Month: April 2019

Mona Siddiqui’s Thought for the Day on Trump’s visit

I’ve said in my previous blog that I generally like Mona Siddiqui’s contributions to ‘Thought for the Day’ and find them among  the best in this often rather irritating genre. However, I had reservations about what she said today in talking about President Trump’s forthcoming visit.

She though that Jeremy C9rbyn and the Speaker were wrong to refuse the invitation to a dinner given in Trump’s honour.  We might disagree with his views but he would be a guest and the demands of hospitality require that we welcome him courteously.

Certainly hospitality is an admirable tradition in Islam – I’ve benefited from it myself in the past – but Trump is not just any guest and his visit raises complicated questions. We are extending the invitation for our own (commercial) reasons and he is accepting it for his – presumably not unconnected with his forthcoming attempt to be re-elected. This isn’t something I’d wish to increase the chances of happening.

I don’t know what reasons Jeremy Corbyn and the Speaker have for refusing to meet him, but if they are motivated by a reluctance to demonstrate even tacit support for his political ambition I can see their point. I like the attitude of the Mayor of Greater Manchester, Andy Burnham, who initially said he wouldn’t meet Trump but then changed his mind and said he would, in order to tell him why he disagreed with him.

As to what members of the public can do, I’d vote, not for demonstrating in the street but for simply  ignoring the visit as far as possible, or alternatively lining the route of his ceremonial progress up the Mall and maintaining complete silence.

Mind you, none of this would have arisen without Mrs May’s ill-advised invitation to Trump made soon after she became PM; just another of her many mistakes, but that’s a different story.

 

Book review: The Problems of Philosophy, by Bertrand Russell

This short book is over a hundred years old but it reads surprisingly freshly. All the same, it isn’t light reading. It tackles a number of philosophical questions, mostly connected with theory of knowledge. Although it’s intended for a non-professional audienc, Russell expects his reader to work quite hard. But the difficulties arise from the ideas themselves and not from Russell’s writing, which as always is clear and humorous. Worth the effort. Read more

How to save $HOME when reinstalling OpenBSD

Everything has gone wrong and you have to reinstall from scratch. It shouldn’t happen but it may if you do something silly – I once accidentally deleted /etc! But you have all sorts of stuff in $HOME that you don’t want to lose. Can you preserve it?

Well, of course, you should have a backup. I save one nightly on Tarsnap. But it may take a long time to restore from backup and it would be better if you didn’t have to.

Fortunately you can save your $HOME quite easily. Here’s how.

  1. When the Install process asks you to use disklabel, choose either OpenBSD or Whole Disk.

2. See which partition contains /home. Suppose it is ‘k’.Delete this with ‘d k’ and remake it with ‘a k’. Choose ‘No mount point’ (this seems to be the defalt at present).

3. Complete the Install process. When the system restarts,  edit /etc/fstab to mount the ‘k’ partition as /home.

It should work – it has worked for me. But if at all possible make a backup first, just in case it doesn’t.

 

 

Book review: Their Finest Hour, by Winston S. Churchill

This is the second volume of Churchill’s six-volume memoir of the second   world war. The dominant impression it gives is of how fine the margin was between victory and defeat. As Wellington said of Waterloo, it was a damn close-run thing. Like the first  volume, it’s enthralling reading.

Read the review.

‘Line of Duty’ spelling mistake?

In ‘Line of Duty’ on BBC1 the mysterious gang boss ‘H’ communicates his orders by text messages on a laptop. In Episode 3 one of these messages contained a spelling error, “definately”. Was this an oversight by the script writers or was it meant to be a clue to the identity of ‘H’ – a corrupt police officer who is lso semi-literate?

Acupuncturists: don’t be afraid of the placebo!

Critjcs of acupuncture always make much of the fact – and it is a fact – that clinical trials generally show little if any difference between so-called sham and real acupuncture. From this they conclude that acupuncture is “just a placebo”.But this statement conceals a lot and needs to be examined in more detail than is always done.

What is sham acupuncture?

So-called sham acupuncture often consists in inserting needles at “wrong” (non-acupuncture) points and/or penetrating only a short way, just below the skin. Another idea is to use a fake needle, in which a blunt probe recedes into the handle like a stage dagger. The trouble with all these techniques is that they all provide a stimulus to the nervous system; they are not neutral.

At most, therefore, they can compare more effective with less effective treatment. And they depend on the assumption that classic acupuncture points exist. That is, there are places in the body where a needle produces particular effects that would not be produced at a different site.

Many modern acupuncturists, of whom I am one, don’t accept the existence of acupuncture points in this sense. We therefore concede the critics’ case, at least in part; not that it makes no difference at all where a needle is inserted, but it doesn’t have to be done in the traditional way.

So are there any alternatives to sham? In a moment I shall suggest a couple, but first I want to take a moment to look at the placebo effect itself.

What is the placebo effect?

There seems to be a widespread idea that the placebo response is somehow unreal. It is supposed to depend on belief (probably untrue) and is not quite genuine in the way that the response to a drug is genuine. It’s “all in the mind”.

But if you think about it for a moment you will see that this can’t be right. It depends on the probably unspoken assumption that there is a ghostly mind hovering just outside the body and producing unreal effects by means of suggestion. But most scientifically minded people don’t accept this idea; they think of the mind as being a function of the brain. In a crude and probably misleading analogy, we could say that the brain is the hardware and the mind is the software.

On this view all mental phenomena are the result of brain activity. In that case the placebo effect depends on the brain and is quite as real as anything else the brain does. So even if acupuncture works partly at the mental level, this doesn’t mean that it doesn’t have a physiological basis.

At the same time we’d like to know more, and in fact there is a lot of evidence from other kinds of research to show that acupuncture has real effects. Here I shall mention two, which I discuss in separate posts. One is an interesting study carried out recently in Canada, and the other depends on the idea of using patients as their own controls.

 

 

 

CFS/ME fails to respond to rituximab

CFS/ME is a disease of unknown cause with no confirmatory tests. It is therefore diagnosed on the basis of its symptoms, which include physical and mental fatigue which may be of overwhelming severity. There is no curative treatment so it is is managed symptomatically.

One theory is that it is an autoimmune diseases  (one in which the body reacts against its own tissues). There have been reports of improvement when patients were receiving chemotherapy for lymhoma or cancer. Also, elderlly patients with ME/CFS have an increased incidence of B cell lymphoma. For these reasons it seemed feasible to try treating ME/CFS with rituximab, a medication that is used to treat certain autoimmune diseases and some cancers.

Unfotunately, a 12-month trial in 151 patients in Norway has not shown a positive effect.  Overall respone rates were 35.1% for placebo and 26.0% for rituximab. Twenty patients (26.0%)  in the rituximab group and 14 (18.9%) in the placebo group had serious adverse events. Few patient in either group showed major improvements and 10% got worse.

Limitations of the trial: the patients were self-referred and outcome measurements were based on self=reported symptoms over two years, so there was possible recall bias.

This is a disappointing result. But at least it’s good that serious research is being done in this baffling and often devastating disease. Up to now there hasn’t been very much, and the quality of what has been done has been rather uneven.

Source: Ann Intern Med doi:10/7326/M18-1451

 

 

Breast cancer screening questions

Should breast cancer screening be routinely offered to women aged over 70? For that matter, is routine breast screening desirable anyway? These questions are the subject of an important new BMJ  article by Susan Bewley and colleagues (BMJ 2019;364:!1293).

In 2009 Public Health England began recruiting millions of women to the Age Extension Trial of Breast Cancer Screening (AgeX). The trial has been criticised for its design, conduct, and lack of transparent scientific processes. which may render it not robust enough to inform policy decisions. Even more serious, “Participants’ understanding and consent to participate in research are not checked despite the risks of surgical and psychological harm.”

At the common-sense level screening for cancer looks like a stupide question to many people.  The earlier it’s caught, the better the chance of a cure, right? Well, that is debatable, at least for breast cancer. Many breasr cancers, particularly in older women, would never cause them any problems during their natuurl life span, so treating them will involve them in unnecessary surgery and quite probably inflict psychlogical harm that will last for the rest of their lives.

The balance of benefits and harms from breast cancer screening remain contested.  Three years after Age X began, an architect of the breast cancer screening programmes argued that deaths after treatment of screen diagnosed breast cancer may exceed those in an unscreened population.  In 2014. the Swiss medical board advised its government to stop recommending mammography screening.  In 2016, an open letter from French scientists who had conducted a consultation into France’s breast cancer screening called for a halt to screening for low risk women under 50, and an end or thorough review of the programme for women over 50.

This is reminiscent of the question of PSA screening for prostate cancer in men.

 

 

An eccentric method of writing blog articles?

When writing posts or articles that are to appear on web pages using programs such as LyX or WordPress it probably seems natural to simply start doing so directly, using the native editor of the program in question. I do this this if I’m writing a fairly short piece, perhaps one or two paragraphs. But if it’s a longer or more complicated text I prefer to do it in a more roundabout way, starting in Vim and pasting the material into LyX, WordPress or whatever later. (The exception is when I’m composing emails, but that’s because I have Mutt set up to use Vim as editor.)

This may seem a little eccentric but I’ve always found it makes my life easier. I’ve been using Vim for many years and it’s mostly second nature to me now. I can think as I’m writing, make quick changes – delete, add, move words, sentences, whole paragraphs – easily and quickly. I can instantly reverse changes I’ve made and undo those changes instantly as well. At the end I can do a spell check to look for typos.

The standard editors supplied by  the programs allow most of this too, of course, but a good deal less intuitively.  It’s more difficult to separate the words you writing from you are writing from how they are going to appear on screen or on the page. But these are different  things.

Writers are often asked whether they write in longhand or directly on the keyboard. People who write in longhand often say that physically shaping the words gives them a sense of creativity and immediacy that is missing if they type at the keyboard. It’s tempting to think that there may be something of an artistic snobbery element at work here, but that’s probably unfair; I think many people genuinely feel this sense of satisfaction in writing longhand.

I can understand this feeling but I don’t share it, perhaps because I associate handwriting with punishment. My handwriting was always a subject of criticism in my early school years, and later, minor infringement of rules was penalised by the requirement to write a number pages of script – always on blue paper, which had to be requested from one’s housemaster. This may well explain my dislike of writing by hand now. Anyway,there is good literary precedent for my view; two renowned authors, Henry James and Winston Churchill, used to dictate their books, although this is not something I’d want to do myself.

Whatever the reason, I find I write better and more fluently at the keyboard. At least for me, writing in this way probably does what writing longhand does for many others.

Qsf – a small fast accurate spam filter

There are plenty of spam filters available for OpenBSD and other BSD systems such as bogofilter or spambayes, but these tend to be overkill for a single user system like mine. Another possibility is bmf, which is described as aiming to be faster, smaller and more versatile than similar Bayesian filters. However, it doesn’t seem to have been updated since 2002 and I didn’t like it too much when I tried it out..

I prefer Quick Spam Filter (QSF), which I have used for a good many years – in fact, since before I changed from Linux to OpenBSD in 2014. Its last update was in 2015. I find that after training it is reliable, with only occasional false positives or negatives. It hasn’t been ported to OpenBSD but it compiles easily. It is available from its author.

The qsf documentation describes how to integrate it with procmail. I have a separate post with details of doing this with fdm.