Showing posts with label medicine. Show all posts
Showing posts with label medicine. Show all posts

Monday, October 7, 2019

Understanding Medical Practices

If you ever received a consent form mere hours or minutes before a hospital procedure, you can imagine how confused the mother was when she received a form asking her to agree to let one of her unborn twins participate in Dr. He Jiankui's gene-editing experiment. Relying on information learned from Dr. Michael Deem, his U.S. Ph.D. mentor, Dr. He used the CRISPR-Cas9 technique to disable the gene that enables HIV to enter a cell by attaching itself to a protein.

     Medical professionals cannot be expected to write informed consent forms lay people can understand. Communication experts in the countries where forms are used need to choose the best ways to translate modern medical research and procedures and to pilot test forms before they are used.

     Since drugs produced in one country are used and sold at different prices throughout the world, they have the potential to be weaponized by overpricing them for, or withholding them from, enemy countries.

     Other practices also require attention. Some countries and companies offer financial rewards for stealing intellectual property.
The FBI is investigating Yu Zhou for making millions by forming a company based on a discovery he made while using U.S. government grants and performing research owned by Ohio's National Children;s Hospital while he worked in a lab there for ten years.

     In a major example of "ethics dumping," the practice of performing a medical procedure in another country that is banned at home, China's health ministry prevented Italian neurosurgeon, Dr. Sergio Canavero, from attaching the head of a paralyzed patient to the body of a deceased donor in China.

     When a doctor suggests a child take a prescribed drug or undergo a procedure, does the child's parent or guardian truly understand the side effects and alternatives? Modern medicine is not only costly; it is complicated. Busy adults often lack time to obtain a second opinion, ask a pharmacist if there is a lower cost generic, analyze internet opinions, or subscribe to and read a newsletter from a medical research center. At the very least, a relationship with a child's doctor and specialists needs to feel comfortable enough to ask questions and follow-up questions to make answers clear. As soon as children are old enough, involve
them in the questioning. They want to know if a needle or the dentist will hurt and how long they will be in the hospital or have to wear a cast or braces.

      Teachers, scouting groups, boys and girls clubs, etc. might look for opportunities to assign reports on subjects, such as gene editing, bioethics, using drones to deliver drugs in Africa, hair growth products, vaccines, and vaping. Also, see if the Red Cross, nursing organizations, emergency medical services, local hospitals, or other medical associations have outreach programs that provide speakers and tours.

     Students always ask how what they are supposed to learn is relevant. Everywhere in the world learning about health is relevant.





Monday, March 4, 2019

Advice for Political Candidates

While a name may indicate a person's individualistic inheritance, it fails to disclose everything people want to know about each other. In the case of political candidates, voters want to know that the politicians they elect will correct the problems that matter most to them.

     In his new book, How Behavior Spreads: The Science of Complex Contagions, Damon Centola, a sociologist at the University of Pennsylvania, explains how changing complex behavior, such as changing a medical system or reducing the effects of climate change, requires multiple contacts reinforcing the same message over and over.

     Individual social media comments on Facebook, for example, can spread a bit of information, such as a job opening, easily and quickly. But it takes more than a march or rally to facilitate complex changes. It takes supporting messages, how-to instructions, and, maybe, competitive motivation from trusted friends, commentators, organizations, and symbols, like a donkey or elephant. Complex changes require effort; they involve physical risk, social ridicule, prayer, an investment of time and money.

     Believing social media has the power to make complex changes is a mistake. Convincing and mobilizing a multitude to take the actions needed to overcome inertia takes hard work. The American Revolution, forming labor unions, cleaning up the Great Lakes, and discovering and distributing a polio cure took more than a one-off Tweet. 

Friday, January 4, 2019

What Happens After Wars?

 Wise decision making does not need data from another war. Human history already has enough data about the positive and negative results of wars to make additional surveys unnecessary. Marathon runners race 26 miles in the Olympics, because the Greeks defeated the Persians in 490 B.C. But no battle is responsible for Olympic figure skating.

     Clearly, wars have resulted in: disarmament, unemployed military personnel and weapon designers and manufacturers, collective security, land grabs and new borders, displaced populations, inflation, economic collapse, new financing for rebuilding, foreign aid, competing ideologies, independence and self determination for ethnic populations, release of prisoners, and medical advances. The question is: could positive outcomes from wars be achieved without bloodshed?

     Students attend Model UN meetings to discuss current world problems, and each year the Foreign Policy Association (fpa.org) prepares a Great Decisions Briefing Book and DVD to guide group discussions and provide topics for student essays. There also could be summits where students decide what wartime achievements could be gained without wars. (In 2019, the Great Decisions' discussion topics include: nuclear negotiations, cyberwarfare, U.S.-China trade and U.S.-Mexican relations, regional conflict in the Middle East, refugees/migration, European populism.)

     The challenge is to find out how similar subjects have been handled successfully after past wars. Has there ever been a way to incorporate a country's former rebel and military leaders into a productive government? Or could the Kurds who now live in Iraq, Turkey, and Syria break away peacefully and form their own country the way the Czech Republic (Czechia in English) and Slovakia did? Instead, as U.S. troops began pulling out of Syria, President Trump has called on Turkey's government, which is responsible for harsh treatment of its Kurds, to protect the Kurds the U.S. troops fought with in Syria, a questionable idea.

   

Saturday, May 26, 2018

Travel Tip Reminders

Even though airlines are allowed to offer short times to make connections with different flights, travel experts recommend allowing  two hours between domestic flight connections and three hours to make connections with international flights.

A US friend who broke a foot in Spain found out Medicare does not cover medical expenses outside the US.

Since poachers use social media photo tags to locate rare animals, safari travelers are advised to disable geotag functions on smartphones.

Might be a good idea to discourage a culture of begging by not handing out cash or goods while on vacation.

On a trip to a park where wild animals run free, stay in vehicles. Don't get out to take pictures like one visitor who was saved from attack when a friend called out to tell her a bear was approaching.

Be aware of surroundings when taking all photos. On trips, I've seen someone back up without noticing he was getting too close to the edge of a cliff, a giant wave knock down and swamp a couple, and a child about to step off a board walk into a volcano's flowing lava.

Saturday, October 7, 2017

Time to Make Futuristic Travel Plans

Travel by air land, and water is being reimagined these days. Tesla is the well-known stock market darling of driverless cars, and Elon Musk also promises travel from Los Angeles to San Francisco in 30 minutes in his frictionless train. Later, on February 6, 2018, Musk successfully launched his
 SpaceX rocket to signal what could be the beginning of commercial space travel. Richard Branson also is in the commercial space travel mix with his plans to take us to Mars.

     We've heard about Amazon using drones to deliver our e-commerce orders. But, when it comes to delivering supplies in a medical emergency, drones can be life savers if they fly over traffic congestion, take the most direct route over lakes and hills, and avoid washed-out and impassable roads to reach rural areas. Yet, there are still challenges of battery life, bad weather, and urban neighbors disturbed by the oncoming buzzing sound.

     Matternet of California, Mercedes-Benz vans, and the Swiss firm Siroop are partners in a pilot project, approved by Switzerland's aviation authority, in which a drone successfully returned lab samples to the roof of a waiting van that delivered them to a hospital in heavily-populated Zurich, Switzerland. E-commerce firms could follow a similar procedure using UPS or other trucking services for the last leg in the delivery process.

     In Norway, Yara is investing in crewless, electric container ships that are expected to cost three times as much as conventional models but offer an operational savings of up to 90% over the costs of fuel and crews on comparable cargo ships. Since travel on autonomous ships in international waters could take until at least 2020 to gain approval by the International Maritime Organization, you're likely to be traveling on an autonomous ferry first.

   

Saturday, July 29, 2017

Your Rattlesnake Bite Might Not Kill You

Millions of years ago all rattlesnakes had venom that could poison blood, damage muscles, and attack nervous systems. No more. Researchers funded by Maryland's Howard Hughes Medical Institute and the National Institutes of Health (NIH) found that evolution caused rattlesnakes to specialize to deal with prey, such as the mongoose, that grew resistant to certain venom. Rattlesnakes began to inherit only the genes for the one or two toxins they needed.

     Mojave rattlesnakes only kept their power to cripple a nervous system. Eastern and Western Diamondbacks didn't, but they still can harm blood vessels and muscles.

     Once researchers see how a rattlesnake's toxin controls blood pressure, by blood coagulation or platelet formation for example, they might be able to use this information about physiology to reduce hypertension. Clues such as this can improve patient health and, yes, lead to a million dollar drug payoff.

     You can never predict where basic research will lead.
   

   

       

Sunday, June 25, 2017

Blind Trust in AI Is a Mistake

For better or worse, combining algorithms with images collected by drones, satellites, and video feeds from other monitors enhances aerial intelligence in a variety of fields.

     Overhead movie and TV shots already provide a different perspective, just as viewing the Earth or a rocket launch from a space craft or satellite does. These new perspectives offer advantages besides entertainment value and a chance to study the dwindling ice cap at the North Pole.

     Seen from above, data about landscapes has various applications. The famous Texas Gulf Sulphur Company case involving insider trading began with aerial geophysical surveys in eastern Canada. When pilots in planes scanning the ground saw the needles in their instruments going wild, they could pinpoint the possible location of electrically conductive sulphide deposits containing zinc and copper along with sulphur.

     When Argentina invaded Britain's Falkland Islands in April, 1982, it's been reported the only map the defenders possessed showed perfect picnic spots. Planes took to the air to locate the landing spot that enabled British troops to declare victory at Port Stanley in June, 1982.

     Nowadays, the aim is to write algorithms that look for certain activities among millions of images. A robber can program an algorithm to tell a drone's  camera to identify where delivery trucks leave packages. An algorithm can call attention to a large group of people and cars arriving at a North Korean missile testing site. Then, an analyst can figure out why, because, to date, artificial intelligence (AI) does not explain how and why it reaches a conclusion.

     Since artificial intelligence's algorithms operate in their own "black boxes," humans are unable to evaluate the process used to arrive at conclusions. Humans cannot replicate AI processes independently. And if an algorithm makes a mistake, AI provides no clues to the reasoning that went astray.

     In other words, robots without supervision can take actions based on conclusions dictated by faulty algorithms. An early attempt to treat patients based on a "machine model" provides a good example. Doctors treating pneumonia patients who also have asthma admit them to the hospital immediately, but the machine readout said to send them home. The "machine" saw pneumonia/asthma patients in the hospital recovered quickly and decided they had no reason to be admitted in the first place. The "machine" did not have the information that their rapid recovery occurred, because they were admitted to the hospital's intensive care unit.

     Google's top artificial intelligence expert, John Giannandrea, speaking at a conference on the relationship between humans and AI, emphasized the effect of bias in algorithms. Not only does it affect the news and ads social media allows us to see, but he also echoed the idea that AI bias can determine the kind of medical treatment a person receives and, based on AI's predictions about the likelihood of a convict committing future offenses, it can affect a judge's decision regarding parole.

     Joy Buolamwini's Algorithmic Justice League found facial-analysis software was prone to making mistakes recognizing the female gender, especially of darker-skinned women. AI is developed by and often tested primarily on light-skinned men, but recognition technology, for example, is promoted for hiring, policing, and military applications involving diverse populations. Since facial recognition screening fails to provide clear identifications of some populations, it also has the potential to be used to identify non-white suspects and to discriminate against hiring non-white employees.

     When humans know they are dealing with imperfect information, whether they are playing poker, treating cancer, choosing a stock, catching a criminal, or waging war, how can they have confidence in authorizing and repeating a "black box" solution that requires blind trust? Who would take moral and legal responsibility for a mistake. The human who authorized action based on AI, wrote the algorithm, or determined the data base the algorithm used to determine its conclusion? And then there is the question of the moral and legal responsibility for a robot that malfunctions while it is carrying out  the "right" conclusion.

     Research is trying to determine what elements are necessary to help AI reach the best conclusions. Statistics can't always be trusted. Numbers that show terrorists are Muslims or repeat criminals are African Americans do nothing to suggest how an individual Muslim or African American should be screened or treated.  AI research is further complicated by findings that also suggest the mind/intellect and will that control moral values and actions are separate from the physical brain that controls other human activities and diseases such as epilepsy and Parkinson's.

     Automated solutions require new safeguards: to defend against hacking that alters information, to eliminate bias,  to verify accuracy by checking multiple sources, and to determine accountability and responsibility for actions.


Thursday, June 22, 2017

Career Choices for an Automated Future

At the end of the day, have any of us thought about the immutable function of nature, i.e. light waves, used to measure distance or why democratic governments recognize their obligation to protect the civil liberties, the rights of their citizens, but Communist governments don't.

     Robots with artificial intelligence might as well take our jobs, if we lack the humility to recognize we don't have all the answers and have no curiosity, no love of learning, no desire to read a book, and no willingness to risk the failure of trying something new.

     Five  thinkers present alternative approaches to future employment.

Personal Touch

Being able to relate, person to person, on an emotional level could be the winning skill for some future careers in fields such as medicine, police work, and religion. What needs are people satisfying, when they check their smartphones, a mirror, or the mole on their arm over and over every day? Are they concerned about social issues outside themselves, life changing measures that offer hope and motivation, reduced anxiety, or a functional benefit that provides more money?

     How much does a patient want to know about her or his condition? the risks of treatment options? how long it will be before treatment provides a better quality of life? Some 81-year-olds will arrive at a doctor's office having done extensive internet research about their ailments and ready to take any risks for the possibility of improving their lives, even if costly pills, twice weekly therapy sessions, and monthly doctor's visits will continue for the rest of their lives. Some won't.

     Eric Mack, who wrote an article for inc.com, suggests students have opportunities in careers that enable them to do what robots can't: deliver personalized service, diagnose and solve non-routine problems, and enter into a collaborative give and take with others. At Big Think (Nov. 13, 2016), Micho Kaku said robots can't match the creativity and imagination needed by gardeners, scientists, and those who write rock and toll tunes. Amazon, Netflix, and Spotify try to pick the books, movies/TV shows, and music you'd choose for yourself and Facebook thinks it can select only the news and ads you want to see, but maybe you or a person who knows you personally can provide even better suggestions.

.
 Cottage Industries

Jack Ma, founder and executive chairman of Alibaba, China's family of Amazon-like e-commerce businesses, expects small companies to use the internet to find customers and sell their products throughout the world. He suggests schools need to prepare students to analyze customer data. To operate on the world stage, he fails to mention a small business owner also needs to understand foreign currencies, laws, and languages. New importers and exporters could benefit from an organization similar to the Food Enterprise & Economic Development (FEED) Kitchen in Madison, Wisconsin. This nonprofit incubator for would-be entrepreneurs in the food industry helps obtain necessary permits; provides kitchen, refrigerator, freezer, dry storage, and dish washing space; and serves as a drop-off point for deliveries.

     Microsoft's co-founder, Bill Gates, echoes Ma's emphasis on the need for educational systems to prepare students to base conclusions on statistical analysis. Where Ma's focus is on consumer data, Gates' is on data related to the spread of disease. He stresses the importance of science, engineering, and economics and equipping students to understand what those in these fields can and cannot do.

     Think about the book and movie, The Big Short, which entertained and explained the financial concepts of the 2008 housing crash. How can entrepreneurs and small businesses in the arts earn a living on the world stage?

Leader/Servant

David Eli Lilienthal, the director and chairman of the government-owned Tennessee Valley Authority that brought electric power to a region not served by private corporations, made a fortune by taking chances in private business after he left the public sector. In the journals, actually loose-leaf notebooks, he began writing when he was a high school student, we learn he found the business life full of creative original minds, but he also found solving management problems was not enough. He missed the gratification of public service until he found a way to combine it with private enterprise in the big, new company he started. He found he could make a profit by helping foreign countries develop their resources for the benefit of their citizens.

In Conclusion

There you have it, advice to offer personal service, start a small business, or found/work for a major corporation that makes big profits from projects that improve the world. Your choice. As Ma believes, "machines will never get the wisdom and experience that comes from being human."

Monday, December 19, 2016

Changing Technologies Become Laughing Matter

Although those on the cutting edge of rapidly changing medical, industrial, and military technologies recognize the need to involve the public in a discussion about how to limit irresponsible applications, I tried to tell a joke that fell flat because those hearing it were unfamiliar with CRISPR.

The joke goes like this. A CRISPR scientist, Trump, a school child, and the Pope were on a damaged airplane that had only three parachutes. The CRISPR scientist, who I later explained was experimenting with the ability to edit cells to produce better crops and possibly to improve the immune properties of genes to cure cancer and other diseases, said she was about to make an important medical breakthrough that would save lives and grabbed one of the parachutes. Trump, who said he was the smartest man in the world and was needed to lead it, also jumped out. The Pope told the student to take the remaining parachute, because he had lived a long productive life and the child had his whole life ahead of him. The student said, "No worries, the smartest man in the world just took my backpack."

If for no other reason, we need to keep up with changing technologies in order to laugh at jokes. There are lots of other reasons, too. Wendell Wallach, in his book, A Dangerous Master, introduces everyone to the challenges of the new technologies and ways to make sure they work for us. (Also see the earlier post, "The Challenge of New Technologies: Prepare to Think.")

Friday, December 9, 2016

Change: How to do it

Whether it's trying to open borders for refugees, to urge professional societies to develop guidelines for new medical technologies, or to train a cat to stop chewing the furniture, some of the principles marketers use when introducing a new product can be helpful, especially when making New Year's resolutions.

1. The new has to have many advantages over the old. You'll be able to wear more attractive clothes and live longer, if you eat better and move more.

2. Demonstrate the advantages of the new. Show how a cat with a new scratching post will prefer that to chewing the furniture.

3. The new is easy to use. Professional medical societies already exist and have conferences and meetings already scheduled, where guidelines and standards can be discussed and codified.

4. Minimize risks.
     a) Financial risk. No refugee can enter a country unless he/she proves a home and job are waiting.
     b) Physical risk. Driving with seat belts, getting enough sleep, and not texting will save your life. How will consumers feel about driverless cars?
     c) Psychological risk: No one will laugh at you for studying or working out, if you do it without any of your friends or relatives seeing you. It's also wise not to tell anyone you've made the decision to start your own business, join the priesthood, become a police officer, etc.

Saturday, April 4, 2015

Global Search for New Antibiotics

Throughout the world, as many as 700,000 people die from drug-resistant infections each year. Since so-called superbugs have become resistant to the antibiotics that have cured cholera, pneumonia, tuberculosis, and other infections from bacteria since the 1940s, there is a two-pronged approach: 1) to reduce the overuse of antibiotics which reduce their effectiveness and 2) to find new antibiotics.

     Antibiotics can be overused unless hospitals monitor the incidence of antibiotic-resistant cases, pharmacists supervise use of antibiotics, and patients are not tested to see if their infections are bacterial or viral. On viruses, antibiotics are useless. Even when infections are caused by bacteria, conventional oral antibiotics, such as penicillin, need to be tried first to cure staph skin infections, C diff bacteria infections in the gut, bronchial infections, and urinary tract infections. Other treatments, such as more expensive daily shots and IV hookups in the hospital, need to be used sparingly and held back as a last line of defense.

     Since overuse of antibiotics contributes to their resistance, the antibiotics farmers use add to this overuse by humans through the food they eat. Because farmers have been using antibiotics as a way to stimulate faster growth of livestock and to prevent disease on factory farms where overcrowding spreads illnesses, under the Preservation of Antibiotics for Medical Treatment Act, proposed federal legislation would regulate antibiotic use on factory farms. A dozen or so manufacturers that produce antibiotics for livestock already have voluntarily agreed to change the directions on their labels to stipulate use for medicinal purposes not artificial growth.

      Once new FDA guidelines are implemented by January, 2017, a licensed veterinarian will have to supervise the use of antibiotics in livestock feed and water to treat and prevent disease and to promote growth. Since treatment of some diseases in cattle and dairy cows now requires low-level feeding of antibiotics, farmers and veterinarians are working to keep animals healthy with improved sanitation and nutrition as well as new vaccines. Pear and apple growers who spray trees to prevent bacterial blight infections also are looking for alternatives to the antibiotics now in use.

     Agricultural use of antibiotics, estimated to be 70% of all antibiotic use, has begun to cost farmers money. Denmark's ban on growth promoting animal antibiotics prevents beef imports from countries still using them. Since consumers are demanding meat and poultry free of routine antibiotic use, suppliers, such as Perdue, have stopped their use. While McDonald's plans to serve only antibiotic-free chicken in the US by the summer of 2017, consumers in other countries will not have this guarantee. Nowhere are McDonald's consumers guaranteed antibiotic free beef or pork.

     Since patients take antibiotics only for a short time, pharmaceutical companies have a greater incentive to develop other drugs rather than new antibiotics to replace the older ones that have lost their effectiveness. To stimulate research for new antibiotics, the National Institutes of Health's Center of Excellence for Translational Research (CETR) has put a $16 million grant behind the effort. When soil studies no longer uncovered new antibiotic microbes, researchers found new sources among ants, plants, and sponges in Florida, Brazil, Puerto Rico, and Hawaii. For example, the microbes in the milky white bacteria that cover some ants produce antibiotic compounds that fight different causes of infection. In the lab, scientists look for compounds with chemical structures that are different from known ones. Genomic sequencing of bacteria also helps determine whether they contain antibiotic-producing microbes. Using CETR grant money, a team of investigators headed by Dr. David Andes, chief of the division of infectious diseases at the University of Wisconsin Hospital, and Cameron Currie, a University of Wisconsin bacteriology professor, have found 15 potential new antibiotics.

     On a side note, the following are three games that teach how viruses spread:
Pandemic is a tabletop game for four players who experience success and failure as they work together to stop the spread of diseases.
Plague, Inc. is an app game where players can see graphs of how lethal contagions are considering health care systems in various countries and global travel.
Pox: Save the People is a board game that uses blue vaccinated and red infected chips.

(This post amplifies information in the earlier post, "Infection-Killing Bugs and Antibiotics.")

 

Friday, January 9, 2015

What's On the Big Screen?

Not just a jumbo tron at sporting events or a way to purchase plane tickets. New uses are being found for digital billboards and interactive touchscreens.

      Advertisers can provide health information, such as pollen counts for allergy sufferers. Missing children can be featured and found. Art can be displayed. Digital screens can raise awareness and provide early detection of childhood diseases. Newspapers have found a new media to publish weather reports, news, and travel information for visitors in real time or on a prescribed schedule.

     Some of the UK companies engaged in these new endeavors are:

  • Outdoor Media Centre
  • Art Everywhere initiative
  • JCDeaux
  • KBH On-Train Media
  • Media Co Outdoor
  • Manchester Evening News