Sunday, December 31, 2006

The God Delusion by Richard Dawkins - Review by Mary Midgley


Chris Street edits in bold.

Mary Midgley has been a long time critic (since 1978) of Richard Dawkins.

  • 07 October 2006
  • Mary Midgley

THIS book is one of many that celebrate an allegedly bitter war between Science and Religion, two epic figures representing rival forces between which we must choose.

Different people understand this "war" differently. In the US, the default attitude (that of normal people) is increasingly assumed to be Religion, because a scientific or Darwinian world view is still taken to mean social Darwinism, the brash, brutal doctrine of the survival of the fittest that Herbert Spencer taught so successfully in the US and which deeply influenced the Nazis. In recent times, the sociobiological rhetoric of "selfishness" and "ruthlessness" in natural selection has served to reinforce this impression of meaningless brutality, leaving religion as the only tolerable option.

In the Middle East, however, talk of a scientific or Darwinian attitude stands for something different but no less hateful. It means primarily western materialism: the brash, greedy, uncaring lifestyle of people whose rulers trampled over oriental cultures and who trample them with increasing vigour today. Traditional religion appears as the only alternative to this odious attitude.

Thus, once the scene is polarised, once the two vast abstractions are set up, their ideologies turn the debate into incurable conflict. In that spirit, the preface of this book cries out for the abolition of the enemy: "Imagine, with John Lennon, a world with no religion. Imagine no suicide bombers, no 9/11, no 7/7, no Crusades, no Gunpowder Plot..."

These examples are, of course, endless, and the thought that removing religion would end such large-scale atrocities accounts in large part for the rise of anti-religious movements. However, the regimes they gave birth to during the 20th century included the governments of Nazi Germany, Pol Pot's Cambodia and Stalin's Russia. It is still not clear how it was possible for these regimes to commit the three most monstrous crimes of the epoch, but what does emerge is that removing religion had not helped at all. The roots of great crimes plainly lie far deeper than the doctrines people use to justify them.

In any culture, rogues defend their actions by professing whatever standards their society respects. Until recently, of course, Christianity was the norm in the west, but Marxism and fascism proved just as effective. Science, too, it turns out, can easily be used this way, as both Germany's and South Africa's justification of racism demonstrates. Religion is not really relevant at all, unless we carefully define "religion" to link it necessarily with atrocities.

This, of course, is the tendency of Dawkins's book. Dawkins is no rogue though; indeed, he is sincere in regarding God and religion the enemies of rationality - and in arguing that they are linked to atrocity to such an extent that they must be resisted. So much so that he is forced to assert that faiths which do not use the concept of God, such as Buddhism, Confucianism and Taoism, are not really religions at all. He also works hard to exclude scientists, such as Einstein, who firmly and repeatedly used religious language to express what are plainly central elements in their thought, from the taint of religion.

Dawkins is irritated by the Einstein phenomenon, and complains of a "confused and confusing willingness to label as 'religion' the pantheistic reverence which many of us share with its most distinguished exponent, Albert Einstein". He insists that this reverence has "no connection with supernatural belief". Pantheism, however, is unmistakably a religious attitude. And when, like Einstein, you speak of an immanent god, a divinity pervading the world, and when, like Spinoza, you equate God and Nature, words such as "supernatural" do not mean much.

Einstein understood this well. His language is only surprising if you assume, as Dawkins seems to, that science is the only possible source of knowledge. Thus in quoting Martin Rees's remark that such questions as why anything exists lie "beyond science", he simply cannot see what this might mean.

Similarly, when he cites NOMA - "nonoverlapping magisteria", the acronym coined by Stephen Jay Gould to describe how, in his view, science and religion could not comment on each other's sphere - and Freeman Dyson's description of himself as "one of the multitude of Christians who do not care much for the doctrine of the Trinity or the historical truth of the gospels", Dawkins declares flatly that they cannot mean what they say. As scientists, they must be atheists.

It seems not to have struck Dawkins that academic science is only a small, specialised, dependent part of what anybody knows. Most human knowledge is tacit knowledge - habitual assumptions, constantly updated and checked by experience, but far too general and informal ever to be fully tested. We assume, for instance, that nature will go on being regular, that other people are conscious and that their testimony can generally be trusted. Without such assumptions neither science nor any other study could ever get off the ground, and nor could everyday life.

When we build on these foundations we necessarily use imaginative structures - powerful ideas which can be called myths, which are not lies, but graphic thought-patterns that shape and guide our thinking. This is not irrational: the process of using these structures is a necessary preparation for reasoning. Thus the selfish gene is a powerful idea, so are the Science-Religion war, Gaia, natural selection, progress, and the hidden hand of the market.

With the largest, most puzzling questions, we have no choice but to proceed in mythical language which cannot be explained in detail at all, but which serves (as Einstein's did) to indicate what sort of spiritual universe we perceive ourselves to be living in. This is the province of religion. Adding God is not, as Dawkins thinks, adding an illicit extra item to the cosmos, it is perceiving the whole thing differently.

For a long time, this kind of language was reasonably well understood. Since the mid-19th century, however, there has been a disastrous attempt to get rid of it, keeping only literal statements of fact. This is, of course, the root of religious Christian fundamentalism, which tries, absurdly, to treat the whole of that strange compilation, the Bible, as literal fact. Yet in so doing it is only responding to a less obvious fundamentalism on the scientistic side, which claims that our knowledge reduces to one fundamental form - the literal statements of science. Both extremes show a similarly crass refusal to admit the complexity of life.

Dawkins is, of course, quite right to express horror at Biblical fundamentalism, especially in the neocon form that centres on the book of Revelation. But it is not possible to attack this target properly while also conducting a wider, cluster-bomb onslaught on everything that can be called religion. Since this particular bad form of religion is spreading rapidly in the world, we urgently need to understand it: not just to denounce it but to grasp much better than we do now why people find it attractive. It is not enough to say, as Dawkins does, that they are being childish.

We urgently need to understand fundamentalism

We also need to ask why they have found the other attitudes that are open to them inadequate. As I have suggested, this means becoming more aware of the inadequacies of our own way of life, which are obvious to them and which put them off the opinions that we profess. What we need, in fact, is a bit more self-knowledge.

From issue 2572 of New Scientist magazine, 07 October 2006, page 50-51

European Guidelines on CardioVascualar Disease











Exec summary - "European Guidelines on Cardiovascular disease (CVD) prevention in clinical practice" - download pdf (from our server) or here Download a series of excellent slides (updated Dec 2003).

This new model for total risk estimation based on the SCORE (Systematic Coronary Risk Evaluation) system.

The SCORE risk assessment is derived from a large dataset of prospective European studies and predicts fatal atherosclerotic CVD events over a ten year period.

This risk estimation is based on the following risk factors: gender, age, smoking, systolic blood pressure and total cholesterol. The threshold for high risk based on fatal cardiovascular events is defined as "higher than 5%" , instead of the previous "higher than 20%" using a composite coronary endpoint.

Using HeartScore total CVD risk can also be projected to age 60 which may be of particular importance for guiding young adults, at the age of 20 or 30, at low absolute risk, but already with an unhealthy risk profile, which will put them at much higher risk when they grow older.

Relative risk can also be estimated from the pie charts. You can read more about the SCORE project in European Heart Journal, 2003, 24; 987-1003. source: European Society of Cardiology

Google Scholar





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Try it!

Statins to reduce heart attacks or strokes

Chris Street edits in bold.

New Scientist magazine (7th October 2006) reports on the use of Statins to reduce heart attacks or strokes.

"So you think you're healthy? You are in your 40s, feel right as rain, normal blood pressure, normal cholesterol, pretty good diet, occasional exercise. How would you react if your doctor suggested you take a powerful drug every day for the rest of your life? The drug, known as a statin, will lower your cholesterol even further and reduce your risk of a heart attack or stroke.

According to one recent estimate, most men and many women over 40 could benefit from the drugs.

If you are worried about side effects, your doctor will reassure you that a meta-analysis that pooled data from 14 trials involving more than 90,000 people shows the treatment is very safe.

The same study suggests that even if your cholesterol level is normal, taking a statin can still reduce your cardiovascular risk. And the greater your risk - if you smoke, suffer from high blood pressure or diabetes, or have a family history of heart disease, for example - the greater the potential benefits."

New Scientist says "Lowering cholesterol is beneficial in pretty much everyone who has been studied," says Colin Baigent, who coordinated the meta-analysis by the Clinical Trial Service Unit (CTSU) at the University of Oxford. "It doesn't really matter what the cholesterol level is. It could be average or even low, but if you reduce it even further in a person who is at high risk you get benefits." Statins also have anti-inflammatory properties, and have shown promising results when used to treat diseases like rheumatoid arthritis, multiple sclerosis and Alzheimer's. Some research even suggests they can help tackle viral infections such as hepatitis C and HIV.

Can any drug really be that good? As enthusiastic doctors put ever more people on statins, sceptics are warning that we don't know enough about the possible adverse effects of taking them over a lifetime.

Others claim that statins' potency against heart disease has little to do with lowering cholesterol and instead results from their anti-inflammatory properties, leading some to dismiss them as "expensive aspirin". So could the rush to put millions more people on statins be a costly mistake?"

"The association between cholesterol, its transport in the bloodstream by a protein called low-density lipoprotein and heart disease is fairly well established. Cholesterol in the form of LDL, so-called "bad cholesterol", can infiltrate the walls of coronary arteries, contributing to the formation of a fibrous plug of immune cells called a plaque. If this ruptures it can trigger the formation of a blood clot that blocks the artery and starves the heart of oxygen - a heart attack, in other words. Equally disastrously, the clot can break free and block arteries in the brain, triggering a stroke."

"Some doctors, however, are alarmed by the trend towards dishing out statins to millions more people and giving higher dosages to lower cholesterol even further. They say the benefits for those who do not already have heart disease are small, while the potential risks are largely unknown. "What price should you pay for a modest effect?" Sutter asks. "The price shouldn't be very high because the effect is weak at best." A 20 per cent reduction in cardiovascular risk may sound impressive, but it doesn't look quite as good when you realise what it means for each individual: if your risk of having a heart attack over the next five years is 5 per cent, say, then taking statins will reduce it only to 4 per cent."

"Sutter and others say that statin researchers have failed to report adverse effects in enough detail to allow doctors and patients to weigh the potential costs against the benefits. "There's no good reporting of adverse effects at high doses and very modest reporting even at moderate doses," Sutter says. "If you are prescribed a statin, the doctor expects you to take it for the rest of your life," says Uffe Ravnskov, an independent researcher and former hospital doctor based in Lund, Sweden, who runs The International Network of Cholesterol Skeptics. He claims almost half of patients have adverse effects."

"Alleged side effects include memory loss, extreme irritability, aggression, suicidal impulses and impotence. Evidence for these remains sketchy, however, coming from small trials and case studies. Statins do cause liver damage in around 1 per cent of patients, but this should be picked up by routine liver function tests and can be reversed by coming off the drugs. It is also clear that statins can damage muscles. As many as a fifth of people taking the drugs in trials say they experience some muscle weakness or pain, and exercise seems to make things worse. These symptoms are commonplace anyway in middle-aged and elderly people, however, and a similar number of patients taking a placebo also report them. So it is difficult to determine the exact extent of the problem. "

"In very rare cases statins cause rhabdomyolysis, a severe form of muscle damage in which the breakdown products cause kidney failure. The rate was especially high with cerivastatin (Baycol), which caused 50 deaths and was withdrawn in 2001. "

"Confusingly, some small studies have hinted that statins increase the risk of cancer while others suggest they may guard against it. The CTSU meta-analysis found no association between cancer and statins, and a similarly large study from the US, which looked at 26 trials involving 87,000 patients, also found no link."

"Most trials, though, have lasted only five years or less. For some this leaves lingering doubts. "You don't get lung cancer after smoking for 10 years; it takes much longer to show up," Ravnskov points out. "Heavy smokers get lung cancer in their 50s and 60s and they have smoked for decades before that." Nevertheless, White, who led the US study, is confident that even after five years some signs of increased cancer risk would show up in trials. "Within the period we were looking at you should at least have started to see some trends," he says. "

"The crucial issue now facing policy-makers is how and where to draw the line that defines who should be offered statins. In the US and Canada, prescribing guidelines focus on lowering cholesterol below certain thresholds, depending on the individual's overall risk of a heart attack or stroke. The lowering of the US target levels in 2004, which is leading to millions more people being put on statins, sparked controversy when it was revealed that eight out of the nine experts involved had ties to statin manufacturers. "

"In Australia, New Zealand and the UK, the emphasis is on treating those with the highest overall risk rather than on cholesterol targets. This year, a Canadian study that modelled the effects of applying the various guidelines concluded that the high-risk approach is more effective in terms of number of lives saved per number treated (BMJ, vol 329, p 529). It found, for instance, that applying the US guidelines would result in twice as many people taking statins as the New Zealand guidelines without preventing any more deaths. "

"Yet even the more conservative guidelines will lead to millions more people taking statins for the rest of their lives, often starting younger or being given higher doses. You could be one of them. If the advocates of statins are right, this policy will come to be seen as a triumph for preventative medicine, saving tens of thousands of lives. If the critics are right, for those with a low risk of heart disease statins could do more harm than good. Which will you bet your life on when your doctor mentions the s-word? "

Biomarkers that can predict a long life

Chris Street edits in bold.

My Action: Test for CRP, IL-6, fibrinogen, EPI and NE etc

What biochemicals can predict how long I will live?


Full Review:
"Combinations of biomarkers predictive of laterlife mortality" in PNAS September 19th 2006 vol. 103 no. 38, Gruenewald et al. Download the full article pdf (save $10) - Recommended.

13 biomarkers, reflecting activity in several biological systems predict death or ill health in older adults.

Neuroendocrine stress hormones
Nerve cells (Neuroendocrine glands) produce four hormones that are released under conditions of stress.

Immune activity

  • C-reactive protein (CRP)
    • a marker of inflammation. High levels indicate risk of developing fatty deposits on inner walls of arteries which can lead to heart attacks.
  • Fibrinogen
    • Fibrin made from fibrinogen is a protein involved in clotting of blood
  • Interleukin 6 (IL-6)
    • is a cytokine secreted by T cells and macrophages to stimulate immune response to trauma, especially burns or other tissue damage leading to inflammation.
  • Albumin
    • most abundant protein in human blood plasma. High levels is a sign of severe dehydration. Low levels can be caused by malnutrition, malabsorption, liver disease, etc.

Cardiovascular functioning

Metabolic activity

Aims:-

  • (i) identify combinations of biomarkers and their zones of values associated with high levels of mortality risk in older men and women
  • (ii) examine whether biomarkers differ between men and women
  • (iii) introduce prediction rules that are based on conjunctions of biomarker conditions.
A secondary aim is to present recursive partitioning (RP) that allows for identification of combinations of biomarkers and their value zones.

Throughout, the focus is on identifying subclinical levels of biomarkers that characterize high-risk (HR) conditions, because such knowledge has the potential to contribute to preventive interventions that might prolong life beyond what is expected on the basis of current clinical risk criteria.

Biomarkers were selected for use in analyses if the biomarker was:-
  • a primary mediator of a biological regulatory system responsive to internal or external challenges (e.g., sympathetic nervous system hormones and inflammatory cytokines, such as IL-6)
  • the biomarker was known to exhibit change in response to interaction with a primary mediator (e.g., CRP production in response to IL-6).
  • The remaining measures were selected to represent secondary outcomes of these mediating processes.


For example, a combination of high levels of NE, CRP, and EPI led to a subgroup of 30 male participants (terminal node 12 in Fig. 1) with a mortality rate of 93.3% within the group. A second group of male participants (terminal node 9) with a high mortality rate (83.3%) is characterized by a combination of biomarkers that includes NE levels in a moderate range, high levels of IL-6, and low levels of HDL cholesterol.

Results
Each biomarker for male and female participants are presented in Table 1.



Recursive Partitioning Forests and Mortality Prediction.




Discussion

In men, markers of the endocrine and immune systems were commonly represented in HR mortality pathways, with a lesser role for indicators of the cardiovascular and metabolic systems. Fewer HR pathways were identified in women, but a range of biomarkers was present, including blood pressure, inflammatory markers, DHEA, and HbA1c.

With a focus on prevention, it may be useful to include assays on biomarkers such as CRP, IL-6, fibrinogen, EPI, and NE as part of a standard physical examination.

A prediction rule for mortality, using a single tree, was specified as follows: predict dead within 12 years of baseline if the individual has biomarker conditions as specified by a pathway into a terminal node with mortality rate 70% (males) or 60% (females).

Water on Mars?


A Year of Extraterrestrial Fountains and Flows
Credit: MGS, MSSS, JPL, NASA

Explanation: The past year was extraordinary for the discovery of extraterrestrial fountains and flows -- some offering new potential in the search for liquid water and the origin of life beyond planet Earth.. Increased evidence was uncovered that fountains spurt not only from Saturn's moon Enceladus, but from the dunes of Mars as well. Lakes were found on Saturn's moon Titan, and the residual of a flowing liquid was discovered on the walls of Martian craters. The diverse Solar System fluidity may involve forms of slushy water-ice, methane, or sublimating carbon dioxide. Pictured above, the light-colored path below the image center is hypothesized to have been created sometime in just the past few years by liquid water flowing across the surface of Mars.

Xmas weight gain

Over Xmas I've gained 1.4 pounds. To be expected!

Saturday, December 30, 2006

Will Inflation be confirmed by discovering cosmological gravitational waves?

Steven Weinberg forecasts the future

  • 18 November 2006

The most important development in physics that I can imagine in the next 50 years would be the discovery of a final theory that dictates all properties of particles and fields. That may be too much to hope for. A major step in this direction would be the discovery of particles like gauginos or squarks that are required by supersymmetry. Alas, we don't know what the masses of these particles would be, and they may be beyond the reach of any particle accelerator.

On the other hand, we can confidently predict breakthroughs in cosmology. We will know whether the density of dark energy varies with time at a rate comparable to the cosmic expansion rate, or is essentially constant - a crucial clue to the nature of dark energy. We will either have confirmed the general idea of inflation by discovering signs of cosmological gravitational waves (which I expect), or we will have ruled out inflation by showing that these gravitational waves are weaker than predicted. We may be using laser interferometers in space to detect cosmological gravitational waves that bear clues about the behaviour of the matter of the universe at energies higher than we can reach in accelerators. But the origin of the universe will remain obscure until we make more progress toward a final theory.

Nothing truly revolutionary is ever predicted because that is what makes it revolutionary.

John D. Barrow forecasts the future

  • 18 November 2006

Cosmologists have much to look forward to: the direct detection of dark matter and gravitational waves, the extraction of more secrets of the early universe, the discovery of the cosmic neutrino background, possibly an exploding black hole, understanding dark energy, decisive evidence for or against the existence of other dimensions of space, new forces of nature and the possibility of time travel; perhaps even nano-sized space probes. I could go on.

All this is exciting, but take a moment to think back 50 years and look forwards. None of the greatest discoveries in the astronomical sciences were foreseen. The transformation in the practice of science brought about by the web is barely 30 years old. No one predicted it. Pulsars, quasars, gamma-ray bursts, the standard model of particle physics, the isotropy of the microwave background, strings and dark energy were equally unexpected. None of these was predicted 50 years ago.

Perhaps scientists are as blinkered as the politicians and economists who failed to foresee the fall of the Iron Curtain and the climatic implications of industrialisation. Yet this myopia may not be a fault. Perhaps it is a touchstone. If you can foresee what is going to happen in your field over the next 50 years then maybe it is mined out, or lacking what it takes to attract the brightest minds. Nothing truly revolutionary is ever predicted because that is what makes it revolutionary.

We may sequence an individual's genome for $1000 and live to 100

Francis Collins forecasts the future

  • 18 November 2006

Fifty years from now, if I avoid crashing my motorcycle in the interim, I will be 106. If the advances that I envision from the genome revolution are achieved in that time span, millions of my comrades in the baby boom generation will have joined Generation C to become healthy centenarians enjoying active lives.

How do we get from here to there? For starters, we must develop technologies that can sequence an individual's genome for $1000 or less. This will enable healthcare providers to identify the dozens of glitches that we each have in our DNA that predispose us to certain diseases. In addition, we need to unravel the complex interactions among genetic and environmental risk factors, and to determine what interventions can reduce those risks. With such information in hand, new treatments will be developed, and our "one-size-fits-all" approach to healthcare will give way to more powerful, individualised strategies for predicting and treating diseases - and, eventually, preventing them.

The challenge doesn't stop there. We are already setting our sights on the ultimate nemesis of Generation C: ageing. Genomic research will prove key to discovering how to reprogram the mechanisms that control the balance between the cell growth that causes cancer and the cell death that leads to ageing. It is possible that a half-century from now, the most urgent question facing our society will not be "How long can humans live?" but "How long do we want to live?"

Parallel universes may be discovered in 50 years

Max Tegmark forecasts the future

  • 18 November 2006

In 2056, I think you'll be able to buy a T-shirt on which are printed equations describing the unified physical laws of our universe. All the laws we have discovered so far will be derivable from these equations.

We will have confirmed beyond doubt, through observation, that what we now call the big bang wasn't the beginning of everything, merely the time when our part of space stopped undergoing an explosive stretching called inflation. We will have understood the physics of inflation well enough to know that inflation continues forever in some faraway places, and that in other places where it has ended and allowed life to evolve, the T-shirts on sale mostly have different equations.

The existence of such "parallel universes" will be no more controversial than the existence of other galaxies - then called "island universes" - was 100 years ago. This idea was controversial until Edwin Hubble settled it in 1925.

We will understand the moment of the big bang

Sean Carroll forecasts the future

  • 18 November 2006

The most significant breakthrough in cosmology in the next 50 years will be that we finally understand the big bang.

In recent years, the big bang model - the idea that our universe has expanded and cooled over billions of years from an initially hot, dense state - has been confirmed and elaborated in spectacular detail. But the big bang itself, the moment of purportedly infinite temperature and density at the very beginning, remains a mystery. On the basis of observational data, we can say with confidence what the universe was doing 1 second later, but our best theories all break down at the actual moment of the bang.

There is good reason to hope that this will change. The inflationary universe scenario takes us back to a tiny fraction of a second after the bang. To go back further we need to understand quantum gravity, and ideas from string theory are giving us hope that this goal is obtainable. New ways of collecting data about dark matter, dark energy and primordial perturbations allow us to test models of the earliest times. The decades to come might very well be when the human race finally figures out where it all came from.

Turning on protective systems in people should create centenarians who are vigorous and productive

Richard Miller forecasts the future

  • 18 November 2006

In ageing research, the key breakthrough will be the elucidation of the molecular pathways that render cells from long-lived animals - whales, people, bats, porcupines - resistant to many forms of injury. Studies in worms have shown that mutations that extend lifespan do so by making them resistant not merely to one kind of stress (DNA damage, say, or oxidative injury) but to multiple forms of harm. Biologists are gradually showing that similar protective pathways also slow ageing in flies and mice, and that these cellular circuits date back further than the evolutionary branch point between yeast and us.

Figuring out how this "injury protection package" is turned on by evolution in long-lived animals, and by ultra-low-calorie diets and dwarfing mutations in mice, dogs, horses and probably people, will be the key step towards development of authentic anti-ageing pharmaceuticals that turn the same trick. It is now routine, in laboratory mammals, to extend lifespan by about 40 per cent. Turning on the same protective systems in people should, by 2056, be creating the first class of centenarians who are as vigorous and productive as today's run-of-the-mill sexagenarians.

Tissue Engineering will give limb regeneration

Ellen Heber-Katz forecasts the future

  • 18 November 2006
I believe that the day is not far off when we will be able to prescribe drugs that cause severed spinal cords to heal, hearts to regenerate and lost limbs to regrow. People will come to expect that injured or diseased organs are meant to be repaired from within, in much the same way that we fix an appliance or automobile: by replacing the damaged part with a manufacturer-certified new part.

Advances in heart regeneration are around the corner, digits will be regrown within five to ten years, and limb regeneration will occur a few years later. Central nervous system repair will occur first with the retina and optic nerve and later with the spinal cord. Within 50 years whole-body replacement will be routine.

Billions of Universes?

Martin Rees forecasts the future

  • 18 November 2006

I hope that in 50 years we will know the answer to this challenging question: are the laws of physics unique and was our big bang the only one? Theoretical horizons have recently expanded astonishingly. According to some speculations the number of distinct varieties of space - each the arena for a universe with its own laws - could exceed the total number of atoms in all the galaxies we see. Most space-times would be sterile or stillborn, but among this cornucopia there could still be immense numbers that allow big bangs that "fly" - allowing the emergence of the rich complexity that leads to atoms, stars, planets, biospheres and brains able to contemplate their origins. So do we live in the aftermath of one big bang among many, just as our solar system is merely one of many planetary systems in our galaxy?

Science will kill religion - not by reason challenging faith, but by offering a more practical moral framework for human interaction

Geoffrey Miller forecasts the future

* 18 November 2006


Applied evolutionary psychology should revolutionise life in three ways by 2056.

First, Darwinian critiques of runaway consumer capitalism should undermine the social and sexual appeal of conspicuous consumption. Absurdly wasteful display will become less popular once people comprehend its origins in sexual selection, and its pathetic unreliability as a signal of individual merit or virtue.

Second, studies of human happiness informed by evolution will reveal ever more clearly the importance of "social capital" - neighbourliness, close-knit communities, local family support, and integration between kids, adults and the elderly. This will, I hope, lead to revolutionary changes in urban planning, leading to a New Urbanist revival of mixed-use landscapes. Enlightened citizens will demand to live in village-type spaces rather than alienating suburbs of single-family isolation and unbearable commutes.

Third, evolutionary moral psychology will reveal the social conditions under which human moral virtues flourish. The US will follow the UK in realising that religion is not a prerequisite for ordinary human decency. Thus, science will kill religion - not by reason challenging faith, but by offering a more practical, universal and rewarding moral framework for human interaction. A naturalistic moral philosophy will replace the rotting fictions of theological ethics.

In these three ways, applied evolutionary psychology will help Enlightenment humanism fulfil its long-stalled potential to make us all brighter, wiser, happier and kinder.

Gravitational waves may be found: a relic of the universe 10-35 seconds after the big bang

  • 18 November 2006, Rocky Kolb forecasts the future
The most significant breakthrough in cosmology will be the discovery of background gravitational waves that were produced in the very early universe, during the epoch of rapid expansion known as inflation.

We can already look out into space, and hence back in time, to 380,000 years after the bang using the cosmic microwave background radiation.

Similarly, by measuring the properties of the neutrino background we can look back to one second after the bang.

But gravitational waves are a relic of the universe 10-35 seconds after the bang.

Nicholas Stern "globally spend 1% GDP on Carbon Dioxide limitation"

Chris Street edits in bold
Fred Pearce
15:02 30 October 2006

Nicholas Stern one of the world’s top economists today warned of a global recession that could cut between 5% and 20% from the world’s wealth later this century – unless the world invests now in the technologies needed to create a global low-carbon economy.

The cost of investment would be trivial by comparison with the possible damage, says Sir Nicholas Stern, former chief economist at the World Bank and an adviser to the British chancellor Gordon Brown, who commissioned the 600-page report.

Stern calls for a global investment of about 1% per year of global GDP over the next 50 years. He says that we should stabilise greenhouse gas concentrations at the equivalent of 500-550 parts per million of carbon dioxide, 25% above current levels. This is a level he regards as “high but acceptable”.

“Economically speaking, mitigation – taking strong action to reduce emissions – is a very good deal,” he says. “A 1% increase in prices is very marginal. We can continue to grow. But if we don’t [invest], the kind of changes that would happen will derail growth.”

Green benefit

Stern warns that climate change risks causing economic consequences “on a scale similar to those associated with the great wars and the economic depression of the first half of the 20th century”. But in the long run we would all benefit from the cleaner, greener energy technologies.

His year-long investigation has not added to the scientific knowledge about the risks of climate change, he says, adding that evidence from international groups like the Intergovernmental Panel on Climate Change is “overwhelming”. But he has interpreted the implications of the scientists’ warnings for the world economy.

“There isn’t scientific certainty,” he says. “But the risks are very big.”

He forecasts huge disruption to African economies in particular as drought hits food production; up to a billion people losing water supplies as mountain glaciers disappear; hundreds of millions losing their homes and land to sea level rise; and potentially big increases in damage from hurricanes. The economic cost of failing to act could approach $4 trillion by the end of the century, he says.

Drastic cuts

Substantial climate change is now inevitable, Stern says. But the worst could be prevented if global emissions can be stabilised within 20 years and thereafter reduced by around 2% per year. “What we do in the next 10 or 20 years can have a profound effect on the climate in the second half of the century and in the next.”

Stern says the primary responsibility for action to cut greenhouse gas emissions lies with the rich industrialised world, which continues to produce most of the world’s emissions.

In response to the report, Gordon Brown has called for industrialised countries to cut their emissions by 30% by 2020 and at least 60% by 2050. Such drastic cuts are needed because CO2, the main greenhouse gas responsible for climate change, accumulates in the atmosphere, lasting for hundreds of years before it is absorbed slowly by the oceans.

Chasm closed

Stern’s findings contradict some past claims by economists that the world would do better adapting to climate change than trying to halt it. Meanwhile, some scientists say the emissions cuts called for by Stern would not be enough to stave off dangerous climate change.

But Michael Grubb, a climate and energy analyst at of Imperial College London, UK, said: “The Stern Review finally closes a chasm that has existed for 15 years between the precautionary concerns of scientists and the cost-benefit views of many economists.”

London’s Mayor, Ken Livingstone, agreed: “For too long, necessary action to prevent catastrophic climate change has been delayed by fears that this would damage economic growth. Stern's report nails this myth – it is failure to take action on climate change that would be the real threat to future economic prosperity."

Livingstone continued: "I welcome Stern's call for an international carbon market and I look forward to working with him, Gordon Brown and indeed Al Gore on how London – a world centre for financial markets, energy companies and high tech industries – can play a leading role in this and the other measures he proposes.”

HeartScore



For the online interactive HeartScore - you can play Doctor and add your own details.

Intervention

Systolic blood pressure
is 130 mmHg, and that is above the normal range.

Raised blood pressure increases your risk for cardiovascular diseases.
It would be beneficial if your blood pressure was lowered from the present 130 mmHg to a level around xx mmHg.

You can contribute to this by choosing a diet rich on vegetables and fibres and by avoiding excessive intake of salt and animal fat.

If you increase your level of physical activity, it will also lead to a substantial reduction in your blood pressure.

In some cases, however, it is necessary to treat a high blood pressure with medicine.


Cholesterol

Your cholesterol is 5 mmol/L, and that is above the normal range.

The lower the cholesterol value gets, the lower the risk of cardiovascular disease.

I therefore recommend that your present cholesterol value of 5 mmol/L is lowered to a value around 5 mmol/L or less. This can be obtained by increasing the intake of vegetables and by eating less animal fat.

In severe cases, drugs may be needed to reduce a high cholesterol level.

GUIDELINES

Systolic Blood Pressure

Your patients blood pressure has been measured to 130 mmHg, 'and that is above the normal range.

The risk of cardiovascular diseases increases continuously as blood pressure rises from levels that are considered to be within the normal range.

The decision to start treatment, however, depends not only on the level of blood pressure, but also on an assessment of total cardiovascular risk and the presence or absence of target organ damage.

In patients with established CVD the choice of antihypertensive drugs depends on the underlying cardiovascular disease.

The decision to lower blood pressure with drugs depends not only on the total cardiovascular risk but also on presence of target organ damage.

Drug therapy should be initiated promptly in individuals with a sustained systolic blood pressure (SBP) > 180 mmHg and/or a diastolic blood pressure (DBP) > 110 mmHg regardless of their total cardiovascular risk assessment.

Individuals at high risk of developing CVD with sustained SBP of higher than 140 mmHg and/or DBP higher than 90 mmHg also require drug therapy.

For such individuals, drugs should be used to lower blood pressure to <140/90mmhg.>

  • diuretics,
  • betablockers,
  • ACE inhibitors,
  • calcium-channel blockers and
  • angiotensin II antagonists.

In many clinical trials, blood pressure control has been achieved by the combination of two or even three drugs, and drug combination therapy is often also necessary in routine clinical practice.

In patients with several diseases requiring drug therapy, polypharmacy can become a major problem and good clinical management is required to resolve it.

In all patients, blood pressure reduction should be obtained gradually.
For most patients, the goal of therapy is blood pressure less than 140/90 mmHg, but for patients with diabetes and individuals at high total CVD risk, the blood pressure goal should be lower.


Cholesterol Guidelines
our patients cholesterol has been measured to 5 mmol/L, and that is above the normal range.

In general, total plasma cholesterol should be below 5 mmol/l (190 mg/dl), and LDL cholesterol should be below 3 mmol/l (115 mg/dl).

For patients with clinically established CVD and patients with diabetes the treatment goals should be lower:total cholesterol <4.5mmol/l(175mg/dl)>1.7mmol/l(150mg/dl),serve as markers of increased cardiovascular risk.

Values of HDL cholesterol and triglycerides should also be used to guide the choice of drug therapy.

Asymptomatic people at high multifactorial risk of developing cardiovascular disease, whose untreated values of total and LDL cholesterol are already close to 5 and 3 mmol/l, respectively, seem to benefit from further reduction of total cholesterol to <>8mmol/l (320mg/dl) and LDL-cholesterol>6mmol/l (240mg/dl) by definition places a patient at high total risk of CVD.

If the 10 year risk of cardiovascular death is >5%, or will become >5% if the individuals´ risk factor combination is projected to age 60, a full analysis of plasma lipoproteins should be performed, and intensive lifestyle advice, particularly dietary advice, should be given .

If values of total and LDL cholesterol fall below 5 mmol/l (190 mg/dl) and 3 mmol/l (115 mg/dl), respectively, and the total CVD risk estimate has become <>5%, lipid lowering drug therapy should be considered to lower total and LDL cholesterol even further.

The goals in such persistently high-risk individuals are to lower total cholesterol to < style="font-weight: bold;" size="4">Diet
General recommendations:

  • foods should be varied, and energy intake must be adjusted to maintain ideal body weight
  • the consumption of the following foods should be encouraged: fruits and vegetables, whole grain cereals and bread, low fat dairy products, fish and lean meat.
  • oily fish and omega-3-fatty acids have particular protective properties
  • total fat intake should account for no more than 30% of energy intake, and intake of saturated fats should not exceed a third of total fat intake. The intake of cholesterol should be less than 300 mg/day
  • in an isocaloric diet, saturated fat can be replaced partly by complex carbohydrates, partly by monounsaturated and polyunsaturated fats from vegetables and marine animals
    Patients with arterial hypertension, diabetes, and hypercholesterolemia or other dyslipidemias should receive specialist dietary advice.
Priorities
The priorities for CVD prevention in clinical practice are :
  • Patients with established coronary heart disease, peripheral artery disease and cerebrovascular atherosclerotic disease
  • Asymptomatic individuals who are at high risk of developing atherosclerotic cardiovascular disease because of
    • multiple risk factors resulting in a 10 year risk of 5% now (or if extrapolated to age 60) for developing a fatal CVD event
    • markedly raised levels of single risk factors: cholesterol 8 mmol/l (320 mg/dl), LDLcholesterol 6 mmol/l (240 mg/dl), blood pressure 180/110 mmHg
    • diabetes type 2 and diabetes type 1 with microalbuminuria
  • Close relatives of
    • patients with early onset atherosclerotic cardiovascular disease
    • symptomatic individuals at particularly high risk
    • Other individuals encountered in your clinical practice
Strategies
Strategies to make behavioural counselling more effective include:

  • develop a therapeutic alliance with the patient
  • gain commitments from the patient to achieve lifestyle change
  • ensure the patient understands the relationship between lifestyle and disease
  • help the patient overcome barriers to lifestyle change
  • involve the patient in identifying the risk factor(s) to change
  • design a lifestyle modification plan
  • use strategies to reinforce the patients´ own capacity to change
  • monitor progress of lifestyle change through followup contacts
  • involve other health care staff wherever possible
SCORE
This new model for total risk estimation based on the SCORE (Systematic Coronary Risk Evaluation) system is now recommended and has several advantages.

The SCORE risk assessment is derived from a large dataset of prospective European studies and predicts fatal atherosclerotic CVD events over a ten year period.

This risk estimation is based on the following risk factors: gender, age, smoking, systolic blood pressure and total cholesterol.

The threshold for high risk based on fatal cardiovascular events is defined as "higher than 5%" , instead of the previous "higher than 20%" using a composite coronary endpoint.

This SCORE model has been calibrated according to each European country´s mortality statistics. In other words, if used on the entire population aged 40-65, it will predict the exact number of fatal CVD-events that eventually will occur after 10 years.

Using HeartScore total CVD risk can also be projected to age 60 which may be of particular importance for guiding young adults, at the age of 20 or 30, at low absolute risk, but already with an unhealthy risk profile, which will put them at much higher risk when they grow older.

Relative risk can also be estimated from the pie charts.

You can read more about the SCORE project in European Heart Journal, 2003, 24; 987-1003.

Peer Review

Peer review (wikipedia) (known as refereeing in some academic fields) is a process of subjecting an author's scholarly work or ideas to the scrutiny of others who are experts in the field. It is used primarily by editors to select and to screen submitted manuscripts, and by funding agencies, to decide the awarding of monies for research.The peer review process is aimed at getting authors to meet the standards of their discipline and of science generally. Publications and awards that have not undergone peer review are likely to be regarded with suspicion by scholars and professionals in many fields. Even refereed journals, however, have been shown to contain error, fraud and other flaws that undermine their formality.

The Root of all Evil? tv documentary by Richard Dawkins



The Root of All Evil? (wikipedia) is a television documentary, written and presented by Richard Dawkins, in which he argues that the world would be better off without religion. The documentary was first broadcast in January 2006, in the form of two 45 minute episodes (excluding advertisement breaks), on Channel 4 in the UK. Dawkins has said that the title "The Root of All Evil?" was not his preferred choice, but that Channel 4 had insisted on it to create controversy.[1] His sole concession from the producers on the title was the addition of the question mark. Dawkins has stated that the notion of anything being the root of all evil is ridiculous.[2] Dawkins' book The God Delusion, released in September 2006, goes on to examine the topics raised in the documentary in greater detail.

BMI - Body Mass Index


I'm overweight. BMI and Waist to hip ratio both indicate that fact.

At 5'7.5" and 12st 131bs or 181 pounds (was 13st 8lbs a few months ago!) my BMI is 27.9.

BMI is Body Mass Index defined by dividing weight in kilogrammes by my height in metres squared. BMI = kg/m2.

My current weight loss goal is to stabilise at 155 pounds (11st 1lb) giving a BMI of 23.9.

For a BMI of 24.9 my weight would be 161.5 pounds (11st 7.5lbs).

For a BMI of 20.9 my weight would be 135 pounds (9st 9Ibs).

I use a simple BMI calculator.

Back in February 1987 I was 11st 13lbs (BMI 25.8 - overweight) and by July 1987 in my first diet (strict calorie counting + exercise) I lost 2 stone to 9st 13lbs (BMI 21.4 - normal weight). Sharon said I looked emaciated at this weight!

By August 1990, 3 years on, I had put on all the weight I had lost in 1987 diet.

Sharon's weight today is 10st 2Ibs, 5'1" - BMI is 26.6. A 24.9 BMI for her is 9st 6Ibs. A 23.9 BMI would be 9st.

But how were these figures calculated in the first place? And is their any variation of these classifications? Wikipedia BMI page has answers.

the following are common definitions of BMI categories:

  • Starvation: less than 15
  • Underweight: less than 18.5
  • Ideal: from 18.5 to 25
  • Overweight: from 25 to 30
  • Obese: from 30 to 40
  • Morbidly Obese: greater than 40

During the past 20 years, says CDC obesity among adults has risen significantly in the United States. The latest data from the National Center for Health Statistics show that 30 percent of U.S. adults 20 years of age and older—over 60 million people—are obese. The U.S. National Health and Nutrition Examination Survey of 1994 indicates that 59% of American men and 49% of women have BMIs over 25.

Being overweight increases the risk of many diseases and health conditions, including the following:

  • Hypertension
  • Dyslipidemia (for example, high total cholesterol or high levels of triglycerides)
  • Type 2 diabetes
  • Coronary heart disease
  • Stroke
  • Gallbladder disease
  • Osteoarthritis
  • Sleep apnea and respiratory problems
  • Some cancers (endometrial, breast, and colon)
BMI or Quetelet Index was invented between 1830 and 1850 by the Belgian polymath, Adolphe Quetelet during the course of developing "social physics".

The BMI has become controversial because many people, including physicians, have come to rely on it for medical diagnosis - but that has never been the BMI's purpose. It is meant to be used as a simple means of classifying sedentary (physically inactive) individuals with an average body composition.

I wouldn't say i was physically inactive (how is that defined?) - I walk Jazzie the dog most days for an hour or so and ride a bike occassionally on a CRABS ride.

Have i got an average body composition?

BMI accuracy in relation to actual levels of body fat is easily distorted by such factors as fitness level, muscle mass, bone structure, gender, and ethnicity. As a general rule, developed muscle contributes more to weight than fat and the BMI does not account for this. Therefore a person with more muscle mass, such as a body-builder, will seem to be overweight. People who are mesomorphic tend to have higher BMI numbers than people who are endomorphic, because they have greater bone mass and greater muscle mass, respectively, than do endomorphic individuals.

Similarly, an ectomorphic individual could conceivably receive an unhealthily low reading, when in fact their body type makes them naturally thin no matter what they eat.

International BMI variations

These recommended distinctions along the liner scale may vary from time to time and country to country. In 1998, the U.S. National Institutes of Health brought U.S. definitions into line with World Health Organization guidelines, lowering the normal/overweight cut-off from BMI 27.8 to BMI 25. This had the effect of redefining 30 million Americans, previously "technically healthy" to "technically overweight". It also recommends lowering the normal/overweight threshold for South East Asian body types to around BMI 23, and expects further revisions to emerge from clinical studies of different body types.

Waist-to-Hip Ratio vs BMI May Be More Accurate Predictor of CV Risk

Chris Street edits in bold.

Wikipedia article Waist to Hip Ratio was updated by Chris Street today:-

WHR not Body mass index (BMI), is the best obesity measure for assessing a person’s risk of heart attack. If obesity is redefined using WHR instead of BMI, the proportion of people at risk of heart attack worldwide increases threefold.[2][3]

News Author: Laurie Barclay, MD
CME Author: Charles Vega, MD, FAAFP

Release Date: November 7, 2005;

Nov. 7, 2005 — Changing the standard from body mass index (BMI) to waist-to-hip ratio would improve accuracy of cardiovascular (CV) risk assessment across ethnic groups, according to the results of a standardized case-controlled study reported in the Nov. 5 2005 issue of The Lancet. The editorialists suggest that this marker should replace BMI.

Obesity and the risk of myocardial infarction in 27 000 participants from 52 countries: a case-control study
Waist-to-hip ratio, not body mass index (BMI), is the best obesity measure for assessing a person’s risk of heart attack, conclude authors of a study published this week. If obesity is redefined using waist-to-hip ratio instead of BMI, the proportion of people at risk of heart attack increases threefold. Heart-attack patients had a strikingly higher waist-to-hip ratio than people in a control group, irrespective of other cardiovascular risk factors......

"Our findings suggest that substantial reassessment is needed of the importance of obesity for cardiovascular disease in most regions of the world," lead author Salim Yusuf, MBBS, PhD, from Hamilton General Hospital-McMaster Clinic in Ontario, Canada, said in a news release.

The INTERHEART Study was a standardized case-control study of acute myocardial infarction (MI), which included 27,098 participants (12,461 cases and 14,637 controls) of varying ethnicity from 52 countries. The investigators evaluated the relationship between BMI, waist and hip circumferences, and waist-to-hip ratio to MI overall and in each ethnic group.

"Waist-to-hip ratio shows a graded and highly significant association with myocardial infarction risk worldwide," the authors write. "Redefinition of obesity based on waist-to-hip ratio instead of BMI increases the estimate of myocardial infarction attributable to obesity in most ethnic groups."

Study limitations include possible underestimation of the true contribution of visceral fat to CV disease risk, case-control design, and inability to determine the relationship between the different measures of obesity on other outcomes or whether there is an increased risk for some diseases in those who are lean.

"The INTERHEART investigators place what seems to be the final nail in the casket for body-mass index as an independent cardiovascular risk factor," Drs. Kragelund and Omland write. "The main message from the new INTERHEART report is that current practice with body-mass index as the measure of obesity is obsolete, and results in considerable underestimation of the grave consequences of the overweight epidemic. A direct consequence of these findings is that, for assessment of risk associated with obesity, the waist-to-hip ratio, and not body-mass index, is the preferred simple measure."

Lancet. 2005;366:1589-1591, 1640-1649

Clinical Context

Risk factors for MI have been extensively studied, but most of this research has focused on individuals in Europe and North America. The INTERHEART study reached out beyond cultures and ethnicities traditionally involved in medical research to include patients in Asia, Africa, the Middle East, and South America. In the original report from this study, published in the Sept. 11 - 17, 2004, issue of The Lancet, the authors found that common risk factors for MI included smoking, raised ApoB/ApoA1 ratio, history of hypertension, diabetes, abdominal obesity, and psychosocial factors. However, the intake of fruits and vegetables as well as alcohol consumption was protective against MI.

These data from the INTERHEART study suggested that waist circumference might be a better predictor of CV risk than another well-known anthropometric measurement, the BMI. The current analysis focuses on this issue.

Study Highlights

  • The study was a case-control trial comparing patients with their first MI vs age- and sex-matched controls. Patients with MI were eligible for study participation if they did not have cardiogenic shock or any major chronic illness. Subjects were evaluated in centers in 52 countries and 6 continents.
  • Cases and controls were compared in terms of demographic factors, socioeconomic status, lifestyle, medical risk factors, and a personal and family history of CV disease.
  • 12,461 cases were compared with 14,637 controls. Logistic regression was used to account for other confounding CV risk factors in comparing anthropometric values.
  • For the overall cohort, the mean BMI was lowest in Asia, intermediate in Europe, South America, and Africa, and highest in North America, the Middle East, and Australia. However, waist-to-hip ratio exhibited different geographic trends, being lowest in China, intermediate in North America, Europe, and other parts of Asia, and highest in the Middle East and South America.
  • Subjects in the highest quintile of BMI had an OR of MI of 1.44 vs those in the lowest quintile. However, the risk for MI associated with BMI was obviated after adjustment for other risk factors.
  • Conversely, subjects in the highest quintile of waist-to-hip ratio had an OR of MI of 1.77 vs those in the lowest quintile. After adjustment for other risk factors, this OR decreased to 1.33, but it remained statistically significant.
  • The risk of MI increased progressively with values for waist-to-hip ratio, with no evidence of a threshold. The association between MI and waist-to-hip ratio was significant regardless of BMI, sex, age, or the presence of other CV risk factors.
  • The waist-to-hip ratio, waist-to-height ratio, waist circumference, and hip circumference were all better predictors of MI vs BMI. BMI was the worst predictor of MI across all 8 ethnic groups, whereas waist-to-hip ratio was the best predictor in 6 of the 8 groups.

Waist to Hip ratio

I'm overweight. BMI and Waist to hip ratio both indicate that fact.

At 5'7.5" and 12st 11 1bs or 179 pounds at 30th December 2006 (was 13st 8lbs a few months ago!) my BMI is 27.6.

Methods for actually measuring body fat percentage are preferable to BMI for measuring healthy body size. Mayo Clinic researchers say the BMI doesn't accurately predict risk of cardiovascular death because it doesn't distinguish between muscle and fat. They say a better measure may be your Waist-hip ratio (wikipedia). The evidences is that in an analysis at Mayo Clinic led by Lopez-Jiminez of 40 studies involving 250,000 people, heart patients with normal BMIs were at higher risk of death from cardiovascular disease than people whose BMIs put them in the "obese" range. The ones in the study who had the highest death rates were people who weighed the least; in other words, they had the lowest BMIs (reference citation required).

My Waist-hip ratio is 104cm/99cm (41"/39") or 1.05, Sharon's is 34"/41" (86cm/104") or 0.83.

According to NICE NHS booklet (December 2006): target for men is <94cm>


Source: NICE Guideline Booklet

Women within the 0.7 range have optimal levels of estrogen and are less susceptible to major diseases such as diabetes, cardiovascular disorders and ovarian cancers. Men with WHRs around 0.9, are more healthy and fertile with less prostate and testicular cancer.

WHR is considered to be factor in a person's attractiveness. Women with a 0.7 WHR are often rated as more attractive by men regardless of culture, race, religion or ethnicity. Such diverse beauty icons as Marilyn Monroe, Twiggy, Sophia Loren, Kate Moss, Salma Hayek and even the Venus de Milo all have ratios around 0.7, even though they have significantly different weights. Congruent with an evolutionary perspective, evidence suggests that humans use subtle biological cues, such as WHR, to indicate mate potential and fertility.

Abdominal Obesity in INTERHEART study

This study found that BMI showed a modest and graded association with risk of Myocardial Infarction MI (Heart Attack). Waist and hip circumferences were both highly significantly associated with risk of MI. Waist-to-hip ratio was a better measure of risk than waist circumference alone.

Obesity and CVD: Biologic Mechanisms

The biologic mechanisms underlying the relation between obesity and cardiovascular risk are unclear. The waist-to-hip ratio is a simple measure for visceral obesity, and visceral adiposity is a manifestation of the metabolic abnormalities that underlie risk of future CVD events. It may be that the ratio of fat to muscle (sarcopenic adiposity) can be a measure of risk of CVD, which is best estimated by waist-to-hip ratio.

Visceral adiposity is the fat that is integrated within the abdominal organs, as opposed to subcutaneous fat, as measured by the "skin-fold" test.

These results suggest that it is not how much fat a patient has, but where it is stored that contributes to overall cardiovascular risk, insulin resistance, and glucose tolerance. It means that waist and hip circumferences provides a predictive power greater than that provided by BMI for estimating the risk of MI.

With the redefinition of abdominal obesity based on waist-to-hip ratio instead of BMI, the estimated risk of MI attributable to obesity was higher than previously assumed and the risk of MI rose progressively with increasing values for waist-to-hip ratios with no evidence of a threshold.

The global burden of obesity has been substantially underestimated by the reliance on BMI.

  • INTERHEART estimated
    • 63% of heart attacks were due to abdominal obesity indicated by a high waist to hip ratio (for men >0.95, for women >0.85).
    • Those with abdominal obesity were at over twice the risk of a heart attack compared to those without.
    • Abdominal obesity was a much more significant risk factor for heart attack than BMI.
    • men (33%) and women (30%) had a high waist to hip ratio.
    • benefits may accrue by redistribution of the body's fat stores to the hips or by increasing muscle mass.

Friday, December 29, 2006

Earth-like planet may be first of many

my edits in bold
  • 28 January 2006
  • Maggie McKee

PLANET hunters have detected what seems to be the smallest extrasolar planet so far, orbiting a red dwarf 22,000 light years away. Because red dwarfs are the most common type of star in the Milky Way, this might mean that Earth-like planets are abundant in our galaxy. In any case, it bodes well for "gravitational microlensing", the technique used to find this exoplanet.

Most planet-hunting techniques pick up massive planets in tight orbits around their host stars. About 170 exoplanets have been found around sun-like stars and until now the smallest had weighed in at 7 Earth masses. Now Jean-Philippe Beaulieu at the Institute of Astrophysics in Paris, France, and his team have found a planet that seems to be just 5.5 times the mass of Earth. To pick out the star they exploited the phenomenon called gravitational microlensing. When one star passes in front of another as seen from Earth, light from the background star is bent and magnified, or "lensed", by the gravity of the foreground star. If the star in the front is playing host to a planet, the planet's gravity can boost the light of the background star for a few hours.

The microlensing event that revealed the new planet was one of about 1000 picked up each year by OGLE, an international collaboration which monitors 170 million stars in the Milky Way's central bulge. Astronomers in Perth, Australia, who follow up some of these events for another consortium called PLANET, found the exoplanet's telltale signal on 9 August 2005.

But there is still some uncertainty as to the planet's mass - it could be anything from 2.8 to 11 Earth masses. That is because the microlensing measures only the ratio of the mass of the host star to the planet's mass, and researchers then have to use models to estimate the most likely mass of the star and the planet (Nature, vol 439, p 437).

The planet appears to orbit its star at about 2.6 times the distance of the Earth to the sun and is as frigid as Neptune and Pluto, with a surface temperature of about -220 °C. It is significant that the planet has been found around a red dwarf because such stars make up about 70 per cent of the stars in the Milky Way, so there could be many more such planets out there.

Other techniques have shown that Jupiter-sized planets are rare around red dwarfs. "This suggests that lower-mass planets are a lot more common than Jupiters around low-mass stars," says team member David Bennett at the University of Notre Dame in Indiana.

The find is also an important milestone for microlensing. "They've proven they can detect these low-mass [planets]," says Sara Seager of the Carnegie Institution of Washington in Washington DC. "It's just a matter of time before they get more."

From issue 2536 of New Scientist magazine, 28 January 2006, page 12

the Bladder is the first human organ ever grown in the lab and transplanted into patients

  • my edits in bold
  • 08 April 2006
  • Peter Aldhous
  • Andy Coghlan
  • Roxanne Khamsi

IT IS being hailed as a landmark in tissue engineering. Seven youngsters who faced a future of incontinence and serious kidney problems have been given new bladders grown in the lab from their own cells, and grafted onto their existing bladders.

Researchers in regenerative medicine are impressed by the results, which were announced this week by Anthony Atala of Wake Forest University in Winston-Salem, North Carolina. "This is the first human organ ever grown in the laboratory and transplanted into patients," says Bob Lanza, head of scientific development at Advanced Cell Technology in Worcester, Massachusetts. "It's the beginning of a new medical era."

Maybe so, but tissue engineers warn that it will be years before they crack the problem of growing more complex, solid organs, such as kidneys and hearts. And Atala's technique does not yet match the results of conventional surgical treatment for severe bladder problems. "It's pioneering work," says Stéphane Bolduc, a paediatric urologist at Laval University in Quebec City, Canada. "But clinically, I'm not yet convinced."

In the late 1990s, while at Harvard Medical School in Boston, Atala replaced dogs' bladders with organs grown from scratch (New Scientist, 13 June 1998, p 16). This week, his team reported on seven people who were all born with spina bifida, which left them with shrunken bladders missing normal nervous connections. They were incontinent, and the fluid in their bladders was at dangerously high pressure, which can damage the kidneys. Between the ages of 4 and 19 they were given lab-grown bladders, and have now had the engineered organs for an average of four years (The Lancet, DOI: 10.1016/S0140-673(06)68438-9).

Atala and his colleagues first took a biopsy from each person's bladder, containing about one million cells. These cells were grown in culture for a month, until they had multiplied to around 1.5 billion cells, and were then seeded onto a sac-shaped "scaffold" made of collagen, a structural protein found in most of our tissues. In some cases this was mixed with polyglycolic acid, a biodegradable material used in surgical stitches. After being grown for a further two months, the engineered bladders were grafted onto the patients' own.

The patients' cultured cells were seeded onto a sac-like scaffold of collagen and then grown for a further two months

The usual treatment to fix defective bladders is to cut out a section of a person's small intestine and graft this onto the bladder. However, this can cause complications, including the secretion of mucus from the intestinal tissue into the bladder, which can lead to urinary infections and bladder stones. Atala's patients didn't have these problems, and their bladder function improved. In general, the organ's overall capacity went up and the pressure inside it went down. Rather than leaking urine almost continuously, the patients could remain dry for several hours at a time, although because they still lacked normal nervous connections, they did not gain full bladder control.

It is an encouraging start, says Bolduc, who is also working on tissue-engineered bladders. But he says the gains in capacity and reductions in pressure reported by Atala's team are still less than conventional surgery can achieve.

Atala admits that he still has some work to do. One goal is to grow a complete bladder, offering hope for cancer patients who must have the entire organ removed. This will require sophisticated surgery to connect the ureters, the tubes that carry urine from the kidneys. It also means growing the sphincter that normally seals the organ shut, opening only when we urinate. "We are actually making sphincter muscles now," Atala says.

Surgical tricks learned with these first bladders should help in future attempts to replace the entire bladder. Atala's best results came when he wrapped the grafts with omentum, a flap of fatty tissue that normally sits over the front of the intestines. It is rich in blood vessels, and seemed to help the grafts establish a blood supply.

Getting a good blood supply is also a key obstacle to researchers trying to grow solid organs, such as hearts and kidneys, and they must find a way to infuse nutrients into the growing structures.

From issue 2546 of New Scientist magazine, 08 April 2006, page 10