Social Sciences https://scienceblogs.com/channel/social-sciences/feed en A conversation with a Rigvir flack https://scienceblogs.com/insolence/2017/10/09/a-conversation-with-a-rigvir-flack <span>A conversation with a Rigvir flack</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>Over the last two Mondays, I've been <a href="http://respectfulinsolence.com/2017/09/25/rigvir-a-cancer-cure-imported-from-latvia-that-cancer-patients-should-avoid/">writing about an unproven cancer therapy</a> that I hadn't really heard much about before. The cancer treatment is called Rigvir; it is manufactured in Latvia and marketed primarily through a Latvian entity called the International Virotherapy Center (IVC).</p> <p>To recap, Rigvir is an unmodified Echovirus, specifically ECHO-7, that, according to the IVC, seeks out cancer cells, replicates in them, and thus lyses the cancer cells (causes their membranes to break, spilling out the cancer cells contents, thus killing the cell), hence the term "oncolytic virus."</p> <p>Somehow, mysteriously Rigvir was approved by the Latvian equivalent of the FDA in 2004 for the treatment of malignant melanoma despite what appears to have been grossly inadequate supporting evidence and then even more mysteriously placed on the Latvian Health Ministry's list of reimbursable medications in 2011. I suspect that the reason that I didn't look into Rigvir earlier was probably because its use had been primarily restricted to Latvia, Georgia, and Armenia. Also, there was the language barrier.</p> <p>Nearly everything available on the web about Rigvir is in Latvian, a situation that has only recently begun to change. </p> <!--more--><p> It was Antonio Jimenez and Ty Bollinger who plucked Rigvir from obscurity. Dr. Jimenez runs the <a href="http://respectfulinsolence.com/2017/06/05/cassandra-callenders-cancer-is-progressing-and-the-quackery-isnt-stopping-it/">Hope4Cancer Institute</a> clinics in <a href="https://hope4cancer.com/about-us/locations/" rel="nofollow">Baja and Cancun, Mexico</a>, and, for whatever reason (probably profit), these clinics started offering Rigvir relatively recently. Then, Jimenez, who's clearly worked with Bollinger in the past, must have turned Bollinger on to Rigvir, and Bollinger included it in a long segment of Episode 3 of his <a href="https://sciencebasedmedicine.org/the-truth-about-cancer-series-is-untruthful-about-cancer/">The Truth About Cancer</a> (TTAC) propaganda series of videos. It was this connection and the deceptive use of patient testimonials by both Bollinger and the International Virotherapy Center to sell Rigvir that formed the basis of my <a href="https://sciencebasedmedicine.org/the-truth-about-cancer-and-the-unethical-marketing-of-the-unproven-cancer-cure-rigvir/">second post on Rigvir last week</a>.</p> <p>As you might imagine, apparently the management of the IVC was not happy about my posts. In fact, so unhappy was the management of the IVC that within 15 hours of <a href="http://respectfulinsolence.com/2017/09/25/rigvir-a-cancer-cure-imported-from-latvia-that-cancer-patients-should-avoid/">my first post about Rigvir</a> going live I got an e-mail from someone named Lelde Lapa, whose title was listed as Assistant of Business Development Department at the IVC, protesting and attempting to refute my post. As <a href="http://respectfulinsolence.com/2017/10/02/if-rigvir-is-effective-virotherapy-for-cancer-why-are-quack-clinics-selling-it-and-quackery-promoters-like-ty-bollinger-promoting-it/">I noted before</a>, 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 was fast to act.</p> <p>What followed was an exchange that currently stands at five e-mails, three from Ms. Lapa, with two responses from me, with Ms. Lapa's tone (if it indeed was only one person writing these) becoming more strident as the exchange went on. Because these e-mails are a great insight into the thinking (such as it is) at the IVC, I decided that a most excellent way to conclude my series on Rigvir as a trilogy would be to annotate and publish these e-mails, and then to compose a final response to Ms. Lapa's third email, at the end of which Ms. Lapa told me that I didn't need to respond. Clearly <a href="https://youtu.be/MNZFZ6jDCR4">she don't know me vewy well, do she</a>?</p> <p>So let's begin. Remember that English is not Ms. Lapa's native language; so be kind. I wasn't kind, but not because of any difficulties Ms. Lapa might have had with English.</p> <h2>Rigvir strikes back, round 1</h2> <p>So on the afternoon after <a href="https://sciencebasedmedicine.org/rigvir-another-unproven-and-highly-dubious-cancer-therapy-to-be-avoided/">my first post about Rigvir</a> went live, I was greeted by this in my e-mail in box:</p> <blockquote><p>From: Lelde Lapa &lt; [REDACTED]@virotherapy.eu&gt; To: [redacted] Subject: Blog about RIGVIR Date: Tue, 19 Sep 2017 00:54:53 +0300 Organization: RIGVIR Development department Orac: Yesterday we encountered one of your blogs (<a href="https://sciencebasedmedicine.org/rigvir-another-unproven-and-highly-dubious-cancer-therapy-to-be-avoided/?utm_source=dlvr.it&amp;utm_medium=twitter">https://sciencebasedmedicine.org/rigvir-another-unproven-and-highly-dub…</a>) Due to the fact that this blog is now widely spread by non-professionals with the title – independent conclusion from international expert, we believe we have the rights to inform you that you are used now as a tool in competition wars. Which we believe was never your intention. The medicine RIGVIR has a clinical experience for more than 50 years and it is registered for melanoma for more than 13 years and before the era of modern trials and most of the evidences is not published. Doctors and clinics in Latvia use this medicine for majority of melanoma patients in Latvia for many years. In Latvia medicine is prescribed only in national clinics and by certified doctors and they have also other alternatives, so probably they know what they do. 2 years ago we started EMA (centralised EU) commercialisation process and even obtained EU commission support from Horizon2020 grant, we also obtained EMA regulatory advice. There is no doubts about the efficacy and safety of the medicine, however we acknowledge that we miss modern trials for centralised registration and we are working on them. This was never a secret to discover. But year ago a group of very active, mostly anonymous people appeared that started to attack us, our cooperation partners, even EU commission, spreading bias data or even lies. They are very aggressive. Part of the sources they use does not exists, part of materials are generated by them self and republished in different sources mostly social networks, then in blogs and then cross-referenced. Part of material is made as compilation of different phrases and translated in English with certain pseudo professionals on them (By the way two such persons appears also in your blog, these persons however has no proper educations, has never been involved in medicine or science). Moreover at the spring anonymous letter (your blog also indicated it ) appeared. It was signed by few professional organisations of which only 2 are related to oncology and in fact were represented by the same people, this letter contains ~80 lies and tendentious distortion of information. Unfortunately there is no author on the horizon to be responsible for aspersion, but there have been cases when TV and portals have withdrawn similar articles and information about us already. Mostly your blog analyses openly available data, but partially it contains false information. It contains also comments of pseudo professionals or anti-PR specialists but the producer of RIGVIR was never approached for clarification or comments. Which is sad especially, referring to the statement from the blog: “Somehow I doubt Rigvir will make it that far. At least, I sincerely hope that it doesn’t….” We believe that also blogs should be objective and respectable professors should use only proven data and also verified sources. So please consider to here also our position and obtain more information about virotherapy with RIGVIR, like clinical trial data and post-registration experience. We do provide special trainings for doctors and medical scientists. I hope you are interested, Looking forward for your replay. Best Regards, Lelde Lapa Assistant of Business Development Department <a href="http://www.virotherapy.eu">www.virotherapy.eu</a></p></blockquote> <p>Of course, I had no idea who this Lelde Lapa was. I couldn't really find anything about her. A <a href="https://www.google.com/search?as_q=&amp;as_epq=Lelde+Lapa&amp;as_oq=&amp;as_eq=&amp;as_nlo=&amp;as_nhi=&amp;lr=&amp;cr=&amp;as_qdr=all&amp;as_sitesearch=www.virotherapy.eu+&amp;as_occt=any&amp;safe=images&amp;as_filetype=&amp;as_rights=">Google search of the IVC website for her name</a> didn't reveal anything. For my purposes, it doesn't really matter, but I did find it odd. I can't help but note here that, although I do not claim to be completely objective, my bias is rather well known: I favor science as the basis of determining which medical treatments do and do not work. I make no bones about that. Moreover, I couldn't help but immediately note that it's pretty hard to use "only proven data" when there is so little in the way of proven data upon which to evaluate Rigvir. That was, in fact, my key problem with the drug, that it is unproven and being marketed without sufficient scientific and clinical evidence that it does what is claimed for it. Here was my response, sent later that evening:</p> <blockquote><p>Dear Ms. Lapa: The Virotherapy Institute must be very on top of its social media to have noticed my post and composed such a lengthy e-mail to me within 15 hours or so after my post went live. If you have any specific examples of errors in my post, feel free to point them out. What I see in your letter is not that; rather, it is spin, as nothing you wrote actually casts into doubt any facts included in my post or in any of my interpretations of those facts. Yes, I used publicly available information because that’s what many bloggers do when they compose posts. Besides, I was interested in what I view as the irresponsible marketing of Rigvir for more than just melanoma, and there is plenty of that to be found on the Internet and social media. The two videos on your website that I discussed fall into that category, without a doubt. In your e-mail, you state that there are "no doubts about the efficacy and safety of the medicine,” but there are doubts—a lot of doubts—so much so that my jaw dropped when I read that. The reason is simple. You yourself said it: “...we miss modern trials for centralised registration.” Basically, you don’t have anything resembling the level of scientific evidence required before we accept any drug as effective and safe. You have no randomized double-blind clinical trials. All you have are a handful of case reports, a couple of very poorly done retrospective studies, and ancient evidence from decades ago that cannot be inspected and assessed for scientific rigor. In my country, our Food and Drug Administration would laugh at such data. If you’re making health claims for your product, particularly the glowing claims made about Rigvir’s anticancer activity, then all that matters to me is whether there is solid evidence to back up those claims published in the peer-reviewed medical literature as indexed on PubMed. Of course, this evidence must be in the form of papers reporting improved recurrence-free and overall survival in well-designed, randomized double blind clinical trials of your product for every cancer for which a claim of efficacy has been made. I do not care about unpublished data that I cannot examine myself. I do not care about claims. I do not care about “registration,” as clearly the registration process in Latvia at the time Rigvir was registered left a lot to be desired. I do not care about pilot grants to start to work on approval by the EU. None of that matters when evaluating a therapy if there is no good clinical trial evidence supporting its efficacy and safety. Unless you can provide me with those data, I have no choice but to find your complaints about my article to be without merit. If Rigvir has been proven safe and effective and isn’t quackery, then why are you selling it to quack clinics in Mexico and Germany? I’m serious. Hope4Cancer, for instance, is a notorious quack cancer clinic that attracts Americans with cancer. This is not in dispute and can be verified by simply reading the Hope4Cancer website and examining the treatments it offers cancer patients. Also, if Rigvir has been proven safe and effective and isn’t quackery, then why was it featured on Ty Bollinger’s “The Truth About Cancer” video series and, more importantly, why is the administration of the International Virology Center proud of being featured in his videos? Bollinger is a notorious promoter of cancer quackery. (I can provide many examples of him promoting dubious, unproven, and quack treatments for cancer.) No reputable company selling a cancer treatment scientifically proven to be effective and safe would ever want to be associated in any way with the likes of Hope4Cancer or Ty Bollinger, because it would tarnish its brand and bring it into disrepute. In actuality, your response makes me more confident than I was originally that I was correct in my assessment. Your paranoia, for instance, is makes me very suspicious. You rail against “anonymous people” attacking Rigvir and the Virotherapy Center, but isn’t it true that the complaints to the Latvian Health Ministry came from the two main oncology professional associations in Latvia? That’s hardly “anonymous.” They are respected professional medical societies! I also have seen quite a few criticisms of Rigvir on blogs and have been able to identify everyone making the criticisms so far. Perhaps you meant The Mad Virologist, but he isn’t really anonymous either. His name is in his Facebook profile, which I found in two minutes. Complaints about “anonymous” people out to disparage a product always make me think a company has something to hide. Finally, I understand that you and Latvia are proud of Prof. Muceniece’s accomplishments, but ask yourself this: If she were alive today, would she want her name associated with selling her discovery before it’s actually scientifically demonstrated to prolong the lives of cancer patients or cure specific cancers? Orac</p></blockquote> <p>In actuality, I had no idea whether Prof. Muceniece would care what the IVC is doing. I just wanted to see if there was any sense of shame over what the IVC was doing with her invention.</p> <h2>Rigvir strikes back, round 2</h2> <p>A couple of days later, I received this. For reference, the blog by Eduards Ritums was discussed in my first post and used in part as a basis for some of my criticisms. In any case, note the somewhat paranoid tone. I also showed my e-mails to a skeptic from Latvia who has been active investigating Rigvir, who thought that the style changed enough that it might have been written by someone else. I don't know for sure if that is the case (you can judge for yourself), but I do know that the fallacies and dubious arguments flow freely and with paranoia:</p> <blockquote><p>From: Lelde Lapa &lt; [REDACTED]@virotherapy.eu&gt; To: '[REDACTED] Subject: RE: Blog about RIGVIR Date: Thu, 21 Sep 2017 10:03:42 +0300 Organization: RIGVIR Development department Dear Orac As we indicated in our last email your blog now is spread widely in Latvia as a proof that our medicine is not effective. Was it a goal of your blog? We got impression that the blog is a part of wider campaign that is currently in place in Latvia and therefore we just wanted to warn you ASAP and protect your reputation by providing more information if you are ready to hear it. Part of your blog is based on the article that is published by author E.Ritums initially in very specific marketing magazine for Pharmacies. This magazine is published by Medicine Information Centre (<a href="http://mic.lv/materia-medica/">http://mic.lv/materia-medica/</a> ) that is not registered in the register of mass media and even provide marketing services (<a href="http://mic.lv/materia-medica/">http://mic.lv/materia-medica/</a>). In addition the content of this magazine (according to law in Latvia) is considered to be specialised publication and may not have public access. The author however (based on google search) is young graduate from faculty of Chemistry that in addition to this particular article has published few (~3) more small articles and hardly is respectable journalist. Particular publication consists of number of fact errors and doubtful allegations and there is no respectable or proven sources, books or reviewed publications indicated as reference. Moreover former manager (for 12 years) of the same publisher and magazine Inara Rubene ( <a href="https://www.linkedin.com/in/inara-rubene/">https://www.linkedin.com/in/inara-rubene/</a>) is presented as independent expert here. The biggest issue is, however, the fact that this article later, bypassing limited access info (according to law) to specialists, was translated (with inconsistencies) and spread widely with help of very small, non registered NGO – Skeptiskā Biedrība (<a href="https://www.lursoft.lv/lapsaext?act=URCP&amp;ref=LurTop&amp;regcode=&amp;task=search&amp;company_name=&amp;tipas=&amp;CompanySearchForm%5BcompanyName%5D=Skeptisk%C4%81+Biedr%C4%ABba&amp;CompanySearchForm%5Bcountry%5D=&amp;utf=0&amp;general=Skeptisk%C4%81+Biedr%C4%ABba&amp;cid=LVA_NG_PROD">https://www.lursoft.lv/lapsaext?act=URCP&amp;ref=LurTop&amp;regcode=&amp;task=searc…</a>), that operates web site – <a href="http://www.skepticisms.lv">www.skepticisms.lv</a>. Do you consider this as trustworthy source to build part of your story on? Please note that official page of the product RIGVIR is rigvir.com and there is no marketing at all. Page virotherapy.eu is mostly dedicated to therapy not medicine – there are news, testimonials and trainings. It is not a clinic or pharmacy to speak about marketing. Should we hide testimonials, if there are such? In Latvia there are very strict regulations for marketing of pharmaceuticals and there is no official judgment from Latvian Health Inspection about as you say “irresponsible marketing”. Moreover the only one claim from Latvian Health Inspection, that initially was stated so, is already changed clearly stating that we cannot be responsible for third party activities. As you know the clinical studies are done mostly for official approval of medicine and according to Bloomberg at least one third of studies are never published. So if you are clearly stating that you don’t care about unpublished data, then please adjust title of your blog to something like “Analysis of published data of RIGVIR”. Because ignoring unpublished clinical trials for more than 30 years, you simply don’t have all the facts to loudly state that our medicine is not effective or it should be avoided. Let us clarify that medicine RIGVIR is registered in Latvia in 2004 for Melanoma, before the era of modern requirements for trials, but based on clinical trials during 30 years period in which ~700 patients was treated with the medicine RIGVIR (there is also registration in Georgia and Armenia). The medicine is used as conventional therapy in Latvian, Georgian and Armenian clinics. In addition to that, patients from all over the world are coming to Latvia or sometimes are sending relatives or trust-persons to Latvia to buy this medicine in case traditional therapies have not succeeded or are not well tolerated. Yes we do train medical doctors from all over the world and probably their patients also have acquired medicine from Latvia. We know that the medicine is effective, we have seen it working on many thousand cases and we clearly know that it has no side effects. So knowing that, should we refuse to help patients of any Doctor? We are not company that is developing innovative solution and according to the heritage of the founder prof. A.Muceniece the medicine should be available to as many patients as possible. We are not refusing the knowledge and information to any official doctor, official clinic or patient groups. So we don’t see any problem also from appearing in The Truth About Cancer series. Most of our critics and also yours complains are catch-22 logic – “give us evidences before you use it -&gt; new evidences requires investments -&gt; to provide investments we need to use medicine –&gt; to use medicine we need to be commercialised -&gt; but with the existing evidences you doubt us to be commercialised …” As if only rich pharmaceutical or biotechnological companies may work in the field… You are stating that you don’t care about existing registration, but unfortunately your analysis is used to doubt the registration. Which is off course strange, because nowhere in the world rules and regulations (in our case standards for clinical trials) are used with backward date. Yes for new registrations - we know the rules – we will provide proper RCT data, but as for now, please respect that the medicine is prescription medicine that is prescribed only in national clinics and by certified doctors for last 13 years. They have alternatives and even reimbursed ones. So obviously these doctors have deeper knowledge about the therapy with RIGVIR, than just analysis of published data, since it is used for more than 70% of Melanoma patients in Latvia. We suggest you to learn about this therapy and try it yourself for your patients (that follows entrance criteria) as well. In such case and with your commitment to make case report and publish it, we would provide all the necessary assistance and medicine free of charge. Best Regards, Lelde</p></blockquote> <p>Gee, Ms. Lapa makes the observation that my blog post has been circulated far and wide in Latvia as evidence that Rigvir doesn't work as though that were a <em>bad</em> thing! In actuality I can't help but feel a bit of a warm and fuzzy feeling in the pit of my cold, black heart that my post has actually been circulated far and wide in Latvia. Those behind IVC will probably take this as evidence that I'm out to get them, but I'm not. I'm out to protect cancer patients. If the IVC had the goods, as far as evidence, the easiest thing for its management to do would have been to publish it or somehow show it to me and other skeptics who are concerned that Rigvir is cancer quackery. We can be persuaded, but it takes evidence. Finally, notice that last part, in which "Ms. Lapa" tries to co-opt me, thinking that if I were to try Rigvir I would conclude that it works. I've noticed this pattern before, and <a href="https://sciencebasedmedicine.org/atavistic-oncology-revisited-dr-frank-arguello-responds/">where I've noticed before</a> it isn't flattering to Rigvir or the IVC. You see, I've discovered that when it comes to cancer quackery or unproven cancer treatments I seem to have special cachet because I am a cancer surgeon and researcher. Thus, from time to time, cancer quacks try to convince me to try the treatment they are selling on my own patients. In my response, I decided to stomp down hard on this offer after giving a bit of a lecture. See what you think:</p> <blockquote><p>Ms, Lapa, Although I appreciate your concern about my reputation, I think I’m probably the best judge of what will or will not damage it. In other words, I’ll take my chances. Regarding Eduards Ritums’ article, which I did cite extensively, I tend to judge an article and its main arguments far more by quality in terms of evidence, science, and reason than by who wrote it. Even though the article I read was an English language translation, Mr. Ritums’ central thesis and arguments nonetheless came across as very sound. It doesn’t matter if he’s young and early in his career and thus hasn’t published very many articles yet. In other words, who cares if Mr. Ritums published his article in a pharmacy magazine and is a new journalist? I certainly don’t. As for whether the magazine is “registered” or not, as far as I’m concerned that is a matter of your country’s specific laws and ways of doing things. It means very little to me as an American reading a translation of the article. In fact, it wouldn’t matter to me if Mr. Ritums wrote for an unregistered blog under a pseudonym if his arguments, science, and evidence were sound. Certainly, you have not demonstrated that they are not sound; you state that there are a “number of fact errors and doubtful allegations,” but, oddly enough, you have not actually specified the errors of fact or “doubtful allegations,” much less used evidence and science to show that they are factual errors or doubtful allegations. You have instead engaged in nothing but ad hominem, which is a logical fallacy. To convince me, you’re going to have to get a lot more specific and provide the evidence to back up your criticisms, something you have not yet done after two long e-mails. I find this very telling. As for your claim that official Rigvir website is not about marketing, I beg to differ. The whole website is clearly all about marketing, as all pharmaceutical company websites are. Indeed, it looks just like any other pharmaceutical company webpage promoting its products, complete with slick videos, like the one on this page. Basically, your website looks like any of a number of websites pharmaceutical companies maintain for individual products, like Herceptin, OncoTypeDX, or various new drugs. It’s not quite as slick, but it is very similar in appearance and content. True, it doesn’t contain patient testimonials, but that doesn’t make it any less a marketing website. Regarding the testimonials on the Virotherapy Center website, as a surgical oncologist, I find them quite misleading. Insufficient information is provided to allow me to judge whether Rigvir might have had an effect, and one in particular is definitely not evidence that Rigvir had a positive effect. Again, when I accused you of irresponsible marketing, I did it from my perspective as a cancer surgeon and researcher. Again, I really don’t care what Latvian law says with respect to marketing pharmaceuticals. Clearly, from my perspective, Latvian law is far too lax if it allows you to market Rigvir. You say that Rigvir was registered in 2004, “before the era of modern requirements for trials.” I hate to tell you this, but the basic standards for modern clinical trials were codified decades before that. In the US, it was 55 years ago in 1962 when the Kefauver-Harris Amendment to the law creating the FDA mandated that the FDA to require rigorous clinical trial evidence of efficacy and safety before it approves a drug for marketing. Are you honestly telling me that 42 years after that Latvia still didn’t require such evidence before approving a drug? If true, I find that shocking. Be that as it may, Latvia’s lax drug regulation 13 years ago is not an argument in support of the efficacy and safety of Rigvir even for melanoma, much less other cancers. Certainly, it doesn’t excuse you from selling the drug to a quack clinic in Mexico. And, make no mistake, Hope4Cancer is a quack cancer clinic, as I have documented elsewhere. (It even offers coffee enemas.) I’d suggest that, if you really want Rigvir to be accepted outside of Latvia, Georgia, and Armenia, selling it to a quack clinic to market to patients it is not a winning strategy. It will taint Rigvir with the stench of quackery. I’d highly suggest that you sever all ties with these clinics immediately, but I suspect that suggestion will fall on deaf ears. You say over and over that you “know” that Rigvir is effective. The fact is that you do not, at least not based on science and clinical trials, which is how doctors are supposed to know which drugs work and which do not. You claim that I ignored 30 years worth of clinical trials. Whose fault is that? You haven’t published them in a form that can be critically examined. If you had, I would have critically examined them. You wouldn’t even have to translate them into English. I’m sure I could find someone to translate the data for me if you were to publish all this data. Why don’t you? No, I will not change the title of my post. It is accurate, as far as I am concerned. I stand by my opinions and conclusions, and, yes, I still strongly believe that you should stop marketing Rigvir until such a time as clinical trials show it to be safe and effective. Certainly it should not be used for any cancer other than melanoma, and even for melanoma I don’t think you’ve shown sufficient evidence that it works to justify marketing it. Again, I say this because you can’t show me any decent scientific or clinical trial evidence to change my mind. Again, why is that? Does this evidence actually exist, or does it actually show Rigvir has such miraculous effects against melanoma? I suspect that it either does not exist or is not nearly as impressive as you claim. Indeed, there is a contradiction here. You say that 70% of melanoma patients in Latvia since 2004 have been treated with Rigvir. Why is it, then, that you could only find 52 melanoma patients treated with Rigvir for your 2015 Melanoma Research paper? Finally, although I am intrigued by your offer to provide Rigvir for free for me to try on my patients, unfortunately I don’t see how I can do it. Let me explain to you how we do things in the US. Doctors here can’t just go around administering unapproved drugs willy-nilly to patients if we feel like it. Were I to administer Rigvir to patients without proper approvals, I would quickly find myself in deep legal trouble—and rightly so! Were I to want to administer Rigvir to patients, it would have to be in the form of a clinical trial. I would first have to submit an Investigational New Drug (IND) application to the FDA, because Rigvir is not approved in the US. The FDA would then have to approve it. Next, I would have to write a protocol for a clinical trial. Let’s say I chose to do a phase I clinical trial, which would not require randomization. That application would have to be approved by the FDA and approved by my institution, specifically my cancer center's Protocol Review and Monitoring Committee and my university's Institutional Review Board (IRB). Both would almost certainly say no, based on lack of evidence to justify the trial. They would want preclinical evidence in cell culture and animal models, at the very least, or more compelling human evidence. You can provide me with neither. Of course, certainly I would be happy to review the educational materials you provide doctors who wish to administer Rigvir to patients. Maybe they would start to change my mind, although I’ll be honest with you and inform you that I doubt it. However, contrary to what you think, my mind is not closed. What it takes to open it more is high quality scientific and clinical evidence. Provide it, and perhaps it will convince me. If you continue to fail to provide it, and you’ll never change my mind. The ball is in your court. Sincerely Orac</p></blockquote> <h2>Rigvir strikes back, round 3</h2> <p>The IVC didn't respond right away. It took a few days. Indeed, I was beginning to wonder if Ms. Lapa was going to respond again at all, particularly after nothing arrived immediately after <a href="https://sciencebasedmedicine.org/the-truth-about-cancer-and-the-unethical-marketing-of-the-unproven-cancer-cure-rigvir/">my second post about Rigvir</a>. Then, just as I was about to send a quick e-mail to tweak Ms. Lapa and see if I could get a response, this hit my e-mail in box:</p> <blockquote><p>From: Lelde Lapa &lt; [REDACTED]@virotherapy.eu&gt; To: [REDACTED] Subject: RE: Blog about RIGVIR Date: Tue, 26 Sep 2017 18:55:40 +0300 Organization: RIGVIR Development department Dear, Dr. Orac ...We are very grateful for every objectively critical remark that is addressed to RIGVIR and we always are trying to provide additional information to the source in order to improve objectivity. This time we however are relay surprised that someone who calls for scepticism and ask for proves, can easily believe to articles without any proven references or sources, that contains statement from people openly in conflict of interest and that is published in non-official portals in order to avoid responsibility for aspersion. And particularly we are sad that you was never interested in our position or in our facts that we openly offered and that are not published. During last month we have seen lots of false news and lies that was spread in Latvia in order to neglect RIGVIR, part of these news is spread under the name of respectable organisations. But unfortunately most of the stories does not have real authors. Most of this campaign is done via social networks so we need time to respond to attacks and we will inform you about the results. In the meantime we are open to organise professional seminars and conventions to share our information. For example, last Friday during the 8th Latvian Doctors Congress, satellite symposium about virotherapy and RIGVIR took place. Reports on clinical trials and post-marketing experience in clinical practice were presented to doctors. Around 5000 doctors were invited and everybody had chance to ask any question to our leading managers. We however received no question from the audience. Regarding rigorous clinical trials, most probably the definition has changed over time. For example the 1.st RCT ever was run just after the WWII. What we today call rigorous was defined only in the late 1990ies. While for example the FDA started requiring 5 year survival data for oncologic drugs, in the early 2000 those kind of data were still available only for a portion of NDAs. However A very direct outcome of WWII was that Latvia lost its independence. As a consequence, Latvia was literally thrown decades back, as well as held back, in all aspects of an advanced society. You may find that shocking to learn in 2017, but we can assure you that was a shocking "experience" already at that time on site. And it lasted for 50+ years. A slight and minor side effect, was that regulatory requirements did not adhere to the US framework. They were the so called Soviet style, which include lack of publication as well. Today, however, Latvia is part of EMA territory with the most up-to-date regulatory requirements. Therefore, the mode of showing efficacy has changed both over time and in space. Nevertheless, the requirements regarding efficacy were and are fulfilled. And this again is approved by the Ministry of Health of the Republic of Latvia that on 4th of September 2017 issued official statement supporting that RIGVIR is registered and included in the list of reimbursed medicines appropriately (see English translation enclosed) and here is in latvian source: <a href="http://www.vm.gov.lv/lv/aktualitates/preses_relizes/5507_par_zalu_registracijas_kartibu_/">http://www.vm.gov.lv/lv/aktualitates/preses_relizes/5507_par_zalu_regis…</a> Regarding the use of Rigvir in Latvia. It may also come as a surprise to you that the medical records system in Latvia has not really changed since WWII. This, of course is not the companies responsibility. It may perhaps assist you in appreciating inclusion criteria used and the effort in managing the analysis published in Melanoma Research. When you discuss about our clinical trials or reproach us about lack of publications we are kindly ask you take into consideration also the economic differences between USA and Latvia fully into account, for example GDP per Capita in Latvia is around 15 thousand Dollars, while in USA it is 52 thousand Dollars or for example the whole budget for melanoma treatment of Latvia is around 0.7 MUSD. In other words you know how much those things costs and you should not judge from the stand point of the most advanced economy with the highest healthcare and science budgets. We are founders (Prof. A.Muceniece) family owned company that’s heritage is to provide this innovative treatment to any patient in the world who needs it and we will not discriminate any patient regardless from which clinic the patient comes. In your latest blog you have analysed part of testimonials about virotherapy with RIGVIR (Please note however that Ty Bolinger’s activates are not related to us). We have seen complains that stories of our patients was just coincidence or that there were other factors behind the survival. But what if we would provide you with many dozens of such testimonials and cases? Is there something at all to convince you? This brings us back to the offer to you - to try the medicine for your patient. For early stage patient they should use medical tourism to Latvia, but with late stages or in cases where there are no other treatment solutions, you might consider in application of extended use of non-registered medicine on-name basis to use the medicine in USA. Off course all the time with your supervision to monitor closely the efficacy. This means that it would be case analysis not a clinical trial. Due to work with EMA we would not initiate any activity with FDA yet, although we have preclinical and clinical evidences to start. We find this discussion, your blog and your activity in twitter really wired. If you suggest that there are better medicine for cancer patients, please use it. We have never limited anyone doing that. RIGVIR is a prescription medicine, patients cannot get the medicine by them self without doctor involvement. So to wrap up - if you would like to explore virotherapy and use it as a treatment, we are ready to cooperate with you and teach you about our evidences. But further correspondence and the exchange of opinions is not necessary any more. Sincerely, Lelde</p></blockquote> <p>Ms. Lapa (or whoever I've been corresponding with) might not think that an exchange of opinons "is not necessary any more" and that she can flounce off, digitally speaking, but I beg to differ. So, instead of responding right away, I decided that a public response would be more appropriate, to be unveiled this morning. So here's my response to Ms. Lapa. I'll be sure to send her a link to this after this post goes live. After all, why bother if the person to whom I respond doesn't see my response? So here we go. Here's my response written over the weekend:</p> <blockquote><p>Dear Ms. Lapa: You clearly don't know me very well if you thought I would not respond to this. Indeed, given what Rigvir Holding and the IVC are doing, I think it's a public service to show what you have been telling me to my readers. It's also not true that I am not interested in your position. If that were the case, I would never have bothered to engage in this lengthy e-mail exchange. That's the point. I've been trying to find out what evidence you have to support all the claims being made for Rigvir's efficacy in melanoma and other cancers. All that's indexed in PubMed is very thin gruel indeed when it comes to clinical evidence. It's not at all convincing. Yet you keep claiming you have this highly convincing evidence while making excuses for not publishing it and whining about people criticizing Rigvir on social media. Well, I have news for you: That's the world. Social media matters. You keep claiming that what's being said about Rigvir is false, but somehow you never actually bother to prove it to be false. And do you know how you could prove that it's false? Show us the data, just like drug companies in the US and EU have to do! So you had a satellite symposium on virotherapy at the 8th Latvian Doctors Congress. That's great, but not enough. A Google search shows that you <a href="https://www.facebook.com/oncolyticvirotherapy/photos/a.1677019435772101.44687.158694647604595/2460629014077802/?type=3&amp;theater" rel="nofollow">had this conference</a> but <a href="https://www.virotherapy.eu/all-news.php" rel="nofollow">nothing about its results</a>. Most satellite conferences publish abstracts of the work presented at the meeting, at least. Such abstracts are not viewed as being as convincing as a publication in a peer-reviewed journal indexed on PubMed, but they are at least something. After your conference, I am currently still left with nothing. It wouldn't even matter to me if the abstracts or conference proceedings were in Latvian. Show me the data! You claim to have clinical trial results and postmarketing results presented at this conference? Publish them! After my previous two posts on Rigvir, I'm sure that I can find someone to translate them if necessary. In the end, I can't help but wonder if your symposium was more of a marketing presentation than an actual scientific conference. Next, I do not need a discourse on the history of clinical trials and FDA requirements for approval of drugs, as I am well aware of that history and when the first randomized clinical trials (RCTs) similar to what we do now were carried out. I mentioned the 1962 Kefauver-Harris Amendment to the law creating the FDA mandated that the FDA to require rigorous clinical trial evidence of efficacy and safety simply to point out that evidence from high quality RCTs has long been a requirement for drug approval in the US and Europe. In oncology at first that meant measuring an endpoint known as overall (or objective) response rates (ORR), which measures what percentage of the patients treated demonstrate tumor shrinkage. Unfortunately, ORR is not a great surrogate for overall survival. So by the early 1980s, the FDA started to require <a href="https://www.fda.gov/downloads/Drugs/Guidances/ucm071590.pdf">evidence of improvement in OS</a>. While it is true that these days, in order to speed up the process of drug approval, the FDA has been accepting surrogates for OS, such as pathologic complete response (pCR) and granting provisional approval for drugs that produce such surrogate endpoints, I note that Rigvir has no convincing published data supporting the conclusion that it can even meet those lower standards for provisional approval. I also do not buy your excuse that Latvia's medical record system hasn't changed since World War II. Believe it or not, until very recently, many US hospitals still used paper charts and relatively primitive record keeping. Many private practices still do. It took laws and incentives from the US government to prod our medical system into adopting electronic health records, and, even then, I note that we will probably never have the excellent centralized medical record systems that some countries in Europe do. As for your excuse that Latvia is a poor country. I counter that the very fact that Latvia is a poor country relative to the US and much of Europe is a very good reason that its government shouldn't be wasting money on cancer treatments whose manufacturer cannot produce strong evidence of efficacy! Yet, since I took an interest in Rigvir recently, I've seen claims that up to 70% of melanoma patients in Latvia are treated with Rigvir. In a country like Latvia, that is insanity if true! Think of what could be done with all that money if it were redirected to treatments that work! I also see Rigvir <a href="http://imedicaltourismcenter.com/rigvir-virotherapy.html" rel="nofollow">being advertised as effective</a> against a wide variety of cancers when not even you have claimed to me that it is effective against any cancer other than melanoma. You claim that Ty Bollinger's activities are not related, but I don't see it that way. In making the long segment on Rigvir in Episode 3 of <cite>The Truth About Cancer</cite> (<cite>TTAC</cite>), Bollinger obviously had the full cooperation of the IVC's leadership. He brought Dr. Antonio Jimenez with him, who runs the quack cancer clinic Hope4Cancer and is now selling Rigvir in Mexico. He had access to your clinic and interviewed luminaries such as Dr. Ivars Kalvins, your medical director Dr. Kaspars Losans, and your director of research and development Dr. Peteris Alberts, as well as three of your patients. The resulting segment was highly laudatory and presented Rigvir as a miracle cure based on dubious testimonials. Like many cancer patients who found out about Rigvir from <cite>TTAC</cite>, I had heard very little about your virotherapy before <cite>TTAC</cite> was released and view the video series as the best marketing for Rigvir I've seen anywhere. Somehow, I doubt that you would have cooperated so much with Mr. Bollinger if you thought his segment would do anything other than praise Rigvir and the IVC the way it did. I conclude by again addressing your offer. I will be blunt. My opinion is that it is unethical, and I will not accept it. Basically, you appear to be paying for case reports that you can publish. My impression of this is backed up by this article on your website about <a href="https://www.virotherapy.eu/publication-grants.php" rel="nofollow">grants for publications</a>, in which the IVC announces that it is offering €5,000 "grants" for "publications on clinical studies of oncolytic virotherapy, observations or clinical cases in a publication that can be quoted in PubMed" and that the study "is intended on using oncolytic virotherapy rather than using oncolytic virotherapy in combination with other cancer therapies, medication etc." In other words, you want case reports or studies looking only at virotherapy, which, given the doubt about Rigvir's efficacy, would be highly unethical. I note that you also request that grant applicants "inform IVC on the publication topic and present to IVC the document draft before commencing the project and submitting it to the chosen journal." To me this sounds as though you expect the paper to be written, regardless of whether the study has already been done or not, but in fairness I will allow that the ambiguity could be due to a poor grasp of English on the part of whoever wrote this web page. Finally, before you express such disappointment with my blog posts and my activity on Twitter, I note that the Business Development Manager of Rigvir Holding, Kārlis Urbāns, has been attacking me on Twitter using fake news sources. He's been quite nasty. Here are examples:</p> <blockquote class="twitter-tweet" data-lang="en"><p dir="ltr" lang="lv" xml:lang="lv">Jā ļoti neatkarīgs Onkologs no ASV, kas nez kāpēc perfekti citē Latviešu valodu un jau iepriekš barojies no farmas - <a href="https://t.co/ENKPlndHFi">https://t.co/ENKPlndHFi</a></p> <p>— Karlis Urbans (@kurbans) <a href="https://twitter.com/kurbans/status/913866495985414145?ref_src=twsrc%5Etfw">September 29, 2017</a></p></blockquote> <script async="" src="//platform.twitter.com/widgets.js" charset="utf-8"></script><p> I note that he cites a post made by a notorious antivaccine blog, Age of Autism. I note that the bloggers at Age of Autism don't like me because I routinely skewer antivaccine pseudoscience. Here's another example:</p> <blockquote class="twitter-tweet" data-lang="en"><p dir="ltr" lang="lv" xml:lang="lv">Un cik nav fake itkā-onkologu vēstule?<br /> Ir jau vēl daudz, piemēram, <a href="https://t.co/bBX9uS8IPg">https://t.co/bBX9uS8IPg</a></p> <p>— Karlis Urbans (@kurbans) <a href="https://twitter.com/kurbans/status/913873997711978496?ref_src=twsrc%5Etfw">September 29, 2017</a></p></blockquote> <script async="" src="//platform.twitter.com/widgets.js" charset="utf-8"></script><p> TruthWiki is a fake wiki maintained by Mike Adams, who runs the quack and alt right (yes, both) website NaturalNews.com and <a href="https://healthwyze.org/reports/616-special-report-the-legend-of-mike-adams-and-the-reality">got his start selling Y2K scams</a>. The conversation after that is quite amusing, even though I can only read it through the stilted English from computer translation from Latvian on Twitter. I note that Mike Adams has been defaming me on his website for a year and a half now and is up to around 40 lie-filled posts about me. You'll excuse me if I don't take your lamentations about how mean and nasty I've been to the IVC seriously when the BDM and CFO of Rigvir Holding is quoting fake news sources that routinely lie about me and trying to portray me as a tool of big pharma out to destroy Rigvir. So to wrap up – if you would like to provide acceptable scientific and clinical evidence for the efficacy of Rigvir against any cancer, I am ready to cooperate with you and learn about it. Otherwise, further correspondence and the exchange of opinions are not necessary any more. Sincerely, Orac</p></blockquote> <p>After that, there's only one last thing to do: <a href="https://sciencebasedmedicine.org/wp-content/uploads/2017/10/giphy.gif"><img alt="giphy" class="aligncenter size-full wp-image-49575" data-entity-type="" data-entity-uuid="" height="211" src="https://sciencebasedmedicine.org/wp-content/uploads/2017/10/giphy.gif" width="400" /></a></p> </div> <span><a title="View user profile." href="/author/oracknows">oracknows</a></span> <span>Sun, 10/08/2017 - 21:36</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/social-sciences" hreflang="en">Social Sciences</a></div> </div> </div> Mon, 09 Oct 2017 01:36:38 +0000 oracknows 22638 at https://scienceblogs.com Rigvir: A cancer "cure" imported from Latvia that cancer patients should avoid https://scienceblogs.com/insolence/2017/09/25/rigvir-a-cancer-cure-imported-from-latvia-that-cancer-patients-should-avoid <span>Rigvir: A cancer &quot;cure&quot; imported from Latvia that cancer patients should avoid</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>This blog is based in the United States, and I'm an American. Unfortunately, this produces a difficult-to-avoid baked-in bias towards medicine as it is practiced in the US and, to a lesser extent, as it is practiced in the English-speaking world, because English is my language and I can read accounts coming out of English-speaking countries. The same bias exists with respect to pseudo-medicine, with our concentration having been primarily on either quackery that is practiced in the US, UK, Canada, or Australia (and <a href="http://respectfulinsolence.com/2017/09/05/patients-lose-when-they-chose-naturopaths-over-real-doctors/">sometimes New Zealand</a>). It's not because I'm not interested in medicine and pseudo-medicine as practiced in non-English-speaking countries. It's just that I tend to lack the tools in terms of language and bloggers with local knowledge to assist me. That's why, whenever I've tried to cover alternative medicine or "integrative medicine" in non-English-speaking countries, such as when I discussed <a href="http://respectfulinsolence.com/2016/11/08/the-deadly-false-hope-of-german-cancer-clinics/">alternative cancer clinics</a> in <a href="http://respectfulinsolence.com/2016/11/09/the-deadly-false-hope-of-german-cancer-clinics-part-2-metastasizing-to-australia-and-beyond/">Germany</a> or the situation with stem cell clinics in Italy (as <a href="http://respectfulinsolence.com/2013/05/06/deregulating-stem-cell-quackery-in-italy/">bad as or worse than in the US</a>), I always feel that I'm missing something. After all, Google Translate often doesn't really provide more than the <a href="http://respectfulinsolence.com/2016/11/09/the-deadly-false-hope-of-german-cancer-clinics-part-2-metastasizing-to-australia-and-beyond/">gist of what a foreign-language article</a> is trying to say.</p> <!--more--><h2>A dubious Latvian cancer treatment shows up on my radar</h2> <p>Perhaps the language barrier, coupled with its being primarily a treatment from a very small country, is part of the reason why I haven't discussed a new form of dubious cancer treatment known as Rigvir before. It's a form of treatment that has been popularized mainly in Latvia, but is also sold in Armenia and Georgia. This situation has made finding sufficient information about Rigvir, the claims made for it, what it is, and what it supposedly does, rather challenging. After all, I don't speak Latvian, and I don't know anyone who does. (And, no, having a Lithuanian background on my mother's side doesn't help.) I was prodded from my complacency by an article published earlier this month from LSM.lv, "<a href="http://eng.lsm.lv/article/society/health/health-ministry-defends-claimed-cancer-treatment.a248914/">Health ministry defends claimed cancer treatment</a>." Basically, a Latvian news magazine, <cite>De Facto</cite>, reported earlier this year that multiple Latvian medical associations had written to the Latvian Health Ministry about Rigvir:</p> <blockquote><p> Crucially, it [Rigvir] is included on the health ministry's list of reimbursable medicines, meaning public as well as private money is spent on it.</p> <p>Yet as De Facto revealed, in January three professional medical organizations, including the Latvian Oncology Association, wrote to the Health Ministry expressing concern that research and publications used to establish the credentials of Rigvir treatment were of poor quality and scientifically questionable: for example in one study supposedly comparing the outcomes for two groups of patients, one group used Rigvir and the other did not, with the Rigvir patients doing considerably better than the control group. However, the Rigvir patients also used chemotherapy, while the control group did not, which should have rendered the findings highly dubious.</p> <p>Oncologists asked that Rigvir be removed from the list of reimbursable medicines and the National Drug Register pending proper clinical data, and also asked for a review of the official guidelines for the treatment of melanoma involving Rigvir.</p> <p>In February, the health ministry <a href="http://www.lsm.lv/raksts/zinas/latvija/izvertes-rigvir-atrasanos-kompensejamo-zalu-saraksta.a223453/">publicly pledged to review the registration of Rigvir</a> and its inclusion in the list of reimbursable medicines. However, De Facto uncovered that a decision to ignore the oncologists' concerns had already been made in the spring. </p></blockquote> <p>What most grabbed my attention about this article was the response of Health Minister Anda Čakša to inquiries about why the Health Ministry decided the way it did. It's a response that'll make a skeptic's jaw drop:</p> <blockquote><p> "One of the key issues to change anything in drug registration or compensation conditions is clear evidence that the medicine is or is not effective and safe; that there are or are not side effects," Minister of Health Anda Čaksa told <em>De Facto</em>.</p> <p>"A letter by some social group saying they don't like something - it's just not helpful. Show us data that this medicine does not work for your patients. We don't have anything to react to at the moment," said Health Minister Anda Čakša. </p></blockquote> <p>My reaction was predictable: This is exactly backward! It is up to the company selling a product to provide evidence that it <em>does</em> work for the conditions for which it is marketed, not to critics to show that it doesn't work! The article also notes that Rigvir is the fifth top selling prescription medicine in Latvia, with growing sales, which is another reason to be concerned. So is the marketing of Rigvir outside of Latvia. For instance, quack cancer clinic in Mexico <a href="http://respectfulinsolence.com/2017/06/05/cassandra-callenders-cancer-is-progressing-and-the-quackery-isnt-stopping-it/">that I've discussed before</a>, Hope4Cancer, offers <a href="https://hope4cancer.com/how-we-treat-cancer/our-therapies/treating-the-cancer/rigvir-virotherapy/" rel="nofollow">Rigvir</a>, which it describes in glowing terms:</p> <blockquote><p> Rigvir®, the world’s first and only non-genetically modified cancer virotherapy agent, is a non-replicative live virus; it is non-pathogenic, and does not reproduce inside the human body or transmit to others. Once introduced in the body, Rigvir® selectively seeks out cancer cells to replicate within, effectively killing the cell in the process.</p> <p>While virotherapy is only now emerging as a new wave of oncological therapies, Rigvir® has been intensely studied by researchers for over 50 years, passing all phases of clinical trials, and is registered by the <a href="https://www.virotherapy.eu" rel="nofollow">International Virotherapy Center</a> in Latvia as a prescription anti-cancer drug. Though registered as a drug, Rigvir offers a completely safe clinical profile, high therapeutic index, absence of side effects, and ability to selectively target cancer cells – making it unlike most available therapeutic agents. </p></blockquote> <p>Not surprisingly, according to Hope4Cancer, Rigvir is fantastic for basically all the common cancers: breast cancer, melanoma, lung cancer, colorectal cancer, pancreatic cancer, prostate cancer, liver cancer, and more. Never mind that the only cancer for which there is anything resembling evidence—albeit weak evidence—is melanoma. Rigvir's proponents claim that it can treat any cancer! The clinic even goes so far as to claim:</p> <blockquote><p> However, given its universal mode of action, it is likely that Rigvir® is effective against a much larger range of cancers that have not been fully studied yet. In fact, at Hope4Cancer, we have used Rigvir® effectively against many cancers not listed here.</p> <p>It is important to note that since Rigvir® is a defined pharmaceutical entity that has been established through a process of validated studies to qualify as a drug, it does not completely fall into the category of conventional, alternative, or integrative medicine. Instead, Rigvir® represents a completely new paradigm in cancer treatment, and we at Hope4Cancer are proud to offer it to our patients. </p></blockquote> <p>No, if Rigvir works, it would be <em>conventional</em> medicine. Viruses that target specific cancers are very much the hot topic now, although results have generally been mixed. The only thing "alternative" about Rigvir is that it is unproven and sold by a quack cancer clinic in Mexico.</p> <p>Meanwhile, over at the International Virotherapy Center in Latvia, where Rigvir is primarily marketed, there are the sorts of <a href="https://www.virotherapy.eu/testimonials.php" rel="nofollow">glowing testimonials</a> (complete with a link to the <a href="http://www.virotherapyfoundation.org/en/patients/" rel="nofollow">Virotherapy Foundation</a>, which provides even more glowing testimonials) that automatically set my skeptical antennae a'twitching. For instance, here is a woman named Zane who was diagnosed with stage I (yes, stage I) melanoma that was completely surgically excised. Yet Latvian doctors prescribed her "virotherapy" (a.k.a. Rigvir) afterward:</p> <iframe width="560" height="315" src="https://www.youtube.com/embed/Ttrk8v-QHOE" frameborder="0" allowfullscreen=""></iframe><p> The treatment for stage I melanoma is basically complete surgical excision with an adequate margin of normal tissue around the melanoma, plus examination of the regional lymph nodes through a procedure called a sentinel lymph node biopsy, if the melanoma is stage IB. (Presumably the woman's lymph nodes were negative, or else she would no longer have stage I melanoma. Rather, she'd have at least <a href="https://www.cancer.org/cancer/melanoma-skin-cancer/detection-diagnosis-staging/melanoma-skin-cancer-stages.html">stage III melanoma</a>.) There is usually no need for any further treatment. Basically, Zane was exposed to "virotherapy" unnecessarily and massively overtreated for her melanoma. Yet she's promoted as a success story, who gushes about how she had feared losing her hair and feeling sick but didn't and how she was able to have a normal baby.</p> <p>This testimonial is a bit more disturbing:</p> <iframe width="560" height="315" src="https://www.youtube.com/embed/yUdhf4rFqDY" frameborder="0" allowfullscreen=""></iframe><p> Basically, it's a British woman named Nadine who had melanoma in 1999 that recurred in 2009. It sounds as though it's been metastatic, but there are no details that would allow a cancer surgeon like me to know where it metastasized to, how rapidly it grew, and other critical information. We learn that Nadine has apparently undergone radiotherapy, chemotherapy, and surgery, along with being a "guinea pig" for experimental vaccine therapies, suggesting that she must have been a subject in at least one clinical trial. She's convinced that Rigvir is helping her, but there's no way to know for sure. Metastatic melanoma is a strange beast among cancers. It can have an incredibly variable course, rapidly growing and killing some patients, and in others exhibiting a much more indolent behavior. Also, excising melanoma metastases can be curative, if they are single or only a few and can be completely excised surgically. Surgical excision of recurrences and metastases could well have prolonged Nadine's life greatly, but insufficient information is given for me even to speculate whether this is the case with her. </p> <p>Basically, there is no way of knowing whether Rigvir helped Nadine or not, but she's convinced that it did. What's disturbing is the segment near the end, where Nadine urges patients to "seek alternative therapies." Near the end, she also states that the melanoma has metastasized "all over my body," but it's not clear where that means. Organ metastases are much more serious than skin metastases, for instance. Whatever the case, this one woman is not evidence that "virotherapy" works for melanoma.</p> <p>There's a lot more where that came from.</p> <h2>What is Rigvir?</h2> <p>The <a href="http://rigvir.com" rel="nofollow">Rigvir</a> website describes the treatment thusly:</p> <blockquote><p> RIGVIR® - the worlds [<em>sic</em>] first oncolytic virotherapy medicine, which is approved for cancer treatment and introduced in medical practice. RIGVIR® contains a live nonpathogenic ECHO-7 virus that has not been genetically modified.</p> <p>RIGVIR® is oncotropic and oncolytic virus. It finds and selectively infects tumour cells. Then replicates in tumour cells and destroys them. Both of these processes, oncotropism and oncolysis, are selective for tumour cells and normal healthy cells are minimally if at all affected.</p> <p>Oncolytic virotherapy with RIGVIR® is safe and effective cancer treatment, which improves time to progression, survival and quality of life of cancer patients. </p></blockquote> <p>I perused what passes for a <a href="http://rigvir.com/indications/" rel="nofollow">product information sheet</a>. Rigvir is provided as a 2 ml frozen solution of an adapted and selected ECHO-7 virus strain, Picornaviridae family, Enterovirus genus, Enteric Cytopathic Human Orphan (ECHO) type 7, group IV, positive-sense single-stranded RNA virus produced under GMP. The titer is not less than 10<sup>6</sup> – 10<sup>8</sup> TCID<sub>50</sub>/ml. (TCID<sub>50</sub> is a <a href="http://www.virapur.com/protocols/TCID50%20Protocol.pdf">measure of active viral particles</a>.) A brief word is in order here. "Orphan" indicates a virus not known to be associated with any disease. (Since the discovery of ECHO viruses, they have been linked with diseases to the point where most ECHO viruses are no longer considered orphan viruses. Even so, the name stuck.) Echoviruses were <a href="http://emedicine.medscape.com/article/216564-overview">first isolated from the feces of asymptomatic children</a> in the context of epidemiological studies of polioviruses and are now known to be one of the leading causes of acute febrile illnesses in children. 90% of ECHO virus infections are asymptomatic, but in the 10% that produce symptoms those symptoms can <a href="http://emedicine.medscape.com/article/216564-overview#a5">range from mild to severe</a>, depending on the age, gender, and immune status of the host and the subgroup, serotype, and enteroviral strain. We're talking anything from a nonspecific febrile illness to aseptic meningitis to respiratory symptoms to myocarditis.</p> <p>What I find most implausible about Rigvir is the claim that it attacks only cancer cells and leaves normal cells alone. It takes a look into the history of Rigvir to get an idea where this claim came from.</p> <h2>Aina Muceniece: Discoverer of Rigvir</h2> <p>The story of Rigvir began several decades ago with a Latvian immunologist Professor <a href="https://en.wikipedia.org/wiki/Aina_Muceniece">Aina Muceniece</a>. Discovering unbiased information on Prof. Muceniece and her discovery of Rigvir is damned near impossible these days, because searches on her name will produce a host of links related to laudatory descriptions of Rigvir and/or associated with the International Virotherapy Center. However, <a href="http://skepticisms.lv/enciklopedija/rigvir-when-science-takes-a-back-seat/">one article</a> does describe the origin of Rigvir thusly:</p> <blockquote><p> In the 1960s a young scientist named Aina Muceniece discovered a way to use a virus to assist in identifying and marking melanoma cells. Using this discovery, she was able to create a medicinal substance which could possibly increase the life expectancy of melanoma patients when used alongside other therapeutic methods. The substance underwent preliminary studies and was proven to be harmless. These results made it possible for the scientist to use it in the treatment of melanoma, while recording her observations.</p> <p>Unfortunately, even the unfailing enthusiasm of Aina Muceniece was unable to successfully turn Rigvir (its name honours Riga, the capital of Latvia), into an approved and widely applied treatment. Efficacy studies would have required much larger resources than were available. </p></blockquote> <p>A PubMed search on Prof. Muceniece's name doesn't turn up very much, just two Russian language articles and a frequently touted clinical study from 2015, to which her name must have been added posthumously given that she <a href="https://en.wikipedia.org/wiki/Aina_Muceniece">died in 2010 at the age of 85</a>. Of course, given the time period of the discovery of what is now called Rigvir (the height of the Cold War), it is perhaps not too surprising that there are few publications indexed in PubMed about it. Be that as it may, the peer-reviewed English literature is not a good place to find out very much about the origin of Rigvir, although there is a <a href="https://www.researchgate.net/publication/267507065_Oncolytic_enteroviruses">2012 review article</a> on oncolytic (cancer destroying) viruses that gives some hints. I find this passage rather telling:</p> <blockquote><p> Oncolytic activity of ECHO viruses was also studied from the beginning of the 1960s by the group of Dr. Muceniece in the Kirchenstein Institute of Microbiology [59]. The oncolytic activity of natural enterovirus strains was increased by multiple passaging in human tumor cell cultures. Clinical trials of five attenuated oncolytic ECHO enterovirus strains began in 1968. The trials were performed in stage IV cancer patient volunteers, when the conventional therapy had proved inefficient. Viral preparations were administered by intramuscular injections. In some patients, a portion of tumor cells were destroyed that show characteristic cytopathic signs, but the overall therapeutic efficiency was low, supposedly because of the large bulk of the tumor and the rapid development of antiviral immunity. Accordingly, the suggested treatment strategy included radical surgery with subsequent virotherapy for the eradication of residual tumor cells and metastases and the stimulation of antitumor immunity [75].</p> <p>Based on the results of the trial, ECHO virus strain ECHO-7, which showed the most pronounced oncolytic properties, was selected for further research and named Rigvir [76, 77]. In 1988, phase III clinical trials began, which compared the efficiency of Rigvir with that of surgery and radio- and chemotherapy. In 2004, a patent was issued for Rigvir, and it was officially registered in Latvia, becoming the first enterovirus medication worldwide to complete the full cycle of clinical trials and to be applied in cancer therapy. Since 2008, Rigvir has been available in Latvia as a prescription medication. The information on its properties and usage is available at the site of the Latvian Virotherapy Center (<a href="http://www.viroterapija.lv">www.viroterapija.lv</a>). </p></blockquote> <p>From what I can tell synthesizing the evidence that I've been able to find, Dr. Muceniece made an interesting discovery in the early 1960s in which she observed that some ECHO viruses appeared to have cytolytic effects on tumor cells (i.e., caused them to lyse, or break apart), but the effect was weak, observed in only a few patients, and attenuated by the rapid development of immunity to the virus. In other words, lost in the mists of scientific history, this is an interesting dead end that appeared to go nowhere. Moreover, assuming this account is reasonably accurate, it certainly casts into doubt the stories of "miracle cures" of patients with stage IV cancer, given that those early trials apparently only looked at patients with stage IV cancer and Rigvir didn't work in them. There are <a href="http://skepticisms.lv/enciklopedija/rigvir-when-science-takes-a-back-seat/">anecdotes from surviving contemporaries of Dr. Muceniece</a> that in melanoma Rigvir produced "such excellent results that all medical staff involved were astonished," but no published data, and, pointedly, many of her contemporaries are happy to express their admiration for her but decline to evaluate the medication that she is credited with developing.</p> <p>Unfortunately, the only primary literature referenced are publications by Dr. Muceniece in Latvian. I searched and could not find any published results of these alleged phase III trials begun in 1988 showing that Rigvir prolongs survival in cancer. Neither could Eduards Ritums, who wrote an <a href="http://skepticisms.lv/enciklopedija/rigvir-zinatne-kalpones-prieksauta/">extensive article in Latvian</a> translated into <a href="http://skepticisms.lv/enciklopedija/rigvir-when-science-takes-a-back-seat/">English about Rigvir</a>. Ritums notes:</p> <blockquote><p> The chain of events should have stopped there. But just a few decades later Rigvir was suddenly included in the list of state-reimbursed medicines and reappeared under new circumstances and in a completely new light, despite the lack of any further trials and contemporaneous developments in similar fields of medical research.</p> <p>Although Aina Muceniece has passed away, a group of enterprises was formed using her name as a cover. The profits of these enterprises come from the sales of Rigvir and illegitimate advertising, consequently attracting desperate patients from abroad. This medicine is used as treatment not only for melanoma patients, but for other cancer patients as well, and advertised in a way that discredits other currently approved cancer treatment methods. It is unlikely Aina Muceniece would have supported or wanted something like this to happen. </p></blockquote> <p>So what evidence is there for Rigvir's anticancer activity? As you will see, it's pretty weak and unconvincing. Even so, somehow Rigvir was approved by the Latvian version of the FDA in 2004 and even more mysteriously found its way onto the list of Latvian state-reimbursed medicines in 2011.</p> <h2>Evidence for Rigvir's anticancer activity: Thin gruel indeed</h2> <p>I did PubMed searches and Google Scholar searches, and, as anyone who tries the same will discover, rapidly found that the published data on Rigvir in the peer-reviewed scientific biomedical literature is incredibly sparse. Ritums <a href="http://skepticisms.lv/enciklopedija/rigvir-when-science-takes-a-back-seat/">notes this in his article</a>:</p> <blockquote><p> However, Peteris Alberts, a spokesperson of the Virotherapy Center, referenced many articles in the medical literature (impressing patients who are looking for possible treatment) in an article written by Gunita Nagle titled “Sellers of Hope”, appearing in the Latvian magazine “Ir” [1]: “Are these not studies? We believe they are convincing.” We should mention that doctors obtain information from internationally recognized databases which are compiled by specific search engines, e. g., Medline. These searches return just a few old articles regarding Rigvir. The most recent information the Virotherapy Center can offer are three retrospective case studies. After reading one of the articles, Janis Eglitis asks a rhetorical question: “Did the long-term remission of three patients occur due to Rigvir? No, this story only tells us that three patients used this drug. Unexplained remission in oncology is possible. That can happen either with the use of Rigvir, or anything else – even vitamin C. That does not reflect or prove a trend.” A similar approach is used by authors of self-help books, namely: “I was doing all sorts of things, using anything available, but I believe only this particular something was helpful, so let us all use only this one particular approach!”</p> <p>Inara Rubene, a pharmaceutical consultant in private practice who has international experience in conducting clinical trials, compares Rigvir’s inclusion in the register of medicinal products with the activities of Ostap Bender (translator’s note: a character from Russian literature, a liar and a boaster, often referred to as ‘the great manipulator’): “The list of clinical trials is absolutely insufficient. Generally recognized phase III trials involving “gold standard” endpoints and overall survival (time to disease progression) are completely absent. Only the great manipulator in his hometown Vasuki would be able to register a medication using such trials.” </p></blockquote> <p>Indeed, if you look at the Virotherapy Center's page of <a href="https://www.virotherapy.eu/clinical-studies.php" rel="nofollow">clinical studies</a>, you won't be surprised to see how thin it is. The early studies are described thusly glowingly, but without enough detail or evidence to judge how convincing the data are. No mention is made of whether the studies were randomized (I get the impression that they were not), how the cases were matched, and survival rates are reported as ranges, which makes me wonder how on earth the investigators were determining their survival rates. For instance, it is claimed that in melanoma patients the three year survival rate for patients treated with surgery alone was between 46% and 58%, while it was 57% to 84% for those treated with surgery plus Rigvir. I assume that the Virotherapy Center is pooling multiple trials, but this sure isn't any meta-analysis. Without a lot more detail, it's impossible to tell what the investigators did several decades ago.</p> <p>What about more recent evidence? As Ritums notes, there is nothing more to be found besides three retrospective studies carried out post-registration, as a perusal of the <a href="https://www.virotherapy.eu/post-registration-experience.php" rel="nofollow">Virotherapy Center's page on its post-registration studies</a> shows. For instance, there is this 2015 study published in <cite>Melanoma Research</cite> by Donina et al, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560272/">Adapted ECHO-7 virus Rigvir immunotherapy (oncolytic virotherapy) prolongs survival in melanoma patients after surgical excision of the tumour in a retrospective study</a>. Basically, it is as the title says, a retrospective, unrandomized study that looked at 79 patients who had undergone excision of their primary melanoma and classified as stage IA, IB, IIA, IIB, or IIC according to surgical findings. The rationale was as follows:</p> <blockquote><p> Current guidelines for melanoma advise no treatment postsurgery for patients who are classified into substages IB and IIA. Patients in substages IIB and IIC are provided three options: participation in a clinical trial, observation and interferon 7,8. In the absence of strict guidelines, treatment with Rigvir was offered. Thus, 52 study participants received Rigvir and 27 were observed according to the guidelines. The patients who had been treated with interferon were excluded from the present analysis as, in the registry, they were too few to allow for any comparison. </p></blockquote> <p>So let me get this straight. This is the rationale? No post-surgical therapy is generally recommended for melanomas Stage IIA and below; so let's just give them Rigvir, instead. This is <em>not</em> a randomized trial. Patients were all offered Rigvir, were treated, and then a retrospective analysis was done after treatment. There was no blinding. There was no evidence of rigorous inclusion criteria. We have no way of knowing whether the Virotherapy Center included all the patients it treated for melanoma of the selected stages during the given time period or if it excluded cases in a way that could bias the results. Also, quite tellingly, no treatment/observation group is, on average, ten years older than the Rigvir group, and has proportionally over twice as many in the stage IIB group, which would have a worse prognosis than earlier stage melanoma. Basically, this study is worthless. I'm disappointed that <cite>Melanoma Research</cite>, normally a very good journal, published this dreck.</p> <p>The rest isn't any better. For instance, there is a <a href="http://onlinelibrary.wiley.com/doi/10.1111/apm.12576/full">2016 paper with three case reports</a> of patients with stage IV melanoma, stage IIIA small cell lung cancer, and a stage IV histiocytic sarcoma, all of whom were treated with Rigvir and all of whom have survived longer than expected. Of course, case reports can be useful for hypothesis generation, but do not generally show efficacy. Another study is listed (but not linked to). It's a retrospective study published in <cite>Latvijas Ārsts</cite> (<cite>Latvian Doctor</cite>) that looked at the progression-free period for stage II melanoma patients and observed that patients treated with surgery and observed were 6.7 times more likely to recur than those treated with oncolytic virotherapy after surgery. This study suffers from the same problems as the 2015 study. It's not randomized. It's retrospective. We have no way of knowing how the cases were selected.</p> <p>All of this leads to the question: Does Rigvir have anticancer activity, particularly against melanoma? My answer is simple: Damned if I know given the lack of valid, rigorous clinical trial evidence, but I tend to doubt it strongly. Rigvir <em>might</em> have weak activity in melanoma (although I doubt even that), but there's no way Rigvir is curing patients with stage IV cancers and it's incredibly unlikely that it is active against the range of cancers for which it is used.</p> <h2>Rigvir is most likely cancer quackery</h2> <p>There are many aspects to the Rigvir story that strongly suggest that Rigvir is probably cancer quackery. First, there is its mysterious origin story. As I read more about Rigvir, I couldn't help but hear echoes of the story of <a href="https://www.csicop.org/si/show/stanislaw_burzynski_four_decades_of_an_unproven_cancer_cure">Stanislaw Burzynski</a>, with the exception that there is no evidence of which I'm aware that Dr. Muceniece ever supported the uses to which Rigvir has been put since its registration in Latvia in 2004. The echoes I heard, however, were distinct and came from the lack of information about the origin of this therapy, which goes back even further than the 1970s origin of Stanislaw Burzynski's antineoplastons. True, the parallel is not anywhere near airtight, but it's troubling.</p> <p>Next, there is the way Rigvir is marketed, which is straight out of the cancer quack playbook. There are slickly produced videos on the International Virotherapy Center website full of appealing patients <a href="https://www.virotherapy.eu/testimonials.php" rel="nofollow">singing the praises of how Rigvir saved their lives in personal anecdotes</a> and even a <a href="http://www.virotherapyfoundation.org/en/patients/" rel="nofollow">foundation that promotes Rigvir</a>, again with glowing testimonials. This is definitely a red flag.</p> <p>Then there's how the International Virotherapy Center has represented the registration of Rigvir. In brief, it tries very hard to make it sound as though the drug was registered in accordance with European Union standards when it wasn't. Again, <a href="http://skepticisms.lv/enciklopedija/rigvir-when-science-takes-a-back-seat/">Ritums tells the tale</a>:</p> <blockquote><p> Rubene is embarrassed that “manipulative patient testimonials are disseminated, and that magazines and newspapers are flooded with promotional articles where Virotherapy Center representatives without any medical education declare Rigvir to be the the [<em>sic</em>] first drug in its group and state there are no similar agents available in the world [2-4]. Rigvir advertising materials also emphasize that this agent was registered in an EU country, thus misleading patients and making them believe that Rigvir was registered according to EU standards, although it is well-known this medication was registered before Latvia joined the European Union. Academic, chemist and Rigvir shareholder Ivars Kalvins (<em>translator’s note: known also as the inventor of meldonium (Mildronate)</em>) [5] keeps asserting without the smallest feeling of guilt that Rigvir is the first-choice agent for the treatment of a “sensitive” tumor [6], even after multiple objections.” </p></blockquote> <p>Then, like many dubious clinics, the Virotherapy Center disparages conventional medicine and portrays Rigvir as "natural":</p> <blockquote><p> Communications expert (<em>translator’s note: online writer on science and evidence-based medicine</em>) Ksenija Andrijanova emphasizes that the way the Virotherapy Center advertises itself is not typical for a medical facility, even though they are trying very hard to look like one. After exploring fraudulent treatment methods (there are many in oncology), Andrijanova has noticed two common features: “First, conventional treatment approaches are blatantly discredited, especially radiation and chemotherapy since they have side effects (which is true). However, the claim that these therapies do not help and recovery chances are very low is much more dangerous, and it is a false statement. Secondly, there are statements that oncology patients can be treated in a ‘natural way,’ and the real cancer treatment agent is safe, natural and harmless. Both features were present in the Virotherapy Center’s materials.” </p></blockquote> <p>Others have noted that Rigvir, when first sold, was inexpensive, but with its growing popularity the price has gone up. A telling quote comes from the Medical Director of the center, Dace Baltina, who was quoted in the magazine <cite>Ir</cite> as saying, “We do not promise to heal”, but “a patient is ready to pay believing the recovery will happen.” Sound familiar? And that doesn't even take into account the association the Virotherapy Center now has with what is without a doubt a quack clinic in Mexico, Hope4Cancer. As I <a href="http://respectfulinsolence.com/2017/06/05/cassandra-callenders-cancer-is-progressing-and-the-quackery-isnt-stopping-it/">documented before</a>, in addition to Rigvir, H4C offers high dose intravenous vitamin C, alkalinization, coffee enemas, juice fasting, near infrared saunas, detox routines, and more quackery. None of this has stopped the EU from <a href="https://medicalxpress.com/news/2016-08-virus-rigvir-cancer-survival.html">providing support under Horizon 2020</a> for a "feasibility" study as a prelude to a phase 2 trial to support registration with the European Medicine Agency. Somehow I doubt Rigvir will make it that far. At least, I sincerely hope that it doesn't, unless of course rigorous clinical trials show that it actually works, which is, based on my reading of the existing data, highly doubtful, albeit not impossible.</p> <p>What we have in Rigvir is yet another example of alternative medicine co-opting an interesting treatment from history that had been largely abandoned, resurrecting it, and riding it to profits. Immunotherapy, including the use of oncolytic viruses to target cancer, is all the rage these days in oncology; so a treatment like Rigvir is easy to sell based on its supposed immunological mechanism. Never mind that there is such a paucity of evidence that it actually works. Cancer patients, beware.</p> </div> <span><a title="View user profile." href="/author/oracknows">oracknows</a></span> <span>Sun, 09/24/2017 - 21:06</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/social-sciences" hreflang="en">Social Sciences</a></div> </div> </div> Mon, 25 Sep 2017 01:06:00 +0000 oracknows 22629 at https://scienceblogs.com Do Mexican cavefish hold the secret to treating diabetes? https://scienceblogs.com/lifelines/2017/09/23/do-mexican-cavefish-hold-the-secret-to-treating-diabetes <span>Do Mexican cavefish hold the secret to treating diabetes?</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><div style="width: 715px;"><img class="mw-mmv-final-image jpg mw-mmv-dialog-is-open" src="https://upload.wikimedia.org/wikipedia/commons/3/34/Astyanax_mexicanus%2C_Palais_de_la_Porte_Dor%C3%A9e.jpg" alt="Astyanax mexicanus, Palais de la Porte Dorée.jpg" width="705" height="452" /> Image of cave dwelling Mexican tetra By <a href="https://commons.wikimedia.org/w/index.php?curid=11154104">Citron via Wikimedia Commons</a> </div> <p>Mexican tetra (<i>Astyanax mexicanus</i>) are a fascinating example of divergent evolution. Over time, some of these freshwater river fish washed into caves where they continue to live. With perpetual darkness, these cavefish have lost their ability to see along with their skin pigmentation. Oxygen and food are also hard to come by in the caves. In fact, the cave dwelling fish may go for months without eating as they wait for seasonal floods to deliver foods. Dr. Cliff Tabin (Harvard Medical School) recently presented his research on these fish at the <a href="http://www.evodevopanam.org/meetings--events.html">Pan-American Society for Evolutionary Developmental Biology</a> meeting held at the University of Calgary, Alberta. His research compared surface dwelling and cavefish to identify metabolic differences in the animals that allow cavefish to thrive in their inhospitable environment. Through these studies he discovered remarkable similarities and differences between the cavefish and people with diabetes.</p> <p>Insulin is a hormone that helps lower blood sugar after a meal by causing muscle and fat cells to absorb it from the blood. In type 2 diabetes, this insulin-induced glucose disposal is impaired causing blood sugar levels to remain high. Dr. Tabin's research shows that cavefish are also insulin resistant due to a mutation in the receptor that insulin binds to in muscles.  Additionally, the livers of these fish store a lot of fat to help cope with times of starvation. Although the cavefish develop fatty liver and insulin resistance like a humans with diabetes, they do not display any pathologies. The researchers hope that by better understanding how these fish cope with sugar and fats, they may discover new ways to treat diabetes.</p> <p><strong>Source: </strong></p> <p><a href="https://www.scientificamerican.com/article/blind-cave-fish-beat-back-diabetes-symptoms-that-would-kill-people/?utm_source=newsletter&amp;utm_medium=email&amp;utm_campaign=sciences&amp;utm_content=link&amp;utm_term=2017-09-22_top-stories">Scientific American</a></p> </div> <span><a title="View user profile." href="/author/dr-dolittle">dr. dolittle</a></span> <span>Fri, 09/22/2017 - 19:29</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/social-sciences" hreflang="en">Social Sciences</a></div> </div> </div> Fri, 22 Sep 2017 23:29:39 +0000 dr. dolittle 150520 at https://scienceblogs.com September Pieces Of My Mind #2 https://scienceblogs.com/aardvarchaeology/2017/09/20/september-pieces-of-my-mind-2-4 <span>September Pieces Of My Mind #2</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><ul><li>Planting a gingko and listening to early Black Sabbath.</li> <li>Sailboat owners around Älgö have a lot of trouble with their wind indicators. The local crows use them as merry-go-rounds, which messes them up.</li> <li>Me: "I am daft today." Autocorrect: "I am Daddy Toast."</li> <li>Friendly local fellow gladly gave us permission to stash our excavation gear overnight behind his garden shed.</li> <li>Heavy downpour making loud whoosh noise on the roof.</li> <li>Rented a van, collected excavation gear and two students, deposited gear at site, bought extra gear, had lunch, returned van, am now in no hurry to airport. Everything went as planned. (But then a storm hit and my flight was delayed for almost six hours.)</li> <li>Went out of the house at 05:15 heading for Gothenburg, was greeted by a beautiful conjunction of Venus and the crescent moon in the south-east.</li> <li>Opening three trenches today in Kungahälla's Viking Period predecessor. Weights &amp; spindlewhorls tell of trade &amp; textile crafts.</li> <li>Mars Society's scifi writer debate panel on humankind's future in space consists of four white men aged 62 and over. Ouch.</li> <li>Have a feeling that a lot of web sites keep re-asking me if I'll accept their goddamn cookies.</li> <li>How can you figure out the average volume of a hole in Blackburn, Lancashire simply by counting them? I mean, you don't know their total volume to begin with. Makes no sense. Lennon was clearly tripping.</li> <li>The damn fire alarm in my hotel room has a bright green blinking LED that keeps me from sleeping. Last night I put a sticky plaster on it, but tonight I decided to take it down. Wearing headphones with loud riff rock in them. So I couldn't hear the angry beeping from the alarm box in the hallway. So security had to come visit. *sigh*</li> </ul></div> <span><a title="View user profile." href="/author/aardvarchaeology">aardvarchaeology</a></span> <span>Wed, 09/20/2017 - 08:20</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/social-sciences" hreflang="en">Social Sciences</a></div> </div> </div> Wed, 20 Sep 2017 12:20:27 +0000 aardvarchaeology 56312 at https://scienceblogs.com The cost of commemorating 9/11 exceeds the benefit. Bin Laden, dead, continues to win. https://scienceblogs.com/gregladen/2017/09/11/the-cost-of-commemorating-911-exceeds-the-benefit-bin-laden-dead-continues-to-win <span>The cost of commemorating 9/11 exceeds the benefit. Bin Laden, dead, continues to win.</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><em>This is a preface to the preface to a piece I wrote in 2011. I have only this to add: </em></p> <p>First as an aside, I suspected Trump could win the presidency, most people simply said it was impossible. But nonetheless, I was just as shocked as anyone else. </p> <p>Here's the thing. American culture reacted to 9/11 in ways that are mostly harmful. Various aspects of culture tend to reside in specific, though often vaguely defined, entities, such as classes taught in schools, crap kids say to each other on playgrounds, religious ceremony, TV shows, etc. Sometimes parts of culture tend to hold, brew, evolve, hybrid, and occasionally exude specific aspects of culture. For example, everybody walks around saying "boohya" (well, not everybody...). This is an example of a widely used expression that comes out of a part of military culture. Big metro areas like New York and LA put out cultural tropes all the time. That sort of thing.</p> <p>Well, I'm pretty sure that many of the bad cultural traits that evolved in our post-9/11 reactionary world, discussed below, now reside in what we can probably safely and accurately label as the Deplorable Right. Also called "The Base" this is the group of people who voted for Trump in 2016, and will vote for him again as many times as they can, the ones that say, "Yeah, Russians taking over is good" and who don't care much about, or know much about, Democracy. The "get her drunk and get her done" crowd. The people who will vote for Trump again and again mainly because it annoys everyone else, and not for any other reason. The people some misguided analysts require us to somehow embrace and cater to. They don't exist because of 9/11, and they have very little to do with 9/11 or anything else historical, social, or political. I'm just suggesting that that may be were some of the awful post 9/11 cultural traits we now have are nicely ensconced. Just a hypothesis. </p> <p>_________________________________________________________</p> <p><em>This is a piece I wrote in 2011, on the tenth anniversary of the 9/11 attacks. (Originally posted <a href="http://gregladen.com/blog/2011/09/generation-911-history-will-be-embarrassed-by-us/">here</a>.)</em></p> <p>I believe that the sauntering I refer to has diminished. But instead of sauntering, our local and county police departments seem to have taken up a different hobby: Shooting unarmed people of color. I think the problems underscored in this essay are mostly worse now than they were five years ago, and the argument I make here for what happened since 9/11/2001 is stronger, more clearly demonstrated by event. Also, the link between 9/11 and the Donald Trump candidacy is as clear as a brand new picture window right after the window washers left. </p> <p>I've made minor edits, but left time references as they were five years ago. This will not affect you reading of this post. </p> <p>Happy Anniversary 9/11</p> <p>_________________________________________________________</p> <p>A former engineering student, on seeing film of the World Trade Center towers collapse on September 11th, 2001, expressed surprise. He told a friend that he would have thought that on being hit with jumbo jets, the two or three immediately affected floors of the tower would have been destroyed but the structures would remain standing, or at most the floors above the impact sites could possibly collapse due to melting support beams but the lower floors would stand. The <em>complete</em> collapse, above and below the impact sites, of <em>both</em> of the structures was a surprise to him, given his engineering training. </p> <p>Those remarks were made shortly after the 9/11 attacks. Almost ten years later the same man who made these remarks was shot to death by US special forces in a raid on a residential compound in the Pakistani town of Abbottabad. He was, of course, Osama bin Laden. (<a href="http://scienceblogs.com/gregladen/2016/08/26/jihad-engineers/">Did you know that a disproportionate number of terrorists have engineering degrees?</a>)</p> <p>Many have spoken of the Post Patriot Act world, affecting day to day life in America, the wars, our treatment of our fellow humans at Gitmo and untold secret prisons around the world, the rise of the most expensive bureaucracy ever, all that. Icons of post 9/11 loom over us largely, and also exist in a small way in every nook and cranny of day to day life. And it rarely makes sense. </p> <p>I <a href="http://gregladen.com/blog/2007/02/911-reverberates-in-boston/">once told you</a> about a rural Iowan, who felt trapped and scared in the Big City, calling an elderly African American homeless wheel chair bound gentleman a "Terrorist" because she had never seen a homeless black wheelchair bound man so, of course, he must be something scary and scary = terrorist. That was an example of regular people substituting mundane daily fears, in this case, the "inner city" the "Black man" and I suppose "Wheel chairs" ... oh, and we were in a "deli" run by "middle eastern people" so there was that too ... with the largely made-up bogeyman of "Terrorist." </p> <p>One day last summer criminals drove down our street and carried out a criminal act before our very eyes, so we called 911. The police showed up way too late to matter and with way too many cops to make me think they were anything but frightened to go out alone, and the first thing they did was to demand to see my identification. I'm standing in my yard at the Weber, coals hot, brats cooking, a long bbq style fork in my hand and an apron that says "A Man and his Grill" on it and the cop is asking me for my identification.<sup>2</sup> I blew him off with a stern look, and he went away. (Our cops are fairly meek. That would not have worked everywhere.) But that has become the norm: When the cops show up, you better assume we live in a police state, or be you'll be assuming the position. Yes, folks, more and more people are being treated just like black folk in this country always have been. That should tell you something. One step backwards. Then a few more steps backwards. Now you know what that's like if you are white, except you don't because it is worse if you are black. #BLM.</p> <p>I used to be a guy who called 911, when appropriate, and probably more than others on average. Now, I only call 911 if someone is in physical danger or needs medical attention. If I'm going to get shaken down for helping the coppers, the coppers can help themselves, thank you. </p> <p>When an accident happens, the First Responders show up and close more lanes than they need to and they saunter. Instead of rushing in and managing the situation safely and effectively, they saunter around in full view of the drivers who are all forced over onto the shoulder to get by the scene. One day I sat in traffic for a half hour going north on State Route 169, and for the last six or seven minutes of that I could clearly see the two fire trucks that were blocking most of the lanes of traffic and the first responders sauntering around with absolutely nothing going on, no debris, no inured citizens, no other vehicles, nothing on the road to clean up, no "investigation" in progress, and they were passing around coffee. I'm sure there were donuts somewhere. I'm a fairly observant person and I'm not especially paranoid, and I'm pretty sure that I'm right: Post 911 first responders think they are the shit because hundreds of them died in the World Trade Center. This change in status and attitude is seen everywhere in our culture, I don't need to convince you of that. Here, I'm just adding in that extra bit of unnecessary and costly sauntering at scenes that should be cleared. Because the cultural details matter even when they are small. </p> <p>Do you know that during the late 1960s, when the US was in the throes of an unpopular war and a on the edge of revolution at home, there were an average of well over one hijacking of a commercial airplane flying out of a US based airport every month? Do you know what the reaction to that was? Metal detectors, and eventually baggage screening. Society did not change. It just got slightly harder, but not much harder, to get onto an airplane. Post 9/11 changes have been enormous and far reaching and pervasive. Now, I'm not trying to equate, or even compare, the scores of hijackings in the late 1960s and early 1970s with 9/11 and related acts (such as the attack on the Cole and the earlier WTC bombing, etc). There is no way to make that comparison. What I am trying to compare is the reaction, then vs. now. And, I'm not even comparing the reaction, exactly. What I'm trying to point out here is that in the 60s, the governmental and societal reaction to a significant spate of hijackings was to address airport security. The more recent reaction to 9/11 was to shift all of society and almost every aspect of American culture, the activities of every government department and agency, the expectations and rule sets, the budgets, the procedural manuals, and everything else to a paranoid modality and to institute what is essentially a low-level police state. That's a difference worth noting. And worth complaining about. </p> <p>Generation 9/11. History will be at least a little embarrassed by us. </p> <p>Recently, <a href="http://gregladen.com/blog/2011/09/demand-that-the-pledge-of-allegiance-not-be-recited-in-your-local-school/">we've been discussing</a> the State Mandated Recitation of the Pledge of Allegiance in schools. The reason this is becoming increasingly enforced around the US is because of various state laws passed in time to be in place for today's anniversary of the 9/11 attacks, or more generally as part of a post 9/11 culture. In one of our local schools, students had interesting responses to this happening on their turf, expressed in a school paper's "debate" layout. The printed views were even ... same number for and same number against. Those against the pledge requirement made all the usual and generally quite convincing arguments and did a great job. Those in favor of the jingoistic approach were, well, jingoistic, but, with an interesting and very positive twist; Most of them gave sway to atheists and agnostics. They said that they fully supported people leaving off the "under god" part and totally understood why they might do that. And none of the pro-pledge opinions were dripping with religious commentary or reference. It is important to note that of all the high schools in the region, the one to which I refer to is in the top four or five with respect to conservatism of the area served, and in the top two with respect to per capita wealth of the residents, and is probably the least diverse district in the state. </p> <p>And that is interesting because the average high school kid is about 16 years old, meaning that they were 6 when the 9/11 attacks happened, and therefore, the attacks themselves are not necessarily part of their own cultural composition to the same degree that it is with older folk. These are kids that grew up in the post 9/11 world without necessarily feeling the powerful shock and disbelief that many of us felt, followed by whatever fear or rage or helplessness or sense of dread or revenge that affected so many. The bad news is that this generation has become accustom to a much, much lower standard of freedom than many older people have, but this also means that when they confront this lack of freedom they may be more willing to rebel against it because they related less directly to the Defining Moment. </p> <p>Sauntering firemen and cocky police officers are not the end of the world and they are not the Nazi's or the Bradbury's Salamander. They are, rather, puddles of dried blood from a minor wound. When you get into a bad accident, you may get a major wound that could kill or maim you, but you will also get a lot of minor wounds that on their own would not mean much. But you know that the accident was truly traumatic when the minor wounds add up to a plethora but are uncounted or ignored because they are just background. Sauntering firemen, cocky police officers, and Iowans who label homeless wheel chair bound African American old guys as "terrorists" are the tiny scrapes and bruises on a battered body. </p> <p>And now might be a good point to ask the question, "What has risen from the ashes of the 9/11 attacks?" There was much talk at the time, and since then, and again today, about how great America is, how great Americans are, and how we will move forward and become better and stronger and so on and so forth. But it is just talk. What has happened instead is something entirely different. </p> <p>The giddy fear and sense of dread that comes from a violent moment clouds the mind, of the individual or more broadly but also the collective social mind. The disorientation that caused that lady from Iowa to mistake the wheel chair bound homeless man for a "terrorist" represents an internal derailing of logic. The guard rail is down, the road is slippery, and rational thought has spun not just into the ditch but across the highway into oncoming traffic. The playbook has become garbled and the Quarterback is running the wrong way. The general, gone mad, is locked up on the army base with the launch codes. Twelve Angry Men, Lord of the Flies ... stop me before I metaphor again! I think you get the point. There are a lot of people who benefit from our present social pathology, and that surely has been a factor. But also, it is simply a social pathology that we are experiencing, a terrorist victory, a lack of character on our part as a nation.</p> <p>But the scary part is what comes out of it, and by now you have probably guessed my point. The Tea Party and things like the Tea Party. Strongly held anti-social illogical destructive beliefs with no hope of critical self evaluation, in a large and organized part of the population. It is obvious why this happened in the Republican Party and not the Democratic Party, but people on both sides of the political aisle have contributed. Literalist, libertarian, paranoid, self-centered, easily frightened, reactionary, willfully unintelligent, deluded in self worth and unmovable in conviction and belief despite all evidence to the contrary. The lady from Iowa, the sauntering firemen, the sheeple who welcome being harassed by the TSA agents at the gate, the people who are happy to click "I agree" when confronted with a 43 page EULA that, somewhere in there, tells you the thing you just bought and paid for is not yours; A general social willingness to be told what to do, fear of not being told what to do, cynicism that we can think of what to do on our own, and utter disbelief that collective progressive action any longer has potential or meaning.</p> <p>The little puddles of drying blood are everywhere, splatter evidence not from the 9/11 attacks but from our national and social flailing about and rending of cloth and flesh as aftermath. It isn't just that the terrorist won on that day; It is much much worse than that. First they beat us, then they recruited us to do ourselves in. </p> <p>And yes, in this latest revision of my perennial post, I am drawing the line between 9/11 and Trump. </p> <p>Happy Anniversary 9/11</p> <p>_____________________________<br /><sup>1</sup>Apparently there is some question as to whether or not Osama bin Laden was actually an engineering student, but we'll roll with it for the present purposes. Here's the video of him making the remarks I paraphrased:</p> <object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/http://www.youtube.com/watch?v=AkdFNLqJajM&amp;w=400&amp;h=330&amp;fs=1" /><param name="allowFullScreen" value="true" /><param name="allowscriptaccess" value="always" /><embed src="http://www.youtube.com/v/http://www.youtube.com/watch?v=AkdFNLqJajM&amp;w=400&amp;h=330&amp;fs=1" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object><p> <sup>2</sup>I'm exaggerating. There was no apron. But I was wearing my <a href="http://www.cafepress.com/getrealnow.334348438">Darwin I Think Cap</a>. </p> </div> <span><a title="View user profile." href="/author/gregladen">gregladen</a></span> <span>Mon, 09/11/2017 - 04:31</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/social-sciences" hreflang="en">Social Sciences</a></div> </div> </div> Mon, 11 Sep 2017 08:31:23 +0000 gregladen 34515 at https://scienceblogs.com A naturopathic cancer quack tries to silence criticism with legal thuggery https://scienceblogs.com/insolence/2017/09/07/a-naturopathic-cancer-quack-tries-to-silence-criticism-with-legal-thuggery <span>A naturopathic cancer quack tries to silence criticism with legal thuggery</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>Regular readers know that, as a cancer surgeon, I become particularly worked up about stories of <a href="http://respectfulinsolence.com/2016/06/01/the-quackery-that-is-naturopathic-oncology/">naturopaths taking care of cancer patients</a>, which all too often <a href="http://respectfulinsolence.com/2017/09/05/patients-lose-when-they-chose-naturopaths-over-real-doctors/">end in disaster for the patient</a>. I've lost count of how many naturopaths I've seen, either on their websites, in talks, or in published literature, claiming that they can cure cancer "naturally," using any of a number of unproven methods, an example being the <a href="http://respectfulinsolence.com/2013/10/18/quoth-sayer-ji-modern-medicine-is-cannibalism/">Gerson protocol</a>, a form of quackery involving 13 larges glasses of raw vegetable and fruit juice, around 150 supplements, and five coffee enemas a day, each and every day. Others have claimed that "<a href="http://respectfulinsolence.com/2017/03/22/naturopaths-use-the-murder-of-a-quack-to-promote-naturopathic-licensure/">chemotherapy is for losers</a>," and frequently use alternative treatments associated with a much <a href="http://respectfulinsolence.com/2017/08/21/alternative-medicine-deadly-for-cancer-patients/">higher chance of dying of cancer</a>. It's no wonder how alarmed I am that naturopaths have created a pseudo-specialty patterned after medical oncology that they call "<a href="http://respectfulinsolence.com/2016/06/01/the-quackery-that-is-naturopathic-oncology/">naturopathic oncology</a>," complete with an abbreviation (FABNO, or, as I like to put it, "FAB? NO!"). They even <a href="http://respectfulinsolence.com/2016/12/27/how-cute-naturopathic-oncologists-are-pretending-that-theirs-is-a-real-medical-specialty/">pretend that it's a real medical specialty</a>, despite all the pseudoscience and quackery involved, when in reality it's just quacks <a href="http://respectfulinsolence.com/2017/08/15/naturopathy-when-fake-doctors-cosplay-real-doctors/">cosplaying real oncologists</a>. It drives me even more crazy to see doctors who should really know better collaborating with naturopaths and then taking self-righteous umbrage when it is pointed out that they are betraying their duty to patients by collaborating with quacks, mainly because they don't realize that naturopathy is so <a href="http://respectfulinsolence.com/2017/09/05/patients-lose-when-they-chose-naturopaths-over-real-doctors/">rooted in pseudoscience</a> that <a href="http://respectfulinsolence.com/2011/01/28/you-cant-have-naturopathy-without-homeop/">you can't have naturopathy without homeopathy</a>, which is an integral part of it.</p> <!--more--><p> So it was with dismay and anger that I discovered that someone whom I consider a friend and most certainly admire for her ability to admit a huge mistake and change course is being targeted for legal thuggery by a "naturopathic oncologist." I'm referring, of course, to ex-naturopath Britt Hermes, who a few years ago came to the startling realization that she was a quack and actually had the courage to give up her profession as a naturopath and undertake studies to become a real scientist. (Seriously, you really should read her blog, <a href="https://www.naturopathicdiaries.com">Naturopathic Diaries</a>. It's an insider account that should end all doubt that even "respectable" licensed naturopaths practice quackery.) As a result of her dishing on her ex-colleagues and exposing the pseudoscience in her previous profession, naturopaths really, really hate her. In this case, a prominent "naturopathic oncologist," Colleen Huber, has served her with a <a href="https://www.naturopathicdiaries.com/colleen-huber-cancer-quack-legal-thuggery/">cease and desist letter</a>. It's not the first time naturopaths have tried legal thuggery; just a month and a half ago, Bastyr University (a.k.a. the Harvard of naturopathy schools, which is not a good thing, by the way) <a href="https://www.naturopathicdiaries.com/bastyr-university-sent-cease-desist-letter/">served her with a similar legal nastygram</a>. It all came about because Hermes came to what looks to me like a reasonable conclusion based on circumstances that Huber had <a href="https://www.naturopathicdiaries.com/dubious-cancer-doctor-colleen-huber-cybersquatting/">cybersquatted her name</a> by buying up domain names based on her name, setting them up to redirect to the homepage of the American Association of Naturopathic Physicians:</p> <blockquote><p> The Wix account of BrittMarieHermes.com is registered with an email address at the domain <a href="https://www.natonco.org/" rel="nofollow">natonco.org</a>, the official website for the Naturopathic Cancer Society and a non-profit organization in Tempe, Arizona run by naturopathic cancer “doctor” Colleen Huber, NMD and her surrogate Hazel Chandler. The organization raises money for cancer patients who desire to use, but cannot afford, expensive alternative cancer therapies such as intravenous vitamins, mistletoe injections, and special diets, which is then funneled to Huber’s clinic Nature Works Best and others. </p></blockquote> <p>Hermes had also pointed out how Huber's claims about her success rate were utterly risible, which apparently stung her, but there's no denying it: They are. (I'll get to why in a moment.) First, though, let's take a look at what Huber claims. I perused her website again (<a href="https://natureworksbest.com">NatureWorksBest</a>), having encountered it before. The first thing one encounters on the splash page of her website are these claims:</p> <blockquote><p> Nature Works Best is a natural cancer clinic located in Tempe, Arizona, that focuses on natural, holistic, and alternative cancer treatments. Our treatments have proved to be an effective alternative to traditional chemotherapy and radiation, which we do not use in our treatments. Rather, we have developed a natural method of treating cancers based on intravenous vitamin therapy which may include Vitmain-C, Baking Soda, and other tumor fighting agents as well as a simple food plan.</p> <p>Our team of naturopathic medical doctors have administered over 26,000 intravenous treatments, used for all stages and types of tumors. As of July 2014, 80% of patients who completed our treatments alone went into remission, 85% of patients who completed our treatments and followed our food plan went into remission; 93% of patients in Stage I through early Stage 4 who did all of our protocols went into remission. No other clinic, of any kind, has such a high documented success rate.</p> <p>Our cancer clinic treats all types of malignancies, at all different stages, often with different co-morbidities, and different patterns of metastases. We have seen patients of all stages do very well with our treatments, with the exception of late stage IV patients. </p></blockquote> <p>So many red flags, and I haven't even gotten past the first page! Intravenous vitamin C? It <a href="http://respectfulinsolence.com/2009/02/18/vitamin-c-and-cancer-has-linus-pauling-b/">almost certainly doesn't work</a>. Even the most charitable interpretation of existing evidence is that, at best and giving every benefit of the doubt, it has a very, very modest antitumor effect, too weak to be of much use. Basically, there's some <a href="https://www.skepticalraptor.com/skepticalraptorblog.php/vitamin-c-and-cancer-scientific-evidence/">in vitro and animal model work</a> that suggests a modest effect against a few tumors, but none of it has been translated into humans. Even if the best possible scenario came out of human clinical trials, high dose intravenous vitamin C for cancer is, as I like to call it, a <a href="http://respectfulinsolence.com/2014/02/10/vitamin-c-for-cancer-trying-to-rise-from-the-grave-once-again/">very long run for a very short slide</a>.</p> <p>Intravenous baking soda (sodium bicarbonate) is another favorite. The first time I ever heard of its being used was by a particularly ridiculous cancer quack named Tullio Simoncini, who claimed that <a href="http://respectfulinsolence.com/2008/08/07/a-fungus-among-us-in-oncology/">all cancer is in reality a fungus</a> and that the way to cure cancer is to kill the fungus. And how do you do that? By injecting baking soda into it. <a href="http://respectfulinsolence.com/2014/01/03/a-fungus-among-us-in-oncology-2014-edition/">I kid you not</a>. Simoncini is so divorced from reality that he claims that all cancer is white, like fungus, apparently never having heard of melanoma or other tumors that are a color other than white, or, for that matter, of the many variety of colors of fungi.</p> <p>Guess what? Huber goes all-in for Simoncini, too, mentioning him in the very first paragraph of her <a href="https://natureworksbest.com/dr-tullio-simoncini-sodium-bicarbonate-cancer-treatment/" rel="nofollow">page on intravenous sodium bicarbonate</a>. After reading partway through her ridiculous pseudoscientific treatise on bicarbonate and cancer, I laughed out loud when I came to this part:</p> <blockquote><p> As for whether cancer is fundamentally a kind of fungus, the jury is still out. However, it is useful to know that not only does sodium bicarbonate disrupt the comfortable environment of tumors, but it also has anti-fungal effect.[4] </p></blockquote> <p>This, after only chuckling a little at this:</p> <blockquote><p> Earlier researchers have found a concurrence between cancer and candida. In Dr. Simoncini’s book, Cancer is a Fungus[3] he notes some similarities between the two. Primarily, both are intractable diseases, each very hard to get rid of. Dr. Simoncini notes that each forms a solid mass of low penetrability, unlike the dispersed forms of bacterial and viral infections in the body or body fluids. Dr. Simoncini notes the problem of surface area in addressing these infections. Whereas bacterial and viral infections are dispersed in the solutions of bodily compartments, and likewise, antibiotics and other anti-microbials dispersed in the same solutions have access to each microbe. </p></blockquote> <p>No, the "jury" is not "still out." <a href="http://www.123hjemmeside.dk/cancer_is_not_a_fungus">Cancer is not a fungus</a>. It is <em>not</em> a kind of fungus. It is the body's own cells freed from normal regulatory constraints that regulate them into doing what they're supposed to do, growing as much as they need to grow for development and tissue repair and then stopping, and functioning the way they're supposed to function. In any case, at least one patient is <a href="https://www.cancertreatmentwatch.org/reports/simoncini.shtml">known to have died</a> as a direct result of Simoncini's treatments.</p> <p>Like many naturopaths, Huber takes a germ of a biologically plausible idea and runs her patients right off the cliff with it. That idea is based on the observation that many cancers exist in an acidic milieu. Much of the reason for this is that they often outgrow their blood supply and therefore exist in a hypoxic (low oxygen) environment. Also, because of the Warburg effect, many tumors exist largely on anaerobic (no oxygen) metabolism, which generates a lot of lactic acid. The idea is that perhaps by reversing the acidity the tumors might become less aggressive—or at least more sensitive to chemotherapy. There are even a few studies in mice (<a href="https://www.ncbi.nlm.nih.gov/pubmed/19276390">like this one</a>, one of whose co-authors I know personally) that suggest treatment with IV bicarbonate can decrease metastases, although the <a href="https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-11-235">primary tumors appear to grow at the same rate</a>. At least one other alkalinizing agent appears to have <a href="http://onlinelibrary.wiley.com/doi/10.1002/cam4.1032/full">similar effects on tumor growth</a>.</p> <p>The problem is that the studies are all pretty much in cell culture and rodent tumor models. There is no good clinical evidence that alkalinization works against cancer in humans yet. <a href="https://sciencebasedmedicine.org/naturopathic-cancer-quackery/">Steve Novella</a> found a <a href="https://clinicaltrials.gov/ct2/show/NCT02531919">clinical trial</a> at the University of Arizona that closed in 2015, but no results have been published yet. I note that this was a phase I trial, which means it wasn't even designed to demonstrate efficacy, just safety and patient tolerance of the regimen. It also involves only oral bicarbonate dosing, which is not what Huber is doing and would be expected to produce a much more limited alkalosis than her protocol. Even if it did, based on the modest effects observed in mice, it is incredibly unlikely that high dose bicarbonate would cure any cancers, which is what Huber claims for her treatments. At best, it might slow down tumor growth, and there are lots of problems with chronic alkalinization of the blood. Thus, I view Huber's claims very skeptically.</p> <p>Of course, like all naturopaths, Huber claims her treatments are "individualized":</p> <blockquote><p> The intravenous nutrients are tailored specifically to each patient’s condition and chosen for their targeted, time tested, and research-documented anti-cancer, or tumor fighting effect. The nutrients we use are different for each patient, but some of nutrients used may include a combination of Vitamin-C, Sodium Bicarbonate, DMSO, in addition to many others. Before we have done a full workup we cannot know which of these nutrients may be used for your treatment, if they are used at all. These treatments are made specifically for each patient, their type and stage of malignancy and may be used exclusively or as a supplement to chemo and radiation. </p></blockquote> <p>Of course, who knows how Huber figures out which patient should get which treatment. This is, as I like to call it, the "make it up as you go along" method.</p> <p>Huber is also very much a believer in the idea that sugar somehow "feeds" cancer. While it is true that, thanks to the Warburg effect, many tumors (but not all) actually do utilize a lot more glucose than normal tissue (if it weren't true, PET scans that use labeled glucose wouldn't be able to visualize tumors), there is no <a href="http://scienceblog.cancerresearchuk.org/2017/05/15/sugar-and-cancer-what-you-need-to-know/">good evidence that sugar "feeds" cancer</a> in the way that Huber and other naturopaths claim or that decreasing sugar intake decreases the growth rate of established cancers and the <a href="http://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-causes/art-20044714?pg=2">risk in healthy people of getting cancer</a>, at least if you control for obesity, which does produce an increased risk of several cancers and can, of course, result from consuming too much sugar. It's also true that diabetes appears to be associated with a higher risk of certain cancers, such as <a href="https://www.ncbi.nlm.nih.gov/pubmed/25556126">pancreatic cancer</a>. However, that increased risk appears to derive from abnormalities in the function of insulin and insulin-like growth factors.</p> <p>Perhaps the most outrageous bit of nonsense on Huber's entire website is her attempt to do clinical research. On the one hand, I almost feel as though I should give her credit for trying (like a participation trophy to a child), but on the other hand she's just so bad at it. We can see for ourselves in her paper, <a href="https://sciforschenonline.org/journals/cancer-research/article-data/IJCRMM-2-127/IJCRMM-2-127.pdf">Cancer Patients’ use of Sweeteners: A 7-Year, Controlled Study</a>, published in 2016 in the <a href="https://sciforschenonline.org/journals/cancer-research/">International Journal of Cancer Research and Molecular Mechanisms</a>.</p> <p>First of all, it's one of the oddest papers I've ever seen. The description of the methodology is beyond cursory, and there is basically zero statistical analysis or anything resembling a trial design. It is "controlled" only in the sense that that the letters line up on the page in fully justified paragraphs. Seriously. This is the whole description of her methods:</p> <blockquote><p> Mortality vs survival was recorded of sweetened food eaters among outpatients with a cancer diagnosis at one clinic. Since 2006, this clinic has recorded data on consumption of sugar and other sweeteners in cancer patients, and has consistently recommended, but never mandated, avoidance of sweetened foods, except with extracts of the plant Stevia rebaudiana, which does not contain saccharides or sugar alcohol. is clinic has no inpatient facilities and no food service. All patients selected and purchased all of their own food, all of which originated from and was almost entirely consumed outside of the clinic. Data from all 317 consecutive patients with a diagnosis of cancer from outside of the clinic are reported in this interventional study, excluding only those cancer patients who chose to forgo further treatment a er less than two weeks in treatment.<br /> Natural methods such as intravenous nutrients with cancer-disrupting e ect were the only ones o ered, choosing among both oral and intravenous, herbal and nutritional interventions, choosing those that patients found tolerable and that we observed to work synergistically, adjusting for individual tolerances and requirements, in accordance with the naturopathic principle of “Treat the whole person”. </p></blockquote> <p>After Huber's most cursory of cursory methods section, the text devolves into commentary before coming around to report Huber's "results":</p> <blockquote><p> Achievement of remission was quite different for the following two categories: all patients: 151/317=48% and those who ate sweetened foods: 9/29=31%. The difference between these two groups was much stronger for the cohort of patients who continued treatments until either remission or death. Comparing all patients who were steadfast in the recommended treatments with the sweetened food eaters who were steadfast in all but dietary recommendations, 151/183=83% of all completely steadfast patients achieved remission, but only 9/25=36% of the steadfast sweetened food eaters achieved remission. Remission was defined as no visibly active tumor on MRI imaging of the same area that had previously active tumor growth. Of all patients who were steadfast in the treatments (including the sweetened food eaters), 32/183=17% died while still under the care of the clinic, but considering only the sweetened food eaters who otherwise consistently pursued the recommended treatments, 16/25=64% died. </p></blockquote> <p>Several tables are presented, which you can peruse on your own. There's no statistical analysis, no power analysis, no hazard ratios presented, no meaningful analysis of any kind. There is no breakdown of how many patients had what kind of cancer or what stage they were. Wait, that's not quite true. Tables 4-6 break down the cases by stages (I, II, III, early stage IV and late stage IV). I note that we generally don't break down cases in such papers by "early" or "late" stage IV. Stage IV is stage IV. Also, lumping together cases of different cancer by stage is utterly meaningless. After all, a stage II pancreatic cancer is a much different beast than a stage II breast cancer, the former having a low survival rate and the latter a very high survival rate. Different mixes of different cancers per stage could produce very different results without any biological effect whatsoever due to her interventions.</p> <p>Then there's this:</p> <blockquote><p> Many patients voluntarily left our practice, against our advice, primarily for financial reasons, while still having cancer. Of the remaining patients, 175 either went into confirmed, complete remission, which we define by no evidence of cancer remaining in the body on imaging, or have remained in good to excellent wellbeing, as determined retrospectively by prolonged stable health of at least 6 months after leaving our care and needing no other physician supervised cancer care, and as confirmed by annual telephone conversation with either the patient or a family member. Those patients in remission stayed in our care an average of 3.7 months; those who left, 2.7 months, (this data last measured in 2010). Eight additional patients went into remission after leaving our clinic, and while being treated at a different clinic, and it is unlikely that our treatments were the decisive factor in that remission. We were still treating 22 patients at July 1, 2014 plus giving ongoing maintenance treatments to some of those who are still in remission. 44 died while still our patients. Of those 44, 12 died after a significant dietary dispute with us. That is 32 patients died although they received our treatments and complied with our requested diet. 22 more were killed by hospital procedures and/or chemotherapy and/or radiation side effects while still our patients. 45 total patients chose to have chemotherapy while having our treatments. Yet, of the 175 who went into remission, only 12 had chosen to have chemotherapy while having our treatments. Stages 1, 2, 3 and early Stage 4 patients at start of treatment had much better outcomes than late Stage 4 patients in general. </p></blockquote> <p>In her paper, she lists 151/317 patients as in "remission or assumed remission." My reaction? You can't "assume" remission. Either the patient is in remission or he isn't. She also lists 20 "iatrogenic deaths in the hospital or by MDs." Really? How do you define "iatrogenic"? Or are these patients who gave up because Huber's treatments weren't working? Who knows? It is known that a high dropout rate is a red flag in any clinical study. Also, over 1/3 of the patients listed in Table 1 received surgery or chemotherapy, leading one to wonder how much of any good results reported was due to actual conventional treatment.</p> <p>I also noticed while poking around Britt's website that Huber had published her "<a href="https://natureworksbest.com/wp-content/uploads/2015/12/Optimal-Diets-for-Cancer-Patients.pdf" rel="nofollow">methods</a>" (such as they are) on her website a couple of years earlier. Funny, but she also left out a lot of this in her paper. She also left out a fair number of patients who received radiation therapy (Table I). Why did she not include these numbers in her published paper? One wonders, one does. I also can't help but mention another analysis by Thomas Mohr, who looked at Huber's numbers and posted his reaction in a <a href="https://www.naturopathicdiaries.com/the-ph-miracle-diet-naturopath-is-guilty-but-california-still-has-a-problem/#comment-2499440981">comment on Britt's blog</a> about a version of Huber's study posted before the final published version:</p> <blockquote><p> The data are difficult to estimate but from the overall table one can conclude that there is complete information for 247 patients (excl iatrogenic deaths, unknown status, etc). Of these 78 died. Of these 13 died in the state of the art treatment arm and 65 died in the naturopathy arm (the numbers are estimated due to the lack of a both surgery and chemotherapy group, I assumed 50 to be in the state of the art treatment arm, accounting for 50% overlap between surgery and chemotherapy).</p> <p>Putting aside the ethical issues of the extremely bad study design, the lack of ethics committee approval or patients agrrement, a quick n' dirty analysis of the data reveals following odds ratio: 2.1 (95% CI 1.01 - 4.40, p&lt;0.05) in favour of state of the art treatment. I.o.W. patients under natural care only have a more than twofold higher risk to die. </p></blockquote> <p><a href="https://www.naturopathicdiaries.com/the-ph-miracle-diet-naturopath-is-guilty-but-california-still-has-a-problem/#comment-2500795821">And</a>:</p> <blockquote><p> An addendum. If one removes data of questionable quality and takes into account only those with complete data and in treatement resp. died during treatment (i.e. in remission, not yet in remission, died) , the odds ratio gets almost 10:1 in favour of state of the art therapy. This is really nasty. </p></blockquote> <p>Indeed it is, also unethical as hell. This paper is so bad that it could be used as an example of how not to do clinical research. In addition, there is no listing of an institutional review board (IRB) approval, appropriate informed consent to patients who filled out her questionnaires, or any of the other usual practices designed to protect patients. Even more despicable is her claim in <a href="https://www.naturopathicdiaries.com/colleen-huber-cancer-quack-legal-thuggery/">her "cease and desist" letter to Britt Hermes</a>:</p> <ul><li>Huber claims her research has been registered with the Office of Human Research Protections and the FDA since 2013.</li> <li>Huber claims her study is a retrospective case series that does not require IRB approval.</li> <li>Huber claims her IRB has extensive and definitive policies regarding informed consent, HIPAA laws, and protection of human research subjects.</li> </ul><p>If the first were the case, Huber could show her IRB approval. Also, an investigator doesn't have to register a human trial with the FDA unless he's seeking FDA approval for the investigational agent being studied. As for the second, Huber is just plain wrong. Retrospective case series <em>do</em> require IRB approval. Period. This is not even a gray area. True, some of them depending on the details, might qualify for an expedited review by the IRB, but from what I can tell Huber's would probably not have qualified because it uses protected patient information. As for her claimed IRB, Britt did a long <a href="https://sciencebasedmedicine.org/wild-west-tales-of-a-naturopathic-ethical-review-board/">post for Science-Based Medicine</a> showing naturopathic IRB shenanigans of the Arizona naturopathic IRB formed by Huber and others.</p> <p>Basically, Huber is unhappy that Britt has been kicking up the rocks and shining light on the quackery practiced by naturopaths and the unethical and incompetent clinical trials being done by them to try to provide a veneer of scientific respectability to their quackery. As a result, she's acted like so many other dubious practitioners and, instead of defending herself with science, has tried to silence critics with legal thuggery.</p> </div> <span><a title="View user profile." href="/author/oracknows">oracknows</a></span> <span>Thu, 09/07/2017 - 00:00</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/social-sciences" hreflang="en">Social Sciences</a></div> </div> </div> Thu, 07 Sep 2017 04:00:37 +0000 oracknows 22619 at https://scienceblogs.com New Research on Assessing Climate Change Impact on Extreme Weather https://scienceblogs.com/gregladen/2017/08/31/new-research-on-assessing-climate-change-impact-on-extreme-weather <span>New Research on Assessing Climate Change Impact on Extreme Weather</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>Three statisticians go hunting for rabbit. They see a rabbit. The first statistician fires and misses, her bullet striking the ground below the beast. The second statistician fires and misses, their bullet striking a branch above the lagomorph. The third statistician, a lazy frequentist, says, "We got it!"</p> <p>OK, that joke was not 1/5th as funny as any of XKCD's excellent jabs at the frequentist-bayesian debate, but hopefully this will warm you up for a somewhat technical discussion on how to decide if observations about the weather are at all explainable with reference to climate change.</p> <p><a href="/files/gregladen/files/2017/08/frequentists_vs_bayesians.png"><img src="/files/gregladen/files/2017/08/frequentists_vs_bayesians.png" alt="" width="468" height="709" class="aligncenter size-full wp-image-24458" /></a><br /> [<a href="https://xkcd.com/1132/">source</a>]</p> <p>We are having this discussion here and now for two reasons. One is that <a href="http://scienceblogs.com/gregladen/2017/08/24/harvey-the-hurricane-is-a-significant-event/">Hurricane Harvey</a> was (is) a very serious weather event in Texas and Louisiana that may have been <a href="http://scienceblogs.com/gregladen/2017/08/28/harvey-the-hurricane-truly-climate-change-enahnced/">made worse by the effects of anthropogenic global warming</a>, and there may be another really nasty hurricane coming (<a href="http://scienceblogs.com/gregladen/2017/08/30/possible-hurricane-irma/">Irma</a>). The other is that Michael Mann, Elisabeth Lloyd and Naomi Oreskes have just published a paper that examines so-called frequentist vs so-called Bayesian statistical approaches to the question of attributing weather observations to climate change.</p> <p>Mann, Michael, ElisabethLloyd, Naomi Oreskes. 2017. <em><a href="http://www.meteo.psu.edu/holocene/public_html/Mann/articles/articles/MLOClimaticChange17.pdf">Assessing climate change impacts on extreme weather events; the case for an alternative (Baesian) approach</a></em>. Climate Change (2017) 144:131-142. </p> <p>First, I'll give you the abstract of the paper then I'll give you my version of how these approaches are different, and why I'm sure the authors are correct.</p> <blockquote><p>The conventional approach to detecting and attributing climate change impacts on<br /> extreme weather events is generally based on frequentist statistical inference wherein a null hypothesis of no influence is assumed, and the alternative hypothesis of an influence is accepted only when the null hypothesis can be rejected at a sufficiently high (e.g., 95% or Bp = 0.05^) level of confidence. Using a simple conceptual model for the occurrence of extreme weather events, we<br /> show that if the objective is to minimize forecast error, an alternative approach wherein likelihoods<br /> of impact are continually updated as data become available is preferable. Using a simple proof-of-concept, we show that such an approach will, under rather general assumptions, yield more<br /> accurate forecasts. We also argue that such an approach will better serve society, in providing a<br /> more effective means to alert decision-makers to potential and unfolding harms and avoid<br /> opportunity costs. In short, a Bayesian approach is preferable, both empirically and ethically.</p></blockquote> <p>Frequentist statistics is what you learned in your statistics class, if you are not an actual statistician. I want to know if using Magic Plant Dust on my tomatoes produces more tomatoes. So, I divide my tomato patch in half, and put a certain amount of Magic Plant Dust on one half. I then keep records of how many tomatoes, and of what mass, the plants yield. I can calculate the number of tomatoes and the mass of the tomatoes for each plant, and use the average and variation I observe for each group to get two sets of numbers. My 'null hypothesis' is that adding the magic dust has no effect. Therefore, the resulting tomato yield from the treated plants should be the statistically the same as from the untreated plants. I can pick any of a small number of statistical tools, all of which are doing about the same thing, to come up with a test statistic and a "p-value" that allows me to make some kind of standard statement like "the treated plants produced more tomatoes" and to claim that the result is statistically significant.</p> <p>If the difference, though, is very small, I might not get a good statistical result. So, maybe I do the same thing for ten years in a row. Then, I have repeated the experiment ten times, so my statistics will be more powerful and I can be more certain of an inference. Over time, I get sufficient sample sizes. Eventually I conclude that Magic Plant Dust might have a small effect on the plants, but not every year, maybe because other factors are more important, like how much water they get or the effects of tomato moth caterpillars. </p> <p>In an alternative Bayesian universe, prior to collecting any data on plant growth, I do something very non-statistical. I read the product label. The label says, "This product contains no active ingredients. Will not affect tomato plants. This product is only for use as a party favor and has no purpose."</p> <p>Now, I have what a Bayesian statistician would call a "prior." I have information that could be used, if I am clever, to produce a statistical model of the likely outcome of the planned experiments. In this case, the likely outcome is that there won't be a change.</p> <p>Part of the Bayesian approach is to employ a statistical technique based on Bayes Theorem to incorporate a priori assumptions or belief and new observations to reach towards a conclusion.</p> <p>In my view, the Bayesian approach is very useful in situations where we have well understood and hopefully multiple links between one or more systems and the system we are interested in. We may not know all the details that relate observed variation in one system and observed variation in another, but we know that there is a link, that it should be observable, and perhaps we know the directionality or magnitude of the effect.</p> <p>The relationship between climate change and floods serves as an example. Anthropogenic climate change has resulted in warmer sea surface temperatures and warmer air. It would be very hard to make an argument from the physics of the atmosphere that this does not mean that more water vapor will be carried by the air. If there is more water vapor in the air, there is likely to be more rain. Taken as a Bayesian prior, the heating of the Earth's surface means more of the conditions that would result in floods, even if the details of when, how much, and where are vague at this level.</p> <p>A less certain but increasingly appreciated effect of climate change is the way trade winds and the jet stream move around the planet. Without going into details, climate change over the last decade or two has probably made it more likely that large storm systems stall. Storms that may have moved quickly through an area are now observed to slow down. If a storm will normally drop one inch of rain on the landscape over which it passes, but now slows down but rains at the same rate, perhaps 3 inches of rain will be dropped (over a shorter distance). What would have been a good watering of all the lawns is now a localized flood. </p> <p>That is also potentially a Bayesian prior. Of special importance is that these two Bayesian priors imply change in the same direction. Since in this thought experiment we are thinking about floods, we can see that these two prior assumptions together suggest that a post-climate change weather would include more rain falling from the sky in specific areas.</p> <p>There are other climate change related factors that suggest increased activity of storms. The atmosphere should have more energy, thus more energetic storms. In some places there should more of the kind of wind patterns that spin up certain kinds of storms. It is possible that the relationship between temperature of the air at different altitudes, up through the troposphere and into the lower stratosphere, has changed so that large storms are likely to get larger than they otherwise might.</p> <p>There is very little about climate change that implies the reverse; Though there may be a few subsets of storm related weather that would be reduced with global warming, most changes are expected to result in more storminess, more storms, more severe storms, or something.</p> <p>So now we have the question, has climate change caused any kind of increase in storminess?</p> <p>I'd like to stipulate that there was a kind of turning point in our climate around 1979, before which we had a couple of decades of storminess being at a certain level, and after which, we have a potentially different level. This is also a turning point in measured surface heat. In, say, 1970 plus or minus a decade, it was possible to argue that global warming is likely but given the observations and data at the time, it was hard to point to much change (though we now know, looking back with better data for the previous centuries, that is was actually observable). But, in 2008, plus or minus a decade, it was possible to point to widespread if anecdotal evidence of changes in storm frequency, patterns, effects, as well as other climate change effects, not the least of which was simply heat.</p> <p>I recently watched the documentary, "<a target="_blank" href="https://www.amazon.com/gp/product/1635651085/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1635651085&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=be6965cc94049355fc7e70faba2810f5">An Inconvenient Sequel</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=1635651085" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" />." This is a fairly misunderstood film. It is not really part two of Al Gore's original "<a target="_blank" href="https://www.amazon.com/gp/product/0670062723/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0670062723&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=5faf59d419cdee5f23bbfcc3d64d357f">An Inconvenient Truth</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=0670062723" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" />." The latter was really Al Gore's argument about climate change, essentially presented by him. "<a target="_blank" href="https://www.amazon.com/gp/product/1635651085/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1635651085&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=be6965cc94049355fc7e70faba2810f5">An Inconvenient Sequel</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=1635651085" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" />" was made by independent film makers with no direct input by Gore with respect to contents and production, though it is mostly about him, him talking, him making his point, etc. But I digress. Here is the salient fact associated with these two movies.<a target="_blank" href="https://www.amazon.com/gp/product/0670062723/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0670062723&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=5faf59d419cdee5f23bbfcc3d64d357f">An Inconvenient Truth</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=0670062723" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" /> came out in May 2006, so it is based mainly on information available in 2005 and before. In it, there are examples of major climate change effects, including Katrina, but it seems like the total range of effects is more or less explicated almost completely. When <a target="_blank" href="https://www.amazon.com/gp/product/1635651085/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1635651085&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=be6965cc94049355fc7e70faba2810f5">An Inconvenient Sequel</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=1635651085" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" />l came out a few weeks ago, a solid 10+ years had passed and the list of actual climate effects noted in the movie was a sampling, not anything close to a full explication, of the things that had happened over recent years. Dozens of major flooding, storming, drying, and deadly heat events had occurred of which only a few of each were mentioned, because there was just so much stuff.</p> <p>My point is that there is a reasonable hypothesis based on anecdotal observation (at least) that many aspects of weather in the current decade, or the last 20 years, or since 1979 as I prefer, are different in frequency and/or severity than before, because of climate change.</p> <p>A frequentist approach does not care why I think a certain hypothesis is workable. I could say "I hypothesize that flies can spontaneously vanish with a half life of 29 minutes" and I could say "I hypothesis that if a fly lays eggs on a strawberry there will later be an average of 112 maggots." The same statistical tests will be usable, the same philosophy of statistics will be applied. </p> <p>A Bayesian approach doesn't technically care what I think either, but what I think a priori is actually relevant to the analysis. I might for example know that the average fly lays 11 percent of her body mass in one laying of eggs, and that is enough egg mass to produce about 90-130 maggots (I am totally making this up) so that observational results that are really small (like five maggots) or really large (like 1 million maggots) are very unlikely a priori, and, results between 90 and 130 are a priori very likely.</p> <p>So, technically, a Bayesian approach is different because it includes something that might be called common sense, but really, is an observationally derived statistical parameter that is taken very seriously by the statistic itself. But, philosophically, it is a little like the pitcher of beer test.</p> <p>I've mentioned this before but I'll refresh your memory. Consider an observation that makes total sense based on reasonable prior thinking, but the standard frequentist approach fails to reject the null hypothesis. The null hypothesis is that there are more tornadoes from, say, 1970 to the present than there were between 1950 and 1970. This graph suggests this is true...</p> <div style="width: 650px;display:block;margin:0 auto;"><a href="http://scienceblogs.com/gregladen/files/2013/05/Tornadoes_over_long_term149520253.png"><img src="http://scienceblogs.com/gregladen/files/2013/05/Tornadoes_over_long_term149520253-640x440.png" alt="" width="640" height="440" class="size-large wp-image-16703" /></a> Annual number of tornadoes for the period 1916-1995; the dashed line connecting solid circles shows the raw data, the red heavy solid line is the result of smoothing. Also shown in the green light solid line is the number of tornado days (i.e., days with one or more tornadoes) per year. </div> <p>... but because the techniques of observation and measuring tornado frequency have changed over time, nobody believes the graph to be good data. But, it may not be bad data. In other words, the questions about the graph do not inform us of the hypothesis, but the graph is suggestive.</p> <p>So, I take a half dozen meteorologists who are over 55 years old (so they've seen things, done things) out for a beer. The server is about to take our order, and I interrupt. I ask all the meteorologists to answer the question ... using this graph and whatever else you know, are there more tornadoes in the later time interval or not? Write your answer down on this piece of paper, I say, and don't share your results. But, when we tally them up, if and only if you all have the same exact answer (all "yes" or all "no") then this pitcher of beer is on me.</p> <p>Those are quasi-Bayesian conditions (given that these potential beer drinkers have priors in their heads already, and that the graph is suggestive if not conclusive), but more importantly, there is free beer at stake.</p> <p>They will all say "yes" and there will be free beer.</p> <p>OK, back to the paper.</p> <p>Following the basic contrast between frequentist and Bayesian approaches, the authors produce competing models, one based on the former, the other on the latter. "In the conventional, frequentist approach to detection and attribution, we adopt a null hypothesis of an equal probability of active and inactive years ... We reject it in favor of the alternative hypothesis of a bias toward more active years ... only when we are able to achieve rejection of H0 at a high... level of confidence"</p> <p>In the bayesian version, a probability distribution that assumes a positive (one directional) effect on the weather is incorporated, as noted above, using Bayes theorem.</p> <p>Both methods work to show that there is a link between climate change and effect, in this modeled scenario, eventually, but the frequentist approach is very much more conservative and thus, until the process is loaded up with a lot of data, more likely to be wrong, while the bayesian approach correctly identifies the relationship and does so more efficiently.</p> <p>The authors argue that the bayesian method is more likely to accurately detect the link between cause and effect, and this is almost certainly correct.</p> <p>This is what this looks like: Frank Frequency, weather commenter on CNN says, "We can't attribute Hurricane Harvey, or really, any hurricane, to climate change until we have much more data and that may take 100 years because the average number of Atlantic hurricanes to make landfall is only about two per year."</p> <p>Barbara Bayes, weather commenter on MSNBC, says, "What we know about the physics of the atmosphere tells us to expect increased rainfall, and increased energy in storms, because of global warming, so when we see a hurricane like Harvey it is really impossible to separate out this prior knowledge when we are explaining the storms heavy rainfall and rapid strengthening. The fact that everywhere we can measure possible climate change effects on storms, the storms seem to be acting as expected under climate change, makes this link very likely."</p> <p>I hasten to add that this paper is not about hurricanes, or severe weather per se, but rather, on what statistical philosophy is better for investigating claims linking climate change and weather. I asked the paper's lead author, Michael Mann (author of <a target="_blank" href="https://www.amazon.com/gp/product/0231177860/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0231177860&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=45a25470be4c56dbed94e91ad8eb3612">The Madhouse Effect: How Climate Change Denial Is Threatening Our Planet, Destroying Our Politics, and Driving Us Crazy</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=0231177860" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" />, <a target="_blank" href="https://www.amazon.com/gp/product/0231152558/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0231152558&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=099a968ebfdc32f63298abaaa53d5d2c">The Hockey Stick and the Climate Wars: Dispatches from the Front Lines</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=0231152558" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" />, and <a target="_blank" href="https://www.amazon.com/gp/product/1465433643/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1465433643&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=a75e2ce7eaa3a6b1147ae2b40c4a40e0">Dire Predictions, 2nd Edition: Understanding Climate Change</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=1465433643" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" />), about Hurricane Harvey specifically. He told me, "As I’ve pointed out elsewhere, I’m not particularly fond of the standard detection &amp; attribution approach for an event like Hurricane Harvey for a number of reasons. First of all, the question isn’t whether or not climate change made Harvey happen, but how it modified the impacts of Harvey. For one thing, climate change-related Sea Level Rise was an important factor here, increasing the storm surge by at least half a foot." Mann recalls the approach taken by climate scientist Kevin Trenberth, who "talks about how warmer sea surface temperatures mean more moisture in the atmosphere (about 7% per degree C) and more rainfall. That’s basic physics and thermodynamics we can be quite certain of."</p> <p>The authors go a step farther, in that they argue that there is an ethical consideration at hand. In a sense, an observer or commenter can decide to become a frequentist, and even one with a penchant for very low p-values, with the purpose of writing off the effects of climate change. (They don't say that but this is a clear implication, to me.) We see this all the time, and it is in fact a common theme in the nefarious politicization of the climate change crisis.</p> <p>Or, an observer can chose to pay attention to the rather well developed priors, the science that provides several pathways linking climate change and severe weather or other effects, and then, using an appropriate statistical approach ... the one you use when you know stuff ... be more likely to make a reasonable and intelligent evaluation, and to get on to the business of finding out in more detail how, when, where, and how much each of these effects has taken hold or will take hold.</p> <p>The authors state that one "... might therefore argue that scientists should err on the side of caution and take steps to ensure that we are not underestimating climate risk and/or underestimating the human component of observed changes. Yet, as several workers have shown ...the opposite is the case in prevailing practice. Available evidence shows a tendency among climate scientists to underestimate key parameters of anthropogenic climate change, and thus, implicitly, to understate the risks related to that change"</p> <p>While I was in contact with Dr. Mann, I asked him another question. His group at Penn State makes an annual prediction of the Atlantic Hurricane Season, and of the several different such annual stabs at this problem, the PSU group tends to do pretty well. So, I asked him how this season seemed to be going, which partly requires reference to the Pacific weather pattern ENSO (El Nino etc). He told me</p> <blockquote><p>We are ENSO neutral but have very warm conditions in the main development region of the Tropcs (which is a major reason that Irma is currently intensifying so rapidly). Based on those attributes, we predicted before the start of the season (in May) that there would be between 11 and 20 storms with a best estimate of 15 named storms. We are currently near the half-way point of the Atlantic hurricane season, and with Irma have reached 9 named storms, with another potentially to form in the Gulf over the next several days. So I suspect when<br /> all is said and done, the total will be toward the upper end of our predicted range.</p></blockquote> <p>I should point out that Bayesian statistics are not new, just not as standard as one might expect, partly because, historically, this method has been hard to compute. So, frequency based methods have decades of a head start, and statistical methodology tends to evolve slowly.</p> </div> <span><a title="View user profile." href="/author/gregladen">gregladen</a></span> <span>Thu, 08/31/2017 - 14:20</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/social-sciences" hreflang="en">Social Sciences</a></div> </div> </div> Thu, 31 Aug 2017 18:20:42 +0000 gregladen 34503 at https://scienceblogs.com Harvey https://scienceblogs.com/stoat/2017/08/29/harvey <span>Harvey</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><a data-flickr-embed="true" href="https://www.flickr.com/photos/belette/36015340003/" title="DSC_6817"><img src="https://farm5.staticflickr.com/4385/36015340003_b0406cc58e_b.jpg" align="right" width="300" alt="DSC_6817" /></a> My feed, as you'd expect, is full of stuff from Houston about hurricane Harvey. A typical example is <a href="http://davidappell.blogspot.co.uk/2017/08/how-climate-change-is-making-houston.html">How Climate Change is Making the Houston Situation Worse</a>. Or Stefan's <a href="https://www.pik-potsdam.de/news/in-short/storm-harvey-impacts-worsened-due-to-global-warming">Storm Harvey: impacts likely worsened due to global warming</a>. I'm sure you can fill in any gaps.</p> <p>But also Timmy's <a href="http://www.timworstall.com/2017/08/29/its-amazing-how-few-people-harvey-has-killed/">It’s amazing how few people Harvey has killed</a>. And ~10<sup>1</sup> is indeed a very small number for a storm of this size. Of course there are many reasons: (government funded) warning systems; lots of planning; high quality infrastructure; a resilient civil society; and so on.</p> <p>So the question is: if we temporarily ignore the economic costs, and consider only the cost in human life, has GW made Harvey better or worse? I'm thinking of the (unrealisable in practice) thought experiment of Harvey as it is, compared to Harvey as the same track, but with weaker SSTs and hence a weaker storm, running over a Houston corresponding to a state in which the infrastructure was built with negligible CO2 emissions. GW, let us take as granted, made the storm stronger and pushed the rainfall up to "unprecedented"; but the CO2 used to make the infrastructure makes the deaths fewer. If we compare with analogues in <s>Bangladesh</s> India, of which <a href="http://www.cbc.ca/news/world/sri-lanka-flooding-mudslides-1.4135542">there's a recent example</a>, then I think the default case is that Harvey is having a weaker effect than it otherwise would have.</p> <p>Obviously, this is not a full analysis. You could easily choose to say "screw the <i>people</i>! What about the property damage?" and that would be a valid viewpoint. Or you could, somewhat mischievously, ask (as one of Timmy's commentators does), that given the usual death rates on Houston's roads is it possible that Harvey has actually saved lives?</p> <iframe src="https://www.facebook.com/plugins/post.php?href=https%3A%2F%2Fwww.facebook.com%2Fphoto.php%3Ffbid%3D10207372860136813%26set%3Da.1821803421937.2103582.1145738233%26type%3D3&amp;width=400" width="400" height="273" style="border:none;overflow:hidden" scrolling="no" frameborder="0" align="right" allowtransparency="true"></iframe><p>[Update: note the Graun's <a href="https://www.theguardian.com/commentisfree/2017/aug/28/climate-change-hurricane-harvey-more-deadly?CMP=share_btn_tw">It's a fact: climate change made Hurricane Harvey more deadly</a>. The headline is then, according to me, dubious. The subheadline "We can’t say that Hurricane Harvey was caused by climate change. But it was certainly worsened by it" is fine, as long as you interpret "worsened" to mean "in a meteorological sense".]</p> <h3>Notes</h3> <p>1. <a href="https://www.nytimes.com/2017/08/29/us/hurricane-harvey-storm-flooding.html">Or 30</a>.</p> <h3>Refs</h3> <p>* <a href="https://quantpalaeo.wordpress.com/2017/08/28/reconstruction-number-5/">Reconstruction number 5</a> by RT<br /> * <a href="https://www.thedailymash.co.uk/news/international/there-are-bad-factions-on-both-sides-of-this-hurricane-claims-trump-20170829134782">There are bad factions on both sides of this hurricane, claims Trump</a><br /> * <a href="https://tamino.wordpress.com/2017/08/29/hurricane-harvey-hurts-texas/">Tamino has a different perspective</a><br /> * <a href="https://scienceofdoom.com/2017/08/21/impacts-xiii-rainfall-3/">Impacts – XIII – Rainfall 3</a> by SoD, featuring Ingram (see-also <a href="https://moyhu.blogspot.co.uk/2017/08/gulf-sst-warm-before-harvey-cool-after.html">Moyhu</a>).<br /> * <a href="https://www.economist.com/news/finance-and-economics/21725009-rich-pollute-poor-suffer-climate-change-and-inequality">Climate change and inequality: The rich pollute, the poor suffer</a> - the Economist.<br /> * <a href="https://www.usatoday.com/story/tech/science/2017/08/29/hurricane-harvey-and-climate-change-there-connection/609046001/">Hurricane Harvey and climate change: Is there a connection?</a> - USA Today<br /> * <a href="http://www.news18.com/news/india/with-ten-times-the-usual-rain-mumbai-heads-towards-imminent-flood-1504367.html">With Ten Times the Usual Rain, Mumbai Heads Towards Imminent Flood</a><br /> * <a href="http://www.politico.com/magazine/story/2017/08/29/a-storm-made-in-washington-215549">How Washington Made Harvey Worse</a> - "A federal insurance program made Harvey far more costly—and Congress could have known it was coming". FEMA and so on.<br /> * <a href="http://cafehayek.com/2017/09/quotation-of-the-day-2182.html">CH on prices and "gouging"</a><br /> * <a href="http://www.independent.org/pdf/tir/tir_15_04_2_shughart.pdf">Disaster Relief as Bad<br /> Public Policy</a><br /> * <a href="http://www.bbc.co.uk/news/world-us-canada-40927487">Houston floods: Uninsured and anxious, victims return home</a> - Beeb.<br /> * <a href="https://vvattsupwiththat.blogspot.co.uk/2017/09/wrong-stuff.html">THE WRONG STUFF</a> from RS. But the trend in deaths from natural disasters is interesting.<br /> * <a href="https://public.wmo.int/en/media/news/wmo-expert-team-statement-hurricane-harvey">WMO (World Weather Research Programme) Expert Team on Climate Impacts on Tropical Cyclones statement on possible linkages between Hurricane Harvey and anthropogenic climate change</a><br /> * <a href="https://initforthegold.blogspot.co.uk/2017/09/neptunes-revenge.html">Neptune's revenge</a> by mt.</p> </div> <span><a title="View user profile." href="/author/stoat">stoat</a></span> <span>Tue, 08/29/2017 - 02:46</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/social-sciences" hreflang="en">Social Sciences</a></div> </div> </div> Tue, 29 Aug 2017 06:46:40 +0000 stoat 54002 at https://scienceblogs.com I wonder if Donald Trump even knows who this guy is. https://scienceblogs.com/gregladen/2017/08/21/dred-scott-slept-here <span>I wonder if Donald Trump even knows who this guy is.</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>One mean spirited decision intended to end the effort to end slavery led to one million dead and the end of slavery anyway. </p> <p>I spent some time this weekend comparing prosecutors and other legal eagles, who were all hoping to get the job of Attorney General. They were Candidates General, I guess. Trump was mentioned, and somewhere along the line, Dred Scott was mentioned as well. I turned to a highly placed official sort of dude and said, "Did you know that Dred Scott lived in Minnesota?" He did not know that. So I asked a couple of other people if they knew, and they did not. Finally I found the smartest person in the room and he didn't know either. </p> <p>Gee, I thought, if you want to be the Attorney General off Minnesota and you are going to invoke the name of Dred Scott, you really ought to know that he lived just a few short miles away from where you are standing there invoking!</p> <p>So I wrote this:</p> <div style="width: 230px;float:right;"><a href="/files/gregladen/files/2017/08/220px-DredScott.jpg"><img src="/files/gregladen/files/2017/08/220px-DredScott.jpg" alt="" width="220" height="312" class="size-full wp-image-24403" /></a> Dred Scott </div> <p>In 1857, US Supreme Court Justice Roger B. Taney ruled that a person who is black and of African ancestry can never be thought of as an American citizen, and therefore, has no standing to bring a law suit in federal court. In the same decision, Taney determined that a previous act of Congress that prohibited slavery in most of the territory north of a certain latitude, in land that was in the United States but not in a given state, was unconstitutional. In so doing he decided and determined that the US Congress could not prohibit slavery.</p> <p>This decision was made in response to a suit filed by a slave named Dred Scott, who lived for a while, during a very important part of his life, just south of the Twin Cities.</p> <p>Mr. Scott had been born a slave in Missouri, but later lived in various non-slave territories, as one of his owners was in the military and moved around a lot. During that time, he met and married Harriet Robinson, who was also a slave. Mr. Scott was owned by a military doctor stationed at Fort Snelling, which had been built on Lakota-Dakota land known as B'Dote (or Bdote) near what is now Bloomington Minnesota, home of the Mall of America. Ms. Robinson's owner was Lawrence Taliaferro, who was the fort's Indian Agent. Since Taliaferro was a Justice of the Peace, it was he who both gave his slave the permission to marry her fiance, and it was he who performed the ceremony.</p> <div style="width: 310px;float:right;"><a href="/files/gregladen/files/2017/08/DredScottQuartersFortSnellingMinnesota.jpg"><img src="http://scienceblogs.com/gregladen/files/2017/08/DredScottQuartersFortSnellingMinnesota-300x226.jpg" alt="" width="300" height="226" class="size-medium wp-image-24404" /></a> The basement quarters of the Scott family at Fort Snelling. </div> <p>At the time, Fort Snelling was in "Wisconsin Territory," which is why, I suspect, Minnesotans by and large don't know that Dred Scott lived here. Wisconsin Territory included parts of North and South Dakota, all of Minnesota, Wisconsin, and possibly tiny bits of adjoining lands. But if you come across a reference to Dred Scott in a history book, the word "Wisconsin" is right there, and Minnesotans think of the Green Bay Packers and move on. </p> <p>Previous legal decisions, and a certain amount of common logic sprinkled with a sense of humanity, had already determined that a slave who then lived as a free person for a while got to be a free person for the rest of their lives. Since slavery was not legal in what was to eventually become Minnesota, and other territories in which Scott lived, he had a pretty solid legal case to make that he should be freed even after his owner moved him back into a slave state at a later time.</p> <p>In order for Justice Taney to determine that Scott's case was invalid, he had to create law that made the federal abolition of slavery in all non-state territories impossible, and to make all blacks non-citizens. Taney's ruling was only the second time the Supreme Court had found an act of Congress unconstitutional, and of all the SCOTUS decisions ever made, this one had by far the greatest and most negative ultimate consequence. </p> <p>Mr. Scott's history is more complicated. There were changes in who owned him. He had tried to buy his freedom. He and his wife had children, including children born in non-slave territory. Abolitionists got involved. The Dred Scott vs. Sandford supreme court case, and all the legal events that preceded it, were major news at the time. The final result of Taney's decision sealed the fate of the United States, set back civil rights by a century and a half, and contributed materially to the violent deaths of about a million people.</p> <p>Fast forward to 1879. </p> <p>From the time of the birth of the nation, but with greater intensity staring around 1830, and getting more and more intense in subsequent decades, the United States continuously wrestled with the issue of slavery. Abraham Lincoln had always thought slavery was bad, but he was enamored with the US Constitution and could see no easy direct way to make slavery illegal country-wide. He felt it would eventually die out as a practice, through a combination of legal and social changes.</p> <p>But reducing or eliminating slavery had become an order of magnitude more difficult than it ever had to be because of Taney's Supreme Court ruling. When Abraham Lincoln was elected to be president of the United States, slave owners felt that their ownership of other humans, and their right to spread that practice to the other sates simply by moving to them (with their property, their slaves) was threatened. This threat was sufficient that they assembled armies, caused their states to separate from the Union, and attacked the US Federal government with military force. The ensuing Civil War is the reason most of the previously mentioned million people died, but many others, blacks, have been killed before, during, and after the war by white supremacists. (This includes Union soldiers who were black, who were routinely killed on the spot when taken prisoner by Southern soldiers.) </p> <p>After the war, there was a rapid and remarkable shift in society and politics in the south. Federal authority made it possible and relatively safe for southern Blacks to run for office and to vote in elections. Suddenly there were black faces in state legislatures and the US Congress. </p> <p>But at the same time organizations like the Klu Klux Klan formed, and these organizations and their supporters infiltrated local and state governments. In some cases, they set up separate governments. On election day, in some jurisdictions, there were two voting boxes, and you could pick which one to cast your ballot in. The white supremacists had their vote, everyone else had a different vote, and when the results were different, the federal government would enforce the correct vote. At times, these disputes turned into small shooting wars, and were sometimes accompanied by random slaughter of blacks living in local communities.</p> <p>Eventually the new fight over the old south fully evolved at the federal level and things got really strange. </p> <p>In 1876, the United States had its most contentious election for president ever. Democrat Samuel Tilden, a Democrat (and thus of the party of the South) from New York (and thus maybe not so much from the party of the south) won 50.9% of the vote to Rutherford B. Hayes' 47.9%. Hayes is credited with having had 185 electoral votes to Tilden's 184.</p> <p>Initially, however, the count was Tilden with 184 electoral votes, Hayes with 165, and 20 votes from that special category of votes that involved the multiple voting boxes and other shenanigans. The states with the bad votes were Florida (of course), Louisiana, and South Carolina (and there was a small problem in Oregon as well).</p> <p>Eventually, a deal was struck. This deal was almost certainly illegal and extra constitutional, but even if that wasn't the case, the deal was bad. But it is hard to say because the process and even details of the decisions made in the deal were kept secret and to this day we are not entirely sure what happened. </p> <p>Rutherford Hayes, the Republican, was awarded all the messy votes, and became president. But, in return for keeping the Presidency out of the hands of the Party of Slavery, the federal authorities that were in the South keeping the white supresists at bay were withdrawn.</p> <p>This is the beginning of the Jim Crow era, the era of terror and and harassment, hate and murder, bestowed by southern whites on southern blacks. </p> <p>OK, fast forward to 1879 but for real this time, now that you have the context. </p> <p>Slavery, a fight against slavery, Roger Taney personally ensures the continuation of slavery for a few, as well as the many, and produces the most bone-headed court decision ever, which is on the top list of three or four reasons that definitely led to the Civil War, followed by a lot of white supremacist whinging about, followed by the Jim Crow era.</p> <p>And that is when art and antiquities collector William Walters (of the Walters Museum), who had hid out in Europe during the Civil War and seems to have been involved in about zero political activities as far as I can tell, paid for the erection of a monument to Roger Taney in Baltimore.</p> <p>Go figure.</p> <p>Now, fast forward a bit farther to March 6th, 2017. That is when this happened:</p> <p><a href="/files/gregladen/files/2017/08/taneyscottreconsile.png"><img src="/files/gregladen/files/2017/08/taneyscottreconsile.png" alt="" width="585" height="359" class="aligncenter size-full wp-image-24402" /></a></p> <p>This is Charles Taney III, a great great grand whatever of Roger Taney, hugging Jynne Jackson, a great great grand whatever of Dred Scott, in front of the Taney statue. This photograph was taken at a ceremony in which Taney publicly apologized to Jackson. </p> <blockquote><p>Lynne M. Jackson winced outside the Maryland State House on Monday as she listened to Charlie Taney repeat some of the words his great-great-grand-uncle wrote in the U.S. Supreme Court’s Dred Scott decision 160 years ago.</p> <p>Black people cannot be U.S. citizens and have no rights except the ones that white people give them. Whites are superior to blacks. Slavery is legal.</p> <p>“You can’t hide from the words that [Roger Brooke] Taney wrote,” Charlie Taney said, standing a few feet from a statue of his ancestor, who lived in Maryland and was chief justice of the nation’s highest court from 1836 until his death in 1864.</p> <p>“You can’t run, you can’t hide, you can’t look away. You have to face them.”</p> <p>Then Charlie Taney turned to Jackson, the great-great granddaughter of Scott, an enslaved man who sued for his freedom. He apologized — on behalf of his family, to the Scott family and to all African Americans, for the “terrible injustice of the Dred Scott decision.”</p></blockquote> <p>And just a few short months later. during the early morning hours of August 18th, as a result of civil unrest stemming from pro-Nazi and pro-white supremacist remarks made by President Donald Trump, that Taney statue was removed:</p> <iframe width="480" height="290" scrolling="no" src="https://www.washingtonpost.com/video/c/embed/f8079592-841a-11e7-9e7a-20fa8d7a0db6" frameborder="0" webkitallowfullscreen="" mozallowfullscreen="" allowfullscreen=""></iframe><p> Many of the Southern statues related to the Civil War, or, I suppose,pro-slavery supreme court decisions, were installed at about the same time as the Taney sculpture. The motivation behind the Taney statue, and possibly, who was really behind it, are an enigma, but in many cases, statues or monuments were erected by local governments under pressure (from within or elsewhere) by organizations like the KKK or other post war white supremacist groups and individuals. These statues were put up after the election of 1876 and the start of the Jim Crow era and their erection was very much part of that social movement.</p> <p>A second wave of statue building and memorializing of things Southern happened during the 20th century Civil Rights Era. At this time, many schools were named after southern notables.</p> <p>So at the start of Jim Crow, blacks living in southern cities were served up a reminder of their place in southern society. During the Civil Rights Era, black students were served up a reminder of their place in southern society, during the period of forced integration of schools.</p> <p>No wonder so many northerners require southerns to prove that they are not a) assholes or b) stupid before giving them a break. Considering that our least racists and overall best presidents have come from the South, and Donald Trump comes from Queens, New York, northerners should give southerners more of a break. But we can do that while at the same time noting that there are a lot of people in this country that don't deserve anyone's respect because of their hateful views.</p> <p>Meanwhile, in Bloomington, MN, you can find a memorial to Dred Scott, as well as a Dred Scott miniature golf course, a playground, and a car repair place.</p> <p>I'd tell you what the plaques in Bloomington say, but I can't find the text. I will visit the park soon and report back, it is not too far from me.</p> <p>Meanwhile, if you live in or near the Twin Cities, get over to Fort Snelling and visit the place where Harriet and Dred lived. There is some interpretive history there, and the rest of the historic site is pretty interesting too.</p> <p><a target="_blank" href="https://www.amazon.com/gp/product/0195145887/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0195145887&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=9deba30c98be40302b8f8b6c8d79dbd9">The Dred Scott Case: Its Significance in American Law and Politics</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=0195145887" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" /></p> <p><a target="_blank" href="https://www.amazon.com/gp/product/1595552650/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1595552650&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=5bc74136f0c72cc3679d14d3a2a58afa">Dred Scott's Revenge: A Legal History of Race and Freedom in America</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=1595552650" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" /></p> <p><a target="_blank" href="https://www.amazon.com/gp/product/0312115946/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0312115946&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=e6c27fc6accd5d24388855db56712957">Dred Scott v. Sandford: A Brief History with Documents (Bedford Series in History &amp; Culture)</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=0312115946" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" /></p> <p><a target="_blank" href="https://www.amazon.com/gp/product/0873514831/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0873514831&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=a252f9df95c68411a84912e9fe8a0dd7">Dred and Harriet Scott: A Family's Struggle for Freedom</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=0873514831" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" /></p> <p><a target="_blank" href="https://www.amazon.com/gp/product/1481427482/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1481427482&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=fb2eea779603940a7bc1b09547667fa1">I, Dred Scott: A Fictional Slave Narrative Based on the Life and Legal Precedent of Dred Scott</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=1481427482" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" /></p> <p><a target="_blank" href="https://www.amazon.com/gp/product/1935546007/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=1935546007&amp;linkCode=as2&amp;tag=grlasbl0a-20&amp;linkId=a5eb5954638e433d89d02629309444ff">Am I Not A Man? The Dred Scott Story</a><img src="//ir-na.amazon-adsystem.com/e/ir?t=grlasbl0a-20&amp;l=am2&amp;o=1&amp;a=1935546007" width="1" height="1" border="0" alt="" style="border:none !important; margin:0px !important;" /></p> </div> <span><a title="View user profile." href="/author/gregladen">gregladen</a></span> <span>Mon, 08/21/2017 - 13:43</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/social-sciences" hreflang="en">Social Sciences</a></div> </div> </div> Mon, 21 Aug 2017 17:43:44 +0000 gregladen 34485 at https://scienceblogs.com Contamination requiring ritual purification: Superstitious concepts at the heart of antivaccine beliefs https://scienceblogs.com/insolence/2017/08/10/contamination-requiring-ritual-purification-superstitious-concepts-at-the-heart-of-antivaccine-beliefs <span>Contamination requiring ritual purification: Superstitious concepts at the heart of antivaccine beliefs</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>Over the years, I've frequently contemplated just where many of the ideas that underlie alternative medicine in general come from. Certainly, I'm not the first to have thought of this by any stretch of the imagination, but over the last 13 years, I've become convinced that it is a fear of bodily "contamination" that harks back to ideas found in many religions. Think about it. Where does the fear of "toxins" in vaccines come from? Vaccines are portrayed as "foreign," as something "unnatural" that is "injected right into the bloodstream." Never mind that vaccines are not injected directly into the bloodstream. To the antivaxer, there is no difference between an intramuscular and intravenous injections because to them both are equally "contaminating." It's also not a coincidence that many of the treatments for "vaccine-induced autism" or any other condition falsely attributed to vaccines are represented as "detoxification." They are basically purges, to purge the "evil humors" that antivaxers believe vaccines to be packed full of. It's not for nothing that I've not infrequently described alternative medicine "detoxification" as being akin to ritual purification of the sort found in many different religions.</p> <p>Sometimes, antivaxers even help to make my case for me. For instance, here's antivaxer and all-around supporter of everything quacky, John Rappoport, declaring the <a href="http://www.greenmedinfo.com/blog/occult-archetype-called-vaccination" rel="nofollow">The Occult Archetype Called Vaccination</a>. Here, Rappoport claims to examine the "archetypes and symbols" that surround vaccination and to him "give it occult power." My first reaction was: Projection, thy name is antivaxer. You know he's off the rails from the very beginning when he begins with a claim that vaccination was begun as a "crude version of homeopathy." Here's a hint. Variolation predated homeopathy by 75 years, and other investigators had tested vaccination with cowpox to protect against smallpox a couple of decades before Samuel Hahnemann dreamt up the sympathetic magic that is homeopathy. Even Jenner's work was roughly contemporaneous with Hahnemann's first descriptions of homeopathy in the late 1790s. Homeopaths (and quacks like Rappoport) love to claim that vaccination was somehow an imitation of homeopathy (or, these days) that homeopathic nosodes are the equivalent of vaccination because of homeopathy's "law" of "like cures like."</p> <!--more--><p>Then we get to the "meat" (if you can call it that) of Rappoport's comparison:</p> <blockquote><p> Today, as a revival of ancient symbology, vaccination is a conferred seal, a sign of moral righteousness. It’s a mark on the arm, signifying tribal inclusion. No tribe member is left out. Inclusion by vaccination protects against invisible spirits (viruses).</p> <p>The notion of the tribe is enforced by dire predictions of pandemics: the spirits of other tribes (from previously unknown hot zones in jungles) are attacking the good tribe, our tribe.</p> <p>Mothers, the keepers of the children, are given a way to celebrate their esteemed, symbolic, animal role as “lionesses”: confer the seal on their offspring through vaccination. Protect the future of the tribe. Speak out and defame and curse the mothers who don’t vaccinate their children. Excommunicate them from the tribe. </p></blockquote> <p>Or it could just be that they understand that herd immunity is important and that unvaccinated children can serve as vectors for disease outbreaks.</p> <p>There's also a rather amazing extension of normal antivaccine arguments in which Rappoport claims that the child is "more than the offspring of the parents" and is now the "property of the village" You might remember how often I point out that the invocation of "parental rights" by antivaxers often assumes that children are the property of the parents. Indeed, I <a href="http://scienceblogs.com/insolence/2017/02/22/in-the-age-of-donald-trump-vaccine-policy-is-becoming-politicized-with-potentially-deadly-consequences/">often quote Rand Paul</a>, who, referring to the "right" of parents not to vaccinate their children, once said, "The state doesn’t own the children. Parents own the children, and it is an issue of freedom.” Now get a load of what Rappoport says:</p> <blockquote><p> The ceremony of vaccination is a rite of passage for the child. He/she is now more than the offspring of the parents. The child is in the village. The child is property of the village. As the years pass, periodic booster shots reconfirm this status. </p></blockquote> <p>See what I mean? The only difference between this remark and Rand Paul's objection to vaccination is that Rappoport substitutes the "village" for the "government" referred to by Paul.</p> <p>Now here's where Rappoport really lets you know that I'm right about their viewing vaccination as contamination by the way he describes what he perceives to be the mystical aspect of vaccination:</p> <blockquote><p> Some ancient rituals presented dangers. The child, on his way to becoming a man, would be sent out to live alone in the forest for a brief period and survive. Vaccination symbolizes this in a passive way: the injection of disease-viruses which might be harmful are transmuted into protective spirits in the body. The injection of toxic chemicals is a passageway into immunity. If a child is damaged in the process, the parents and the tribe consider it a tragic but acceptable risk, because on the whole the tribe and the village are protected against the evil spirits (viruses).</p> <p>The psychological and occult and archetypal impact of vaccination is key: modern parents are given the opportunity to feel, on a subconscious level, a return to older times, when life was more bracing and immediate and vital. That is the mythology. Modern life, for basic consumers, has fewer dimensions—but vaccination awakens sleeping memories of an age when ritual and ceremony were essential to the future of the group. No one would defect from these moments. Refusal was unthinkable. Survival was All. The mandate was powerful. On a deep level, parents today can experience that power. It is satisfying. </p></blockquote> <p>There is no doubt that there is a feeling of satisfaction that vaccinating one's children can bring. It is indeed the feeling of protecting one's offspring against diseases that might threaten their lives. It has little to do with the "mandate" of the "tribe" or anything else like that. What's interesting is that Rappoport tries to dismiss the societal mandate to vaccinate as though it were nothing more than some ancient tribal ritual transplanted into modern society. I think that's very telling. He can't explain vaccine mandates any other way than as ritual. He also represents vaccination as some sort of dangerous process that might damage the child, when in fact it is very, very safe, with serious adverse reactions exceedingly rare.</p> <p>Then there is the religious aspect. Note the language: "Injection of the disease-virus." This is a very clear reference to the "contamination" that I was talking about. Indeed, this choice of phrasing is very common in antivaccine circles, where vaccines are often referred to as "injecting disease matter," which is technically true but phrased to make it sound as scary as possible.</p> <p>And, of course, who is at the center of this "mystic ritual"? You guessed it. It's the physician, who is portrayed by Rappoport as a shaman:</p> <blockquote><p> The doctor giving the injections is, of course, the priest of the tribe, the medicine man, the holder of secrets. He is the spiritual source of, and connection to, “unseen realms” where opposing spirits carry out warfare and struggle for supremacy. Without the medicine man, the tribe would disintegrate.</p> <p>The medicine man is permitted to say and do anything. He can tell lies if lies serve a noble purpose and effect greater strength of the tribe. He can manipulate language and truth and meaning. He can turn day into night. He can present paradox and contradiction. No one can question his pronouncements.</p> <p>Loyalty to the medicine man is absolute. In this regard, a rebel is exiled or destroyed. </p></blockquote> <p>Methinks that Mr. Rappoport vastly overestimates the power that physicians have in society. Oddly enough, what he is describing seems to be an extreme version of medical paternalism that was common 70 years ago but hasn't been a part of medicine for decades. There is much projection here, as well. In fact, the real shaman/healer/medicine man tends to be the alternative medicine practitioners and the antivaccine doctor-"heros" like Andrew Wakefield whom antivaxers do basically idolize much like the description of medicine men above. Indeed, I've <a href="http://scienceblogs.com/insolence/2012/08/22/quackademic-medicine-versus-cancer-quackery/">explained in depth</a> why the appeal of this sort of unscientific medicine, part of which includes antivaccine beliefs, is the <a href="http://scienceblogs.com/insolence/2015/03/09/integrative-medicine-the-lure-of-the-healer-companion/">appeal of the shaman</a>, a view that Dr. Mehmet Oz, of all people, appears to support without realizing it.</p> <p>The sort of thinking that Rappoport is attributing to those advocating vaccination is in actuality much more characteristic of believers in alterntive medicine in general and the antivaccine movement and their quacks in particular.They are the unquestioned, shaman-healer so common in so many societies in pre-scientific times. Bringing us back to the religious aspect of "contamination" that I started out with, as I've pointed out time and time again, in ancient Egypt, physicians were also priests; both functions, physician and priest, were one, which made sense given how little effective medicine there was. Praying to the gods for patients to get better was in most cases as good as anything those ancient physicians could do. All of this is of a piece with the antivaccine view of vaccines as "contamination" that makes the child "unclean" such that he must be ritually purified with "detoxification."</p> <p>I sometimes like to reference the <em>über</em>-quack and <em>über</em>-scammer Mike Adams, because he goes so over the top that he often illustrates my points for me, albeit in a sort of <em>reductio ad absurdum</em> manner. A couple of days ago, <a href="http://scienceblogs.com/insolence/2017/08/08/dumb-and-dumber-kent-heckenlively-and-mike-adams-team-up-to-support-an-antivaccine-whitehouse-gov-petition/">he was claiming that Facebook</a> was "censoring" Natural News. Today he's claiming that is "<a href="https://web.archive.org/web/20170809080657/http://www.naturalnews.com/2017-08-09-facebook-declares-war-on-children-censors-independent-science-that-tries-to-protect-infants-from-medical-harm.html" rel="nofollow">declaring war on children</a>" by "censoring him." I must admit that in this rant Adams outdoes himself in pure looniness, but inadvertently he helps make some of my points for me, again largely by projection.</p> <p>For instance, to him vaccination goes beyond mere "contamination" and becomes both violation (as in rape) and contamination with something even more unspeakable than "toxins" or "disease matter":</p> <blockquote><p> Mark Zuckerberg isn’t accused of raping little children with his biology, but he controls the social media network that openly espouses the medical violation of childrens’ bodies with toxic injections — a form of “medical rape” that obscenely violates the American Medical Association’s medical ethics when mandated by coercive government (as has already happened in California with SB 277).</p> <p>Further adding to the horrifying truth of what Zuckerberg and Facebook are really up to, many vaccines given to children in America today are made from the ground-up, homogenized, disease-inoculated organs of aborted black babies. These “human embryonic lung cell cultures” are openly listed as chicken pox vaccine ingredients by the CDC and vaccine manufacturers, all of whom also openly admit that vaccines are made from diseased animal organs such as African Green Monkey kidney cells. (MMR vaccines are also made from the tissue of aborted human babies.) </p></blockquote> <p>I will give Mikey credit for one thing. I've heard and debunked the claims that vaccines are made from the "tissue of aborted babies" (dude, cells isolated from a fetus in the 1960s and maintained in culture over 50 years are <a href="http://scienceblogs.com/insolence/2017/03/07/how-aborted-fetal-cells-in-vaccines-saved-lives/">not the same thing as "tissue from aborted human babies"</a>) and many others, including the fear mongering about African Green Monkeys. I've also <a href="http://scienceblogs.com/insolence/2014/09/30/anti-vaccine-not-pro-safe-vaccine-vaccination-described-as-rape/">dealt with the vile simile that likens vaccination to rape</a>. However, I've never heard the claim that vaccines are made from the "ground-up, homogenized, disease-inoculated organs of aborted black babies." I did some Googling and was unable to find the origin of that incredible (and false) claim. Seriously, Mikey. Now you're just making shit up even more than usual.</p> <p>Now, as ridden with hyperbole this is, it is far too close to normal, common antivaccine claims to be Mike Adams. So, naturally, Adams has to ramp the stupid and outrage up to 11 and beyond by likening vaccination to ritualistic child sacrifice and cannibalism:</p> <blockquote><p> Today, Mark Zuckerberg and Facebook demand the <strong>ritualistic sacrifice of children to the “vaccine gods”</strong> as a way to appease their globalist controllers. Just like in the era of the Maya, children are especially prized for their innocence which is violated by puncturing the skin and <strong>injecting the child with foreign DNA extracted from other children sacrificed at abortion centers</strong>.</p> <p>Quite literally, the dead children are liquefied and “fed” to other children, many of whom are maimed or killed by the toxic intervention (yes, this is how vaccines are manufactured). This is all carried out in the name of “science,” just as the Maya high priests carried out their sacrifices in the name of “cosmic powers.”</p> <p>What few people have recognized yet is that in the realm of globalist power, <strong>the sacrifice of children is always required for an ascending globalist to “prove” their commitment to the cause</strong>. Zuckerberg, you see, wants to become a “high priest” of the modern technocracy which is founded in a scientific dictatorship, medical tyranny and the power of the coercive state. The ritualistic sacrifice of children is a necessary component of those ascensions to power. </p></blockquote> <p>I had to read that passage three times because I couldn't believe what I had just read, Yes, Adams really wrote it. So let me get this straight. Dead children are somehow "liquified" and "fed" to other children, thus both contaminating them in such a way that "violates" their innocence, presumably both because it is (to Adams) like rape and because it also somehow "contaminates" them. Again, projection is the key here. This is how hard core antivaxers think.</p> <p>Lest you think that Adams is so over-the-top, that Natural News is a wretched hive of scum and quackery so much scummier and quackier than all the other wretched hives of scum and quackery that it can be ignored, let's take a look at another article, over at Megan Heimer's wretched hive of scum and antivaccine quackery, entitled <a href="http://www.livingwhole.org/what-you-didnt-know-about-the-aborted-baby-parts-in-your-vaccines/" rel="nofollow">What You Didn’t Know About the Aborted Baby Parts in Your Vaccines</a>:</p> <blockquote><p> You might have also heard that only two babies were used and it was a really long time ago, which justifies the continued use of shooting up live babies with dead babies. This just simply isn’t true and if you think it is, watch one of the many Planned Parenthood videos. These people are harvesting baby parts for a reason.</p> <p>Aborted baby is supposedly some sort of magic that makes vaccines more effective (albeit safely untested and could contribute to conditions like autism and cancer). </p></blockquote> <p>No, the only people invoking "magic," "ritual," "contamination," and "purification" with respect to vaccine components are people like Mike Adams, John Rappoport, and Megan Heimer. That's because so much of the antivaccine belief system is rooted in ancient superstitious and religious concepts, the most prominent aspect of which are contamination and ritual purification. Sometimes they even throw violation (rape) in there for good measure. Basically, to many antivaxers vaccines are like fluoride in Dr. Strangelove. They sap and contaminate your precious bodily fluids, but they'll go even beyond that. They'll <a href="http://scienceblogs.com/insolence/2012/03/14/beware-vaccines-will-sap-and-impurity-yo/">contaminate you so much that they corrupt your DNA</a>. I wish I were exaggerating about these beliefs, but I'm not.</p> </div> <span><a title="View user profile." href="/author/oracknows">oracknows</a></span> <span>Wed, 08/09/2017 - 21:00</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/social-sciences" hreflang="en">Social Sciences</a></div> </div> </div> Thu, 10 Aug 2017 01:00:59 +0000 oracknows 22602 at https://scienceblogs.com