BCS BULL: AN ANGRY CALL TO BOYCOTT
I won’t list a bunch of reasons to justify the need for a playoff system in college football because I’d be preaching to the choir, but I will illustrate how absurd the BCS system is. Imagine the NFL skipping the wild card, divisional, and conference playoff weekends. Imagine them going straight from the regular season directly to the Super Bowl with the best team in the AFC and the best team in the NFC. To hell with all those “lesser” teams who deserve a chance to get to the Super Bowl. How stupid would that be? So if we see the utter stupidity of going directly to a two-team playoff (Super Bowl) after the regular season in a league with only 32 teams, then why would we go directly to 2 teams to play in the BCS Championship in a league with over 100 teams? To further illustrate how dumb this is, imagine that the NFL does have wild card, divisional, and conference post-season games, but they are only consolation games. They can’t play in the Super Bowl—even though many are outstanding teams and capable of beating the two best teams. Would you watch those games? That’s exactly what currently happens with the college football bowl season, excluding the BCS championship game. The magnitude of this stupidity is off the charts. The great majority of teams know they cannot win the national championship at mid-season. For the past several years, I’ve watched the BCS Championship game, and very few of the other bowl games. I don’t like to watch consolation games. But what can we do about it? Boycott.
I’m uncertain if the true source of the problem lies in the BCS committee, the college presidents, the television networks (or some combination), but I do know a solution. I don’t accept the idea that the fans are powerless. In fact, the fans can be almost entirely responsible for the BCS structure changing to a playoff system of 4 or more teams. How? Hit ‘em where it hurts—it the wallet. I’m not calling for a total boycott of all future games. Few of us would do that. Rather, I’m calling for a TV boycott of the first week of the 2012 season. I’m asking all fans in the USA to avoid watching televised games in week one. The sponsors will likely apply enough pressure to get us results. The lost revenue of this one week would send the message that the fans are taking control if they don’t cough up a playoff system. This BCS bull must end and the fans are the suckers if they don’t act.
VIOXX, HEART ATTACKS, OPIODS & FALLS
A Tale of Technology, Risks, and Unintended Consequences
Invited Post by John Nail, Ph.D.
Modern pharmaceutical drugs, along with other medical technologies, have doubled life expectancies during the past 100 years. There is a real possibility that the news media, politicians, lawyers and gullible jurors will put an end to these advances. The news media appears to enjoy reports of ‘dangerous products’ that the politicians embrace as it gives them a way of diverting attention from their own lack of competence. Trial lawyers earn their living by convincing gullible jurors that the ‘big companies’ are to blame for anything adverse that occurs when someone uses their product. Often, the result of the media and political orgy is that useful products are removed from the market. This is the story of a drug that was removed due to safety reasons and the possible unintended consequences of its removal. Before we proceed, we should note that 1) ALL technologies have unintended adverse consequences, 2) It is not possible to know what these consequences will be until large numbers of people start using (and abusing) the product, and 3) Decisions have unintended consequences, including often making a situation worse when trying to make it better.
Vioxx (generic name rofecoxib) was a prescription drug for the treatment of pain from osteoarthritis (this is the type of arthritis that occurs when bones are rubbing against each other). Vioxx was approved for use by the US Food and Drug Administration on May 20, 1999; it was discontinued on September 30, 2004, due to concerns regarding cardiovascular problems (heart attacks and strokes) in patients that used the drug.
A considerable amount of testing is required before the FDA will approve the use of a new prescription drug. One of the pre-approval tests involving Vioxx was the ‘VIGOR’ study – a double-blind test in which one group of participants (the study group) was given Vioxx and the other, (the control group) naproxen, a non-prescription pain reliever. This trial found that the Vioxx group members who had pre-existing heart attack risk factors were four times more likely to have a heart attack than were the participants of the naproxen group with pre-existing heart heart attack risk factors. One interpretation of this result is that Vioxx causes heart attacks in people with heart disease risk factors; the other interpretation is that naproxen prevents heart attacks in people with heart disease risk factors. We know that aspirin prevents heart attacks, so it is reasonable to assume that naproxen prevents heart attacks. Interestingly, there was no difference between the two groups in regards to deaths from heart attacks, nor was there a difference between heart attack rates between the two groups in people who did not have heart attack risk factors. Thus, if a person has heart attack risk factors and should be taking a ‘baby’ aspirin each day, that person’s chance of a heart attack is four times higher if the person is taking Vioxx instead of naproxen.
APPROVe was another Vioxx clinical study in which the ‘control’ group was given a placebo (sugar pill). During this study, it was found that, after 18 months, the participants who were being given Vioxx were almost twice as likely to have a heart attack than were the participants who were being given sugar pills. However, the heart attack deaths (mortalities) were equivalent between the two groups. Thus, as in the VIGOR study, the rate of heart attacks were greater in the Vioxx group, but the rate of heart attack deaths were identical between the two groups. The APPROVe results and the resulting media uproar resulted in Vioxx being withdrawn from sale.
Bextra and Celebrix were Vioxx’s competitors. Bextra was withdrawn due to increased heart attack and stroke risks in patients who were taking Bextra while recovering from heart surgery. Celebrix is still being marketed, however, it has a ‘black box warning’ that it should be used only as a last resort on patients who have heart disease or a risk of developing heart disease.
One of the arguments for why Vioxx and Bextra should no longer be sold was that “osteoarthritis patients have other options for relieving their pain” – these other options are over the counter pain relievers (aspirin, naproxen, acetaminophen, ibuprofen, etc.), and opioids such as codeine, demerol and morphine. While opioids are among the most effective of all pain relievers, they have unintended effects such as narcosis (sleep inducement) and physical and psychological addition. Rush Limbaugh allegedly became psychologically addicted to opioids.
Recently, a study determined that switching osteoarthritis patients from Vioxx or Bextra to opioids has resulted in a fourfold increase in falls and broken bones in elderly osteoarthritis patients. A quote from an article in The Journal of Higher Education that discussed this increase in falls and broken bones,
“Somebody should have thought more carefully about the elderly before making these recommendations” (switching elderly osteoarthritis patients from drugs such as Vioxx to drugs such as codeine to control their pain), says Bruce N. Cronstein, a professor of medicine at New York University’s Langone Medical Center. “Falls in an elderly population can be very dangerous, leading to long hospitalizations and even death.” ….”We don’t have wonderful alternatives for treating chronic pain”… Long treatment with aspirin or ibuprofen, for instance, often irritates and damages the digestive system…Falling down seems like one of the most obvious adverse effects, says Dr. Cronstein. “That’s not rocket science,” he notes. “The elderly are more frail. They have a host of factors that could lead to falls. If you add something that makes you a little unsteady, it increases the risk”
Thus, the choices for people with osteoarthritis are (and were) over the counter drugs such as aspirin and ibuprofen, that can cause digestive damage from long-term use, prescription narcotics that increase a person’s risk of falling by fourfold, or prescription drugs such as Vioxx that, in people with heart attack risks, increased their risk of heart attacks, however, these did not increase their risk of dying from a heart attack. The media and political storm that resulted in Vioxx and Bextra being removed from the market appears to have resulted in either more pain in osteoarthritis sufferers due to their not treating the pain, or the possibility / reality of digestive system damage, or increased use of opioid drugs which has produced an increase in falls and broken bones.
Elderly patients also don’t have the best of memories. This sometimes leads to accidental overdoes of opioid (and other drugs) due to a patient’s forgetting that they had already taken their pain pill for that day. It is also known that people often develop tolerances to opioid drugs, making these increasingly less effective.
I leave you with a comment uploaded to the discussion section from The Journal of Higher Education article:
‘“In addition to the danger of increased falls, the removal of Vioxx and Bextra from the market meant increased arthritis pain for millions of people (including me). The possibility of heart problems for some won out over the reality of pain for millions. I hope that not all medical decisions are made this way” John C.’
Unfortunately, this is how medical decisions are made during a media generated crisis. The next time that there is a media uproar about ‘dangerous medical products’, remember that the unintended consequences from the product’s alternatives may be worse than the product’s unintended consequences.
DR. NAIL is Chair of the Chemistry Department at Oklahoma City University
FRUIT OF THE LOONS
BY JOHN NAIL, Ph.D. [Contributing Blogger]
On Christmas day, a terrorist attempted to explode 80 grams of the explosive PETN on an airliner while it was landing at the Detroit airport; the explosive had been hidden in the terrorist’s underwear – specifically, the crotch of his underpants. SEE ABC NEWS STORY.
Not surprisingly, this incident has generated a considerable amount of political debate during this holiday week, along with new rules for passenger behavior during airline flights. One aspect that has not been discussed is ‘could 80 grams of PETN in a person’s crotch have caused an airliner crash?’
Before answering this question, I should mention that while I am not an explosives expert, I do teach Chemistry and a Weapons of Mass Destruction course that includes a very basic discussion of explosives.
One issue is that 80 grams (about 45 cc, or 1.6 ounces by volume) of PETN isn’t a lot of explosive. As demonstrated by the show Mythbusters, considerably more than 1.6 (volume) ounces of a powerful explosive (such as PETN) is required for a highly damaging explosion (http://www.youtube.com/watch?v=VKZZLw5kTJk); the 3 cc of the high explosives (possibly PETN) in the video blew a grapefruit sized hole in a foam board. The terrorist had 45 cc of PETN, which would blow a larger hole in a foam board.
Another issue is the location of the PETN – specifically that it was inside the crotch area of the terrorist’s clothing. Had the PETN exploded, it would have seriously damaged his legs and crotch area – the only possibly fatality would have been to the terrorist, as his body would have absorbed the blast and, ironically, protected the other passengers.
Could the terrorist have caused the plane to crash? The answer is: highly unlikely, as 80 grams of PETN does not have enough explosive energy to have seriously damaged the plane fuselage or damage the controls.
At worse, the terrorist could have blown a hole in the fuselage, which would have caused the plane to depressurize. It is highly unlikely that this would have lead to any fatalities as the passengers would have the emergency breathing masks. However, for 80 grams of PETN in a person’s crotch to be able to blow a hole in the plane fuselage, the terrorists would have needed to be in a window seat and had his crotch pressed against the fuselage during the explosion. Even had this happened, the explosive shockwave would have taken the ‘path of least resistance’ which is through the terrorist’s body and not the fuselage wall. Once again, the terrorist would have fared much worse than the passengers, crew or plane.
While we often want absolute safety, we need to admit that this is impossible. It is unreasonable and impractical to find every hidden small packet of a substance that may be incorporated into a person’s clothing. The only way to ensure that another underwear bomb incident cannot occur would be to have all airline passengers remove all of their clothing prior to boarding; presumably, everyone would either fly naked or would be issued secure clothing for the flight. This wouldn’t ensure absolute safety either as a terrorist could always have an explosive surgically inserted in his or her body.
One problem with terrorism is that while we can try to guess at every method that might be used to attack us, however, we can never know what the terrorists have conceived but we haven’t. Consequently, they act and we react. As with all risk management issues, we must keep things in perspective; time and time again, we become overly concerned with unlikely risks and ignore those that are more likely to harm us.
JOHN NAIL, Ph.D., is Chair of the Chemistry Department at Oklahoma City University
