SCI-ART LAB

Science, Art, Litt, Science based Art & Science Communication

Q : Can placebo and nocebo effects affect clinical trials and research?

Krishna : Yes, they can, if you don't take precautions.  That is why double blind trials are so important. Not telling patients what they are getting, a real drug or a placebo is important to not to screw up your results. You don't know whether the drug is actually working or it is the placebo effect that is making the patient feel better. If the patient feels better even after taking just a sugar pill, you cannot attribute medicinal properties to sugar pills.

But still that is how, sham medicine who prey on the desperate and, if they are lucky, fool people into feeling better, works!

I f I ask one of my aunts whether  Homeopathic medicines she 's taking 's working, she says, "YES" emphatically despite the evidence*(1) we have to the contrary.

That is why depression, back pain, chemotherapy-related malaise, migraine, post-traumatic stress disorder: The list of conditions that respond to placebos — as well as they do to drugs, with some patients — is long and growing.

That is why identifying the molecules in the drugs that really work, and studying how they work (actual mechanism) in different set of conditions is extremely important to pin point the accuracy. Understanding the body's healing mechanisms is important too. Because 'feeling better' does not actually 'cure' you of deadly diseases like cancer. Placebos might work for migraine but don't work for malaria! 

Researchers need to assume that the placebo effect is part of every drug effect, and that drugs can be said to work only to the extent that they worked better than placebos. An accurate measure of drug efficacy would require comparing the response of patients taking it with that of patients taking placebos; the drug effect could then be calculated by subtracting the placebo response from the overall response.

Q: What is the reason for placebos working?

Krishna:  Earlier most of these reasons have traditionally been linked to psychology, based on mechanisms like expectancy — the set of beliefs that a person brings into treatment, the comfort  and reassurance s/he gets while dealing with a 'doctor' that talks 'sweetly and softly'.  The 'rituals' embedded in the doctor-patient encounter are fundamental to the placebo effect, where a suffering person puts his or her fate in the hands of a trusted healer. The placebo effect is a biological response to an act of caring.

It is like a baby getting comfort from her mother's  sweet talk (sing-songy way) and the action of arms-cradling. The baby stops crying! Isn't that a miracle?!

But placebo effect responses vary from person to person. That made scientists think different mechanisms 're at play. An enzyme called COMT affected people’s response to pain and painkillers. Levels of that enzyme, researchers found, were also correlated with Parkinson’s disease, depression and schizophrenia, and in clinical trials people with those conditions had shown a strong placebo response. COMT was also correlated with pain response — another area with significant placebo effects.  It is not possible to assay levels of COMT directly in a living brain, but there is a snippet of the genome called rs4680 that governs the production of the enzyme, and that varies from one person to another: One variant predicts low levels of COMT, while another predicts high levels. When scientists analyzed the I.B.S. patients’ DNA, they found a distinct trend. Those with the high-COMT variant had the weakest placebo responses, and those with the opposite variant had the strongest. These effects were compounded by the amount of interaction each patient got: For instance, low-COMT, high-interaction patients fared best of all, but the low-COMT subjects who were placed in the no-treatment group did worse than the other genotypes in that group. They were, in other words, more sensitive to the impact of the relationship with the healer.

Scientists also found that the rs4680 gene snippet is one of a group that governs the production of COMT, and COMT is one of a number of enzymes that determine levels of catecholamines, a group of brain chemicals that includes dopamine and epinephrine. (Low COMT tends to mean higher levels of dopamine, and vice versa.) Hall points out that the catecholamines are associated with stress, as well as with reward and good feeling, which bolsters the possibility that the placebome (  how genomics might influence the role of the placebo in patient care and clinical research)  plays an important role in illness and health, especially in the chronic, stress-related conditions that are most susceptible to placebo effects.

The new approach, therefore, is - the placebo effect is not just some constant to be subtracted from the drug effect but an intrinsic part of a complex interaction among genes, drugs and mind. 

Q: Why do we get scientific explanations and data evidence to pseudo-science too?

Krishna: Very good Q.

While collecting data for pseudo-science, the opposite for data collection for genuine science happens. First the 'researcher' comes to a conclusion. Like for example, nose rings protect you from microbes entering your nose ( this is a genuine pseudo-scientific explanation given by some for using nose rings by women and we proved it wrong too!). Even before verifying it, his belief drives him to collect data or interpret what he found that supports his conclusion.

You hear of  someone predicting the future correctly using astrology or palmistry - and for some reason that weighs more heavily than every other time they didn't! In other words - a broken clock is right twice a day. If you take a large enough data sample, something weirdly specific is going to happen, and if you then throw out every failed attempt - it looks like this "weird stuff" happens - when actually it's just a quirk of large sets of data.

I read a report in which some researchers started collecting data for the cause of cancer. When the data was analyzed, strangely, the colour of the socks  people used could be linked to cancer! How?

People wearing red socks got cancer more frequently! Funny! There is actually no link between the red colour or any colour  or socks in the first place to the cause of cancer. But still if you collect large amount of data it shows some strange patterns and can be interpreted in any way you want. You can connect unrelated things and report it using your numbers as evidence to confirm your beliefs or conclusions! That is how pseudo-science works.

Scientists have to train for very long periods to be good at data collection - and then we have to train ourselves to only look at what is there using our knowledge - not what our human senses or emotions are telling us, because they lie more often than not.

Q:Why is the rocket science the most difficult of all fields of science?

Krishna: If you really know what cancer science is, you will rethink your assumption! Recently when a physicist came to know about why it is difficult to find a cure to cancer,  he reacted in this way: "Oh my, rocket science is damn easier and very primitive when compared to this!" 

Rocket science is not the most difficult field in science. Biology is! Because it is the most complex system Nature has put before us and thrown a challenge at us to test our intelligence!

Q: Who or what controls science and scientific research?

Krishna: Scientific method. 

There are multiple groups that issue guidelines, or education programs, or host development groups on scientific method and methodology: Professional groups focused on specific areas of knowledge or practice (like the NIH, AMA and AAMC for medicine). International groups, often including multiple professional areas, that also exist to arrange conferences and create communication tools for development of the sciences. Universities and major research institutes.

Journals that publish science papers too somewhat control how science is conducted. Papers won’t be published if peer reviewers see that your research used poor methodologies. Papers will be criticized and your work will not be cited or picked up by other scientist if your reasoning, supporting facts or analysis is illogical, insufficient or does not deal properly with the accumulated understanding and practices in your field. You will lose funding if your lab and other efforts are sloppy, not properly documented, violate best practices, findings are not recreatable, and so on.If you present findings or argue for research agendas that are not soundly structured or are based on unsupported science, that contain false data or inaccurately characterizes the current consensus, then you will lose all reputation with others in your field and that can literally end your ability to practice scientific research (which is a highly collaborative effort) or to have any impact with “research” you conduct and fund entirely on your own. If you have a history of sound research/publication/teaching, but then start mis-representing your area of study in the popular media, or advocating new ideas without building a basis for them in the professional journals and conferences, or use your credentials in one field to advocate in a different field, then you will lose reputation and suffer the consequences above.

Q: Is Neil deGrasse Tyson overrated?

Krishna: Science is not finished until it’s communicated.

"Telling people about science is just as important as conducting the science".

Why? Because

MISINFORMATION IS A WEAPON OF MASS DESTRUCTION.

I don’t think Neil de Grasse Tyson is overrated. We need science communicators to finish the other half of work of science. Without science communicators science cannot reach common people. As it is most people don’t know what is going on in the labs around the world and how it can help them. Then vested interests take charge and spread misinformation that might cause severe harm to the societies we live in. Without the help of science communicators that try to bring light to the world outside , the world becomes darker place with all the light concentrated only in the labs. Communicators are helping the world in negotiating the science maze successfully.

Science communicators around the world are doing a great job to bring sanity to the deranged societies we live in. Give them a big applause.

Dr. Krishna Kumari Challa's art work based on this theme... The World of Science

AS-68-THE-WORLD-OF-SCIENCE

After interacting with several people on the street, I felt, their perception of science and scientists was very interesting to notice.
Some told me that science was beyond their understanding and they, therefore, place it at unreachable heights! (So I painted it on the top of a mountain). Some said that the scientists lived in the domains of their own and were inaccessible to them! (The fort represents this perception). According to them the doors of the world of science are closed to a layman! The only connection from the scientific world to the common man’s world is through media! Media interprets science in its own language and therefore cannot always be considered as correct and a gap always remains between the scientific and ordinary worlds. So I painted this picture of common man’s sketch of science with media people in two small houses at the door of the “Fort of Science”!
However, majority of the people I came across agreed that scientists try their best to spread light around the world and remove darkness.
( I must add here that more and more scientists are coming out of their fort’s these days and are trying to interact with people outside. The doors of the world of science are not closed. They are just ajar. If people try to open them completely, they too can get inside. All that it needs to get into the arena of science is their interest in science! Science communicators are trying to open the doors of labs fully)

(Taken from http://www.kkartfromscience.com )

Q: what do scientists feel other people understood about them?

Understood about their science, a lot. That is why science communication became a special branch of science.

Science is not finished until it’s communicated.

"Telling people about science is just as important as conducting the science".

Why? Because

MISINFORMATION IS A WEAPON OF MASS DESTRUCTION.

We need science communicators to finish the other half of work of science. Without science communicators science cannot reach common people. As it is most people don’t know what is going on in the labs around the world and how it can help them. Then vested interests take charge and spread misinformation that might cause severe harm to the societies we live in. Without the help of science communicators that try to bring light to the world outside , the world becomes darker place with all the light concentrated only in the labs. Communicators are helping the world in negotiating the science maze successfully.

Science communicators around the world are doing a great job to bring sanity to the deranged societies we live in. Give them a big applause.

Q: What is the scientific reason behind a baby's complete head shave in India?

Krishna: It is based on culture, not science.

The ‘scientific reasons’ given by people like ‘The shaving helps to regrow a thicker shaft of hair. It thus promotes hair growth’ or “stimulate proper growth of the brain and nerves of baby” are wrong. Shaving doesn’t help hair to regrow thick. The rough ends after a shave make you think so, that’s all. As the conditions that control the growth and diameter of your baby's hair play out in the scalp itself, shaving his head will not have any effect on his hair growth. Proper growth of the brain depends on nutrition, not on hair.

There is simply no scientific evidence to suggest that this practice is helpful at all. Therefore, the answer to the Q ‘Does shaving your baby's head encourage hair growth? is an emphatic “NO”.

A baby’s scalp will be tender. The top of his head, called the fontanelle, is especially soft because his skull bones have not fully knitted together. Hair protects it actually. Therefore delaying the cultural practices until the baby’s skull is fully strengthened is actually recommended by experts. Hair and scalp hygiene is important to help your child develop a healthy head of hair. Experts advise parents to wash their baby's scalp regularly.

The only reason I can think of that could be correct is , getting rid of head lice, obtained from their mothers or any other members of their family. But as soon as the hair grows, these pests can return. Therefore, it is only a short term solution.

My parents told me my head was never shaven. I never faced any harm because of this.

Q: Does keeping animals at home can have adverse consequences?

Krishna: Heard about a thing called zoonoses, the diseases we get from animals? Whether the animal is friend or food or foe, it can carry dangerous diseases!

No doubt, animals make us feel better. They actually contribute to our health. People who keep pets tend to have lower cholesterol levels and lower blood pressure. They tend to get more exercise and to feel less lonely. 

However, pets and other animals can get sick. And some of these illnesses can be quite dangerous. If they are not treated, these can be passed on to human beings. Rabies, tularemia, plague, monkeypox, listeria, anthrax, ... these are diseases that are very serious if one gets them.

Recent research (2) has shown that keeping animals such as poultry, which can be disease carriers, free range in the home can contribute to childhood diseases that exacerbate malnutrition.

Q: I have a craving for Fuller's Earth. Why is this and how can I get rid of this?

Krishna: There is a condition called PICA. It is an eating disorder that involves eating items that are not typically thought of as food and that do not contain significant nutritional value like dirt, soil, paint, chalk, starch, charcoal and things like that. 

PICA is mainly observed in children, pregnant women and people with mental disorders.

However, medical practitioners usually associate it with  mineral or nutrient deficiencies like calcium and iron. Therefore, the first-line treatment for pica involves testing for mineral or nutrient deficiencies and correcting those. In many cases, concerning eating behaviours disappear as deficiencies are corrected. If the behaviours aren’t caused by malnutrition or don’t stop after nutritional treatment, a variety of behavioral interventions are available. Scientists have developed several different effective interventions, including redirecting the person’s attention away from the desired object and rewarding them for discarding or setting down the non-food item.

Consult a doctor to get rid of this problem of yours.

Q: Who knows better, doctors or scientists?

Krishna: "Knowing better" depends on the quantity and quality of knowledge acquired by a person, not on profession. 

Without scientists finding out something through thorough research, nobody can acquire genuine knowledge. That is why more and more doctors are getting into clinical research these days. Almost all the major hospitals here have a clinical research wing now. That is really good. If the doctors add deep genuine research based knowledge to their learned or observed superficial knowledge in hospitals or educational institutes, they can treat the patients in a better way.

Q: What don't you understand but find so fascinating?

Wronger than wrong: When people thought earlier (now also some people think it is still flat!) the Earth was flat, they were wrong. When people thought the Earth was spherical, they were wrong. But if you think that thinking the Earth is spherical is just as wrong as thinking the Earth is flat, then your view is wronger than both of them put together.
Asimov explains that science is both progressive and cumulative. Even though scientific theories are later proven wrong, the degree of their wrongness attenuates with time as they are modified in response to the mistakes of the past. For example, data collected from satellite measurements show, to a high level of precision, how the Earth's shape differs from a perfect sphere.
The oblate spheroid (a sphere that is squashed at its poles and swollen at the equator), or oblate ellipsoid, is an ellipsoid of revolution obtained by rotating an ellipse about its shorter axis. It is the regular geometric shape that most nearly approximates the shape of the Earth
Therefore, being wronger than wrong is actually worse than being not even wrong (that is, being unfalsifiable).
Later Earth was thought to be completely spherical.
Finally Earth was found to be an oblate spheroid (a sphere-like but not perfectly spherical body). Now which was is more closer to truth? A flat Earth or a sphere? A sphere. Therefore thinking that it 's  flat is not equal to thinking that it 's a sphere. 
Both are wrong but flat is absolute wrong and sphere is relatively wrong. There lies the difference. 
Scientific facts are like that now. The search for something better must continue. Although provisional, scientific facts are getting closer to truth now than earlier times. Therefore, if you say, 'theories are always preliminary and science really doesn't 'know' anything' is not actually correct. Science is relatively correct now ... until someone falsifies it, it has to be accepted as the best knowledge we have now on any topic.
Q: Can science find and tell the world  true facts when various governments around the world trying to control it?
Krishna: Genuine science needs total freedom. Any outside control is detrimental to its existence. However,  science, the thing this universe is made of, is an eternal fact. No power can take away that fact. People can only control our understanding of it, not the science this universe is made of. We get comfort from the thought.
Only the world is getting fooled with tight controls. We are loosing our benefits.
But the   universe still goes on based on science. It doesn't make any difference whether you find  the facts or not to the universe and science that runs it.
Q: Does eating sugar cause diabetes?
Krishna: Sugar processing in a living body is a complex process. Briefly, Insulin  is a hormone that — in people without diabetes — ferries glucose, or blood sugar, to cells for energy or to be stored for later use. In people with type II diabetes, cells are resistant to insulin; as a result of this insulin resistance, sugar accumulates in the blood. While eating sugar by itself does not cause insulin resistance, foods with sugar and fat can contribute to weight gain, thereby reducing insulin sensitivity in the body.
Moreover, when a person becomes fat as a result of eating lots of sugary substances, there won't be enough insulin in the fatter body  to go around. 
Therefore, you can say sugar indirectly is the reason for diabetes.
Q: Can real Draculas exist according to science?
Krishna: Some people suffer from certain mental conditions which make them kill and drink people or animal blood. These things have been reported in the media. Then some people perform some sort of rituals in which they sacrifice living beings and drink their blood or use it in other ways like smearing it all over their bodies. 
In earlier times, it was reported - though these things cannot be verified now - some people killed and drank the blood of their enemies. It seems, some old men too did this believing that killing young men and drinking their blood can give them youthful vitality. Some epileptic patients used to drink blood to 'cure their condition' because of a false belief. These beliefs were mainly associated with some cults and religions around the world. Some vampires 're looking for psychic energy that gives them strength, others  believe their need for blood is purely physiological. Others think it is psychological. Medical fraternity agrees with the latter explanation. It mostly works like a placebo.
Yes, some normal people too drink blood. Some of these people say the oxygen- and iron-enriched substance gives them energy, if  taken in limited quantities. These people claim to suffer from a strange medical condition – fatigue, headaches, and excruciating stomach pain – which, they believe, can only be treated by feeding on another human’s blood.
However, because blood is so rich in iron — and because the body has difficulty excreting excess iron — any animal or person that consumes blood regularly runs a risk of iron overdose. While iron is necessary for all animals - and indeed most life, in high doses it can be toxic. This condition, called haemochromatosis, can cause a wide variety of diseases and problems, including liver damage, buildup of fluid in the lungs, dehydration, low blood pressure, and nervous disorders.
The bodies of animals that digest blood, like the vampire bats, have adapted specialized digestive mechanisms. They have special process for secreting the excess. Research on this process suggests that bats have a mucous membrane along the intestinal tract that acts as a barrier to prevent too much iron from getting into their bloodstreams. Because humans did not evolve such an iron-extracting mechanism, drinking a large quantity of blood can kill us.
If the vampires can come out into the open and co-operate with the scientists, they can really find out why some people are blood thirsty and find a cure for it. 

Citations: 

1. 1,800 Studies Later, Scientists Conclude Homeopathy Doesn’t Work

2. https://www.scidev.net/global/livestock/news/keeping-animals-out-of...

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