A radical shift away from the biomedical bubble

The front cover of the July issue of The Lancet:

Some people have been calling for and working towards that radical shift for decades. Dr. Patch Adams comes to mind.

Sadly, alternative medicine has mainly only paid lip service to “social, behavioural, and environmental determinants of health,” while being much more truly defined by and deeply invested in snake oil and pseudoscience. What a tragic missed opportunity! Alt-med could easily have inspired/shamed mainstream medicine into that important “radical shift”, but instead it’s done nothing but drive ever deeper into left field.

The biomedical model definitely isn’t all wrong, and indeed much about it is so right we should actually double-down on it (e.g. vaccination!). We definitely do not need a “radical shift” away from those strengths. Of course.

However, the biomedical model has been a terrible failure for a lot of patients — especially pain patients — and there certainly a need for a radical shift away from those weaknesses. And when a pendulum needs to be swung, it’s often necessary to push away from where it’s been, to vigorously reject the past.

I have a highly relevant little-known article, one of my own favourites, that explores the strengths and weaknesses of both alt-med and mainstream medicine: Alternative Medicine’s Choice: Alternative to What?

And one more “see also”: physical therapist Sigurd Mikkelsen put together a great little compilation of related points.

Sainz to race for McLaren from 2019

McLaren have today confirmed that Carlos Sainz will replace outgoing racer, and fellow spaniard, Fernando Alonso for the 2019 season, in the Formula 1 world championship.

Twenty-three year old Sainz ‘Jnr’, son of former double World Rally Champion, Carlos Sainz, will move from the Renault team that he currently drives for.

McLaren, Formula OneSpeaking to McLaren.com, Zak Brown, Chief Executive Officer for McLaren Racing said; “We’re incredibly excited to have Carlos join us as a McLaren driver. We’ve been assessing him for some time now and rate him very highly among the next generation of young talent emerging through the ranks in Formula 1.

“Carlos brings with him the perfect blend of youth and experience. Although he’s just 23, he’ll be starting his fifth season in the sport with us and will bring with him a huge amount of racing experience, both in Formula 1 and with our partner Renault.

“It’s no secret that Carlos is a huge admirer of Fernando’s, and it’s fitting that he will be stepping into his seat as a Spaniard with a legendary name in motorsport. We think he’ll be a great fit for McLaren and we’re really excited to have him join us from next season and beyond.”

While Carlos Sainz had this to say; “I’m delighted to finally be able to confirm that I’ll be a McLaren driver from the 2019 season. It’s something I’ve been looking at for a while and I’m very excited about this next chapter in my career.

“I’ve been a McLaren fan for as long as I can remember. It’s a great name in the sport with an incredible heritage, and the list of drivers that have raced for McLaren over the years are among the heroes of Formula 1.

“Fernando is of course one of them, so it’s particularly special that I’ll be taking his seat as part of the next generation of Spanish racing drivers behind the wheel of a McLaren.

“Finally, I’d like to thank everyone at McLaren for giving me this opportunity to fulfil a childhood dream. The team has a long-term plan for the future and I’m very much looking forward to playing a key role in its journey back to success.”

McLaren will communicate its full driver line-up for the 2019 season in due course.

Rockingham future uncertain after sale

Rockingham Motor Speedway’s future looks uncertain as the circuit last night released a statement admitting that there would be a ‘change of business operations’ following the sale of the Northanptonshire venue.

The statement read; “A sale of Rockingham Motor Speedway Ltd has now completed and as a result, there will be changes in business operations at the venue.

We would reassure all customers that these changes will not impact any aspect of events scheduled to run during 2018, nor the opportunity to stage further events this year. Until the end of the year, the Rockingham team will remain 100% committed to delivering the venue and associated services as professionally and proudly as ever before.

We thank you for your continued support and a further statement will follow shortly.”

RockinghamRockingham Speedway, the only circuit of it’s kind in the UK, opened in 2001 and twice hosted the British round of the CART (Indycar) championship, along with the British Touring Car, British Formula 3, and British GT championships.

Earlier this year the BTCC announced it’s 2019 calendar with Rockingham missing from the schedule, while the Corby track is also missing from the British GT ’19 schedule.

Battle of Britain action heads for Croft

Next weekend (August 25/26th) sees competitors on two, three and four wheels converge on Croft Circuit for the traditional Battle of Britain race meeting organised once again under the expertise of Darlington & District Motor Club.

The meeting is unique in as much that it runs cars, bikes and sidecars at the same meeting and what’s more, there is still time for competitors to enter and get the chance to race at North Yorkshire’s premier motorsport venue which only a couple of months ago, hosted the Dunlop MSA British Touring Car Championship.

The bike classes, run by the Auto 66 Club as part of their club championships, include Ultra Lightweight (up to 125cc non GP & Classic 125GP), Lightweight (up to 500cc including 125cc/250cc GP & 251cc to 500cc), 450-650cc Super Lightweight (Supertwin & Minitwin), Junior 600cc, Senior 701cc to 1300cc, Classic Superbike, Count of Cadwell (Solo Open 175cc to 1300cc), Open Sidecars, ACU/FSRA British F2 Sidecar Championship and Ducati Cup.

The popular Northern Sports & Saloon Car Championship will see full grids over three races in the various classes, culminating with a scratch race for the prestigious Battle of Britain Trophy meaning an action-packed weekend.

Regulations and entry forms for cars and bikes are on the D&DMC website www.darlington-motor-club.org.uk and any remaining competitors can book and pay directly by contacting Lesley Starkey via email [email protected].

Battle of Britain meeting, Croft CircuitHaving originally been staged at the track near Darlington when it opened its doors as Croft Autodrome back in 1964, and in deference to Croft’s aerodrome roots and its role as the most northerly Bomber Base in the UK during the Second World War, under the command of the Royal Canadian Air Force, for many years, the traditional August Bank Holiday highlight, was the Battle of Britain race meeting which regularly drew crowds of up to 30,000 who were wowed by the on-track action and captivating aerial displays from the spectacular Red Arrows and a thunderous Lancaster Bomber.

The event raised substantial funds for charity and local heroes always featured prominently, including motorcycling ace Ken Redfern, car racing front-runners Andy Barton and Ron Harper and sidecar stars Matt Hobson and Colin Appleyard. What’s more, the meeting became so well established on the annual motor sport calendar that by the 1970s it was attracting sponsorship from global oil giant Texaco and drivers of the calibre of legendary world champions James Hunt and Barry Sheene as well as multiple grand prix-winner Patrick Tambay to perform demonstration runs and present trophies.

The action gets underway at 9.30am on Saturday and from 12.00 noon on Sunday. Adult admission is just £11.00 on both days in advance or £15.00 on the day with accompanied children aged 15 and under admitted FREE on both days. A weekend ticket costs £15.00 in advance or £25.00 on the gate. There is also FREE car parking and FREE paddock access.

Taking out the trash: purging predatory journals from my bibliography

Recently I shared a study on social media (Ghorbanpour et al). It seemed to be an unusually low quality paper, and soon after I posted it I was informed that it was published in a suspected “predatory journal” — a fraudulent journal that will publish anything for pay (literally anything, even gibberish). They are scams, ripping off academics who are desperate to publish or perish. I just blogged about predatory journals a few weeks ago:

The scientific literature is severely polluted with actual non-science, with an insane number of papers that were published under entirely false pretenses, the fruit of fraud.

Although I’ve been aware of this debacle for several years, I have not paid close enough attention to be aware of how to identify predatory journals. I assumed I didn’t have to worry about it. But the journal in this case was on a list of sixty suspected predatory journals in the rehabilitation field specifically, put together by Manca et al. That’s my turf! If that list is trustworthy (which seems likely), it’s a depressing but invaluable resource for me. Since then I’ve learned about other lists (see PredatoryJournals.com and BeallsList.weebly.com).

My next job was to audit my own bibliographic database for those bogus journals. The bibliographic database for PainScience.com contains 2450 papers. How many are the spawn of predatory journals? How heavily have I relied on their unreliable conclusions? Not a comfortable chore! But an unavoidable one.

Here’s what I found lurking in my bibliography

  • 14 journals on Manca’s list appear to be indexed by PubMed (making it much more likely that they’d be in my database)
  • 11 papers in my bibliography are in one of those journals. Not too bad…
  • 9 of those paper are from one journal! The Journal of Physical Therapy Science.
  • 8 of were rated by me, all mediocre at best.
  • 4 had proper summaries (meaning I invested significant time in understanding and explaining the paper). I’d specifically noted that one of them was poorly written.

Obviously I was well aware that these were shabby papers. Which isn’t really surprising, because these days — for many reasons — most papers are “guilty until proven innocent.” I deal with bad papers all the time. I just didn’t know that these papers were not really published.

And how were those bad sources cited?

My real concern was that I might discover that I’d used some worthless studies to support a personal bias. Was I using non-science to make any important points?

Nope! I mostly passed this test. Here’s how they were used:

  • Both Iqbal and Kim are cited on two pages as examples of “a handful of very weak studies” that support deep cervical flexor training for neck pain. I checked the only other reference I have for that, Gupta. It wasn’t on Manca’s list, but the journal’s website looked super sketchy, and I was quickly able to find it on another list of suspected predatory journals. So all three are worthless, and there is literally no real science supporting DCF training. I am Jack’s complete lack of surprise.
  • Both Hyong and Yoo are also double-cited, along with a three others, to support the claim that “just the right exercises do indeed preferentially engage the [vastus medialis muscle]”. Collectively I characterized those studies as “all admittedly small, but also all quite straightforward and probably adequate.” But not those two! So a bit wrong there, but not horribly.
  • Cheng is just barely cited (at the end of a footnote for another citation) as having conclusions “similar to” Gross, which is in turn presented as mostly inconclusive “garbage in, garbage out” review of studies of exercise for neck pain. So no real harm done there.
  • Both Ravichandran and Amin are in a list of 17 studies of massage for trigger points. The low quality of Amin is made clear even in summary: “no control, mixed results, poorly written paper.” Ravichandran is presented as just a “small negative RCT.”

That last one is the most interesting of the batch: I actually read Ravichandran et al quite carefully just a few months ago, and wrote a thorough summary of it, in which I slammed the authors for spinning their data to make the results look more positive than they were. I think it’s “one of the few clearly negative trials” of massage for trigger points, which rubs my bias the wrong way: I want to believe that massage helps trigger points! So I’m actually smugly pleased to see this paper discredited.

So that’s a dozen citations to papers that are completely useless, but — phew — I didn’t rely on any of them heavily for anything that mattered.

The remaining papers, which I had not yet gotten around to citing, and now never will:

All of these will remain in my bibliography, but their quality will be prominently questioned, and all will have the 1-star ratings that I apply only to “bad example” papers. I’ll remove most of the citations to them, as examples of the lack of support for a claim.

No doubt there’s more

I did my initial search for predatory journals in my own database before I discovered other lists of predatory journals, so I have more auditing to do, and I fully expect to find more of these festering pustules in my bibliography. However, based on these preliminary results, I suspect I won’t be too horrified by what I find.

And I will now be systematically checking the origins of every significant new citation. PainScience.com will never knowingly cite anything from a predatory journal ever again, except as a bad example.

Could these papers have some value?

Is it overkill to disqualify them entirely? It is theoretically possible for a good paper to end up in a predatory journal, but there’s know way for us to separate those from the rest. I think publication in a predatory journal almost completely undermines the credibility of a paper. Even in legit journals, with flawed but earnest peer review, we have an appalling problem with underpowered crappy little trials, the p-hacking epidemic, and so on. Peer review is deeply flawed, and in some journals it’s not much a lot better than the rubber stamp at a predatory journal, but in any half decent journal it’s a lot better than nothing.

Without it, I think the value of a paper and the credibility of its authors drops to near-zero. They might have good intentions, but they certainly don’t have good judgement. It casts doubt on the value of all their research, wherever and whenever it is published — it’s a serious stain on their record.

Alonso will not race in F1 in 2019

Double Formula One world champion Fernando Alonso has confirmed he will not be racing in F1 in 2019. A statement from McLaren read;

McLaren Racing today confirms that double F1 World Champion Fernando Alonso will not race in Formula 1 in 2019.

Fernando, who turned 37 in July, is competing in his 17th F1 season, his fifth with McLaren, and has amassed 32 wins, 22 pole positions and 97 podiums to date. Beyond his two titles – in 2005 he became the then-youngest world champion in F1 history – Fernando has been championship runner-up three times.

Zak Brown, Chief Executive officer of McLaren Racing went on to say;

“Fernando is not only an outstanding ambassador for McLaren but also for Formula 1. His 17 years in the sport, as arguably the pre-eminent driver of his generation and undoubtedly an F1 great, have added another layer to Formula 1’s rich history.

“There is a time for everyone to make a change and Fernando has decided the end of this season to be his. We respect his decision, even if we believe he is in the finest form of his career. Our open dialogue with Fernando has meant we could plan for this eventuality.

“While evaluating his future during the past months, Fernando’s competitiveness has been undimmed. He has continued to perform at the highest level throughout, as we know he will do in the remaining nine races of this year’s championship.

“I know that the entire team joins me in paying tribute to Fernando’s enormous contribution to McLaren; he is a legend both for the championship and for the team. Fernando is an important part of our story and will join an illustrious line of McLaren drivers. On behalf of Shaikh Mohammed, Mansour and our entire board, we wish Fernando every success in the future.”

Fernando Alonso, McLarenWhile Fernando Alonso, himself, added;

“After 17 wonderful years in this amazing sport, it’s time for me to make a change and move on. I have enjoyed every single minute of those incredible seasons and I cannot thank enough the people who have contributed to make them all so special.

“There are still several grands prix to go this season, and I will take part in them with more commitment and passion than ever.

“Let’s see what the future brings; new exciting challenges are around the corner. I’m having one of the happiest times ever in my life but I need to go on exploring new adventures.

“I want to thank everyone at McLaren. My heart is with the team forever. I know they will come back stronger and better in the future and it could be the right moment for me to be back in the series; that would make me really happy. I have built so many great relationships with many fantastic people at McLaren, and they have given me the opportunity to broaden my horizons and race in other categories. I feel I am a more complete driver now than ever.

“I made this decision some months ago and it was a firm one. Nevertheless, I would like to sincerely thank Chase Carey and Liberty Media for the efforts made to change my mind and everyone who has contacted me during this time.

“Finally, I would also like to thank my former teams, team-mates, competitors, colleagues, partners, journalists and everyone I have worked with in my F1 career. And, especially, my fans all over the world. I am quite sure our paths will cross again in the future.”

Source: McLaren

Pirelli ‘ready to face’ F1 tyre war

Although Pirelli are “ready” to face a tyre war should F1 go in that direction, Mario Isola believes having one supplier makes more financial sense.

Pirelli become Formula 1’s sole supplier at the start of the 2011 season, replacing Bridgestone.

Bridgestone had been F1’s only supplier from 2007 after Michelin withdrew from the sport.

And while Pirelli has often stated they do not want a tyre war, the company’s F1 boss says they’ll deal with it if Formula 1 opts to go that route again.

“If they decide to come back to this situation as we said in the past, we are ready to face also this new challenge,” Isola said.

“It is a new challenge because if you’re a sole supplier you have some targets.

“You supply the same tyres to everybody so you can have a tyre with high degradation, with different targets.

“If we are in competition with our tyre supplier the target is just performance. It is clear. It’s like for teams.

“Their target is safety for sure but safety is a target, it’s always there, it’s always a priority but after that it’s just performance.”

For now, though, Isola believes Formula 1 will stick with just one supplier.

“The direction of Formula One is still to have one supplier,” he added.

“Obviously what is changing quickly but the single supplier is saving money for everybody.

“If you introduce, again, what they call the “tyre war” or multiple suppliers you have to consider that in the past it was necessary to have additional test sessions or in the past the teams had a proper tyre test team and obviously this means additional costs.

“If they want to reduce the cost, this is probably not the right direction.”

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Has IndyCar dropped a hint about Alonso’s plans?

IndyCar may have dropped the biggest hint yet about Fernando Alonso’s future plans, either for 2019 or for lunch today.

This past weekend the double World Champion took to social media to announce, well, an upcoming announcement.

The McLaren driver, whose has been linked to a move away from Formula 1 and to IndyCar, hinted of an August 14th announcement.

What that relates to he didn’t say.

IndyCar, though, may have given the game away.

The American motor racing series, in which Alonso competed when he tried his hand at the 2017 Indianapolis 500, responded to the McLaren driver’s tweet with one of their own.

“We still on for lunch tomorrow, Fernando Alonso?” read the tweet.

And while we will all have to wait until later today to learn whether it is a lunch date or a move to IndyCar that awaits Alonso, fans seem to be hoping he’s off to America.

Leclerc: Progress looks bigger than it is

Date published: August 14 2018

Charles Leclerc reckons Sauber’s in-season progress has looked “bigger” than it is really is given his struggles in the opening races.

Leclerc made his Formula 1 debut at the start of this season, racing alongside Marcus Ericsson at Sauber.

The duo both struggled in the opening races and it wasn’t until round four of the championship that Leclerc put his Sauber into Q2.

That resulted in Leclerc’s first points of this season to go with the two that Ericsson scored in Bahrain.

The Monaco driver would go on to add another four top-ten results with Ericsson scoring on two more occasions.

“I think we made it look bigger than it was, even though it’s huge,” Leclerc told Autosport.

“At the first race I was just not driving well, so obviously the performance was less good than it should have been because of me.

“Then from Baku until now the progress that we see is mostly because of the car, and because we progress with the car.

“So, this is definitely still a big step.

“We are now very close to Q3 in the last few grands prix, which is a very positive sign and it gives a lot of motivation to the whole team.”

F1 News Courtesy of https://www.planetf1.com