A closely watched anti-terrorism case came to a close in London last week. In it, British prosecutors charged that 8 British Muslims had planned to disguise liquid explosives as soft drinks, smuggle them onto 7 airliners, and detonate them while the planes flew from London to North America.

The evidence included bomb making equipment, flight schedules on memory sticks, martyrdom videos and a tape of the conspirators at a safe house. But ringleader Abdulla Ahmed Ali claimed his group planned to carry out a lesser stunt, perhaps detonating small devices at harmless locations, perhaps at Heathrow airport.

The jury didn’t believe Ali, but they couldn’t be sure what he was up to. They convicted 3 men of conspiracy to “murder persons unknown,” a lesser charge. They could not reach a verdict on 4 others and acquitted the last one, who was alleged to have been an advisor from al-Qaeda.

In picking up the pieces, some noted that the case was processed per routine through the British criminal justice system. To them, the disappointing result proves that prosecuting the war on terror requires extra-legal processes such as military tribunals and changed rules regarding pre-trial detention periods and rights to privacy and council.

To others, the British police had moved in too quickly. Had they waited a bit longer, they would have had purchased airline tickets and completed bombs-in short, better evidence.

Google insists it’s not a monopoly. Sometimes it just can’t help acting like one.

Just ask Dan Savage who started sourcetool.com, a B2B web site in 2005. Sourcetool is a directory of industrial products distributors. It adds value to conventional search by ranking distributors in dimensions Mr. Savage believes are important.

Mr. Savage’s business relies fundamentally on Google. He pays Google to place ads for Sourcetool at the top of search pages generated by terms like “crankshaft.” For people that follow Google’s path to Sourcetool in search of crankshafts, Mr. Savage pays Google AdSense to place targeted ads on his site.

Initially, things went well. Mr. Savage generated revenues of $650K/month. He paid Google $500K/month for the ads and after other expenses, he cleared $115K/month.

Then one day Sourcetool’s traffic went pffffft.

Savage’s ads had stopped appearing on Google. When he asked why, Google replied that it had updated its search algorithms and the new ones determined that Sourcetool’s landing page quality was low. As a result, Google increased the minimum required bid for Sourcetool ads from 6 cents to at least $1. The new minimum bid exceeded Mr. Savage’s limit, so Sourcetool’s ads vanished.

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A study published in the Annals of Emergency Medicine found that the majority of patients who are discharged from emergency rooms leave with little understanding of what happened to them in the ER and what they are supposed to do to take care of themselves after returning home.

Investigators tracked 140 patients discharged from the ERs of two Michigan hospitals to determine whether they understood their diagnosis, treatment, home-care instructions and a list of signs which signified the need for immediate follow-up.

78% of the patients did not understand of at least one of these four areas, and half didn’t understand at least two of them.

The biggest problem was home-care instructions, things like when and how to take medications, activity limitations, wound care and the need for follow-up.

The communication breakdown often caused medication errors and complications necessitating return trips to the ER and even hospital admission.

ERs are a set-up for poor doctor-patient communication. Physicians are busy with multiple patients including some who are quite ill, and patients are distressed by the condition prompting their visit.

Experts suggest two strategies to reduce these errors. The first is a teach-back method in which a patient, ideally while accompanied by a friend or relative, repeats instructions to the physician. The second is a dual-discharge method in which a nurse follows up with patients after physicians discharge them.

In Pune, India this summer a judge relied on evidence from a brain scan to convict a woman, Aditi Sharma, of murder. Sharma insists she is innocent.

The controversial machine is named the Brain Electrical Oscillations Signature test or BEOS. It was developed by Champadi Mukundan, the former Chief of Clinical Psychology at Bangalore’s National Institute of Mental Health.

BEOS is based on preliminary observations by several American scientists including J. Peter Rosenfeld, a psychologist at Northwestern, yet Rosenfeld was quick to denounce the verdict. “Technologies which are neither seriously peer-reviewed nor independently replicated are not…credible,” he said. “The fact that an advanced, sophisticated democratic society…would …convict persons based on unproven technology is…incredible.”

Apparently, BEOS software interprets patterns derived from a conventional electroencephalogram (EEG) recorded while the suspect listens to details of the crime she supposedly committed. Mukundan asserts that certain areas of the brain respond when experiences are relived, and that BEOS can differentiate between memories of witnessed events and memories of deeds they committed.

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In his 1962 treatise The Structure of Scientific Revolutions, Thomas Kuhn introduced the term “paradigm shift” to describe an abrupt breakthrough in science theory that jump-starts a whole new platform of inquiry, one that could not be envisioned using the older paradigm.

Einstein’s Theory of Relativity was a paradigm shift. So was the discovery in the 19th century that many diseases are caused by bacteria.

Now come whispers of a potential paradigm shift in cancer biology that may speed work towards curing the scourge in its many forms.

The theory is that cancers arise from stem cells.  It hadn’t even been appreciated until recently that all human tissue contained stem cells.

The new theory turns the prevailing model of tumorogenesis upside down. Cancer had been thought to result from mutations in fully differentiated cells such as epithelial cells of the bronchi or neurons in the brain. The new theory means it might possible to develop stem cell targeted treatments which might be more effective and less toxic than those developed under the current paradigm.

The cancer stem cell hypothesis has been the focus of many recent scientific studies. It is the cover story in this week’s Economist.

The FDA has banned imports of 28 drugs manufactured by Ranbaxy Laboratories after it discovered quality issues at two manufacturing facilities. Ranbaxy is one of world’s largest generic drug manufacturers. Its corporate offices are in Gurgaon, India.

The FDA has found no evidence that consumers have been harmed and views its move to be preventative in nature. In particular, FDA tests revealed no evidence of contamination, incorrect potency or unsafe ingredients in drugs produced at offending facilities.

The FDA instituted the prohibition after finding ineffective sterilization procedures, inadequate protections against contamination from allergy-causing ingredients, and incomplete records at the plants.

The FDA can inspect facilities of companies that export products to the US, but it has no regulatory control over them. All it can do is prohibit companies from exporting to the US.

The FDA has been hassling Ranbaxy about its production processes since 2006. Ranbaxy has addressed many but not all issues that the FDA had raised.

The prohibited drugs include those for diabetes, high cholesterol, allergies, acne and high blood pressure. The only drug not produced by other generic manufacturers is ganciclovir. This medication will be allowed into the US after careful inspection and additional assurances from Ranbaxy.

Ranbaxy’s response to the ban is here.

Adm. Mike Mullin, the chairman of the Joint Chiefs of Staff arrived in Pakistan on Tuesday for hastily arranged briefings regarding an incursion September 3 by US commandos based in Afghanistan.

Pakistani military leaders declared recently that they would attack all foreign forces that crossed the border and threatened the country’s sovereignty.

The US is frustrated by Pakistan’s ambivalence regarding Taliban and al Qaeda militants that use its territory as a safe haven for attacks on US and NATO forces in Afghanistan. Until recently, US forces used airstrikes, artillery attacks and Predator drone attacks to deal with insurgents that had fallen back into Pakistan, so the US commando raids into Pakistan represent a change in strategy. Apparently, President Bush gave the go-ahead for commando attacks in July without notifying anyone in the Pakistani military or government.

The US embassy in Pakistan requested that Mullin come in person to discuss matters with Prime Minister Yousaf Raza Gilani and the nation’s top military commander, Gen. Ashfaq Parvez Kayani.

Recently we described how the US health system increasingly relies on foreign medical students to address manpower shortages in general internal medicine. Foreign nurses are streaming into the US for the same reasons, but sometimes things work out unfairly for them.

The US has experienced a nursing shortage for at least the last 15 years. Some predict we will have only 2/3 of the nurses we need to deliver care in 2020. The shortage has prompted 17% of US hospitals to recruit foreign staff, and more than 300 nurse recruiting agencies are out there to help. In 2004, 4% of our RNs were educated abroad; the number is higher now.

But foreign nurses have experienced a gamut of problems in the US: they are posted to jobs below their skill levels, end up working for providers other than the ones they signed contracts with, and occasionally they get unreasonably low salaries.

Now, a coalition of health providers has promulgated a code of ethics designed to shield foreign nurses from unfair employment practices in the US. The voluntary code summarizes relevant employment laws and suggests training and support for these nurses. The code is meant to be used by prospective US employers who might not know what rights foreign nurses have.

Already this year we’ve seen meltdowns in the housing and mortgage markets, skyrocketing foreclosure rates, the collapse of major investment banks and federal bailouts of Fannie Mae, Freddie Mac and AIG. And it’s only September!

Into these headwinds, John McCain spits “the fundamentals of our economy are strong!” It seems everybody but Top Gun knows what happens when you spit into the wind.

The crises have devastated millions of US households. 86% of those polled by ABC News last week said the economy was “not good.” GDP growth, anemic as it has been, is artificially propped by last spring’s one-time fiscal stimulus.

Now, unemployment is starting to accelerate. There are worrisome declines in retail and automotive sales, and there’s more debt out there than people can count.

Maybe Top Gun means we won’t crash and burn like the Great Depression? That’s true because modern economic shock absorbers do work. The recent surge in commodity prices helped US mining and agriculture interests, for example. The weakening dollar contributed to a hike in exports. Now these trends have faded and inflation worries have faded with them.

Maybe we’re not headed towards Great Depression II, but it’s time for some real Straight Talk from McCain: if current policies continue, we’re looking at years of little or no growth at best.

A study published in today’s American Journal of Psychiatry concludes that when it comes to treating schizophrenia in children, older, less expensive antipsychotic drugs are just as effective as the new ones and they don’t cause certain side effects.

Investigators carried out a multicenter, double-blinded, randomized trial of 119 youth with psychotic symptoms. The children received either Zyprexa (Eli Lilly), Risperdal (Janssen) or molindone, an older drug. The primary outcome was response to treatment at 8 weeks as judged using standard assessment tools.

They saw improvement in 34% of the Zyprexa group, 46% of the Risperdal group, and 50% of the molindone group. These differences were not significant.

Importantly, youths receiving the new drugs experienced marked weight gain-13 pounds in the Zyprexa group and 9 pounds in the Risperdal group. The Zyprexa group also had increased total cholesterol, LDL (bad) cholesterol, and liver enzymes. These changes were not seen in the molindone group, although as expected many of them experienced disordered movement.

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