Archive for the ‘Uncategorized’ Category

Misleading science: How a 1980 publication led to US opioid crisis

August 14, 2017

Not all of science is built on the shoulders of giants.

Sometimes science stumbles when it is based on political agendas, on fake science, on exaggerations and even – in this case – on mistaken conclusions.

Eventually science gets corrected, but much damage can be done till then.

In January 1980, the New England Journal of Medicine published this letter from scientists at the Boston University Medical Center (Vol 302, No 2).

This “letter” has been cited extensively in justifying the use of opioids and in the assumption that this would be non-addictive.

Now the same journal has published a new study (Vol 376, June 2017) which traces the current opioid crisis to this letter which has been “heavily and uncritically cited as evidence that addiction was rare with long-term opioid therapy”.

Leung et al, A 1980 Letter on the Risk of Opioid Addiction, N Engl J Med 2017; 376:2194-2195, June 1, 2017, DOI: 10.1056/NEJMc1700150

The prescribing of strong opioids such as oxycodone has increased dramatically in the United States and Canada over the past two decades.1 From 1999 through 2015, more than 183,000 deaths from prescription opioids were reported in the United States,2 and millions of Americans are now addicted to opioids. The crisis arose in part because physicians were told that the risk of addiction was low when opioids were prescribed for chronic pain. A one-paragraph letter that was published in the Journal in 19803 was widely invoked in support of this claim, even though no evidence was provided by the correspondents (see Section 1 in the Supplementary Appendix, available with the full text of this letter at

We performed a bibliometric analysis of this correspondence from its publication until March 30, 2017.  …….. 

In conclusion, we found that a five-sentence letter published in the Journal in 1980 was heavily and uncritically cited as evidence that addiction was rare with long-term opioid therapy. We believe that this citation pattern contributed to the North American opioid crisis by helping to shape a narrative that allayed prescribers’ concerns about the risk of addiction associated with long-term opioid therapy. In 2007, the manufacturer of OxyContin and three senior executives pleaded guilty to federal criminal charges that they misled regulators, doctors, and patients about the risk of addiction associated with the drug. Our findings highlight the potential consequences of inaccurate citation and underscore the need for diligence when citing previously published studies.

Without skepticism there is no science.



Would religions survive if children were not brainwashed into them?

May 25, 2017

Whether “indoctrination” of an empty child’s mind is less reprehensible than the “brainwashing” of an adult mind that has existing beliefs is not the point.  At issue is whether beliefs, which, by definition, exist outside the realm of knowledge, can be force-fed. No religion allows its followers to develop their own beliefs. All religions presume to instill their standard beliefs onto their own adherents and onto potential converts. Can beliefs be externally imposed or must they be developed internally? My own “belief” is that an idea, which is not the result of an individual’s own cognitive processes but is externally imposed, cannot be a true “belief”. All societies permit, and most approve, the indoctrination of children into the religions of their parents (or guardians). Apart from coerced conversions (which are still going on), I would guess that over 95% (and perhaps 99%) of all those who follow a religion, follow that of their parents.

Human behaviour has effectively made religion hereditary. Religion is not controlled by our genes except in that our genes may determine how susceptible we are to indoctrination. Yet our religious beliefs are determined by who our parents are. Unfortunately parents have not succeeded as well in indoctrinating children away from other undesirable behaviour. The growth or decline of religions across the world simply mirrors fertility on the one hand and the coercive conversion of peoples into the religion.

If a group of children were brought up in isolation on a desert island, by robotic instructors confined to teach only in the area of knowledge, and to answer any question in the space of ignorance with a “don’t know”, some of the children may well develop “religious” beliefs with divine power being attributed to the sun and the moon and the winds and the waves. But for there to be war between the sun-worshipers and the wind-worshipers there would first need to be those arrogant enough to anoint themselves as priests. There would be no organised religions without priests appointing themselves as special messengers of the divine powers. There would be no religious wars without “turbulent priests” bent on religious expansion. If every child was allowed, as it felt necessary,  to develop its own religious beliefs, organised religions would never catch hold. And if organised religions did exist they would merely wither and die without a continuous stream of new adherents in the form of brain-washed children growing up.

The problem lies not in whether one believes in gods or not, but in that organised religions exist and that they compete. They compete by claiming that one set of beliefs in the space of ignorance are superior or better than another set, also in the space of ignorance. The claims for the one or for the other are made by turbulent priests. It has been so ever since organised religions came into being. It is still so today, whether it is a mad mullah pronouncing a fatwa or a Hindu God-man calling for the destruction of a mosque or a Buddhist monk attacking unbelievers or a “celibate” Pope pronouncing on family values.

Who will rid us of these turbulent priests?


A politically correct distribution of the seven vices

December 25, 2016



Japan rejects Washington opposition as Putin visits Tokyo

December 13, 2016

The impact Trump is having even before he assumes office is becoming apparent, both domestically and on the international stage.

He is just the President-elect but it seems that shifts are already taking place in geo-political alignments. It seems that Trump is going to be a non-ideological, transactional and rather pragmatic President. Everything is going to be on the table and everything is going to be about negotiation.  China already has understood that they will have to “offer” something to get the new US to continue with the One-China policy. Iran has also understood that a new negotiation is underway. Ideological regime change is no longer an objective. Domestically, the defense industry is understanding that their normal cosy, bloated, overcharging of the government will be resisted. Trump needs to cut public spending drastically to allow his infrastructure projects to go ahead. Industry in general is getting the message loud and clear that there will be tax breaks for creating jobs and tax penalties for shifting them abroad.

Well, we shall see.

In the meantime the Obama administration has been trying to get Prime Minister Abe to cancel or, at least, postpone an Abe/Putin summit in Japan. But what the Obama administration wants no longer carries much weight.

Prime Minister Shinzo Abe and Russian President Vladimir Putin hold talks on the sidelines of an Asia-Pacific Economic Cooperation summit in Lima last month. | KYODO

The Japan Times:

Japan has disregarded U.S. opposition to a planned bilateral summit between Prime Minister Shinzo Abe and Russian President Vladimir Putin in Tokyo later this week, diplomatic sources said.

Last month Washington repeatedly conveyed its objection to the Abe-Putin meeting in the capital out of concern that it might relieve pressure on Moscow by the Group of Seven economies, but on Thursday Japan formally announced the summit for Friday, as well as another meeting in Yamaguchi Prefecture on Thursday. The administration of President Barack Obama has been critical of Russia over its annexation of Crimea in 2014 and for backing the government of Syrian President Bashar Assad.

But Abe wants to maintain good relations with Russia in hopes of achieving a breakthrough in the decades-old territorial dispute between the two nations and concluding a postwar peace treaty. The Japanese government’s decision to go ahead with staging a summit with Putin in Tokyo highlights a rift between Tokyo and Washington on the issue. …..

The U.S. government voiced concern that staging such a meeting in Tokyo could send the wrong message that the Group of Seven (G-7) industrialized nations is not totally united in pressuring Moscow, the sources said.

The Japanese government is believed to have told Washington that the Russian leader’s visit should not be seen as according Putin special favors as he will not be granted a meeting with Emperor Akihito.

A Japanese government source said, “Although Japan needs to play a role as a G-7 member, it is also natural for us to pursue national interests and holding a summit meeting in Tokyo causes no problem.”


It’s all over as the establishment circles its wagons around Hillary

November 7, 2016

They read fast over at the FBI.

650,000 emails read and analysed in a week is pretty impressive. That the FBI ( and the Department of Justice) are part of the political establishment that Hillary belongs to is fairly obvious. In any event the FBI interventions have put some life into the final stages but now, as the establishment wagons circle around Hillary, her victory tomorrow seems a foregone conclusion.

So the US will have another Clinton as another dodgy President. The new First Lady will probably be Huma Abedin. Bill Clinton can be President Emeritus.

The odds of another Clinton being impeached are fairly high. The odds of another President being forced to leave prematurely like Nixon are also fairly high.

The markets should gain today.


Diwali 2016

October 29, 2016

Little Diwali in South India today and the main celebrations tomorrow.





The Age of Man is the age of fire

September 1, 2016

There is much discussion about when to define the start of the Anthropocene  epoch “that begins when human activities started to have a significant global impact on Earth’s geology and ecosystem” . Scientists are looking for the parameters which could define the start of this geological age in the 4.5 billion year history of the Earth. There are suggestions that it should be 1945 when the first nuclear test was carried out or 1950 when radioactive particles began to be detected in the atmosphere. Others have argued for 1610 when “an unusual drop in atmospheric carbon dioxide and the irreversible exchange of species between the New and Old Worlds” began. Others still argue for 1964.

Homo timeline (Wikipedia)

Homo timeline (Wikipedia)

But I find these arguments unconvincing. There is, in fact, a single development (whether it was a single event or a development, discovered and rediscovered, perhaps at many places and over a long period). That single development was the control of fire. I wrote a year or so ago “The Age of Man began when Homo Erectus learned to produce fire at will and to contain fire in a hearth.”

The one single capability which initiated the divergence of humans from all other animals and which has resulted in the inevitable development and domination of modern humans is the control of fire. And that was around 400,000 years ago. The Age of Man began when Homo Erectus learned to produce fire at will and to contain fire in a hearth. I would even speculate that without fire Homo Erectus would not have survived to evolve into Homo Sapiens. Without fire Homo Sapiens would not have thrived through the ice ages or left the tropics to colonise more northern climes.

When our ancestors came down from the trees and developed bipedalism, they did not have control of fire. There were just another primate species – one among many. The earliest stone tools were developed without fire possibly by homo habilis. It may well be that this tool making ability was a key survival attribute which allowed this species to become skillful hunters and shift to a diet containing much raw meat. The brains of homo habilis grew in size and the species continued evolving to become homo erectus and other bipedal primates died out. And then around 1.8 – 1.5 million years ago, homo erectus gained some control over fire. It is possible that it was the skill in stone cutting which itself led to the discovery that flint and iron pyrites struck together could create a spark. It may have been an ancient stone tool maker who, accidentally, first discovered a method of creating a spark and igniting a fire. While the earliest known hearths are only from around 400,000 years ago, hearths are relatively sophisticated technology. Primitive ignition techniques and a rudimentary control of fire must have been available earlier and was probably available to the common ancestors of both Neanderthals and AMH (anatomically modern humans). The size of the evolving homo erectus brain grew sharply as cooked meat dominated the diet and the biological energy resources available to an individual of the species took off. The – albeit primitive – control of light and heat from an external source would have been revolutionary. Though fire was not necessary for stone tools, the ability to make and hone stone tools, and fire-hardened wooden weapons, after the hunting day was done would have been a giant leap in the technological stakes.

There is a clear link between diet and energy availability and brain size evolution.

Smithsonian: Wherever humans have gone in the world, they have carried with them two things, language and fire. ….. Darwin himself considered these the two most significant achievements of humanity.

Harvard biologist Richard Wrangham, … believes that fire is needed to fuel the organ that makes possible all the other products of culture, language included: the human brain. Every animal on earth is constrained by its energy budget; the calories obtained from food will stretch only so far. And for most human beings, most of the time, these calories are burned …… in powering the heart, the digestive system and especially the brain, in the silent work of moving molecules around within and among its 100 billion cells. A human body at rest devotes roughly one-fifth of its energy to the brain, regardless of whether it is thinking anything useful, or even thinking at all. Thus, the unprecedented increase in brain size that hominids embarked on around 1.8 million years ago had to be paid for with added calories either taken in or diverted from some other function in the body. Many anthropologists think the key breakthrough was adding meat to the diet. But Wrangham and his Harvard colleague Rachel Carmody think that’s only a part of what was going on in evolution at the time. What matters, they say, is not just how many calories you can put into your mouth, but what happens to the food once it gets there. How much useful energy does it provide, after subtracting the calories spent in chewing, swallowing and digesting? The real breakthrough, they argue, was cooking.

……. Carmody explains that only a fraction of the calories in raw starch and protein are absorbed by the body directly via the small intestine. The remainder passes into the large bowel, where it is broken down by that organ’s ravenous population of microbes, which consume the lion’s share for themselves. Cooked food, by contrast, is mostly digested by the time it enters the colon; for the same amount of calories ingested, the body gets roughly 30 percent more energy from cooked oat, wheat or potato starch as compared to raw, and as much as 78 percent from the protein in an egg. …..

…..Fire detoxifies some foods that are poisonous when eaten raw, and it kills parasites and bacteria. Again, this comes down to the energy budget. Animals eat raw food without getting sick because their digestive and immune systems have evolved the appropriate defenses. Presumably the ancestors of Homo erectus—say, Australopithecus—did as well. But anything the body does, even on a molecular level, takes energy; by getting the same results from burning wood, human beings can put those calories to better use in their brains. Fire, by keeping people warm at night, made fur unnecessary, and without fur hominids could run farther and faster after prey without overheating. Fire brought hominids out of the trees; by frightening away nocturnal predators, it enabled Homo erectus to sleep safely on the ground, which was part of the process by which bipedalism (and perhaps mind-expanding dreaming) evolved. By bringing people together at one place and time to eat, fire laid the groundwork for pair bonding and, indeed, for human society.

I can see that once fire had been controlled and cooking developed, the sudden (relatively) advance of that species was inevitable. Both for evolution and for technology development. Within the individual it provided the elements necessary for the brain to grow. That in turn led – also inevitably – to speech (c. 200 kya) and language (c. 100 kya) and writing (c. 50 kya). Stone tools were sufficient – without fire – to lead to meat eating. But it was fire which gave cooking, which allowed an energy-rich diet containing cooked vegetable and animal proteins. But fire did not just give cooking. It provided the starting point for virtually all technology as we know it today. Fire provided safety. Hearths gave a focus for a cooperative society to develop. Hearths led to ovens and kilns and eventually to smelters. Light in the dark and heat in the bitter northern winters, probably gave rise to the first ever “leisure times”. The Stone Age, with fire, gave way to the Bronze Age. As the ability to control and contain even higher temperatures were developed, the Iron Age was born. Gods and alchemists and priests and shamans needed fire. The Sun in its avatar of fire paved the way for the first religions (though this may not be considered much of an advance). Temperature was recognised as being a critical parameter because of the control of fire. Blacksmiths and alchemists gave rise to Metallurgy and Chemistry and Physics. Sand and fire gave glass and Astronomy. The Steel Age and the Plastics Age and now the Semiconductor Age were all inevitable once fire had been controlled and harnessed. The species not only survived Ice Ages, it thrived through them. Our ancestors only expanded into the more northern climes because of the availability of fire. In due course, fire gave rise to electricity and then the dark, or the cold, or the heat, could all be banished at will.

The Age of Man has been, and is, the age of fire.

First came hominids and then came fire and the rest is history.

Homo sapiens is now with gravitation where ancient  homo erectus was with fire. As the magic of fire was understood and brought under control and harnessed, so the magic of gravitation, too, will be understood and controlled and harnessed to the service of homo superieur.



Light blogging while the Olympics are on

August 8, 2016

The 5 hours time difference to Brazil means that the event finals are held around 2 or 3 am here.

Which means that during my normal blogging hours I am fast asleep.


Hillary Clinton finally goes where Obama dreads to step

June 15, 2016

No doubt it was under some pressure from Trump, but Hillary Clinton has finally used the term “radical Islam” when referring to their terrorist acts. She has gone further and it was long overdue. She has finally entered territory that Obama is terrified of coming close to. She has connected the terrorists with their mentors and financiers in Saudi Arabia and Qatar and Kuwait. There is an element of hypocrisy involved here, since the Saudis have also contributed large amounts to the Clinton Foundation and her campaign. Nevertheless, it was a much needed statement from Hillary.


HILLARY CLINTONThe third area that demands attention is preventing radicalization and countering efforts by ISIS and other international terrorist networks to recruit in the United States and Europe. For starters, it is long past time for the Saudis, the Qataris and the Kuwaitis and others to stop their citizens from funding extremist organizations. And they should stop supporting radical schools and mosques around the world that have set too many young people on a path towards extremism. We also have to use all our capabilities to counter jihadist propaganda online. This is something that I spend a lot of time on at the State Department.

Jordan’s official news agency, Petra News Agency, reported on Sunday citing the Saudi crown price, namely that Saudi Arabia is a major funder of Hillary Clinton’s campaign to become the next president of the United States.

……. the Petra News Agency published on Sunday what it described as exclusive comments from Saudi Deputy Crown Prince Mohammed bin Salman which included a claim that Riyadh has provided 20 percent of the total funding to the prospective Democratic candidate’s campaign.

The connection with Saudi Arabia is something that Barack Obama is terrified to even think about – let alone mention. Instead he castigated Trump for focusing on the words “radical Islam”. But Trump had a point when he said that Obama was more angry with him (Trump) than with the shooter.

I am not sure whether it is a fear of being seen as an Islamophobe or a fear of offending Saudi Arabia which is more important to Obama. Probably they are equally important to him. But they are both fears. His 8 years in office have been dominated by his fears of taking actions. A sort of parlaysis by analysis. And Obama’s wilful denial (by omission) that “radical Islam” has to be confronted does not impress.

Whether the Orlando shooter was gay or not does not mitigate his actions. There are some gay commentators who seem more concerned about labelling the massacre a “homophobic” action – and suppressing any connection to radical Islam – just to win “brownie points” for the gay community (Owen Jones for example). But that is to miss the point. Equally trying to blame the US gun regulations is also missing the point. With the examples of Paris and Brussels, Obama knows that, but it is a convenient diversion and another excuse to avoid confronting radical Islamic terrorism.

Of course, all Muslims are not terrorists. But more terrorists are inspired by radical Islamic perversions than can be ignored. All Buddhist monks are not bigots, but many in Myanmar (and in Thailand and in Sri Lanka) are and are too many to be ignored or denied. Far too many of the “Hindu God-men” are bigots and perverts.

To confront religious extremism and fanaticism is not an attack on the religion. Obama needs, at least, to be able to distinguish that. (Of course, no organised religion whatsoever ought to exist and impose its opinions on anybody — but that is a different story).


Noted while travelling

February 15, 2016

Noted while travelling:

  1. Frankfurt Airport is a pain when making transfers. It’s time Lufthansa reacted to the LH experience being ruined by Frankfurt (logistics and the mindless rudeness of its security staff).
  2. It took 14 minutes from docking at the gate after a long haul flight to Madras (Chennai), to clear immigration, get through customs, collect baggage and get to the waiting transport. Not bad for India (or anywhere for that matter).
  3. Life is back to normal but signs of the flood damage can still be seen in Chennai – but you have to look pretty hard. What is gratifying and a small miracle is that there were no outbreaks of any diseases after the floods receded. Public health officials can take a bow.
  4. I don’t much like writing on my IPad and still prefer my pc and my large keyboard and my mouse. The tablet is fine for reading – even long texts – but I cannot write more than a few lines. And diagrams and links are beyond my thick fingers. So blogging will remain thin while I’m in transit.

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