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Sizing up the most fashionable address in New York City

Our OSS Blog - Wed, 2014-07-30 18:40

The most fashionable address in New York is no longer Central Park West. It is 66 East 11th St., in Greenwich Village. The building doesn’t look like much from the outside; it was once a factory, then a parking garage. Now totally remodelled on the inside, it has been dubbed as “wellness real estate,” with a focus on the environment and the health of its residents.

A healthy wallet is definitely a requirement for moving into a home that claims to support cardiovascular, respiratory and immune health through a variety of amenities that range from showers infused with vitamin C to photo-catalytic coatings on surfaces designed to counter contamination by microbes. Prices of units range from about $14 to $15 million. But for that, you get to hobnob with your neighbours, such as Leonardo DiCaprio, which may be a plus, or Deepak Chopra, a definite minus.

Chopra is the New Age guru who has amassed a fortune with his confused and confusing books in which he rambles on nonsensically about how “we are thoughts that have learned how to create the physical machine, the body” and “there is no physical world, it’s all projection.”

He adds that “the whole thing is a Quantum Soup and reality exists because you agree to it.” Well, there is a reality Chopra seems to have agreed to. And that is to shill for Delos, the company that designed the multimillion-dollar abode, and which calls itself the “pioneer of Wellness Real Estate.”

The stunning habitat comes with a grab bag of science and nonsense. There is a special water-filtration system that “reduces disinfectant byproducts, chlorine, pesticides and some pharmaceutical and personal care products.” Nothing unusual here; many such systems based on activated carbon and ion-exchange resins are available for home use. The question then is why there is a need for “shower water infused with vitamin C which neutralizes chlorine to promote healthy hair and skin.” Hasn’t the filter system already removed the chlorine? Yes it has, otherwise it would be a pretty useless system.

So the only reason for the vitamin-C infusion is to get some mileage out of the common association of vitamin C with health. Vitamin C can indeed neutralize hypochlorous acid, which is the active form of chlorine in water, but it does not do so very efficiently. A gram of vitamin C would eliminate chlorine from about 400 litres of water, which is roughly equivalent to three to four showers. And there is no evidence that this would have any effect on hair or skin.

Installation of an air-purification system that filters pollen and other small particulate matter, and that uses ultraviolet light to kill microbes in the air ducts, does get marks. But there is less scientific support for incorporating substances, in all likelihood titanium dioxide, into counters and floors to destroy bacteria on contact.

This may be welcome in an operating theatre, but there is no need for such anti-bacterial warfare in a home. Disease-causing bacteria do not lurk around every corner and we happily coexist with the vast majority of bacteria. But generally bacteria are regarded as public enemy and antibacterial claims are good for marketing. Rinsing surfaces with soap and water serves us just fine.

Much is made of outfitting the rooms with just the right kind of lighting to prevent the body’s biological clock from going out of kilter. Here we do have some science. Light of any kind suppresses the secretion of melatonin, the so-called “Dracula hormone,” but blue wavelengths do it more effectively. Melatonin is produced during darkness and is associated with sleep. In the morning when we want to boost alertness, suppression of melatonin production is desirable, which is why Delos installed lights with a blue emphasis in showers and around bathroom mirrors. Hopefully people who like to take their showers at night can switch off these lights.

During the day, emphasis should be on wavelengths other than blue to prevent a big drop in melatonin, which has been associated with adverse health effects. Studies have linked working the night shift and exposure to bright light to cancer, diabetes, heart disease and obesity, possibly due to low levels of melatonin. There have been suggestions that night workers should wear glasses that filter out blue wavelengths in order to boost their melatonin levels. It might be a good idea to have such filters on reading lamps that are used before falling asleep.

For enhanced sleep, total darkness is desirable to enhance melatonin production, and accordingly Delos has equipped windows with programmable blackout shades. Night lights are red since these wavelengths have the least power to suppress melatonin and shift circadian rhythms. Delos’s advertising correctly describes that lighting can affect health, but then goes on to say that protection is needed from electromagnetic fields that disrupt sleep. There is no evidence that EMF fields are harmful, nor that “electromagnetic field panels” are of any use.

Speaking of questionable benefits, is there data to back up claims that “impact absorbent floors improve lumbar support?” Noise reduction with soundproof Sheetrock sounds great, but the claim that noise decreases the production of telomerase, an enzyme associated with youth, is at best speculative. And how about the “reflexology path” in the bathroom, featuring an uneven floor with hard protrusions to stimulate acupressure points that are supposed to stimulate energy meridians in the body? Not exactly hard science.

If you are lacking the millions to purchase a Delos condo, you can still experience the “wellness” effects with a stay at the MGM Grand in Las Vegas. A number of rooms have been outfitted with the same “health” amenities, including a special TV channel where holistic guru Deepak Chopra greets guests and offers advice about using acupuncture instead of Prozac and eating pink food for fewer wrinkles. That’s a reference to astaxanthin, a carotenoid that is responsible for the pink colour of salmon. Astaxanthin may actually offer some protection against sun-induced skin damage, but only when taken in supplement form.

Chopra goes on to inform the lucky guests that they will be experiencing “the next frontier in well-being” and an environment that “basically allows your body to self-regulate.” I think just the prospect of turning on the TV and possibly seeing Chopra mutter about “quantum consciousness” would keep me from forking out the surcharge for a wellness room at the MGM. It would make me feel unwell.

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Apples and Sex

Our OSS Blog - Tue, 2014-07-29 08:38

Did Eve eat an apple to have a better sex life with Adam? One might come to that conclusion after reading a paper published in the Archives of Gynaecology and Obstetrics with the alluring title “Apple consumption is related to better sexual quality of life in young women.” Indeed one might come to that conclusion if one ignores the poor quality of the paper as well as the fact that the Bible never mentions an apple as being the fruit of the tree of knowledge.

The peer-reviewed publication is the corner stone of science. It ensures that a published paper has been reviewed by an editor and at least a couple of experts before appearing in print. In theory, any published paper should add to the body of scientific knowledge, after all that is why research is carried out. Unfortunately this is not always the case. There are many papers of questionable quality that are published with large scale speculation based on a sprinkling of data. Since professional careers are often judged by the number of publications produced and the impact they have in terms of readership, there is motivation to crank out as many papers as possible especially on topics that might generate publicity.

It surely did not escape the recent paper’s authors’ attention that a title linking apples to sex would capture the imagination of the press. And indeed it did. Articles enticed readers with headlines such as “Apple a Day Keeps Your Sex Life Okay,” “Why Eating Apples May Be The Cure For A Rotten Sex Life,” “The Snack That Boosts Your Sex Life,” “An Apple a Day: Your Newest Actionable Sex Tip” and “Eating an apple a day improves women's sex lives, study shows.” Really? That is not exactly what the study shows. In fact what it shows is that women who eat at least one apple a day as opposed to those who hardly eat apples have no greater desire for sex, are not aroused more easily, do not have more orgasms and actually experience less satisfaction.

So how do you get a title that claims “better sexual quality of life” out of that? By doing a lot of data dredging with the aim of getting some publicity. Here is what was actually done. Seven hundred and thirty one women were enlisted through posters on hospital bulletin boards to fill out questionnaires about their apple consumption and sex lives as determined by the “Female Sexual Function Index (FSFI). ” This Index is based on a number of questions including one on “lubrification” which happens to be the only one that detected a difference between the apple eaters and the non-eaters.

It must be emphasized that no laboratory investigation was carried out, this was a matter of personal judgement. Not an easy judgement one would think since the same degree of lubrification might be evaluated differently by different people. Without an actual measurement, such data is essentially useless. Unless you are looking for a publication. Then you can add up the results from all the questions in the two groups and come up with a total that will be different solely because of a questionable difference in the answers to that one question about lubrification. You can then go on to speculate about why there is a difference in the FSFI by talking about pharmacologically active substances such as phytoestrogens, polyphenols and antioxidants and hypothesize that these can activate the body’s nitric oxide system that increases blood flow to thye vaginal area. Never mind mentioning that substances that are actually known to increase nitric oxide secretion, such as Viagra, have no effect on female sexual function. Neither does soy, which contains far more phytoestrogens than apples.

If you leave out the question about “lubrification”, and look at the more meaningful ones like degree of satisfaction, you can actually conclude, again meaninglessly, that abstaining from apples improves women’s sex lives. That, though, is not likely to arouse much attention. Another point. This paper has, count them, fifteen authors! They all come from different institutions. Could it be that some got their names on this paper for doing no more than posting a notice on bulletin boards to solicit subjects for the study. I suspect that may be the case. As far apple consumption goes, I have long advocated “An Apple A Day” for various reasons, none of which involve sexual function.

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Protein supplements: powerful powder or powerful promotion?

From Our Contributors - Tue, 2014-07-29 07:09

Google the words ‘protein supplements for athletes’ and a number of links will appear in your browser. While apparently just a click away from learning the ‘truth’ about these dietary additions, it is advisable to consider the nature of whichever website you fall upon before hollering hallelujah. Company websites marketing protein supplements claim to give athletes the ability to ‘beat their best competition’ and to ‘get bigger and/or stronger’. Promasil, ‘the athlete’s protein’, for example, features seven of the world’s most powerful proteins. Imagine the industrial strength containers needed to keep these key ingredients from escaping. No more five dozen eggs a day to grow biceps the size of barges (the strategy adopted by Disney’s Gaston), a more palatable and practical solution is delivered in the form of a delicious flavoured powder. Since proteins are a major component of muscle, it surely makes sense that consuming more would result in extra bulk. But protein supplementation is not only about bodybuilding. For those more concerned about beating personal bests and leaving the competition trailing behind, protein supplements are also argued to directly enhance endurance performance and to optimise recovery of muscle function following exercise.

So how does it work? Naming a chocolate bar after a long-distance running event (and later rebranding using a word that sounds like underwear in British vocabulary - ‘Snickers’), no doubt taught the importance of carbohydrate as an energy source. Through reduced breakdown of carbohydrate during prolonged exercise, protein supplements are thought to enhance performance and to more quickly replete muscle glycogen (a specific type of carbohydrate) during recovery. By stimulating muscle protein synthesis, protein supplementation is also theorised to reduce muscle damage and speed up the recovery of muscle function. If you recently ran down a hill or lifted some weights, ideally not at the same time, you may later have felt soreness in your muscles, caused by damage to proteins that are required for muscle contraction. In such circumstances, rates of muscle synthesis and degradation are increased, and without sufficient protein intake, rates of degradation exceed synthesis and a negative net protein balance results. Consuming protein supplements during recovery from exercise should, however, promote the production of skeletal muscle (muscle that is attached to bones and contracts on demand).

Despite the logic behind these claims, a systematic assessment of the evidence to support or refute the relationship between the use of protein supplements and exercise performance, muscle damage and soreness, and recovery of muscle function has until recently been lacking. Earlier this year, Pasaikos, Lierberman and McLellan addressed this dearth by publishing two review articles in the journal Sports Medicine.  Examining publications reporting findings from ‘healthy human adults’ (no chimpanzees thankfully) between 18 and 50 years of age, they found no apparent relationship between recovery of muscle function, muscle soreness and muscle damage when protein supplements were consumed prior to, during or after a bout of endurance or resistance exercise. If supplemental protein was consumed after daily training sessions, however, beneficial effects such as reduced muscle soreness and damage became more evident. They also found that when carbohydrates were at optimal levels during or after exercise, protein supplements provided no performance enhancing effects. In particular, sparing of muscle glycogen stores was not supported as a mechanism leading to enhanced endurance performance.

Pasaikos et al. warned, however, that small numbers of participating adults and lack of dietary control limited the effectiveness of several of the investigations they examined. Since studies did not measure the effects of protein supplementation on direct indices of muscle damage or muscle glycogen, for example, the interpretation of the data was often limited. What does seem clear, however, is that if athletes maintain a healthy diet, by consuming enough protein and carbohydrate through traditional means (for example regular food), protein supplements are unlikely to generate record breaking results. Only when the healthy human adults involved in the studies examined by Pasaikos et al. were lacking in nitrogen (found in amino acids that make up proteins) and/or energy balance were performance enhancing effects of protein supplements found to be greatest. Endurance is of course built by training and not protein alone. Whilst Pasaikos et al. demonstrated the need for further high quality research on the potential benefits of protein supplements, a healthy diet, sufficient rest and undeterred dedication seem to be best recipe for success.

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In the beginning there was…Persil

Our OSS Blog - Fri, 2014-07-25 05:28

The world’s first commercially available laundry powder was Persil, introduced by the German company Henkel in 1907. The name derived from perborate and silicate, two key components in the product. Persil was introduced as an improvement over the action of soap, the traditional cleaning agent first formulated around 1500 BC. Just heat some sort of fat with ashes from a wood fire and you get soap. The ashes supply the alkaline chemicals needed to break down the molecules of fat and convert them into salts of fatty acids which we know as soap. One end of the soap molecule has an affinity for water, the other for oily substances. Washing with soapy water then removes oily residues from a surface. While soap cleans well by emulsifying and removing greasy stains, it does present some problems. It isn’t great on colored stains and it forms a precipitate when used in water that has a high mineral content. This “scum” is hard to rinse away and dulls clothes. Persil addressed both of these problems.

Sodium perborate is an oxygen releasing agent, and oxygen is effective for destroying stains. As the prototype “oxidizing agent,” it can steal electrons from molecules. Since electrons are the glue that hold molecules together, exposure to oxygen can break down complex molecules, such as the ones responsible for stains. This is why traditionally laundry was either hung out to dry or spread out over grassy fields. Not only did this expose the fabric to oxygen, but also to ultraviolet light from the sun which can also break down colored molecules. Sodium perborate did the work of the air and the sun at the same time. The addition of sodium silicate had a “water softening” effect, meaning that minerals like calcium and magnesium responsible for forming a scum with soap were in a sense neutralized. These minerals react with silicates to form precipitates, just as they do with soap, but the difference is that these precipitates are readily rinsed away and tend not to deposit on the fibers of the cloth being washed. Silicates have great suspending and anti re-deposition qualities. Today’s detergents are chemically far more complex than the original Persil, and Persil itself has a range of products to cater to different needs, but it will always retain its place in history as the “first self-acting laundry detergent,” and the image of the White Lady introduced in 1922 and featured on numerous placards and signs remains an advertising classic.

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Marketing appears to trump science on antibacterials

Our OSS Blog - Thu, 2014-07-24 07:24

Store shelves these days sag under the weight of antibacterial soaps, cosmetics, socks, toys and even garbage bags. There’s no question that “antibacterial” on a label increases sales, but there are plenty of questions about the wisdom of impregnating everything in sight with compounds that kill bacteria indiscriminately.

Triclosan has been the hot antibacterial ingredient in household products for about four decades. But it is now itself feeling the heat, due to concern about endocrine disruption, the promotion of antibiotic resistance and effects on aquatic ecosystems.

The state of Minnesota has already passed legislation to phase out triclosan except in a medical setting such as a hospital, and regulatory agencies around the world are considering doing the same. Companies such as Johnson & Johnson, Avon and Colgate-Palmolive are all planning to remove triclosan from their formulations. This raises the question of whether triclosan is to be replaced by some other antibacterial. “Quaternary ammonium compounds” are likely candidates, but they also come with baggage. Exposure has been linked to respiratory irritation, and more specifically the triggering or exacerbation of asthma.

It stands to reason that the use of any chemical should be based on a proper evaluation of risk vs. benefit, but such an evaluation is often problematic.

Triclosan was first registered as a pesticide in 1969 and it quickly found its way into the operating room as a surgical scrub to replace hexachlorophene. It was less toxic, more effective and more biodegradable; so the risks greatly outweighed the benefits. Triclosan also proved to be useful in protecting adhesives, plastics, caulking compounds, carpets, sealants and fabrics from attack by bacteria, fungi and mildew. There is no great issue here because any leaching from these products is minimal. However, the story is different when it comes to soaps, deodorants, shaving creams, cosmetics, dishwashing liquids and toothpaste, residues of which go down the drain. Here the risk-benefit ratio has been the subject of some bitter controversy.

A fear of bacteria is legitimate, although not of all bacteria. Most live happily in our body and on our skin without causing any harm. But indeed there are the pathogenic varieties that can cause a great deal of misery. Salmonella, listeria, campylobacter, streptococci, E. coli, staphylococci, botulinum clostridium and mycobacterium tuberculosis are worthy of dread, as they are responsible for hundreds of thousands of cases of illness every year — as well as a significant number of deaths.

Aside from toothpaste, while there is actual evidence that 0.3% triclosan can help reduce cavities, plaque formation and gum inflammation, there is no compelling evidence that the addition of triclosan to household products reduces bacterial illness. True, antibacterial soaps can be shown to reduce bacterial counts more than regular soap, but that is not the same as demonstrating a reduction in infections. Marketing seems to have trumped science here.

Another point is that many of the diseases germophobes worry about are caused by viruses unaffected by antibacterials. The viruses that cause the common cold, hepatitis and many gastro problems scoff at antibacterials. Triclosan may even cause mutations in some viruses, possibly enhancing the risk of viral infection. More importantly, ordinary soap works as well as antibacterial soaps in getting rid of bacteria as long as hands are properly washed, 15 seconds on each side.

The development of bacteria that are immune to antibiotics is a significant concern. Whether or not bacteria can become resistant to triclosan, and whether triclosan can induce resistance to other antibiotics, are hotly debated topics, as is the issue is what happens to all the triclosan that enters the environment from our array of antibacterial consumer products.

Waste water treatment does not eliminate triclosan. About four per cent is discharged into natural water systems, including those that supply our drinking water. And the rest remains in sewage sludge that often ends up being used as fertilizer. Here residual triclosan may interfere with the action of bacteria that help fix nitrogen, and it may even affect earthworms.

Some studies have shown that triclosan can react with the chlorine used to disinfect drinking water to form chloroform, an established carcinogen, and that under the influence of sunlight it can even form small amounts of the notorious dioxins. Then there is the matter of endocrine disruption, with concern being raised about triclosan’s chemical similarity to thyroid hormones and its potential disruption of hormone activity by binding to thyroid hormone receptor sites. This merits further investigation given that triclosan has been found in breast milk, meaning that it finds its way into the body.

Indeed the chemical is so widespread in the environment that it turns up in the urine of the majority of the North American population. Of course, detecting triclosan in the urine does not necessarily mean that we are at risk, although studies on mice and fish have shown a hindrance of heart-muscle contraction at doses that are not far from human exposure.

Finally, there is the hypothesis that our overuse of cleaning agents and antimicrobials may be disrupting the human biome, that collection of 100 trillion bacteria that inhabit our body, outnumbering human cells 10 to one. Some researchers believe that the increase being noted in the incidence of allergies, celiac disease, Crohn’s disease, diabetes, mood disorders, obesity and even autism is linked to a shift in the body’s microbial environment.

The industry line is that triclosan is a “thoroughly researched chemical that has been safely used for decades.”

That is actually a hollow argument because the “thorough” research did not focus on the kinds of subtle effects that are raising eyebrows, and “safe use” is based on lack of acute effects.

Indeed triclosan has no acute toxicity since its biological effect is based on the compound’s ability to block a key bacterial enzyme that humans do not possess. While no specific health or environmental consequence has been linked to the widespread use of triclosan, it is unlikely that we would be worse off if it were removed from products where its claimed effectiveness to reduce bacterial disease has not been backed up by evidence.

Our microbiome may even thank us.

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An Apple a Day!

From Our Contributors - Wed, 2014-07-23 18:12

An apple a day may keep the doctor away and is a good idea title for a book, but it’s probably a bad premise for a scientific study. The other day, a friend of mine drew my attention to a headline in the UK Telegraph “Eating an apple a day improves women's sex lives, study shows.” Bad grammar not withstanding, I defied my better judgment and decided to read the article. The Telegraph doesn’t have the best track record of health reporting. Recently they wildly misreported a study about edible flowers and true to form they botched this one as well.

The article makes a number of claims. It says that that apples have “been show to be an aphrodisiac,” that “an apple a day can improve the sex lives of women” and that they “boost sexual pleasure in healthy women.” These are impressive attributes for a simple fruit, so I decided to read the actual study this report was based on.

The study was published in the Archives of Gynecology and Obstetrics. Essentially researchers took 731 women and asked them how many apples they ate every day and then asked them to fill out a questionnaire about their sex lives in areas such as desire, arousal, satisfaction, pain, etc. Researchers found an improvement in lubrication and consequently in the total score, but not in any other area of the questionnaire. Here is an actual quote from the study, “No significant differences between the two study groups were observed concerning desire, sexual arousal, satisfaction, pain and orgasm.” (Interestingly, the group that ate less apples had a slightly higher satisfaction score 4.5 vs. 4.3). This strikes me as fairly convincing that apples are don’t affect the quality of women’s sex lives at least in terms of the metrics that actually matter. Having read this study, I cannot for the life of me figure out how the Telegraph could have generated their headline. I can only assume they didn’t actually read it and just parroted the press release.

Even if you accepted their one single positive finding, the study has a lot wrong with it. First off, it is not a randomized clinical trial. Even though the newspaper story seemed to imply that it was, here researchers simply asked women how many apples they ate and did not actually conduct an experiment. It is easy to image why women who ate apples on a daily basis would be different than women who did not. They were likely more health conscious, probably exercised more, and probably had a better diet overall. Those who ate more apples probably ate more bananas, more oranges, more pears and more fruits in general. Researchers did not ask about other fruits and they likely could have just as easily shown an association with kiwis or pomegranates. So why apples? I guess the link to the biblical story of Adam and Eve was too good to pass up. Of course, the fruit of the tree of knowledge wasn’t actually an apple but why quibble on details.

The newspaper article also then makes a number of claims that the benefits of apples are due to phloridizin and polyphenols.  This is pure speculation. This study, as I mentioned, did not measure any hormone levels or perform any tests on the apples themselves. It was purely the analysis of questionnaire sent out to women.  Clearly, throwing in a few “sciency” terms (and adding the requisite photo of an alluring women biting into an apple) made the article more appealing to the newspaper editors.

Apples are unlikely to improve your sex life and, while we’re at it, neither will oysters, chocolate, or ginseng. An overall healthy lifestyle with regular exercise and a balanced diet is probably your best bet (but admittedly this would make for a lousy headline). So what can we conclude overall about eating an apple day? No effect on sexual desire or satisfaction, great title for a book, and (from my point of view) it’s bad for business.

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Dr. Sen’s Perfect Vision System

Our OSS Blog - Wed, 2014-07-23 18:05

I’m accustomed to being forwarded all sorts of videos about miraculous cures that are being suppressed by the establishment. There’s usually some “maverick doctor” who has made an astounding, shocking discovery about curing every disease known to mankind with some revolutionary herbal treatment, exotic juice or dietary supplement. There are testimonials, “rock solid” money back guarantees, and warnings about the need to click on the “buy now” button right away because of the uncertainty of keeping the video on the web. Why? Because the “establishment” is making every effort to remove it so as to protect the sales of Big Pharma’s worthless drugs. The products being promoted are usually safe but useless. Some people may actually be satisfied with their purchase because of the power of the mind over the body. I’ve seen dozens of these scams but now I’ve come across something new, at least to me. “Dr. Sen’s Perfect Vision System.” Yes, anyone can have perfect vision. Forget short sightedness, forget far sightedness, in fact forget macular degeneration, glaucoma and all other visual problems. These are not due to genetics, we are told, they are not due to a physical problem with the eyeball, they are, get this, learned traits! Our visual problems are due to focusing too frequently on books, television screens and computers. And glasses are not the answer, nor are contacts. These are scams perpetrated by optometrists and they actually make our vision worse. And laser surgery, well not only does it not correct vision, it can make you blind! So what is the answer? Dr. Sen knows. He has made an eye-opening discovery. And of course it is all natural. Who is Dr. Sen? According to the video, he’s a retired Chinese optometrist who is now ready to reveal his secret for perfect vision for free. Why? Because he has taken the Hippocratic Oath and abides by the philosophy of doing good for his patients. He is tired of the eye care industry trying to suppress the easy solution to visual problems so they can keep digging into their endless goldmine. Actually optometrists are not physicians and do not take the Hippocratic Oath. And no trace of the mythical Dr. Sen can be found outside of this revolting video. We just hear about his miraculous eye training method from someone called Samantha Pearson who voices the video. We are given no details except that using Dr. Sen’s “somewhat unusual” eye exercises, anyone can achieve 20/20 vision in just fourteen days. A true miracle! Actually there is a miracle here. It is that there are actually people who buy into this scam. Some must, otherwise the video would not crop up so often. What we have here is a demonstration both of the gullibility of some people and of scientific illiteracy. If you order right now, the video informs us, you also get Dr. Sen’s guide about how certain popular medications can worsen your eyesight and you also get to learn the secret of how one unusual food can cure blurry eyes in hours. This is no snake oil, we are told. For just thirty seven dollars, you are guaranteed to throw away your glasses and contacts. Actually, I’ll guarantee that the only thing you will be throwing out is thirty seven dollars.

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The Depraved Peter Popoff

Our OSS Blog - Mon, 2014-07-21 19:05

You never know what you will come across when surfing TV channels late at night, hoping against hope that you will come across a Seinfeld episode you haven’t seen a hundred times. Last night I was shocked to come across the villanous Peter Popoff yet again milking the gullible in a shameless fashion with his offer of “miracle water.” Exactly what was to be done with the water was murky, but its effects were clear. Financial fortune would befall those who called the number on the screen to ask for a “free sample” of the water. There were testimonials galore from people who saw money mysteriously appear in their bank accounts and others who suddenly were able to purchase cars and houses. There is indeed wealth to be gained from the miracle water. By the crooked Popoff. When you call the number you are asked to provide your name and address. Within days a letter arrives with a plastic bag filled with the miracle water, but alas, it has to be activated. You have to quickly send in a check or money order for $27, as “seed” money to show that you have faith in God’s intent to dole out money.

This is the same Peter Popoff who was famously exposed by Randi as a fraud back in 1986 when he was shown to be receiving information from his wife via an earpiece during his faith healing act. She was backstage going through the “prayer cards” that members of the audience had submitted so that Peter could “divine” who needed what sort of healing. After the exposure Popoff went bankrupt, but like the Phoenix rose from the ashes to practice this new form of chicanery. This man is pure evil. He is not a misguided believer in some higher power, he knows full well what he is doing. He is a reverse Robin Hood, robbing the poor to give to the rich, namely himself. And he has recouped all his losses, and more. Drives ritzy cars and lives in a multi-million dollar home. If there is a hell, Peter Popoff has a room waiting. Hopefully equipped with a torture rack.

The program was on Vision Television, a channel that is dedicated to religion. The only thing Peter Popoff worships is money. Popoff’s antics were so disturbing that I had to wash them away with one of my favourite Seinfeld episodes that I had recorded. It was the one about George seeking advice about his tonsil from a kooky New Age healer equipped with a pyramid, wacky sayings and a concoction made of who the loony new age healer, with his pyramid, wacky sayings, and a tea made of “cramp bark,” “cleavers” and “couch grass.” Needless to say it made George gag. Which is just what Popoff does to any reasonable viewer.

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A miracle bites the dust

Our OSS Blog - Mon, 2014-07-21 09:35

It's frustrating, but most scientific studies end with the line, "more research is needed." But not always. We have one of these rare cases in a study published in the New England Journal of Medicine about the use of niacin to improve cholesterol profile. Niacin is familiar to many as the B vitamin that prevents pellagra but when it is used to decrease LDL (the "bad" cholesterol) and increase HDL (the "good" cholesterol) it is given in far higher doses than the amount that prevents pellagra. At a dose of 1000 mg a day, niacin is a drug. It has been used for decades in people with cholesterol problems because it clearly does decrease LDL and increases HDL. But that is not the same as reducing cardiac events. Now we have a study that quite categorically shows that in spite of the impact on cholesterol levels, niacing does not reduce cardiac events. Furthermore, it complicates diabetes and results is an increased risk of gastrointestinal, musculoskeletal and dermatological problems.

This was a very well designed study of some 25,000 people who were taking statin drugs because of cardiac risk. They were properly randomized to take a placebo or time-released niacin in combination with laropripran, added to reduce the classic flushing side effect of niacin, After four years the results were definitive. No reduction in cardiac events and an increase in side effects. No doubt the "natural treatment" advocates will declare that this study was contrived by Big Pharma to show that natural therapies do not work. Of course at doses needed to alter blood cholesterol, niacin can hardly be called natural. We'll see how many of the websites that promote niacin for reducing cardiac risk will change their sales pitch. Will Dr. Agatston change his mind? How about Dr. Oz who also recommends taking 400 mg of niacin a day. And Joe Mercola, who wildly promoted niacin on Dr. Oz's show while telling people to stay away from statins? Will be interesting to see.

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Exoplanets

Our OSS Blog - Mon, 2014-07-14 00:59

I’ve long been fascinated by space travel. I think I was first turned onto the idea back around 1957 with one of the first television shows I remember watching. “Rocky Jones, Space Ranger” was a kind of space policeman who would blast off from Earth and travel to other heavenly bodies where wicked aliens needed to be taken care of. There was no explanation as to where these worlds were, or how it was that the aliens always spoke English. I think the only concession to science was that Rocky’s spaceship looked like a German V-2 rocket which was also the prototype for the Redstone rocket that allowed Alan Shepard to become the first American in space in 1961. By that time I was hooked on space travel and was riveted to the TV set as Shepard was launched into his suborbital flight.

Then in 1965 along came Lost in Space, a television series that actually had smidgens of science. The plot centered around a family who set out from an overpopulated Earth to colonize a planet circling the star Alpha Centauri. At the time the show was produced no planets outside the ones that orbit our sun had been discovered. But the show was actually set in 1997, which is interesting because the first planeting orbiting a sun other than our own was discovered in 1995. More than 300 “exoplanets” as they are called have been discovered since. The show also paid some attention to the huge distances involved in space travel by having the travelers be frozen in some sort of state of suspended animation, only to be reanimated when approaching their target which had been chosen because space probes had revealed that the planet possessed ideal conditions for human life.

Lost in Space overlapped with the most successful of the TV science fiction shows which of course was Star Trek, debuting in 1966. The show was set in the twenty-third century so as to allow for ample passage of time to have developed the scientific wonders like phasers, beamers and travel at warp speed. The latter was necessary because it allowed travel faster than the speed of light which would be needed to travel to the diverse planets visited by Captain Kirk and his crew. Watching all these shows was great fun. And still is. But how far are they from reality? Unfortunately very, very far. That’s because the distance that would have to be travelled to get to a planet outside our solar system is almost unimaginable. Tremendous publicity was given this year to the discovery of the first planet, Kepler-186f, that may be sort of a cousin to Earth because it may have liquid water. How far is it? About 490 light years away. So when we see Kepler-186f we are really seeing that planet as it was 490 years ago, that is how long it took for the light to reach us. And how far have we travelled in space? We have made it to the moon. That is 1.2 light seconds away! So visiting other planets or being visited by aliens that may be out there remains firmly entrenched in science fiction.

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What kind of exercise is best?

Our OSS Blog - Sun, 2014-07-13 01:12

Let’s face it, running on a treadmill isn’t one of life’s most exciting activities, but it does provide time to contemplate life and think about what is likely to extend it. There’s plenty of evidence that exercise will, which is why one plods away on the treadmill in the first place.

But should one gear up for short bursts of high-intensity exercise or scamper along at a slower pace for a longer time? The scientific literature is ambivalent on the issue, but it is one that I follow closely because I am sort of addicted to the treadmill. That’s why a New York Times blog with the headline “For Fitness, Push Yourself” accompanied by a photo of competitive runners obviously at full tilt got my attention.

“Intense exercise changes the body and muscles at a molecular level in ways that milder physical activity doesn’t match, according to an enlightening new study,” the article began.

Was there finally an answer to the exercise conundrum?

The study was enlightening all right, if you are a mouse. This is not a criticism of the research, which was carried out by a very reputable group at the Scripps Research Institute in Florida. But it is a criticism of the interpretation of the study, not only by the New York Times blog, but by many other media reports that concluded “to realize the greatest benefits from workouts, we probably need to push ourselves.” There were also quotes from one of the researchers involved in the study about “no pain, no gain.” Coming to such a conclusion based on a study involving specially-bred mice scuttling on a treadmill is way too adventurous.

The study’s basic goal was to examine how the hormones adrenalin and noradrenaline affect muscle structure. These hormones are released under stressful conditions and are known to prime muscles for “flight or fight.” Since intense exercise is also known to release these chemicals, it is reasonable to explore its potential to increase muscle strength. The effects of the stress hormones are thought to be manifested through the activation of a specific protein termed CRTC2, present in mice as well as in people. The Scripps researchers therefore bred mice that were genetically programmed to produce more of this protein, put them on a program of strenuous treadmill exercise and found that they developed larger muscles and were more efficient at releasing fat for use as fuel than control animals. Interesting, but genetically modified mice are a long way from humans and the study does not justify giving any sort of advice to people.

The researchers also talk about “searching for molecular therapeutics that will activate the CRTC2 protein so that even an average exercise routine could potentially be enhanced and made more beneficial.” Sounds like an attractive research project, but I suspect it won’t be long before an inventive marketer puts the cart before the horse and starts promoting some sort of “CRTC2 enhancer.”

In the anti-aging business, making more of reputable science than is warranted is par for the course. Consider these headlines: “Cocoa Extract Highly Effective in Protecting Against Alzheimer’s disease, Says New Study” or “Worried About Alzheimer’s? Go on a Chocolate Binge, Study Says.” Well, no. The study doesn’t say anything like that. The grossly exuberant headlines were prompted by a paper published in the Journal of Alzheimer’s disease titled “Cocoa extracts Reduce Oligomerization of Amyloid-beta: Implications for Cognitive Improvement in Alzheimer’s disease.”

Did the researchers from the Mount Sinai School of Medicine in New York carry out experiments with cocoa on Alzheimer’s patients? No. Did they feed cocoa to animals? No. What they did was study the effects of a specific type of cocoa extract on the activity of nerve cells in mouse brain tissue dosed with synthetic compounds thought to model Alzheimer’s disease.

One of the hallmarks of Alzheimer’s disease, which affects an estimated 36 million people worldwide and is expected to double by 2030, is the deposition of a protein known as amyloid-beta between nerve cells. This virtually gums up the workings of the brain by preventing neurotransmitters, the chemicals nerve cells use to communicate with each other, from crossing the synapse, the gap between nerve cells. Since amyloid proteins are formed from smaller fragments called peptides, any interference with the ability of peptides to aggregate into the troublesome proteins is worthy of investigation.

Flavanols are a class of compounds found in cocoa that have been proposed as candidates for interfering with the formation of the amyloid proteins. The Mount Sinai researchers decided to use an unfermented, lightly processed cocoa known as “Lavado” in their investigation because of its high flavanol content. Most commercial cocoa is “Dutched” and has undergone alkali treatment to reduce bitterness, a treatment that also significantly reduces flavanol content. As far as chocolates go, their flavanol content is minimal.

The experiment that generated all the publicity consisted of bathing brain slices from mice specially bred to be prone to Alzheimer’s disease in solutions of the amyloid precursor peptides mixed with different cocoa extracts. When the nerve cells in these tissues were electrically stimulated, transmission of information between them was enhanced with Lavado cocoa extracts.

While this is interesting research, it cannot be used to draw any conclusion about people consuming cocoa. There is no way to know how the amount of the cocoa extracts used in these experiments relate to amounts of flavanol that may make it to the brain from eating chocolate or drinking cocoa. And mouse brain slices in a lab are a long way from a functioning human brain. Although maybe not so far from the human brains that clutter the media implications for human health based on preliminary laboratory or animal experiments.

Needless to say, I won’t go out searching for Lavado cocoa, at least not until a proper randomized trial in humans shows a benefit. And as far as the treadmill goes, I have no idea what “intense” mouse exercise means in human terms, but on looking into the issue, I did come across a scientific paper that added some pep to my treadmilling. The title was “Physical Exercise Protects Against Alzheimer’s disease.” I won’t be shouting about it from rooftops, though. The study was on mice genetically modified to develop the disease.

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Safe Sunscreens But No Safe Tans

Our OSS Blog - Sat, 2014-07-12 11:25

When it comes to health matters, scientists rarely make statements that do not begin with “may.”  But here is one.  Excessive exposure to sunlight causes skin cancer!  There’s no “may” about it.  And here is another one.  Chemical protection can effectively reduce exposure.  Uncertainties do, however, emerge when it comes to deciding on which specific chemicals to use.  Activists claim that some sunscreens are unsafe and blame regulatory agencies for not looking after the welfare of the public while manufacturers profess that their products have been thoroughly tested for safety and efficacy.  As usual, the public is left confused.  Actually, when you blow away the superfluous blather emanating both from the alarmists and from industry, there is some simple advice to offer.  Let’s work it out.

The challenge is clear.  Find a chemical or mixture of chemicals that can be applied to the skin to reduce exposure to the full spectrum of ultraviolet light.  Then make sure these chemicals do not degrade upon exposure to light, have no topical or systemic toxicity, are minimally absorbed into the body, are resistant to water, do not have a greasy feel, are cosmetically acceptable, do not stain clothing and can be incorporated into a “vehicle” that allows for easy spreading.  Quite a list of demands.

The first commercial “sunscreens” appeared in the 1960s and were designed to filter out “UVB,” the shorter wavelengths of ultraviolet light (290-320 nanometers).  These are the rays that cause sunburn, which was the main concern at the time.  Slightly longer waves, those responsible for tanning, were deemed safe.  Finding chemicals that absorb the nasty UVB rays was not particularly difficult, with para-aminobenzoic acid (PABA), octocrylene, phenylbenzimidazole sulfonic acid and various cinnamates and salicylates being up to the task.

Products with different concentrations of these ingredients were introduced for different skin types, each prominently featuring a “Sun Protection Factor (SPF),” basically a measure of the time it takes for skin to redden compared with having no protection.  The SPF value is determined in the laboratory by applying 2 mg of product per square centimeter to the skin of volunteers.  Using a product with an SPF of 15 means that a person who normally begins to burn in ten minutes can in theory stay in the sun for a hundred and fifty minutes before experiencing any visible effect on the skin.

It didn’t take long for this scenario to prove to be too simplistic.  As a clear link between skin cancer and UVB emerged, the focus shifted from preventing sunburn to preventing skin cancer, resulting in an industry frenzy of products with higher and higher SPF values.  In truth, an SPF of 15 already blocks 94% of UVB, only 3% less than one labeled as SPF 30.  In any case, these numbers are only meaningful if the product is applied the same way as in the lab studies, which turns out not to be the case.  Most people were applying far less than 2 mg per square centimeter and were not getting the protection they thought they were getting.  What many were getting, though, were various skin reactions.  And something else became apparent as well.  The longer wavelengths of ultraviolet light, 320-400 nm, known as UVA, previously thought to be inoccuous, were found to be more deeply penetrating than UVB and responsible for premature wrinkling and aging of the skin (“photoaging”).  Unlike UVB, they can even pass through glass.  Furthermore, UVA also was found to be potentially carcinogenic.

Now there was a need for a novel class of products that would protect the skin both from UVB and UVA.  Ideally, not one that would just absorb some wavelengths, but one that would reflect all ultraviolet light.  Titanium dioxide and zinc oxide, both mineral pigments, fit the bill, but left a white residue on the skin.  That was alright for lifeguards’ noses, but not for vane sunbathers.  The search was on for cosmetically acceptable molecules capable of absorbing UVA.  Oxybenzone and avobenzone (Parsol 1789) were up to this task, but as usual, there are some “buts.”

When oxybenzone absorbs ultraviolet light it becomes energized and some of this energy is dissipated through the production of free radicals.  These are very active molecular species that have been linked to cancer.  Oxybenzone also undergoes a reaction in the presence of ultraviolet light to form a compound called a semiquinone which in turn can inactivate some of the naturally occurring antioxidants in the skin, such as reduced glutathione.  Not a good thing since antioxidants offer protection against free radicals.  And if that weren't enough, it turns out that oxybenzone can also mimic the behaviour of estrogens, at least in fish exposed to high doses.  It has therefore been labeled a potential "endocrine disruptor."  Concern has been raised, mostly by the Environmental Working Group, an American activist organization, because surveys have shown that ozybenzone can be found in the blood of 97% of the population.

But, and a big but it is, there is no evidence reported in the scientific literature of oxybenzone being linked to any human health problem, except for photodermatitis, a skin reaction triggered by exposure to sunlight. There are hundreds and hundreds of compounds, both natural and synthetic, that if scrutinized the same way as oxybenzone, could be linked to problems.  Phthalates, bisphenol A, soy extracts and various pesticides are estrogenic.  We live in a world full of hormone-like substances and a complete analysis of our blood would reveal hundreds of these.  All of this goes to say that the risks of oxybenzone as implied by the Environmental Working Group, I think, are overstated.

Avobenzone is cosmetically elegant, non-irritating, but becomes unstable after a couple of hours of exposure to ultraviolet light.  However, its stability is increased when combined with oxybenzone, especially if another stabilizing agent known as diethylhexyl-2,6-napthalene (DEHN) is added.  This combination, developed by Neutrogena, is known as Helioplex.  An important question arises here.  What happens to the UV energy that these chemicals absorb?  The energy has to go somewhere, might it not have a damaging effect?  DEHN takes the energy absorbed by avobenzone and transfers it to oxybenzone which then fluoresces it as harmless red light.

Another effective broad spectrum sunscreen is tetraphalydine dicamphor sulphonic acid, which goes by the trade name Mexoryl.  It is stable, absorbs UV light and dissipates the energy as harmless heat.  Mexoryl isn’t absorbed through the skin and so far there are no safety issues.  And recently, excellent products using “micronized” titanium dioxide and zinc oxide have been developed which do not leave a tell-tale white residue.  Presently it is difficult to judge exactly how much protection a product affords against UVA because there is no SPF-like system has yet been devised.  But regulatory agencies are working on it.

There is one more “may” about sunscreens that has been converted to fact.  We no longer have to say that sunscreens may prevent skin cancer, we can say they do.  A study in Australia, where skin cancer is a huge concern, involved 1600 subjects who were given sunscreen to use every day for four and a half years.  They developed 40% fewer squamous cell cancers than a control group who just maintained normal skin care without being given specific instructions about the use of sunscreens.

So there it is.  Sunscreens can prevent skin cancer, which is not a rare disease.  The World Health Organization estimates 48,000 deaths a year from melanoma (likely sun related but not conclusively proven) and 12,000 from other forms of skin cancer.  What to do?

Look for a product with SPF 30 containing for avobenzone, Mexoryl, titanium oxide or zinc oxide.  Apply fifteen minutes before going out in the sun, use a shot glass full for the body and half a teaspoon for the face.  Reapply frequently.  Forget terms like “waterproof,” “all day protection” and “sweatproof.”  They’re meaningless.  And if you are buying something that is “chemical-free,” you are not getting a good deal because you’re buying a vacuum.  Sunscreens should not be used to prolong sun but rather to protect the skin when exposure is unavoidable.  Above all, remember that unfortunately there is no such thing as a healthy tan.

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Diet, Hygiene and Alzheimer’s Disease

Our OSS Blog - Tue, 2014-07-08 08:00

The incidence of Alzheimer’s Disease varies widely around the world. There are far more cases diagnosed in Europe and North America than in Africa, Asia or India. The question is why. Is it genetics? Some difference in lifestyle? Or is the disease just underreported in developing countries? India has a low rate of Alzheimer’s but with less access to physicians and fewer tests available it is possible that many cases of Alzheimer’s are not being recognized as such.

Genetics is not likely to account for the pattern of Alzheimer’s around the globe. For example, Asians who have grown up in North America have the same rate of Alzheimer’s as other Americans. Nigerians in the U.S. experience a higher rate than Nigerians in Africa. In Japan, a country that has traditionally had a low rate of dementia, Alzheimer’s has been increasing significantly. This obviously cannot be attributed to a change in genetics, so it seems that some sort of lifestyle factor that distinguishes poorer and wealthier countries is at play. Diet would seem to be a prime candidate because of significant differences in what people consume around the world. Rice is a staple in most developing countries and is far less widely consumed in the West. Meat, on the other hand, is a western institution. Could it be that the fat content, or the cholesterol, or the iron in meat somehow predispose to Alzheimer’s? In Japan, the incidence of the disease appears to have increased in step with a increase in meat consumption and a decrease in rice consumption. That could mean that rice has some protective factor, or that something in meat is a problem or it could mean nothing.

Epidemiological studies cannot distinguish between associations and cause and effect relationships. For example, there is a highly significant correlation between the divorce rate in the state of Maine and the per capita consumption of margarine. Interesting, but in all likelihood meaningless. There is also a correlation between strict hygiene and sanitation methods as practiced in wealthy countries and the prevalence of Alzheimer’s Disease. Could that be meaningful? In countries with access to clean drinking water the incidence of Alzheimer’s is increased and in countries with a low rate of infectious disease such as Switzerland or Iceland the rates of Alzheimer’s are higher by some 12% than in China and Ghana, both countries with high rates of infectious disease. Is this some spurious correlation or is it meaningful?

The “hygiene hypothesis” is gaining traction when it comes to allergies and asthma with the theory being that exposure to bacteria, viruses and worms early in life primes the development of a healthy immune system. In the absence of exposure to organisms that can actually cause disease, the immune system targets innocent bystanders such as certain food components. Maybe, some researchers suggest, the deposition of proteins in the nervous system, one of the hallmarks of Alzheimer’s, is a result of an immune system that has gone astray. Sounds pretty far fetched, but the absence of any proven cause of Alzheimer’s makes for all sorts of half-baked theories being hatched.

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Souvenaid

Our OSS Blog - Sat, 2014-07-05 20:59

I suspect we will soon be hearing a lot about "Souvenaid," a dietary supplement that is supposed to be of some help in the early stages of Alzheimer's Disease. It was developed by Dr. Richard Wurtman of MIT, a very reputable researcher and the formulation of Souvenaid is based on legitimate science, but unfortunately the evidence for its effectiveness is virtually negligible.

In Alzheimer’s there is a loss of synapses, the connections between nerve cells that form when protrusions develop in cell membranes and reach out towards neighbouring nerve cells. The theory is that providing nutrients needed for healthy cell membranes encourages the formation of new synapses to compensate for the experienced loss.

Souvenaid provides a range of nutrients that include including omega-3 fatty acids (EPA and DHA), phospholipids, choline, uridine monophosphate, vitamins E, C, B12, B6, folic acid and selenium based on the theory that these are needed for the synthesis of phosphatidylcholine, a major constituent of synaptic membranes. The more phosphatidylcholine in cell membranes, the greater the likelihood of synapse formation, at least so goes the theory. But a theory needs evidence to back it up if it is to evolve into practical recommendations. And that evidence is not forthcoming. It isn’t for lack of effort.

A number of studies have been carried out on Alzheimer’s patients with Souvenaid using standardized assessment scales. The results are disappointing. There is no evidence of decreasing the rate of cognitive decline or delaying the progression of the disease in any way, but one of the studies offered a slight glimmer of hope. In patients experiencing early Alzheimer’s Disease, who are not yet taking medication, there was an improvement in verbal recall. That isn’t much to hang a hat on, but at least the supplement was tolerated without side effects. Souvenaid is on the market in Europe and Australia but not yet in the US or Canada despite the low level of evidence that is required for selling dietary supplements. My guess is that Souveanaid will not be of much aid in Alzheimer’s Disease.

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Trumpet Plastic Surgery

From Our Contributors - Sat, 2014-07-05 00:44

The world of instrument making is a peculiar blend of tradition and innovation. Once a good design is found, it’s rare for major modifications to occur. The big names we have heard of, Stradivarius violins (or as Homer Simpson says, “Strada-who-vious?”), or Steinway grands, are physically quite similar to their ancestors - a quality openly sought by musicians who buy these makes. More often, the innovation occurs from within the constraints of the traditional form of the instrument. We’ve switched out the cat gut for more resilient plastics (though you can still find the purist who swears by the older string type), and moved away from wooden piano frames, which has resulted in much fewer pianos spontaneously collapsing, releasing their strings, bound so tightly they could cleanly remove a finger. It’s therefore rare to come across a trumpet that’s almost completely made of plastic.

The “tiger trumpet”, a plastic trumpet that comes in a variety of vibrant colours, is the latest in a trend of professional quality plastic instruments. Likely inspired by the “p-bone”, a plastic trombone, and the first (and arguably, simplest) of the brass instruments to depart from its metallurgical heritage, the tiger trumpet is the answer to the trumpeter with a penchant for ‘toys’, which if you know any trumpeters, is all of us. At the highly affordable price of $295, I was able to get my hands on a beautiful blue and yellow model and examine it.

The horn itself is almost entirely made of plastic. It seems like a cop out to begin by saying that plastic has its limitations, as the horn is truly quite impressive. However, the basis of function of the valves still requires a small amount of metal, and indeed, with exception to a thin layer of aluminum which coat the valves, and supply the mechanical energy in the springs, the tiger trumpet is all ABS plastic.

Acrylonitrile Butadiene Styrene - for the more seasoned chemists, or the well-informed consumer, this plastic may ring a bell. You’ve probably come across it in the form of the beloved (and sometimes painful) children’s toy Lego, but it’s used in a variety of other applications. The plastic is rigid through a large range of temperatures, and when molten can be coloured with a variety of dyes. The plastic does have a drawback, and this is best told by the tale of the world’s largest auto recall of which several million cars manufactured by GM were subject. As it would turn out, ABS is prone to photo oxidation, and the mechanism of the seat belts in several GM SUVs made roughly over a 10 year period contained this plastic, which degraded, and was the cause os several hundred car accidents. Beyond the inherent wastefulness in the manufacture of most plastics, which use impressive amounts of petroleum products for their synthesis, photo oxidation, and solvency in acetone (keep that nail polish remover away from your trumpet) are the principal causes for concern with an ABS trumpet.

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Phytoceramides

Our OSS Blog - Sun, 2014-06-29 21:10

“As seen on the Dr. Oz Show” is a claim that is guaranteed to boost sales for any product. Like the “phytoceramides” glorified by a couple of plastic surgeons on the show. Incorporated into dietary supplements, these plant derived chemicals are supposed to rejuvenate the skin. There’s no magic pill, Dr. Leif Rogers commented, but “this is pretty close.” And after Dr. Oz wondered “why we haven’t used this earlier,” marketers went to work and quickly filled websites with advertisements about how you can “fake a facelift” with phytoceramides. As is often the case, some websites bleated about Dr. Oz’s “phytoceramide scam,” a common ploy to attract an audience to their site which claims that the product shown on the Oz Show is not as good as the “authentic one” that they are selling.

Perhaps the most impactive statement on the show was Dr. Rogers’ claim that phytoceramides had recently been approved by the FDA. This is totally misleading. In the U.S. dietary supplements do not need premarket approval by the FDA, all that is required is a “Dietary Ingredient Notification” describing what is in the product and why it is believed to be safe. That was not a problem in this case because not only do ceramides occur naturally in our skin, they also can be found in a variety of foods that include dairy products, eggs, soybeans, rice, millet, spinach and wheat. The term “phyto” means plant, so “phytoceramides” are ceramides found in plants.

Ceramides are a class of compounds, along with fatty acids, proteins and cholesterol found in the skin’s outer layer, that help retain moisture. By plumping up the skin, moisture can reduce the appearance of wrinkles. Topical ceramides have long been incorporated into moisturizing creams with positive effects but there are all sorts of substances that can be smeared on the skin to prevent moisture loss, ranging from Vaseline and Crisco to snail extracts. They all work in terms of retaining moisture, but the feel on the skin can be very different. The phytoceramide pills seek to circumvent the problem of finding the right topical moisturizer by delivering the ceramides into the skin directly from blood vessels.

Some studies have indeed shown that such delivery is possible but of course the critical question is whether taking phytoceramide supplements has a noticeable effect. There’s plenty of anecdotal evidence and pictures on the web that show spectacular changes but of course it isn’t hard to fake photos. Then there are claims of celebrities using the product, ranging from Ellen DeGeneres to Jennifer Aniston. We are told that they are not allowed to speak about their use pf phytoceramides because they have contracts with other cosmetic companies. Well, if that is the case, how would anyone know they use phytoceramides?

It is possible that these pills may have an effect, however it is doubtful it would be “near magical.” No surprise that Dr. Rogers uses that expression, given that he sells his own brand of phytoceramides, along with a host of other cosmetics., something that was not mentioned on the Oz Show. Dr. Rogers’ did manage to milk his appearance by prominently featuring “as seen on the Dr. Oz Show” on his website where he also promotes the product she sells. Highly unethical to say the least.

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Would Osler stand by his famous quote today?

Our OSS Blog - Sat, 2014-06-28 10:04

“The desire to take medicine is perhaps the greatest feature which distinguishes man from animals.”

That was the opinion of Sir William Osler, graduate of McGill University, professor of medicine at McGill, one of the founders of the Johns Hopkins University School of Medicine, and a man often called the Father of Modern Medicine.

Osler introduced the concept of clinical clerkship, insisting that third- and fourth-year medical students be exposed to hands-on experience with patients. He also pioneered the idea of a residency program for medical graduates, to further hone their skills. He reportedly asked for no other epitaph than that he taught medical students in the wards, something he considered his most useful and important work. By putting less emphasis on lectures and books, and more on practical skills, he fundamentally changed the way medicine was taught.

“Listen to your patient,” he told his students. “He’s telling you the diagnosis.”

Osler’s statement about man’s desire to take medicine, which was made in a lecture he delivered to the public, is widely quoted, but his follow-up sentence isn’t:

“Why this appetite should have developed, how it could have grown to its present dimensions, what it will ultimately reach, are interesting problems in psychology.”

He was expressing his concern that while physicians “have gradually emancipated ourselves from a routine administration of nauseous mixtures on every possible occasion, and when we are able to say that a little more exercise, a little less food, and a little less tobacco and alcohol, may possibly meet the indications of a case, you, the people should wander off after all manner of idols, and delight more and more in patent medicines and be more than ever at the hands of the advertising quacks.”

It isn’t surprising that Osler was critical of the use of medicines at the time, because most of them did not do much good.

“One of the first duties of the physician is to educate the masses not to take medicine,” he maintained, believing in the self-limiting nature of disease.

Osler himself prescribed relatively few drugs, his basic armamentarium consisting of quinine for malaria, digitalis for heart failure, opiates for pain and coughs, and iron and arsenic for anemia. Instead of drugs, he recommended bleeding the patient for a variety of conditions including pneumonia, stroke and mumps, and he suggested acupuncture for sciatica and neuralgia. He also thought that for nosebleeds there was no harm in trying the insertion of a cobweb into the nostril.

That, of course, sounds pretty curious to us, but throughout history people have resorted to every imaginable remedy for their ailments, from a toothache poultice made of “mashed mouse” to a whiff of flatulence stored in a jar to ward off the Black Plague.

Most of the treatments failed, but eventually, through trial and error, at the expense of much misery, some effective drugs did emerge. As early as 70 AD, Dioscorides described the use of the seeds of autumn crocus to treat gout. The active ingredient, colchicine, was not extracted and identified until 1820. Some drugs, penicillin being a classic example, were discovered by accident; others, such as Taxol, for cancer, by a meticulous search for physiologically active compounds found in nature.

Today, drug research focuses on molecular structure and known mechanisms of action. Gleevec (imatinib), a drug that dramatically increases the survival rate in chronic myelocytic leukemia (CLM), was developed based on the finding that CML patients produce an abnormal version of the enzyme tyrosine kinase, which in turn leads to an overproduction of white blood cells. Knowing the molecular structure of the enzyme, researchers were then able to design and synthesize a compound that would inhibit its action.

In some cases, the effectiveness of a drug for an ailment was discovered when it was being used for a different condition.

Antidepressants known as monoamine oxidase inhibitors (MAOI) are a classic example. In 1951, isoniazid was introduced as a treatment for tuberculosis with great success. But it wasn’t long before concerns about bacterial resistance arose, and when that happens, chemists begin to tinker with the molecular structure of the drug to develop a derivative that will help stave off resistance. Within a year, iproniazid was ready for testing in tuberculosis hospitals. While it turned out not to be effective against TB, the drug had a remarkable side effect. Doctors and nurses noted a significant improvement in patients’ mood, with some even taking to dancing in the hallways. Not a common sight in any hospital.

As it turned out, iproniazid inhibited the action of monoamine oxidase, an enzyme that normally degrades norepinephrine and serotonin, two compounds that control mood. Inhibition of the enzyme raises blood levels of both and leads to feelings of happiness. After favourable results were obtained on testing depressed patients, iproniazid hit the marketplace as Marsilid, only to be withdrawn in 1961 because of liver toxicity. But iproniazid had demonstrated the principle of antidepressant action, and opened the way to the introduction of other monoamine oxidase inhibitors, which are still in use, although they have mostly given way to the newer serotonin reuptake inhibitors (SSRIs).

Other drug actions that have been discovered in this fashion include sildenafil (Viagra), first introduced as an anti-anginal medication. However, it was its ability to elevate more than just mood that brought it fame and fortune.

Amphetamine was introduced as a treatment for congestion and asthma, but it was its stimulant side-effect that led to its use both by the Allies and the Germans during the Second World War as a performance-enhancing substance. A further surprise was when amphetamine, despite being a stimulant, proved to be effective in the treatment of attention deficit hyperactivity disorder (ADHD).

So then, is it really the desire to take medicine that distinguishes us from animals, as Osler opined?

I would suggest it is the making of medicines rather than taking them that sets us apart.

After all, chimps have been known to seek out certain plants when they feel ill, but only humans have the ability to isolate and identify and perhaps improve upon the active ingredient. Who knows, maybe our next drug will come from some sort of monkey business.

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Interview with SETI Institute

Our OSS Blog - Sat, 2014-06-28 09:49
I was interviewed for Big Picture Science. My part is at about 37 minutes in but I think the whole program is interesting!   Click Image to listen to Interview with SETI Institute:  Read more

FOLLOW DR. KO: Medical Mission to Haiti – Paul’s last days and a few highlights

From Our Contributors - Sat, 2014-06-28 09:36

It was one of those happy endings. Paul, albeit still frail, was now smiling, eating, and chatting with his family. When I first met him, as described in my last post, he couldn’t even breathe on his own. He had been lying listless in the Intensive Care Unit (ICU) bed for days, skin and bones, barely moving a muscle. It was New Year’s Day, and I couldn’t think of a better time to tell him that he was ready to be discharged home. Paul was one of my first patients on a medical volunteer trip to Haiti earlier this year at Bernard-Mevs Hospital. Paul had been admitted to the ICU for acute respiratory failure secondary to an exacerbation of chronic obstructive pulmonary disease. I had made it my personal project to find him the best treatment regimen with the very limited resources we had. Often, especially at night, I was the only physician covering triage, the emergency room, the inpatient unit and the ICU, and I had only my pocket medicine book to rely on. That, and my own judgment. It is pretty amazing how quickly a resident physician can grow when forced to think and act by herself without the usual close supervision of an attending, as is the usual case during residency. I remember my second night shift when, while all the volunteers went out to dinner, I was assigned to stay behind to woman the fort. With a mere one and a half years of experience in internal medicine under my belt, it was a tad daunting to be left in charge of the entire hospital. Lo and behold, an ambulance rolled in with blaring sirens, bringing in a young man who was in a motorcycle accident. Just as I was evaluating this patient, another ambulance pulled in, followed by another. Just like that, I was in the entrance of the hospital, surrounded by three ambulances and a crowd of spectators. Seeing as we had our hands full, the third ambulance was diverted to MSF (Médecins Sans Frontières) France which was about 15 minutes away. As I gave instructions to stabilize the motorcycle accident victim’s neck with a neck collar to prevent worsening of potential cervical spine injury, I tried to gather some history about my second patient. “He has high blood pressure” was all that I could obtain from the paramedics. He was a transfer from another hospital, and apparently they couldn’t handle him so sent him to Bernard-Mevs. No one could tell me what his latest set of vital signs were, or what symptoms he had, so I jumped into the ambulance to take a look for myself. Read more

The Precautionary Principle

Our OSS Blog - Fri, 2014-06-27 10:37

“When there is substantial, credible evidence of danger to human or environmental health, protective action should be taken despite continuing scientific uncertainty.” That’s the “Precautionary Principle” stated in its simplest format. Sounds like motherhood and apple pie. How can there even be a discussion about its application? But there is. That’s because “substantial, credible evidence” is open to interpretation and different countries approach the issue in different ways. Europe has introduced REACH, which stands for Registration, Evaluation, Authorisation and Restriction of Chemicals, a program that requires manufacturers to submit toxicity data to the European Chemical Agency before a chemical can be approved.

In the U.S., chemicals are governed by the Toxic Substances Control Act which is now under revision but historically has required proof of harm before acting on controlling a chemical. In Canada, chemicals are subject to the Chemicals Management Plan which is not quite as stringent as Europe’s REACH, but caters less to industry than U.S. regulations. The basic problem with all these regulations is that when it comes to the population being exposed to small amounts of chemicals, the data is very difficult to interpret. Occupational exposure, animal experiments and laboratory studies can provide clues but how relevant these data are to everyday human exposure is unclear. The most reasonable approach would be to weigh the need to use a certain chemical against toxicity data.

Consider food dyes as an example. While the data are not particularly compelling, there is some evidence that synthetics such as Red Dye No. 40, Yellow Dyes No. 5 and 6 may cause behavioural problems in some children and animal data suggest possible carcinogenicity. But different countries come to different conclusions about what to do. The U.K. Belgium, Switzerland, Denmark and France do not allow Red Dye No. 40, while Canada and the U.S. do. Here is a case where the precautionary principle should prevail. Food dyes are unnecessary, do not add anything in terms of nutrition and often make nutritionally poor foods more appealing. We don’t need them.

Bromates are another interesting case. When added to flour potassium bromate improves the baking qualities but is a suspected carcinogen. Bromates are not allowed in Europe or Canada but can be used in the U.S. because FDA says that they are destroyed during baking and only trace amounts remain. But if the rest of the world can get by quite nicely without adding bromates to flour, why can’t the U.S.? Because bromates make for the soft white texture and white colour that Americans have been goaded into preferring. Here too one can apply the precautionary principle. Remove bromates from flour.

However, when it comes to chemicals like preservatives, decisions become more difficult because these have obvious benefits. Theoretical risks for something like butylated hydroxyl toluene (BHT) or sodium nitrite have to be weighed against their demonstrated effects at keeping fat from going rancid or preventing botulism. The precautionary principle should also ne applied to using the precautionary principle.

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