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Chris Hadfield
Retired Canadian Astronaut & Author
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David Frum: Hopes and Worries for John McCain

Question: What are your hopes and worries for Candidate McCain?

David Frum: John McCain offers something very exciting to the Republican Party. That is, he offers the possibility of reform and change and transformation. That's really what his career as a politician has been about.

The downside, the weakness of his candidacy, is that, as fervent as he is about the need for change, the actual content of the things he offers has always been a little thin.

John McCain has brought his greatest reforming energy to issues about which people tend to care very little. And he also has a very weak screen for sorting good ideas from bad. So in campaign finance, for example, he became tremendously infatuated with a series of solutions that almost everyone else who looked at them said, "These solutions are going to make worse all the problems that you say you care about. And if what you're concerned about is a kind of bias of the political system toward the wealthy and powerful, then McCain-Feingold is going to make that problem a lot worse"--as indeed it's done. So I worry about that.

I served very briefly in government, and not in a very important job, but that short experience created in me an even greater respect than I already felt for the importance of executive management, the ability to make things work. Those are very particular human skills and they are not developed by a career in the Senate. Nor is the Senate a good place to become a close student of the consequences, both intended and unintended, of the bright ideas that occur to you.

Question: What defines great leadership?

David Frum: I don't think there is such a thing as leadership in the general sense.

You see all these books on the bookshelves that will say, "Leadership Secrets of Joan of Arc." Now, the kind of leadership that inspired a mob of semi-literate French soldier peasants to fight a foreign invader five hundred years ago, those are not necessarily the same techniques you use to organize the company softball team.

John McCain tries to draw a distinction between leadership and management, but usually what happens when people talk about leadership is they end up describing themselves. All the characteristics that they have, all the good points they have, they say that is the essence of leadership and they set aside all the things they don't have as not important.

To run the U.S. government effectively requires tremendous attention to detail, it requires tremendous follow-through.  The government is a tremendously resistant machine. It is very hard to make it do the things you want it to do. It's never enough to set broad goals and it's never enough to inspire people. You actually have to manage the beast day by day by day. And to make it go in a direction in which it's not already going, that requires not just the exciting quality of the orator or the exciting qualities of the visionary, that requires some of the very daily humdrum qualities of the manager, of the person who checks that the job is being done, follows through, holds people accountable.

Recorded on: May 5 2008

 

 

 

Reform, change and transformation are hopes. Obsession with the wrong issues, like campaign finance reform, are worries.

A new hydrogel might be strong enough for knee replacements

Duke University researchers might have solved a half-century old problem.

Photo by Alexander Hassenstein/Getty Images
Technology & Innovation
  • Duke University researchers created a hydrogel that appears to be as strong and flexible as human cartilage.
  • The blend of three polymers provides enough flexibility and durability to mimic the knee.
  • The next step is to test this hydrogel in sheep; human use can take at least three years.
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Predicting PTSD symptoms becomes possible with a new test

An algorithm may allow doctors to assess PTSD candidates for early intervention after traumatic ER visits.

Image source: camillo jimenez/Unsplash
Technology & Innovation
  • 10-15% of people visiting emergency rooms eventually develop symptoms of long-lasting PTSD.
  • Early treatment is available but there's been no way to tell who needs it.
  • Using clinical data already being collected, machine learning can identify who's at risk.

The psychological scars a traumatic experience can leave behind may have a more profound effect on a person than the original traumatic experience. Long after an acute emergency is resolved, victims of post-traumatic stress disorder (PTSD) continue to suffer its consequences.

In the U.S. some 30 million patients are annually treated in emergency departments (EDs) for a range of traumatic injuries. Add to that urgent admissions to the ED with the onset of COVID-19 symptoms. Health experts predict that some 10 percent to 15 percent of these people will develop long-lasting PTSD within a year of the initial incident. While there are interventions that can help individuals avoid PTSD, there's been no reliable way to identify those most likely to need it.

That may now have changed. A multi-disciplinary team of researchers has developed a method for predicting who is most likely to develop PTSD after a traumatic emergency-room experience. Their study is published in the journal Nature Medicine.

70 data points and machine learning

nurse wrapping patient's arm

Image source: Creators Collective/Unsplash

Study lead author Katharina Schultebraucks of Columbia University's Department Vagelos College of Physicians and Surgeons says:

"For many trauma patients, the ED visit is often their sole contact with the health care system. The time immediately after a traumatic injury is a critical window for identifying people at risk for PTSD and arranging appropriate follow-up treatment. The earlier we can treat those at risk, the better the likely outcomes."

The new PTSD test uses machine learning and 70 clinical data points plus a clinical stress-level assessment to develop a PTSD score for an individual that identifies their risk of acquiring the condition.

Among the 70 data points are stress hormone levels, inflammatory signals, high blood pressure, and an anxiety-level assessment. Says Schultebraucks, "We selected measures that are routinely collected in the ED and logged in the electronic medical record, plus answers to a few short questions about the psychological stress response. The idea was to create a tool that would be universally available and would add little burden to ED personnel."

Researchers used data from adult trauma survivors in Atlanta, Georgia (377 individuals) and New York City (221 individuals) to test their system.

Of this cohort, 90 percent of those predicted to be at high risk developed long-lasting PTSD symptoms within a year of the initial traumatic event — just 5 percent of people who never developed PTSD symptoms had been erroneously identified as being at risk.

On the other side of the coin, 29 percent of individuals were 'false negatives," tagged by the algorithm as not being at risk of PTSD, but then developing symptoms.

Going forward

person leaning their head on another's shoulder

Image source: Külli Kittus/Unsplash

Schultebraucks looks forward to more testing as the researchers continue to refine their algorithm and to instill confidence in the approach among ED clinicians: "Because previous models for predicting PTSD risk have not been validated in independent samples like our model, they haven't been adopted in clinical practice." She expects that, "Testing and validation of our model in larger samples will be necessary for the algorithm to be ready-to-use in the general population."

"Currently only 7% of level-1 trauma centers routinely screen for PTSD," notes Schultebraucks. "We hope that the algorithm will provide ED clinicians with a rapid, automatic readout that they could use for discharge planning and the prevention of PTSD." She envisions the algorithm being implemented in the future as a feature of electronic medical records.

The researchers also plan to test their algorithm at predicting PTSD in people whose traumatic experiences come in the form of health events such as heart attacks and strokes, as opposed to visits to the emergency department.

Hints of the 4th dimension have been detected by physicists

What would it be like to experience the 4th dimension?

Two different experiments show hints of a 4th spatial dimension. Credit: Zilberberg Group / ETH Zürich
Technology & Innovation

Physicists have understood at least theoretically, that there may be higher dimensions, besides our normal three. The first clue came in 1905 when Einstein developed his theory of special relativity. Of course, by dimensions we’re talking about length, width, and height. Generally speaking, when we talk about a fourth dimension, it’s considered space-time. But here, physicists mean a spatial dimension beyond the normal three, not a parallel universe, as such dimensions are mistaken for in popular sci-fi shows.

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How often do vaccine trials hit paydirt?

Vaccines find more success in development than any other kind of drug, but have been relatively neglected in recent decades.

Pedro Vilela/Getty Images
Surprising Science

Vaccines are more likely to get through clinical trials than any other type of drug — but have been given relatively little pharmaceutical industry support during the last two decades, according to a new study by MIT scholars.

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