Smartphone Apps for the Smart Cryonicist

As every modern consumer knows, smartphones are today’s go-to portable technology. Everything from GPS navigation to finding a good deal on your next meal or haircut right NOW to a wide variety of games and applications may be had at the touch of a button. But developers of smartphone applications (i.e, “apps”) are only just beginning to realize the true capabilities of having so much computing power in the palm of your hand. Indeed, the possibilities for health monitoring applications in combination with GPS location bodes well for cryonicists.

Until cryonics-specific apps become available, there are several existing applications useful to cryonics members and organizations. Here are some of the most interesting from the Android Market:

ICE (In Case of Emergency):   Emergency personnel look for ICE information in patient mobile phones. This ICE app has a couple of widget options and can be accessed even when the phone is locked. My favorite feature is the ability to put any special instructions (like the protocol from your Alcor bracelet) on the main screen. The app acts primarily as an emergency contact list. Your cryonics service provider should be #1, followed by family and friends who support your cryonics arrangements. Additionally, you may enter your vital stats, medical and dental insurance information, and any known allergies, conditions, and/or medications.

For those with “dumb phones,” just create a contact called “ICE” and enter your cryonics organization’s emergency number. Additional information about placing ICE  numbers in your cell phone may be found in this article by Fred and Linda Chamberlain.

Emergency Button: Emergency Button sends a distress signal with your coordinates to a defined recipient when pressed. This has obvious utility for all matters of personal safety, and can be used to alert your cryonics organization to emergency health situations as soon as they emerge.

Google Latitude: Latitude is a GPS location tracking app. It allows for various privacy settings and can be configured to share only with specific people. A cryonics organization could, with its members’ permission, use such an app for real-time location tracking.

These are just three basic apps that are commonly available and useful to cryonicists now. I hope to be updating this list as improvements in smartphone technology continue.

The healthy skeptic

Consumers are constantly bombarded with advice about health. Lower your cholesterol, avoid carbs, take dietary supplements, avoid Teflon, get a full body scan, etc. Such advice does not fall on deaf ears. Who does not want to remain healthy, look good, and extend life? Two other factors contribute to our eagerness to consume and follow health advice. First, the accelerating growth of knowledge in fields such as biology and biochemistry. Second, a reasonable assumption that if some chemicals and behaviors can harm us,  there must be chemicals and changes in behavior that can confer great benefits.

The role science plays in contemporary thinking about health is a double edged sword. On the one hand, it can be used to debunk grandiose claims about health by subjecting these claims to rigorous scientific investigation. On the other hand, the authority of  scientists can can be abused to support products or lifestyle changes for which there is little evidence. For many people and journalists, the phrase that “research proves” something is often enough to act on health recommendations, regardless of the nature and quality of the evidence. But it does make a lot of difference whether “research proves” means a small number of experiments in a test tube or a multi-country randomized human trial.

And that is where Robert J. Davis’ book The Healthy Skeptic: Cutting through the Hype about Your Health comes into play. What makes Davis’ book stand out over other books debunking contemporary health claims is that he gives the reader a set of solid guidelines to evaluate scientific statements about health in general. Another major strength is that the author does not single out one group of health hustlers but argues quite persuasively that misinformation about health is not confined to pharmaceutical companies or sellers of dietary supplements, but is rampant among government, non-profit organizations, and consumer activists as well. For example, as  the author writes about consumer activists:

Simply because they’re looking out for our welfare doesn’t necessarily mean that the public interest groups always tell us the truth. Rather than helping us, they can sometimes cause harm by frightening us unnecessarily and diverting our attention from risks that are far more important. As healthy skeptics, we need to apply the same scrutiny to their advice as we give to that from the industry-funded groups or anyone else.

The most “timeless” aspect of the book is the chapter where the author discusses the use and abuse of science in health. Before drawing our wallet or changing our diet, we can ask ourselves the following eight questions:

1. What kind of study is it (laboratory research, short-term human studies, randomized clinical trials etc.)
2. How big is the effect?
3. Could the findings be a fluke?
4. Who was studied?
5. Is there a good explanation?
6. Who paid for the research?
7. Was it peer reviewed?
8.  How does it square with other studies?

As should be clear from those questions, behind the phrase “research proves” are many shades of grey. As the author points out, the question of how a study squares with other studies is perhaps the most crucial question. There is so much (poor) research being published that almost any claim about health can be supported by scientific studies. Sellers of dietary supplements often exploit this by presenting only studies that “support” their recommendations. If health advice does not come with qualifications and/or opposing research conclusions are not mentioned at all, one should be very wary.

Perhaps the most important chapters for life extentionists are those on dietary supplements and “anti-aging doctors.” Davis gives a number of useful recommendations to evaluate claims about supplements:

– Verify “clinically proven” claims
– Don’t assume that “natural” means safe
– Be skeptical of claims that a souped-up or specifically targeted vitamin or mineral supplement is better than an ordinary one
– Don’t be swayed by weasel words (such as “maintains heart health” or “provides immune support”)
– Be wary of organizations or individuals who provide information about supplements and also sell them

When all is said and done, the book does not recommend any radical interventions to improve health or prolong life and sticks to the usual recommendations (don’t smoke, exercise, moderation in eating and drinking, etc.) This is not because of cynicism, but because the more radical claims are just not backed up by contemporary science.

Life extensionists and futurists may believe that they are mostly immune to wishful thinking and the marketing of snake oil but  they may be less immune to more subtle psychological (deadly) traps such as the belief that “this time, things are different,” or the naive assumption that all problems can be solved, given enough time and knowledge. Although progress in science can benefit from scientists that are committed to achieve  important goals like increasing the maximum life span or even defeating death altogether, in reality it is often hard to tell the difference between being motivated by such desires and simply assuming that they will be satisfied, and thus crossing the line into meliorist dogmatic belief.

An interview with the author can be found on the Amazon page for the book.

Gender differences in stroke treatment and prevention

Over the years, experimental science has developed a standard protocol for the testing of medical hypotheses using animal models which calls for the use of males only. Why? Because no laboratory scientist wants to deal with those pesky female hormones. Female hormone fluctuations are viewed as just another variable to be controlled (generally by excluding females altogether) — all the better for making interpretation of results simple and straightforward.

But, as common sense might dictate, it turns out that results from male-only animal models often give a less-than-accurate view of the whole picture when this research is translated and applied to treatment of disease in humans. Why? Because, as most people without a doctorate in physiology can tell you, physiological gender differences exist. Is it any surprise, then, that disease treatment and prevention should also be prescribed with these physiological differences in mind?

And so the buzz for the past few years in the medical community is the astonishing fact that stroke treatment and prevention are not the same in men and women. In labs that have recently begun to investigate these differences, drugs that were found to protect male brains against stroke in animal models did nothing to protect female brains. The major message behind all this press: doctors cannot continue to apply one-size-fits-all prescriptions for stroke prevention and treatment.

The real fact is that it is even more complicated than a “simple” physiological difference. Traditionally, cardiovascular disease has been viewed as a “man’s disease” (men have about a 19 percent greater chance of stroke than women). Accordingly, studies have found that women are less likely to receive prescriptions for blood pressure medications or be advised to take aspirin, both of which have been shown to reduce stroke risk. Strangely, women are less often treated after having a stroke, even though they appear to respond better to acute stroke treatment (such as tissue plasminogen activator) than men. So while men do indeed have more strokes, women are still more likely to die from stroke.

Women are also at increased risk if they take birth control pills, use hormone replacement therapy, have a thick waist and high triglycerides, or are migraine sufferers. And, contrary to anecdotal evidence, women appear to be less likely to go to the hospital at the first sign of stroke symptoms.

Oregon Health and Science University is at the forefront of research into gender differences in medicine, having developed the first research institute of its kind, the OHSU Research Center for Gender-Based Medicine. Given that Oregon recently ranked 46th out of 50 states for incidence of stroke deaths among women (as reported by Making the Grade on Women’s Health: A National and State-by-State Report Card, 2007), there is obviously a need for gender-based medical research to save the lives of women at increased risk of cardiovascular and other disease.

BioTime's quest to defeat aging

Unless you are a long-time cryonicist or a surgeon, you may not have heard of BioTime before. This company, recently profiled for its innovative stem cell research in Life Extension Magazine, is best known for producing the blood-volume expander Hextend, which was initially developed by Trans Time, an early cryonics company performing ultra-profound hypothermia research. Realizing the potential for Hextend’s conventional medical applications, BioTime was formed and, as they say, the rest is history.

These days, BioTime does its best to distance itself from its early history. As documented in this 2004 WIRED magazine article, BioTime prefers to downplay its (prior) relationship with Trans Time even though the association is well documented. Furthermore, their development of products like Hextend and its modification HetaCool, which can be used as a blood substitute to allow cooling to ultra-profound hypothermic temperatures for heart and brain surgery, as well as newly-developed HetaFreeze, a cryoprotectant solution used for long-term tissue and organ preservation at sub-zero temperatures, point to their cryonics past.

But things are changing at BioTime. Under the direction of CEO Dr. Michael West, and capitalizing on the highly successful sales of Hextend and related products, the company is now heading in a new direction: regenerative medicine. Dr. West, who received his Ph.D. from Baylor College of Medicine in 1989 concentrating on the biology of cellular aging, is pushing the envelope of aging research by developing new forms of stem cells that can be used to reverse cellular aging, perhaps eventually leading to the ability to reverse aging of the entire human body.

In “Regenerative Medicine Breakthroughs: Will BioTime Reset the Clock of Aging?” (November 2008), Life Extension Magazine documents Dr. West’s mission — to understand how to make somatic (i.e., body) cells immortal and then apply this technology to the treatment of aging and aging-related diseases. BioTime is now driven by the potential for stem cell therapy to repair and regenerate organs and tissues and, if possible, to radically extend human lives.

To understand the problem of cellular aging, we must first know what happens to cells as they age. One of the most important contributions in this field was first made by Alexy Olovnikov in the early 1970s, who proposed that the DNA sequence at the ends of each chromosome (called a telomere) shortened each time a cell replicated. Once the telomeres “ran out,” the cell stopped dividing. Olovnikov also theorized that germ (i.e., reproductive) cells, whose telomeres never shorten, do not age due to the production of an “immortalizing enyzme.”  Dr. West became so convinced of Olovnikov’s theory that he formed a company called Geron to investigate it further. As reported by Life Extension Magazine:

“Forty million dollars later,” West recalls, “the gamble paid off.” West’s group had in fact produced Olovnikov’s mysterious enzyme, now known as telemorase, because of its ability to continuously spin out the vital strands of telomere DNA that keep germ cells immortal.

However, getting telemorase into aging cells is easier said than done. Instead of attempting what basically amounted to gene therapy, Dr. West decided to take another route to cell immortalization: stem cell therapy. Because embryonic stem cell research has been so controversial, Dr. West and his team at BioTime are using a technique developed by researchers at Kyoto University to create stem cells from aged somatic cells. In this procedure, transcription factors are removed from egg cells and placed in somatic cells, which transform back into colonies of stem cells over a few weeks’ time, effectively reversing the aging clock in those cells. These cells are then called induced pluripotent stem cells (iPS). They function exactly like embryonic stem cells, but do not come from an embryo.

“And since numerous papers on iPS have now shown switching on the telemorase gene in these cells,” continues Dr. West, “I believe that within the next 12 months, the scientific community will have documented, for the first time ever, the reversal of aging of a human cell.”

Dr. West’s team at BioTime still has a long way to go, however. For starters, they are trying to figure out how those stem cells “decide”  what type of cell to become. With this information, the researchers can better direct stem cells in regenerative therapies to the correct tissue or organ needing repair. Reversal of aging of distinct cell populations could lead to reversal of aging of the entire human body.

Of course it should be noted that one of the many scientific feats cryonics depends upon to succeed is regenerative medicine: it would not be ethical or practical to revive an aged cryonics patient to live in a frail and diminished state. So it seems that BioTime may eventaully be reunited with its roots….

PLAC blood test for sudden cardiac arrest and stroke risk

Life Extension Foundation (LEF) unveiled a new blood test in an article in this month’s Life Extension Magazine (November 2008). Unlike cholesterol testing, which simply gives a measurement of high-density (HDL) and low-density (LDL) lipoprotein levels and provides little information about acute risk of stroke or heart attack, the PLAC® blood test “can accurately identify artherosclerotic plaque that is vulnerable to rupture,” essentially providing a direct assessment of sudden heart attack and stroke risk.

The PLAC® test, developed by diaDexus, Inc., provides this assessment by measuring levels of lipoprotein phospholipase A2 (Lp-PLA2), an enzyme that is directly involved in endothelial dysfunction leading to atherosclerosis (an inflammatory response of the blood vessel wall), plaque accumulation (build-up of lipid deposits inside blood vessels), and rupture (breaking loose of plaque which can then block a blood vessel, causing heart attack or stroke). The PLAC® test specifically measures Lp-PLA2 associated with oxidized LDL particles. In research studies, high levels of Lp-PLA2 have been determined to be highly specific for plaque inflammation: an elevated PLAC® test indicates an increased amount of inflamed atherosclerotic plaques and thus a higher risk of plaque rupture.

Because of the sensitivity and high specificity of the PLAC® test for such inflammation, the predictive value of the test for risk of cardiac arrest and/or stroke is higher than other markers for the prediction of acute events. Furthermore, the PLAC® test is inexpensive and convenient in comparison to CT and other imaging procedures since it involves only the collection of a blood sample.

In general, the PLAC® test is appropriate for those known to be at high risk for cardiovascular disease and stroke, and LEF recommends that it should be performed once a year in persons who are obese or are regular smokers, those with high blood pressure or cholesterol, type 2 diabetes, or a family history of stroke and coronary heart disease. The PLAC® test can be used to guide patient treatment options: from their article, the LEF panel “recommends that patients with high Lp-PLA2 levels be upgraded from moderate risk to high risk, or from high risk to very high risk. In these patients, a suitable goal is to lower LDL to 100 mg/dL in high-risk patients and to 70 mg/dL in very high-risk patients.”

The PLAC® test is currently the only blood test approved by the FDA to assess atherosclerotic risk for coronary heart disease and stroke. While this is useful for guiding patients in their use of known treatment options, it is not known whether lowering Lp-PLA2 itself will result in a reduction of this risk. A large study (IBIS-2 trial) is now underway to shed more light on this topic. In the meantime,  LEF claims that the PLAC® test is by far the most reliable, convenient, and inexpensive method for determining one’s risk of acute ischemic cardiovascular events and is undoubtedly a beneficial tool for helping patients to keep tabs on their risk level and to implement a more aggressive treatment strategy if indicated.

-=Get the PLAC® blood test=-

Revitalize aging feet

My mother, being a decidedly well put-together woman, impressed upon me the importance of self-care from an early age. She was obsessed with skin maintenance and especially careful to instruct me in hand and foot care. I was given my first bottle of moisturizer at the age of fourteen (“I heard your skin starts losing its elasticity at that age”) and vividly recall sharing in an invigorating bi-weekly foot soak and pedicure. Later on, after developing severely fallen arches (aka “flat feet”) and enduring the pain associated with that condition, foot care became an especially important part of my self-care routine and I have since become somewhat of a foot care proselytizer.

As such, I was delighted to see an article entitled “Revitalize Aging Feet: The Importance of Proactive Foot Care” in the latest issue of Life Extension Magazine. This article, by Dr. Gary Goldfaden, begins with a spiel that I also frequently employ, alerting readers to the fact that the feet are the most overworked and undercared for part of the human body. For these reasons, our feet are particularly susceptible to injury, fatigue, infection, and skin aging –more so as we age and they lose their protective fat cushioning and have been exposed to a lifetime of ultraviolet radiation.

But, as with most things related to the body, an ounce of prevention is worth a pound of cure. Preventative foot care can not only make your feet look better, it can also lessen pain and muscle fatigue, which ultimately makes your entire body feel better.

As Dr. Goldfaden points out, many commercial foot creams consist primarily of water, which only serves to “plump up” the skin, thus smoothing out wrinkles, for as long as the water remains. Additionally, many of these products also contain oils that can actually increase free-radical oxidation and accelerate skin aging! Fortunately, there are some natural products that can significantly improve the look and condition of the feet.

Essential oils such as eucalyptus and menthol are a great place to start. Eucalyptis oil contains a compound called 1,8-cineole, which helps facilitate the production of skin lipids (ceramides), an important factor in retaining moisture in the skin. Eucalyptus oil also serves to protect feet from microorganisms that cause odor and infection, and acts as a natural analgesic for soothing achy joints and muscles. Menthol is also an effective pain reliever, and has the added benefit of providing a cooling sensation which is very refreshing for tired feet. Both eucalyptus oil and menthol also have beneficial effects on foot circulation, increasing blood flow to the feet and promoting the delivery of oxygen and nutrients to the deepest layers of the skin.

Also discussed is tea extract, which is rich in anti-oxidants which can protect feet from oxidative stress and inflammation. Other properties of antioxidant tea blends, such as their vitamin C activity, are also believed to contribute to improved skin tone and structure by strengthening connective tissues. Squalene, found in olive oil, is a natural emollient that hydrates and nourishes tissue while also providing anti-oxidant effects and inhibiting the proliferation of microorganisms. Coconut oil has an abundance of medium chain triglycerides that are “almost identical to the medium chain fatty acids found in human sebum” and is also a proven antibacterial, antiviral, and antifungal agent. Last, but not least, shea butter is touted for its abundance of vitamin E, a powerful antioxidant that is known for its ability to diminish wrinkles and smooth skin tone. I have personally found that buying vitamin E oil from a pharmacy is also very cost effective and works wonders to keep my feet looking and feeling soft and supple.

While the LEF article is timely and full of good advice, I was somewhat disappointed that it did not discuss other aspects of preventative and therapeutic foot care such as wearing appropriately supportive shoes, inserts and orthotics, visiting a specialist in case of foot disorders such as flat feet or neuromas, and the benefits of massage and reflexology. Expect to see a follow-up at this blog covering these topics in the near future.

Gary Taubes and bias in nutrition science

In a recent blog post, Overcoming Bias reports that Gary Taubes, who has written much to further the idea that refined carbohydrates are a stronger contributing factor to overweight and “diseases of civilization” than dietary fat and cholesterol, has compiled his thoughts on the subject in a major 600-page work called Good Calories, Bad Calories.

Why is Taubes so interested in bias?  For several decades, it has been the conventional wisdom that dietary fat (and especially saturated fat) contributes to obesity, heart disease, and cancer.  Judging from Taubes’ exhaustive research — indeed, I’d be surprised if any other book examined bias within a particular scientific field in such detail — the conventional wisdom was based on unreliable and slender evidence that, once established and institutionalized in government funding, set a pattern of confirmation bias by which further research was judged (or ignored).

Related: The Entitled to an Opinion blog on bad cholesterol and political correctness.

Selection bias and dietary supplements

One problem in assessing the merits of taking a specific dietary supplement (ranging from vitamins to  exotic multi-ingredient compounds) is widespread selection bias in the documentation that is supposed to support the use of the supplement in question.  The sheer number of scientific studies combined with variation in research methodologies virtually guarantees that for every supplement a supporting study can be found. For example, the recent issue of Life Extension Magazine (August 2008) has an article on the multiple health benefits of melatonin with 81 references. All these studies discuss either the biochemical properties of melatonin or show beneficial effects. This is what is what is seen. What is not seen are the studies in which melatonin is not effective or has adverse effects.  Or the studies that never got published as a result of “publication bias.” Granted, melatonin seems to be a remarkably effective agent for a diverse number of conditions, including its use as a neuroprotective agent in stroke, but such selective presentation of biomedical research seems to be a mainstay in the marketing of dietary supplements.

Another limitation of such documentation is that the studies that are used to recommend the taking of a supplement often solely address the (short-term) effects of that compound on the medical condition in question. Although it would not be practical to report on all the studies that investigate (chronic)  administration of the compound on other systems in the body, such unrelated adverse effects should not be ruled out when considering prolonged use. It is a major leap from demonstrating beneficial effects of a compound in rodents and preliminarily studies in humans to “recommending” the use of that compound for prolonged use in humans. And it is a giant leap to go from such studies to combining different effective compounds in very high dosages in a single product.

Promoting the use of supplements with a hodgepodge of  encouraging in-vitro studies, small animal studies, and observations in humans is not necessarily wrong, nor constitutes deliberate selection bias. Human biochemistry is extremely complex, and rigorous  research would require enormous resources and longitudinal experiments.  In real life there is a need to make informed decisions based on the evidence at hand. Still, our current state of knowledge and our ignorance about how all that we know adds up for specific individuals should induce modesty and, perhaps, moderation. For those who take supplements as a means to radical life extension, making cryonics arrangements remains the irreplaceable  cornerstone of such a program because it increases the odds to reach a time where truly meaningful (molecular) life extension technologies will be available, aside from the protection cryonics offers against most “lethal” accidents.