Cthia Skeptic

Chinese rare earth element near-monopoly

2010-09-01T05:45:00.000-05:00

There is a looming global shortage of Neodymium.

"So what?" I hear you ask.

The "rare earth elements" are key components of many electronic devices, from your cell phone to electric cars. Without the rare earth oxides, we can't build many electronic modern gadgets.

It turns out the technology for creating oxides of these elements, which are the forms we use, was invented in the USA. But, most of the capacity for converting rare earth elements to a usable form, has moved offshore and China produces most of the material.

Except, China has announced a major reduction in what they are willing to export. It seems they want us to buy the material only in Chinese products.

Ubuntu & Cthia

2010-04-07T21:48:00.000-05:00

If Windows is the answer, what the heck was the question?

Ubuntu is one flavor of linux. There are a variety of different distributions and every single one of them gives more "Power to the People!" than Windows, or even OS/X. The latest version is due out by the end of this month.

Linux is an operating system for personal computers that puts total control in the hands of ordinary people. It also requires you to think and exercise your brain. Hopefully, if you are reading this, you are not averse to thinking. Linux has several advantages. First, it's free. It is released under a license which prohibits you from charging for the program itself. Second, if you take time to really learn it, you can control everything that your computer does and Redmond, Washington, no longer makes choices for you. Because it's free and because of the power it puts in the hands of the ordinary user, businesses such as Microsoft and totalitarian governments find it threatening. Freedom is scarey, did you notice?

Cthia requires free thinking and free access to unfiltered data. Operating systems which are proprietary and make choices for you limit your freedoms, by default.

Ubuntu, Linux Mint, Debian, Mandriva, and the other distributions of linux are all supported by the cooperative efforts of volunteers. Imagine an operating system supported by volunteers from all around the world, who work on each update tirelessly, so that it is in general more stable and bug-free than commercial products. Why would they do that?

For the answer to that question, visit: www.ubuntu.org to understand the philosophy behind the cooperative effort.

Other linux distributions may be found at:

www.linuxmint.com
www.debian.org

www.opensuse.org
www.mandriva.com
www.fedoraproject.org

Michael

Health Care Reform

2010-04-07T14:27:00.000-05:00

I'm a physician, so I'm supposed to hate the new health care reform law. I chose to reserve my opinion, for the moment.

Allow me to observe that our congress and other "leaders" have been talking about health care "reform" since the Truman administration. This is the most comprehensive overhaul, for good or ill, since the creation of Medicare. I think almost no one yet understands what exactly it will do.

I chose to compliment President Obama for having the tenacity to finally get something through congress, when so many have failed. I chose to criticize our senators and congresspersons for failing to do anythign sooner than this.

Other than that, I'm simply going to wait and see. Like everyone else.

Health Care "Reform"

2009-12-06T08:00:00.001-06:00

Medical care in the United States of America costs "too much." That's a generally accepted wisdom, I think. Not too many physicians believe we get paid too much, although I think one could make a good case that physician salaries or profits are somewhat out of proportion. Many physicians believe insurance companies are the cause of excessive health care costs.

Do we do too much medicine? I think so. In the mid 1990's, I was stationed at an Air Force base in Mississppi and I suffered a broken jaw when another softball player ran into me at full speed. My jaw had to be wired for a month and I lived on Ensure and similar food. When I went to the ER for the immediate care, I had to refuse a CAT scan. I did not have a concussion; I did not lose consciousness. But it had become "standard of care" to perform a CAT scan after any injury to the head.

It is now standard of care to perform laboratory tests to monitor patients taking many medicines. Not all of the tests are unreasonable, but some of them get fairly expensive and the yield is pretty low. All of these tests drive up costs.

Doryx is a new doxycycline antibiotic. Generic doxycycline can be purchased for about $30 for a month's supply. Doryx costs over $600 for a month supply. Olux is a sophisticated foam vehicle for clobetasol, a topical steroid we use frequently. A 100 gm can of Olux runs around $250, whereas generic clobetasol solution can be purchased for less than $50 for 100 cc. Aldara is a medicine brought out 3M ten years ago for the treatment of warts. It was too expensive in 1997 at $125 for 12 little packets of the drug (one month supply at 3 packets a week). Subsequently, it was shown to be useful for the treatment of actinic keratoses (pre-skin cancers) and for early, superficial skin cancers. 3M has sold off its pharmaceutical arm and the new manufacturer, Graceway Pharmaceuticals, sells the medicine for about $250 for twelve little packets. I refer the reader to The Truth About the Drug Companies: How They Deceive Us and What to Do About It. by Marcia Angell. The author is the former Editor-in-Chief of the New England Journal of Medicine. She documents only too well how pharmaceutical company profits have risen over the years, at all of our expense. She documents how research has been driven by pharmaceutical companies and not by NIH, the FDA, or universities.

Our prescription writing is also affected by biased publication. Please see Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy, by Turner, et al, in the New England Journal of Medicine, 2008; volume 258, page 252. From the abstract: "Among 74 FDA-registered studies, 31%, accounting for 3449 study participants, were not published. Whether and how the studies were published were associated with the study outcome. A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies). According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive. Separate meta-analyses of the FDA and journal data sets showed that the increase in effect size ranged from 11 to 69% for individual drugs and was 32% overall." To put that more simply, the published literature misrepresents the real effectiveness of antidepressant medicines. They are not as good as we think. If a careful, responsible physician were to carefully read the literature, he or she would get an overly positive view of the use of these medicines. So, we are paying for medicines that are not as good as we think they are. We are being misled. With intent? I am unable to answer that question.

What about marketing? Does it influence us? See Dr. Angell's book for comments about marketing. The Association of American Medical Colleges (AAMC) published a symposium, The Scientific Basis of Influence and Reciprocity , which is available for free download. It is a large file in PDF format. Basically, we ae severely influenced by pharmaceutical companies. Worse, we have built-in incentives to over use and over-charge. We are also not as honest as we think we are. You should also read, "Following the Script: How Drug Reps Make Friends and Influence Doctors" from PLoS Medicine.

I will have lots of comments in this blog about this subject. For the record, I own stock in Abbott Laboratories. I don't take drug lunches or dinners. I subscribe to the philosophy outlined in No Free Lunch. More succinctly, from Robert Heinlein's novel, The Moon is a Harsh Mistress, he coined a phrase, TANSTAAFL (There Ain't No Such Thing As A Free Lunch).

Finally, I remember Pogo, a cartoon character from when I was a child and young adult. He has disappeared from the newspaper comic sections, but certain of his comments live on: "We Have Met the Enemy, and He is Us".

We all own this problem.

Yours for Cthia,

Michael

Kruschev

2009-12-01T21:29:00.000-06:00

We are sorely afflicted
As Khruschev predicted,
By our own insipid depravity
Reflected in a hollow cavity.

We sit bemused, intellect disrupted,
By a dogfood commercial passively corrupted.
We accept, with abandoned reason
Anything offered as entertainment this season.

A box, a simple cube.
What object is this,
To arouse such hate?
Marx was wrong.
It is not religion,
But television
That leads us to our fate.

Copyright, Michael J. White
Written in 1977

What's a Cthia?

2009-12-01T21:06:00.000-06:00

"Cthia" is a word from the Star Trek lexicon. It has been defined by a number of authors, including Diane Duane, in her novel Spock's World. Loosely defined, it means "reality truth". My understanding of it: "Cthia: That perception, understanding, or belief which most closely approximates reality."

Reality is not politically correct. It does not care about me, about you, about the Pope or what we were taught in school. We can't change cthia, only our perceptions of it. Cthia is a philosophy or a perception. It isn't reality, but our perception of it.

This blog will be an on-going exploration of cthia. I hope it will be a skeptical enquiry into subjects you find interesting. Sometimes it will be politics, sometimes religion, sometimes science, sometimes nonsense.