Friday Foolery #10. 6 x X-Rays

7 11 2009

“X-rays” were in the news this week, at least there was an illuminating exposure on Twitter. Here are 6 stories, half serious and half not so serious.

[1] First, voters have picked the X-ray machine as the most important scientific invention (objects in science, engineering, technology and medicine), in a poll to celebrate the centenary of the Science Museum in London. As a matter of fact medical inventions were in the top three places in the poll (1. X-ray machines 2. Penicillin and 3. DNA double helix), ahead of the Apollo 10 capsule (no. 4) and the steam engine (8).

BBC: http://news.bbc.co.uk/2/hi/health/8339877.stm
BMJ: http://www.bmj.com/cgi/content/short/339/nov05_3/b4602?rss=1

[2] Margaret Daalman came to hospital complaining of stomach ache – and one glance at her X-ray showed why:  the 52-year-old woman’s stomach contained an entire canteen of cutlery. She had to go under the knife to remove the (78!) forks and spoons. (see fotos here) The woman told the doctors: ‘I don’t know why but I felt an urge to eat the silverware – I could not help myself.’ She was somewhat picky however, as she never ate knives.
The images were actually taken over 30 years ago, but they were published for the first time this week in a Dutch medical magazine. Yes the woman was Dutch. At least according to the Daily Mail…….

However, the actual story published as a case in Medisch Contact is somewhat different.They actually state below the article:

Mededeling redactie

Over deze casus is in de populaire media foutieve berichtgeving gaande. De in andere media opgevoerde ‘mw Daalmans’ heeft niets te maken met deze casus. Het betreft, in tegenstelling tot wat elders wordt beweerd ook geen casus van 30 jaar geleden.

Which means something like: in contrary to what has been stated by the popular press this case has nothing to do with Mrs Daalmans, nor did it happen 30 years ago.
In effect, the Daily Mail mentions both (?) Rotterdam and Sittard as towns where this should have taken place, but in Medisch Contact only Helmond was mentioned. The towns are far apart.

One wonders why, because the story is extraordinary enough.

Daily Mail: http://www.dailymail.co.uk/news/worldnews/article-1223563/The-woman-knife--swallowing-entire-canteen-cutlery.html
Twitter: http://twitter.com/drves/status/5403151285
Medisch Contact: http://medischcontact.artsennet.nl/blad/Tijdschriftartikel/Bestek-in-de-maag.htm

[3] An obese man died after refusing an X-ray taken in a machine for zoo animals because he was too large for the hospital’s X-ray machine, the maximum capacity of most hospital machines being around 200 kilo. Later his wife told that the man felt too humiliated to go to the zoo.

The Local (Germany news in English, Bild.de.) http://www.thelocal.de/society/20091103-22993.html

[4] Todays Friday Funny post of dr. Val at Better Health is Joyful Radiology or Merry X-Ray

engrish-funny-merry-xray

Better Health: http://getbetterhealth.com/the-friday-funny-joyful-radiology/2009.11.06

[5] A special X-Ray: CAT-scan

4076270034_aa19e6dd2b cat-scan

http://www.flickr.com/photos/robinkearney/ / CC BY-NC-SA 2.0

[6] When both your arm and the X-ray are broken:

Cyanide and Happiness, a daily webcomicCyanide & Happiness @ Explosm.net

Ooh, I wonder whether the great number of X-ray related posts has something to do with the upcoming overlooked holiday: X-ray day (November 8th).

Can someone put the light off?

Articles by Zemanta

Reblog this post [with Zemanta]




Blue Ribbon Blog Rally for Free Speech Online; een Blauw Lint voor Vrijheid van Meningsuiting

26 04 2009

I have never been a person who would stoop to self-censoring and I never will be. I’d rather not write at all if I have to stop being frank and honest in my words. -Omid-Reza Mir-Sayafiblackribbonsign

Thanks to T at Notes of an Anesthesioboist for getting this going, a group of bloggers is holding a blog rally in support of Roxana Saberi, who is spending her birthday on a hunger strike in Tehran’s Evin Prison, where she has been incarcerated for espionage. According to NPR, “The Iranian Political Prisoners Association lists hundreds of people whose names you would be even less likely to recognize: students, bloggers, dissidents, and others who, in a society that lacks a free press, dare to practice free expression.” blackribbonsign-2

Hearing reports like these has prompted us to do a ribbon campaign. Blue for blogging.

Please consider placing a blue ribbon on your blog or website this week in honor of the journalists, bloggers, students, and writers who are imprisoned in Evin Prison, nicknamed “Evin University”, and other prisons around the world, for speaking and writing down their thoughts. Also, please ask others to join our blog rally.

Omid, incidentally, means hope in Farsi. Omid-Reza Mir-Sayafi is dead. Hope has to live on.

————————-

Text is from Notes of an Anesthesioboist and Paul Levy of Running a hospital

*********************************************************************

nl vlag NL flagI have never been a person who would stoop to self-censoring and I never will be. I’d rather not write at all if I have to stop being frank and honest in my words. -Omid-Reza Mir-Sayafi

Omid, incidentally, means hope in Farsi. Omid-Reza Mir-Sayafi is dead. Hope has to live on.

T van Notes of an Anesthesioboist heeft ander bloggers opgeroepen om deze week een blauw lint op hun blog te plaatsen. Blauw staat voor bloggen, vrijheid van bloggen wel te verstaan.

De aanleiding is dat de Amerikaans-Iraanse journaliste Roxana Saberi, die beschuldigd wordt van spionage en vastzit in Iran, vandaag haar “verjaardag viert” in een Teheraanse Gevangenis, alwaar ze in hongerstaking is gegaan.blackribbonsign-2

In de Iraanse gevangenis zitten honderden, veel minder bekende mensen gevangen: studenten, bloggers, dissidenten, en anderen die hun vrije mening durfden te uiten in een land dat geen vrije pers toestaat.

In navolging van T wil ik u daarom ook vragen om deze week ook een blauw lint op uw blog of website te plaatsen om alle journalisten, bloggers, studenten, en schrijvers te ondersteunen die gevangen zitten in de Evin gevangenis, ook wel “Evin Universiteit” genoemd, of waar dan ook ter wereld voor het vrij uiten van hun gedachten.

Wilt u ook anderen vragen om aan deze blogrally mee te doen?

Jacqueline.





Reference Management Software, Shut Down of 5 Google Apps and a Plane that Crashed.

18 01 2009

Reference Management software, shut down of 5 Google apps and a plane that crashed. What have they in common? Nothing, except that these three unrelated subjects all reached me via Twitter last Thursday eve.

[1] When I checked my Tweetdeck (a twitter client) I saw a huge number of tweets (twitter messages) about the crash of a plain in the Hudson river. It now appears that Twitter and Flickr broke the news 15 minutes before the mainstream media. Below is the first crash picture which was posted on Twitter from an iPhone, taken by Janis Krums from a ferry. Earlier (Twitter as a modern tam tam) I gave some other examples of Twitter as a breaking news platform.

jkrums-plaatje-voor-blog

[2] Twitter is also a useful tool for up to date information and exchange of thoughts. For instance some tweeple (people on Twitter) had been asking about free reference management software. I had retweeted (RT, resend) the message and Thursday eve DrShock (of Dr Shock MD, PhD) tweeted a very useful link to Wikipedia which compared all reference management software, which was retweeted to the Twitter community.

The wikipedia article gives a comprehensive overview of the following software: 2collab, Aigaion, BibDesk, Biblioscape, BibSonomy, Bibus, Bookends, CiteULike, Connotea, EndNote, JabRef , Papers, ProCite, Pybliographer, refbase, RefDB, Referencer, Reference Manager, RefWorks, Scholar’s Aid, Sente, Wikindx, WizFolio, Zotero.

The following tables are included: the operating system support, export and Import file formats, citation styles, reference list file formats, word processor integration, database connectivity, password “protection” and network versions.

Very useful (although not always accurate). See: http://en.wikipedia.org/wiki/Comparison_of_reference_management_software.

wiki-ref-man-system

[3] @Symtym (of the blog Symtym) had just learned me how to use Google Notebook to clip and collect information as you surf the web, organize the notes in notebooks and publish the public notes automatically to twitter via twitterfeed. I found it real handy and gathered some material to write a post about it.

But then came the news, brought to me by @Dymphie (of Deetjes (Dutch)), that Google decided to close many services, including Notebook as well as Google Video, Catalog, Jaiku, Dodgeball) or as ReadWriteWeb says it: “Google Giveth, and Taketh Away”. (see announcement on the Google Operating System blog).

google-stopt-met-aantal-zaken1

Although Google Notebook itself will remain, the active development will be stopped. Of course this was shocking for many faithful users, including me, Dr. Shock and many others (see comments here)

wtf-gn-is-going-down-shock

What are the alternatives? Soon @DrCris, author of several blogs including Applequack, tweeted on a solution soon to come: “Evernote is working on a Google notebook importer“. I heard great things about Evernote, many doctors seem to use it, so I might as well give it a try.

evernote-google-nb-importer

Diigo is also planning to make a GN importer (see here). Presumably other tools will follow soon.

Note added:

Two articles in Lifehacker give tips [1] “where to go when google notebook goes down” and [2] describe how you can import the entirety of your google notebook to ubernote (Thanks Dr.Shock.)

——————-

nl vlag NL flag“Reference Management software, shut down of 5 Google apps and a plane that crashed”. Wat heeft dit met elkaar te maken? Niets eigenlijk, behalve dat ik donderdagavond hiervan via twitter op de hoogte gesteld werd.

[1] Eerder gaf ik al voorbeelden dat twitter als een moderne tam tam werkt en vaak een primeur heeft. Donderdag was dat ook het geval. De eerste berichten van het neerstorten van een vliegtuig in de Hudson rivier kwamen via twitter binnen.

[2] Twitter is ook nuttig om informatie te delen. Deze week vroegen mensen naar gratis reference manager software. Ik twitterde dat door (RT of retweet) en donderdag kwam @DrShock (van Dr Shock MD, PhD) met een erg nuttige link naar een artikel in wikipedia. Vervolgens werd door ‘retweeten’ een groot aantal volgers op de hoogte gesteld

In het artikel wordt de volgende software vergeleken: 2collab, Aigaion, BibDesk, Biblioscape, BibSonomy, Bibus, Bookends, CiteULike, Connotea, EndNote, JabRef , Papers, ProCite, Pybliographer, refbase, RefDB, Referencer, Reference Manager, RefWorks, Scholar’s Aid, Sente, Wikindx, WizFolio, Zotero met betrekking tot de volgende punten: “the operating system support, export and Import file formats, citation styles, reference list file formats, word processor integration, database connectivity, password “protection” and network versions”.

Heel erg nuttig en overzichtelijk (in tabelvorm met kleurtjes). Zie: http://en.wikipedia.org/wiki/Comparison_of_reference_management_software.

[3] Van @Symtym (blog: symtym) had ik juist geleerd hoe ik Google Notebook kon gebruiken om teksten al surfende op het net te knippen, bewaren en verzamelen in kladbloks en vervolgens te publiceren op twitter via twitterfeed (berichten automatisch ingekort tot 140 lettertekens). Ik vond het ontzettend handig. Het is een ideale manier om snel informatie te organiseren om later te bekijken, om er een stukje over te schrijven en/of om direct met anderen te delen.

Maar toen kwam als donderslag bij heldere hemel het nieuws via @Dymphie (van Deetjes) tot mij dat uit verschillende Google applicaties de stekker zou worden getrokken. Ook uit Google Notebook. En daarnaast Google Video, Catalog, Jaiku, Dodgeball).

Google Notebook zelf zal nog wel even blijven, maar de ontwikkeling zal worden stopgezet. Natuurlijk is dit nogal een schok voor trouwe gebruikers. Eerst worden mensen geenthousiasmeerd om een nieuwe tool te gebruiken en vervolgens wordt deze hen weer ontnomen

Gelukkig twitterde @DrCris, auteur van o.a. Applequack, vrijwel direct dat Evernote werkt aan een Google notebook importeerfunctie. Ik heb erge goede dingen gehoord van Evernote en veel artsen gebruiken het, dus ik ga dat ook maar eens proberen. Diigo is ook bezig met het ontwikkelen van een GN importeerfunctie (zie hier). Waarschijnlijk zal dit wel navolging krijgen. Toch blijft het vervelend om steeds maar van tool te moeten veranderen. Maar misschien moet je dat op de koop toenemen bij gratis applicaties.

Achteraf toegevoegd

Twee artikelen in ‘Lifehacker’ gaan over dit laatste punt [1] “where to go when google notebook goes down” en [2] describe how you can import the entirety of your google notebook to ubernote (Met dank aan Dr.Shock.)





Yet Another Negative Trial with Vitamins in Prostate Cancer: Vitamins C and E.

15 12 2008

Within a week after the large SELECT (Selenium and Vitamin E Cancer Prevention) Trial was halted due to disappointing results (see previous posts: [1] and [2]), the negative results of yet another large vitamin trial were announced [7].
Again, no benefits were found from either vitamin C or E when it came to preventing prostate ànd other cancers.
Both trials are now prepublished in JAMA. The full text articles and the accompanying editorial are freely available [3, 4, 5].

In The Physicians’ Health Study II Randomized Controlled Trial (PHS II), researchers tested the impact of regular vitamin E and C supplements on cancer rates among 14,641 male physicians over 50: 7641 men from the PHS I study and 7000 new physicians.

The man were randomly assigned to receive vitamin E, vitamin C, or a placebo. Besides vitamin C or E, beta carotene and/or multivitamins were also tested, but beta carotene was terminated on schedule in 2003 and the multivitamin component is continuing at the recommendation of the data and safety monitoring committee.

Similar to the SELECT trial this RCT had a factorial (2×2) design with respect to the vitamins E and C [1]: randomization yielded 4 nearly equal-sized groups receiving:

  • 400-IU synthetic {alpha}-tocopherol (vitamin E), every other day and placebo (similar to the SELECT trial)
  • 500-mg synthetic ascorbic acid (vitamin C), daily and placebo
  • both active agents
  • both placebos.

Over 8 years, taking vitamin E had no impact at all on rates of either prostate cancer (the primary outcome for vitamin E), or cancer in general. Vitamin C had no significant effect on total cancer (primary outcome for vitamin C) and prostate cancer. Neither was there an effect of vitamin E and/or C on other site-specific cancers.

How can the negative results be explained in the light of the positive results of earlier trials?

  • The conditions may differ from the positive trials:
    • The earlier positive trials had less methodological rigor. These were either observational studies or prostate cancer was not their primary outcome (and may therefore be due to chance). (See previous post The best study design for dummies).
    • Clinical data suggest that the positive effect of vitamin E observed in earlier trials was limited to smokers and/or people with low basal levels of vitamin E, whereas animal models suggest that vitamin E is efficacious against high fat-promoted prostate cancer growth (20), but lacks chemopreventive effects (i.e. see [1,4] and references in [5], a preclinical study we published in 2006).
      Indeed, there were very low levels of smoking in the PHS II study and the effect of the vitamins was mainly assessed on induction not on progression of prostate cancer.
    • Eight times higher vitamin E doses (400IE) have been used than in the ATCB study showing a benefit for vitamin E in decreasing prostate cancer risk! [1,4]
  • Other forms of vitamin E and selenium have been proposed to be more effective.
  • As Gann noted in the JAMA-editorial, the men in both recent studies were highly motivated and had good access to care. In SELECT, the majority of men were tested for PSA each year. Probably because of this intense surveillance, the mean PSA at diagnosis was low and prostate cancers were detected in an early, curable stage. Strikingly, there was only 1 death from prostate cancer in SELECT, whereas appr. 75-100 deaths were expected. There also were indications of a deficit in advanced prostate cancer in PHS II, although a much smaller one.
    In other words (Gann):
    “how can an agent be shown to prevent serious, clinically significant prostate cancers when PSA testing may be rapidly removing those cancers from the population at risk before they progress?”
  • Similarly, in the SELECT trial there was no constraint on the use of other multivitamins and both studies put no restriction on the diet. Indeed the group of physicians who participated in the PHS II trial were healthier overall and ate a more nutritious diet. Therefore Dr Shao wondered
    “Do we really have a placebo group – people with zero exposure? None of these physicians had zero vitamin C and E” [7]. In the Netherlands we were not even able to perform a small phase II trial with certain nutrients for the simple reason that most people already took them.

What can we learn from these negative trials (the SELECT trial and this PHS II-trial)?

  • Previous positive results were probably due to chance. In the future a better preselection of compounds and doses in Phase 2 trials should determine which few interventions make it through the pipeline (Gann, Schroder).
  • Many other trials disprove the health benefits of high dose vitamins and some single vitamins may even increase risks for specific cancers, heart disease or mortality [9]. In addition vitamin C has recently been shown to interfere with cancer treatment [10].
  • The trials make it highly unlikely that vitamins prevent the development of prostate cancer (or other cancers) when given as a single nutrient intervention. Instead, as Dr Sasso puts it “At the end of the day this serves as a reminder that we should get back to basics: keeping your body weight in check, being physically active, not smoking and following a good diet.”
  • Single vitamins or high dose vitamins/antioxidants should not be advised to prevent prostate cancer (or any other cancer). Still it is very difficult to convince people not taking supplements.
  • Another issue is that all kind of pharmaceutical companies keep on pushing the sales of these “natural products”, selectively referring to positive results only. It is about time to regulate this.

1937004448_dfcf7d149f-vitamines-op-een-bordje1

Sources & other reading (click on grey)

  1. Huge disappointment: Selenium and Vitamin E fail to Prevent Prostate Cancer.(post on this blog about the SELECT trial)
  2. Podcasts: Cochrane Library and MedlinePlus: (post on this blog)
  3. Vitamins E and C in the Prevention of Prostate and Total Cancer in Men: The Physicians’ Health Study II Randomized Controlled Trial. J. Michael Gaziano et al JAMA. 2008;0(2008):2008862-11.[free full text]
  4. Effect of Selenium and Vitamin E on Risk of Prostate Cancer and Other Cancers: The Selenium and Vitamin E Cancer Prevention Trial. Scott M. Lippman, Eric A. Klein et al (SELECT)JAMA. 2008;0(2008):2008864-13 [free full text].
  5. Randomized Trials of Antioxidant Supplementation for Cancer Prevention: First Bias, Now Chance-Next, Cause. Peter H. Gann JAMA. 2008;0(2008):2008863-2 [free full text].
  6. Combined lycopene and vitamin E treatment suppresses the growth of PC-346C human prostate cancer cells in nude mice. Limpens J, Schröder FH, et al. J Nutr. 2006 May;136(5):1287-93 [free full text].

    News
  7. The New York Times (2008/11/19) Study: Vitamins E and C Fail to Prevent Cancer in Men.
  8. BBC news: (2008/12/10) Vitamins ‘do not cut cancer risk’.
  9. The New York Times (2008/11/20) News keeps getting worse for vitamins.
  10. The New York Times (2008/10/01) Vitamin C may interfere with cancer treatment.








Huge disappointment: Selenium and Vitamin E fail to Prevent Prostate Cancer.

16 11 2008

select

October 27th the news was released that ([see here for entire announcement from nih.gov]

“an initial, independent review of study data from the Selenium and Vitamin E Cancer Prevention Trial (SELECT), funded by the National Cancer Institute (NCI) and other institutes that comprise the National Institutes of Health shows that selenium and vitamin E supplements, taken either alone or together, did not prevent prostate cancer. The data also showed two concerning trends: a small but not statistically significant increase in the number of prostate cancer cases among the over 35,000 men age 50 and older in the trial taking only vitamin E and a small, but not statistically significant increase in the number of cases of adult onset diabetes in men taking only selenium. Because this is an early analysis of the data from the study, neither of these findings proves an increased risk from the supplements and both may be due to chance.”

SELECT is the second large-scale study of chemoprevention for prostate cancer. Chemoprevention or chemoprophylaxis refers to the administration of a medication to prevent disease. The SELECT trial aimed to determine whether dietary supplementation with selenium and/or vitamin E could reduce the risk of prostate cancer among healthy men. It is a randomized, prospective, double-blind study with a 2×2 factorial design, which means that the volunteering men received either one of the supplements, b2x2-select-vierkantoth supplements or no supplements (but placebo instead), without knowing which treatment they would receive.
The trial volunteers were randomly assigned to one the following treatments:

  1. 200 µg of selenium and 400 IU of vitamin E per day. (both supplements)
  2. 200 µg of selenium per day and placebo
  3. 400 IU of vitamin E per day and placebo
  4. two different placebo’s (neither supplement)
    (µg = micrograms, IU = International Units)

Enrollment for the trial began in 2001 and ended in 2004. Supplements were to be taken for a minimum of 7 years and a maximum of 12 years. Therefore the final results were anticipated in 2013. However, but due to the negative preliminary results, SELECT participants still in the trial are now being told to stop taking the pills. The participants will continue to have their health monitored by study staff for about three more years, continue to respond to the study questionnaires, and will provide a blood sample at their five-year anniversary of joining the trial, to ensure their health and to allow a complete analysis of the study. (see SELECT Q & A).

In an interview with CBS, one of the investigators Dr Katz, said he was highly disappointed and concerned, because he had high hopes for the trial. “I”m disappointed with the study. I’m very concerned about the results of the trial.

more about “Vitamin E A Flop In Prostate Cancer T…“, (with 15 sec advertisement first) posted with vodpod. This video is derived from CBS news.

Dr. Klein, one of the principal investigators, has published as many as 14 publications on the SELECT trial (see PubMed). He has always been a strong advocate of this huge trial.

The question now is:
Was there enough evidence to support such a large trial? Could this result have been foreseen? Would the trial have had different outcomes if other conditions had been chosen?

The SELECT trial seems to add to the ever growing list of disappointing “preventive” vitamin trials. See for instance this blogpost of sandnsurf on “a systematic review of all the published randomized controlled trials (RCTs) on multivitamins and antioxidant supplements in various diseases, and their effect on overall mortality” concluding:

“Taking the antioxidant vitamins A (and its precursor beta-carotene) and E singly or in multivitamins is dangerous and should be avoided by people eating a healthy diet. On a diet like that recommended here, the intake of these and other important vitamins should be high, with no need for supplementation.”

Quite coincidentally I commented to Sandsnurf blogpost referring to the SELECT trial, 1 week before the bad outcome was announced):

Indeed, in many RCT’s vitamin supplements didn’t have the beneficial effects that they were supposed to have. Already in the early nineties, adverse effects of beta-carotene (higher mortality in smokers) have been shown in several RCT’s. Still, because vitamin E had an expected positive effect on prostate cancer in one such trial, vitamin E is now being tested together with selenium (2X2) in a very large prostate cancer trial. Quite disturbingly, 8 times higher doses vitamin E are being used (400IE) compared to the original study. If the Lawson study is right, the outcome might be harmful. Worrying.

It might be argued that it is easy to criticize a study once the outcome is known. However, this critique is not new.

Already in 2002 a very good critique was written by MA Moyad in Urology entitled: Selenium and vitamin E supplements for prostate cancer: evidence or embellishment?

Here I will summarize the most important arguments against this particular trial (largely based on the Moyad paper)

  • SELECT was based on numerous laboratory and observational studies supporting the use of these supplements. As discussed previously such study designs don’t provide the best evidence.
  • The incidence, or rate of occurrence, of prostate cancer was not the primary focus or endpoint of the few randomized controlled trials studies on which the SELECT study was based.
  • A 2×2 design is inadequate for dose-response evaluations, in other words: before you start the trial, you have to be pretty sure about the optimal dose of each supplement and of the interactive effect of vitamin E and selenium in the particular doses used. The interaction between two agents might be synergistic or additive, also with respect to any negative (i.e. pro-oxidant) effect.
  • Eight times higher vitamin E doses (400IE) have been used than in the ATCB study showing a benefit for vitamin E in decreasing prostate cancer risk! This is remarkable, given the fact that high doses of anti-oxidants can be harmful. Indeed, a prospective study has shown, that vitamin E supplements in higher doses (> or =100 IU) are associated with a higher risk of aggressive or fatal prostate cancer in nonsmokers.
  • Other forms of vitamin E and selenium have been proposed to be more effective. For instance dietary vitamin E (gamma tocopherol and/or gamma tocotrienols) might be more effective in lowering prostate cancer risk than the chemically-derived vitamin E (dl-alpha tocopherol acetate) used in SELECT. Also the used selenomethionine might be less effective than organically-bound selenium.
  • Selenium and vitamin E supplements seem to provide a benefit only for those individuals who have lower baseline plasma levels of selenium or vitamin E.
  • There may be other compounds that may be more effective, like finasteride, lycopene, statins (or with respect to food: a healthy lifestyle)

Katz said. “I would have hoped this would have been the way to prevent cancer in this country.”

Isn’t it a little bit naive to expect such huge effects (25% less prostate cancers) just by taking 2 supplements, given the thoughts summarized above?

In the interview, shown in the CBS-interview LaPook concludes “This is a major disappointment, but it is also progress. Because it’s also important to know what does not prevent cancer.”

Well I wonder whether it is ethical ànd scientifically valid, to do such a costly experiment with 35.000 healthy volunteers, based on such little evidence. Do we have to test each single possibly effective food ingredient as a single intervention?

SOURCES:
Official publications and information

– EA Klein: http://www.ncbi.nlm.nih.gov/pubmed/12756490
– Lippman SM, J Natl Cancer Inst. 2005 Jan 19;97(2):94-102. Designing the Selenium and Vitamin E Cancer Prevention Trial (SELECT). (PubMed record)
new2.gif The results of the SELECT trial are published in JAMA: Effect of Selenium and Vitamin E on Risk of Prostate Cancer and Other Cancers: The Selenium and Vitamin E Cancer Prevention Trial. Scott M. Lippman, Eric A. Klein et al SELECT)JAMA. 2008;0(2008):2008864-13, published online December 9th 2008.

– SELECT Q&A: www.cancer.gov/newscenter/pressreleases/SELECTQandA
– General information on SELECT http://www.crab.org/select/
– Information on Study design (from Cancer Gov.clinical trialsSWOG s0000) and from clinicaltrials.gov

– More information on study designs and the ATCB trial (on which this study was based) in a previous post: the best study design for dummies

NEWS
– CBS Evening News Exclusive: Vitamin E And Selenium Fail To Prevent The Disease In Large Clinical Trial, NEW YORK, Oct. 27, 2008
– Los Angelos Times; Vitamin E, selenium fail to prevent prostate
– Emaxhealth: NCI stops prostate cancer prevention trial. With many good links to further information





Nature science blogging conference

30 08 2008

There is official forum for Science Blogging in London, today. The event is organized by Nature Networks.

You can find the program and the attendees here.

AJCann of Science of the Invisible has summarized in this post how you can virtually follow this conference.

At this moment (saturday 11.45 am) you can follow the forum live here

HATTIP: Twitter : @AJCann, @Jobadge

———————————-

Vandaag is er een conferentie voor ‘wetenschapsbloggers’ in Londen.

het wordt georganiseerd door Nature Networks

Hier kunt u het programma bekijken.

Op dit moment (zaterdag 11.45 uur) kunt u het programma hier live volgen.

AJCann van Science of the Invisible heeft hier samengevat hoe u deze conferentie kunt volgen.

HATTIP: Twitter : @AJCann, @Jobadge





New OvidSP-release, Version 2 – Part I

21 08 2008

Thursday August 14th, the new OVID-release went live.

It seems that the release comes in two phases, the first focusing on workflow improvement and the second on new features (My Projects, a workspace area for saving and managing files, and Ovid Universal SearchTM, a cross-platform search) (see OVID-SP latest news ; OVID-SP-screenshots and blogpost of Michelle Kraft; follow this link to register for a webex course).

The following changes have now been implemented: (Note that I avoid the word ‘enhancements’, because I’ developed an allergy against the recent abuse of this term, although in this particular case “enhancement” may be justified)

* A new Multi-Field Search tab.
Makes me think of advanced search beta in PubMed, or searching in the Cochrane Library, just as it reminds Michelle Kraft of EBSCO-searching. Like Michelle says, this tab basically allows you to easily search for multiple things within multiple fields all at one time. Perhaps useful for the beginner, but not of much use to the advanced searcher, who knows the field codes by head.

* New and Improved User Workflow Tools

  1. Collapsible Search Aid box
  2. Results Manager is collapsible and available above and below the main search box
  3. Ability to move the Search History above the main search box, sort searches in ascending or descending order, and identify each search by search type
  4. Customize common limits on the main search page
  5. Ability to create, edit, and add multiple annotations to a citation
  6. Browse Books and Browse Journals links are now on the Select a Database page
  7. Browser support for adjusting font size
  8. When logged into their personal accounts, users will see their name and institution.

To begin with the last point, I was unpleasantly surprised that I had to fill in a whole list of details (name, address, institution) when I assessed one of my saved searches. With the emphasis on one. I’ve literally a few dozens of accounts, at least one for each patron. Should I fill in the patron’s name or mine?…each time? Dee (on twitter) said she just filled in 0 in most boxes. You can also press the back button.
OVID apparently requires this personally identifiable information for My Projects so you can create a community to collaborate with others later on.

But what an improvements! :) This is really what I had hoped for (see this post on the new OVID SP; and a previous one about Ovid causing RSI). ‘All’ boxes collapsible, and movable… Although I first didn’t succeed in moving the Search History, but via the OVID-SP-screenshots I found out that it was just a little grey square you had to press (with a pop-up if you move your mouse over it, see figure above). No more endless scrolling, no more pain in my wrists after a whole day searching. Almost, almost ideal… If..If …the Search Tip wasn’t so prominent. :( As I said before, the Tip (that never gave me any useful information) fills 1/3 of the search screen. Because of this, the unnecessary addition of the field “Search Type” and the broad columns, the search history itself comprises less than 1/4th of the screen. Thus it is difficult to keep a good overview over large searches (see for instance the screenshot and the video below )

Compare the “usual view”

with the search in “print” format

And see the original search in this ultrashort video:

I’m not the only one that dislikes the Tipbox. According to a recently finished survey on the original OvidSP-version redesign earlier this year the number one thing people wanted to change was to remove or hide the Ovid Tips (see PDF of Danielle Worster’s and Debbie Pledge’s poster here). Overall one of the main concerns was the usage of screen space by the new design including features- including the Tips on the right hand side and the new placement of Results Manager.

But, as Danielle points out at her (shared) blog The healthinformaticist, the response was quite heterogenous, what was “annoying” to one person was “fine” to another! And vice versa!

With Danielle I wonder how the recent changes will be perceived. Will the people who complained about the new interface be pleased with the new arrangements? And what about the people that just thought it was fine? And those who’s main frustration was the adaptation to the new interface? One librarian sighed at the MEDLIB-list: “what is the credibitiy of the library in promoting the 3rd Ovid advanced search version in less than a year over the relatively consistent PubMed interface?” It is interesting how perceptions can differ. Personally I find it much harder to explain why functionalities (like ATM!) change radically while the interface looks the same (and are therefore not noticed).

Isn’t it most important that adaptations represent (1) improvements, (2) preferably easy to understand? Of course there is a limit to the number of substantial changes and their frequency. We know that the second update of OvidSP version 2 lies ahead and I sure wish that it will be soon followed by a third one that brings us an optional TIP-box. I don’t hope that the suggestion raised at Danielle’s blog, that “the Tip-box was created for advertising (commercials?) to recover the cost of all these (unnecessary) changes” is true.
More basic changes concerning Reference Manager as discussed by Krafty are also welcomed, at least by me.

——————–

Afgelopen week, op donderdag 14 augustus, “ging de nieuwe OVID release in de lucht”.
De release gaat in 2 stappen. Deze eerste stap dient om het zoekproces te versoepelen, bij de 2e komen er nieuwe functionaliteiten bij (My Projects en Ovid Universal SearchTM) (zie OVID-SP nieuws ; OVID-SP-screenshots, blogpost van Michelle Kraft; en volg evt. deze link om u op te geven voor een webex instructie).

Dit zijn in grote lijnen de veranderingen:

* Multi-Field Search tab.
Een manier om tegelijk op verschillende termen in verschillende velden te zoeken. Misschien handig voor de beginner, maar voor een gevorderde die de commando’s kent werkt advanced search veel sneller.

* Nieuwe Tools

  1. Inklapbare Search Aid (nooit gebruikt)
  2. Results Manager inklapbaar; zowel boven als onder het zoekvak aanwezig.
  3. Zoekgeschiedenis verplaatsbaar, sorteren in op- of aflopende volgorde. Elk zoektype aangeduid.
  4. Algemene limieten op de hoofdpagina zijn aangepast .
  5. Mogelijkheid tot het maken van notitities bij een record.
  6. Browse Books and Browse Journals links zijn nu aanwezig op de “Select a Database” pagina.
  7. Grootte van het lettertype kan aangepast
  8. Na inloggen (op persoonlijk account) verschijnt naam en instituut.

Om met dat laatste te beginnen, ik werd nogal onaangenaam verrast dat ik een hele waslijst met gegevens moest invullen (naam, adres instituut, titel, beroep etc) toen ik één van mijn opgeslagen searches wilde openen. Met de nadruk op één. Ik heb namelijk tientallen accounts, tenminste 1 voor elke klant. Moet ik mijn of zijn/haar naam invullen? Elke keer opnieuw? Dee (op twitter) zei dat ze gewoon 0 in alle vakjes invulde. Je kunt ook ‘n pagina terug gaan in je browser.
OVID heeft kennelijk deze persoonlijke gegevens nodig voor ‘My Projects’ zodat je later een eigen samenwerkingsgroep kunt creeeren.

Maar wat een verbetering zeg, deze versie, geweldig! :) Hier had ik aan het begin van het jaar niet op durven hopen (zie bijv. dit bericht over OVID en RSI). Bijna alle vakjes inklapbaar, of verplaatsbaar… Hoewel het wel even duurde voordat ik door had hoe je de Zoekgeschiedenis nu kon verplaatsen (niet dat ik dat wilde, maar om ff te checku)… maar de OVID-SP-screenshots brachten uitkomst: je moest gewoon op een klein grijs blokje rechtsboven klikken (zie Figuur hierboven). De toelichting verschijnt als je er met de muis overgaat, maar dat moet je maar net weten.
Geen eindeloos gescroll meer, geen pijn meer in mijn polsen na een-hele-dag-Ovid-zoeken. Haast ideaal, ware het niet … dat de zoektip nog steeds zo prominent in beeld staat. Zoals ik al eerder heb gezegd neemt de (voor mij nutteloze) TIP 1/3 van het zoekscherm in horizontale richting in beslag. Daarnaast is in de zoekgeschiedenis ook nog een extra kolom toegevoegd (zoektype) en zijn veel kolommen onnodig breed. Resultaat: zoekactie wordt gecomprimeerd tot 1/4e van het scherm. Het is dan moeilijk om overzicht te behouden, het leest naar en je moet alsnog scrollen (zie fig en video hierboven).

Gelukkig sta ik niet alleen. Uit een recent onderzoek naar de tevredenheid van ervaren informatiespecialisten over de OvidSP-makeover begin dit jaar, bleek dat het verwijderen of verbergen van de OvidSP Tip met stip op nummer 1 van het wensenlijstje stond (zie hier voor poster van Danielle Worster en Debbie Pledge). In het algemeen was de ruimte-inname door het nieuwe design een veelgehoorde klacht.

Maar zoals Danielle op haar (gedeelde) blog The healthinformaticist vermeld, was de respons nogal uiteenlopend. Wat de een vervelend vond, vond de andere wel best!

Ik ben, met Danielle, benieuwd hoe men tegen de huidige veranderingen aankijkt. Zullen de mensen die klaagden over de nieuwe interface nu wel tevreden zijn? En de mensen die het allemaal juist prima vonden? Of diegenen wier grootste frustatie het steeds weer wennen aan de nieuwe interface was? Een informatiespecialist verzuchtte hoe je als bibliotheek nog geloofwaardig kunt zijn als je in minder dan een jaar 3x een nieuwe Ovid advanced search moet promoten terwijl PubMed redelijk hetzelfde blijft” Grappig hoe verschillend mensen tegen iets aan kunnen kijken. Zelf vind ik het veel moeilijker uit te leggen waarom een ogenschijnlijk identiek Pubmed achter de schermen toch de zoekactie anders uitvoert (ATM).

Is het niet het belangrijkste dat de veranderingen die doorgevoerd worden ook verbeteringen zijn en niet te moeilijk op te pakken? Natuurlijk is er een grens aan hoe veel en hoe vaak je een interface verandert. We weten dat er een 2e update van OvidSP version 2 in het verschiet ligt en ik mag hopen dat de 3e ons een optionele OvidSP-TIP brengt. Meer fundamentele veranderingen bijv. voor wat betreft Reference Manager (zoals gesuggereerd door Krafty zijn ook zeer welkom, zeker wat mij betreft.








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