I’m watching the Daily Show right now (Comcast in Washington, DC), and I’ve already seen 4 ads about clean coal (it’s 11:20).  Within the same commercial break, I’ve seen both of these commercials:

Washington’s metro stations and train cars are plastered in yellow ads with mermaids holding black rocks and the URL thisisreality.org. US News has an interesting blog post on the “reality campaign” here.

It’s clear that this debate is gaining momentum in this time of economic downturn. It seems that the stimulus bill, with its provisions for developing green jobs and sustainable energy sources is, perhaps, having an impact on our national energy outlook. But in the spirit of “shovel ready” projects, is clean coal the answer?

The fact is, there is no clean coal right now. Clean coal requires the development of systems and technologies that are not currently available. The “clean” part of clean coal is the idea that carbon released from the combustion of coal can be kept out of the atmosphere – using carbon capture and sequestration. Time Magazine, by no means a paragon of left-leaning values, explores some of the technology hurdles in this January article.

The NY Times has an interesting piece on how the stimulus is bringing back the clean coal rhetoric that we heard during the Presidential campaign last year. This is why the metro ads are back up and the Daily Show is alternately being sponsored by the pro- and con-clean coal lobbies.

[A digression on my personal views: Don't get me wrong - I think we should invest in research into clean coal through standard research mechanisms found in NSF, DOE, and EPA. I just think it's premature to invest in clean coal plants when the technology is fuzzy at best and certainly completely untested.]

What I find particularly interesting about these lobbying campaign is that one is far more sophisticated than the other. The Reality Campaign is hipper. It uses irony and some of the more recently popular advertising tactics, like the serial ads that don’t mean anything until you put them together (see mermaid reference above), or an unusual and annoying sound to recapture a viewer’s attention in a TV ad. Besides this, the creative is brilliant. What better way to draw attention to the drawbacks of coal than to choose a canary as your mascot?

On the other hand, the America’s Power campaign follows the typical political ad, simply replaying parts of Obama’s campaign speeches. While this attempts to capture the energy of “the moment”, I think they’ve missed their chance. The “Yes we can” chant at the end of the ad is so January 19th. From Inauguration Day onward, Obama has taken a much more sober tone in his speeches and with the economic troubles continuing, the sense of hope many of us experienced is being beaten down by layoffs, disappearing 401Ks, and the number of nominees with tax problems. I know Obama’s popularity is still up there, but we are no longer chanting “Yes we can!” So this campaign seems to have missed the moment altogether. I think it will be far less effective than the quirkiness and irony of the Reality Campaign.

Before my blogging sabbatical, I was working on an article about the “new” prostate cancer screening recommendation recently released by the US Preventive Services Task Force.

Until this report came out in August, the standing recommendation was generally understood to be that men over the age of 50 should be screened via PSA testing and a DRE. The 2008 USPSTF report found that they couldn’t determine whether there was any benefit to screening over the age of 75. So the new recommendation is not against testing men over 75, because the harms are likely to outweigh the benefits.

When you look closely, there’s no change in recommendations. I’ve spoken with three leading specialists in prostate cancer treatment and research from three different practice fields. They all agree that for all intents and purposes, this does not change how a doctor should care for a 75-year old man.

Interestingly, the urologist with whom I spoke (who is a member of a surgical society that does not accept the new recommendations), said that nothing changed and it won’t affect his practice. The medical oncologist was somewhat concerned about the overall message about screening being less clear – because she treats patients whose cancer was not found early enough. And the population scientist felt very strongly that these findings were important because the data do not support any benefit coming from screening.

To illustrate how these three opinions about the report could boil down to the same conclusion of no change in the way care is provided, you have to look closely at the language. The American Cancer Society’s recommendation says that men should have a conversation about PSA testing with their doctors starting at age 50:

The American Cancer Society (ACS) does not support routine testing for prostate cancer at this time. ACS does believe that health care professionals should discuss the potential benefits and limitations of prostate cancer early detection testing with men before any testing begins. This discussion should include an offer for testing with the prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) yearly, beginning at age 50, to men who are at average risk of prostate cancer and have at least a 10-year life expectancy.

The language is pretty vague, but essentially the recommendation is to have a discussion; whether you’re over 50 or over 75.  And this makes sense to me. There are many factors that go into this decision, and it illustrates the “art” that goes into medicine. We don’t have a one-size-fits-all approach.

But I think the way we deal with uncertainty as individuals makes us want medicine to be a science. The urologist I spoke with is comfortable because he doesn’t perceive any uncertainty in the decision. If an active 80-year old comes into his office for screening, he will have the discussion with him. If a 55-year old in poorer health comes in, he’ll also have the discussion.

On the other hand the population scientist was adamant that the data show no benefit, much like Schweitzer. In fact, she is waiting for the results of the PLCO (prostate, lung, colorectal, and ovarian) Cancer Screening Trial, because as the ACS statement alludes to, the benefit of PSA testing is not clear.  Perhaps the population-wide study will not find that lives are being saved – or at least extended – through early detection. Or perhaps it will find that they are, but that the negative impacts of screening (false positives, false negatives, excess biopsies, etc.) make the relative benefit very small. She’s unprepared to deal with the uncertainty.

The medical oncologist wants everyone to be screened. She doesn’t care about the uncertainty, as long as at least one person benefits.

I did not end up writing the story about this for work because I ran out of time trying to find a coherent narrative about it for my institution. It’s a little hard to weave these difficult conversations about uncertainty into an official story.

Chris Mooney has an interesting column on Science Progress this week. He – rightly in my opinion – identifies Colbert as one of the leading (or only) popular purveyors of science on TV. Chris says:

In other words, you might say that George W. Bush’s anti-intellectual administration created a perfect opening for Stephen Colbert’s hugely popular caricature of anti-intellectualism; and this in turn transformed Colbert into possibly our most important defender and explainer of scientific knowledge. (Again, if you get the jokes.)

This led me to think about where we go (as a nation/culture) for our information. Although the numbers are steadily dropping, I will assume that many people still rely primarily on the evening news shows to to find out what’s going on in the world. And the amount of science you get there is really slim.  In fact, NBC’s  Nightly News no longer has a science or technology link in its left-hand nav. (CBS Evening News and ABC World News thankfully do still have them.)

Generally though, we get health segments that interview doctors about the impact of a new finding, but not about what the finding is. More often, it’s a story about a potty trained parrot. I kid you not – this is one of the stories that came up on NBC NN’s site when I searched for science.

I have a general dissatisfaction with the evening news shows (how much news can you really convey in 22 minutes?), but why does the Post have so little original science reporting (most of it now comes from HealthDay and AP)? The Times is trying to limp on with its reduced staff. But I think the real question is why the public is not demanding in-depth science coverage.

In the 1950s and 60s, there is no way a paper could get by without covering the science being done at our national laboratories, or the technology and engineering feats that went into building some of the first space age rockets.

I could go on about this, but I think the real question is one that Mooney brings up in his column – what will happen now that we have an administration that promotes science? Will America’s inventions, discoveries, and achievements once again take a central role in our sense of national pride?

This brings me to Sanjay Gupta. Having a charismatic, media-friendly Surgeon General or National Science Advisor, or Secretary of HHS would do wonders for public perception of science and its importance (of the three, Gupta is the only one suited to this role). If Gupta accepts the offer as Surgeon General, and is confirmed by the Senate, his role would be that of spokesperson – or maybe even science evangelist.

I’m not sold on the idea that we should hire our scientific and medical leadership based on their social appeal. But being in PR, I struggle to find someone with the charisma, knowledge, and the time to be an evangelist for my organization, or for science. So perhaps this is the right approach for the administration, as long as Gupta and Obama ensure that someone is doing the hard science work behind the scenes.

Incidentally, Chris, I think you took the right approach to the Report. Did you see the interview with Philippe Petit the next night? He skewered Colbert, making me want to see his movie far less than I had wanted to before.

Medical Students (courtesy UofL)

The new crop of med students has just started. As always, they’re noisy, full of dreams, sufficiently sarcastic in conversation with one another to sound jaded, and they think this place is all about them. It’s in their swagger, the way they talk too loudly on the university shuttle, the way they ware their newly bestowed waist-length white coats, and above all, in the way they take up the whole damn sidewalk on their way to and from class.

Tourists on Segways (courtesy Segs in the City)

They are like tourists in a lot of ways. Ignoring the locals trying to go about their daily lives as they ooh and ahh in gaggles that block any forward motion, talk too loudly in public spaces about their plans for the day or what so-and-so said about such-and-such or as they count each and every stop on the metro, checking and re-checking the map after each station.

I don’t really hate the med students. I’m jealous of their exhuberance and annoyed by their thoughtlessness. I’m fascinated by the many reasons they have for subjecting themselves to at least 7 more years of almost certain debt and nearly no control over their daily routine.

The pomp and ceremony and supposed prestige are the carrots for that giant 7+ year stick, so I can’t really be upset with the attitudes that come out when they’re in a group. And now with the white coats distributed, and the stethoscopes duly hung around necks, they begin their new routine. Everyone in dress shoes for clincal rounds on Tuesdays, gross anatomy experiences bonding those who had never experienced death, and study groups meeting at the coffee shop.

Wyle as Dr. John Carter (courtesy NBC)

It’s an experience I was never interested in, but I (clearly) view it with some nostalgia. I think I wish I knew all the doctors I now work with as newly-minted white coats. I wish I could watch them develop into the physicians and researchers they are today. And see first-hand how that person’s personality was formed.

I am reading Jerome Groopman’s Second Opinion right now, and just saw an episode of Hopkins for the first time, which really doesn’t do much to de-romanticize the profession. So these thoughts are far more pronounced now than normal. Plus I can never discount the nostalgia I feel for ER, which I stopped watching in 1996 but is about to start its final season (with a return from Noah Wyle who was my first doctor stereotype after my family’s dry pediatrician).

Of course, I get my sometimes more than daily dose of Orac as well.

The Olympics are an amazing international event. I can’t think of any other organization that is able to bring together (nearly) all of the countries of the world for an equally positive experience. While each country roots for their own athletes, this national pride does not create conflict. Instead, we celebrate each others’ achievements and recognize the incredible skill and dedication of all the athletes.

While the International Olympic Committee (IOC) is not without its politics and controversies, compare its achievements to those of the United Nations (UN). The IOC brings the world together every 2 years for a sporting event of unparalleled proportions. Unfortunately, the UN is not able to bring together its member states to deal with some of today’s pressing issues, such as hunger, poverty, and education. Nor do UN summits and events bring forth the excitement and good will seen in the Olympics – from the participants or the general public.

In the United States, the summer Olympics allow kids to dream of becoming the next track star, star gymnast, or swimming star. And that has the effect of pushing kids outside to practice their long jump, sprints, or even badminton. One summer my brother and I hosted a mini-Olympics for the neighborhood kids. We spent days cutting and spray painting silver, gold, and bronze medals made of plywood and strung with green ribbon.

So how can we incite this passion for science? Not just in kids, so they can once again dream of growing up to be PhDs, but in everyone in all countries?

In the United States, the only period that compares is the Space Race of the 1960s that truly captured the imagination of the entire country. Kids wanted to be astronauts and physicists. Adults followed the competition between the US and the USSR, rooting for NASA’s plans for manned spaceflight and the trip to the moon. Astronomy, and more importantly, astrophysics and engineering, were like national sports, with the results closely watched.

Competition helps spur public interest, but it is difficult to imagine a scientific competition today that would spark long-term interest in the general public without creating tensions and animosity toward other countries. The Space Race was such a successful public campaign because of the ongoing conflict with the USSR, which fanned the flames of nationalism.

I can think of several big problems that are worthy of competition: an AIDS vaccine or cure, a cost-effective method for creating biofuels from waste biomass (not edible biomass like corn), or a synthetic ozone layer.

A couple of recent science competitions have received some level of public attention, but less I would have hoped. The Human Genome Project was certainly a hot topic at the beginning of the 21st century when Craig Venter’s company, Celera Genomics, raced the international effort led by the National Institutes of Health. Interest in the race heated up as each side claimed to have completed the project, but fell as the details of the relative completeness were discussed. Gaining even less attention than the HGP was the X Prize competition, which aimed to spur private companies to create vehicles capable of space travel.

So, what can be done to spur public attention to and involvement with a scientific competition or challenge?

In the spirit of the Olympics, ScienCentral posted the results of a science literacy quiz awarding countries medals for their correct answers.

After much convincing (of him), my boyfriend and I drove up to the Montgomery County Agricultural Fair last night. While I expected the canival rides, the impossible-to-win games, and the cow, goat, sheep, and (really cute) rabbit barns, I was surprised to see two circus freak sideshow tents.

I’ve studied the history of science – in which freaks of nature play a leading role during the middle ages – and I honestly never considered the possibility that these types of displays would continue to draw in customers (for the cut-rate price of only $5!).

I think that most people know that “deformities” – really just physical abnormalities that occur in the developmental process – exist in nature. Think of 6-toed cats. At the same time, most of us have probably not seen examples of this in its most dramatic form: a dog with one head and two bodies, goats with five or six legs, pigs “with human hands on all four legs.” As you walk by this enclosed tent at the Agricultural Fairgrounds, the announcer describes these “amazing” creatures.

The weird and abnormal (read different) will always fascinate people. Luckily, we no longer ascribe these creatures to the devil. We understand that development is a complex process, and that biology sometimes goes haywire. Even so, at what point will we stop demonizing things that are different?

As a society, we now understand what causes goats to grow an extra leg. While the developmental patterns are not completely understood in all their intricacies, the homeobox genes responsible for these patterns were discovered 25 years ago.

I guess I just find it strange that in 2008, I can go to an ag fair in the (far-)suburbs of DC and find a sideshow dedicated to animals that have extra body parts. More than anything else, I find the exhibits sad. I feel terrible for the dog with two bodies – it must be a painful and uncomfortable life.

It’s been a week since Herberman of University of Pittsburgh Cancer Institute publicly declared his fear of a link between cell phones and cancer. Several more mainstream media sources have since covered this topic, including Larry King Live.

Larry King’s segment (scroll down to the cell phone transcript) featured only scientists and physicians. This has not been typical in the MSM where health – or science – related panels often include consumer/patient advocates or industry marketing professionals.

Thank god there was a scientist who can talk clearly on camera and whose position reflects the scientific consensus. Ted Schwartz, director brain tumor surgery at Weil Cornell, introduced his perspective (“First let me say…”), then clearly stated that “there is no conclusive evidence” and we don’t create health policy based on inconclusive evidence.

Devra Davis of UPCI’s Center for Center for Environmental Oncology was also on the show, and in fact stayed on for the entire segment (unlike most others who came in mid-way or dropped off). Davis has had good media training, and her message comes across very clearly and rationally. Unfortunately, the first two doctors to appear on the segment with her could not get their message across to counter her claims.

Dr. Keith Black, Chairman, Dept. of Neurosurgery, Cedars-Sinai Medical Center:

We know that microwave radiation can damage cells, and there’s been some experimental evidence to suggest there are harmful effects. As Dr. Davis said, at this point, they’re looking at the relationship between cell phone use and brain cancer. We have conflicting studies. Some studies, which are not absolutely perfect, showed no correlation. We also have some studies that tend to suggest a correlation.

Ok, that’s not terrible – but definitely not great. Compare it to Schwartz’s “there is no conclusive evidence.” Also, the opening statement about microwave radiation is misleading since it’s such a vague statement (what dose damaged cells, and what constitutes damage to cells?). Black continues with:

One of the recent studies from Sweden show that if you use cell phones an hour a day for ten years, your risk may be increased as much as two-fold. The real concern is analogous to this: we’ve only been using cell phones for a short period. Most of the studies are for a short period of time. So if you have a 14-year-old who smokes cigarettes, we don’t expect that 14-year-old to develop lung cancer at 24. We expect them to develop lung cancer at 54. If you have an eight-year-old using a cell phone, we don’t expect them to [do you feel get] lung cancer at 18, but at 48.

He just lost everyone who is not an epidemiologist. There are too many numbers in there, and honestly, don’t think that many people understand the timing of the relationship between smoking and lung cancer – at least not when it’s articulated like this.

Later on, Paul Song, a radiation oncologist from somewhere in LA (institution not identified), injects the idea that your phone getting hot while in use implies radiation exposure:

I think the most important thing is that when we look at any type of radiation exposure, whether or not it’s radio waves or gamma waves, is that the duration of your exposure. So clearly if you’re on the cell phone for a long period of time — I think we all have been in situations where our ear gets warm — that clearly means maybe we’re on a little too long.

There is no direct association here, but the implication is there. My understanding is that the heat from cell phones is a byproduct of the electrical processes that take place in the phone. It’s the same thing with the CPU in your computer. The radiowaves being emitted by phones are not like the waves emitted by your microwave, so your brain is not being cooked. Think about it – the phone itself gets hot. If radiation were heating your ear, the phone would stay cool and your ear would warm up.

The CTIA (wireless company association) sent a great statement saying that this issue needs to be guided by science:

This is an issue that should be guided by science. The overwhelming majority of studies that have been published in scientific journals around the world show that wireless phones do not pose a health risk. Furthermore, this is the public position of leading health organizations, such as the United States Food and Drug Administration, the American Cancer Society and the World Health Organization. Public statements and declarations not guided by published scientific research can have the effect of misinforming the general public. As technology continues to evolve, the industry supports continued research. But we want to stress the fact that this a consensus among leading health organizations concerning published scientific research, and they show no reason for concern.

Sanjay Gupta (CNN’s Chief Medical Correspondent) and Otis Brawley (Chief Medical Officer of ACS) inject a rational discussion of the issue.

Later that night (July 29th), I watched the Colbert Report where author Eric Roston talked about the role of science and technology in our society. One statement really stood out to me:

Science is the foundation of our technology, technology is the foundation of our economy, and if we don’t follow the carbon and we are serious about our future we should go back and look at the fundamental architect, builder and building block of civilization.

His new book is about carbon, but I thought the sentiment also applied to this cell phone debate and the role of science in our society. Just replace the word carbon with science in the quote above.

The announcement from University of Pittsburgh Cancer Institute’s (UPCI) director today is completely irresponsible and should not be covered by the mainstream media (MSM). In his letter to the UPCI faculty and staff about the cancer-causing capabilities of cell phones, Ron Herbeman cites a document which acknowledges that epidemiological studies show nothing conclusive. In short, in broad population-based studies, no association has been found.

The international expert committee which released (I see no information about whether this document was published) the report includes Devra Davis, director of UPCI’s Center for Environmental Oncology. Everytime I have broached the subject of responding to Davis’ claims in the media, epidemiologists I work with tell me she has no standing in academia and that her claims cannot be taken seriously because there is no data behind them. And yet, the MSM continues to invite her on their shows.

Science works through peer-review. We all know that a lot of science is far too complicated for people without specialized training to understand. Most of us take it as a matter of faith that the scientists know what they’re doing. (I similarly take it as a matter of faith that my broker is appropriately managing my 401k – maybe not always a great idea.)

But in science, the vetting is done by peers through the publishing process. Scientists publish their data in peer-reviewed journals where subject area experts examine the methods, results, and conclusions with a fine-tooth comb, sometimes sending the paper back for additional analyses to be completed. Only after a study has gone through this process and is being published do scientists consider the work complete and accurate. At this point, the media is notified of the discoveries, NOT BEFORE.

Furthermore, the PR team at UPCI and at Pitt should never have allowed the internal email or the public announcement to go out. Communications professionals are there to be gatekeepers to prevent inappropriate announcements from being released. We have a responsibility to protect the reputation of our institutions. I believe this can and should be done in a responsible way (let’s not hide our faults, acknowledging them is not only the right thing to do but also helps you put it behind you sooner – take the Lewinski scandal as an example).

Of course, the MSM had to cover this story. Here are a couple examples:

• Tara Parker-Pope at Well,
• WebMD provides an overview of reactions to the statement,
• The Chicago Tribune offers pros and cons of cellphone use while noting the unusualness of Herbeman’s statement,
• The Washington Post emphasizes the many studies that do not show a link between cellphones and cancer, and
• The BBC unfortunately titled it’s article “US cancer boss in mobiles warning,” which does far less to minimize the damage of the announcement.

Like the evolution “debate,” media coverage of this issue needs to be clear about the actual amount of debate within the scientific community. By and large, I think the articles above are accurate representations. I hope, though, that the splash of this announcement quickly fades as the real scientific message comes through.

I can’t wait to hear from Epi Wonk and Orac – the real scientists in the blogosphere – on this latest dose of woo. PalMD at the denialism blog has already posted on this. Check out a couple older posts on the topic from others at ScienceBlogs: Framing Science, Pure Pedantry, denialism blog, and The Island of Doubt.

Talk about way cool science. The Scientist is reporting on their blog that a vaccine grown in tobacco plants has successfully completed a phase 1 clinical trial. The paper comes out in PNAS tomorrow.

The vaccine treats non-Hodgkin’s lymphoma, and the use of plants as a medium is so important because the vaccine must be personalized to each individual patient – a typically expensive and time consuming process. I just wanted to expand on The Scientist’s explanation of how this works.

Each patient treated in the trial received a vaccine made up of proteins found on their own tumor’s B-cell surface Ig proteins. These antigens are expected to create an immune response against this protein found on the cancer cells, activating the body’s own immune system to fight the disease.

In this case, the researchers produced the human proteins using plants – by loading a plant virus with the patient’s Ig gene (which becomes the antigen). The virus replicates in the plant and makes millions of copies of the Ig protein which are then purified and injected into a patient.

In simple terms, the plants are the host for viruses producing human proteins. And not just generic human proteins, but proteins found on a specific patient’s tumor. This isn’t the first time someone has done this, but commercialization of this method hasn’t taken off yet.

Aside from the coolness factor, the benefit to doing this in plants (instead of animals) is speed and cost. From The Scientist:

Total time from biopsy to treatment averages three to four months, according to the paper. Animal-based vaccine production for B-cell lymphoma takes double that time, said Levy.

So a new methodology looks like it may be able to put treatments within reach of many more patients. Of course, this was only Phase 1, so there’s no data on how well it worked yet.

WAMU, my local NPR station, recently launched it’s own social network powered by Ning. Creatively called “The Conversation” (perhaps a shout-out to Joseph Jaffe), it’s touted as a way for listeners to add to the news coverage. It’s obviously also a way for WAMU to keep listeners engaged, not only promoting their programming, but also providing additional opportunities to give.

I commend WAMU for seeking feedback from their listeners. This is an important business function gained from social media, and it’s what consumers now expect. I am far more likely to contact them online, than by calling in to provide a comment. But I’m not sure that I would be an avid enough commenter/participant to want to sign up and join a community around this.

But I thought I would check it out, support my local NPR station, and maybe learn a thing or two as well.

Brendan Sweeney, a producer at WAMU, posted a question about rising food prices on May 15th. There are now 14 replies, including replies to replies by Sweeney. Some of the topics suggested are pretty interesting: Carlito, a non-WAMU employee brought up the idea of high fructose corn syrup being the basis of our cheap food in the US. Sweeney and colleague Kay discuss some interesting angles on high fructose corn syrup, and Jo Arpee chimes in with the full contact information for a nutrition expert at the University of Maryland.

This info raised my suspicions that Arpee might be a press officer at University of Maryland, but a quick Google search suggests she’s a nutritionist herself. Sweeney and Kay’s initial public discussion does spark further comments and gets members of the public involved.

It seems the original discussion originated out of an episode of the Kojo Nnamdi show that aired on April 10th.

Kojo Nnamdi Show: The Global Impact of Rising Food Prices – April 10, 2008

They followed it up with a show on June 2nd: Kojo Nnamdi Show: Local Effects of Rising Global Food Prices – June 2, 2008 So Sweeney’s original post makes a lot of sense.

If you take time to listen to the segment, you’ll see that the high fructose corn syrup is part of the lead to the story and part of the explanation of the economics of school lunch menus by Susan Levin. Really fascinating stuff. Another user comment on organics developed into a guest on the show who talks about developing a $60/week organic food budget.

From this one example, I’m happily surprised by the impact WAMU’s Conversation is having on its programming. I now plan to join The Conversation at wamu.org!