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Posts Tagged ‘medicine

“Biology gives you a brain. Life turns it into a mind.”*…

 

Mind

 

I have a confession. As a physicist and psychiatrist, I find it difficult to engage with conversations about consciousness. My biggest gripe is that the philosophers and cognitive scientists who tend to pose the questions often assume that the mind is a thing, whose existence can be identified by the attributes it has or the purposes it fulfils.

But in physics, it’s dangerous to assume that things ‘exist’ in any conventional sense. Instead, the deeper question is: what sorts of processes give rise to the notion (or illusion) that something exists? For example, Isaac Newton explained the physical world in terms of massive bodies that respond to forces. However, with the advent of quantum physics, the real question turned out to be the very nature and meaning of the measurements upon which the notions of mass and force depend – a question that’s still debated today.

As a consequence, I’m compelled to treat consciousness as a process to be understood, not as a thing to be defined. Simply put, my argument is that consciousness is nothing more and nothing less than a natural process such as evolution or the weather. My favourite trick to illustrate the notion of consciousness as a process is to replace the word ‘consciousness’ with ‘evolution’ – and see if the question still makes sense. For example, the question What is consciousness for? becomes What is evolution for? Scientifically speaking, of course, we know that evolution is not for anything. It doesn’t perform a function or have reasons for doing what it does – it’s an unfolding process that can be understood only on its own terms. Since we are all the product of evolution, the same would seem to hold for consciousness and the self.

My view on consciousness resonates with that of the philosopher Daniel Dennett, who has spent his career trying to understand the origin of the mind. Dennett is concerned with how mindless, mere ‘causes’ (A leads to B) can give rise to the species of mindful ‘reasons’ as we know them (A happens so that B can happen). Dennett’s solution is what he calls ‘Darwin’s dangerous idea’: the insight that it’s possible to have design in the absence of a designer, competence in the absence of comprehension, and reasons (or ‘free-floating rationales’) in the absence of reasoners. A population of beetles that has outstripped another has probably done so for some ‘reason’ we can identify – a favourable mutation which produces a more camouflaging colour, for example. ‘Natural selection is thus an automatic reason-finder, which “discovers” and “endorses” and “focuses” reasons over many generations,’ Dennett writes in From Bacteria to Bach and Back: The Evolution of Minds (2017). ‘The scare quotes are to remind us that natural selection doesn’t have a mind, doesn’t itself have reasons, but is nevertheless competent to perform this “task” of design refinement.’

I hope to show you that nature can drum up reasons without actually having them for herself. In what follows, I’m going to argue that things don’t exist for reasons, but certain processes can nonetheless be cast as engaged in reasoning…

Distinguished neuroscientist and psychiatrist Karl Friston argues that the special trick of consciousness is being able to project action and time into a range of possible futures: “The mathematics of mind-time.”

See also: “How the Brain Creates a Timeline of the Past” (source of the image above).

* Jeffrey Eugenides, Middlesex

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As we get our minds around our minds, we might spare a thought for Oliver Wolf Sacks; he died on this date in 2015.  A neurologist, naturalist, historian of science, and author, he had an active clinical practice, but is more widely-remembered for his writing, mostly case studies from his clinical experience and memoir in which which he treats himself as a clinical subject.  Awakenings, for example, recounted his experience treating post-encephalitic patients with a new drug (levodopa); it was a best seller that served as the basis of a BBC Discovery documentary and was adapted into a feature film.  Widely honored for his prolific work, Sacks was the recipient of the 2001 Lewis Thomas Prize for excellence in scientific writing.

250px-9.13.09OliverSacksByLuigiNovi source

 

Written by LW

August 30, 2020 at 1:01 am

“Person, woman, man, camera, TV”*…

 

dementia

 

In a reversal of trends, American baby boomers scored lower on a test of cognitive functioning than did members of previous generations, according to a new nationwide study.

Findings showed that average cognition scores of adults aged 50 and older increased from generation to generation, beginning with the greatest generation (born 1890-1923) and peaking among war babies (born 1942-1947).

Scores began to decline in the early baby boomers (born 1948-1953) and decreased further in the mid baby boomers (born 1954-1959).

While the prevalence of dementia has declined recently in the United States, these results suggest those trends may reverse in the coming decades, according to study author Hui Zheng, professor of sociology at The Ohio State University… “what was most surprising to me is that this decline is seen in all groups: men and women, across all races and ethnicities and across all education, income and wealth levels.”…

Baby boomers’ childhood health was as good as or better than previous generations and they came from families that had higher socioeconomic status. They also had higher levels of education and better occupations.

“The decline in cognitive functioning that we’re seeing does not come from poorer childhood conditions,” Zheng said…

Reversing of a trend that has spanned decades: “Baby boomers show concerning decline in cognitive functioning.”

On a different, but quite possibly related note, these examples from Patrick Collison‘s recent post on the effects of pollution:

• Chess players make more mistakes on polluted days: “We find that an increase of 10 µg/m³ raises the probability of making an error by 1.5 percentage points, and increases the magnitude of the errors by 9.4%. The impact of pollution is exacerbated by time pressure. When players approach the time control of games, an increase of 10 µg/m³, corresponding to about one standard deviation, increases the probability of making a meaningful error by 3.2 percentage points, and errors being 17.3% larger.” – Künn et al 2019

• “Utilizing variations in transitory and cumulative air pollution exposures for the same individuals over time in China, we provide evidence that polluted air may impede cognitive ability as people become older, especially for less educated men. Cutting annual mean concentration of particulate matter smaller than 10 µm (PM10) in China to the Environmental Protection Agency’s standard (50 µg/m³) would move people from the median to the 63rd percentile (verbal test scores) and the 58th percentile (math test scores), respectively.” – Zhang et al 2018

• Politicians use less complex speech on polluted days. “We apply textual analysis to convert over 100,000 verbal statements made by Canadian MPs from 2006 through 2011 into—among other metrics—speech-specific Flesch-Kincaid grade-level indices. This index measures the complexity of an MP’s speech by the number of years of education needed to accurately understand it. Conditioning on individual fixed effects and other controls, we show that elevated levels of airborne fine particulate matter reduce the complexity of MPs’s speeches. A high-pollution day, defined as daily average PM2.5 concentrations greater than 15 µg/m³, causes a 2.3% reduction in same-day speech quality. To put this into perspective, this is equivalent to the removal of 2.6 months of education.” Heyes et al 2019

• “Exposure to CO2 and VOCs at levels found in conventional office buildings was associated with lower cognitive scores than those associated with levels of these compounds found in a Green building.” – Allen et al 2016. The effect seems to kick in at around 1,000 ppm of CO2.

The entire (chilling) piece is eminently worth reading.

And on another related note– one going not to the quality, but to the quantity of life– this characteristically-great set of infographics from Flowing Data exploring the demographic reality that underlies our (directionally-accurate) contention that “40 is the new 30 [or whatever]”: “Finding the New Age, for Your Age.”

* President Trump, recounting the memory test he took (not to establish his mental acuity, as he seemed to suggest, but rather as part of a screening for senile dementia)

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As we agonize over aging, we might recall that it was on this date in 1909, off the coast of Cape Hatteras, that telegraph operator Theodore Haubner called for help from the steamship, S. S. Arapahoe.  He was momentarily confused because a new telegraph code “SOS” had recently been ratified by the Berlin Radiotelegraphic Conference to replace the old “CQD” distress call, and he wondered which signal he should send.  He sent both.  Haubner’s transmission was the first recorded American use of “SOS” to call for help.

august_11_araphoe

Clyde steamer Araphoe. Image from the Library of Congress.

 

 

“Not with a bang, but with a whimper”*…

 

death

Death Table from Tuberculosis in the United States, prepared for the International Congress on Tuberculosis, September 21 to October 12, 1908. Image: U.S. National Library of Medicine

 

Recent history tells us a lot about how epidemics unfold, how outbreaks spread, and how they are controlled. We also know a good deal about beginnings—those first cases of pneumonia in Guangdong marking the SARS outbreak of 2002–3, the earliest instances of influenza in Veracruz leading to the H1N1 influenza pandemic of 2009–10, the outbreak of hemorrhagic fever in Guinea sparking the Ebola pandemic of 2014–16. But these stories of rising action and a dramatic denouement only get us so far in coming to terms with the global crisis of COVID-19. The coronavirus pandemic has blown past many efforts at containment, snapped the reins of case detection and surveillance across the world, and saturated all inhabited continents. To understand possible endings for this epidemic, we must look elsewhere than the neat pattern of beginning and end—and reconsider what we mean by the talk of “ending” epidemics to begin with…

Contrary to hopes for a tidy conclusion to the COVID-19 pandemic, history shows that outbreaks of infectious disease often have much murkier outcomes—including simply being forgotten about, or dismissed as someone else’s problem: “How Epidemics End.”

* T. S. Eliot, “The Hollow Men”

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As we contemplate the end, we might send insightful birthday greetings to Nettie Maria Stevens; she was born on this date in 1861.  A geneticist– and one of the first American women to achieve recognition for her contributions to scientific research– she built on the rediscovery of Mendel‘s paper on genetics (in 1900) with work that identified the mechanism of sexual selection: its determination by the single difference between two classes of sperm—the presence or absence of (what we now call) an X chromosome.

220px-Nettie_Stevens source

 

“We can judge our progress by the courage of our questions and the depth of our answers, our willingness to embrace what is true rather than what feels good”*…

 

science

 

If one takes Donald Trump and his administration to embody modern conservatism, it is easy to see in their response to the coronavirus pandemic the right’s final divorce from science and expertise. There was the case of Rick Bright, the Health and Human Services scientist who claims that the Trump administration retaliated against him when he objected to the administration’s rapid push to distribute anti-malaria drugs that were largely untested for treating coronavirus patients. There are reports that the president for months ignored his own intelligence experts’ warnings that the virus threatened our shores. There was the ongoing drama over whether Trump would fire Anthony Fauci, who has headed the National Institute of Allergy and Infectious Diseases since 1984. And there was the president’s daily passion play—the White House press briefings where he’d stand next to scientists who grimaced as he speculated that the death toll was exaggerated and that sunlight inside the body might kill the virus.

The White House’s sorry Covid-19 track record has sparked a chorus of dissent recently distilled by New York Times columnist Michelle Goldberg, who argues that the crisis displays conservatives’ long-standing “antipathy to science,” owing to “populist distrust of experts, religious rejection of information that undermines biblical literalism and efforts by giant corporations to evade regulation.” But this narrative is too pat. While something is plainly amiss in the relationship of the Trumpian right to science, it is hardly as principled as the religious objections of, say, creationists opposing evolutionary theory. Neither is it straightforwardly hostile.

What’s more curious about the response by the president and his allies to the virus is rather their embrace of scientific expertise of a sort…

The story of the crisis is not quite that of scientists who knew the answers and one political party that just wouldn’t listen to them. Rather, it is a story of fracture—of conflict and confusion, of experts earning mistrust, of each side cultivating its own class of experts to own the other’s. It is also a perverse story of how a group of self-styled truth-telling outsiders turned science’s mythology against its institutions, warping it from a tool to fight the virus into a tool to attack the establishment.

How did we get here?…

Ari Schulman (@AriSchulman) explains how a new class of outsider experts is exploiting institutional failures and destabilizing knowledge: “The Coronavirus and the Right’s Scientific Counterrevolution.”

TotH to Byrne Hobart, who notes (in his nifty newsletter, The Diff):

… this essay obviously takes a side, but it tries to be fair to the side it disagrees with. Which means there are two Straussian readings: maybe it’s an essay about how science is on one side in an American political context, and the other side only makes vague gestures towards empiricism. Alternatively, it could be an essay on how science never answers political questions, but politics corrupts science. (Why doesn’t science answer political questions? Because you can’t build a coalition out of stating the obvious, but you can build one from denying it—if your beliefs are crazy, you can spot members of the ingroup. So most scientific questions are irrelevant to politics, and when they’re relevant, politics wins by default in the short term, even if it loses long-term. To build a coherent and healthy ingroup, you need beliefs that are crazy but don’t lead to bad decisions.)

Pair with another of Hobart’s suggestions: “On Cultures That Build” (and the reasons why, the author argues. the U.S. is not one).

* Carl Sagan

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As we commit to learning, we might note that today is the birthday of not one but two extraordinary mathematicians:  Gottfried Wilhelm Leibniz (1646; variants on his date of birth are due to calendar changes), the German  philosopher, scientist, mathematician, diplomat, librarian, lawyer, co-inventor, with Newton, of The Calculus, and “hero” (well, one hero) of Neal Stephenson’s Baroque Trilogy…  and  Alan Turing (1912), British mathematician, computer science pioneer (inventor of the Turing Machine, creator of “the Turing Test” and inspiration for “The Turing Prize”), and cryptographer (leading member of the team that cracked the Enigma code during WWII).

Go figure…

Turing (source: Univ. of Birmingham)

Giambattista Vico was also born on this date in 1668.  A political philosopher, rhetorician, historian, and jurist, Vico was one of the greatest Enlightenment thinkers.  Best known for the Scienza Nuova (1725, often published in English as New Science), he famously criticized the expansion and development of modern rationalism and was an apologist for classical antiquity.

He was an important precursor of systemic and complexity thinking (as opposed to Cartesian analysis and other kinds of reductionism); and he can be credited with the first exposition of the fundamental aspects of social science, though his views did not necessarily influence the first social scientists.  Vico is often claimed to have fathered modern philosophy of history (although the term is not found in his text; Vico speaks of a “history of philosophy narrated philosophically”). While he was not strictly speaking a historicist, interest in him has been driven by historicists (like Isaiah Berlin).

 source

 

Written by LW

June 23, 2020 at 1:01 am

“If you don’t have a plan, you become part of somebody else’s plan”*…

 

pscil

 

 

In 1955, a bank executive and a New York society photographer found themselves in a thatch-roofed adobe home in a remote village in the Mazateca mountains. Gordon Wasson, then a vice president at J.P. Morgan, had been learning about the use of mushrooms in different cultures, and tracked down a Mazatec healer, or curandera, named María Sabina. Sabina, about 60 at the time, had been taking hallucinogenic mushrooms since she was a young child . She led Wasson and the photographer, Allan Richardson, through a mushroom ceremony called the velada.

“We chewed and swallowed these acrid mushrooms, saw visions, and emerged from the experience awestruck,” Wasson wrote in a Life magazine article, “Seeking the Magic Mushroom.” “We had come from afar to attend a mushroom rite but had expected nothing so staggering as the virtuosity of the performing curanderas and the astonishing effects of the mushrooms.”

Appointing himself as one of the “first white men in recorded history to eat the divine mushrooms,” Wasson inadvertently exposed much of the Western world, and the burgeoning counterculture movement, to psychedelic mushrooms. On the other side of the globe, the Swiss drug company Sandoz received 100 grams of the mushrooms from a botanist who had visited Sabina on one of Wasson’s return trips. They went to the lab of Albert Hofmann (see here) the Swiss chemist who first synthesized LSD. In 1963, Hofmann traveled to Mexico with pills containing synthetic psilocybin, the active compound in magic mushrooms.

“We explained to María Sabina that we had isolated the spirit of the mushrooms and that it was now in these little pills,” Hofmann said during an interview in 1984. “When we left, María Sabina told us that these tablets really contained the spirit of the mushrooms.”

Hofmann’s pills were the first indication that while people can have spiritual and transcendent experiences from eating the mushrooms themselves, they can also have such experiences with a man-made version of just one of the mushroom’s compounds: psilocybin.

This development is particularly relevant today, as scientists study psychedelic mushrooms as potential treatment options for those who suffer from severe depression, addiction, and more. In clinical trials, such as those ongoing at Johns Hopkins University and Imperial College London, participants don’t eat caps or stems. They consume synthetic psilocybin, made in a lab by chemists in a way similar to how Hofmann first made his psilocybin.

It’s a necessary hurdle: Psilocybin mushrooms can be grown relatively easily, and aren’t expensive to produce. But researchers have to source their psilocybin from highly regulated labs because natural products vary, and researchers need consistency in chemical composition and dosage in order to do controlled studies. Clinicians need to know how much of a drug they’re giving to a patient, how long it takes to kick in, and how long it lasts; they also need to be sure their drug isn’t tainted with other chemicals. It also helps to be able to mass-produce large amounts and not be threatened by variables, like weather, that affect agricultural products.

As psilocybin moves closer to becoming a legal medicine meeting all the regulatory requirements, doctors won’t be writing prescriptions for mushroom caps or stems—and this will come at a certain cost. Johns Hopkins researchers have claimed they’ve paid labs $7,000 to $10,000 per gram of psilocybin, whereas the street price of magic mushrooms is around $10 per gram. Besides the cost of chemical materials, the steep sticker price comes from the labor required to adhere to the U.S. Food and Drug Administration’s strict drug-making standards, known as Current Good Manufacturing Practice.

It’s an unprecedented moment, and psychedelic culture must reckon with what it means for a magic mushroom to become a synthetic pill, to be picked up at your local pharmacy or from a doctor. There’s some wariness in the psychedelic community about what synthetic psilocybin represents: big business, questionable investors, and patents on experiences they think shouldn’t have a price tag or a profit margin. Since it’s a known natural compound, psilocybin itself cannot be patented, but the way it’s made and used can be. Already there are organizations applying for patents for their synthesis process, and innovators coming up with new ways to make large amounts of synthetic psilocybin, all seeking protection for their intellectual property…

The truth is, there is money to be made in psychedelics, and investors are flocking to back startups in the psychedelic and mental health spaces. The current antidepressant medication market was valued at $14 billion in 2018 and is estimated to grow to $16 billion in the next three to five years. Any drug company that can compete stands to become very wealthy…

As magic mushrooms make the shift from recreational drug to mental health treatment, patients won’t be eating caps and stems, but a synthetic product made in a lab—one that pharma companies can patent and from which they can profit: “Get Ready for Pharmaceutical-Grade Magic Mushroom Pills.”

* Terence McKenna

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As we ponder the profound, we might recall that it was on this date in 1956 that city authorities in the California beach town of Santa Cruz announced a total ban on the public performance or playing of rock and roll music, calling it “detrimental to both the health and morals of our youth and community.”

It may seem obvious now that Santa Cruz’s ban on “Rock-and-roll and other forms of frenzied music” was doomed to fail, but it was hardly the only such attempt. Just two weeks later in its June 18, 1956 issue, Time magazine reported on similar bans recently enacted in Asbury Park, New Jersey, and in San Antonio, Texas, where the city council’s fear of “undesirable elements” echoed the not-so-thinly-veiled concerns of Santa Cruz authorities over the racially integrated nature of the event that prompted the rock-and-roll ban… (source)

rock ban source

 

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