Clinical Use of Placebos: Medicine, Neuroscience, Ethics and the Law

When I am sick, I go to my doctor. She takes a history, does a physical examination, and tells me what is wrong. I expect that she will tell me what medicine to take, what exercises to do, what to eat or what surgery is needed. I want an answer and a solution. My thinking can be summed up in just one phrase, Fix it! But what if there is no medicine, no treatment, nothing to do about the condition? What then? I still want some remedy that will help me. My doctor wants me to be satisfied with her care and to feel better. Perhaps she will recommend a pill or an exercise with no inherent therapeutic value-a placebo instead of sending me on my way, empty-handed. Is it a good idea? Would other doctors do the same thing? This paper scrutinizes the use of placebos in clinical medicine from four different perspectives. Section I introduces the subject. Section II defines the essential terms and considers the power of the placebo effect in medical practice. Section II evaluates the clinical treatment of patients with placebos from the physician\u27s perspective. The neuroscience of the placebo effect is explicated in Section IV. Section V contemplates the ethical implications of placebo treatment. Jurisprudential concerns are the subject of Section VI. Section VII discusses inappropriate and appropriate clinical use of placebos. Section VII contains my conclusion

Curvature Dependence of Peaks in the Cosmic Microwave Background Distribution

The widely cited formula $\ell_1\simeq 200 \Omega_0^{-1/2}$ for the multipole number of the first Doppler peak is not even a crude approximation in the case of greatest current interest, in which the cosmic mass density is less than the vacuum energy density. For instance, with $\Omega_M$ fixed at 0.3, the position of any Doppler peak varies as $\Omega_0^{-1.58}$ near $\Omega_0=1$.Comment: 7 pages, Late

Dark Energy and Right-Handed Neutrinos

We explore the possibility that a CP violating phase of the neutrino mass matrix is promoted to a pseudo-Goldstone-boson field and is identified as the quintessence field for Dark Energy. By requiring that the quintessence potential be calculable from a Lagrangian, and that the extreme flatness of the potential be stable under radiative corrections, we are led to an essentially unique model. Lepton number is violated only by Majorana masses of light, right-handed neutrinos, comparable to the Dirac masses that mix right- with left-handed neutrinos. We outline the rich and constrained neutrino phenomenology that results from this proposal.Comment: 10 pages, 2 figure

Tracing early structure formation with massive starburst galaxies and their implications for reionization

Cosmological hydrodynamic simulations have significantly improved over the past several years, and we have already shown that the observed properties of Lyman-break galaxies (LBGs) at z=3 can be explained well by the massive galaxies in the simulations. Here we extend our study to z=6 and show that we obtain good agreement for the LBGs at the bright-end of the luminosity function (LF). Our simulations also suggest that the cosmic star formation rate density has a peak at z= 5-6, and that the current LBG surveys at z=6 are missing a significant number of faint galaxies that are dimmer than the current magnitude limit. Together, our results suggest that the universe could be reionized at z=6 by the Pop II stars in ordinary galaxies. We also estimate the LF of Lyman-alpha emitters (LAEs) at z=6 by relating the star formation rate in the simulation to the Ly-alpha luminosity. We find that the simulated LAE LFs agree with the observed data provided that the net escape fraction of Ly-alpha photon is f_{Ly-alpha} <= 0.1. We investigate two possible scenarios for this effect: (1) all sources in the simulation are uniformly dimmer by a factor of 10 through attenuation, and (2) one out of ten LAEs randomly lights up at a given moment. We show that the correlation strength of the LAE spatial distribution can possibly distinguish the two scenarios.Comment: 9 pages, 4 figures. Summary of the talk given at the "First Light & Reionization" workshop at UC Irvine, May 2005. The published article is available from http://dx.doi.org/10.1016/j.newar.2005.11.00

On Type Ia Supernovae From The Collisions of Two White Dwarfs

We explore collisions between two white dwarfs as a pathway for making Type Ia Supernovae (SNIa). White dwarf number densities in globular clusters allow 10-100 redshift <1 collisions per year, and observations by (Chomiuk et al. 2008) of globular clusters in the nearby S0 galaxy NGC 7457 have detected what is likely to be a SNIa remnant. We carry out simulations of the collision between two 0.6 solar mass white dwarfs at various impact parameters and mass resolutions. For impact parameters less than half the radius of the white dwarf, we find such collisions produce approximately 0.4 solar masses of Ni56, making such events potential candidates for underluminous SNIa or a new class of transients between Novae and SNIa.Comment: 4 pages, 4 figures, 1 tabl

Improving Highway Work Zone Safety

Highway work zones disrupt normal traffic flow and can create severe safety problems. Due to the rising needs in highway maintenance and construction in the United States, the number of work zones is increasing nationwide. With a total of 1,010 fatalities and more than 40,000 injuries occurring in 2006, improvements in work zone safety are necessary. The three primary objectives of this research project included: 1) to determine the effectiveness of a Portable Changeable Message Sign (PCMS) in reducing vehicle speeds on two-lane, rural highway work zones; 2) to determine the effectiveness of a Temporary Traffic Sign (TTS), (W20-1, “Road Work Ahead”); and 3) to determine motorists’ responses to the signage. To accomplish these objectives, field experiments were conducted at US-36 and US-73 in Seneca and Hiawatha, Kansas, respectively. During the field experiments, an evaluation of the effectiveness of the PCMS was conducted under three different conditions: 1) PCMS on; 2) PCMS off, but still visible; and 3) PCMS removed from the road and out of sight. The researchers also divided the vehicles into three classes (passenger car, truck, and semitrailer) and compared the mean speed change of these classes based on three different sign setups: PCMS on, PCMS off, and the use of the TTS (W20-1, “Road Work Ahead”). A survey was also conducted at the experimental work zones to obtain a general understanding of the motorists’ attitudes as they traveled through the construction areas. Based on the data analysis results, researchers concluded that the presence of the PCMS effectively reduced vehicle speeds on two-lane highway work zones. A slow speed is more likely to reduce the probability of a crash or the severity of a crash. In addition, researchers performed a univariate analysis of the variance test to determine if a significant interaction existed between motorists’ responses and the sign conditions. The results showed a significant interaction between the signs and passenger car vehicles

Fuzzy Supernova Templates I: Classification

Modern supernova (SN) surveys are now uncovering stellar explosions at rates that far surpass what the world's spectroscopic resources can handle. In order to make full use of these SN datasets, it is necessary to use analysis methods that depend only on the survey photometry. This paper presents two methods for utilizing a set of SN light curve templates to classify SN objects. In the first case we present an updated version of the Bayesian Adaptive Template Matching program (BATM). To address some shortcomings of that strictly Bayesian approach, we introduce a method for Supernova Ontology with Fuzzy Templates (SOFT), which utilizes Fuzzy Set Theory for the definition and combination of SN light curve models. For well-sampled light curves with a modest signal to noise ratio (S/N>10), the SOFT method can correctly separate thermonuclear (Type Ia) SNe from core collapse SNe with 98% accuracy. In addition, the SOFT method has the potential to classify supernovae into sub-types, providing photometric identification of very rare or peculiar explosions. The accuracy and precision of the SOFT method is verified using Monte Carlo simulations as well as real SN light curves from the Sloan Digital Sky Survey and the SuperNova Legacy Survey. In a subsequent paper the SOFT method is extended to address the problem of parameter estimation, providing estimates of redshift, distance, and host galaxy extinction without any spectroscopy.Comment: 26 pages, 12 figures. Accepted to Ap