Minor Thoughts from me to you

Personalized medicine is the future. It is where the science is going. It is where the technology is going. It is where doctors and patients will want to go.  Yet unfortunately for many of us, this is not where the Obama administration wants to go.

John Goodman gives several examples of how personalized medicine has saved lives and improved health. This truly is exciting, cutting edge stuff. But it's not where the government wants to steer the healthcare industry.

ObamaCare's premise rests on the idea that everyone can be given the exact same treatments and medicine can be standardized in order to cut costs. So, it has no provisions for personalized medicine.

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Small government and free-market capitalism are about to get put to the test in Honduras, where the government has agreed to let an investment group build an experimental city with no taxes on income, capital gains or sales.

The laws in the city will be separate from those in the rest of Honduras. Strong said that the default law that will be enforced in the city will actually be based on Texas state law, which has relatively few regulations.

“It will be Texas law with more freedom of contract. Texas scores well on state economic freedom rankings,” he explained.

This will be an interesting experiment to watch. Hong Kong 2.0?

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Kyle Baxter, with some great ideas on how to create a newspaper for the web, that can survive and thrive.

The newspaper’s value, then, is by slowing down when everything else has sped up. The web has a nearly unlimited number of sources publishing new news every second, and the result is that there is no understanding. We scan what’s new, move on to what’s then new after that, but we don’t stop and consider what any one event means. The newspaper solves that. It turns the torrential stream into a regular, daily update of what’s new in a realistic portion. There’s a finite amount of articles within each day’s edition, and because we know there’s an end, we can take the time to actually read and digest each article. The newspaper is a sort of daily review where you can take some time, relax and consider events. That’s incredibly powerful. It’s a sort of counterbalance to the web’s always-on, always-new, always-moving nature.

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This is a super cool piece of technology.

The instrument uses a near-infrared light that penetrates just below the skin and reflects off blood vessels. VeinViewer senses hemoglobin, the oxygen-carrying component in blood, which an onboard computer uses to distinguish veins from arteries. It then projects an image of veins on the skin surface in a green light.

It's especially useful on dark-skinned patients, whose blue veins aren't readily visible, and overweight patients, whose veins tend to be deeper. It also highlights the tiny veins of infants.

"It's a great tool to reduce a baby's stress," Ginny Johnson, director of women's services at North Hills, said as she demonstrated the instrument on 1-day-old Zoey White. Helped by a little rubbing of her wrist, VeinViewer traced Zoey's threadlike veins as she awoke from a nap.

It costs $17,000 but the patient satisfaction with these things has to be off the charts. If I was spending my own money on healthcare, this would definitely be something that I'd be looking for in the hospital or doctor's office.

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In a small clean room tucked into the back of San Diego–based startup Organovo, Chirag Khatiwala is building a thin layer of human skeletal muscle. He inserts a cartridge of specially prepared muscle cells into a 3-D printer, which then deposits them in uniform, closely spaced lines in a petri dish. This arrangement allows the cells to grow and interact until they form working muscle tissue that is nearly indistinguishable from something removed from a human subject.

The technology could fill a critical need. Many potential drugs that seem promising when tested in cell cultures or animals fail in clinical trials because cultures and animals are very different from human tissue. Because Organovo's product is so similar to human tissue, it could help researchers identify drugs that will fail long before they reach clinical trials, potentially saving drug companies billions of dollars. So far, Organovo has built tissue of several types, including cardiac muscle, lung, and blood vessels.

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If you had asked an 11-year-old Jeff Bezos to let his imagination run wild and think of the stuff that he would most dream to have as an adult, he might have said:

The world's biggest bookstore! Maybe even a bookstore that can beam any book directly to your hand in an instant (and movies and music, too!).

A giant sky computer that can imitate human intelligence. 

A spaceship.

...And maybe even a robot army. 

Of course any adult would have smiled slightly condescendingly, patted him on the head and helpfully explained that these things aren't possible. 

This is so great. I love what Jeff Bezos has done for the world.

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Using math and computer science concepts decidedly more advanced than most of those in Khan’s video library, the Khan engineers have trained the website’s exercise platform how to predict, with startling accuracy, how likely it is that a student will correctly answer the next practice problem -- and whether that student will be able to solve the same type of problem a week, two weeks, and a month later.

An interesting look at how the Khan Academy is trying to use their platform to predict how well someone actually knows a concept, instead of just knowing how well that person did on one test or drill.

In the future, they'd like to be able to create a whole new credentialing system—a way for employers to know what a candidate really knows instead of just knowing what school a candidate went to and what the candidate might know.

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Glenn Reynolds links to Megan McArdle's defense of kitchen gadgets and posts reader email praising a rotating pizza oven.

Reader Paul Curtis writes:

Funny, you recommended the Pizzazz Pizza Oven more than four years ago on the blog. I know because I bought one at the time, and I’ve never tired of it! In fact, this year I bought additional turntables, because I’ve put so much wear on the original.

The device is so convenient, I’ve even started carrying it with me in my car, when I visit friends.

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Megan McArdle writes a very nice defense of kitchen gadgets.

If you really think that laborious food prep is that elevating, you should go back to the methods of your grandmother. Buy whole nuts and crack them by hand, picking out the meats and hoping you don't accidentally get a bit of shell. Throw out the powdered gelatin and use calf's foot jelly. Make your own confectioner's sugar with a food grinder or a rolling pin. Pluck your own chickens. Render your own lard.

If you think that doing these things would be ridiculous--which it would--then why is it ridiculous to have a machine chop your onions or make your bechamel? There's no particular reason to assume that we have reached some sort of technological plateau where the things that we happen to do by hand right now represent the best possible methods for accomplishing those tasks.

In other words, the "one knife, one pan", "I don't need kitchen gadgets" snobs aren't a better, purer sort of cook; they're just ignoring most of the contents of their kitchen. How many of them cook over an open fire, rather than using one of those high-faluting fancy stoves with their automatic temperature regulation and their electric lights? Why are they storing all their food in a cold box rather than shopping for each day, the way people do in India? Who needs a special pot for coffee when your great grandparents just boiled it up in a saucepan and settled the grinds by dropping eggshells into the resulting brew? Why own a blender instead of putting the food through a grinder and then a chinois? Wouldn't the dishes get cleaner if you boiled up water and washed them by hand? And hey, what's that toaster doing there?

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Do you want to live for a long time, in decent health? If the rate of innovation in medical science doesn’t slow down, you just may be able to.

If Aubrey de Grey's predictions are right, the first person who will live to see their 150th birthday has already been born. And the first person to live for 1,000 years could be less than 20 years younger.

A biomedical gerontologist and chief scientist of a foundation dedicated to longevity research, de Grey reckons that within his own lifetime doctors could have all the tools they need to "cure" aging -- banishing diseases that come with it and extending life indefinitely.

"I'd say we have a 50/50 chance of bringing aging under what I'd call a decisive level of medical control within the next 25 years or so," de Grey said in an interview before delivering a lecture at Britain's Royal Institution academy of science.

"And what I mean by decisive is the same sort of medical control that we have over most infectious diseases today."

De Grey sees a time when people will go to their doctors for regular "maintenance," which by then will include gene therapies, stem cell therapies, immune stimulation and a range of other advanced medical techniques to keep them in good shape.

Maybe I should get a Hyundai for my next car.

Engineers from General Motors Co. took apart Hyundai Motor Co.'s Elantra sedan in 2009, studying the engine and trying to predict what the Korean auto maker might do next. When the latest Elantra launched this year, GM engineers were surprised: The compact sedan beat their predictions for weight, fuel economy and cost as well.

"In terms of momentum, [Hyundai] is a bigger threat right now than anyone else," says Bob Lutz, former vice chairman of GM, who still consults for the Detroit car maker. "I worry about them a lot."

Hyundai has had a lot of success building on it’s roots of keeping costs low (especially labor costs) and being able to innovate quickly, releasing new models faster than Toyota, Honda, or Ford can.

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Should you get a new bike seat, for the good of your sexual health? As the Blogfather would say, why take chances?

John Tierney, reports.

“I’ve spent much of my journalistic career debunking health scares, but the bike-saddle menace struck me as a no-brainer when I first heard about it. Why, if you had an easy alternative, would you take any risk with that part of the anatomy? Even if you didn’t feel any symptoms, even if you didn’t believe the researchers’ warnings, even if you thought it was perfectly healthy to feel numb during a ride — why not switch just for comfort’s sake? Why go on crushing your crotch?”

Alternative bike seats listed at healthycycling.org.

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Brown was living in Berlin, Germany back in 2007, dealing with HIV and leukemia, when scientists there gave him a bone marrow stem cell transplant that had astounding results.

“I quit taking my HIV medication the day that I got the transplant and haven’t had to take any since,” said Brown, who has been dubbed “The Berlin Patient” by the medical community.

... Both doctors stressed that Brown’s radical procedure may not be applicable to many other people with HIV, because of the difficulty in doing stem cell transplants, and finding the right donor.

“You don’t want to go out and get a bone marrow transplant because transplants themselves carry a real risk of mortality,” Volberding said.

He explained that scientists also still have many unanswered questions involving the success of Brown’s treatment.

“One element of his treatment, and we don’t know which, allowed apparently the virus to be purged from his body,” he observed. “So it’s going to be an interesting, I think productive area to study.”

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"If you have democracy, people will vote for washing machines".

Hans Rosling talks about the magic of the washing machine — a device that turns drudgery into books.

This is a popular topic around our house: our washing machine and our dishwasher free up hours each day and many more hours each week, allowing us to do more things together as a family.

It's only 9 minutes long, so do yourself a favor and watch it.

(Or, avoid Flash and watch the video directly.)

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Division of labor, specialization, and mass production. The result: complex heart surgeries for $1,800 and the head doctor wants to bring the price down to just $800. Now that's healthcare reform.

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Derek Lowe has a very interesting post on Where Drugs Come From:

We can now answer the question: "Where do new drugs come from?". Well, we can answer it for the period from 1998 on, at any rate. A new paper in Nature Reviews Drug Discovery takes on all 252 drugs approved by the FDA from then through 2007, and traces each of them back to their origins. What's more, each drug is evaluated by how much unmet medical need it was addressed to and how scientifically innovative it was. Clearly, there's going to be room for some argument in any study of this sort, but I'm very glad to have it, nonetheless. Credit where credit's due: who's been discovering the most drugs, and who's been discovering the best ones?

Spoiler: Overall 58% of all new drugs come from the pharmaceutical companies. BUT, 53% of all drugs for unmet needs came from either biotech companies or universities and 56% of all truly novel drugs came from either biotech companies or universities.

My conclusion: all 3 sources are important parts of the drug innovation system and we shouldn't bash or diminish the importance of any of the 3 sources.

Obamacare delenda est

James Byrne wrote about new developments in cancer treatment for Scientific American. Researchers are looking at ways to use bacteria to kill cancerous tumours, without making you sick the way chemotherapy and radiation do.

The usefulness of bacteria is limited to certain types of cancer as the requirement for this therapy to be useful is tumours large enough to be dead in the middle.

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Large tumours with dead or necrotic nodes (necrosis can develop as one large deposit or multiple small foci in the centre of the tumourous tissue) are very common and in many cases act as a marker of the primary tumour where metastases are observed. This makes them very interesting target locations for therapeutics even though direct treatment of the necrosis itself has not been shown to aid recovery.

The current limitations with traditional treatments are reasonable well known and this stems largely from the nature if these therapies. Chemotherapy and radiotherapy are designed to kill all fast growing cells including cancerous cells but other cells grow quickly too leading to hair loss, depletion of the immune system, fatigue and fertility problems. It's the inability to target the therapy that results in much tissue damage associated with treatment. So naturally its been suggested that if a there were a way to target chemo- or radio- therapy these treatments would sho significantly less toxicity. But how do you target tumours alone?

It is here that bacteria can prove their worth. Bacterial species such as Clostridia, Listeria monocytogenes and Salmonella cannot grow well or in some cases at all in the presence of oxygen and so find it very difficult to grow in most locations of the body unless its necrotic.

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Despite the positive activity observed over the last 20 years in particular a purely bacterial therapy for cancer treatment will not be the full answer to cancer. The real promise lies in combination therapies that place bacterial approaches alongside traditional approaches.

Under extensive research now is the possibility of altering Clostridial species the express pro-drug converting enzymes such as Cytosine Deaminase (CD) or Thymidine Kinase (TK). CD converts the non-toxic 5-Flurocytosine into the cytotoxic 5-Flurouracil and TK phosphorylates the non-toxic Ganciclovir converting it into the active toxic compound. Ordinarily chemotherapeutic agents are administered intravenously and allowed to spread throughout the entire body before eliciting their effects on the quickly reproducing cells of the body. By including the pro-drug converting enzymes within the Clostridia the non-toxic pro-drug can be administered in higher concentrations, as the toxic form will only be present where the bacteria are expressing the enzymes required for its conversion.

I'll freely admit that I only understand about 50% of this article. Here's what it sounds like to me. Bacteria grow best in the dead cancer cells. Researchers will put chemotherapy drugs inside of the bacteria. The bacteria will travel through the body, looking for the dead cancer cells where they can grow and survive. Once the bacteria start reproducing, they'll release the chemotherapy drugs, which will attack the living cancer cells. Between the bacteria attacking the dead cells and the chemotherapy attacking the living cancer cells (and only cancer cells), the combination drug will knock out the tumour without knocking out the rest of your body.

I think the whole article is definitely worth a read through. (If nothing else, you can check my understanding of it.) This is the kind of medical research that really excites me. I really hope researchers are successful in targeting cancers this way.

Obamacare delenda est

We're going to run out of oil someday -- whether it's now or 75 years from now. Plastics are pretty important and we'll need a way to produce them once we run out of oil. Given all of that, how cool is this?

Engineered yeast could produce low-cost plastics from renewable resources:

The researchers engineered C. tropicalis to transform fatty acids into omega-hydroxyfatty acids, a monomer that when polymerized provides a variety of options for developing new bio-based plastics with attractive physical properties. Usually, these acids are difficult and expensive to prepare using traditional methods. The key to getting the yeast to produce large amounts of omega-hydroxyfatty acids was eliminating certain enzymes that further oxidize these acids into unwanted diacids. The researchers identified and eliminated 16 genes and other oxidation pathways, which resulted in a 90% reduction in the activity that converts omega-hydroxyfatty acids to diacids.

As the scientists explained, this new engineered strain of C. tropicalis provides a foundation for the development of low-cost methods of producing omega-hydroxyfatty acids for conversion into plastics. Plastics produced by this method could have a variety of uses, as previous research has shown that plastics produced from a very similar omega-hydroxyfatty acid are strong, ductile materials. The plastics could have applications in lubricants, adhesives, cosmetics, and anti-cancer therapies, and could also be recycled through a conversion process that results in a biofuel similar to biodiesels such as Soy Gold.

Obamacare delenda est

Scene Stealer - The Web Is Pouncing on Hollywood's Ratings - NYTimes.com

The standard Hollywood ratings -- G, PG, PG-13, R and NC-17 -- must now compete with all manner of Internet-based ratings alternatives, some of which are gaining new traction through social networking tools.

SceneSmoking.org, which monitors tobacco use in movies, issues pink, light gray, dark gray or black lungs to films, depending on how smoking is depicted. Kids-in-Mind.com ranks movies on a scale of 1 to 10 in categories like "sex and nudity" and "violence and gore."

Movieguide.org issues ratings from a Christian perspective. A "+4," or "exemplary," means "no questionable elements whatsoever." A "-4," or "abhorrent," means "intentional blasphemy, evil, gross immorality."

The article goes on to talk about how people want to "fix" the MPAA ratings, according to various pet standards.

Why?

It seems like something great is happening. People that are passionate about different things -- and have different standards of acceptability -- are creating and disseminating their own ratings. Parents, or discriminating movie goers, who care about particular standards can use the ratings from a group that shares those same standards. There's absolutely, positively no way that Hollywood -- or the FTC -- can create a single rating system that represents all of those different standards.

There's a simple reason for that. One group of parents believes that nudity and coarse language is a natural and normal part of life. They believe that sex and nudity should be celebrated while their children should be protected from exposure to violence and aggression. There are other parents who would be horrified at the thought of their children seeing some bare skin but are perfectly okay with their children seeing movies that depict massive amounts of violence. Now, design me a PG-13 or R rating that makes both groups of parents happy.

I celebrate the diversity in ratings. I may even use one standard to evaluate which movies my children will be allowed to see and a completely different standard to evaluate which movies I'll see. Vive la difference!

Incandescent Bulbs Return to the Cutting Edge - NYTimes.com

...the incandescent bulb is turning into a case study of the way government mandates can spur innovation.

... The first bulbs to emerge from this push, Philips Lighting's Halogena Energy Savers, are expensive compared with older incandescents. They sell for $5 apiece and more, compared with as little as 25 cents for standard bulbs.

But they are also 30 percent more efficient than older bulbs. Philips says that a 70-watt Halogena Energy Saver gives off the same amount of light as a traditional 100-watt bulb and lasts about three times as long, eventually paying for itself.

It's a case study in the way that mandates can spur innovation, but I'm not sure the news is as good as the New York Times seems to think it is. A government mandate has so far managed to make incandescent bulbs 30% more efficient and 1900% more expensive. This is progress?