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The 2nd Yale Research Symposium on Complementary and Integrative Medicine. Part I

March 4, 2010

Today I went to the one-day, 2nd Yale Research Symposium on Complementary and Integrative Medicine. Many of you will recall that the first version of this conference occurred in April, 2008. According to Yale’s Continuing Medical Education website, the first conference “featured presentations from experts in CAM/IM from Yale and other leading medical institutions and drew national and international attention.” That is true: some of the national attention can be reviewed here, here, here, and here; the international attention is here. (Sorry about the flippancy; it was irresistible)

I’ve not been to a conference promising similar content since about 2001, and in general I’ve no particular wish to do so. This one was different: Steve Novella, in his day job a Yale neurologist, had been invited to be part of a Moderated Discussion on Evidence and Plausibility in the Context of CAM Research and Clinical Practice. This was not to be missed.

I arrived early enough to take a relatively inconspicuous seat near the back. My plan was to honor the Prime Directive, at least until late in the day when Steve was to speak. Alas, ‘twas not to be. Not long after I’d lodged myself there, the young man who had organized the conference came right up to me and said “welcome, Dr. Atwood.” He is 2nd year Yale medical student John Millet, an enthusiastic kid who had clearly worked hard on this task and who later gave a nice talk. He said that he recognized me from the picture on my blog, by which I guess he meant SBM (which, he said, he reads faithfully). Except that there is no picture of me on SBM, so clearly he is an empath!

For a “CAM” Conference, there wasn’t much “CAM”

The welcoming comments were offered by our John and by Deputy Dean of Education Richard Belitsky, one of two speakers who had borne the brunt of the criticism following the 2008 conference. I criticized him at the time for his “obsequious welcoming statement,” which “betrayed either an ignorance of science and critical thinking or an ignorance of ‘CAM’.” I am happy to report that it seems to have been the latter, both because he apparently had something to do with inviting Dr. Novella to the conference and because his welcoming statement today was more measured than the last. In particular, he said something to the effect (my pen had run out of ink at that point) that “this is the Yale University School of Medicine, and we consider it very important that all conference material be presented with the utmost scientific rigor.”

The agenda seemed to reflect that theme. The 2008 conference had included talks on Therapeutic Touch, Reiki, chiropractic, Qi Gong, “integrating mind, body, and spirit,” David Katz’s infamous “invitation to think more fluidly about evidence,” and, well, Bernie Siegel. This conference, in contrast, had hardly any “CAM” talks at all. Below is the schedule. For the talks that I attended (in the early afternoon there were two, competing tracks), I’ve indicated which ones were about “CAM” and which were not; among those that I missed were a couple on “mindfulness meditation” for stress reduction and one on hypnosis to reduce anxiety, which are hardly “CAM.” Another that I missed was “auricular acupuncture,” which I assume was “CAM”:

Yale Research Symposium on Complementary and Integrative Medicine

Welcome and Opening Remarks

John Millet YSM 2012 and Richard Belitsky MD

Plenary Session: An Integrative Approach to Cancer: The Biology of Lifestyle Interventions and Cancer Survival

D. Barry Boyd MD, MS (Not CAM)

Keynote Lecture:  Progress in Research in Complementary and Alternative Medicine

Josephine P. Briggs MD (Mostly Not CAM )

Concurrent Sessions:

Traditional Chinese Medicine, Nutrition, and Research Methods Track

Auricular Acupuncture as a Treatment for Pregnant Women Who Have Low Back and Posterior Pelvic Pain: A Pilot Study

Shu-Ming Wang MD, Lac (CAM)

Globalization of Chinese Medicine:  A Case Study of PHY906, A Traditional Chinese Medicine Formula as Adjuvant Chemotherapy for Cancer Treatment

Yung-Chi “Tommy” Cheng PhD (Mostly Not CAM)

N-Acetylcysteine for Pediatric Trichotillomania

Michael H. Bloch MD (Not CAM)

Effects of Walnut Consumption on Endothelial Function in Type 2 Diabetes: A Randomized, Controlled, Crossover Trial

John Millet YSM 2012 (Not CAM)

Patient Experiences and CAM Use in Chronic Lyme Disease: A Qualitative Study

Ather Ali ND, MPH and Lawrence A. Vitulano PhD

(CAM, but not quite as bad as it looks)

The Impact of Dietary Protein on Calcium Absorption and Kinetic Measures of Bone Turnover in Women

Karl L. Insogna MD (Not CAM)

Psychological Stress and Sudden Cardiac Death: The Downside of the Mind-Body Connection

Rachel Lampert MD (Not CAM)

Piloting a Mindfulness Based Stress Reduction Curriculum for Internal Medicine Residents

Auguste H. Fortin VI MD, MPH

Development and Initial Psychometric Testing of the Determinants of Meditation Practice Inventory

Anna-leila Williams PA, MPH, PhD(c)

Mindfulness Training as Treatment and Mechanistic Probe for Addictions

Judson Brewer MD, PhD

How Does Stress Increase Alcoholism Relapse and Affect Chronic Disease Risk?

Rajita Sinha PhD

Pre-Operative Hypnosis: A Bio-behavioral Model for Reduction of Anxiety in Surgical Patients

Haleh Saadat MD

Moderated Discussion on Evidence and Plausibility in the Context of CAM Research and Clinical Practice

Moderator: D. Barry Boyd MD, MS

Panel:  David Katz MD, MPH

and Steven Novella MD

Open Forum Discussion with Expert Panel

Moderator:  Lawrence A. Vitulano PhD

Panel:  D. Barry Boyd MD, MS, David Katz MD, MPH, Steven Novella MD

In this post I will discuss the conference up to the point at which Dr. Novella became involved (oh no, you’re thinking: that’s the best part!), but I’ll try to follow with the second part within a day or so.

The Morning: Drs. Boyd and Briggs

Most of the “Not CAM” talks were reasonably presented and, well, reasonable. Two that are worth mentioning in a bit of detail were those by oncologist Barry Boyd, on “An Integrative Approach to Cancer: The Biology of Lifestyle Interventions and Cancer Survival,” and the talk by Josephine Briggs, the Director of the NCCAM since 2008. Dr. Boyd’s talk, in spite of a title promising everything from “visualize your immunocytes” to “antineoplastons,” was mainly about one thing: diet/exercise and cancer progression (and to a lesser extent cancer formation). It boiled down to some intriguing evidence from animal studies, biochemistry, and epidemiology suggesting that purposeful, modest weight loss may improve cancer prognosis in patients who are still in relatively good shape. The physiology is essentially the physiology of the “metabolic syndrome,” involving insulin resistance, up-regulation of insulin and insulin-like growth factor 1 (IGF-1, which probably acts as a tumor growth factor), and a systemic inflammatory state (which, by leading to epithelial cell proliferation, provides more opportunity for carcinogenesis).

If you’re interested, Dr. Boyd has an article available online covering similar material. I talked to him several times during the course of the day: he seemed completely scientific in his outlook, and excited about new possibilities in the way that smart people in academic medicine can be. He correctly called the Gonzo regimen “nonsense.” In his talk he showed a slide with a small box labeled chemotherapy-radiation therapy-surgery-biological; it was contained within a “the bigger box” labeled lifestyle changes-dietary interventions-exercise-stress reduction (hormonal was kind of on the surface of the little box). Beyond the bigger box, which was labeled Non-Conventional Medicine, was the real “CAM”: TCM, Ayurvedic, Energy Healing, Homeopathy, Botanical.

I agree with him: diet and exercise, other than pseudoscientific drivel, are not “CAM.”  At one point I asked him why he even thought of himself as “integrative.” He replied that he did not! Why, then, does he identify himself with the woo crowd? Why does he tout Michael Lerner, who defends boundless nonsense including Gerson (whose regimen is similar to Gonzo’s)? Why does he tout Ralph Moss, who championed Gonzo? Why does he tout James Gordon, who pushed at least one hapless patient into the hell that was the Gonzo trial? Doesn’t he know how the politics of quackery works? In spite of those issues, I had a good time talking with him and I hope to do it again sometime.

Josephine Briggs, the NCCAM Director, talked mostly about “supplements” studies sponsored by the Center. Surprise: they’ve all been disconfirming. Hoodathunk? Well, she did present evidence for something that I’ll admit I’d poo-poo’d in the past. It turns out that there was a large-enough-to-be-noticeable diminution in public demand for echinacea and glucosamine-chondroitin sulfate beginning not long after each NCCAM-sponsored trial had been publicized; the same is now expected, not only by Dr. Briggs but according to a trade magazine that she cited, for ginkgo biloba. Not that this justifies such trials at taxpayers’ expense, of course.

Dr. Briggs identified “areas of promise in natural products research,” naming “insight into molecular targets of dietary small molecules [etc.]” Hmmm: that sounds suspiciously like “lend[ing] a drug development aspect to an otherwise ‘herbal’ application.” Later I asked her if, in fact, the NCCAM had changed its previous attitude about refusing to fund studies proposing to look for active molecules in natural products, and she said “yes.”

Dr. Briggs herself seems to have a rational, scientific way of looking at things. No surprise: she was, for decades, a renal physiologist. She betrayed her own nerdiness with a slide titled “Quirky ideas from outside the mainstream,” which purported to show examples of, well, quirky ideas whose time eventually arrived: physical resistance training for people recovering from physical trauma (Pilates 1915); breathing techniques to help with labor pains (Lamaze 1940); breast feeding better than formula for babies (Froelich 1950s); dying patients would be better off with fewer medical interventions and more palliative support (Saunders, etc. 1960s); mindfulness-based stress reduction can help with pain management (no author or date). No arguments there, except that those ideas were never “quirky,” unless the term is defined by what the preponderance of practicing physicians was NOT doing or recommending at the time. How do those histories justify investigating implausible claims?

They don’t, but listening to Dr. Briggs one would think that the future of the NCCAM will stay away from the highly implausible. Rather, it will involve rational natural products research, investigations of reasonable physical techniques (“yoga and Tai chi for balance and avoiding falls in elderly people”), uncontroversial (i.e., not psychokinesis) mind-body techniques to help with symptoms, mainly pain, and research into the nature of the placebo effect. (She listed acupuncture as a “mind-body practice.” Did she really mean that? Was she acknowledging that it is a placebo?) If that were the extent of it, I could think of better things to do than spend my time criticizing the Center.

Alas, it won’t be, because Dr. Briggs must walk on a tightrope being shaken by Senator Harkin at one end and Senator Hatch at the other, with Congressman Burton making sure that there is no safety net underneath. And there will remain such sticky problems as the NCCAM putting the cart before the horse by funding “integrative medicine centers”; by continuing to wear its blindfold regarding the ongoing, largest and most expensive NCCAM trial yet funded, that should have long ago been terminated because of scientific and ethical misconduct and unnecessary risks to human subjects; and by continuing to offer misleading information to the public, right on the NCCAM website.

Dr. Briggs seemed unaware of the last point (I don’t recall her mentioning the other two). She was quite pleased with the website and recommended it more than once. Lover of irony that I am, I offer an example of misinformation attributed to the NCCAM website that unwittingly insults some of the Center’s own ‘stakeholders,’ and is printed right in the 2010 Yale Research Symposium syllabus:

In homeopathic medicine, there is a belief that “like cures like,” meaning that small, highly diluted quantities of medicinal substances are given to cure symptoms…”

Ouch! That’s, er, the opposite of homeopathy. To wit:

The curative power of medicines, therefore, depends on their symptoms, similar to the disease but superior to it in strength, so that each individual case of disease is most surely, radically, rapidly and permanently annihilated and removed only by a medicine capable of producing (in the human system) in the most similar and complete manner the totality of its symptoms, which at the same time are stronger than the disease.

It is the despised “allopathy” that seeks merely to cure the symptoms:

Whenever it can, it employs, in order to keep in favour with its patient, remedies that immediately suppress and hide the morbid symptoms by opposition (contraria contrariis) for a short time (palliatives), but that leave the disposition to these symptoms (the disease itself) strengthened and aggravated.

That language is the historical basis for homeopaths (and related sects) claiming to cure “the underlying cause of the disease, not just the symptoms.” (I wonder if Dr. Briggs knows that she might get into trouble if she spends too much effort advocating for studies of methods that offer “contributions to symptom management”). Unlike that example, of course, most of the misinformation on the NCCAM website serves not to diminish “CAM” practices but to embellish them.

The Afternoon

There is little to say about the talks that I attended; most of them were straightforward and uncontroversial, as their titles suggest (I don’t consider studying walnut consumption as a source of polyunsaturated fatty acids to be “CAM”). Each of the small efficacy trials showed some evidence of benefit. OCD expert Michael Bloch reported that N-acetylcysteine, a drug already used for other purposes, shows promise in the treatment of trichotillomania, an obsessive-compulsive disorder in which the individual pulls out her hair to the point of being severely disfigured, and for which there is currently no good pharmacologic treatment. I don’t know why this topic was even presented at a “CAM” conference, except perhaps that the drug is sold as a “supplement.”

Walnuts appear to improve endothelium-dependent vasodilatation in type II diabetics; impaired vasodilatation is correlated with cardiovascular disease, so perhaps walnuts are useful for this high-risk group. John Millet, the medical student who had “outed” me at the beginning of the day, gave that talk in a most competent fashion and is one of the authors of the published article.

Dietary protein appears to increase calcium absorption from the gut in post-menopausal women, according to Karl Insogna, an endocrinologist who is Director of the Yale Bone Center. He gave a great talk; look for the results of his Spoon study (Supplemental Protein to Offset Osteoporosis Now) within a couple of years.

The talk on “CAM use in Chronic Lyme Disease” deserves mention. The speaker was Ather Ali, a very deferential and soft-spoken young man whose background appears to include a large dollop of pseudoscience (Bastyr University) followed by a sprinkling of science at the Yale School of Public Health, folded into a ribbon cake of mixed messages at David Katz’s Integrative Medicine Center. Why the talk was not quite as bad as it looks is that the speaker mostly backed away from “Chronic Lyme Disease” (CLD) as a formal label, deferring to “medically unexplained symptoms.” These, he noted, might also be labeled chronic fatigue syndrome, fibromyalgia, multiple chemical sensitivity, and more. The choice of the term “Chronic Lyme Disease” is an operational one: the ongoing qualitative study that he discussed asks questions of subjects who “self-identify or (have been) diagnosed with CLD” and “providers who diagnose and/or treat patients with CLD.”

Some of the preliminary results reveal problems with this purely qualitative study—both interpretational and ethical. The questions that the subjects are asked are many, ranging from cultural influences and “narratives” to laboratory values. One of the “salient insights” that Ali presented was this statement from a patient:

On finally obtaining a diagnosis:

It felt really good. That’s actually an understatement. It felt like for as sick as I was, and as awful as I felt that day, it just felt like I had a ray of hope for the first time in I don’t know how long.

This is no surprise; we don’t need a study to find this out. What we probably won’t find from this study, because of self-selection of subjects, are any who do not feel so good when given this “diagnosis.” Some may be scared out of their wits; others may recognize the scam and walk right out the door. In any event they have all been told a lie. What is the message here? I’m reminded of another such foray by naïve academic “CAM” enthusiasts (immortalized in the very first W^5), who unwittingly gave a perfect description of quackery when they wrote:

Chiropractors never have to put a patient’s pain in the category of the “mind.” They never fail to find a problem. By rooting pain in a clear physical cause, chiropractic validates the patient’s experience.

Are we to conclude that real physicians should be so dishonest?

The ethical problem with this survey arises because the investigators will inevitably stumble upon practitioners who are pushing dangerous treatments; that’s the nature of the beast known as “Lyme Literate.” The preliminary results have already identified an example, colloidal silver, which appeared on one of Ali’s slides (without his commenting, as I recall). In the question period I made that point and asked if either the IRB or the investigators had addressed it. He replied that the IRB had not, that he hadn’t seen anyone injured, and that he felt that it wasn’t an issue because this is merely an observational, not an interventional, study. I was tempted to ask, “what are you going to do, wait until someone turns gray?”—but I held my tongue.

I was confident, when I asked that question, that the IRB had not considered the issue. IRBs, like most people and most physicians, have no idea what dangers lurk under rocks dignified with labels such as “holistic,” “integrative,” “functional,” and the like. IRBs and investigators, however, are responsible for protecting human subjects, even in purely observational studies. There are numerous ethical and legal bases for this assertion, but for now consider this quotation:

…the lack of treatment was not contrived by the USPHS but was an established fact of which they proposed to take advantage.”

–Dr. Charles Barnett, Emeritus Professor of Medicine at Stanford, quoted in “Debate Revives on the PHS Syphilis Study,” Medical World News (April 19, 1974), p. 37

The statement was an attempt to excuse the Tuskegee Syphilis Study on the grounds that it had been merely “observational.” The Yale IRB need only replace “lack of treatment” with “mistreatment,” and “USPHS” with “Yale investigators,” to understand the point. The IRB might also consider that the mere presence of “experts” from Yale will be interpreted by subjects as tacit (at least) approval of the practices and the practitioners.

It is, nevertheless, possible that the qualitative CLD study will yield useful information. More likely is that it will be understood and presented by its authors in a “non-judgmental” way or as sympathetic to the practitioners (see above re: chiropractors), and thus it will be up to those with more savvy to read between the lines.

End of Part I

Link to Part II

Posted in: Chiropractic, Clinical Trials, Health Fraud, Herbs & Supplements, Homeopathy, Medical Academia, Medical Ethics, Nutrition, Politics and Regulation, Science and Medicine

Leave a Comment (26) ↓

26 thoughts on “The 2nd Yale Research Symposium on Complementary and Integrative Medicine. Part I

  1. edgar says:

    I saw Dr. Briggs give the same talk in Philadelphia last year at APHA. Fascinating stuff.

    Thank you for this post, but I do think CAM does have a place when it is able to affect behavior change.

  2. You can see some of the tragi-comedy of the first meeting on YouTube at Integrative Baloney @ Yale, complete with a straight-face introduction by the Dean of Yale School of Medicine. It beats me how this rubbish has penetrated a real medical school.

  3. moderation says:

    Please … if CAM infiltration was only in medical schools it would not be so frightening. CAM is also infiltrating medical associations. See the AAP Section on Complementary and Integrative Medicine as an example. They state that they are advocating for better research into the use of CAM in children, but a look through their website and newsletters reveals tacit to outright approval of the use of CAM.

    BTW the only good thing about Bastyr University of CAM is the WABL (Washington Beer Lovers) microbrew festival that is held on their grounds every summer.

  4. kdv says:

    > in the 2010 Yale Research Symposium syllabus:

    >> In homeopathic medicine, there is a belief that “like cures like,” meaning that small, highly diluted quantities of medicinal substances are given to cure symptoms…”

    > It is the despised “allopathy” that seeks merely to cure the symptoms

    And of course, the other slight problem with the quoted text is that “small, highly diluted quantities” should be changed to “zero quantities”. Of course, they can’t do that because [irony mode on] any person reading it would immediately recognise it as total nonsense.

  5. Jeff says:

    The NCCAM study on glucosamine was designed to fail. It used the hydrochloride form of glucosamine, which has not been proven effective. Most glucosamine supplements use the sulfate form, which has repeatedly been proven effective:

    http://www.guidetrial.co.uk/

    Dr. Briggs identified “areas of promise in natural products research,” naming “insight into molecular targets of dietary small molecules [etc.]” Hmmm: that sounds suspiciously like “lend[ing] a drug development aspect to an otherwise ‘herbal’ application.”

    That’s unfortunate. Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal has the same view of natural molecules. FASEB published this study and Dr. Weissman’s initial response is, “How can we turn DHA into a drug?”

    “Swedish scientists exposed neuroblastoma cells from the nervous system to DHA and analyzed the cells for byproducts as the DHA was metabolized into the cells. Researchers then examined the affect of both DHA and its derivatives on the growth of cancer cells. Results showed that DHA killed the cancer cells, but that the toxic derivatives produced by DHA were even more effective at killing the cancer cells. The cancer cells were unable to deactivate the accumulation of DHA metabolic by-products which accumulated to the point of killing them. By comparison, non-cancer cells activate a natural protective system that neutralizes these DHA byproducts as they are produced, preventing toxicity in normal cells.”

    As a preventive measure, why not advise people to consume fish oil? It’s beneficial, safe, affordable, and widely available. This is exactly what the Pentagon is considering for U.S. soldiers.

  6. twaza says:

    Quote:

    In homeopathic medicine, there is a belief that “like cures like,” meaning that small, highly diluted quantities of medicinal substances are given to cure symptoms…”

    Ouch! That’s, er, the opposite of homeopathy. To wit: …

    Actually homeopaths are not 100% consistent. Arnica and homeopathic arnica are sold for the same symptoms. My guess is that both products work equally well/poorly at promoting healing of trauma.

  7. TsuDhoNimh says:

    @tewaza – Arnica (the herb) has an anti-inflammatory effect.

    Many “alternative medicine” providers offer a full spectrum of woo, from herbal medicines to homeopathy, with stops on various parts of the energy spectrum.

    They fail to see that if homeopathy works, herbal medicine (which administers whole herbs or even concentrates of the active ingredients) should not. If acupuncture’s meridians are valid, chakras can’t be … etc.

  8. TimonT says:

    Thanks for this excellent report. I’m looking forward to part 2.

  9. rosemary says:

    Congratulations! It sounds as if all the efforts of the doctors and scientists promoting scientific medicine are starting to show good results!

    Silver supplements used to treat Lyme disease have already caused two cases of argyria, gray skin, that I am aware of. One is reported in the med. lit., another to me personally.

  10. daijiyobu says:

    This is an idea of how bad Yale School of Medicine had gotten

    [perhaps had is past-tense, and perhaps only 'bad partner-wise' is also past tense!]:

    in 1998 I began the University of Bridgeport’s ND program which was offered under the academic label of “Division of Health Sciences” [yup, and still!] and in 2000 my Epidemiology and Public Health course for that program was taught by Katz at YMS.

    So, the ND students sat there in EPH with all the other Yale students who take that course — including their MD candidates.

    ‘How the hell did I end up at Yale Medical School?,’ I’d often wonder.

    Now, UB’s ND is — as all of North American naturopathic education is still / essentially — expressly centered around sectarian science-ejected concepts [the vitalistic, the supernatural, the absurd-whackaloon ect.] then falsely labeled, obviously, SCIENCE.

    That’s how bad Yale, in my view, got — perhaps only ‘by association’. An association that apparently ended, at least per EPH.

    UB, in my view and in my experience is, “12 Fraudulent Years On”, EVIL.

    Any legal-types out there can always contact me through naturocrit.blogspot.com if you have any suggestions / comments!

    I am always eager to be an expert witness, also.

    I offer this analogy:

    Tammy Kitzmiller : ID = meself : ND

    -r.c.

  11. Versus says:

    “In any event they have all been told a lie.”

    Thanks, Dr. Atwood. How refreshing to see the word “lie” used to describe a sCAM “diagnosis!” Telling a patient he has “chronic lyme disease,” “subluxations,” or blocked “chi” is as much of a lie as Bernie Madoff telling investors they were earning 9%.

  12. Ian says:

    Part 2, part 2! :D

  13. StatlerWaldorf says:

    I too look forward to part 2 :)

  14. Part II will be posted Tuesday afternoon. (Sorry, I had completely forgotten that on Saturday I had to take the ACLS course. Aargh).
    KA

  15. keleton says:

    I was just reading part II, then clicked one of the links in it and it is now gone. Not ready to post yet I guess?

  16. tanha says:

    Each of the small efficacy trials showed some evidence of benefit. OCD expert Michael Bloch reported that N-acetylcysteine, a drug already used for other purposes, shows promise in the treatment of trichotillomania, an obsessive-compulsive disorder…. I don’t know why this topic was even presented at a “CAM” conference, except perhaps that the drug is sold as a “supplement.”

    Your only issue with this is that it’s not CAM? I’d like a reference for this.

  17. @keleton:

    Sorry, that was a false start, but it’s up now.

    @tanha:

    What is your question?

  18. tanha says:

    The question will be obvious once you provide the reference.

  19. @tanha:

    Please be clear: a reference for what?

  20. Joe says:

    @Kim, in your first part on Yale, you wrote that a student recognized you, supposedly from your blog. I thought I recalled seeing your picture recently. I suppose the student could have been covering for someone … or saw it in the newest issue of Skeptical Inquirer.

  21. tanha says:

    Uh… that N-acetylcysteine shows promise in the treatment of trichotillomania

  22. @tanha:

    OK. (It sounded at first as though you wanted a reference for it not being “CAM.”)

    There is one published trial in adults:

    N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study.

    The trial that Michael Bloch reported at the Yale conference is a pediatric trial and has not yet been published.

    Other potentially useful articles:

    Nail-biting stuff? The effect of N-acetyl cysteine on nail-biting.

    Trichotillomania: neurobiology and treatment.

  23. agualuna says:

    One of our readers asked us about a suspicious site called “agua luna” and asked if we knew of any reviews. We didn’t, but decided to take a look. It was astonishing madness to say the least. Are they nuts — or just con artists? Perhaps some of you can answer this question.

    Now let us take a close look at some of their insanity:

    Under the link DIY guides, there is a large button for “Never pay for electricity again”. Perhaps it is meant to be an advertisement, or perhaps it is related to agua luna. The site magniwork.com claims “Our easy-to-follow guide will show you how to construct the Magniwork free energy generator, which will run infinitely and create free electric energy. This method has been thoroughly researched, and is currently considered as a possible mean of completely solving the energy crisis. A Magnetic Perpetual Motion Device much like Magniwork refers to a device that works perpetually i.e. indefinitely, and produces more energy than it consumes, which ultimately results in a surplus of electrical energy which can be used to power your home.”

    Most of you know this from school — but just in case you didn’t take science, remember this: Perpetual Motion machines DO NOT EXIST because they are impossible. Even more outrageous are machines that claim not only run forever, but generate excess power as well. To their credit, they have a video that ends with a comment that “if it works, they will have to rewrite some of the laws of physics”.

    There is little point dissecting insanity, but it is interesting that the web site looks a lot like those earth4energy web sites and both seem to have originated from down under. Down under what, I am not sure :-) I did live in Melbourne and loved it, so Ausies please don’t take offence.

    Agua Luna is also selling a book “How to build a hydrogen generator and run your car on water”. This too is total fraud. The book has detailed drawings of the hydrogen generator with lots of circuits and terminology to give it a “scientific flavor” but it just like the perpetual motion machine because:

    Splitting water into hydrogen and oxygen requires energy. This is the same energy that is released when you burn the hydrogen later. Where did the energy come from? Good question — and the crux of the problem. Are you going to burn gasoline to generate electricity to convert water into hydrogen so that you can burn it again and get energy so that you don’t have to burn gasoline? Hopefully this sounds foolish to you. Remember, ever time you break water into hydrogen and oxygen, or burn the hydrogen to make water, or burn gasoline — or any other transformation — you lose some energy as heat and this further reduces your efficiency. Extra steps might look impressive but they are just there to make the process look important.

    They state: “Water is pumped into a chamber where electrodes are vibrated using an electrical pulse, which breaks up H2O (regular tap water) into H2 (Hydrogen). Hydrogen is a very clean combustible, removing ozone-destroying exhaust from your vehicle. When the pressure builds reaching 30-60 psi, you turn the key and go. You step on the pedal, you send more energy to the electrodes, thus more vapor fuel (Hydrogen) to the cylinders, which in return creates more power. (The system also will create burnable even cleaner oxygen)”. This is total foolishness. Vibrating electrodes does nothing to disassociate water. You cannot create more power than you start with.

    So far we have two perpetual motion machines on Agua Luna. Now lets look at the e-book “How to build a wind turbine” by Dan Martin. Having read the excellent books, “Home Brew Wind Power” and the books by Paul Gipe, I can definitely state that the statement “build a wind turbine for less than $50″ and “no more utility bills” do not go together. Phrases like “install on roof, side or back of any house” clinch it as there is very little wind in these locations.

    There is much more on their web site, including workshops, a $199 certificate stating that your business exceeds “agua luna” standards, etc. that lead me to believe that the entire operation is a scam. I cannot imagine a legitimate organization which claims that impossible things have been “tested here on the ranch”.

    Fortunately, the FTC is starting to crack down on energy scams. See FTC Sues Promoters of Bogus Fuel Efficiency Device. This suit is definitely applicable as a legal precedence for this scam, especially the hydrogen generator and Fuel Catalyst scams.

    Note from the Federal Trade Commission:

    The FTC works for the consumer to prevent fraudulent, deceptive, and unfair business practices in the marketplace and to provide information to help consumers spot, stop, and avoid them. To file a complaint or to get free information on consumer issues, visit ftc.gov or call toll-free, 1-877-FTC-HELP (1-877-382-4357); TTY: 1-866-653-4261. The FTC enters consumer complaints into the Consumer Sentinel Network, a secure online database and investigative tool used by hundreds of civil and criminal law enforcement agencies in the U.S. and abroad.

    To report this scam, use the FTC consumer complaint assistant.

    http://www.nlcpr.com/Deceptions7.php

  24. …the lack of treatment was not contrived by the USPHS but was an established fact of which they proposed to take advantage.

    My original attribution for that quotation was incorrect (although the quotation itself remains accurate). I have corrected the citation in the text above.

    KA

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