Home Blog Page 13

Spotify Trapped? The algorithm is not what’s keeping you from new music

Nick Garratt
-
0
Spotify Trapped? The algorithm is not what’s keeping you from new music

It’s the end of the year and, as is becoming tradition, everyone’s social media is being flooded with Spotify Wrapped. This year I discovered Sleep Token and am furious with myself for missing them at Bloodstock back in 2022 (I did see them this year in Manchester, but the ordeal that was getting to that gig is a story for another day!).

And in another tradition almost as old as the Spotify Wrapped share, we are seeing the opinion pieces pouring out of every newspaper and blog feed about how we are all “trapped by the algorithm!!” And they all seem to follow the same rough outline:

Spotify is collecting all of our data. It knows what music we like, when we like to listen to it, what our friends listen to… and that is scary! Back in the good old days, we all used to go into music stores and pick up any random album we saw and thought the artwork was interesting, then we’d discover that, actually, we do like New Wave Indie Jazz! I’d share music with all my diverse friends, no two of whom had ever listened to the same band, and who constantly introduced me to something new. It was a glorious time of musical revolution! Then the algorithm came along, and now I listen to the same bands I have been listening to for decades and never find anything new – and that is the fault of the app, not me.

You can perhaps guess what my opinion of these opinion pieces is going to be. Let’s take a look at some of the claims and break them down…

Back in Good Old Days I’d constantly be finding new and interesting music!

Yes, this is probably true. When people think about this, they are usually thinking back to their teen years. You were developing your own tastes, your own means to listen to music – be that a record player, stereo stack, cassette player, Walkman, or even a CD-Walkman! Personal music devices were a game-changer (and no doubt had their own panic surrounding them).

You also had, for the first time, your own disposable income, perhaps from your first job, or maybe you got paid by your parents to do chores around the house. You were learning what bands or artists tickled that bit in your brain that makes you want to sing or dance.

You were also learning which ones weren’t your thing. I am a metalhead at heart and grew up during the 00’s Nu-Metal era. KoRn were the first concert I went to without an adult, Slipknot and Disturbed were my preferred weapons of choice against my mum’s Tina Turner and Celine Dion. I wasn’t interested in listening to Nelly Furtado or The Killers, because their music didn’t instil any great joy in me, not like System Of A Down did. Which brings me to my next point.

My friends introduced me to new music, not The Algorithm!

Again, this might be true, but why should it be any different now? My friends still introduce me to new music, and we use Spotify to do it. I share songs on social media that I like. I have a WhatsApp group full of people I met at festivals and we all share all the time: “What’s your favourite act from this year?”, “Anyone into Ren?”, “Zeal & Ardour’s new album isn’t great…” If you aren’t having these conversations with your friends anymore, maybe you should do something about it?

As for the suggestion that all our friends listened to different music – no, they didn’t. Musical taste was one of the things that helped form the “in” group. You look at Mods and Rockers, or Scallies/Townies and Moshers; the music was a defining aspect of the scene, along with the fashion. The fashion was usually a visual signifier that you were part of the same crowd, and a conversation could always be started with “so what bands are you into?” knowing there will be some common ground.

Having an app that works based on similar knowledge, by grouping artists that often appear on other users’ playlists together, means I get to discover Hilltop Hoods because my enjoyment of Watsky merged via Bliss & Esso. The algorithm helped me find a new favourite group! None of my friends were into Australian Hip-Hop, but other Spotify users were, and so it connected me.

I used to go to record stores and buy anything to hear something new, and the hit-and-miss was great!

I struggle to believe that all these bloggers and columnists were wandering around record stores, completely ignoring the genre signs above the sections of music, and buying stuff at random. Some claim that, as music journalists, they were doing this to find new music – but that isn’t how it works. Generally, a band/artist/record label/producer would reach out to music magazines asking for a review, and a journalist would be tasked with reviewing it. The journalists are rarely going out to find any random band to review, and never without a preconceived idea of their intent. That would be madness.

If you want to find new music on the app, just type in what kind of thing you want to look for, and the algorithm will spit out what people into that scene usually like. I just tried this with “alt-jazz” and that is not my thing, but now I know that for sure.

Good reasons to criticise Spotify

Spotify collects a lot of data, this is true. It massively underpays artists for their art (a typical stream of a song pays £0.003, hardly a living wage for the majority of musicians). They pay millions of dollars every year to platform a misinformation and disinformation podcaster in Joe Rogan.

The company will skew results for the artists that sign exclusivity contracts and punish those that fail to do so – make this the focus of your complaints about the algorithm. I am not saying that Spotify is incorruptible or even a good company. But the complaints around the algorithm giving people what they like are weak at best. If you got older and settled into your music choices, then that was a decision you made.

You have access to the world’s biggest music store, and you can listen to it all, any time you like. Choosing to press play on Oasis for the 100th time this year isn’t the algorithm pushing them on you, it’s you listening to your music. Don’t pretend you’d actually be into vampire-mall-punk if only the app gave you the opportunity to try it – stop blaming the algorithm, and just embrace being a 90s indie kid.

Lemme Purr: the celebrity-backed wellness gummies trading on intimate insecurities

Alice Howarth
-
0
Lemme Purr: the celebrity-backed wellness gummies trading on intimate insecurities

Much has been written about Gwyneth Paltrow, and her wellness brand, Goop. Much has been written in this magazine, in fact. Some of it has been written by me. But despite being the most visible of the celebrity wellness influencers, Gwyneth Paltrow is not alone – she’s joined by the likes of Elle McPherson (whose supplement powders, teas, tablets and elixirs, should perhaps have been as much of a red flag as her romantic relationship with Andrew Wakefield), Kate Moss’s (owner of Cosmoss, whose herbal teas claim to “protect against the stress, pollution and toxins our body is exposed to during the day”) and even beauty influencer Tati Westbrook, whose Halo brand offers supplements for hair, nails and skin. Even international treasure Gillian Anderson has dipped her toe into the wellness world.

If Paltrow was a trailblazer, hot on her heels was celebrity celebrity Kourtney Kardashian, founder of not one but two wellness brands. My initial introduction into Kourtney’s wellness empire was via her lifestyle platform Poosh, which has been roundly criticised for how closely it took inspiration from Goop.

POOSH is the MODERN GUIDE to LIVING YOUR BEST LIFE.

Our mission is to EDUCATE, MOTIVATE, CREATE, and CURATE a modern lifestyle, achievable by all.

I decided to launch Poosh because I felt that there was something missing in the healthy lifestyle space. Healthy living gets a bad rap; it’s as though if you care about what you put in — or on — your body, then you’re not sexy or cool. But this just isn’t true, and Poosh is here to prove just that.

I’m not alone in seeing the similarities to Goop – back in 2019, Elle magazine reported that Gwyneth Paltrow was aware of the comparisons, but had no issue with Kourtney or Poosh. In fact, the two have gone on to demonstrate their mutual appreciation by collaborating on the creation of a candle, called “This Smells Like My Pooshy” – a nod to Goop’s headline-baiting “This Smells Like My Vagina”.

However, Poosh is not Kourtney’s only venture into wellness – she is also the founder of a brand called Lemme. As the Lemme website explains:

I have tried so many different things and met with doctors, gurus, specialists, in pursuit of living my healthiest and most balanced life – from oversized supplements that are difficult to swallow to gummy vitamins that were ok on taste but not so good on ingredients, and I learned so much along the way! None of this made sense to me. Why can’t it be yummy and be good for you?

Lemme tell you, it can!

Meet Lemme – My new line of vitamin and botanical supplements I’ve created to become a divine part of your everyday life.

Lemme’s product range will be familiar to anyone who pays attention to supplement companies – with a product called Lemme Glow which is for skin, nails and hair, and Lemme Matcha for energy and metabolism, and Lemme Debloat for digestion, plus Lemme Chill, Lemme Sleep and Lemme Focus. But while many supplement brands sell (questionable) supplements for PMS or the menopause (and Lemme does have a “tincture” for PMS), Kourtney has gone one further, by going straight for the vagina.

Lemme Purr is the name of the company’s ‘vaginal health gummies’, which they claim are:

The purr-fect lemme: Clinically-studied SNZ-1969™ probiotics support vaginal health and freshness.* Supports healthy vaginal pH levels.* Supports vaginal odor.* Supports a healthy vaginal microflora.* Supports vaginal health.* Supports vaginal freshness.*

Note the asterisks, which follow every one of the claims, and which lead the eagle-eyed reader to a tiny statement at the bottom of the page (way below all the product info and the reviews) which reads

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Well, there’s that box ticked, I guess.

According to the site, Lemme Purr gummies contain:

  • SNZ 1969™ – “A clinically-tested probiotic (Bacillus coagulans), SNZ 1969™ is shown in clinical studies to support vaginal health, freshness and odor. This strain of probiotics is tested to survive the harsh, acidic stomach environment and make it to your digestive tract where they are most effective. Each serving contains 1 Billion CFUs of SNZ 1969 probiotics*”;
  • PINEAPPLE EXTRACT – “Lemme Purr has 100 mg of real Pineapple per serving”; and
  • VITAMIN C – “A powerful antioxidant and pro-collagen vitamin that is an essential nutrient to support immune system health, skin health and promote overall health and well-being.*”

Now, firstly and most importantly I want to make clear that we do not need to do anything to alter our vaginal freshness or odour. This is a social pressure put on people with vaginas about how the natural body smells and is complete and utter bullshit. The vagina is self-cleaning and needs no extra help. The vulva can be washed with a very gentle soap or soap free cleanser when you shower.

If you notice a change in your smell or your discharge you might have picked up a bacterial or yeast infection and should see a doctor (or self-treat if you’ve had them before and your doctor has advised you on self-treating). If you find you have skin problems, you can make sure you’re wearing cotton underwear, and wear jeans a little less frequently. But we don’t need special pills or supplements, or special soaps or wipes. In fact, wipes and soaps that might have chemicals not tested for the sensitive skin of the vulva can cause dry skin, increase the risk of minor tears and damage to the skin and increase the risk of infection.

A pile of blue jeans
Time to ditch them, at least for a while? Pile of Jeans by Marco Verch under Creative Commons 2.0

The vagina does have a microbiome – that is the set of healthy bacteria that live on the skin and help keep us in balance – and it is true that sometimes that microbiome can get out of whack. Sometimes, that’s because we’ve had a bacterial infection treated by antibiotics which have also killed the healthy bacteria.

There is some research into the use of probiotics for people who’ve had bacterial vaginosis treated with antibiotics, because a change in the microbiome can make it a little easier for a reinfection to take hold, but the evidence is in the early days and says nothing about prevention in people who haven’t already had an infection. According to the Cochrane Collaboration:

Despite the marketing and the benefits associated with probiotics, there is little scientific evidence supporting the use of probiotics. None of the reviews provided any high-quality evidence for prevention of illnesses through use of probiotics.

What’s more – the vagina mostly has a bacteria called lactobacilli. This is a completely different bacteria to the one in the Lemme Purr gummies. None contains the variety of lactobacillus that we find in a healthy vagina – instead, as the Guardian noted in a recent article, if these kinds of products contain any lactobacilli at all, it’s typically lactobacillus plantarum, lactobacillus rhamnosus or bifidobacterium animalis lactis. These are typically found in the gut, rather than the vagina – if they ever did manage to find their way into the vagina, there’s no evidence to say they’d be of any use there.

We have no good evidence these gummies help in any way, but it’s worth, as ever, considering if they cause any harm. I think the harm here is around the idea that you need to do something special to make your vagina appealing or keep it healthy. The vagina is pretty happy looking after itself, and the vulva just needs some gentle cleaning once in a while.

In fact, introducing special measures as often promoted by the wellness industry can actually cause harm to the vulva and vagina, by increasing the risk of skin damage, which increases the risk of infection. Or it can kill off the healthy bacteria that we know are good for keeping infections at bay in the first place. The gummies probably aren’t going to do that – but their existence feeds into the very idea that they are needed, and needlessly feeds into the insecurities so many women already have.

Author’s note: this article was originally written in September 2023. Since then, Lemme Purr has come under investigation by a class action litigation firm for allegedly deceptive marketing around their supplements.

Does pill packet branding change the placebo response, or is this just another placebo myth?

Mike Hall
-
0
Does pill packet branding change the placebo response, or is this just another placebo myth?

Even among scientists and science communicators, it’s often claimed that the placebo effect is powerful, clinically useful, and demonstrates the incredible control of the mind over the body. I would argue that this is not fully supported by the literature, which shows a placebo effect that is at best unreliable, and perhaps indistinguishable from bias.

One stark illustration of this was a study published in the New England Journal of Medicine in 2011, examining the placebo effect in asthma. This study has been discussed in some detail in The Skeptic before, but we can reiterate briefly.

Forty-six asthmatic patients were randomised to receive either a real inhaler, a fake inhaler, sham acupuncture, or no treatment. The real inhaler improved lung function by 20%; the other groups only showed around a 7% improvement. There was no placebo effect here, the fake interventions had the same effect as no treatment. The marginal improvements in those groups can be attributed to effects like regression to the mean.

However, when asked how much better they felt they were, patients told a different story. Recipients of both real and fake inhalers reported around a 50% improvement, despite the lung function tests showing there were no meaningful improvements for any of the sham groups. The discrepancy highlights the powerful role of bias: patients were reporting improvements they didn’t really have. Without the objective measurements for comparison, we might have mistakenly concluded that inhalers are a waste of time, since their sham counterparts are just as effective.

Another commonly cited benefit of the placebo effect is the effect of branding. One study used as a basis for claims like this was published in the British Medical Journal in 1981, under the title ‘Analgesic Effects of Branding in the Treatment of Headaches’, and authored by Branthwaite & Cooper.

Researchers recruited 835 women who reported using painkillers at least once a month and split them into four groups. The first group were given 50 aspirin in the packaging of a recognisable aspirin brand. The second group were given 50 aspirin in plain packaging labelled ‘analgesic tablets’. The third group were given 50 dummy pills, in the branded packaging. The final group were given 50 dummy pills labelled ‘analgesic tablets’.

Over a two-week period, the women were told to take two tablets from the box any time they have a headache. They should record how much better they felt after 30 minutes and then again after one hour. Scores were recorded on a six point scale: ‘worse’, ‘the same’, ‘a little better’, ‘a lot better’, ‘considerably better’, and ‘completely better.’

Branthwaite found that after one hour users of the unbranded dummy pills reported a mean pain relief of 1.78 while users of branded dummy pills reported a mean pain relief of 2.18. Unbranded aspirin scored 2.48 and branded aspirin scored 2.7. They conclude that branded tablets were significantly more effective than unbranded in relieving headaches, and that these effects were due to the increased confidence in obtaining relief from a well known brand.

Branded aspirin boxes on a shop shelf, "Aspirin regimen, BAYER, Buffered aspirin (NSAID) pain reliever. WOMEN'S Low Dose Aspirin with a Calcium Carbonate Buffer. 81mg. 60 coated caplets"
Bayer Aspirin Low Dose… for women! By Mike Mozart via Flickr, CC BY 2.0

I believe this conclusion to be overstated.

There are some methodological limitations in the study. Participants were recruited by going door-to-door, which means some participants may have known each other and been able to communicate about the study design. Branthwaite tries to control for this by requiring recruiters to skip ten houses after every successful sign-up, but the possibility remains.

The number of participants involved is good, but the duration of the study is relatively short. Moreover, when some women had not recorded any headaches over the two weeks, they were permitted to extend the trial for a further two weeks. The dummy pills were also not taste-matched to the real aspirin, so anyone familiar with the taste of aspirin, especially users of that brand, would be able to identify they were getting fakes.

The largest issue, however, is the conflation of an effect with a reported effect, a problem I understand to be common in the medical literature at large, not just in placebo effect research. While it may genuinely be the case that taking pills from a branded packet truly affords greater analgesia than an equivalent pill from an unbranded packet, it could equally be the case that taking a pill from a branding packet merely makes one more likely to report greater analgesia regardless of any true change in physiological pain.

The data in Branthwaite cannot tease these scenarios apart. Think back to the lung function tests: patients reported huge improvements in their lungs, apparently on the basis of bias alone, when actually there was no meaningful improvement. In Branthwaite, we have no objective measure to check against so we cannot be sure whether the reported differences between branded and unbranded pills reflect real pain relief.

It is fair to say that pain represents perhaps a unique case in placebo research, as there are completely fair and reasonable questions to be asked about whether a change in pain and a change in the perception of pain are meaningfully different. However, even the perception of pain is still different to reported pain. Patients could experience identical levels of perceived pain, and yet still report them differently because of the role of bias.

While this may seem like a trivial distinction, it has real-world implications. In 2016, Australian regulators fined Reckitt Benckiser, the makers of Neurofen, several million Australian dollars for selling identical painkillers branded and priced differently to target specific types of pain. Consumers were being charged a premium for products like Neurofen Tension Headache or Neurofen Period Pain, when the active ingredient and dosage were actually the same across variants.

Despite this, some advertising agencies continue to advocate for selling such products at inflated prices. They cite studies like Branthwaite to argue that Neurofen Period Pain would genuinely work better than regular Neurofen or generic ibuprofen for period pain, because of how it is branded. The placebo effect validates the claim, and so justifies the premium.

Many claims about the placebo effect assume that the placebo itself is responsible for the observed outcomes but, as these examples show, the effects we attribute to placebos are often a mix of statistical effects, patient bias, and other artefacts of the research process. For this reason, we should be both vigilant and cautious when evaluating the clinical relevance of placebo interventions.

Studying the promotion of health misinformation by the Bolsonaro government

Cesar Baima
-
0
Studying the promotion of health misinformation by the Bolsonaro government

This story was originally written in Portuguese, and published to the website of Revista Questão de Ciência. It appears here with permission.

Disinformation is, in the strictest sense of the word, the composition and dissemination of information that is knowingly false or misleading with the aim of influencing individuals, groups or public opinion in favour of strategic, political, ideological, economic or even personal interests. It is not new for people, companies, institutions and governments to deliberately lie, whether to protect themselves, attack, discredit or hinder opponents and enemies, promote their agendas or obtain some kind of gain or profit.

There is no shortage of historical examples. From the Allied operations that helped convince the Nazi leadership that the invasion of Europe would take place through the Calais region in World War II, to the oil industry’s struggle to first deny the harmful effects on public health of adding lead to fuels, and then global warming and climate change, to the tobacco industry and the link between smoking and cancer.

Until recently, disinformation initiatives were laborious and slow. But today, with the internet and social media, lies travel at the speed of light, reaching well-defined target audiences with surgical precision, or as weapons of mass destruction of truth, credibility or public trust in people, policies or institutions. It is no coincidence that in recent years we have seen the rise of several anti-science movements, from the seemingly harmless flat-earthers to the clearly dangerous anti-vaccine movement, as well as the advance of radical ideologies, notably the far right, and religious fundamentalism.

Two face masks, a white respirator and a blue surgical mask.
A 3M N95 mask and a basic surgical mask, which offers very limited protection against airborne viruses.

In an attempt to understand this phenomenon, however, a new science has also emerged. It is called “Agnotology”, the study of the production and promotion of ignorance, of how people, groups, communities or even entire societies can remain or are kept ignorant or oblivious to certain information and facts, and the interests that this serves.

This field already has its researchers in Brazil, such as Nayla Lopes, a PhD student in Political Science at the Federal University of Minas Gerais (UFMG). As part of her thesis, Lopes seeks to establish a link between denialism in the Covid-19 pandemic and a deliberate promotion of ignorance in the government of former president Jair Bolsonaro.

“My goal is to study people’s denialist behaviour regarding the pandemic,” she says. “Before, I had the impression that there would be a limit to this behaviour, that ensuring the survival of oneself and those one cares about would outweigh this denialism. But what we saw was that this limit being repeatedly exceeded. People risked their own lives and the lives of those they cared about in the midst of one of the biggest health crises in history.”

Question of intention

According to Lopes, one of the biggest challenges of agnotology is to determine the intentionality of the spread of ignorance. Fortunately for her – and unfortunately for Brazil – the former president himself did not shy away from offering evidence of this in relation to the pandemic, with measurable impacts on the number of cases and deaths from Covid-19 in the country .

On more than one occasion, for example, Bolsonaro confessed that he was “the only head of state in the world” to have gone against the main recommendations of experts and health authorities to prevent the spread of the disease, such as social distancing. At the same time, there is no shortage of examples of the times he encouraged people to gather in crowds, some of them at the worst moments of the pandemic in Brazil, when the country was recording thousands of deaths per day. These were events in which he also made clear his opposition to the use of masks, another fundamental non-pharmacological measure to try to control the spread of the virus.

“By repeatedly saying that he was ‘the only head of state’ who was against these non-pharmacological measures and using this as a kind of ‘badge of honor’, Bolsonaro only gives more proof of his intention”, considers Lopes.

This also includes the discourse of minimising the health crisis, such as the many times the former president referred to Covid-19 as a “little flu” that could be easily cured by a non-existent “early treatment”.

“Who expects the president of a country to lie blatantly?” asks the researcher. “This type of minimisation by a person whom the public looks to for information and leadership fuels a tendency to calm down and become less alert at the individual level. Which, in the case of the pandemic, has made people even more vulnerable to the disease.”

The result was a direct, and tragic, impact on pandemic statistics in Brazil: “It is no coincidence that we observed, for example, that places with a higher proportion of Bolsonaro supporters also had a higher mortality rate from Covid-19 .”

A graph showing the five countries with the most recorded deaths from Covid-19. US is top at over 200k, followed by Brazil at approaching 150k, India just under 100k, Mexico around 75k and the UK around 45k. 2020 data.
In 2020, the US had the world’s highest death toll with about 205,000 fatalities followed by Brazil on 141,700 and India with 95,500 deaths. Via BBC News (29 September 2020)

Furthermore, the former president did not act alone. It was not uncommon for Bolsonaro, members of his government, or his supporters to enlist supposed experts to try to legitimise his denialist discourse, in a typical disinformation tactic and further evidence of intentionality.

“When people first started talking about agnotology, the studies were about the tobacco industry and its strategy of spreading uncertainty and doubts about the relationship between smoking and cancer, the ‘merchants of doubt’ (a reference to the title of the book by science historians Naomi Oreskes and Erik M. Conway on the subject),” Lopes recalls. “And experts play an important role in constructing this discourse. The tobacco industry funded studies to sow doubts about the scientific consensus, and the oil industry followed suit with climate change, in a format that seeks to bring scientific legitimacy to the agnotological discourse. During the pandemic here in Brazil, for example, we had the so-called ‘Doctors for Life’, a group that gained notoriety by prescribing useless ‘Covid kits’ and defending nonexistent ‘early treatment’.”

Lopes explained for those studying agnotology, the process of promoting ignorance, disinformation is key. And it can come in many forms, not necessarily lies, such as the straw man fallacy or anecdotal evidence, causing confusion in the public’s mind.

“There is no need to lie to present a denialist framework of reality,” she emphasises. “During the pandemic, for example, Bolsonaro said he took hydroxychloroquine and got better from Covid-19. But he could very well have taken nothing and got better, too. It is not a lie that he got better, but it changes the focus of the issue. Personal experience is not necessarily a lie, but it is incompatible with the scientific method. It is all part of the tactic of sowing doubt, and thus science is discredited by agnotological agents.”

Documentary evidence

Another important aspect of the work, says Lopes, is the collection of documentary evidence of the deliberate promotion of ignorance by these agnotological agents. In the cases of the tobacco and oil industries, history has shown how they accumulated knowledge about the relationship between their products with cancer and climate change, respectively, and their actions in an attempt to cover up or confuse the issue. The Covid-19 pandemic, however, is a recent event, which initially makes it difficult to study with the benefit of time and distance.

Once again, however, the former president, members of his government and his supporters made the researcher’s work easier, leaving many traces of denialist actions. Lopes recalls that, while in the first wave of the pandemic it was still possible to have doubts about the best strategy to face the health crisis, from mid-2020 and the beginning of the second wave of Covid-19, it was already established that hydroxychloroquine did not work against the disease, and the search for a supposed “herd immunity” was not only illusory but dangerous, with the potential to cause thousands of deaths and the collapse of health systems.

“There are more than a thousand warning documents ignored by the Bolsonaro government ,” she says. “From the second wave onwards, it was already possible to distinguish what worked and what didn’t in preventing the disease. Even without a vaccine, it was already possible to alleviate the situation with non-pharmacological measures. The information was available. So much so that Boris Johnson in the United Kingdom, and even (Donald) Trump in the US, in a way corrected the course. Bolsonaro insists to this day that he was right, even in the face of the tragic numbers of the pandemic in Brazil.”

The Brazilian Senate’s pandemic parliamentary inquiry also helped to accumulate documentary evidence about the denialist actions of the federal government and its supporters during the health crisis. Among them, Lopes cites the attempt to change the hydroxychloroquine package insert, discussed in a meeting at the Planalto Palace, and the “Brazil cannot stop” campaign, also conceived and implemented by the presidential office via the Presidency’s Communications Secretariat (Secom).

“The idea of ​​all this was to mislead and confuse the public. There’s no way to say it wasn’t intentional”, he says.

Another example of this, the researcher adds, was the so-called Covid-19 “data blackout” promoted by the federal government. Back in June 2020, the Ministry of Health stopped releasing consolidated figures on the pandemic in the country, and then, forced by the Supreme Federal Court (STF) to provide the information again, manipulated the structure of the epidemiological reports to reinforce the government’s denialist discourse, such as with the decision to highlight the number of recoveries and minimise deaths. These decisions led Brazilian media outlets to join forces in a consortium to verify the information and ensure its credibility with the public.

“Information control is another aspect of this action. Not only the framing, but also the provision of basic information about the pandemic was neglected by the Bolsonaro government,” she says. “Even if people did not want to be guided by what political leaders said, they had difficulty informing themselves about the reality of the pandemic in the country so they could make their own decisions.”

Given this, Lopes believes he will have sufficient evidence to support the agnotological thesis of promoting ignorance in the Bolsonaro government that helped fuel the denialism of part of the Brazilian population in the face of Covid-19.

“Hydroxychloroquine, early treatment, herd immunity, people didn’t come up with these ideas alone,” she says. “Putting it all together, we have a very likely scenario of agnotological intentionality on the part of Bolsonaro, his government and supporters regarding the pandemic.”

Huge social media accounts glorify ancient architecture, while whitewashing the past

Mark Horne
-
0
Huge social media accounts glorify ancient architecture, while whitewashing the past

I’ve often walked down the street and wondered: why aren’t new buildings a bit nicer? To my personal taste at least, modern architecture feels rather drab.

Earlier this year, the social media platform formerly known as Twitter read my mind. I had a virtually blank, follow-free account on X for the purposes of following the UK election, and the algorithm wasn’t happy. What was I interested in? It tried references to TV shows I’d never watched, influencers that I’d never heard of, funny cat videos, even supposedly British humour, none of which secured my engagement. Eventually the algorithm hit on a series of accounts featuring laments on the architecture of days gone by, threads about great works of art, discussions about history and culture, and photos of buildings with structurally unnecessary but visually appealing flourishes.

Most of these accounts followed each other. It felt, briefly, like I’d discovered an active community of enthusiasts for aesthetically appealing architecture. Maybe there was something lovely on X after all. Then I noticed that many (though certainly not all) of these accounts featured varying degrees of enthusiasm for a lost time of imagined glory, traditional Catholicism, pseudoscience, right-wing politics, and Mel Gibson’s worst films…

One account that posts frequently about subjects likely to make a Skeptic reader wince is Culture Critic (1.5m followers). In amongst explorations of ancient Greek and medieval architecture and art by Bosch and Boticelli, one can find an essentially uncritical thread on the St Michael’s ley line – “The line reflects the epic final stroke of St. Michael’s sword that sent Satan to Hell” – and repeats of architectural myths about the golden ratio as it relates to the Parthenon and beyond.

Culture Critic doesn’t hide its enthusiasm for religion, so there is also understandable discussion of religious relics, including the ever-controversial Turin shroud, which in fairness has had two major studies this year reported in the news, one saying it could actually be 2,000 years old, the other that it definitely wasn’t created by imprints from a human body. Given the popular sympathetic coverage in mainstream media of the Turin shroud, I can’t really argue with this coverage.

A replica of the Turin Shroud in a Polish church, displayed under a Latin inscription "DISCIPULUS VIDIT SUDARIUM VIDIT ET CREDIDIT"
Shroud of Turin replica displayed in a Polish church. Photo by Krzysztof D. on Flickr. CC-BY-2.0

However, even in this area of interest, the account introduces errors that are sympathetic to the church. For example, the account has a long thread about the construction of cathedrals, which paints a picture of religiously inspired communities pulling together to achieve something extraordinary. One post says that “Most of the labor [to construct a cathedral] was ordinary townsfolk or local craftsmen, carving it all lovingly by hand.” This is not correct; the stonecutters who carried out some of the more advanced work were typically itinerant and went wherever there was paid work.

Culture Critic talks about community-wide enthusiasm for the creation of these multi-generational edifices, but we know that many local folk contributed unskilled or semi-skilled labour on the promise of forgiveness of sins – aka indulgences – and paid for the construction through enforced tithes. Church taxes, spiritual blackmail and workers going wherever the work was isn’t really “the general will of the people” as the account claims.

World Scholar (40k followers) also mixes curious historical errors with genuine archaeological wonders. One thread on ancient wonders suggests the Tower of Babel actually existed, and features a picture of the Colossus of Rhodes that is, perhaps, an order of magnitude too large compared to the actual statue.

Yet another account with curious historical errors is Thinking West (130k followers), which has threads that glory in Roman roads, Gothic architecture, and… feudalism! The account says that criticism of feudalism for limiting social mobility has “some merit, but is often overblown”, citing the following example:

William Marshall became the most prominent knight in England despite being born into a relatively obscure family. His martial feats made him a legend, and he went on to knight two kings and take custody over Henry III before the young king came of age.

The word relatively is doing some heavy lifting here. William Marshall’s father John was an Anglo-Norman nobleman who was Marshall of England under Henry I. John held lands in Somerset and Berkshire, property in Winchester, and two castles in Wiltshire, before William was even born. The average Hollywood nepo baby would be green with envy for such a warm connection. Thinking West goes on:

Serfs had it tougher, but by the late middle ages were granted increasing liberties, and a gradual shift from serfs to landowning peasants occurred. In England, a middle class emerged called “yeoman,” who were often minor landowners, guards, or subordinate officials.

This at least acknowledges that serfdom was bad, although “had it tougher” understates it. Serfs could not permanently leave their village, marry, or change their job without permission, and were often treated harshly without any avenue of redress. And pointing out that serfdom declined over time is not a defence or mitigation of feudalism. The end of serfdom was an important step towards the end of the feudal system more generally. The suggestion that feudalism’s negatives weren’t so bad because eventually one of the key negative aspects of feudalism declined isn’t a great defence of the feudal system.

While there’s an obvious danger in all this – users engaging with the delightful pictures and the interesting slices of history, and then being misinformed or drawn into certain ideologies along the way – there’s also an interesting overlap in the opposite direction.

For example, Culture Explorer (77k followers) mixes odes to Braveheart as the “most quintessentially masculine movie” and enthusiasm for the children to be educated towards the Classic Learning Test (whose exams “draw heavily from the Catholic intellectual tradition”) with stunning pictures of palaces, cathedrals and modern-classical sculpture. But the account also features a passionate thread about the most bike-friendly cities in Europe, to generally positive engagement from its followers.

And, to be absolutely clear, many of the accounts within this community are uninterested in politics, religion or pseudoscience. Mediterranean Aesthetics (278k followers) features very little other than lovely pictures of the Mediterranean. Cultural Tutor (1.7m followers) is as enthusiastic about classical music, art and history as some of the aforementioned accounts, but with the added bonus of sticking to the facts and evidence. I’m not an enthusiastic user of social media – obviously, otherwise I’d have active accounts! – but it seems to me there’s still value for Skeptics in engaging with X, for those who can face it.

As to my original question – why modern architecture seems to be dull and missing stylistic flourishes – there are lots of opinions available, from staying bland in order to satisfy the largest number of people and incidentally saving a few quid for the property developers, to a sense of powerlessness causing apathy on the part of the general public. Perhaps, in 2024, we get the architecture we deserve.

Left-wing conspiracy theories and ‘missing’ votes in the wake of Trump’s election win

Dave Hahn
-
0
Left-wing conspiracy theories and ‘missing’ votes in the wake of Trump’s election win

My subject of interest is conspiracy theories. I’ve written 20 articles for this site and only a few are about something other than conspiracy theories. I’ve never really encountered a lack of material for the subject; conspiracy theories exist about everything and anything. In the course that I teach on the subject, I initially had to focus on the “greatest hits” of conspiracy theories: Moon landing deniers, JFK assassination theories, 9/11 “truth”, and the then growing Flat Earth movement. I used conspiracy theories as a way to teach critical thinking – here is why the people shilling for gold are wrong (it’s just as much of a currency as anything else), these are the fallacies you need to accept to believe the 9/11 truth movement, etc.

Then the world changed. My country elected President Trump on the basis – at least in part – of a series of anti-immigrant conspiracy theories, economic pseudoscience, and a purposeful misunderstanding of climate science. The UK Brexited based on – again, at least in part – anti-immigrant conspiracy theories, misrepresented economic regulations, and the shapes of bananas. Conspiracy theories moved from the fringe sections of conservative parties to the centres of them. As actual government policies began to shift, we started to understand that those elected officials weren’t just giving lip service to the conspiracy theory believer, they were believers as well.

One of my dissertation advisers wrote that it was not our differences that divide us, it is division. Conspiracy theories serve to widen those gaps. They place one group in a perceived state of oppression that they claim the other is responsible for. This was most obvious during the pandemic, where “they” were trying to get us to take ‘poison’ vaccine shots to prevent a disease that didn’t exist.

How could anyone refuse the Covid-19 vaccine? It didn’t make sense, because the disease had so fundamentally changed the world, and the vaccine was going to change it back. During my dissertation defence, which was over Zoom because of the pandemic, I did something rare for a philosophy dissertation: I made a prediction. I predicted that if a vaccine was created, society wasn’t ready to face the refusal of it – unfortunately, I was right. The fact that the vaccines were going to fix the world did not matter, because the emotional weight of the conspiracy theories was far heavier.

Plenty of writers for this magazine, including myself, have stressed that what attracts people to conspiracy theorising (and I include CAM and pseudoscience in the term “conspiracy theory”) is never the facts. Moon landing denialists aren’t attracted to the theory based on the “c-rock” or the radiation from the Van Allen Belts; it’s their suspicion that the government is lying to us, that they are smarter than the rest of us, or that they have a need to feel unique. Skeptics have spilled lots of ink and burned many pixels making this point, so I won’t retread those points in this article.

A green electrical box in front of a brick wall with white spraypaint graffiti reading "9-11: Lies!"
Conspiracy graffiti in Clifton, UK. Image by Hayley Constantine, via Flickr. CC BY-NC-ND 2.0

The unimportance of facts is so important that we must repeat it to those around us, and then slap our forehead when no one listens. I can present a series of links to academic studies that argue facts do not work and, when people still won’t believe me… well, that just proves the point, actually. What matters, the most important thing in dealing with conspiracy theories, is the motivation.

In recent memory, it’s been kind of easy to deal with conspiracy theories because they were all things that “they” believed. I prefer not to call conspiracy theory believers my “opponents” because that implies a desire for conflict when what I want is unity. I feel for these people, and I share their frustrations in the world around us. It was easy because conspiracy theories about Brexit or Trump were not “our” beliefs. We could feel a sense of righteous justification when we tried to combat the theories because they were not only objectively wrong, but also involved the dehumanisation of groups of people. Skepticism about conspiracy theories is easy, when it’s them. It’s much harder when it’s us. It’s much more difficult to look at our allies and friends to ask, “How do you know that is true?”

As the world knows now, my country re-elected a twice-impeached convicted felon to the office of President. This result is largely shocking to those of us in the US skeptical community, and I would hazard to claim the rest of you as well. It was only a few months ago that I wrote about the president-elect’s conspiracy views. When election night rolled around, I was nervous, anxious, but hopeful. Harris had momentum and Trump, I reasoned, could not have picked up new supporters. I assumed that Harris would inherit President Biden’s numbers and, worst-case scenario, Trump would just hold the line. I was not expecting a repeat of 2004, when your press asked how America could be so dumb (It was the Daily Mirror but still…).

All of the -isms (racism, nationalism, etc), the warnings about Project 2025, the misogyny, the threat to use the military against protestors; none of that mattered. None of it mattered because all of that was subservient to the anger and frustration that his voters felt. Yes, they were motivated by conspiratorial reasoning. Yes, he lost votes, but not enough.

When the dust settled and he was, once again, president-elect, those on the political left began noticing something weird, or “interesting.” It wasn’t writers like Aaron Rabinowitz, writing here about what compels young men in the US to vote for Trump. Nor is it the numerous think pieces on what Harris did wrong, what Biden did wrong, or what the Democrats did wrong (there are way too many to link, and they just keep coming).

It was that 15m people who voted for Biden/Harris in 2020 apparently didn’t vote for Harris/Walz in 2024. This was interesting, because it didn’t seem that there would be much difference in a Harris administration and a Biden administration, especially given that she is his Vice President. The salient difference is that she’s much younger than him, which ought to have overcome the trepidation that voters had regarding Biden’s re-election campaign. So, they seemingly just didn’t show up.

6 blue 'I VOTED' stickers with the United States of America's flag, stuck lightly to a grey metal surface.
Classic “I voted” sticker – but, clearly, a lot of people didn’t. Photo by KOMUnews, via Flickr. CC BY 2.0

Conspiracy theories from the left began erupting. There must have been interference in the election process. Whether that came from the Chinese or Russian governments, Trump’s own people, or right-wing election terrorists; something must explain why that 15m sat it out. It wasn’t the first time we saw this kind of thinking – a few months prior, left-wing conspiracy theories also abounded about the attempted assassination of Trump, too. At the time, conspiracy theories exploded, claiming that the attempt was faked in order to gain support. The biggest mystery of that shooting, though, is how quickly we moved on from it; but questioning these notions earned the ire of people that were supposed to be skeptical of such theories.

If there is anything that serves as proof for the emotional draw of conspiracy theories, it’s when it comes from our own side. Conspiracy theories about the missing 20m, 15m, or 8m votes, are just that – conspiracy theories. The idea that the missing votes were stolen is much easier to swallow than the possibility that the number just reflects voter apathy toward the Harris/Walz candidacy.

It’s easier to believe in shenanigans than accept the idea that so many people were unconcerned about the possibility of the incoming administration. Women who were unconcerned about the direct loss of bodily autonomy that Trump’s last administration caused through judicial appointments, people of various immigrant statuses who believe that it’s not “them” that the administration will target, and those people who know that the incoming administration does not understand what a tariff does; so this number needs to explain why a large portion of the Biden/Harris voters decided to stay on the bench for the Harris/Walz.

Maybe. The ultimate problem with the conspiracy theory is that the 2020 number is a final number while the 2024 number is a developing one. While the election is over, the final tally is going to be something that we must wait for. The election will not be officially certified until January, and only then will we get the final number of voters in the 2024 US election.

The conspiracy theory is a knee-jerk reaction to a shocking result. Any conspiracy theory in a developing story is like that. What is important for skeptics is that we understand that while our emotional reaction to events is not something we can control, we can control our ability to recognise it.

Will we soon face AI-related risks? Maybe, but they are probably overestimated

Georgy Kurakin
-
0
Will we soon face AI-related risks? Maybe, but they are probably overestimated

On 22 March 2023, Future of Life Institute published an open letter titled “Pause Giant AI Experiments: An Open Letter”. In this letter, eminent AI researchers and venture investors such as Yoshua Bengio, Elon Musk, and Steve Wozniak called on “all AI labs to immediately pause for at least 6 months the training of AI systems more powerful than GPT-4”. The motivation for this letter were alleged risks of loss of control on AI and massive job loss due to the replacing humans by AI. Geoffrey Hinton, who has recently won the Nobel Prize for neural network research, expresses similar concerns. In his interview after winning the Nobel Prize, he said that AI could “get smarter than we are” and “take control”.

These concerns of the scientists are in line with the common trend: we are now facing the rise of “AI anxiety”, the widespread concerns that AI can undermine our safety or activities. Can they have a real basis? It is difficult to answer this question definitely, but let’s try to address it and consider it point by point.

Taking control, or “machine rebellion”

The fear of a “machine rebellion” has been influencing the public consciousness long before the emergence of modern-type AI. The full-fledged scenario of robot takeover can be found in R.U.R., a famous play of Karel Čapek. The same literary writing introduced the term “robot” into our language – so the cultural concept of machine rebellion appears to be as old (if not older) as the scientific concept of robot. By the early 2000s, the concept of machine rebellion – occurring as soon as we have self-learning robots – came even in children’s literature, for example in the novel Eager by Helen Fox. Wide implementation of neural networks in our life has just triggered these pre-existing fears.

Modern neural networks are unlikely to have self-awareness and even any type of real cognition, yet, when dealing with language models – especially chatbots – it can seem that they do. Microsoft’s AI chatbot confesses love for a user, its counterpart by Google seems outraged by a prompt and asks the user to die. Such behaviour might convey the impression that these AI’s can experience emotions and produce speech in a voluntary manner, but they don’t really understand the meaning of a single word they actually say.

A graphical representation of an artificial neural network
A neural network graphic, via MDPI

The things that we call neural networks are essentially a complicated way of fitting mathematical models connecting input and output information. As David Adger, Professor of Linguistics at Queen Mary University of London, explained to Serious Science, AI doesn’t even grasp any model of grammar like we do in our mind. Instead, AI uses a pre-fitted statistical model describing the probability that any specific word B will follow the word A.

For example, I didn’t write “a pre-fitted statistical modelled” because I know that an adjective usually requires a noun, not a verb in the past tense. And the verb ‘uses’ requires the same. AI doesn’t know that ‘model’ is a kind of entity described by a noun. It just “knows” that the chance of meeting the word ‘model’ after the words ‘uses’ and ‘statistical‘ is much larger than the chance to meet ‘modelled‘. And, if an AI wrote this text, it would use ‘model’ just because it is more probable. Not because it makes sense. Modern AIs do not consider any “sense”.

This leads to the understanding that modern AIs are far from sentient. Serg Masís, an American data scientist and the author of a bestselling book Interpretable Machine Learning with Python, explains:

If AI is to supersede or even complement human intelligence in more than a narrow way, it has to improve at generalizing. And right now, AI is powered by deep learning, which is a very brute force resource-intensive approach that lacks the kind of guardrails natural intelligence has, such as a lattice of symbolic, physical, and causal reasoning. 

Artificial general intelligence may really be once created, but this will probably require new technologies. Neutral networks we have now are bio-inspired but this doesn’t make them sentient. As I explained in my article for The Biochemist, neural networks are not the only type of bio-inspired AIs. At least, there are also artificial immune systems, which doesn’t sound quite as scary. Yet, neural networks are not more self-aware than artificial immune systems.

Such types of AI have no awareness, will, or emotions. Without motivation and awareness, any “rebellion” is impossible. “If the concern is about robots taking over, it’s not going to happen anytime soon” – Serg Masís agrees.

But what about job loss?

Job loss, or “they will replace us”

I work as a freelance medical translator. Often, I receive orders for post-editing the machine translation. Even if this machine translation is loaded into a well-configured computer-assisted translation (CAT) system with all the translation databases, some tasks appear to be extremely arduous. Sometimes, the in-house neural network of the customer hallucinates a table full of numbers, and you have to edit each number manually. Or it translates genetic terms incorrectly, and the painstaking process of hunting down these mistakes awaits me.

Even if a good AI engine is used (for example, DeepL), it cannot cope with all the terminological nuances of the biological text, and editing the text translated with it is much more frustrating than editing the text translated by a human colleague.

People who work in other creative jobs have similar impressions about AI. Diana Masalykina, a freelance illustrator and animator, is skeptical of the possibility that currently existing AIs outcompete human artists:

There’s still a lot of drawing to do in neural illustrations. In general, neural networks are of little help in illustration so far; they could rather be used as a source of inspiration.

The accounts of people using neural networks as a co-pilot for creative jobs confirm the idea expressed by Filip Vester in his article for The Skeptic: creativity is the sphere where existing AI cannot replace humans. Serg Masís takes the same view: “Narrow AI (the AI that exists today) will slowly take jobs that are cognitively manual and repetitive (honestly jobs nobody wants) and enhance other jobs by automating manual and repetitive portions of those jobs”. So, AI is unlikely to deprive us of the dream of finding a creative job. 

It is still just a tool, not a full-fledged independent creator. But can it be misused in a dangerous way?

AI misuse, or “the root of evil”

For this final question, my answer is probably yes. Unfortunately.

In the beginning of 2023, an university student Erika Schafrick tearfully told her TikTok audience of a “zero” grade in Philosophy: “Like sorry I didn’t <freaking> cheat and use ChatGPT just like everyone else in the <freaking> course probably did who passed. I actually tried to do it myself and use my own ideas. But that’s what I get right. That’s what I <freaking> get.”

Irrespective of whether her explanation of this grade was true, her emotional speech again revealed the emerging problem of academic cheating with AI. It is probably widespread in universities, and – much worse! – such cases are increasingly identified in scholarly publications.

While Erika Schafrick sparked a discussion on TikTok, one of the highest-cited chemists, Rafael Luque, was caught in the middle of a scandal. His unusually high publishing activity has attracted the attention of the scientific community: on average, he published an article every 37 hours! Moreover, he once confessed that used ChatGPT to “polish” his texts. University of Córdoba fired him from multiple affiliations as a formal cause. One month later, a Danish biologist Henrik Enghof found his name repeating in a scientific preprint, but didn’t find any of his works cited: instead, all citations were just hallucinated by a neural network, referring to papers that never existed.

A flock of Agent Smiths (Hugo Weaving) in The Matrix Revolutions, dressed in their signature black suits and ties with silver tie clip and black sunglasses.
Hugo Weaving plays the oppressive, indefatigable Agent Smith in the Matrix films, one of the most famous machine apocalypse settings. In The Matrix Revolutions, he copies himself many times. Via wired.it

The academic community faces an unprecedented challenge for scientific integrity. Now, any text submitted to a journal could appear to be generated by AI. We have some automated methods to identify such a misuse: unusual words in the text or the traces of a probabilistic way of generating texts (which I mentioned above) can be the sign that a text has been generated by an AI. But such checks require additional time and give rise to a climate of mistrust in science.

One more problem is the possibility of illegitimate use of AI to control and track people. The documentary book The Perfect Police State by Geoffrey Cain, using the example of China, shows how such control can provide a technological basis for mass reprisals in authoritarian states. These concerns have been reflected in the EU Artificial Intelligence Act, which directly prohibits using AI for social scoring, real-time biometric identification, and assessing the risk of an individual committing a criminal offence. Unfortunately, it is only the first act of its kind and applies only in the territory where the risk of using such technologies is minimal. But this is a perfect framework for regulating the use of AI, providing the key ideas behind its use needing to be prohibited as potentially dangerous.

Does AI itself pose any threat to the values of scientific integrity and democracy? In my opinion, no – it is humans that pose such a threat. AI is just a tool. We still need to find out how to regulate its use to minimise all related risks. But we must remember that now, like 100 and 200 years ago, all illegitimate actions are committed by humans. Not by AI.

Like hundreds of years ago, technologies may not be evil, per se. Only humans do evil, and nothing about that has changed yet.

It’s far to soon too tell patients platelet-rich plasma injections can treat infertility

Alice Howarth
-
0
It’s far to soon too tell patients platelet-rich plasma injections can treat infertility

Platelet-rich plasma (PRP) injections are all the rage these days, for a lot of things. They’re responsible for the “vampire facial”. They’re the key ingredient of the “O” – an injection into the vagina and clitoris to apparently improve orgasm. They’re also key to the penile equivalent, the “P” shot, where PRP is injected directly into the head of the penis.

PRP is produced by taking a patient’s blood into a test tube and spinning it in a centrifuge. The heavy red blood cells are pulled to the bottom of the test tube and the lighter plasma – made of platelets and white blood cells – is separated up at the top of the tube. This plasma can be removed to a fresh tube and further concentrated by spinning it once more in a centrifuge, so that the heavier platelets coalesce at the very end of the tube as a pellet. Then, the top two thirds of the plasma is removed before recombining the platelet pellet into the remaining plasma.

There are other methods of doing this, one involving spinning the blood at a higher speed so it separates into three fractions – the red blood cell layer, the plasma layer and, between the two, the “buffy coat”, where the white blood cells and the platelets sit together. Then you can remove the plasma from the top layer and very carefully take the buffy coat out separately. I’ve actually done this before in the lab, but it’s tricky because the buffy coat is very sticky and likes to take some red blood cell off with it, if you’re not careful or skilled.

What’s so great about platelet-rich plasma?

Platelets are one of the many different things floating around in our blood. We have red blood cells – the ones that carry oxygen and carbon dioxide around our body. And then we have white blood cells – there’s many different types of those: granulocytes include basophils, eosinophils, neutrophils, and mast cells and agranulocytes which include lymphocytes (those are your T and B cells and your natural killer cells) and monocytes, which can become macrophages. The white blood cells are part of our immune system.

But we also have platelets. Platelets aren’t really cells; they’re more like fragments of cells. They’re made by really big cells that hang out in the bone marrow called megakaryocytes, which grow really fat and then package up some of their insides into pre-platelet structures and then release them. Once they’ve done their job, they get shifted out into the blood and head to the lungs for the lung immune cells (alveolar macrophages) to eat them.

Platelets are important because they help us plug wounds. When you get a wound, any platelets that are already in the area first grab on to the edges of the wound. Pretty much immediately after this happens, a signalling pathway that activates platelets is triggered. At this point, the platelets start to change shape – they send out protrusions, which are like fibres, to allow all the platelets in the area to grab onto each other and aggregate, forming a plug that fills up the wound and prevents bleeding.

Platelets are also full of growth factors, which help stimulate the pathways needed to heal the wound once it’s been temporarily plugged. The theory is that we can use PRP in any situation where we want to promote healing – it’s been trialled for arthritis, rotor cuff damage, and elbow tendinitis for example.

However, those aren’t the applications I want to discuss. I want to talk about the application I found while scrolling the webpages of Goop, when I came across the headline “Is Ovarian Rejuvenation an Effective Fertility Treatment?”. Of course my interest was piqued.

The article, published in May this year, says:

“Platelet-rich plasma (PRP) therapy, which uses your own plasma to try to restore the cells and tissues in your body, is widely used for orthopedics, dentistry, hair growth, and skin care. But its use for ovarian rejuvenation—a procedure where a doctor injects PRP directly into the ovary—is a new frontier in the fertility world.”

I am always hesitant with “new frontiers” when it comes to any medical treatment. I think science is incredible, and has made remarkable strides when it comes to improving healthcare. But it is not magic. It can be a slow process, filled with lots of false starts. There are many exciting treatments that have lots of scientific plausibility that just never pan out. And there are many others that do eventually pan out, but take decades or more to develop. It’s not that I’m cynical about “new frontiers”, it’s just that I’m pragmatic. We need to wait it out until we have more information. And while we are waiting, we need to be careful when it comes to giving patients false hope around these novel treatments.

The Goop article continues:

Pink baby shoes on a bench Photo by 🇸🇮 Janko Ferlič on Unsplash

“It is both promising and potentially too good to be true: Studied effects include increased chances of conception, improved hormone regulation, and no response at all. It is too early to know definitively whether it’s worth your time and your money. But the early research is certainly intriguing.”

This is precisely where I think we need to be careful. Patients exploring fertility treatments are often particularly vulnerable to the risk of false hope or the weight or expectation and pressure. I don’t think you can add a couple of caveats and think you are absolved of any responsibility. 

That being said – the Goop article is surprisingly balanced. In an article with fewer than 800 words, it mentions the possibility or likelihood of this treatment not working no less than seven times. It’s just hard to know how much their readers will take those caveats into consideration.

Platelet-rich plasma and infertility

A systematic review was published earlier this year in BMC Pregnancy Childbirth, looking at 14 studies to find out more about the potential application of platelet-rich plasma for infertility.  

It concluded:

“Although there was an improvement of baseline hormones (AMH, FSH and E2) after intraovarian injection of PRP, this improvement failed to reach statistical significance (except the improvement of serum AMH analyzed in quasi-experimental studies).”

In other words, there was no improvement in baseline hormones identified, because failing to reach statistical significance means those differences could just be normal variation.

The strongest positive effect the meta-analysis found was an increase in antral follicle count – this is a measure taken by counting the number of follicles visible on the ovaries using ultrasound and is a reasonable measure of fertility, as fertility measures go – we don’t really have any good measures of fertility. But there are a number of limitations to the data in this study.

Firstly, none of the studies were randomised control trials, studies where patients are randomly assigned to either a test group or a control group. There is a high possibility of bias when patient groups aren’t randomised in this way.

Most of the studies didn’t look at “clinically significant outcomes such as pregnancy and live birth rates” – and as I said before, we don’t have great fertility measures. The best way to measure someone’s fertility is to look at the pregnancies or births.

Where studies did report pregnancy and births, they didn’t compare the results to pre-treatment measures, or controls. So, we can’t actually know if there’s been an increase or not.

All 14 studies were very variable in their study design, baseline hormonal levels, timing of PRP injection, the time for the outcomes assessment and reporting of outcomes. This makes it very hard to compare the results across these studies.

For me, the take-home message from this review is that it’s far, far too early to say anything about PRP intra-ovarian PRP injections. What we have is almost as good as no data. It might be enough to encourage further studies, but we shouldn’t be offering false hope to patients that this is a potential treatment, or one they might have access to any time soon.

Too often, we’re too quick to share the next big possibility when it comes to helping patients and we don’t question whether doing so is ethical or reasonable. I work in open research – I believe in making research accessible, but that also means we have to work hard to contextualise it, and avoid sensationalising it.

1...121314...152Page 13 of 152

Expert skeptical analysis of pseudoscience, conspiracy theory and claims of the paranormal.

[email protected]

About

Categories

Shop