A dubious homeopathy study made its way into a scientific journal. Will it be retracted?

Homeopaths did it again–they snuck a dubious study into a respectable journal. Well, sort of. Let's quickly look at the study, and then look at the journal that published it.

The paper has a very science-y sounding title, which likely helped it sneak under the radar: "Ultra-diluted Toxicodendron pubescens attenuates pro-inflammatory cytokines and ROS-mediated neuropathic pain in rats." It seems they were studying pain in rats, but what else is hiding inside this title?

The first warning here is the phrase "ultra-diluted." In the world of homeopathy, substances are diluted until there is literally nothing left, not a single molecule. Some of the dilutions in this paper were indeed extremely dilute, down to 10-30, which means that they were just water. So they can't possibly have any therapeutic effect, at least no more effect than plain water.

You might also be wondering what Toxicodendron pubescens is. That's poison oak! Here's what homeopaths claim about poison oak: that if you dilute it down sufficiently, it reduces itching and pain. This is one of the basic principals of homeopathy, that "like cures like"–that if you want to treat a symptom, using a substance that causes the same symptom, only dilute it way down. Feeling itchy? Rub some poison oak on that! I'm not kidding–here's a link to a product you can buy that really makes this claim.

Of course this is utter nonsense, as I and many others have written before. Homeopathy doesn't work for anything at all, as a massive Australian study concluded back in 2015.

Now let's look at where this dubious study appeared: in a journal called Scientific Reports. Scientific Reports is a mega-journal that publishes 25,000 papers per year, making it the largest journal in the world. What's also interesting is that it is published by the Nature publishing group, which also publishes the highly prestigious journal Nature and many other related, high-quality journals. (Full disclosure: I've published many papers in those journals.) PLoS ONE was the first mega-journal, and it was so successful (i.e., it made so much money for its publishers) that Nature decided to imitate it. They've managed to steal a lot of the "customers" from PLoS ONE because the Nature brand is, apparently, more appealing to many authors.

It's tempting to argue that everything in Scientific Reports is just low-quality stuff, so one more bad paper doesn't mean anything. But it's not so simple. Scientific Reports is trying to be a decent journal, one that has a very high acceptance rate (59%, according to their website) but that nonetheless publishes only valid science. Last year I was involved in a kerfuffle with them over a plagiarized paper, and after lots of pressure, we did get them to retract the paper. It wasn't easy, but the Editor in Chief corresponded with me at the time, and he really does seem to be trying to enforce some decent standards.

When you publish 25,000 papers a year, though, some garbage is going to slip through. To their credit, Scientific Reports has now issued a note of concern on this homeopathy paper, as reported by the alert team at Retraction Watch. Here's the note in its entirety:
"Editors’ Note: Readers are alerted that the conclusions of this paper are subject to criticisms that are being considered by the editors. Appropriate editorial action will be taken once this matter is resolved."
The right thing to do would be to retract this paper, because its results are simply not valid. We'll see if that happens.

Meanwhile, when reading the paper, I noticed that no less than eight of its references are to a journal called Homeopathy, published by Elsevier, one of the biggest and most profitable academic publishers in the world. Unlike Scientific Reports, Homeopathy is not even trying to publish valid science; its entire existence is premised on a nonsensical set of beliefs.

The good folks over at Retraction Watch wrote about this journal two years ago, in an article called "Does a journal of homeopathy belong in science?" Spoiler alert: it doesn't. As Ivan Oransky and Adam Marcus wrote then:
"the issue is that science publishers, even legitimate global corporations like Elsevier, will accept something patently unscientific if it might make them money."
So while Nature does deserve criticism for letting bad science slip into its mega-journal, Elsevier has a lot more explaining to do. At least Nature is trying.

World Health Organization endorses TCM. Expect deaths to rise.

Mother and young rhinoceros killed for their horns.
Image credit: Wikipedia
A few days ago, a news story in the journal Nature reported that the World Health Organization, which is supposed to be devoted to improving the health and medical care of people around the globe, will for the first time endorse a belief system called "traditional Chinese medicine." I'm labeling TCM a belief system because that's what it is–but the WHO will be endorsing it as a set of medical practices.

The Nature writer, David Cyranoski, presents this news in a classic two-sides-of-the-story format, describing the "endless hours" that TCM proponents spent on such important topics as the "correct location of acupuncture points and less commonly known concepts such as ‘triple energizer meridian’ syndrome." Later in the article (but much later), he points out that scientists have argued that qi and meridians simply don't exist.

Cyranoski also falls into the trap of using the phrase "Western medicine" as if it were just an alternative point of view. An apt response is this comment from a biology Ph.D. student, who goes by @astrelaps on Twitter:
"What a weak, equivocal article from the world's preeminent scientific journal. "For those steeped in Western medicine..." is like writing "For those steeped in climate science" or "For those steeped in evolutionary biology" when reporting on climate change denial or creationism."
Well put. On the other hand, Cyranoski does point out that the major motivation for TCM is money:
"[China] has been aggressively promoting TCM on the international stage both for expanding its global influence and for a share of the estimated US$50-billion global market."
Were you thinking this was about health care? Afraid not. Cyranoski goes on to point out some serious problems with TCM, for example:
"Critics view TCM practices as unscientific, unsupported by clinical trials, and sometimes dangerous: China’s drug regulator gets more than 230,000 reports of adverse effects from TCM each year."
Actually, it's much worse than this.  Here's what TCM really looks like: the horrific slaughter of the last remaining rhinoceroses in Africa in order to hack off their horns, which are sold to become part of elixirs that some people mistakenly think confer strength or virility. Last year, National Geographic ran a heart-wrenching photo essay showing some of the awful results of rhinoceros poaching in Africa; take a look at these photos here.

TCM also looks like this: black bears kept in grotesquely cruel "farms" with a permanent tube inserted into their abdomens so that their bile can be harvested. Despite a growing movement to end this inhumane practice (see this NY Times story), it persists today, with thousands of bears kept in cages so small they can barely move. No one can view photos such as these and say that TCM is a good thing.

And TCM is behind the slaughter of the last remaining wild tigers, which are virtually extinct now in Asia, so that men can foolishly eat their bones, claws, and genitals in the mistaken belief that tiger parts will make them virile. Here too, National Geographic has details and photographs that are almost too painful to look at.

And don't get me started on pangolins, the beautiful, peaceful mammal that's now perilously endangered because TCM practitioners think its scales have some sort of medicinal value. (They don't.) For more on these gentle creatures, see the article I wrote last year.

I can almost hear the counter argument: but what about artemisinin? That's a plant extract derived from Artimisia annua, an herb that was traditionally used in China to treat malaria. Turns out that it really works, and artemisinin is now the basis of a number of modern malaria treatments.

Well, great. If an herb has the potential to treat disease, we should (and can, and do) study it, figure out what the active ingredient is, develop a controlled process for delivering effective doses, and use it. That's what happened with artemisia, and it also happened with taxol, an effective cancer chemotherapy derived from the Pacific yew tree, and common aspirin, derived from the willow tree.

But one success doesn't excuse hundreds of bogus claims that are based on little more than magical thinking.

There's no legitimate reason to use terms such as "Chinese" medicine, or American, Italian, Spanish, Indian, or [insert your favorite nationality] medicine. There's just medicine–if a treatment works, then it's medicine. If something doesn't work, then it's not medicine and we shouldn't sell it to people with false claims. The same is true for alternative, holistic, integrative, and functional medicine: these are all just marketing terms, with no scientific meaning. They merely serve to disguise sloppy, unscientific thinking at best, and in a less charitable interpretation, outright fraud.

As the Nature article points out, TCM has been a scam for decades: it was revived and heavily promoted in China by former dictator Mao Zedong, who didn't believe in it himself, but pushed it as a cheap alternative to real medicine. I won't go over that again here, but see these stories from Alan Levinovitz in Slate and David Gorski at Science-based Medicine.

Finally, why would the World Health Organization start pushing a set of unscientific practices that are likely to harm people's health? Support for TCM grew during the tenure of former WHO director Margaret Chan, who ran the WHO until 2017 and who had close ties to China. When Nature tried to contact Dr. Chan, the WHO responded that Chan "is not answering questions on matters related to the WHO."

By endorsing TCM, the WHO is taking a big step backwards. Let's hope that the current leaders of the WHO will realize that this step undermines their core mission. The WHO should not advocate treatments that not only have no evidence to support them and that can cause real harm to patients, but also are the primary reason that humans are hunting rhinoceroses, tigers, pangolins, and other animals to extinction.

Play Tennis For A Longer Life. Science Proves It.

Chris Evert and former President George H.W. Bush playing
tennis at Camp David during Bush's presidency.
Tennis might just be the best thing you can do to extend your life.

A new study from Denmark, published just last week by Peter Schnohr and colleagues, shows that playing tennis may extend your life by nearly 10 years. That's a remarkably big benefit, one that even the study authors were surprised at.

It's been well-established for a while now that exercise helps you live longer. For example, the Cardiovascular Health Study found that people over the age of 75 can expect to gain 1 to 1.5 years of healthy living by being active rather than sedentary. Others studies have looked at the effects of running or walking and found similar positive benefits.

The authors of the new study wanted to look at other sports activities, not just running. Using a large cohort of 20,000 healthy people in the Copenhagen City Heart Study, they identified 8,577 who were in the study from the early 1990s until 2017 and who met a variety of other criteria for inclusion. This gave them 25 years of followup, long enough to ask the question: how does participation in sports affect life expectancy?

In particular, they looked at tennis, badminton, soccer, jogging, cycling, calisthenics, swimming, and health club activities (which included treadmills, ellipticals, and weights).

The bottom line: compared to a sedentary lifestyle, playing tennis extends one's life expectancy by 9.7 years. The other sports all provided benefits too, though tennis was the clear winner. Here's a summary:

  • Tennis: 9.7 years gain in life expectancy
  • Badminton: 6.2 years
  • Soccer: 4.7 years
  • Cycling: 3.7 years
  • Swimming: 3.4 years
  • Jogging: 3.2 years
  • Calisthenics: 3.1 years
  • Health club activities: 1.5 years

The authors didn't expect tennis to do so well, as you can see in this quote:
"Surprisingly, we found that tennis players had the longest expected lifetime among the 8 different sports."
For those who don't read scientific papers regularly, I should point out that the word "surprisingly" rarely gets past the editors unless the result truly is surprising. One part of the surprise is that spending more time exercising did not correlate with the greatest benefits. In fact, the cohort of people who spent the longest time on their exercise was the health club group, who showed the smallest increase in longevity.

One possible reason for tennis, badminton, and soccer doing so well is that out of the 8 sports studied, these are the ones that require 2 or more people and involve social interaction. As the authors explain,
"Belonging to a group that meets regularly promotes a sense of support, trust, and commonality, which has been shown to contribute to a sense of well-being and improved long-term health."
Or it might be that the type of exercise you get in tennis – short bursts of activity rather than slow, steady plodding exercise – might be better for you. The authors noted that
"short repeated intervals of higher intensity exercise appear to be superior to continuous moderate intensity physical activity for improving health outcomes."
If you're still skeptical, the only other study similar to this one, a very large study from Britain published last year, came to the same conclusion: racquet sports had the greatest benefit on all-cause mortality, followed by swimming and aerobics.

So if you're not doing it already, take up tennis! It's easy to find clinics and teams at almost any level (in the U.S., that is), thanks to the thousands of local clubs and to the huge network of USTA leagues, with play ranging from beginners on up, and age groups up to 85 and even 90.

That's right, there are tennis leagues for the 90-and-over set. Maybe tennis players really do live longer.

(Caveats: this was an observational study, based on surveys of people's behavior over a 25-year time span. The scientists tried to take into account all the other variables that might affect life expectancy, but humans are complicated and surveys are never entirely reliable. We don't know that tennis, badminton, and the other sports were the cause of longer life–it might be that people who play sports are generally healthier, and that both leads to longer life and allows them to play more sports.)

Can fasting help you burn off those vacation pounds?


Vacation's over, and with it comes the end of the french fries, ice cream, and other delicious but fattening foods that are hard to resist. "I'm on vacation," we tell ourselves, "I can diet later."


Well, it's later now. How about fasting? Is that an effective way to take off the weight?

Fasting has been growing in popularity in recent years. One of the latest fads is intermittent fasting, in which you fast at regular intervals and then eat all you want in between. There's the 5-2 fast, where you eat for 5 days and fast for 2, every week. Or there's alternate-day fasting, where you eat one day and fast the next, for as long as you can. Or you can fast every day for 16 hours and get all your eating done in the other 8.

Here's the thing: eating is easy, and fasting is hard. If you're going to fast to lose weight, you probably will lose a bit, but the evidence is that most people gain the weight back fairly soon once the fasting diet is over. So fasting might provide a quick reward in terms of weight loss, but the loss will be fleeting.

Suprisingly, though, fasting may be a good idea. A recent review by Stephen Anton and colleagues, in the journal Obesity, found that intermittent fasting may come with a variety of health benefits, including reducing inflammation, improving the ratio of lean tissue to fat, improving cognitive function, preventing type 2 diabetes, and possibly even prolonging life span.

How does fasting produce these benefits? Professor Valter Longo of USC, one of the leading researchers on fasting and longevity, hypothesizes that fasting forces your body to recycle many of its immune cells, particularly white blood cells. Then your body works hard to replenish its white blood cells, essentially re-setting parts of your immune system. Longo is also the inventor of the fast-mimicking diet, where you eat a special diet for 5 days every month, one that makes your body think you're fasting even though you're getting adequate calories and nutrients. (See Alice Walton's story in Forbes for more about that.)

Another effect of fasting is a change in metabolism. As Anton's article explained:
"the key mechanism responsible for many of these beneficial effects appears to be flipping the metabolic switch." 
This happens when the body runs out of its normal fuel, glucose, and begins to burn fat, which means it's converting fat to fatty acids, which in turn produce ketones. The body then uses ketones instead of glucose.

So how much fasting do you need to flip the switch from glucose to ketones? Anton et al. write that
"The metabolic switch usually occurs between 12 and 36 hours after cessation of food consumption, depending on the liver glycogen content and on the amount of exercise during the fast."
This doesn't tell the whole story, because once the switch occurs, you need to burn ketones for some time to gain any benefits. Back in 2014, I wrote about new evidence (from Valter Longo's research) that a longer fast, such as 3 days or more provide significant long-term health benefits. Three days is a long time to fast, but Longo has said that you don't need to do it more than a few times per year.

If you do decide to try a fast, don't expect it to be easy: you're going to get really hungry, and fasting can also interfere with social obligations in an inconvenient way.

I should emphasize that the evidence isn't yet clear for any of these strategies, and there are multiple studies going on now that may provide a clearer picture. Nonetheless, despite the current fad of fasting strategies and diets, fasting really does seem to have some potential health benefits.

(A final caveat: fasting can be harmful, especially for people who have other health problems. If you’re seriously thinking of trying this, you should consult your doctor first.)

Conspiracy theories and snake oil, the perfect pair

Why on earth would people rely on a conspiracy theorist, someone with only a high school education, for medical or health advice? And yet, some people do.

Alex Jones, the far-right conspiracy theorist who runs the Infowars radio program and website, was temporarily suspended by Twitter this week, following bans by Apple, YouTube, and Facebook. These social media companies banned him for repeatedly violating their rules about hate speech and inciting violence. Among other notorious claims, Jones has falsely claimed that children murdered in the mass shooting in Sandy Hook were just actors and that their parents faked their deaths.

What many people don't know, though, is that Jones also runs a dietary supplement business from his Infowars site. Despite reports that Jones' supplements are little more than "overpriced, mundane vitamins," his supplement sales seem to be quite profitable–so much so, in fact, that Buzzfeed reported that the supplement business "largely funds Jones' highly controversial Infowars media empire."

I was curious to see what Jones was selling, so I looked at his Infowars web store. It features an array of products with names like:


Each of these products is marketed with breathless claims for what it can do, including testimonials from Jones himself. For example, Brain Force Plus claims to "supercharge your state of mind," and Jones plugs it with this quote:
"This is what I take before a hard-hitting show. I absolutely love it, and the crew does too. This stuff is over the top powerful!"
Well then. Never mind that Brain Force is really just a collection of herbal extracts and vitamin B-12, none of them proven to "supercharge" your mind or any other body part.

In a similar vein, Jones hypes Super Male Vitality with this claim:
"This product works so well for me that I actually had to stop taking it before I go on air or else I would want to do hours and hours of overdrive with complete focus on the topics at hand."
From the name, you might guess that Super Male Vitality has something to do with testosterone, and the website does state that it "may help support normal testosterone levels in men." What's in it? A collection of plant extracts, none of them proven to maintain or increase testosterone or to have any actual medical benefit.

Of course, if you follow the asterisks on both of these pages and read further down, you'll see that
"These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease."
This statement is the standard disclaimer that supplement manufacturers make in order to avoid FDA oversight. There's no actual scientific evidence (and Jones's Infowars pages don't attempt to cite any) that these products do what the text on the very same page says they do. You just have to take Jones' word for it.

This is pure snake oil. That shouldn't be surprising, not coming from a man who has accused grieving parents of faking their children's deaths, and who claims the U.S. government was behind the 9/11 attacks. It's hard to understand why anyone believes any of the outrageous claims this guy makes, and especially bewildering that people who trust him to advise them on health and diet. His supplements aren't even a good buy, as Buzzfeed reported a year ago. All I can say is, caveat emptor.


You Think It's Hot Now? Just Wait.

Figure from Steffen et al.: a global map of potential
tipping cascades. The individual tipping elements are
color-coded according to estimated thresholds in global
average surface temperature (tipping points).
It's getting hotter all over the planet.

This week the temperature in Bar Harbor, Maine, reached 91° F (32.8° C). In my 20 years vacationing here, this is easily the hottest weather I've ever experienced.

Up and down the U.S. east coast, cities are sweltering, and temperatures out west are even hotter, with California seeing all-time high temperatures, including the hottest July on record in some areas, which has fed damaging fires across the state. Death Valley is always hot, but this week has been crazy, with temperatures on August 7 reaching 122° F (50° C).

At the same time, Europe is baking under a "heat dome" that has brought unprecedented high temperatures, including 45° C (113° F.) in Portugal. It's so hot that people aren't even going to the beach.

Global warming is here, folks. I know we're supposed to call it "climate change," because it's much more complex than simply warming, but warming is one of the most obvious consequences.

And yes, a single heat wave doesn't prove anything, and weather is not the same as climate. I know. But a just-released study from Oxford University found that climate change made this summer's heat wave in Europe twice as likely.

And now, a new study published last week in the Proceedings of the National Academy of Sciences, says it could get much, much hotter if we don't do something about it. In this paper, an international team of climate scientists led by Will Steffen and Hans Joachim Schellnhuber explain that, thanks to human activities, the planet is well on its way to a "Hothouse Earth" scenario.

In a Hothouse Earth, global average temperatures would rise 4–5° C (7–9° F) and sea levels will rise 10–60 meters (33–200 feet) above today's levels. This would be catastrophic for many aspects of modern civilization. Many agricultural regions would become too hot and arid to sustain crops, making it impossible to feed large swaths of humanity. Low-lying coastal areas would disappear or become uninhabitable without massive engineering efforts, displacing hundreds of millions of people. As Steffen et al. put it:
"The impacts of a Hothouse Earth pathway on human societies would likely be massive, sometimes abrupt, and undoubtedly disruptive."
That's putting it mildly.

One reason this scenario is happening, as the study explains, is that we are very close to "tipping points" beyond which certain changes cannot be stopped. (We may have already passed some of them.) These include losing the Arctic ice cap in the summer, and losing the Greenland ice sheet permanently: because they are basically white, these massive expanses of ice serve as giant reflectors to send much of the sun's heat back into space. Without the ice, the darker planet surface absorbs far more heat, creating a positive feedback effect. Another example is the melting of the permafrost, land that has been frozen for thousands of years and that contains a great deal of carbon in the form of methane. Once that methane is released, it will create further warming.

We are also likely to lose the Amazon rainforest, all of our coral reefs, and huge swaths of boreal forests. (See here for a global map of these tipping points.)

If this seems grim, Steffen and colleagues point out that we still have time to avoid it. They propose that societies must act collectively to create a "Stabilized Earth" at no more than 2° C above pre-industrial levels, which is possible but not easy:
"Stabilized Earth will require deep cuts in greenhouse gas emissions, protection and enhancement of biosphere carbon sinks, efforts to remove CO2 from the atmosphere, possibly solar radiation management, and adaptation to unavoidable impacts of the warming already occurring."
None of this is beyond our abilities. We know what we need to do, but it requires large-scale, coordinated action that many governments must agree on if it's to have an impact. Unfortunately, humans (and our governments) tend to do nothing until faced with an emergency, and the tipping points leading to a Hothouse Earth may not look like emergencies, not at first. For example, Arctic sea ice has been declining steadily for 25 years or more, but because few people are aware of this (and even fewer experience it first hand), it doesn't seem urgent. Yet it is.

So perhaps this summer's heat wave can serve as a wake-up call that we need to pay more attention to our planet's health. Otherwise it's going to get a lot hotter.

European Union gets it wrong on GMOS. Again.

Teosinte on the left, modern
corn on the right, a hybrid in
the center.
A European Union court just issued a new decision about GMOs. Disappointingly, this decision is likely to confuse rather than clarify this complex and contentious issue. The court announced that plants whose genomes have been modified with CRISPR technology, a very precise form of genome editing, are subject to the EU's very strict restrictions on genetically modified crops.

More specifically, the Court of Justice of the European Union (ECJ) decided that:
"Organisms obtained by mutagenesis are GMOs."
If we take this literally, then here’s a list of all the foods that have never been subjected to mutagenesis, and are therefore NOT GMO:
  1. Salt
  2. Wild boar
  3. Wild blueberries
That’s it. (OK, maybe there are a few others.)

We have been modifying the genes of the foods we eat for millenia. Every loaf of organic, non-GMO bread is made from wheat that humans have modified since ancient times. Every glass of milk from your grass-fed, bovine-growth-hormone-free cow comes from a cow that humans have bred for centuries. All cows are genetically modified. Those delicious croissants you bought at the organic bakery? Sorry, those are GMOs, no matter how organic you think they are.

And corn? Have you seen what ancient corn, called teosinte, looks like? I encourage you to Google it (or see the image on this blog, above). Modern corn is the result of many generations of human-driven genetic modifications.

To be fair, the EU court recognized that many of our foods have been genetically modified for a long time, and that it might be impractical to remove all of them from our food supply. So they carved out an exception:
"varieties [of plants] obtained by means of mutagenesis techniques which have conventionally been used in a number of applications and have a long safety record are exempt...."
What's ironic here–though I'm confident that the EU court didn't mean this–is that by this definition, virtually all of the GMO crops in the U.S. are exempt. You see, we've been eating them for decades, and they have a phenomenal safety record.

Two years ago, the US National Academies of Sciences, Engineering, and Medicine issued a massive report that reviewed over 1,000 studies of GMOs. The bottom line: there are no health risks whatsoever from eating genetically modified foods.

Earlier gene editing technology sometimes added foreign genes to an organism, such as adding a bacterial gene to a plant. The EU court's new decision is intended to clarify that even if a foreign gene is not involved, plants bred using the newest form of gene editing (CRISPR technology) are nonetheless GMOs.

Banning GMOs doesn't make sense, and it never did. Genetic technology is just a tool, one that can be used for countless purposes, some of them highly beneficial–such as golden rice, which has the potential to prevent blindness in countries where many people depend on rice as their main staple food. If someone objects to a particular use of GM technology, such as Monsanto's use of it to create herbicide-resistant plants, that's something we can reasonably debate. But banning all GMOs is throwing out the baby with the bathwater.

Now if you'll excuse me, I've got to go out to my grill and see how my wild boar is doing. It might need a bit more salt.

Should we all take aspirin? Not so fast.

I thought we'd put this one to bed. A large-scale study showed that low-dose aspirin (one quarter of a standard 325 mg pill, or about 81 mg) taken once a day can prevent heart attacks and some common types of cancer, including colon cancer.

I wrote about this topic just over a year ago, and I've followed my own advice, taking daily 81mg aspirins since then. The US Preventative Services Task Force recommends this too: regular, low-dose aspirin for people between the ages of 50 and 69 helps to prevent heart attacks, strokes and some types of cancer.

But now, a new study just published in The Lancet upends that advice. It's not that the previous study was wrong–it wasn't. It's just that the effects of aspirin vary significantly based on body weight. Essentially, the new study finds, almost all of the benefits accrue to people who weigh 70 kilograms (154 pounds) or less.

The study, a re-analysis by Peter Rothwell and colleagues of ten large trials that included 117,279 participants, is too long and complex to summarize here, so I'll just highlight a few key points. (Because the paper is open access, anyone can read it for free, just by clicking here.)

The good news, for people who weigh between 50 and 70 kg (110-154 lbs), is that the benefits of daily low-dose aspirin are quite good, possibly even better than we thought. The relative risk of a heart attack, stroke, or other major heart-related event is about 25% lower for people in this group.

The bad news, for the rest of us, is that we seem to get no heart-related benefits from taking a daily low-dose aspirin.

So perhaps those of us who weigh more than 70 kg just need a slightly larger daily aspirin pill. There is some good news here: Rothwell and colleagues found that, indeed, higher doses of aspirin are effective at reducing the risk of heart attacks for people who weigh more than 70 kg. This makes sense: adjusting the dosage based on weight is how most drugs are given. The problem is that aspirin generally comes in only 3 pill sizes: 81, 325, and 500 mg. So the studies have only looked at these 3 doses, and 325 mg is likely too large a dose for most people, because it increases the risk of bleeding events.

What about the cancer risk? As I wrote in 2017, the biggest benefit from daily low-dose aspirin is its reduction in the risk of colon cancer, breast cancer, and prostate cancer. Here, the new study doesn't quite give the whole picture, because it didn't look at breast cancer or prostate cancer. For colon cancer, low-dose aspirin reduces the risk significantly for people who weigh less than 70 kg. For heavier people, low-dose aspirin had little to no effect on colon cancer risk, but regular-sized aspirin (325 mg) worked for people up to 80 kg (176 lbs).

What to do now? The new study concludes that:
"The one-dose-fits-all strategy for daily aspirin use is unlikely to be optimal."
 In other words, you will probably benefit from daily aspirin, but the amount you should take depends on your weight. If you weigh less than 70 kg, the 81-mg tablets that you can find almost anywhere will do nicely. 

But what if you weigh more (as most men and many women do)? The science doesn't yet give us an answer: you could simply take 2 low-dose pills a day, but too much aspirin increases the risk of serious bleeding events. You could instead take a few extra pills per week, depending on your weight, which is what I'm going to do, at least until we get better data and more precise guidelines.

(Final note: as always, before you make any changes in your medication, ask your physician.)

Mosquito wars: what works to keep these little buggers away?

It's summer time, and with it comes outdoor dining, sports, and strolls through the neighborhood. But the loveliest evening can be spoiled by mosquitos, who torment us as they suck our blood and leave itchy welts behind.

How can we keep these pests away? Do citronella candles work? How about Victoria's Secret Bombshell perfume? (No, I'm not kidding. Read on.)

First, about mosquitos: they are more than just a nuisance. They also carry diseases, including West Nile virus, which now affects the entire U.S., and far more deadly diseases in other countries, including malaria, yellow fever, and Zika virus.

(Aside: West Nile virus first appeared in the U.S. in 1999, in New York, after a mosquito apparently hitched a ride on a plane from somewhere in the Middle East. A few years later it started spreading rapidly across the country, and now it's basically everywhere. West Nile fever usually manifests as a flu-like illness, but about 1 in 150 people get severe, life-threatening symptoms.)

One of the most popular ways to keep mosquitos off the backyard patio is easy to spot on a summer night in my neighborhood: burning citronella candles (such as this one from Cutter), which contain a natural oil made from grass whose scent is supposed to repel mosquitos. These are very popular and widely sold, but do they work?

Fortunately, the Journal of Insect Science published a study just last year, by Stacy Rodriguez and colleagues from the University of New Mexico, that gives us an answer. The scientists purchased a dozen different products, all from Amazon or local stores, and ran a very nice experiment to figure out how well each product worked.

Here's the setup: the scientists placed a cage full of mosquitos near a human volunteer, who sat 1-3 meters away, with a gentle breeze blowing from the humans towards the mosquitos. (This made it easier for the mosquitos to smell the humans, and also meant that they had to fly against the breeze if they wanted to bite the subjects.) The scientists applied each mosquito repellent (or device) to the volunteers, opened the cage, and counted how many mosquitos were attracted. They also ran controls where the subject had no protection.

So what worked? First off, with no protection, about 88% of the mosquitos were attracted to the human subjects. The three products that worked best at repelling mosquitos were:

  1. OFF!® Clip On™, where just 27% of the mosquitos were attracted
  2. Cutter® Lemon Eucalyptus, with 30%, and
  3. Ben’s® Tick & Insect Repellent, with 34%. 

Nothing else worked nearly as well as these, although several products reduced the proportion of mosquitos from 88% down to 60-70%.

Notably, some of the products did not work at all, including citronella: Cutter Citro Guard had no effect on the mosquito's attraction to the human volunteers. Other failures were Invisaband™ and Mosquitavert, wrist bracelets containing geraniol oil, and the PIC® Personal Sonic Mosquito Repeller, a clip-on ultrasonic device that emits a sound that mosquitos presumably don't like. Mosquitos basically ignored these devices.

So what's the secret in the products that do work? The OFF! device contains metofluthrin, which appears to be the most effective repellent on the market. Lemon eucalyptus oil is a natural product that is nearly as effective, and Ben's Tick & Insect Repellent contains DEET, which has long been known as an effective defense against mosquitos.

The only one of these products that purports to work on a whole area (like your backyard patio) rather than just one person is the citronella candle, which unfortunately just doesn't work. So if you want your garden party guests to be protected, you may have to keep on hand a basket full of products with metofluthrin, lemon eukalyptus oil, or DEET.

And what about Victoria's Secret Bombshell perfume? Well, the same scientists looked at Bombshell in a 2015 study, where they included the perfume thinking that it would attract (rather than repel) mosquitos. Surprisingly, it had the opposite effect: even though DEET and metofluthrin are more effective, the scientist found that:
"Victoria Secret Bombshell repelled mosquitoes quite effectively 120 min post application."
And what is the active ingredient? According to the same study, that's unknown.

Why is a university hosting a conference on a practice that may be an abuse of human rights?

Sometimes you think you've settled an issue, and you can move on. Demonstrating that a health practice is useless and sometimes harmful should be enough to squash it–but not always.

A few days from now, the University of Northern Iowa will host a conference on "facilitated communcation," a thoroughly debunked practice that harms patients and their families and that has been called unethical by leading medical societies.

For those who haven't heard of it, facilitated communication, or FC, is a method where a person (the "facilitator") sits next to someone and guides their hand over a keyboard. For example, a facilitator will hold the hand of a nonspeaking autistic child and guide her as she types out messages.

The problem is, scientific evidence going back 25 years shows that it doesn't work at all. All of the messages come from the facilitator–who might not even be aware that s/he is doing the actual communicating. Even worse, there are multiple documented instances where FC led to false charges of sexual abuse, invented by the facilitator, that severely damaged families and even led to imprisonment of innocent parents. Nonetheless, FC is still used today, and it is easy to find websites claiming that it can help parents communicate with their autistic children.

The American Speech-Language-Hearing Association has recently written that
"FC is not an effective form of communication and does not provide access to communication... [it] has been associated with significant preventable harms arising through false allegations of sexual abuse and mistreatment. (Boynton, 2012; Chan & Nankervis, 2014; Wombles, 2014)"
Others have been even more blunt, writing that "FC is an abuse of human rights." And yet it has not disappeared.

Why do people still practice facilitated communication? Are they even aware that what they're doing is deeply harmful? A compelling case is made in this lengthy expose, published in 2012 by a former facilitator, Janyce Boynton, who admits that she was responsible for "graphic depictions of rape and sexual assault that had no bearing in reality." Her actions led to a family being split apart and the parents being charged with child abuse. 

Yet Boynton believed at the time that what she was doing was real–as she puts it, she simply "did not want to believe that FC was a hoax." She also makes it clear that many of the people she learned from sincerely believed that FC was real. Boynton herself was crushed when she realized that she–and not the severely autistic child who had been entrusted to her care–was typing all the messages. As Boynton eventually discovered: 
"By the mid-1990s, the scientific community had proved over and over again that it was the facilitator—not the disabled communication partner—who was typing the messages. Every time. Full stop."
Ms. Boynton is now leading the effort to try to convince the University of Northern Iowa to cancel its workshop promoting Facilitated Communication. She helped put together a letter, signed by dozens of doctors, scientists, and speech pathologists, urging the dean of the UNI's School of Education not to host the conference.

I wrote to the UNI dean as well, and she forwarded my questions to Christine Ashby, a faculty member at Syracuse University which is co-sponsoring the conference. Prof. Ashby declined to answer my questions, and instead sent me a document that "provides additional information about the method and the research pertaining to its use," as she wrote. I read the document and looked at the references, but I could find nothing that refuted the earlier double-blind studies (or other, more recent studies such as this one) that have shown that FC is ineffective.

The fight against dangerous pseudoscience never ends. As five professors of speech pathology and psychology wrote just a few weeks ago:
"It's time to stop exposing people to the dangers of Facilitated Communication."
And yet it is nearly certain that the University of Northern Iowa will proceed with its workshop on June 18-19, where attendees will not only get college credit, but they may emerge with the mistaken belief that they can unlock hidden thoughts in children who are unable to communicate. This can only cause harm.

Another anti-vax paper bites the dust

Anti-vaxxers learned a lesson from discredited, de-licensed former doctor Andrew Wakefield, who in 1998 published a badly flawed article in The Lancet pushing a link between vaccines and autism. Wakefield's study was eventually shown to be not only flawed but fraudulent, leading all of the co-authors except Wakefield himself to disavow it, and in 2010 the journal finally retracted it after Wakefield lost his medical license.

But it took The Lancet 12 years to retract the paper, and in that time the anti-vaccine movement flourished. Wakefield became a hero within that movement, and continues to push his anti-vaccine propaganda today, even making films presenting himself as a lone hero fighting for truth.

Other anti-vaxxers are very familiar with this saga, and they have followed Wakefield's recipe by writing scientific papers and attempting to get them published in reputable journals. Usually they fail, but now and then one slips through, which they then point to as "proof" that vaccines are harmful.

The latest example is a paper that appeared in Scientific Reports in November 2016 and that the journal just retracted last week. It has a title that sounds highly technical: "Murine hypothalamic destruction with vascular cell apoptosis subsequent to combined administration of human papilloma virus vaccine and pertussis toxin." (Wakefield's 1998 paper had a similarly obscure title.)

What that lengthy title hides is the paper's anti-vaccine message: that the HPV vaccine might cause neurological damage. The paper was quickly called out as pseudoscience by the scientific community, who reacted within days in the blogosphere and elsewhere, as described by a news article in Science that appeared just after the paper's publication.

(Aside: the HPV vaccine protects people from human papillomavirus, which causes many cases of cervical cancer as well as throat cancer. It's the first vaccine that prevents these cancers, which is an amazing breakthrough. Millions of doses have been administered with essentially zero cases of harm.)

What did the paper do? Basically, it was a setup. The authors–most of them from Tokyo Medical University–gave mice a huge dose of HPV vaccine plus (here's the kicker) a large dose of pertussis toxin. There's no valid reason to administer that toxin except to try to induce brain damage, which the authors could then blame on the HPV vaccine. The study design was clearly awful, and the paper should never have been published.

Just after the paper appeared, two groups of scientists wrote to the Nature publishing group (which publishes Scientific Reports) to protest, as reported in the Science story. One letter, from a group of HPV experts at the University of Antwerp, explained that:
"This experimental setup in no way mimics the immunization with HPV vaccines but is gross over-dosage and manipulation of membrane permeability."
This is putting it mildly. For a blunter assessment, see Orac's aptly titled "Torturing more mice in the name of antivaccine pseudoscience," which appeared in November 2016.

What was not publicly known before now was that I too wrote to the journal editors, asking them to "take action quickly, rather than waiting for over 10 years as The Lancet did." First I wrote to the immunology sub-editor, who forwarded my letter to the Editor-in-Chief, Richard White. Dr. White replied on 29 Nov 2016 that "We are looking into the specific issues raised regarding this paper."

That was the last I heard of it, until the journal announced last week that they have retracted the paper.

So in the end, the scientific record was corrected. But why did it take Scientific Reports 18 months to do it? Haven't they learned from the Wakefield debacle how much damage can be done while antivaccine articles like this one remain in the literature? The journal's editors had a responsibility to act more quickly, and they failed. The scientists who wrote those letters back in 2016 had the same complaint, as reported by Dennis Normile in Science last week. Not surprisingly, Scientific Reports refused to comment (when asked by Science) on any details of their review process.

That's not good enough. Scientific Reports is a "mega-journal," a new type of journal that publishes thousands of papers per year, with a relatively low bar for acceptance. The idea (not a bad one, in theory) is that any valid scientific study, even one that makes only a very small contribution, still merits publication somewhere.

What publishers have learned is that these mega-journals are very profitable, because they charge a publishing fee that more than covers their costs. In return for these profits, Nature Publishing has an obligation to remove harmful papers far faster than they did in this case. Otherwise, it's only a matter of time before anti-vaxxers do this again.

Finally, let me repeat something that can't be said often enough: vaccines are perhaps the single greatest medical advance in human history. They have saved millions of lives, and they continue to save lives today. Scourges such as smallpox and polio, which once swept through populations causing terrible pain, suffering, and death, have been conquered thanks to vaccines. Medical researchers continue to work on new vaccines against the infections that still plague us, and they are the real heroes.



How not to respond to the EPA's science denialism

You would think that the editors of the top science journals in the world would know how to write clearly. But if you read their joint statement in the journal Science last week, you might be forgiven for wondering what the heck they are talking about. It's not that complicated, really. Let me explain.

EPA Administrator Scott Pruitt, when he's not busy taking expensive trips, renting rooms at a deep discount from coal lobbyists, or building $48,000 soundproof booths for his office, is doing his best to make the U.S. a friendly place for fossil fuel industries. As part of his pollution-friendly mission, Pruitt denies the scientific consensus that climate change is real and is caused in part by human activities, especially by carbon dioxide emissions.

Pruitt has devised a clever new strategy to make science denialism part of official EPA policy, while pretending otherwise: he's issued a new proposed rule that requires the EPA to use only "transparent" science. (The official Federal Register entry is here.) In his press release, Pruitt stated
"The era of secret science at EPA is coming to an end. The ability to test, authenticate, and reproduce scientific findings is vital for the integrity of rulemaking process."
The press release, which is titled "EPA Administrator Pruitt Proposes Rule To Strengthen Science Used In EPA Regulations", seems to be all about science and openness. One thing I've got to give them credit for: the PR people at the EPA know how to obfuscate.

It turns out this is just a ruse. As Pruitt certainly knows, many of the EPA's rules are based on studies of human subjects, which are governed by strict privacy rules–which are necessary not only to get people to participate in the studies, but also because violating people's privacy can be highly unethical. This means that many studies showing the harms of pollution–for example, this massive study, which found that fine-scale particulate matter from coal plants increases the risk of lung and heart disease–are not "transparent" enough for the EPA, because the identities of the participants as well as all their health records are confidential.

In other words, the new EPA policy isn't about scientific transparency. It's a transparent (!) attempt to ignore the negative health effects of pollution, so that Pruitt can put in place new rules allowing polluters to dump more pollutants into our air and water. See how that works?

In response, the Editors-in-Chief of Science, Nature, the Public Library of Science, and the Proceedings of the National Academy of Sciences issued a joint statement. Alas, their statement is anything but clear. They spend about three-fourths of it explaining about how they support data sharing, and finally, in their last sentence, they write this:
"Excluding relevant studies simply because they do not meet rigid transparency standards will adversely affect decision-making processes."
That's it. Even the most sophisticated reader could be forgiven for not understanding what the issue is, not from this statement alone.

Here's what they should have said: the EPA wants to ignore the health consequences of pollution when creating policy. The EPA administrator, Scott Pruitt, has announced a new policy that pretends to be about scientific transparency, but is nothing of the sort. Instead, this policy is designed to undermine the EPA's mission, which is (and you can read this right on the EPA's website "to protect human health and the environment."

Since the EPA's creation in 1970, the U.S. has made tremendous strides in cleaning up our air and water. Let's not start backsliding just to enhance the profits of a few polluters.

[Note: I have written the EPA and asked for comment. I will update this article if they respond.]

Sniffle. It's allergy season again. Do those shots work?

Ah, spring is in the air. The flowers are blooming and the trees are bursting into leaf.

For many of us, this time of year means one thing: allergies. The price of going outside for any length of time is sneezing and itchy eyes that last for many hours, even after we return indoors. Rather than going out and enjoying the warm air and colorful vegetation, we close the doors and windows and stock up on antihistamines and eye drops. Studies show that 20–40% of people in the U.S. have allergies.

Your local pharmacy has shelf after shelf of allergy treatments, ranging from mildly effective (Zyrtec and its equivalents) to laughably ineffective (anything homeopathic). But even the best pills have side effects, and they only serve to suppress the symptoms. As one study put it:
"Patients struggle to alleviate their misery, frequently self-adjusting their treatment regimen of over-the-counter and prescription medications because of lack of efficacy, deterioration of efficacy, lack of 24-hour relief, and bothersome side effects."
Isn't there a way to tell your body to just stop it already? After all, pollen is not a pathogen. Our misery is caused by our own immune system's over-reaction: it ramps up in response to the foreign particles (pollen) in our eyes and airways and creates a histamine reaction, which is simply not necessary.

None of the over-the-counter pills prevent this reaction, but they can dampen it–hence the term "antihistamine." However, what if there were a way to tell your body to simply chill out and ignore the pollen?

Well, maybe. You can get allergy shots. This is a surprisingly simple procedure: your doctor takes a small, diluted amount of the allergen (pollen, cat dander, etc.) and injects it into your arm. Over the course of many months, your doctor will very gradually increase the amount being injected. You have to go for the shots every week, and continue them for several years.

The question is, do they work? The answer is a qualified yes.

NIH and the Agency for Healthcare Research and Quality (AHRQ) have put together a long explainer of the evidence for and against allergy shots, which you can find at PubMed Health. The NIH study looked at 74 clinical studies of allergy shots. To save you some time, I'll cut to the chase: the evidence is quite good that shots work. Or, as the AHRQ study put it,
"we found high grade evidence that subcutaneous immunotherapy reduces rhinitis/rhinoconjunctivitis symptoms."
This might seem like pseudoscience, but it's not: what's happening is that your immune system is being de-sensitized to the allergen. It doesn't work for everyone, but in many people, this gradual de-sensitization trains their immune system not to react so badly. It's not necessarily permanent, either: after stopping the shots, allergies might re-appear after a few years.

So if you're looking out your window at the beautiful spring weather with a box of tissues by your side, maybe you have a way out. Talk to your doctor or visit the AAAAI site to find an allergy specialist. Don't expect miracles or a quick fix, but allergy shots are the best we've got, for now.


Anti-vaxxers use religious exemptions as false cover for their beliefs

History of measles in the 20th century.
For several years now, anti-vaxxers have been claiming that they have religious objections to vaccines. This is nonsense.

Just last month, the New England Journal of Medicine featured an article describing how the federal Equal Employment Opportunity Commission (EEOC) has been suing hospitals that deny employee requests for religious exemptions to the hospitals' vaccination requirements. The NEJM documented 14 cases where employees sued claiming that they had religious objections to the flu vaccine. Six of the cases were settled, and in the other cases, sometimes the hospital won, sometimes the employees. It's a mess.

The NEJM article focused on the legal perspective, advising hospitals on how they might avoid lawsuits. That's understandable, but it misses the broader point: there's virtually no such thing as a religious objection to vaccines. All of the world's major religions support vaccination, and only a few tiny, extremist sects teach their followers that vaccines are contrary to their faith.

What's really going on is that anti-vaxxers are using religious exemptions as cover for non-religious (and erroneous) objections to vaccines. The anti-vaxxers have convinced people that vaccines are harmful, or scary, or both. They are wrong.

Vaccines are the probably the greatest success story in the history of medicine. They've saved millions of lives. Consider that in the decade before the measles vaccine was introduced in 1963,
"3 to 4 million people in the United States were infected each year [and] an estimated 400 to 500 people died, 48,000 were hospitalized, and 1,000 suffered encephalitis (swelling of the brain) from measles." (Source: CDC)
And that's just measles. People no longer suffer and die from smallpox and polio, which have been eradicated worldwide (except for a few countries where polio still has a foothold). Vaccines protect us from multiple other formerly common childhood infections, and they've been so effective that people are no longer afraid of these diseases. That very success is the opening that the anti-vaxxers use to spread disinformation and fear.

It's not just the EEOC that has been enabling anti-vaxxers. Many U.S. states have passed laws that allow religious exemptions to vaccination. (Note that vaccines are required before children can enroll in public school systems, an incredibly important public health requirement. The exemptions refer to this requirement.)

Here, though, there are signs of hope. After suffering from repeated outbreaks of preventable diseases like measles, many states have recently awakened to the risks caused by unvaccinated children in public schools, and they are moving to remove or tighten these exemptions.

New Jersey is the latest state to act. While the bill introduced in the New Jersey legislature last week doesn't quite eliminate religious exemptions, it makes them harder to get, requiring considerably more documentation from parents claiming a religious exemption from vaccines for their children. NJ took action after realizing that these so-called "religious" objections had risen dramatically, from 3,865 in 2009 to 10,407 in 2016. That rise was fueled, apparently, by anti-vaxxers taking advantage of the loophole in the law, not by any genuine religious objection to vaccines.

It's worth noting that all states allow medical exemptions to childhood vaccination, which are legitimate and necessary. For example, a child undergoing leukemia treatment may have a severely weakened immune system, and a vaccine would be ineffective and possibly harmful. These children are precisely the ones who can only be protected by requiring all the other children in their school to be vaccinated.

Meanwhile, the EEOC should stop suing hospitals. Hospitals are filled with very sick and vulnerable people, and employees have an obligation not to expose patients to possibly deadly infections. If a hospital employee doesn't take that obligation seriously, then s/he should find another job.

Here's $142M we'll be wasting on pseudoscience in the new US Budget

After much unnecessary drama and 6 months late, Congress finally passed a budget last week funding the government for the fiscal year that started in October 2017. While much of the news is good, or at least not too bad, the 2,232 page budget contains lots of goodies for special interests.

I downloaded the whole thing so you don't have to.

One of the worst pieces of wasteful spending is tucked away on page 934: $142,184,000 for the National Center for Complementary and Integrative Health. Incredibly, this is a 9% increase over the NCCIH's 2017 budget of $130.5 million. Is this because they've discovered new and effective treatments? Alas, no.

NIH has been spending money on so-called alternative medicine since 1992. Over the years, the budget has increased from just $2 million to the very hefty $142 million this year. NIH has now spent a total of $2.366 billion dollars on its alternative medicine center.

The NCCIH started as an "office," funded by a $2 million earmark by former Senator Tom Harkin, who later elevated it to a National Center called NCCAM. On Harkin's retirement in 2015, his buddies renamed it as NCCIH, adopting the buzzword "integrative" as a jazzier word than "alternative." It's a classic (and sad) example of how once something gets started by Congress, it grows relentlessly, creating its own constituency of people and industries who consume the funding and clamor incessantly for more.

What have we learned for our $2.4 billion? Have new cures been developed, new medicines been discovered? Has NIH provided good scientific evidence that any of the "alternative" methods–which include acupuncture, homeopathy, naturopathy, Ayurveda, therapeutic touch, reiki, aromatherapy, and others–actually work? The answer to all these questions is no.

On the other hand, the real work of biomedical research, funded by the rest of NIH, has yielded tremendous progress on a wide range of diseases. These include cures that we could only have dreamed about 10 or 20 years ago, such as this amazing stem cell cure of a 7-year-old boy with a devastating skin disorder, or this leukemia treatment reported in 2013.

After 26 years and $2.3 billion spent trying–and failing–to prove that alternative medicine works, it's long past time to end this nonsense and shut down NCCIH, as I and many other scientists have been saying for years. That $142 million could be used far more effectively studying real treatments for real diseases, rather than imaginary treatments that have failed, time and again, to prove their merits.

$142 million. To those who argue that it's only a small percentage of the NIH budget, I would point out that a typical NIH research grant is under $500K. This means we could fund at least 300 additional biomedical research projects every year if we got rid of this giant special-interest earmark that has utterly failed to produce anything useful.

Instead, someone in Congress managed to sneak in the largest budget increase that NCCIH has seen in 15 years. What a waste.

Starving science: a petty, shortsighted national "strategy"

This image taken approximately 438 miles above the earth's
surface provides a spectacular view of the Lena Delta in
Russia. Image courtesy of the U.S. Geological Survey, whose
 images are all in the public domain.
150 years ago, passenger pigeons were so numerous that they could black out the sky when their flocks passed overhead. The last passenger pigeon, a female named Martha, died in the Cinncinnati Zoo in 1914. All we have left of this species are specimens held in museum collections.

One of the most extensive collections of animal specimens in the world is managed by a tiny unit of the U.S. Geological Survey, called the Biological Survey Unit. A small group of curators maintains a collection of more than one million animals collected over the past 130 years by scientists and ordinary citizens across the U.S.

Now, for reasons that are at best mysterious, the USGS is planning to eliminate the Biological Survey Unit. The BSU has a very small budget, a mere $1.6 million out of the USGS's budget of $1.1 billion, and an even tinier fraction of the country's $4.4 trillion budget.

What the heck are they thinking? Shutting down the Biological Survey Unit won't save enough money in the vast government budget to even be noticed, but the loss of its precious collections will reverberate through the decades. Does someone in the USGS or the Department of the Interior have a grudge against the BSU? Or are they just petty?

The BSU's collection resides in the Smithsonian Museum of Natural History, one of the great museums of its type in the world. The collection contains some 370,000 birds, 300,000 mammals, and 390,000 amphibians and reptiles, many of them dating back to the late 19th century. These specimens represent a unique view back in time, illustrating the natural history of our continent and the animals that have lived on it over the years.

It's only through collections like this that scientists can understand how human activities have affected our natural world. For example, historical collections of eggs from wild birds allowed scientists to document the thinning of eggshells caused by the pesticide DDT, which was made famous by Rachel Carson's book Silent Spring.

Just a few weeks ago, the presidents of three of the leading animal science societies in the U.S. wrote a letter to Science magazine pleading for the USGS to continue funding its Biological Survey Unit. So far, the USGS has not responded to them.

Museum collections may not be as flashy as some areas science (perhaps we need a new Indiana Jones movie to raise their profile), but that doesn't mean they are not critically important to our understanding of the natural world. Once the BSU disappears, it's not coming back: the curators will retire or find other jobs, and the collection will become inaccessible, even if it still exists somewhere in the bowels of the Smithsonian.

The plan to shutdown the Biological Survey Unit seems indicative of a larger trend of neglecting investment in our future. It may reflect a particular form of neglect by the USGS, as pointed out by Cynthia Ramotnik in a 2015 article. It also reflects the severe cut to the USGS budget proposed by Donald Trump last month: he requested a total budget of $860 million, which represents a 20% cut from the current year's budget of $1.08 billion. But in the case of the BSU, the budget impact is so small that it seems worse than neglectful to cut it: it is shortsighted and petty.

When asked by the Washington Post, former House speaker (and current Trump enthusiast) Newt Gingrich admitted that the cutting the BSU's $1.6 million budget wouldn't matter to the larger budget, but he then went on to comment, “if this collection is that valuable, there are probably 20 billionaires that could endow it.”

Great: let's hand over our national resources to billionaires, and if they're not interested, well, it must be that the resources weren't that valuable in the first place. Not.

This is ridiculous. We're still a rich country, and we shouldn't be eliminating projects like the Biological Survey Unit just to give a massive tax cut to rich people, or just to make a point about budget cutting, or whatever the reason that the USGS and the Department of the Interior might offer. (The USGS hasn't responded to my inquiries.) Maintaining our museum collections not only shows respect for the thousands of people who built them over the years, but it benefits the countless scientists, educators, school children, and others who will learn from these collections in the future.

Coffee causes cancer. Coffee prevents cancer. Who to believe?

California might soon start requiring Starbucks to warn its customers that coffee causes cancer. Has  California gone nuts, or is there something to this?

A lawsuit filed in 2010 by a group called the Council for Education and Research on Toxics is in its final stages, and the judge might rule soon unless the plaintiffs settle the case. Several of the plaintiffs, including 7-Eleven, have already settled and agreed to post warnings in their stores.

The basis for the lawsuit is that brewing hot coffee produces acrylamide, which is on a list of substances that California claims cause cancer or reproductive toxicity. (It's a very long list.) Even though acrylamide has been on the list since 1990, it wasn't until 2002 that Swedish scientists discovered that acrylamide is present in many foods.

As the American Cancer Society explains,
"Acrylamide is found mainly in plant foods, such as potato products, grain products, or coffee. Foods such as French fries and potato chips seem to have the highest levels of acrylamide."
Uh oh. Coffee, french fries, and potato chips. Where's the joy in life without these?

But wait a second: how come people aren't keeling over with cancer left and right, especially in our coffee-loving, french-fry-loving society? (And what about the French?)

It turns out the evidence against acrylamide is pretty sketchy. If you give it to mice in the lab, at doses 1000 times greater than the amounts found in food, it does seem to increase their risk of cancer. But mice are not people, and 1000 times is a whole lot of acrylamide. The ACS concludes that
"it’s not yet clear if acrylamide affects cancer risk in people."
It's just as easy to find claims that coffee prevents cancer. A 2017 review found that one cup of coffee a day is associated with a slight reduction in the risk of liver cancer and endometrial cancer. A 2010 review of over 500 studies found the same reductions, but a slight increase in the risk of bladder cancer among heavy coffee drinkers. Another large review in 2017, by Robin Poole and colleagues in the UK, found not only a reduced risk of cancer, but a reduction in heart disease and overall mortality.

The Poole study concluded:
"Coffee consumption seems generally safe within usual levels of intake, with [the] largest risk reduction for various health outcomes at three to four cups a day, and more likely to benefit health than harm."
Coffee lovers, rejoice! But let's not kid ourselves: no one is drinking coffee for its health benefits, are they? The stuff just tastes good.

Finally, in answer to my own question at the top of this article: yes, California has gone a bit nuts. Or, as the nonprofit American Council on Science and Health put it:
"If coffee is deemed carcinogenic, then the State of California will be required to give up all pretense at common sense and sanity."
An afterthought: the lawsuit may be just about money. As Bloomberg News explained last October, in a story about the California coffee case: "Unfortunately, it is very easy for ‘bounty hunters’ to file Prop. 65 lawsuits against even small businesses and the cost of settlement and defense often exceeds other types of abusive litigation." The American Council on Science and Health was even more blunt, calling it an attempt to grab "a giant bag of money."

Let's hope the judge in the California case pays attention to the science. Meanwhile, the rest of us can focus on more important questions, such as: dark roast or light? French press or drip?