(Visited 15 times, 1 visits today)FacebookTwitterPinterestSave分享0 Patients are encouraged to seek only “evidence-based” treatments for disease, but a look behind the scenes of clinical trials reveals some of the same human foibles that plague any science: shortcomings in honesty and transparency.Finding cause-and-effect relationships in medical science is notoriously difficult. Supposedly, the path to reliable findings is to use randomized clinical trials, where a proposed new therapy goes through three distinct phases of testing on large numbers of people. Sounds good in theory, but what happens when investigators find less-than-full disclosure and potential conflicts of interest? Those issues were addressed in Science Insider recently. Violations are, unfortunately, more common than expected.We’ve heard of studies funded by tobacco companies that prove cigarettes are safe. Give a researcher enough money, and it’s tempting (though not necessarily guaranteed) his or her findings will corroborate the company’s claims. How are conflicts of interest avoided? How are standards for reporting maintained? Science Insider attended a recent International Congress on Peer Review and Biomedical Publication in Chicago, and reported some red flags: (1) “Published trial results often differ from those initially posted“; and (2) “Potential conflicts of interest often go unreported.”The honor system, such as merely deploying forms asking researchers to list all conflicts of interest, is insufficient. Despite years of reminding researchers how important it is to maintain transparency about potential conflicts, many still fail to disclose them. Often it is left up to the researcher’s own judgment whether such conflicts are “relevant” to the trial. Ignorance of the need for high standards, the Congress on Peer Review and Biomedical Publication found, is sadly widespread.Although most of the doctors disclosed relationships they had with the firm funding the published research, fewer than half shared relationships they had with industry competitors. And despite all the talk in recent years about conflicts, 16% who had a financial tie to a sponsor or drug manufacturer leading the study didn’t report it. One example cited by Rasmussen: a physician who was an advisory board member and speaker for AstraZeneca, maker of the drug being covered by the paper, who declared he or she had no conflicts.“I was actually very disappointed” by this, says Vivienne Bachelet, editor-in-chief of the journal Medwave in Santiago, who was not involved in the study. In her country, she says, the “level of awareness is just nil” about conflicts of interest. Medical societies in particular get substantial funding from drug companies but almost no one—the societies themselves, drug regulators, or the individual doctors—see this as something that should be disclosed, Bachelet says. “If they’re not disclosing over there,” in Denmark, “what’s to be expected in Chile?”Regarding publication discrepancies, a survey of thousands of papers revealed frequent inconsistencies between public reports and journal publications about results of primary endpoints (main purposes of the trial) and secondary endpoints (serendipitous findings):For 21% of the primary endpoints, what appeared in the journal wasn’t exactly the outcome described on ClinicalTrials.gov, and in 6%, the Yale group suggested that this difference influenced how the results would be interpreted.For secondary endpoints, the difference was even more dramatic: Of more than 2000 secondary endpoints listed across the trials, just 16% appeared the same way in both the public database and the published article along with the same results. Results for dozens of secondary endpoints were inconsistent. “Our findings raise concerns about the accuracy of information in both places, leading us to wonder which to believe,” Becker said.The director of ClinicalTrials.gov at the National Library of Medicine called the website a “view into the sausage factory” of how research results are reported.Speaking of randomized clinical trials (RCT), Nature reported that little more than half of them produce treatments better than the standard of care – and that’s as it should be, given that RCT outcomes are unpredictable. Progress is incremental but steady. There’s no question that cancer patients are surviving much longer on average than they were a couple of decades ago, thanks to clinical trials.The slowness of the process, though, is frustrating to patients, especially those with cancer, who can’t wait a decade for all three phases to complete before government approval is given. Medical Xpress raised the question of whether clinical trials are always necessary. Sometimes phase III (comparing the new treatment with the standard treatment) might be superfluous if a new therapy has already shown benefit, and patients are out of options. Another recent trend is toward individualized care based on genetic screening or specific tissue sample characteristics. Trends like that may not jive with randomized clinical trials, because each patient is treated as a unique case (a sample of one). Alternatives to RCT may need to be devised for such new developments.In the philosophy of science, nothing like peer review or RCT (as practiced) is set in stone. As practices and findings change, policies and procedures need to keep in step with them. One thing that should not change, though, is a scrupulous insistence on honesty.Update 9/14/13: Medical Xpress reported that leading medical societies in Britain and America are poised to start publishing negative findings. This is important, be knowing what doesn’t work can be just as important as knowing what does. “It is ethically correct for pharmacologists working in academia, industry and the health services to publish negative findings,” the head of the British Pharmacological Society said. “Openness not only ensures that the research community is collectively making the best possible use of resources, but also that clinical trial volunteers are not unnecessarily exposed to likely ineffective or potentially unsafe treatments when evidence may already suggest that the drug target in question is flawed.” The lack of openness about negative results can waste time and resources if researchers unknowingly repeat a failed trial. “Historically, negative findings have tended to remain unpublished,” one journal editor noted with apparent regret. Another expert feels that all clinical results, both positive and negative, should be in the public domain.No science can survive without honesty. We are often told that science is self-checking. The problem is that the checking is inconsistent, and often found out long after damage has been done. This is shameful. In medical clinical trials, people’s lives are on the line. How can the public have confidence in findings, when they lose confidence in the honesty of the researchers? Miracle treatments are promised that might actually be hyped by the drug company funding the research, or the researcher is on the company’s board, but refuses to disclose the conflict of interest, considering it (in his opinion) “not relevant.” Then there is the temptation to announce breakthroughs to advance one’s career or the reputation of the institution. Now we hear about the actual very low rate of honest reporting. To put it mildly, “What they found was not particularly encouraging.”This is not to disparage the many honest, hard-working individual researchers with pure motives, or the reputable institutions that succeed in finding and helping patients with new effective treatments. It just goes to show that scientific research is nothing without honesty. The answer is not to run from “evidence-based” research toward unproven alternative therapies, many of which have even less evidence and are riddled with deeper conflicts of interest (such as hyped claims motivated to sell a product). There are quacks who prey on the desperate, but conspiracy theories alleging collusion with drug companies to keep alternatives off the market are sometimes a ploy to mislead by undermining the credibility of competition. In the morass of potential pitfalls, is anything better than clinical trials? The answer is to improve the system: require independent checking for compliance, publicly humiliate violators, and financially punish institutions found culpable.Randomized clinical trials offer the best hope for establishing cause and effect in medical research, but sometimes the anecdotal reports of alternative treatments have merit; we should remain open to them and check them with a skeptical yet inquiring eye, weeding out conflicts of interest as best we can, investigating the reasonableness of the correlation. As these reports show, “evidence-based” reports sometimes fail to live up to their ideal. Honest researchers will keep an open mind about alternatives. There’s much human beings do not know. Things that work for some individuals do not always work for others.One other lesson: if correlations are this difficult to establish in humans, of which there are 7 billion to test, how much more error-prone are claims about the unobservable past supposed millions of years ago – especially when certain researchers have a conflict of interest to maintain their secular worldview?
Share Facebook Twitter Google + LinkedIn Pinterest June 15th has been circled on many calendars in farm country. That is when President Trump will release plans to put tariffs on $50 billion worth of China goods. It is also when soybean farmers will find out how retaliation measures taken by China may impact their bottom line. The Ohio Ag Net’s Ty Higgins has more with Ohio Soybean Association President Allen Armstrong.
Hashan Tillekaratne, who played 83 Tests and 200 ODIs for Sri Lanka, made the sensational claim while appearing in a TV show.India’s triumph in the ICC World Cup earlier this month has come under the match-fixing cloud after a former Sri Lankan captain’s accusation that the unlawful practice has been rampant in the island nation’s team. Appearing on a TV talk show, cricketer-turned-politician Hashan Tillekaratne raised his doubts about the selection of the Sri Lankan team for the World Cup finals. The Lankan team had made as many as four changes for the vital match against India, held on April 2 in Mumbai. Tillekaratne, who played as many as 83 Tests and 200 ODIs in his 16-year international cricket career, questioned the logic behind making extensive changes for such an important match. Maintaining that he did not think that the final match was fixed, Tillekaratne said that it was unfair to have replaced spinner Ajantha Mendis and all-rounder Chamara Silva. Tillekaratne claimed that match-fixing has been a problem in Sri Lankan cricket since 1992. He said he knew all the people responsible for it and would expose them soon. He alleged that every time the matter of match-fixing was brought up, it was quietly swept under the carpet by corrupt administrators. He alleged that money was exchanged to hush up the issue.Earlier, former captain Arjuna Ranatunga had also raised concerns about the manner in which cricket was being run in his country. A day after the visitors lost to India in the finals, Ranatunga told Headlines Today that “mafia” had got into Sri Lankan cricket and that corrupt administrators were running the game.”When we won the World Cup, we had a very honest, very good cricket precedent. But the business mafia got involved in cricket and they knew that the money is there and all unwanted… some of them were involved in bookies, they come from bookie families, some of them ordinary business people who wanted to get into cricket to create a name,” said Ranatunga, who led his side to win the coveted cup in 1996.”Even now what they do is, they appoint wrong people to run cricket. They enjoy the comfort, they enjoy the money that comes from cricket… and I tell you, lot of money has gone under the carpet. I think government has to be blamed,” he said.advertisement
Phase II of the Cornwall Regional Hospital Rehabilitation project, which includes significant work on the ventilation system, is expected to be completed in the 2018/19 fiscal year. Story Highlights Phase II of the Cornwall Regional Hospital Rehabilitation project, which includes significant work on the ventilation system, is expected to be completed in the 2018/19 fiscal year.This was disclosed by Governor-General, His Excellency the Most Hon. Sir Patrick Allen, while delivering the 2018/19 Throne Speech in Parliament on February 15.Citing other programmes that will be undertaken by the Administration in the health sector, he said priority will continue to be placed on the promotion of a healthy and active lifestyle as a means of countering the ongoing epidemic of non-communicable diseases (NCDs), through the Jamaica Moves campaign.The Jamaica Moves campaign is the Government’s signature health promotion intervention, which places emphasis on increased physical activity, healthy eating and regular health checks.The Governor-General said the completion of the pre-investment works and breaking of ground for the construction of a Child and Adolescent Hospital in Western Jamaica will also be undertaken.He said the focus remains on creating a healthier Jamaica, and programmes to rehabilitate and make new investments in critical health infrastructure will continue.“Productivity of all sectors hinges on the health and well-being of our people, and while focusing on prevention, we must also continue to expand access and improve the quality of care to optimise the quality of life of all Jamaicans,” the Governor-General said.The Throne Speech was delivered under the theme ‘Continuing on the Path to Prosperity’. The Governor-General said the completion of the pre-investment works and breaking of ground for the construction of a Child and Adolescent Hospital in Western Jamaica will also be undertaken. Citing other programmes that will be undertaken by the Administration in the health sector, he said priority will continue to be placed on the promotion of a healthy and active lifestyle as a means of countering the ongoing epidemic of non-communicable diseases (NCDs), through the Jamaica Moves campaign.
Here’s a timelapse of images over 2.5 hr from May from @keckobservatory of the supermassive black hole Sgr A*. The black hole is always variable, but this was the brightest we’ve seen in the infrared so far. It was probably even brighter before we started observing that night! pic.twitter.com/MwXioZ7twV— Tuan Do (@quantumpenguin) August 11, 2019 Scientists aren’t quite sure why this strange flash occurred, but it’s apparently nothing to be concerned about. Speaking to ScienceAlert, Tuan Do (an author on the study which spotted the bright light) said the flash could be the result of another star (S02) passing close by, thereby changing the way gas flows into the black hole. Another working theory is the flash was caused by G2, a gas cloud which also recently passed close (36 light-hours) to the black hole in 2014. There is a possibility this is a delayed reaction to that event. 3 Other teams and telescopes, such as Spitzer, Swift, Chandra, and ALMA, have also been observing Sagittarius A*. Do is curious to see if they too spotted the strange emission. Perhaps that data can help shed new light on this strange burst of infra-red light. Taken when I was @keckobservatory, this raw image shows the brightest Sgr A* has ever been observed in the infrared (center). The emission associated with the black hole also changed by a factor of 75 over that night. Is Sgr A* waking up? Will we finally see 🎆? pic.twitter.com/lX7ZO2PhX2— Tuan Do (@quantumpenguin) August 8, 2019 16 Photos What is a black hole? The universe’s dark, mysterious monsters Tags Sci-Tech Culture Robin Dienel/Carnegie Institution for Science In news that reads like the beginning of a dire science fiction novel Sagittarius A*, the supermassive black hole at the centre of our galaxy, has emitted a large burst of infrared radiation brighter than anything ever produced by that black hole. The black hole is well-known to scientists, and was one of the subjects of our first ever efforts to image the cosmic beasts, but its still throwing up new mysteries all the time.After observing for over four days using the Keck II Telescope in Hawaii, a team that has been studying Sagittarius A* for 20 plus years noticed the infrared light increased by 75 times. Comments Share your voice
Infosys shares continued their downward spiral on Friday to end with a weekly loss of almost 4 percent as investors viewed the company losing its multi-million dollar Royal Bank of Scotland (RBS) project with concern. The BSE Sensex ended 46 points lower at 28,077.The Infosys stock closed at Rs. 1,021.10 on Friday on the Bombay Stock Exchange (BSE), a fall of 3.98 percent from its previous Friday close of Rs. 1,063.30. In intra-day trade, the stock plunged to Rs. 1,019, almost near to its 52-week low of Rs. 1,012.25.Last Saturday (August 13), the Bengaluru-based IT software services exporter had said in a statement that RBS had scrapped a project to spin off and list Williams & Glyn (W&G) as a separate entity. Infosys, along with IBM, had won a project in September 2013 to develop computer systems for W&G for an estimated Rs. 2,500 crore. Infosys had deployed about 3,000 people on the project as the technology partner.”Infosys has been a W&G program technology partner for Consulting, Application Delivery and Testing services, and subsequent to this decision, will carry out an orderly ramp-down of about 3,000 persons, primarily in India, over the next few months,” the company had said in the statement.”The Royal Bank of Scotland announced last week that it will no longer pursue its plan to separate and list a new UK standalone bank, Williams & Glyn (W&G), and instead will pursue other options for the divestment of this business. RBS is a key relationship for Infosys and the company looks forward to further strengthening our strategic partnership and working with them across other strategic and transformation programs,” Infosys added.The BSE Sensex ended with losses on Friday after Thursday’s 118 point rally.Top Sensex losers included Coal India, TCS, Lupin and Wipro, while stocks that lifted the 30-scrip benchmark equity index included State Bank of India (up 4.15 percent at Rs. 258.50), Tata Steel and Cipla. The week saw private sector lender RBL Bank’s initial public offering (IPO) commencing. The public issue will remain open till August 23.The bank raised Rs. 364 crore from anchor investors by issuing shares to 28 anchor investors at the upper price band of Rs 225. The bank’s track record on the loan front is considered sound because of its client profile. “Market experts are of opinion that the bank has stayed away from stressed sectors such as steel, power as well as infrastructure, which has helped it to maintain its asset quality at better levels compared to its peers,” Dynamic Levels said in its IPO note.
The combination of Prime Minister Narendra Modi and BJP president Amit Shah in 2019 may have exorcised the ghosts of the party’s disastrous 2004 ‘India Shining’ campaign.Twitter/IANSExit polls have predicted the return of Prime Minister Narendra Modi to power, sending the markets into a tizzy. The huge majority expected for the Bharatiya Janata Party (BJP)-led National Democratic Alliance (NDA) has spurred the stock markets to new highs. Traders hope that the prospect of the installation of a market-friendly government will bring back the foreign portfolio investors (FPI) that had taken flight during the six-week-long seven-phase election process.The markets are likely to price in the euphoria ahead of the May 23 counting and there is a chance of the volatility peaking. The election outcome is likely to emerge only in a day or two after the counting begins because of the delay in matching the VVPAT (voter-verified paper audit trail) slips with the EVM (electronic voting machine) numbers.The exit polls predict that the NDA could win between 267 and 354 seats in the 543-member Lok Sabha. In contrast, the BJP-led NDA won 336 seats in 2014, as against 60 of the main opposition Congress party-led United Progressive Alliance (UPA) that is projecting Rahul Gandhi as its prime minister candidate. The mish-mash of regional parties and the left outfits won 147 seats in 2014.But the political observers have been right in cautioning the market to temper the euphoria that the exit polls have triggered. They cite the euphoria created by the exit poll predictions of 2004 after the Atal Bihari Vajpayee-led BJP mounted the India Shining campaign. Most major exit polls then suggested that the NDA would come back to power with a wide lead over the Congress-led alliance. Congress president Rahul Gandhi would fervently want to draw parallels between 2004 and 2014 Lok Sabha election campaigns.Of course, the figures that the surveys threw up then were much moderate than the 2019 exit polls. Only Sahara DRS and Star News Cvoter surveys placed NDA beyond the half-way mark of 272 seats. Sahara DRS poll projected a tally of 278 seats for NDA against 181 for the UPA, while Star News CVoter survey gave the NDA 275 seats and UPA 186. In fact, the average of five major surveys predicted 260 seats for the BJP-led front and 188 for the UPA. However, the NDA ended up with 189 seats against the UPA’s 225. The rest is history with two stints of Manmohan Singh as prime minister until the 2014 Modi wave.Some experts point out that exit polls would be closer to the actual results in a less emotionally charged election. This is because exit polls often reflect the voters’ perception of the scenario rather than his or her actual preference. In an atmosphere that is extremely vitiated by the social media and massive campaigns, there is all the more a chance of the voters’ perception being influenced by the last message that got imprinted in the memory.Therefore, veteran traders suggest caution while trading the election news with tight stop-loss settings. The market could see some profit-taking ahead of the results on Thursday, especially after the single day surge of more than 1,400 points to close at 39,352 points of the Bombay Stock Exchange (BSE) benchmark Sensex and 400 points of the National Stock Exchange benchmark Nifty to close at 11,828 points taking the benchmark indices to shouting distances of all-time high points.Of course, 2019 is not exactly 2004 and the combine of Prime Minister Modi and BJP president Amit Shah is not that of Vajpayee and LK Advani. The BJP’s vote share has surged since 2004 and there is no denying that the party has spread into more areas with strong organizational buildups. Therefore, the exit polls this time could hit the bull’s eye.
Bachchu Rahman, president of Rajshahi’s Mohanpur upazila unit Jubo Dal takes treatment at hospital in Rajshahi on Wednesday. Photo: UNBMiscreants abducted a local Juba Dal leader in Rajshahi’s Mohanpur upazila and shot him in his both legs, reports UNB.The victim Bachchu Rahman, is president of Mohanpur upazila unit Jubo Dal, the youth wing of BNP, and son of Lokman Ali of Soipara village in the upazila.Locals said a group of miscreants picked Bachchu up in a microbus from the Rajshahi-Naogaon highway in his area in the afternoon.They took him to Achinghat in Bagmara upazila where they shot him in both begs before leaving the spot.Locals rescued the bullet-hit Juba Dal leader and took him to Rajshahi Medical College Hospital.Contacted, officer-in-charge of Mohanpur police station Abul Hossain said he was unaware of the incident.