SGU Episode 362

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SGU Episode 362
23rd June 2012
(brief caption for the episode icon)
SGU 361                      SGU 363
Skeptical Rogues
S: Steven Novella
B: Bob Novella
R: Rebecca Watson
J: Jay Novella
E: Evan Bernstein
P: Perry DeAngelis
Guest
Z: Professor Zhong Lin Wang
Quote of the Week
I believe in nothing, never have, never will. What matters is what I can see, hear, smell, taste, touch. Tangible things, physical things, reality. The rest is imagination.
Wolverine
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Introduction

You're listening to the Skeptics' Guide to the Universe, your escape to reality.

This Day in Skepticism (0:39)

History.com: Hudson set adrift by mutineers

News Items

Mystery Carbon Spike (6:17)

Nature: Mysterious radiation burst recorded in tree rings

Younger Dryas Impact (10:17)

The Daily Mail: Meteorite storm 'smashed the Earth 12,000 years ago and killed off a prehistoric people'

Liberation Procedure Study (16:05)

Science-Based Medicine: Liberation Procedure for Multiple Sclerosis

S: So I have a bit of an update on CCSVI. You guys remember what that is?

E: That's that show on CBS. They solve crimes.

S: Chronic cerebrospinal venous insufficiency.

E: Oh, that too.

S: So, in 2009, Dr. Paulo Zamboni, who's an Italian vascular surgeon, published a paper in which he claimed that 100% of MS patients that he investigated showed signs of venous blockage. And he concluded that--

J: Venous?

S: Yeah, so blockage in the veins that drain blood from the brain cause back pressure on those vessels and that leads secondarily to the inflammation and damage that we see in multiple sclerosis, in MS. This is a radical departure from the last 50 years of research into MS, which says that the inflammation is primary, that it's an autoimmune disease, although this isn't the first time that people have proposed these paradigm-changing hypotheses of what's really causing MS, but those have all crashed and burned over the years as well. The claim was met with immediate skepticism, as you might imagine. It's an extraordinary claim; it's like, "never mind those past 50 years of research; this one preliminary study I've found something completely different."

E: Yeah, just 'cause he found it in 100% of his patients; what'd he look at, three people?

S: No, he looked at a number of people, but the other wrinkle to this, which is-- doesn't mean he's wrong, but it does raise an eyebrow-- is that his wife has MS. He set out to find a cure for MS and he found one that happened to be in his specialty as a vascular surgeon. It's all a little convenient, you know what I mean? But regardless, the data was preliminary and... we had to say "OK, let's see if it's replicated." Over the last three years, his finding of 100% correlation was never replicated. And that was also, I think, a red flag. You know, 100%, we never see that in medicine; it's just too messy. Which suggests that there's significant researcher bias there, and if bias can explain some of the findings, maybe it can explain all of the findings. In any case, there have been a number of studies finding a range of percentages of patients with MS with some level of venous blockage, from 0% in some studies to like 20-40%, where most studies come down. However, healthy controls also have similar rates of venous blockage, or patients with other types of neurological disease that don't have MS. So, the correlation's very imperfect; it's highly variable; it depends a lot on what technique you use to look at the veins, because there's different ways you can look at it: Doppler, ultrasound, or MRI scan or angiography. The evidence, I think, overall is basically negative, but maybe there's some correlation with MS. What I suspect is that if this effect, which is much smaller than what Zamboni suggested-- if it is real at all, than it's probably incidental; it's just, yeah there's inflammation around the blood vessels and maybe that causes some scarred veins but it's not pathogenic, all right; it's not causing MS, it's just a consequence of it. What's really interesting from a skeptical point of view is that-- so you have a lone researcher proposing a radical new hypothesis based upon pretty flimsy evidence; it's not really being replicated very well; the data is mixed but tending to be generally negative, and it's being met with an appropriate level of scientific skepticism. But among a sub-group of MS patients, the reaction has been to conclude that this is the cause of MS, treatment of it is a potential cure, and it's being suppressed by neurologists to protect their sort of monopoly over MS, and of course, they're in bed with Big Pharma. Right, so this is--

B: Right.

S: Turf war and Big Pharma protecting their drug profits. Every article online about this issue is filled with comments from people saying: One, anecdotal evidence, which is worthless. "Hey, I got the treatment and I feel a little better." And two, raging conspiracy theories based on absolutely nothing. Meanwhile, there's actually been quite a bit of science on it in just three years for a theory that nobody really thinks is that plausible. There's been about a hundred or so actual studies of it, so it's actually been quite thoroughly investigated, which goes against the conspiracy-mongering notions that it's being suppressed or ignored or whatever. It's like, despite the fact that we don't think it's very likely, people are studying it just to make sure, to give it its due diligence. They're just not finding impressive results. There was one interesting study recently where they tied off the jugular veins in mice. So if you think back pressure from narrowing of the jugular veins is causing MS, you should be able to cause MS in mice by tying off their jugular veins. They did that; it caused nothing; it caused no problems, no back pressure, no demyelination, none of the kinds of findings or deficits that you would see in MS. So that's a pretty strong mark against it. It's also interesting, the different ways you could answer-- ask this question, you know, the animal model versus the clinical data. The news item here is that there was a recent study conducted in Canada, where patients have been the most vociferous in demanding this procedure-- called the "liberation procedure", opening up the veins, the blocked veins. The government essentially bowed to public pressure and allocated $400,000 to study this and now we're getting some preliminary results from this study; the data so far looked at 30 individuals with MS who got the liberation procedure, compared to 10 controls who didn't, and they found there was no benefit at all from the procedure. Interestingly, four of those patients actually had clots form in the jugular veins, so the jugular veins clotted off and became totally blocked after the procedure, which is one of the possible complications, and their MS did not worsen. So again, you would think, if MS was caused by the blockage, that would have been associated with the worsening. So, blocking off the veins didn't make it worse, opening up didn't make it better, pretty devastating evidence against the whole concept. And whatever you think about the concept, the treatment didn't work.

B: It reminds me of chiropractic, Steve, and why quadriplegics or paraplegics don't have multiple organ failure, because--

S: Yeah.

B: It's like, hello, that's kind of a death blow to your theory.

S: Yeah, if you think that the subtle subluxations and nerve impingements can cause organ failure, then what about people whose entire spinal cords are crushed? They seem to do fine. It's incompatible with subluxation, innate intelligence theory. I think the results of this study are fairly incompatible with Zamboni's MS theory. So, you know, it's being researched; it's being given more, I think, research attention than it really deserves, just from the plausibility of the science and the preliminary studies, because of the public interest, which raises an interesting question: how much scientific research, especially clinical studies like this, should be driven by public interest versus scientific plausibility?

J: I would say zero public interest.

S: Yeah, but then people are clamoring for this procedure and they want answers, you know?

J: Well, we all want answers to something, it just boils down to "where's the science".

R: Yeah, but whether or not it's true doesn't determine public interest, unfortunately.

S: I do think that this kind of data will marginalize it. My concern is that it's going to be marginalized but not disappear. So, historically for example, we can go back to the 1970s, when researchers proposed the notion--

B: Laetrile?

S: Well, you can go-- yeah, laetrile or psycho-motor patterning; you know, you can improve children who have developmental delay by passively taking them through the crawling stages to try to stimulate the brain to develop. Completely wrong; the studies showed it has zero effect, it doesn't work. It's still around today on the fringe; the scientists who came up with the idea just started their own institute and are still doing it today. So, in 20 years, is Zamboni or his acolytes going to be doing liberation procedures to treat MS on the fringe? You know, that's-- I'm interested to see if this is going to play out the same way. Or, when the data really comes back negative, is he going to acquiesce to the data and say "OK, it was a nice idea but I was wrong"? He doesn't seem to be--

R: Yeah, let's hope that Zamboni puts his theory on ice.

B: Ohhhh!

(laughing)

S: Waiting for that one, right? It would be really sad if this becomes a fringe treatment, but you know, the patients are seeking out the treatment despite the lack of evidence for it. It's also-- it's not risk-free; there have been two deaths in Canadian patients who have gotten the procedure; it can cause serious complications. So, it's not risk-free; if you do a risk-benefit analysis right now, the data is really against it. The FDA put out a warning saying, "don't do this; the risk versus benefit is not there."

Testing Female Athletes (25:48)

EurekAlert.com: Proposed testosterone testing of some female olympians challenged by Stanford scientists

S: Well, let's move on. Rebecca, you're going to tell us about testing testosterone levels in female athletes. We have the Olympics coming up, the Summer Olympics in London, so we're going to be seeing some news stories related to that.

R: Yeah. The Olympic committee has started this process in which they are hoping to implement a new rule that will police the gender of female athletes, more or less. This is a policy that was already implemented by the International Association of Athletics Federation last year in response to the 2009 case of Caster Semenya. But you might remember her, she is a teenage South African runner who beat her opponent so thoroughly that they demanded she be subjected to an investigation into her sex, and that resulted in months of embarrassment for Semanya as her personal private sex and gender identity were pretty much paraded through the mass media and subjected to much speculation. After eleven months of being banned from competition while that investigation was ongoing, the results came in and though they were kept private she was once again branded as female and allowed to compete. And she'll be running in the Olympics and frankly I'm hoping she beats everyone so thoroughly that they have to start a new campaign to decide whether or not she is human. (laughter)

E: Part cheetah.

R: Anyway, this new policy would require hormone testing for any woman accused of being too awesome. The test will try to determine if the woman's testosterone is too high, and if it is she'll either be banned from competition or else forced to undergo treatment that will lower her testosterone. And there are a number of serious problems with that, as many doctors and scientists have come forward to say. I'll detail a few of them. For a start, hormones do not solely determine sex. A woman with high testosterone is still a woman. As we've discussed on this show in the past, sex is a complicated matter that involves interplay between... It involves your chromosomes, your anatomy, your hormones, your brain. Just having high testosterone doesn't make you less of a woman. And a female brain deals with testosterone in a different way than a male brain. Secondly, there's no baseline for what a normal level of testosterone is for a high performing female athlete, so it's impossible at this point to determine what amount would be 'too high'. Thirdly, there's no evidence that higher testosterone in women is directly related to improved athletic ability. And fourthly, even if high testosterone in women did correlate to improved athletic ability, so what? High performing athletes are high performing athletes for a reason. Different people have different innate abilities. Basketball players aren't banned because of pituitary disorders that might give them an "unfair advantage" over shorter players.

E: As long as this person is not cheating, it should not be a problem. I don't see what the problem is.

S: Well, here's the problem. The problem is that sports treats gender in a binary fashion. You're either on the men's team or the women's team. But sex is not, as Rebecca was saying, it's not that simplistically binary. It's actually a complicated sort of a spectrum. So there's always going to be people that are going to fall in the gray zone, and then the sporting world is going to have to deal with how to assign them to the binary rules of you have to be either competing as a man or competing as a woman. So that's, I think... This issue is sort of running afoul of that inherent problem. There could be cases that are even more ambiguous, where it might actually be challenging to decide what exact criteria are we going to use to assign this person to compete as a man or a woman.

R: Right. I mean there are people out there who are intersex, but the thing is that they're so few and far between. And there have only been two instances in which an actual man was caught trying to masquerade as a woman in the Olympics. And intersex athletes are incredibly rare and there's no evidence to suggest that intersex athletes somehow are dominating the upper echelons of women's sports. So basically what's happening is the Olympic Committee is trying to solve a problem that doesn't really exist, using a test that won't work, and which will only subject top female athletes to public ridicule and scorn while preventing them from competing. I mean if you look at what happened to Semenya, she won a race and one of her opponents who came in sixth place was quoted as saying "These kind of people should not run with us. For me, she's not a woman. She's a man." And we're talking about...

E: Sour grapes, sour grapes.

R: Yeah, we're talking about a teenage girl. And if the Olympics adopt this policy, then literally every woman competing will be at risk of being forced to undergo testing and taking a temporary ban from her sport just because her opponents are bitter. And when a woman is temporarily banned, you can be sure that the media is going to blow it up and subject her to public scrutiny just like they did with Semenya. And this isn't the first time gender policing has come up in regards to the Olympics. IN the '60s, female athletes had to walk naked in front of a panel of experts who would determine their sex. That was replaced by chromosome tests...

B: Oh my God!

J: That sounds like Old Boy's Club type bullshit. "Oh, you must parade in front of us naked!" Yeah...

E: "Now gallop, now trot..."

R: Yeah, it's ridiculous.

S: The Pope needs to have his genitalia examined before he can become the Pope...(silence) Because a woman masqueraded as a...

E: That's an excuse! Come on.

R: There was a woman... yeah, a woman snuck in.

S: Do you guys remember Renée Richards?

B: Oh yeah.

E: Yeah, married to Sharlie Sheen [sic]? Oh, wait, that's Denise Richards.

S: Yeah, Renée Richards was born Richard Raskind, a man, and then had gender reassignment surgery and then tried to compete in tennis professionally as a woman. He was, or she at that time was banned from the U.S. Open, who sited an unprecedented Woman-Born-Woman policy. "You can only compete as a woman if you were born a woman". And that ban was then challenged and the Supreme Court ruled in her favor in 1977, so she was able to compete as a female athlete. And this is considered a landmark decision in transsexual rights.

J: Now that I'm an adult thinking back on that, you know, I don't know how fair that is now. Because there's a reason why they have men and women competing separate, and that's because there is a gap between the two in most strength-based sports. I don't know, what do you guys think. Is that fair?

R: Look at the top female athletes in the world. How many of them are transgendered or transsexual. You know, we're not...

E: Very, very few.

R: If any! We're not at all at risk of having transgender women overtaking cisgendered women in sports. It's just not going to happen, and certainly not going to inspire a bunch of men to go and undergo serious surgeries and hormone replacement therapies just so that they can compete against women. It's a problem that isn't even a problem, it doesn't exist, you know.

S: It's kind of a hypothetical problem, almost, but with the very rare cases cropping up.

J: Yeah, I'm just saying... in that specific instance an athlete had a sex change, but was still technically — and now we're getting into that discussion again about "What's the difference between men and women?" and is there a way to define that, but...

S: I know what you're saying, Jay, and there is no objective answer here. It comes down to some value judgments as to what you think is more important. And again, as Rebecca's saying, the cases are so rare, just erroring on the side of the individual, who may be either transgender or ambiguous gender or whatever, if they want to compete as a man or a woman and it's reasonable, let 'em, who cares? It's not a big problem, and I think it's a reasonable approach. Trying to be really strict on the gender definitions is kind of problematic and doesn't seem to be worth the heartache that it causes, you know, 'cause it's just not that much of a problem.

R: And look at how Renée Richards ranked. I just looked this up to be sure, but her highest ranking at the end of the year was 22nd. So, you know, she was a good tennis player. Did she dominate other women? No. There's nothing about her being born and labeled as a man that led to her getting some advantage over other women, it just didn't happen.

Interview with Zhong Lin Wang (35:28)

Ideas, Inventions and Innovations: Ancient Effect Harnessed To Produce Electricity From Waste Heat

Audible Podcast advertisement (48:54)

• http://audiblepodcast.com/skepticsguide

Who's That Noisy? (50:41)

(Answer to last week: Baby rhinos)

S: Evan!

E: Doctor?

S: You know what I'm gonna say.

E: I do! Has it been a week already since we played the last Who's That Noisy?

S: It has.

E: How time flies.

B: Seems like only a couple days.

E: It's true Bob. Well, I will remind you all by playing last week's Who's That Noisy. Guess what this is, here we go —

[high-pitched animal noises]

E: Alright, so what do you think that was?

S: Some kinda 'animalcule'?

E: Yes, good, good, keep going.

J: It was a bird. I think it was a bird. Remember last week I said…

E: No, not a bird, not a bird.

S: I think it was a vertebrate of some sort.

B: With fur.

E: Uh huh, yeah, yeah. Rebecca, any guesses?

R: Nope. (laughter)

J: (mocking Rebecca) Nope, nope.

E: I don't… It was a baby rhinoceros.

B: Whoa!

S: Really…

J: That's adorable!

E: And that, I mean, they sound cute and they look cute and these are cute animals, I've got to admit it.

S: Baby rhinos?

E: Baby rhinos.

B: It's funny, you think of a baby rhino but they probably weigh 350 lbs. They are impressive creatures. Driving by one of them? Oh my God, they are amazingly massive. Cool.

J: Oh yeah, they do everything big, everything.

E: And we're going to announce the winner of this weeks Who's That Noisy, ahh… next week. So we'll actually be announcing two winners next week.

B: Just because.

E: Alright, now, on to fresh news, on to new stuff. And… without… further… delay… or pause…

J: Evan, what the hell? Why do you… what's this big presentation? "AND NOW… WITHOUT FURTHER ADO… COMING TO YOU FROM MY COMPUTER TO YOUR EAR!" What is that? Why do you do that?

E: That's a fair question. Well, I queue up all the Who's That Noisys in this one little device I have and it takes time to switch over from one file to another. It's not an instantaneous thing, so it takes me a couple seconds. And, you know, the little box can be a little finicky sometimes and not queue up exactly immediately so I have to fill the air, you know. Dead air is no air.

J: Why didn't you say something? All this time I thought you were like "I MUST BE PRESENTATIONAL!"

E: AND NOW, TIME FOR MY ACTING REHEARSAL!

S: Actually, Jay, I usually edit that out, so our audience rarely hears any of Evan's delaying. I knew what he was doing, just delaying while he's queuing it up. I just edit it out.

J: Five… I'm sorry, seven years of Evan delaying.

E: And it's been puzzling you, keeping you up at night, wondering, thinking…

J: It didn't occur to me till right now that "What the hell is he doing? Like, what? Is this a wind up?"

E: "Is he trying to be cheesy deliberately?" No, no, I'm a slave to technology and these are the limits of technology.

J: Oh, I feel much better.

B: Is there a Noisy in our future?

E: Alright, it is in queue and I am ready to play it for your enjoyment. Guess Who's That Noisy?

[recording] There's no evidence of evolution from one species to another. There's microevolution within species, but not going from one species to another.

So go ahead, figure out who that is and send us your answer. You can email us at SGU Website or post on our forums at SGU Forums. And of course, as I say every week, and I mean it with all my heart: Good luck to everyone!

J: "GOOD LUCK EVERYBODY!" (laughter)

Questions and Emails (54:32)

Fetal Pill Update

A few weeks ago you referenced and discussed an article that came out of South Korea, concerning the seizure of shipments of pills that contained ground human foeti (correct spelling of the plural of foetus?) that had been sent from China. The comment was made and I'm sorry but I forget by whom, that aside from the lack of fact checking there was a lack of information to back up the Asian/Eastern medicine beliefs extending to human body parts. Those beliefs being, that the consumption of certain parts of humans provide medicinal benefits much in the way eating birds' nest soup or shark fin soup, or dried tiger penis will impart some sort of advantage. I have come across some information that would state otherwise. Now I recognize that it is coming from a tertiary source, but the research of this source tends to reputable. Joel Brinkley, Pulitzer prize winning author and journalist of "Cambodia's Curse" references just such a belief. His references is a Chinese bureaucrat sent to the Angkor kingdom in the year AD 1295 and 1296 by the name of Zhou Daguan. On page 21 of "Cambodia's Curse" Brinkley makes expressive mention of Cambodians, the Vietnamese (Champa) and others eating human body parts. There is even mention of this continuing well into the 20th century. The belief in various parts of the body being inhabited by spirits remains strong in Cambodia and other parts of SE Asia. This article from the Phnom Penh Post, provides further evidence and perhaps discussion: (link unavailable). So, presumably the feotal tablets are not inconceivable knowing the value ascribed to human life and those of others and the beliefs in certain types of medicine that persist here in Asia. I of course being a "barang" (foreigner) am not privilege to all of these beliefs and can only provide anecdotal evidence based upon my observations, but as I said before the pills made of human babies is possible. Thank you for your time and keep us thinking.

Greg Pellechi Phnom Penh, Cambodia

Science or Fiction (59:18)

Item number one. A recent review of evidence concludes that, contrary to common belief, fathers in centuries past were nurturing and heavily involved in child care. Item number two. A new study finds that children born to older fathers have a longer life expectancy. And item number three. A review of over 500 studies concludes that a nurturing and accepting relationship with one's father is often more important to healthy psychological development than with one's mother.

Skeptical Quote of the Week (1:14:31)

I believe in nothing, never have, never will. What matters is what I can see, hear, smell, taste, touch. Tangible things, physical things, reality. The rest is imagination.

J: Wolverine!