August 14, 2025

A few good links for the not-quite-yet weekend mood

Enjoy.

August 13, 2025

📚 Finished reading: The Occasional Human Sacrifice by Carl Elliott

The Occasional Human Sacrifice puts faces, personalities, anxieties and neuroses to the names of people who acted as whistleblowers to some of the biggest ethical failures in clinical trials. Some are textbook, like Tuskegee or the Willowbrook hepatitis studies, but many were either new to me, or just barely registered when they were briefly covered.

Elliott was himself a whistleblower in the case of Dan Markingson so he is hardly impartial to their cause — caveat lector — but the cases presented seem truly egregious. And not all of them are ancient history: Paolo Machiarrini experimented on humans without oversight as recently as 2014.

The picture you get is bleak and does not fill one with confidence about clinical research anywhere in the world. Physician-scientists are careless at best, selfish profiteers at worst, people who sit on ethics committees are a bunch of box-checkers, institutions are insular and protective of their own. Of course, there is major selection bias going on: yes, institutions protect their own but then there are many of their members who are accused daily of misconduct by conspiracy theorists, biopharma lobbyists, and the occasional psychopath. Some IRBs are indeed approval mills, but then there are those which truly protect research subjects, though alas what they do doesn’t make it into a book. How to tell where the equilibrium should lie?

In fairness to the book, it does not pretend to be a grand unifying theory of what is wrong with medical research. It is a collection of vignettes, no more and no less, and as such is an important source of “real-world” information to the research community. It is also a big honking red flag to any person thinking to blow the whistle on wrongdoings medical or not: it is a difficult path to take, with no vindication at the end.

August 12, 2025

Is lithium deficiency an important factor in developing Alzheimer’s disease? A recent paper in Nature provides some convincing evidence, mostly from mice. For example:

Replacement therapy with lithium orotate, which is a Li salt with reduced amyloid binding, prevents pathological changes and memory loss in AD mouse models and ageing wild-type mice.

I know quite a few doctors who would say lithium (carbonate) deficiency is responsible for many behavioral issues in adults, but this is not what they had in mind! (↬Derek Lowe)

August 11, 2025

In the story of Spanish solar power, the FT finds a country with energy abundance and doesn’t like what it sees. A few choice quotes:

Pedro Sánchez calls his country a ‘global benchmark’ in the transition to greener energy, but prices — and profits — have plunged.

Spain has built so much solar capacity that at certain times of day it produces far more electricity than it needs. Prices have plunged as a result, dragging down owners’ profits with them.

Free power is gratifying for customers, but bad for generators.

Etc, etc. Good for Spain! The monetary matters will settle themselves out.

August 10, 2025

For your Sunday reading pleasure

There is banger after banger in the most recent weekend edition of the FT, which is apparently Steve Bannon’s favorite newspaper:

Cave turns to me. “So what’s your skill then, spinning stuff into a story?”

“No,” I reply. “My skill is keeping a straight face when someone tells me something, and inside I’m thinking: fucking hell.”

All gift links with limited activations, so enjoy while you can!

August 9, 2025

Well that was fast:

“At the FDA’s request, Dr. Vinay Prasad is resuming leadership of the Center for Biologics Evaluation and Research,” HHS spokesperson Andrew Nixon said. “Neither the White House nor HHS will allow the fake news media to distract from the critical work the FDA is carrying out under the Trump administration.”

Maybe lobbying isn’t as effective as I thought? I am sure there are stories to be told about what happened during these two weeks.

August 8, 2025

For your weekend reading pleasure

Happy Friday, etc.

August 7, 2025

Nori Parelius wrote a thoughtful article about taking notes, managing slip-boxes and “working with knowledge” in general. It matches my experience fiddling with various methods: what should be a playful exploration of ideas can easily become laborious bookkeeping. Caveat scriptor! (ᔥZettelkasten)

August 6, 2025

Mid-week links

August 5, 2025

Making lobbying great again

Here are a few good comments on what recently happened at the FDA:

V(inay) P(rasad)’s ouster was clearly death by lobbyists, but then they had plenty of fodder. The current administration does seem to be going for a mid-to-late 19th century vibe in many ways, and this is one of them. Sure, Ulysses Grant probably didn’t coin the word, but isn’t that the peak period when those who had the president’s ear could get things done quickly and blatantly? Whether that excites you or scares you, well, that depends on what kind of person you are and what you do for a living.

Selfishly speaking, it will be good to see VP back publishing oncology papers. Here is a recent one about informative censoring in clinical trials, with a lay summary here. More of that, please.