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Monday, February 20, 2017

#HIMSS17 in Orlando


I'm sure it will be interesting again, but I'm not attending this year. The uncertainty of my Jaco's looming demise was a factor. Now that he's gone (sadly had to put him down Friday), I'm still heavy with mourning. He wasn't a "pet," he was a canine family member, a total delight. At 15 years old, he still had the rambunctious playfulness of a puppy. We were lucky to have found him in 2003.


I'll just follow the HIMSS trade press reports like everyone else. Last time they held the show in Orlando was 2014. I was there. I first covered the HIMSS conferences in 2012, in Las Vegas (where I was living at the time, working for the Meaningful Use REC). The 2013 conference in NOLA was great fun. As was the 2016 conference, back in Las Vegas.

Next up for me on the conference front will be this year's "AARP Innovation 50+" event, which has expanded from a one-day conference to two days.

Will continue this week with my "STEM the Denialism" effort, and try to get caught up on my endless reading.

Also, visit the excellent new site "Calling Bullshit."

"What do we mean, exactly, by the term bullshit? As a first approximation, bullshit is language, statistical figures, data graphics, and other forms of presentation intended to persuade by impressing and overwhelming a reader or listener, with a blatant disregard for truth and logical coherence.

While bullshit may reach its apogee in the political domain, this is not a course on political bullshit. Instead, we will focus on bullshit that comes clad in the trappings of scholarly discourse. Traditionally, such highbrow nonsense has come couched in big words and fancy rhetoric, but more and more we see it presented instead in the guise of big data and fancy algorithms — and these quantitative, statistical, and computational forms of bullshit are those that we will be addressing in the present course."
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HIMSS17 "INTEROPERABILITY"


FIRST KEYNOTE
 
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NEUROBABBLE UPDATE

Interesting book review over at SBM:
Daniel and Tana Amen’s Book The Brain Warrior’s Way: Standard Health Advice Mixed with Misinformation and Fanciful Ideas
Daniel Amen, the media-savvy psychiatrist and promoter of SPECT scans, has teamed-up with his wife Tana to write a self-help book that hopelessly muddles good medical advice with misinformation and speculation
So much neurobabble, so little time. SBM is a great site.

@Health2con update
A Million Jobs in Healthcare’s Future
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More to come...

Tuesday, February 14, 2017

Next up, STEM the Denialism

It has been a difficult week at my house. My terminally ailing elder dog Jaco may die or have to be put down at any time. I slept in fits and starts last night on the couch in the family room staying close by. We all know here that time is short. Keeping up with my reading, but I'm not getting much done at the keyboard.

In support of The March for Science effort and its important larger long-term purpose, I'm probably gonna start a new blog dedicated specifically to those issues. And will probably open it to co-contributors. Let me know if you're interested. bobby[dot]gladd[at]comcast[dot]net.




FRIDAY 17th UPDATE

My precious Jaco is gone. Had to have him put down today. Crushingly sad.


SATURDAY UPDATE

Morose here today. Carlos (my other dog) is confused. Where's his Big Bro'? I am struggling to accept Jaco being gone. I shall miss him terribly.

Just in, a new academic effort I saw reported over at STATnews:

The world is awash in bullshit. Politicians are unconstrained by facts. Science is conducted by press release. Higher education rewards bullshit over analytic thought. Startup culture elevates bullshit to high art. Advertisers wink conspiratorially and invite us to join them in seeing through all the bullshit — and take advantage of our lowered guard to bombard us with bullshit of the second order. The majority of administrative activity, whether in private business or the public sphere, seems to be little more than a sophisticated exercise in the combinatorial reassembly of bullshit...
From the FAQ page:
Why are you doing this?
As we explain on our home page, we feel that the world has become over-saturated with bullshit and we're sick of it. However modest, this course is our attempt to fight back.

We have a civic motivation as well. It's not a matter of left- or right-wing ideology; both sides of the aisle have proven themselves facile at creating and spreading bullshit. Rather (and at the risk of grandiose language) adequate bullshit detection strikes us as essential to the survival of liberal democracy. Democracy has always relied on a critically-thinking electorate, but never has this been more important than in the current age of false news and international interference in the electoral process via propaganda disseminated over social media...
Their course syllabus page.

Cool. Yeah, See, e.g., Dr. Frankfurt's book "On Bullshit."
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More to come...

Wednesday, February 8, 2017

Neurobabble update

I've had my sport here before with poseurs claiming to traffick beneficently in applied commercial "neuroscience." Recall these tweets.


Ahhh.... Jim Kwik, Mr. "I Build Better Brains." Then there's the jovial self-proclaimed neuro-musicology "scientist" Will Henshall.

Now comes "Neurocore Brain Centers" "Boost Your Brain Power in 2017."

Lordy. I've reached out to them repeatedly to no avail, asking for independent documentation of the underlying neuroscience upon which their "therapy" is ostensibly based. They're not gonna respond to some piss-ant ankle-biter like me. The temerity!
Their basic summary pitch:
The Neurocore Brain Performance Center Experience
At our Brain Performance Centers, we look past labels and assumptions to uncover the root cause of your symptoms. Based on your unique brain map, we create a personalized program to help you train your brain to its optimal performance. It’s safe and drug-free.


Brain Diagnostics
Rather than acting solely on observed behaviors, Neurocore takes a scientific approach to understand what’s wrong. Your comprehensive assessment includes brainwave analysis using qEEG technology, heart rate and breathing analysis and other diagnostic tests to paint a clear picture of what’s going on in your brain.

Customized Program
Once your brain shows us what is causing the problem, your unique brain map becomes our guide to designing a personalized treatment program. Through positive reinforcement and repetition, neurofeedback sessions train your brain to function better, more efficiently – so you feel better.

Lasting Results
Over time, your symptoms recede and in many cases disappear. This is unlike medication, which simply masks your symptoms until it wears off and it's time for the next dose. At Neurocore, we fix the problem, not just cover it up. Our drug-free solution lasts beyond each treatment session and can provide benefits to your brain and life for years to come.
Watch their "overview" video clip here.


That's a broad list of clinical conditions.

Turns out that Neurocore's principal investor is the controversial newly-confirmed Trump Administration Secretary of Education Betsy DeVos.
DeVos-Backed Company Questioned on ADHD, Autism
Neurocore touts its autism, ADHD treatment

By Benjamin Herold •February 7, 2017
President Donald Trump's nominee to head the U.S. Department of Education is a major backer of a company claiming its neurofeedback technology can "fix" problems such as attention deficit hyperactivity disorder and has "proven and long-lasting" positive effects on children with autism.

Current scientific evidence does not support such claims, according to the clinical guidelines of the American Academy of Pediatrics and three leading researchers Education Week consulted.

"It's misleading the public to say neurofeedback is effective in treating kids with ADHD and autism," said Nadine Gaab, an associate professor of pediatrics at Boston Children's Hospital and a faculty member at the Harvard Graduate School of Education. "It's still an experimental treatment that needs more rigorous research."

Launched in 2006, Neurocore is based in Grand Rapids, Mich. That's also the hometown of billionaire school choice advocate Betsy DeVos, Trump's pick to become U.S. secretary of education.

DeVos sat on Neurocore's board from 2009 until November, when she resigned the position to avoid potential conflicts of interest should she be confirmed. As part of her divestiture plan, which has been approved by the federal Office of Government Ethics, DeVos and her husband, Richard DeVos, Jr. , will maintain an indirect financial interest in the company. On her disclosure forms, DeVos valued that stake at between $5 million and $25 million.
...A spokesman for the DeVos family declined to respond to Education Week's inquiries about the investment in Neurocore. The Trump administration did not respond to Education Week's request for comment.

Neurocore CEO Mark Murrison defended his company's work and marketing. He pointed to an emerging body of research in which neurofeedback in general has shown promise, as well as information Neurocore collects from its clients.

"What we provide to our clients truly makes a difference, and our internal outcomes data and testimonials bear that out," Murrison said in an interview...
"Internal outcomes data and testimonials?"

...Murrison, Neurocore's CEO, acknowledged that there have to date not been any such high-quality studies conducted about Neurocore specifically. The first peer-reviewed study of the company's outcomes, for clients with anxiety and depression, "should be going to press in the next few months," he said. Another peer-reviewed study of Neurocore's impact on clients with ADHD is in the works, according to Murrison...
Yeah, I'll hold my breath.

The internet wags have wasted little time.
"Education Secretary Betsy DeVos Unveils Common NeuroCore Standards"
LOL. "Neurobabble." How about "NeuroPractic?" "NeuroQuackery?" (my irascible reactions)

I hope the good folks at Science Based Medicine will give this a go. Other media outlets are starting to chime in. See, e.g., "Betsy DeVos-Backed Doctor Says TV Can Remedy Attention Deficit Disorder."  

NY Times is also on it. "Betsy DeVos Invests in a Therapy Under Scrutiny."
“Is it time for a mind makeover?” the company asks in its advertising. “All it takes is science.”

But a review of Neurocore’s claims and interviews with medical experts suggest its conclusions are unproven and its methods questionable.


Neurocore has not published its results in peer-reviewed medical literature. Its techniques — including mapping brain waves to diagnose problems and using neurofeedback, a form of biofeedback, to treat them — are not considered standards of care for the majority of the disorders it treats, including autism. Social workers, not doctors, perform assessments, and low-paid technicians with little training apply the methods to patients, including children with complex problems...


Neurocore lists 40 "scientific papers" on their "learn more" page. Critics have countered that these window-dressing citations go to various aspects of neuroscience in general, but none go to the company's internal controlled trial studies.

Because, by the CEO's admission above, there aren't any to date. At this point, all we have is "neurobabble." Whether we get to "neuroquackery" remains to be seen.

ERRATUM

Join the March for Science. See my prior post "Update on the March for Science"
and the antecedent "I am not a scientist."

Just in: Feb 9th War on Science update:
The Backpedaler-in-Chief
The Trump administration has retracted its most alarming anti-science moves. Is that heartening or a sign of more disturbing policies to come?
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On science and "transparency." The Theranos VC lesson.


In this regard, see "Bill Maris: Here's why Google Ventures didn't invest in Theranos."

NEW BOOK

One of three new ones I have going at the moment, actually.


Gloriously written. Stay tuned. The other two are here and here.

SOME PAINFUL PERSONAL NOTES

About a month ago our precious 15 yr old rescue dog Jaco was diagnosed as "terminal" with a number of tumors in his liver. Absent "exploratory surgery" (which the vet said would be a coin-flip in any event), he's expected to die soon, or have to be put down should he get really bad.


It's been day-to-day, sometimes hour-by-hour ever since. Several times I though he was dying or already gone. Once I determine he's in significant pain, I will have him euthanized, but we're not there yet -- apparently. There's no good way to tell.

Trying to give him "A Good Death," but, well, you know...

Also, two days ago, my dear friend Kurt Kolstad finally succumbed, losing his 11-year struggle against mantle cell lymphoma. We are all distraught. As I posted on my Facebook page:
My dear friend of 43 years, Kurt Kolstad, has finally succumbed after an excruciating 11 year battle with mantle cell lymphoma. I am really heartbroken today. Kurt was one of the best drummers in the world. Period. He could've played for Sting. He also played guitar, and keyboard, and wrote great songs. Beyond all that, he was a wonderful human being. I was blessed to share a stage with him up in the Seattle area many years ago. While I am glad his suffering is finally over, I will miss him sorely. http://bgladd.com/KurtKolstadSuddenSamba.mp3
He began his illness with pre-ACA health insurance,written through his wife's employer. He maxed out the policy and they lost coverage. Then they lost their home to foreclosure. THEN, not quite four years ago kurt's wife Cyndy died. I got there as soon as I could. I posted a YouTube clip:
My dear friend Kurt, who has been fighting off Mantle Cell Lymphoma for 8 years, lost his wife Cyndy 48 hours ago. I'm over at his place in Tacoma. I started singing "Lean on me," which spurred him. "Let me play for ya this tune I wrote 4 years ago. It's my "Lean on me'. It's on a CD out in the car."

This is off my iPhone. BobbyG's Left Hand Unsteady Cam Productions.

Self-explanatory. This glorious musician-writer (with whom I shared a stage 39 years ago) and his family have been reduced to crushing penury by nearly a decade of acute, life-threatening illness. Now with personal tragedy piled atop it.
Very sad time here of late.
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More to come...

Thursday, February 2, 2017

Update on The March for Science

Recall my prior post "I am not a scientist." 

In my inbox this morning.

Hello!

We are overwhelmed and grateful at the incredible support we've had in organizing this march. In the last week, almost 40,000 people have reached out to us eager to help.

We want to thank you so much for your support of the March for Science — and for you patience while we secured permits and coordinated with sister marches.

The March for Science is a celebration of our passion for science and a call to support and safeguard the scientific community. 

On April 22, 2017, scientists and science enthusiasts will take to the streets.

We will be reaching out to you for volunteer help in the coming weeks — we look forward to collaborating with you on outreach, planning events, fundraising, developing apps, brainstorming next steps, orchestrating satellite marches, and improving the world through science!

Satellite marches are being formed in countries across the globe from Canada to Australia. In Washington DC, our march will lead to a rally on the Washington Mall where scientists will hold teach-ins about their work and how science impacts our every day lives. Scientific discovery can be an arduous process, but it's also fun — it's time we share that excitement with the world!

The March for Science Team
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I was beginning to wonder. I put in to volunteer straight away, but never heard anything in response.

They've now mounted a web page.


Twitter, Facebook, and Instagram links there. Hashtag #marchforscience.

Nice "diversity" statement:
In the past days, scientists have voiced concern over many issues - gag orders for government science agencies, funding freezes, and reversing science based policies. We recognize that these changes will differently and disproportionately affect minority scientists, science advocates, and the global communities impacted by these changes in American policies. Addressing these issues is imperative in understanding how recent developments will affect all people - not simply the most privileged among us. We take seriously your concerns that for this march to be meaningful, we must centralize diversity of the march's organizers at all levels of planning. Diversity must also be reflected in the march itself - both through the mission statement and those who participate.

At the March for Science, we are committed to highlighting, standing in solidarity with, and acting as allies with black, Latinx, Asian and Pacific Islander, indigenous, Muslim, non-Christian, non-religious, women, people with disabilities, poor, gay, lesbian, bisexual, queer, trans, non-binary, agender, and intersex scientists and science advocates. We must work to make science available to everyone and encouraging individuals of all backgrounds to pursue science careers, especially in advanced degrees and positions. A diverse group of scientists produces increasingly diverse research, which broadens, strengthens, and enriches scientific inquiry, and therefore, our understanding of the world.
Indeed.

I would gladly go and attend the DC march (I could see and stay with my son at his house in Baltimore), but I am also quite willing to help establish and participate in a Bay Area march. I will be making a donation as well.

See also the related ScienceDebate.org.

I again call attention to some excellent reading going to the central issues.


The first four comprise a compelling tour from the Big Bang to today's troubling Anthropocene era. The latter three go to issues of science denial and effective, potentially "disruptive" communication in a digital age. I've cited them before. All highly recommended.

Shawn Otto's book The War on Science dwells in particular on three areas of front-burner policy contention: [1] evolution, [2] climate change, and [3] human reproductive rights (long under attack, but increasingly so of late).

"Science Denialism" runs rampant on the first two. My position on the latter, politically radioactive topic has been set forth in some detail on one of my other blogs. See my 2008 post "Diploid Dave, Zelinda Zygote."

Shawn Otto:
When Does Life Begin? Another example of the thorny intersection of science with traditional ideas, law, and politics comes from the biosciences. Careful, reproducible observations and measurements have forced us to repeatedly refine our ideas about what life is and when it begins. Is a human being first a life when it emerges from the birth canal? Does it have any legal rights as a person before then? Or is it a life when it is able to survive independently outside of the womb even if it is removed early, as can happen naturally with premature birth or with a Caesarean section? Or is it perhaps a life at quickening (the moment a mother first feels a fetus move, at about four months), as was the legal standard for a life when America was formed? But wait! Perhaps it is really a life when a fertilized egg first implants in the uterine lining, which, based on observations, is the medical definition of when a pregnancy begins. A woman cannot be said to be pregnant until her body begins the chemical and biological changes that accompany a symbiotic hosting of the embryo, can she? If it does not implant, the egg, even if fertilized, is simply flushed. Here we get into a tricky area, because many religious conservatives say, “No, it is a life when egg and sperm meet,” whether or not the fertilized egg ever implants. 

But then, a scientist would ask the fundamentalist, is it still a life at the moment of fertilization, even if we know from careful observation that one-third to one-half of fertilized eggs never implant, and as many as three-quarters fail to lead to an ongoing pregnancy? And, of course, that brings up more questions: What are fertilized eggs that never implant? How should we define them, if life occurs at fertilization? As miscarriages? Abortions? Nonpregnancies? Suicides? Murders? Something else? What implications might that definition have— legally, ethically, morally— for the use of birth-control pills that inhibit implantation? Is that abortion, murder, or pregnancy prevention? 

As our careful observations of life continue, so does our power both to assist and prevent pregnancy. But as our skills improve, new, more troubling questions form. What if we remove the uterus from the process entirely? Is it a life when sperm and egg are joined in a test tube at a fertility clinic and allowed to divide into a group of, say, sixteen cells that are then frozen for future implantation in a woman desperate to have children? Can the woman be said to be “pregnant” as long as this microscopic clump of frozen cells exists? What does Burwell v. Hobby Lobby Stores say about that? What, if any, rights should these frozen cells possess? And is a child conceived in this way— a “test-tube baby,” as we once called them— without a soul, as was suggested by some religious conservatives in the 1970s? Once born, are the joy they bring and the contributions they make less valuable? If we make a special exception for them, by agreeing that in vitro fertilization is not interfering with God’s plan, or by acknowledging that they do appear to have souls, why? On what basis? And what does that make the dozens of frozen cells we discard after a successful pregnancy? 

While we’re pondering these linguistic, legal, and ethical quandaries, our observations lead us to yet another new understanding. We don’t need sperm to fertilize an egg; we can do it with the nucleus of another cell from the same being. We try this, and sure enough, we find we can create many identical genetic copies of a sheep or mouse. We call them clones. But then we have to ask: Is it a life if it is just an ovum that has had its nucleus removed and replaced by the nucleus of another cell, and has then been chemically or electrically shocked to induce the natural process of cell division, without fertilization by sperm? If egg and sperm have never met, is it a life? Or is that creature— possibly, one day, a human— damned or soulless as it was once argued “test tube babies” would be? 

Observations tell us that beings produced in nontraditional ways seem to be the same as any other creatures. We have to ask, then, is every one of the roughly 1.5 million eggs a woman has in her ovaries at birth a life with rights? When, exactly, does life begin? Is it true, as the comedy troupe Monty Python sang in The Meaning of Life, that “every sperm is sacred”? 

What happens if we transform adult skin cells into stem cells, and those into sperm and egg, and then fertilize one with the other? Is that a clone or something else? What if we take the troublesome term “fertilization” out of the picture? Is it a life if we design its genome on a computer (as scientists at the J. Craig Venter Institute have done), buy a high-quality DNA synthesizer on eBay for $ 8,000 or so, use it to make fragments of the genome we designed, chemically stitch the fragments together, inject the complete genome into a cell with an empty nucleus, and shock it into replicating? Here, we have made a living, reproducing thing starting with a computer design and a few common chemicals. What does that mean for our ideas about life and our definition about conception? Is it wrong to be doing this? To be asking these questions? Applying these observations? Gaining these powers? 

What is life? Is life an unbroken chain of genetic code, running down through the generations, endlessly recombining in new forms? Is it software? Does the software beget the hardware? When does it become an individual with rights? Where do we draw the legal line? The moral line? Can we draw a line at all? Is that the right way to be thinking about it? And if we do, how do we define the terms conception, fertilization, implantation, and pregnancy?
Otto, Shawn Lawrence (2016-06-07). The War on Science: Who's Waging It, Why It Matters, What We Can Do About It (Kindle Locations 1120-1164). Milkweed Editions. Kindle Edition.
"When does life begin?"

The (soon likely to be again pressing) Constitutional question is "when does personhood begin?"

I'm not sure "science" can answer that. It can help inform the answer, but the answer will necessarily come from serious, difficult moral deliberation. Serious deliberation, not the preening clean-hands moral dilettantism that seems to be at the anti-choice activist policy fore.

THE "PETITION"
"Given the many urgent scientific and technological challenges facing America and the rest of the world, the increasing need for accurate scientific information in political decision making, and the vital role scientific innovation plays in spurring economic growth and competitiveness, we call for public debates in which the U.S. presidential and congressional candidates share their views on the issues of science and technology policy, health and medicine, and the environment."
I never sign online petitions, because you typically end up as a Mark, with your info sold to fundraising hucksters. I'm making an exception this time.

UPDATE

Rational reasoning and truth have been much on my mind as we enter a world of alternative facts and crypto-fascist edicts from the White House, less than two weeks into Donald Trump’s Administration. Last week, when “1984” rose toward the top of Amazon’s best-seller list, I dug out my dog-eared paperback copy and reread a quotation that I had underlined a decade and a half earlier: “For, after all, how do we know that two and two make four? Or that the force of gravity works? Or that the past is unchangeable? If both the past and the external world exist only in the mind, and if the mind itself is controllable—what then?”

In recent days, as Trump and his cohorts have peddled blatant falsehoods—that his Inauguration attracted the largest crowd in history, or that he lost the popular vote owing to millions of votes by illegal aliens—I have wondered about the extent to which minds can be controlled, or, rather, commandeered, by the relentless deluge of misinformation...


The muddling of fact and fiction is a tried-and-true tactic of totalitarian regimes. What’s more, when the two are confused for long enough, or when an indefatigable war on truth has been waged for a year, or two years, or perhaps eight, it will likely be harder and more tiresome to untangle them and remember a time when a firm line was drawn between the true and the false as a matter of course. If amnesia breeds normalization, fatigue has always served as the authoritarian’s great accomplice...

In the next four to eight years, American children will be born in a country led by a vainglorious man who wishes to fit facts—and their future—into the convenient shape of his ego. But democracy, freedom of expression, and, above all, the right to truth are not antiquated pieties. They belong to citizens who can still make their voices heard, before resignation metastasizes into complacency, exhaustion into self-doubt. The struggle will be to maintain openness and tolerance as the norm, the values that our children absorb into their identities naturally—to be defended rather than be defensive about...
- Jiayang Fan
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UPDATE: SOME NOTES ON TRUMP'S "EXTREME VETTING" 

Fear-mongering and otherwise pandering authoritarian irrationality extends to policy areas beyond explicit science topics such as climate change, evolution, and reproductive biology. Take, for example, the current dust-up over Trump's Executive Order immigration ban and his methodologically / operationally TBA promise of "extreme vetting." I'd call it "Total Information Awareness 2.0."

I've written on this topic elsewhere as well. After the GW Bush administration proposed a "Total Information Awareness" panoptic surveillance initiative in the wake of 9/11, I posted a web page entitled The Homeland Security Act and the proposed DARPA "Total Information Awareness" (TIA) program. (Probably a good bit of 'link rot' on that 15 yr old old thing. BTW, I had a bit of sport with the TIA Director here. Yes, I actually sent that via snailmail.)

I expanded on that riff in a more comprehensive 2008 blog post entitled Privacy and the 4th Amendment amid the "War on Terror."

Among other things, you're hemmed in by Bayes. Prevalence matters. Technologically, the gumshoe real world is not yet "The Bourne Ultimatum."
 
UPDATE: MARCH FOR SCIENCE SAN FRANCISCO FACEBOOK GROUP


Just joined. Group link here. There's also a Twitter group. One of an increasing number, it would seem.

FEB 3RD UPDATE, "EXTREME VETTING"
BUT WAIT! THERE'S MORE!

Via my now-daily email newsfeed from Scientific American:
PUBLIC HEALTH
Trump Immigration Ban Can Worsen U.S. Doctor Shortage, Hurt Hospitals
Thousands of U.S. physicians and medical students from banned countries may leave hospitals without staff 


The U.S. could face a shortfall of thousands of doctors, experts warn, because Pres. Donald Trump issued an executive order last week that banned citizens of seven majority-Muslim countries from entering the U.S. for 90 days. The order has created fears among foreign-born doctors and medical students—more than a quarter of the physician workforce in the U.S. comes from other countries, including Syria and Iran—that they will be persecuted in the U.S. or forced to leave. Medical school leaders say that sought-after applicants are likely to move their careers to other countries...
The Stupid. It burns.

UPDATE: Michael Specter nails it in The New Yorker, "The Deep Denialism of Donald Trump."
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More to come...