="https://scienceblogs.com/channel/medicine/feed#comment-1366547">#permalink</a></em> <article typeof="schema:Person" about="/user/0"> <div class="field field--name-user-picture field--type-image field--label-hidden field--item"> <a href="/user/0" hreflang="und"><img src="/files/styles/thumbnail/public/default_images/icon-user.png?itok=yQw_eG_q" width="100" height="100" alt="User Image" typeof="foaf:Image" class="img-responsive" /> </a> </div> </article> </footer> </article> </section> <ul class="links inline list-inline"><li class="comment-forbidden"><a href="/user/login?destination=/insolence/2017/10/02/if-rigvir-is-effective-virotherapy-for-cancer-why-are-quack-clinics-selling-it-and-quackery-promoters-like-ty-bollinger-promoting-it%23comment-form">Log in</a> to post comments</li></ul> Mon, 02 Oct 2017 01:40:29 +0000 oracknows 22634 at https://scienceblogs.com