This week, the Senate will bicker over health reform, EHR vendors will continue their anxious wait for government agencies to release Meaningful Use criteria on which their financial viability depends, people  will continue arguing whether middle-aged women should get mammograms, and world leaders from 100 countries will convene in Copenhagen to hammer out a new agreement that prevents or at least slows down global warming.

There’s not much doubt which issue will have the most impact on the health of US citizens, at least those who are around 50-100 years from now.

In 1997, the global family of nations released a document known as the Kyoto protocol. Its goal was to reduce worldwide greenhouse gas emissions to levels 5.2% below those produced in 1990 by year-end, 2012.

Since then, 187 countries have signed the document, including China, Russia, India and every country in Europe. But Uncle Sam, the source of nearly one-third of the world’s carbon emissions, never did. 

In the absence of leadership from the world’s biggest offender, global carbon-dioxide emissions rose 33% since the treaty was signed.

That’s despite the ready availability of cheap, low-carbon technologies which can be deployed in both developed and developing nations. Electricity can be produced by wind and solar plants, hydropower and nuclear fission, and cars and trucks can run on electricity and biofuels.

Views on the matter of climate change are as divergent as can be. Some are convinced that life on the planet hangs in the balance: we must reach an accord in Copenhagen and make it stick in major offending countries like the US…or else. Others think the global warming is unrelated to human activity and is likely to self-correct in a century or two.

Nobody really knows whether global warming is man-made or how bad it will get, so it’s no wonder that it’s been hard to persuade people to spend money on a fix. It’s the mother of all externalities.

Yet as The Economist points out, this uncertainty is precisely why man needs to tackle global warming, now. If we knew that temperatures would rise by just a few degrees in the next century, then the argument to let things go would seem somewhat reasonable.

But the Intergovernmental Panel on Climate Change (IPCC), which was organized by the UN to develop evidence-based consensus on the matter, and which used every shred of evidence it could find, could do no better than give a range. It concluded that if things are left as they are, by the end of this century the average temperature on planet Earth will rise somewhere between 2-11ºF.

No sane person can argue that temperature elevations near the top end of this estimate would be anything less than catastrophic. More than a billion people would be displaced by coastal flooding, and at least that many would be severely affected by associated climate change.

But there’s some good news. Assuming humans approach the problem smartly (as discussed for example, here), the costs of averting that kind of catastrophe are not nearly as great as many think…about 1% of the world’s global economic output for the next several years.

On average, US homeowners spend about that percentage of their income insuring their homes. Heck, just last year, the world spent 5% of total global output bailing out the banking system.

The technology to control global warming is here. Global warming is a problem with unknown but potentially catastrophic consequences that can be averted with no worse than mild economic consequences. How could we not do this?

In 1924, the National Research Council dispatched 2 engineers to study the effects of shop-floor lighting on productivity at the Hawthorne Plant, a telephone-parts factory near Chicago.

Their observations led to an unexpected, but soon-to-be widely accepted principle of management science. The “Hawthorne Effect” posits that being observed, whether by a scientist or a supervisor, changes peoples’ behavior.

The phenomenon was derived from the engineers’ accounts of their experiments, in which they observed that the output of workers on an assembly line increased when lighting was raised in the factory, but also when it was lowered.

The worker’s behavior improved, it appeared, when they realized they were being watched.

Many had questioned the validity of those conclusions, and the original data was thought to have been lost.

Recently however, University of Chicago economists Steven Levitt and John List discovered the data and decided to reanalyze them using new econometric techniques.

The pair concluded that worker productivity at the Hawthorne plant did not change in response to lighting alterations at the plant, and that the engineers’ incorrect interpretation resulted from an epiphenomenon they had not accounted for.

The engineers, it turns out, always adjusted plant lighting on Sundays, when the plant was closed. Monday’s worker output was indeed greater than Saturday’s, but that was true even for weeks in which no adjustment was made to the lighting on Sundays.

Levitt and List concluded that workers just worked harder on Mondays.

Similarly, the engineers had noted that plant output fell after their experiment ended, which supported their conclusion. But they ceased experimentation during the summer. The economists found that similar summer drop-offs occurred in the years before and after the engineers ran their trials.

It does get hot in Chicago in the summer, after all.

Several conditions associated with aging, such as atherosclerotic blockages of the arteries and cataracts can be treated nowadays, but for osteoarthritis, a condition that affects millions in this country alone, little can be done save the administration of anti-inflammatory agents and pain relievers.

Osteoarthritis of the knees can be particularly unfortunate since afflicted individuals typically cut down their physical activity in response, and this can exacerbate or cause other health conditions like diabetes. 

A cure does not appear imminent, but a new technique developed by Lior Shamir and colleagues at the NIH might just be able to predict who will get the condition 20 years prior to symptom onset.

This would be good since people found to be at risk could be encouraged to lose weight, exercise properly, and alter their diet to ward off the onset of the painful condition.

Shamir’s group digitized 200 x-rays that were taken in the 1980s for a project designed to document human aging. All radiographs had been read as normal at the time.

Since the images were obtained, many of these people developed osteoarthritis of the knees.

The researchers sorted the original x-rays into 2 groups: one group included “normal” pictures from the people that eventually developed osteoarthritis while the other had pictures from people that did not.

The researchers then looked for subtle structural alterations of the bone and cartilage in both groups of x-rays.

From the inter-group differences they detected, they built a computer algorithm designed to predict which individuals would eventually develop osteoarthritis and which would not.

Their algorithm proved to be accurate 72% of the time, an astonishing finding considering that the x-rays had originally been read as normal and that they were obtained 20 years before symptom onset.

The write-up is in Osteoarthritis and Cartilage.

Most of us are no longer surprised to learn that people from politicians to priests lie and cheat. Scientists do too. Take for example, the notorious case of Hwang Woo-Suk, who claimed to have cloned human embryonic stem cells, a lie so spectacular it was sure to be exposed with time.

But low-level fudging is harder to detect: the subtraction of a data point to enhance the appearance of a graph or to render results statistically significant, for example, or Photoshopping a jpeg to enhance a key feature.

Daniele Fanelli of the University of Edinburgh decided to quantify the pervasiveness of minor fraud among scientists, and concluded it is more common than most would have suspected.

Fanelli reviewed 18 published surveys of the matter. He found that only 2% of scientists confessed to outright fraud (such has modifying data to improve study results) at least once in their careers.

But nearly 10% fessed-up to dicey practices like “dropping data points based on a gut feeling” or “failing to present data that contradict one’s previous research.”

And survey participants proved more willing to point fingers at their colleagues than at themselves. Fully 14% of them said they’d seen colleagues falsify or fabricate data.

When the question was phrased in general terms like carrying-out experiments using substandard techniques or misrepresenting data, 46% of those queried said they saw their colleagues engaged in such misconduct.

Surprisingly, survey responders chose to intervene only half the time when they witnessed the shenanigans.

Come to think of it, the findings of Gregor Mendel, generally considered to be the father of modern genetics, were impossibly accurate given what we now know of his methods.

Fanelli’s write-up appears in the Public Library of Science.

Beginning with Norman Vincent Peale’s 1952 classic, “The Power of Positive Thinking”, self-help experts have implored those with low self-esteem to recite positive statements about themselves in an attempt to change their outlook.

Now, research by Joanne Wood of the University of Waterloo suggests such recommendations may be counterproductive.

Psychologists know that people tend to accept input that is consistent with their own views and reject discordant input. For example, a person who believes she is outgoing and who is told she is will accept that input, but loners will reject it. 

Wood‘s team designed experiments to see whether this phenomenon applied to the advice of Peale and his deciples. They surveyed 68 people using accepted methods for the measurement of self-esteem, and then asked them to jot down their current thoughts and feelings.

During this process, half the participants were told to repeat to themselves “I am a lovable person” each time they were prompted by a bell.

Following that experience, participants were asked questions like, “what is the probability that a 30-year-old will be involved in a happy, loving romance?” Wood’s team measured the participants’ responses on a 35-point scale in which higher numbers reflected happy moods.

Among participants with high self-esteem, those who repeated “I’m a lovable person” posted an average score of 31, while those who did not repeat the phrase posted an average of 25.

However, participants with low self-esteem who made the statement averaged a dismal 10, while those who did not repeat the mantra managed a more respectable 17.

Wood concluded that the dissonant self-statements exacerbate negative moods in those with low self-esteem. And since many readers of self-help books suffer from low self-esteem, their advice  may be worse than useless.

The write-up is in Psychological Science.

Asthma is common in first world nations, unheard of in the developing world and rising quickly in countries making the transition.

Many theories have been posited to explain this association. They range from the idea that clean living somehow revs-up the immune system to a belief that swimming pool chemicals bring on the allergy-mediated condition.

The common denominator is that environmentally mediated phenomena associated with economic development are directly triggering asthma.

Shadmehr Demehri and colleagues at Washington University in St. Louis have postulated an indirect link, in which environmental factors trigger eczema, a benign though annoying skin condition, and the distressed skin cells create chemical signals that in turn trigger asthma. 

Eczema is also linked to economic development. Nearly 17% of US children have it, and nearly 70% of children with eczema develop asthma, even though the prevalence of the letter condition in the general population is only 4-8%.

Demehri’s team believes the culprit is thymic stromal lymphopoietin (TSLP), an immune-stimulating molecule released by skin cells when they are damaged, as by eczema. TSLP, they theorize, causes lung tissue to over-react to allergens, which leads to asthma.

The team wrote-up the results of 3 experiments in the Public Library of Science Biology that provide support for its hypothesis.

First, the scientists showed that mice genetically engineered to develop eczema were prone to develop asthma. Then they deleted the gene coding for the TSLP receptor in the bronchial tissue of such mice and voila, the new editions did not develop asthma.

In the third step, the scientists created mice that over-produced TSLP in the absence of skin problems. These mice wheezed up the wazoo.

Case closed, at least in mice. Eczema is easily treated, by the way, with low-dose topical steroids.

Everyone knows that bathroom mirrors fog up during a hot shower. To evaporate the mist for its privileged guests, some top-end hotels put heating coils behind the mirrors.

But humid conditions can cloud-up eyeglasses or camera lenses by the same mechanism, and there has heretofore been no way to fix the problem short of a smudge-producing wipe.

And the same problem can become dangerous when a car’s windshield is affected, especially for those who don’t understand that the AC needs to be on in order to solve that problem.

When warm, humid air contacts a relatively cold glass surface, water vapor will condense on the glass. The condensate consists of billions of water droplets that diffract light.

Various sprays and chemical alterations have largely failed to solve the annoyance, but now a Chinese team may have figured it out once and for all.

Junhui He and colleagues from Beijing’s Chinese Academy of Sciences have created an anti-mist coating made of nanoparticles that can be applied to windshields at a cost of a few cents per item.

He’s team recognized that certain nanoparticles, applied just so, effectively break the surface tension of the water droplets when they try to form. The result is a transparent film of water that does not scatter light.

After experimenting with various shapes and chemicals, He’s team determined that oxygen-treated, silicone-covered polystyrene spheres shaped like raspberries were most effective in this regard.

The team plans to commercialize the process immediately.

In December, 1997, goats, cattle and sheep began dropping dead in north-eastern Kenya. A month later people began doing the same. The cause was Rift Valley fever. Nearly 100,000 animals died and as many humans were infected. Hundreds of people died.

Exactly ten years later, livestock once again began dying off in the same area, but the outbreak was largely avoided in humans because NASA scientists had tipped off the Kenyans before things got nasty.

Acting on the news, Kenyan officials distributed mosquito nets and told folks to stop eating their livestock. The 2007 outbreak killed 300 people, but the number would have been twice that or more without the head’s up.

The warning resulted from the research of Kenneth Linthicum, of the US Department of Agriculture, who used data derived from satellites to predict the outbreak. 

Linthicum and his colleagues noticed in retrospect that the first outbreak was preceded by a rise of one degree Fahrenheit in the surface temperatures of the Indian Ocean near the east coast of Africa.

That had triggered monsoon rains and cloudy, warm weather over the Horn of Africa, which caused explosive growth in the mosquito population. Linthicum’s team saw the same thing happening in September, 2007.

Heretofore, efforts to predict epidemics relied on slow, expensive fieldwork. Satellite data is cheaper to obtain. It includes information about precipitation, temperature, vegetation cover and chlorophyll production.

Confirming the value of satellite-derived information, Jacques-André Ndione of Dakar’s Centre de Suivi Ecologique cites a satellite study showing that malaria spreads more quickly in suburbs than in cities.

In that study, satellite images revealed that suburbs have more ponds and puddles, and that their longevity, salinity and mud content tended to favor mosquito happy times.

Incidentally, the EDEN project, a public-health cooperative involving European and African countries, has used satellite findings to conclude that malaria, dengue fever and Rift Valley fever will soon enter Europe.

Indeed, chikungunya, a mosquito-borne viral disease previously found only in tropical Africa and Asia, has recently shown up in Italy and Albania. A sign of things to come, maybe?

Research suggests that violent video games promote aggressive thoughts, and probably, violence itself. The thing is, not all video games are violent. In fact some actually reward socially constructive behavior like sharing things or saving the planet.

Could these so-called “pro-social” video games foster salutary behavior in players?

Two recent studies suggest the answer might be yes.

In the first, Iowa State’s Douglas Gentile, a noted video-game researcher, and his colleagues asked 161 students to play one of 6 games for 20 minutes. Some were assigned Ty2 or Crash Twinsanity, which feature wall-to-wall violence.

Others were told to play Chibi-Rob!, in which players help video characters with chores, or Super Mario Sunshine, in which participants erase graffiti and eliminate pollution. A control group got to play neutral maze games like Pure Pinball and Super Monkey Ball Deluxe.

After the session, the scientists asked participants to select from a smorgasbord of easy, medium and hard puzzles that a partner would complete, and told them the partner would receive a gift upon their successful completion.

Students assigned to the pro-social games were more likely to select easy puzzles for the partner, while those assigned violent games selected the more difficult puzzles.

In the second experiment, Tobias Greitemeyer and colleagues from the University of Sussex asked 46 students to play either Lemmings, a pro-social game, or Tetris, a neutral control.

After the session, the scientists asked students to complete story lines such as what happens after a driver nearly collides with a bicyclist. Lemmings players proposed endings characterized by fewer aggressive thoughts, responses and actions than Tetris players.

Alas, the medium is rarely the message. Both write-ups will be published in the Journal of Experimental Social Psychology.

Electricity powered cars not only run cleaner than their gasoline powered ancestors, they also run more quietly.

For inhabitants of noise-polluted cities, this might seem like a positive but there is growing concern that pedestrians and cyclists can’t hear the cool-running vehicles, thus increasing the risk of accidents. 

That’s why many believe it’s time to trick-out electric and hybrid cars with external sound systems.

In fact Congress is considering a bill that would establish minimum sound levels for non-gasoline powered vehicles so that the visually impaired and pedestrians can hear them approach. The European Commission is pondering a similar proposal.

What kind of sounds should electricity powered vehicles make? Perhaps they could beep as do some pedestrian crossings, or buzz like a power tool.

The work of Laurence Rosenblum and colleagues at UC California Riverside has convinced them otherwise. “People want cars to sound like cars,” he told the Economist. The sound needn’t be loud; just a slight enhancement of the current noise would suffice to improve safety substantially, he added.

Such external sound systems are already in the works. Lotus Engineering, for example, recently inked a deal with audio system maker Harman Becker to produce one. Their system also produces internal sounds that change with speed and use of the throttle, providing audible feedback to drivers.

This means carmakers will soon be able to create sounds that help with brand promotion. Drivers might someday even be able to select from a menu of engine sounds, perhaps downloading them like ringtones.

The Fisker Karma, for example, will be outfitted with a sound generator when the luxury electric hybrid goes into production late this year. It will be up to Fisker to decide how, exactly, a luxury electric vehicle should sound.

Last fall, Google’s philanthropic division released Flu Trends, a tool that purportedly predicts regional influenza outbreaks 7-10 days faster than traditional methods. The bio-surveillance tool relies on the fact that people use Google to search flu-related terms well before calling their physicians.

Now, a study of similar methodologies appears to show that the Mountain View-based company’s omnipotence extends to the prediction of economic trends as well.

Hal Varian, an economics professor at UC Berkeley who moonlights as Google’s chief economist, and  Hyunyoung Choi, a Google employee tested the hypothesis that variations in search frequency for certain phrases improves the accuracy of econometric models used to forecast retail and home sales, among other things.

Such data are available to the public through Google Trends, which enables interested parties to access reports on search volumes for particular categories and terms. The reports are updated daily.

The scientists found that addition of such information improves the predictive value of the standard models used to forecast car and truck sales by 18%.

Similarly, search volume on terms like Hong Kong and other ports of call carried out in Australia, India, the UK and the US can foretell bumps in tourist volume to these locations.

The tool still needs refining, however. The scientists showed for example that searches for real estate agents are better predictors of future home sales than those for home financing.

Virtually every nation on Earth struggles with endemic poverty.

Children of the poor are at greater risk for underachieving as adults regardless of the system of government where they live and the quantity and quality of both social services and educational systems available to them.

The problem has been poorly understood until, perhaps, now.

Three years ago, Martha Farah at the University of Pennsylvania demonstrated that the working memories of kids raised in poverty are smaller than those of middle-class children.

Working memory is the capacity to hang on to bits of information for current use; the items on a small shopping list, for example. It is required for solving problems and understanding language, and serves as a gateway to permanent memory.

Now, Cornell University’s Gary Evans and Michelle Schamberg have reported that Farah’s findings are almost certainly caused by the adverse effects of stress on brain development in children.

The scientists examined results from a longitudinal study of 195 participants of both sexes.

They assessed stress using a measure known as the allostatic load which combines the values of 6 parameters: systolic and diastolic blood pressure, serum levels of 3 stress-related hormones, and the BMI.

In all cases, higher values indicate more a more stressful life, and indeed poor kids had higher values than those in the middle class for all 6. (more…)

From a Filipino marimba prodigy to a hyper-precise British carpenter to Kim Peek, the person with an eidetic memory whose character was portrayed by Dustin Hoffman in Rain Man, stories of gifted people who have developmental disabilities have created buzz for decades.

Now scientists are beginning to understand the link, and have begun to speculate how the new information might apply to “neurotypicals.”

King’s College scientist Patricia Howlin for example, will soon post a paper in Philosophical Transactions of the Royal Society suggesting that up to 30% of autistic people possess some kind of savant-like ability in areas like computation and music.

And Francesca Happe will contribute a piece suggesting that the genius may derive from RBBIs, restrictive and repetitive behaviors that are a sine qua non of the autistic spectrum.

Obsessive interests and behaviors, Happe speculates, enable afflicted individuals to practice, even if inadvertently, the skill they have become obsessed with.

Malcolm Gladwell wouldn’t disagree.

In his new book, “Outliers,” the popular author cites research suggesting that many people can achieve greatness at something if they’re willing to practice it for oh, say, 10,000 hours.

According to the line of reasoning, this would be cake for many autistic individuals, whereas their neurotypical counterparts would long since have given up due to boredom.

To build her case, Happé refers to a twin study that found childhood talent in art and music to be associated with RRBIs, even in people that do not meet classical criteria for autism.

As Happe explained to the Economist, “the child with autism who would happily spend hours spinning coins, or watching drops of water fall from his fingers, might be considered a connoisseur, seeing minute differences between events that others regard as pure repetition.”

When scientists showed that images of nearly nude females triggered alterations in cerebral blood flow and certain behaviors that were not entirely under the conscious control of males, some just shrugged.

What could be more obvious?

But the link between conscious and unconscious thought remains a hot topic among neurobiologists, even when sexual desire is not involved.

Joydeep Bhattacharya of Goldsmiths’ College in London and Bhavin Sheth of the University of Houston recently demonstrated that insight itself, the eureka moment when one reaches a breakthrough solution to a problem, is generated unconsciously before one becomes aware she’s solved it.  

The remarkable findings appear in the Journal of Cognitive Neuroscience.

The scientists affixed electroencephalographs to 18 adults and then challenged them with a brain-teaser that required just such a flash of insight to solve.

The problem was that there are 3 light switches on the ground-floor of a house, 2 of which do nothing while the third controls a light bulb on the second floor. The bulb is off at the start. Determine which switch is operational while making only one trip to the second floor.

Each EEG-wired subject was given 90 seconds to solve the puzzle, at which point a hint was provided. The hint was to turn one switch on for a good while before turning it off.

Some subjects solved it, some did not. What was interesting though was data from the EEG could be used to differentiate the insightful few from the rest of us.

Only the former exhibited increased gamma wave activity in the right frontal cortex.

And the knock-your-socks off corollary was that the gamma wave activity was observed up to eight seconds before the subject had the “aha!” moment.  (more…)

Hillarycare was already on the ropes in ’93 when Big Insurance landed a haymaker in the form of Harry and Louise, a TV commercial series featuring 2 everyday Americans scared sleepless that health reform meant government meddling and bloated bureaucracy. 

Now, the Big O claims we can’t tame deficits without a health care do-over and HHS nominee Kathleen Sebelius adds that 40% of recent home foreclosures are related to financial stress caused by uninsured health expenses, so it would be vexing indeed if Big insurance scuppered reform yet again.

At first it seemed to be on board, floating constructive proposals and even manning up for the Big O’s morning teas.

But recently, things have turned frosty.

Big Insurance has warned it will oppose any plan involving a government-sponsored insurer that competes against the privates, a cornerstone of several reform proposals, including those of Speaker Nancy Pelosi and Sebelius herself.

And don’t look now but Big Insurance may secure providers as allies on the matter.

Mayo Clinic boss Denis Cortese is on record for example, with concerns that a public insurer would underpay providers, as Medicare has done to Mayo, according to Cortese, to the tune of $840 million in the last year alone.

Meanwhile, Harvard health economist Regina Herzlinger has pointed out that the apparent cost advantages of a government run program are in part an artifact of accounting trickery.

The Feds don’t have to set aside funds to meet future obligations like Big Insurance does, she told the Economist. “The government does not have the $36 trillion needed to finance the services it has promised to those who pay for Medicare.”

Last year, JAMA editor Catherine DeAngelis received the Catcher in the Rye humanitarian prize “because of her leadership on discussions of conflicts of interest in medicine.”

This year she’s knee-deep in shmutz regarding JAMA’s questionable handling of just such a matter.

The dust-up began last spring when JAMA published a study of methods to prevent depression in stroke patients. In the study, Robert Robinson and a team from the University of Iowa compared counseling, antidepressant therapy with Lexapro, and a placebo.

Robinson heaped praise on the pharmaceutical intervention following publication of his study.

 “Every stroke patient who can tolerate an antidepressant should be given one,” he told USA Today.

The study had shown that both counseling and Lexapro outperformed placebo, but there wasn’t a whit of difference between the 2 treatment groups.

Robinson acknowledged that in a letter to JAMA last fall.

Robinson’s letter prompted Lincoln Memorial University professor Jonathan Leo to sleuth around a bit.

He discovered that Robinson had accepted speaker’s fees from Forest Laboratories, the maker of Lexapro, and had not disclosed this.

Leo notified JAMA. The journal said it would investigate, but according to Leo, 5 months passed and nothing happened. That’s when he and a colleague published the discovery in a letter to the British Medical Journal.

Three nanoseconds later according to Leo, DeAngelis phoned Leo and his dean threatening to cut off Leo’s work from the light of JAMA’s day forever.

DeAngelis denies this.

Robinson has since admitted receiving speakers’ fees from Forest Laboratories “in 2004 and perhaps 2005.” He apologized in a letter to JAMA citing “errors of memory.”

The same day, JAMA published an accompanying erratum.

It appears that JAMA intended to publish these latter 2 items even if Leo’s letter hadn’t been posted in BMJ days before.

The AMA has asked a journal oversight committee to investigate.