The Divine Law and blood X

Call It a Bloodless Coup
Date: April 1, 2013

Hopkins uses some 60,000 units of blood products a year. “That alone,” says Steven Frank, “justifies prudence.”  

Hopkins uses some 60,000 units of blood products a year. “That alone,” says Steven Frank, “justifies prudence.”

Though some form of the “bloodless surgery” that lowers the need for transfusions has been around almost two decades, a new body of clinical research looks to cement its hold at Johns Hopkins and extend it to more patients. Also, new work suggests now may be the time to rethink assumptions about blood-banking. 

“We’re seeing that we can do a lot more with less blood during surgery and afterward,” says anesthesiologist Steven Frank, medical director of The Johns Hopkins Hospital’s umbrella program for bloodless medicine and surgery. “Our aim is to reduce transfusions by 10 to 20 percent throughout our medical system. 

“The tactics we use don’t only benefit those who traditionally refuse transfusions for personal concerns about contamination or, like the Jehovah’s Witnesses, for religious beliefs. We’ve come to see bloodless surgery as best practice for more patients in general.”  

What drives the new goal, Frank says, are four landmark studies—the most recent including Johns Hopkins data. All the trials followed large numbers of patients during hospital stays, comparing survival based on whether or not their hemoglobin levels had been boosted by transfusions. The trials varied in details, though all involved very sick people experiencing blood loss. 

“The bottom line,” says Frank, “was that patients held to a lower hemoglobin reading before getting transfusions* did just as well or better than those transfused at a traditional higher triggering point. So we see no advantages in routinely giving extra blood. All you do is introduce cost and risk.

“Transfusions aren’t necessarily benign,” he adds. Transfused patients are two to three times more likely to get acquired infections. Also, receiving donor blood sparks antibodies that work against future transfusions.

Just-out work from Hopkins adds another consideration: the blood supply. Yes, worldwide shortages exist in banked blood. But banking itself warrants a second look. Blood banks’ equivalent of a “sell by” date—six weeks—is likely off, Frank says. He and colleagues show that blood starts becoming “stale” after three weeks. Red blood cell membranes stiffen, which can slow passage in capillaries. That likely explains transfused patients’ slightly higher risk of cardiac complications.

One remedy, however, lies in reducing blood bank demand. 

 So the hospital program goes beyond modern tactics that recycle blood lost during surgery, shrink operating fields through robotics or beef-up patients’ presurgical red cell count. Tactics are increasingly patient-tailored. And research continues on best practice. A large hospital database, for example, showed Frank’s team how a simple $9 IV-based device that one Hopkins critical care unit used halved blood loss during testing.

The benefits of blood conservation, Frank says, are clear: They lower risk. They lower cost. And they improve outcomes. 

Outcome of Patients Who Refuse Transfusion After Cardiac Surgery: A Natural Experiment With Severe Blood Conservation FREE

Gregory Pattakos, MD, MS; Colleen G. Koch, MD, MS, MBA; Mariano E. Brizzio, MD; Lillian H. Batizy, MS; Joseph F. Sabik III, MD; Eugene H. Blackstone, MD; Michael S. Lauer, MD

ABSTRACT

ABSTRACT | METHODS | RESULTS | COMMENT | ARTICLE INFORMATION |REFERENCES

Background Jehovah's Witness patients (Witnesses) who undergo cardiac surgery provide a unique natural experiment in severe blood conservation because anemia, transfusion, erythropoietin, and antifibrinolytics have attendant risks. Our objective was to compare morbidity and long-term survival of Witnesses undergoing cardiac surgery with a similarly matched group of patients who received transfusions.

Methods A total of 322 Witnesses and 87 453 non-Witnesses underwent cardiac surgery at our center from January 1, 1983, to January 1, 2011. All Witnesses prospectively refused blood transfusions. Among non-Witnesses, 38 467 did not receive blood transfusions and 48 986 did. We used propensity methods to match patient groups and parametric multiphase hazard methods to assess long-term survival. Our main outcome measures were postoperative morbidity complications, in-hospital mortality, and long-term survival.

Results Witnesses had fewer acute complications and shorter length of stay than matched patients who received transfusions: myocardial infarction, 0.31% vs 2.8% (P = . 01); additional operation for bleeding, 3.7% vs 7.1% (P = . 03); prolonged ventilation, 6% vs 16% (P < . 001); intensive care unit length of stay (15th, 50th, and 85th percentiles), 24, 25, and 72 vs 24, 48, and 162 hours (P < . 001); and hospital length of stay (15th, 50th, and 85th percentiles), 5, 7, and 11 vs 6, 8, and 16 days (P < . 001). Witnesses had better 1-year survival (95%; 95% CI, 93%-96%; vs 89%; 95% CI, 87%-90%; P = . 007) but similar 20-year survival (34%; 95% CI, 31%-38%; vs 32% 95% CI, 28%-35%; P = . 90).

Conclusions Witnesses do not appear to be at increased risk for surgical complications or long-term mortality when comparisons are properly made by transfusion status. Thus, current extreme blood management strategies do not appear to place patients at heightened risk for reduced long-term survival.

Red blood cells (RBCs) not only are in short supply but are also associated with increased morbidity and reduced survival after cardiac surgery.1- 3 Jehovah's Witness patients (Witnesses) hold beliefs that disallow blood product transfusion and therefore offer a natural experiment in severe blood conservation. Their beliefs encourage the use of a number of blood conservation practices, including preoperative use of erythropoietin and iron and B-complex vitamins, hemoconcentration, and minimal crystalloid use; intraoperative use of antifibrinolytics and cell-saver and smaller cardiopulmonary bypass circuits; and postoperative liberal use of additional operation for bleeding along with tolerance of low hematocrit levels postoperatively. Although some of these practices may be beneficial to all cardiac surgical patients, others are associated with well-documented morbidity,4- 6 and their effect on long-term survival is uncertain.

Although prior investigators compared immediate postoperative outcomes between Witnesses and non-Witnesses,7- 16 comparisons of long-term survival are lacking. Comparison is hampered, however, by impossibility of randomization to religious preference or blood transfusion, typical of any natural experiment. We have therefore used propensity-based comparative effectiveness tools17- 19 to compare morbidity and long-term survival of Witnesses undergoing cardiac surgery with a propensity-matched group of patients who received transfusions.

Outcomes in cardiac surgery in 500 consecutive Jehovah's Witness patients: 21 year experience.

Vaislic CD1, Dalibon N, Ponzio O, Ba M, Jugan E, Lagneau F, Abbas P, Olliver Y, Gaillard D, Baget F, Sportiche M, Chedid A, Chaoul G, Maribas P, Dupuy C, Robine B, Kasanin N, Michon H, Ruat JM, Habis M, Bouharaoua T.
Author information
Abstract
BACKGROUND:
Refusal of heterogenic blood products can be for religious reasons as in Jehovah's Witnesses or otherwise or as requested by an increasing number of patients. Furthermore blood reserves are under continuous demand with increasing costs. Therefore, transfusion avoidance strategies are desirable. We describe a historic comparison and current results of blood saving protocols in Jehovah's Witnesses patients.
METHODS:
Data on 250 Jehovah's Witness patients operated upon between 1991 and 2003 (group A) were reviewed and compared with a second population of 250 patients treated from 2003 to 2012 (group B).
RESULTS:
In group A, mean age was 51 years of age compared to 68 years in group B. An iterative procedure was performed in 13% of patients in group B. Thirty days mortality was 3% in group A and 1% in group B despite greater operative risk factors, with more redo, and lower ejection fraction in group B. Several factors contributed to the low morbidity-mortality in group B, namely: preoperative erythropoietin to attain a minimal hemoglobin value of 14 g/dl, warm blood cardioplegia, the implementation of the Cornell University protocol and fast track extubation.
CONCLUSIONS:
Cardiac surgery without transfusion in high-risk patients such as Jehovah Witnesses can be carried out with results equivalent to those of low risk patients. Recent advances in surgical techniques and blood conservation protocols are main contributing factors.

PMID: 23013647 [PubMed - indexed for MEDLINE] PMCID: PMC3487917 Free PMC Article

Comparisons of cardiac surgery outcomes in Jehovah's versus Non-Jehovah's Witnesses.

Stamou SC1, White T, Barnett S, Boyce SW, Corso PJ, Lefrak EA.

Author information

Abstract

Jehovah's Witnesses is a Christian faith whose members will not accept blood or blood products under any circumstances on the basis of religious grounds. To date, no comparative studies have evaluated the outcome of open heart surgery in Jehovah's Witnesses compared with patients who accept the transfusion of blood products. The present study was conducted to systematically compare the operative mortality and early clinical outcome after open cardiac surgery in Jehovah's Witnesses versus non-Jehovah's Witnesses. From January 1990 to July 2004, 49 Jehovah's Witness patients underwent cardiac surgery, and their data were compared with those of a contemporaneous control group of 196 non-Jehovah's Witnesses. Logistic regression analysis was used to compare operative mortality, postoperative intensive care unit care, and hospital length of stay between the 2 groups, controlling for preoperative risk factors. The Jehovah's Witnesses were matched in a 1:4 ratio to the non-Jehovah's Witnesses using propensity scores. No significant differences were identified in unadjusted stroke (p = 0.5), acute myocardial infarction (p = 0.6), new-onset atrial fibrillation (p = 0.106), prolonged ventilation (p = 0.82), acute renal failure (p = 0.70), and hemorrhage-related reexploration (p = 0.59) rates between the 2 groups. On multivariate analysis, Jehovah's Witnesses had operative mortality (odds ratio 0.66, 95% confidence interval 0.12 to 3.59, p = 0.63), intensive care unit stay (odds ratio 1.36, 95% confidence interval 0.46 to 3.97, p = 0.58), and postoperative length of stay (odds ratio 1.43, 95% confidence interval 0.92 to 2.20, p = 0.16) comparable to those of the non-Jehovah's Witnesses, after controlling for preoperative risk factors through matching. In conclusion, cardiac surgery in Jehovah's Witnesses is associated with clinical outcomes comparable to those of non-Jehovah's Witnesses by adhering to blood conservation protocols.

PMID:

 

17056333

 

[PubMed - indexed for MEDLINE]

Safety of cardiac surgery without blood transfusion: a retrospective study in Jehovah's Witness patients.

El Azab SR1, Vrakking R, Verhage G, Rosseel PM.

Author information

Retraction in

• Notice of retraction. [Anaesthesia. 2010]

Abstract

The aim of this retrospective study was to compare the utilisation of blood products and outcomes following cardiac surgery for 123 Jehovah's Witnesses and 4219 non-Jehovah's Witness patient controls. The study took place over a 7-year period at the Amphia Hospital in Breda, the Netherlands. A specific protocol was used in the management of Jehovah's Witness patients, while the control group received blood without restriction according to their needs. Patients' characteristics were comparable in both groups. Pre-operatively, the mean (SD) Euro Score was higher in the Jehovah's Witness group (3.2 (2.6) vs 2.7 (2.5), respectively; p < 0.02). Pre-operative haemoglobin concentration was higher in the Jehovah's Witness group (8.9 (0.7) vs 8.6 (0.9) g.dl(-1), respectively; p < 0.001). The total cardiopulmonary bypass time did not differ between groups. The requirement for allogenic blood transfusion was 0% in the Jehovah's Witness group compared to 65% in the control group. Postoperatively, there was a lower incidence of Q-wave myocardial infarction (2 (1.8%) vs 323 (7.7%), respectively; p < 0.02), and non Q-wave infarction (11 (9.8%) vs 559 (13.2%), respectively; p < 0.02) in the Jehovah's Witness group compared with controls. Mean (SD) length of stay in the intensive care unit (2.3 (3.2) vs 2.6 (4.2) days; p = 0.26), re-admission rate to the intensive care unit (5 (4.5%) vs 114 (2.7%); p = 0.163), and mortality (3 (2.7%) vs 65 (1.5%); p = 0.59), did not differ between the Jehovah's Witness and control groups, respectively.

Comment in

• Safety of cardiac surgery without blood transfusion: a retrospective study in Jehovah's Witness patients. [Anaesthesia. 2010]

PMID:

 

20402872

 

[PubMed - indexed for MEDLINE]

Comparison of outcome in Jehovah's Witness patients in cardiac surgery: an Australian experience.

Bhaskar B1, Jack RK, Mullany D, Fraser J.

Author information

Abstract

INTRODUCTION:

Despite the advances in modern medicine, cardiac surgery remains associated with significant amounts of blood transfusion and is responsible for nearly 20% of all transfusions in Australasia. Progressive advances in perfusion technology and perioperative supportive management have made it possible for members of the Jehovah's Witnesses (JW) religious group to undergo open cardiac operations with remarkable safety. This study systematically compares the operative mortality and early clinical outcome after cardiac surgery in JWs.

METHODS AND MATERIALS:

Data was obtained from the cardiac surgery and intensive care unit databases from January 2002 to December 2005. A total of 5353 patients who underwent cardiac surgical procedures including coronary artery bypass grafting with cardiopulmonary bypass (n=4041) and valvular heart surgery (n=2287) were assessed in this study. Of the 5353 patients 49 patients refused blood and blood products because of their religious beliefs. Models were constructed to determine the association between JWs and non-JWs and three outcomes: (1) operative mortality, (2) postoperative variables and (3) length of stay in intensive care unit. Propensity scores were computed from these models and used to match JWs with non-JWs.

RESULTS:

There were minimal differences in the baseline patient demographic characteristics between the two groups. Haemoglobin and haematocrit levels were higher in JWs both before (13.7g/dL vs 12.8g/dL; P=0.01, and 40.0% vs 39.2%; P=0.08) and after (10.8g/dL vs 9.9g/dL; P=.003, and 34.0% vs 30.9%; P=.001) surgery. Jehovah's Witnesses experienced significantly less bleeding, almost half compared to the control group, with 

CONCLUSION:

This study concurs with the international published data that outcomes for JW patients who undergo cardiac surgery are similar to those who receive transfusion. Every appropriate opportunity to reduce the use of allogeneic blood products.

Copyright © 2010 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. All rights reserved.

PMID:

Even Darwinists admit that there is legitimate cause for doubt re:the Cambrian explosion

BioEssays Article Admits "Materialistic Basis of the Cambrian Explosion" is "Elusive"
Casey Luskin June 24, 2009 12:51 PM 

A recent paper in BioEssays, "MicroRNAs and metazoan macroevolution: insights into canalization, complexity, and the Cambrian explosion," admits the lack of a "materialistic basis" -- that is, a plausible materialistic explanation -- of the Cambrian explosion. As the article states:

Thus, elucidating the materialistic basis of the Cambrian explosion has become more elusive, not less, the more we know about the event itself, and cannot be explained away by coupling extinction of intermediates with long stretches of geologic time, despite the contrary claims of some modern neo-Darwinists.
(Kevin J. Peterson, Michael R. Dietrich and Mark A. McPeek, "MicroRNAs and metazoan macroevolution: insights into canalization, complexity, and the Cambrian explosion," BioEssays, Vol. 31 (7):736 - 747 (2009).)

The authors give no indication that they themselves support intelligent design (ID), and it seems they are still hopeful for a "materialistic" explanation for the Cambrian explosion, but they nonetheless give a witty nod to some observations and arguments made by ID proponents:
Beginning some 555 million years ago the Earth's biota changed in profound and fundamental ways, going from an essentially static system billions of years in existence to the one we find today, a dynamic and awesomely complex system whose origin seems to defy explanation. Part of the intrigue with the Cambrian explosion is that numerous animal phyla with very distinct body plans arrive on the scene in a geological blink of the eye, with little or no warning of what is to come in rocks that predate this interval of time. The abruptness of the transition between the ''Precambrian'' and the Cambrian was apparent right at the outset of our science with the publication of Murchison's The Silurian System, a treatise that paradoxically set forth the research agenda for numerous paleontologists -- in addition to serving as perennial fodder for creationists. The reasoning is simple -- as explained on an intelligent-design t-shirt.
Fact: Forty phyla of complex animals suddenly appear in the fossil record, no forerunners, no transitional forms leading to them; ''a major mystery,'' a ''challenge.'' The Theory of Evolution -- exploded again (idofcourse.com).
Although we would dispute the numbers, and aside from the last line, there is not much here that we would disagree with. Indeed, many of Darwin's contemporaries shared these sentiments, and we assume -- if Victorian fashion dictated -- that they would have worn this same t-shirt with pride.
(Kevin J. Peterson, Michael R. Dietrich and Mark A. McPeek, "MicroRNAs and metazoan macroevolution: insights into canalization, complexity, and the Cambrian explosion," BioEssays, Vol. 31 (7):736 - 747 (2009), internal citation numbers removed, emboldened emphasis added.)


While their article then directly goes on to admit the "elusive" state of any "materialistic basis" of the Cambrian explosion, it doesn't really offer any explanation for the Cambrian explosion other than a vague mention of the open niche hypothesis and adaptive radiation. The rest of the article focuses on explaining the overall loss of phyla and body plans since the Cambrian, rather than the explosive emergence of new body plans in the Cambrian explosion. At some point, however, neo-Darwinism must account for the origin -- an abrupt one at that -- of new body plans, not merely the inability to evolve new ones in post-Cambrian times (what they call the "canalizing" of development). It would seem that after this article, the explanation for the origin of the phyla in the Cambrian explosion is no less "elusive" than before it.

Now Europe peers into the abyss.

Europe Bans Animal -- Not Human -- Cloning
Wesley J. Smith September 19, 2015 5:40 AM 

I am always amazed at how there is a great anger in Europe against technologies like plant GMOs, but far less outrage over the prospect of human genetic modification, in the early stages of implimentation. From The Indpendent story:

The genetic manipulation of human IVF embryos is set to start in Britain for the first time following a licence application by scientists who want to understand why some women suffer repeated miscarriages.

If the research licence is granted by the Government's fertility watchdog it will be only the second known occasion in the world where the chromosomes of human embryos have been genetically manipulated using a revolutionary gene-editing technique called Crispr/Cas9.

Meanwhile, Europe has banned farm animal cloning. From the Science Insider story:

The European Parliament today voted to ban the cloning of all farm animals as well as the sale of cloned livestock, their offspring, and products derived from them. The measure, which passed by a large margin, goes beyond a directive proposed by the European Commission in 2013, which would have implemented a provisional ban on the cloning of just five species: cattle, sheep, pigs, goats, and horses.

The supporters of the ban cited animal welfare concerns, claiming that only a small percentage of cloned offspring survive to term, and many die shortly after birth.

The ban does not cover cloning for research purposes, nor does it prevent efforts to clone endangered species.

Continuing with the theme of this post, human cloning has not been similarly banned throughout Europe.

Indeed, while there is a protocol against allowing a cloned baby to be born, and some countries like Germany outlaw creating human cloned embryos, others like Great Britain-which even permits the use of animal eggs in cloning attempts-allows the human cloning research to proceed full speed ahead.


Sometimes I think that in the minds of some, animals matter more than humans.

Darwinism Vs. the real world. XII

The Human Body Continues to Give Evolutionary Biologists High Blood Pressure

Howard Glicksman September 18, 2015 4:27 PM | 

Editor's note: Physicians have a special place among the thinkers who have elaborated the argument for intelligent design. Perhaps that's because, more than evolutionary biologists, they are familiar with the challenges of maintaining a functioning complex system, the human body. With that in mind, Evolution News & Views is delighted to present this series, "The Designed Body." Dr. Glicksman practices palliative medicine for a hospice organization.

Let's review what this series of articles has shown so far about human life. The body is made up of trillions of cells, each of which must control its volume and chemical content while receiving what it needs to live, grow and work properly. Since the body is made up of matter, it is subject to the laws of nature, which demand that it have enough energy to do what it needs to do to survive.

To get enough oxygen to meet its metabolic needs, the lungs must have fast enough airflow, large enough volume and efficient enough gas exchange in addition to having enough hemoglobin in the blood. Since it is the blood in circulation that provides the cells with what they need, the body must also make sure it has enough water, sodium and albumin to maintain enough blood volume. Moreo4ver, since blood has mass, it needs the heart to pump it throughout the body against forces like inertia, friction and gravity that naturally prevent it from moving anywhere. To do this adequately, the heart must have a properly working electrical system, which is dependent on having the right amount of potassium in the blood, and enough coronary blood flow, proper valve function and sufficient ventricular relaxation and contractility.

Having enough of whatever is needed to follow the rules set down by nature also requires being able to take control and each of the systems the body uses has a sensor, an integrator and an effector to get the job done right. And since life doesn't take place inside a vacuum or within the imaginations of evolutionary biologists, when it comes to living and dying, real numbers have real consequences. This means that to survive within the laws of nature, life must make sure that each of its numerous chemical and physiological parameters must stay within a certain range.

We've already looked at how the blood volume and cardiac output are properly maintained. But it is possible for both of these parameters to be normal and death can still take place due to an abnormal blood pressure. How does that happen?

Blood pressure is the force which blood applies against the walls of a chamber or blood vessel through which it is moving. Think of it like the pressure that can be felt as water rushes through a garden hose. Since blood flows from the heart through the arteries to the capillaries in the tissues, and back again through the veins, this means that there are many different blood pressures throughout the cardiovascular system. However,the blood pressure used in clinical practice is understood to be the force of blood exerted against the walls of the brachial artery that is located in the upper arm. In other words, the blood pressure is synonymous with the force the blood applies against the walls of the large systemic arteries.

When it comes to measuring blood pressure, it is important to understand the cardiac cycle and how blood flows within the arterial system. Systole makes up one-third of the cardiac cycle during which the left ventricle pumps blood through the aortic valve into the aorta and from there into the large arteries. As this blood is added to what is already present within the brachial artery, this causes the blood pressure to rise to a maximum. This is called the systolic pressure (SP).Diastole makes up two-thirds of the cardiac cycle, during which the left ventricle relaxes and fills with blood.

Once pumped out of the left ventricle, the blood travels down narrowing vessels until it meets resistance in the arterioles. Some of the blood flows through to the capillaries while some rebounds back towards the heart where it again meets resistance, this time from the closed aortic valve. The blood then continues to ping-pong back and forth between the arterioles and the closed aortic valve during diastole, allowing some of it to pass into the capillaries. By the time diastole ends and systole is about to begin, the blood pressure within the brachial artery has dropped to a minimum and is called the diastolic pressure (DP). In other words, at the end of diastole there is still a lot of blood within the large arteries.

The blood pressure is measured by pumping up a pressure cuff, placed around the upper arm, high enough to block the blood flow in the brachial artery. While slowly releasing the pressure, the doctor uses a stethoscope to listen for the first sound of turbulent blood flow (SP) and then its total disappearance (DP). The blood pressure is measured in units called millimeters of Mercury (mmHg)and is usually expressed as the SP/DP, such as "120/60." Since systole lasts for one-third of the cardiac cycle and diastole, two-thirds, it is possible to calculate the mean arterial pressure (MAP) as 1/3 SP + 2/3 DP. So the MAP for a BP of 120/60 would be 80 mmHg (1/3 (120) + 2/3 (60)).

It is important to remember that the blood pressure represents the driving force that moves blood throughout the circulatory system to feed the cells what they need to live, grow and work properly. This means that, in general, blood flow is directly related to blood pressure. It is the MAP that is often used when considering blood flow because it represents the average blood pressure. Like all matter, blood is affected by natural forces such as inertia and gravity, which must be overcome by the pumping heart to move it where it needs to go. Just as friction slows the movement of an object on the ground, blood flow meets its counterpart, called vascular resistance in the blood vessels. In particular, the vascular resistance that is generated by the peripheral arterioles is called the peripheral vascular resistance (PVR).

Inertia, vascular resistance and gravity are the three main forces that prevent blood from going where it needs to go in the body. The body must generate enough blood pressure to maintain enough blood flow throughout the circulation. The three main factors that affect the blood pressure are the cardiac output, the total blood volume and its distribution within the circulation, and the peripheral vascular resistance. The harder and faster the heart pumps, the more blood enters the arterial system and the higher the blood pressure, and vice versa.

The total blood volume is dependent on how much water and sodium is in the body. The systemic arteries usually contain about 12 percent of the body's blood while the veins have about 60 percent. So, the more water and sodium in the body, the more blood volume, and when the body shifts more of it from the systemic veins into the arteries, the higher the blood pressure and vice versa. The vascular resistance applied to blood flow by the peripheral arterioles causes less blood to go into the capillaries and more to stay inside the arteries. So more peripheral vascular resistance results in higher blood pressure and less peripheral vascular resistance, lower blood pressure.

It is the laws of nature that demand that each cell have enough energy and nutrients to live and do what it is supposed to do inside the body. However, it is these same laws that the body must overcome by having enough arterial blood pressure to get enough blood flow to its cells and provide them with what they need. In other words, as clinical experience has shown, too low of a blood pressure is a big problem. Since blood vessels are made of tissue that can withstand only so much pressure, too high of a blood pressure is just as bad. Next time we'll look at how the body takes control of its blood pressure to be able to survive within the laws of nature.

On why Darwinism fails as search strategy.

ntelligent Design in Action: Optimization

Evolution News & Views September 16, 2015 3:59 AM

In the past we've discussed several sciences that rely on principles of intelligent design: among them, archaeology, forensics, cryptology,informatics, SETI and SEETI, and more. Now a paper describing a remarkable achievement offers the opportunity to explore another: optimization. The paper by University of Washington machine-learning researchers Abram Friesen and Pedro Domingos is well described in aUW news item. Jennifer Langston defines optimization and tells how useful the field is.

The key to solving many of the most important problems in business, science and technology lies in optimization --finding the values for variables that give you the highest benefit.

Whether those are which stocks to buy, which search results to return, what best predicts the outcome of the next presidential election or which amino acids to string together in a new drug to fight malaria or cancer, optimization is crucial to getting what we want. When a problem is simple, we can program a computer to solve it. When it's too complex for that, optimization is how the computer finds the solution by itself. [Emphasis added.]

We all know a computer is incapable of finding a solution all by itself. An appropriate algorithm designed into it, however, can seemingly hit the jackpot automatically.

In essence, optimization is a search strategy. William Dembski deals extensively with search in his latest book, Being as Communion. Search is closely tied to the concept of information, which Dembski defines as a winnowing process that realizes possibilities by ruling out others. If the information desired is a solution with the highest benefit, a search must be conducted for that information. The science of optimization, therefore, is the study of algorithms or strategies that realizes the optimum solution by ruling out others. As such, it is an information-rich field.

Friesen and Domingos have scored an impressive achievement in this field. Their new optimization algorithm, named RDIS, performed an optimization task between 100,000 and 10 billion times more accurately, on average, than standard techniques. It was so good it won the top prize at the 24^th International Joint Conference on Artificial Intelligence in July. This giant leap in optimization can help speed up finding solutions listed by Langston, and others like road recognition for self-driving cars and determining folds for custom proteins.

Domingos explains why optimization is more important than many people realize:

"In some ways optimization is the most important problem you've never heard of because it turns up in all areas of science, engineering and business. But a lot of optimization problems are extremely difficult to solve because they have ahuge number of variables that interact in intricate ways," said senior author Pedro Domingos, UW professor of computer science and engineering.

Figuring out protein folds, for instance, has been a long-standing problem. A protein begins with a chain of amino acids, but folds into a complex, three-dimensional shape. For all but small proteins, predicting the shape from the chain -- given that the amino acids interact in complex ways -- has defied many previous searches. RDIS may be able to speed the solution for synthetic drugs by optimizing the amino acid sequence for the desired shape. Another application is to determine a three-dimensional shape from a series of two-dimensional images.

Making RDIS work so well relied on several techniques. One was a divide-and-conquer strategy called decomposition. By breaking down the problem into smaller problems and treating them as independent problems (even though they are not), the designers converged on the optimal solution much faster. Another strategy is recursion. These and other technical details are described in the paper.

Optimization is not limited to AI or computers. Every logically thinking person faces optimization problems; e.g., "How shall I distribute my funds to optimize my return on investment?" "What players shall I call up for this football play?" "Shall I drop off the kids at school before going to the bank, or after?" "Where is traffic likely to be worse?" Optimization rapidly becomes more difficult as the complexity of the problem rises, indicated in a pithy analogy:

Solving optimization problems is like being left blindfolded at the top of a hill and asked to walk to the ocean. One way to do that is to judge where to go by feeling around with your foot and taking one step a time in the steepest downward direction. That works if there's only one hill. But if you're at the top of the Himalayas, you'll quickly get stuck because there are thousands of peaks and foothills and flat parts. That's essentially what happens with current optimization algorithms.

"If you're lucky, maybe you'll wind up in the sea but more likely you'll wind up in a valley or a lake," said Domingos. "If you could see the whole landscape, you'd say 'oh, here's where I have to go,' but the problem is you can't see everywhere and neither can today's algorithms."

This analogy will sound familiar to those acquainted with evolutionary biology. The "fitness landscape" metaphor coined by Sewall Wright deals with hills and valleys, too; in that context, peaks represent high fitness and valleys represent low fitness. Wright and subsequent evolutionary theorists realized that organisms could get stuck on local fitness peaks (optima). Reaching a higher fitness peak would require losing fitness temporarily to cross a valley (see "Complexity by Subtraction"). And yet it appears frequently that animals did cross valleys, losing and regaining traits multiple times according to phylogenetic trees. Could organisms reach high levels of fitness by blind, unguided processes?

It's obvious that Friesen and Domingos did not design RDIS to rely on blind search. It was intelligently designed, in multiple ways, throughout. First, they had to know a lot about existing optimization tools. Second, they had to understand their goal. Third, they had to design multiple interacting factors to achieve their goal. It's also a case of hierarchical design. In a real sense, they had to optimize their optimization tool.

Intelligent designers know how to cross valleys to reach higher peaks, because they can see a distant goal and aim for it. Natural selection has no foresight. Portraying neo-Darwinism's mechanisms as optimization strategies is, therefore, wishful thinking (see "Evolutionary Computing: The Invisible Hand of Intelligence"). Dembski has shown in Being as Communion and in his earlier book No Free Lunch that no search strategy is superior to blind search -- unless information is added to the system by intelligence.

Optimization is a good example of intelligent design at work in the sciences. Not only is the field permeated with ID concepts from start to finish, it is also highly useful and widely applicable. So is ID a "science stopper" as Darwinists often claim? Quite to the contrary.

Lamarck's revenge II

Natural Genetic Engineering? Natural Popcorn? Or Something More Important?

Denyse O'Leary September 15, 2015 3:47 AM 

It is just not Darwin's world any more. Life forms share genes,irrespective of ancestry, pick up traits during their lifetimes that they pass on, can lose key functions and then get them back later, and treat their genomes like projects under construction.

It is certainly not the world anyone expected to find when we first started mapping genomes. The scientist best known for pulling together some ideas around natural genetic engineeringis bacterial geneticist James Shapiro, author ofEvolution: A View from the 21st Century (2011).

He also wrote a series of essays at theHuffington Post, noting, as sympathetic book reviewer Franklin Harold (Department of Microbiology, University of Washington) puts it:

Briefly, the architecture of genomes turned out quite unlike what had been expected. In higher organisms, at least, genes are composed of both coding and non-coding sequences, and must be spliced prior to expression. Classical protein- coding sequences make up an astonishingly small proportion of the genome, just a few percent. The remainder features regions that specify an intricate network of regulatory elements, many based on RNA rather than proteins. These are concerned, not only with the expression of individual genes, but with the fidelity and architecture of the genome as a whole. Genomes also contain numerous stretches, long and short, of repetitious DNA, whose physiological functions are not obvious.

...

At first sight, the continuous makeover seems merely to supply more variations for selection to winnow, but Shapiro argues that there is much more to it than that. Natural genetic engineering generates different kinds of variation from those produced by classical mutations, one gene at a time. Rearrangements can take place at multiple locations at once and shuffle entire domains from one protein to another, producing novel combinations quickly and abruptly, perhaps even purposefully. Genomes, it seems, are built to evolve -- not at the petty pace of classical genetics, but in leaps that entail rearrangement of the genetic architecture or the import of foreign information. So could this be the way that organisms generate the multiple, coherent variations that seem required to manufacture complex organelles such as eyes or flagella? At the end of the day, that is a question that must be answered by experiment; we are not there yet, but the technology to address such issues is coming to hand.

That said, he argues that we can deal with all these questions without really major conceptual changes (2013):

If experiments show that cells can make distinct appropriate NGE responses to different adaptive challenges occurs, we need to figure out how they do so. This almost certainly would prove to be more than a strictly mechanical process. How do cells carry out their computations to make useful goal-oriented responses? A successful answer to that question will certainly involve cybernetics. If such investigations take evolution science into areas that are more than strictly material, so be it. As long as we stay within the realm of natural processes, there are no boundaries on what science can address.

But some of us are not so sure. Philosopher James Barham thinks the main issue is seeing life forms as if they were machines:

We are finally beginning to realize, on the basis of irrefutable empirical evidence, as well as more careful analysis of Darwinian theory itself, that purposeful action in living things is an objectively real phenomenon that is presupposed, not explained, by the theory of natural selection.

Yes, that is the problem: Why does the animal want to live?

We can build machines -- we create them to do what we want -- and then put them out with the trash. But not free-living life forms. They try to survive. To deny this would require us to say, as Barham notes, that purpose is an illusion.

Part of the problem between Barham and Shapiro, which led to an exchange of views, sounds conceptual. What does Dr. Shapiro mean by "natural" processes, as opposed to "more than strictly material" ones, as above? A strictly material process would be a series of events fully explained by material processes (for example, what happens when a loose stone falls off a cliff).

But some entities in nature are not material at all: the number 7 comes to mind. Some philosophers have argued that we can construct a theory of items grouped by sevens without using a concept like 7. But whatever advantages these philosophers' suggestion may offer, it does not represent what people do. We have an immaterial concept of 7 that organizes items and events, instantiated in various media at various times. It is natural without being material in any meaningful way.

Life forms seem to be somehow in between. They are material, but unlike stones, they don't just exist. They want to exist, and to go on existing. They often seem to have a number of additional, related goals.

If Dr. Shapiro can account for the purposeful way in which life forms strive to sustain their own existence as part of a natural world, it is -- as he clearly recognizes -- a natural world that is far removed from the Darwinism of the science textbooks, which emphasizes the random nature of these processes.

Well, we must shortly look at the Darwinism of the textbooks.

Matter over mind?

Group Delusions Aside, Sentient Robots Aren't on the Way

Erik J. Larson March 26, 2015 11:33 AM 

Our colleague Wesley Smith commented yesterday on a piece in Nature,ntelligent robots must uphold human rights." We read there:

There is a strong possibility that in the not-too-distant future, artificial intelligences (AIs), perhaps in the form of robots, will become capable of sentient thought. Whatever form it takes, this dawning of machine consciousness is likely to have a substantial impact on human society.

More:

Academic and fictional analyses of AIs tend to focus on human -- robot interactions, asking questions such as: would robots make our lives easier? Would they be dangerous? And could they ever pose a threat to humankind?

These questions ignore one crucial point. We must consider interactions between intelligent robots themselves and the effect that thesee exchanges may have on their human creators. For example, if we were to allow sentient machines to commit injustices on one another -- even if these 'crimes' did not have a direct impact on human welfare -- this might reflect poorly on our own humanity. Such philosophical deliberations have paved the way for the concept of 'machine rights'.

"Machine rights"? I have to confess, when I read articles like this I have an almost visceral reaction. It amounts to a full-blown, ongoing perplexity and fascination with the capacity of otherwise intelligent people to engage in serious-sounding group delusion. To pick this apart is a little like explaining to someone why his interest horoscopes is probably untethered to any genuine scientific knowledge about the planets, the relevant laws governing their motion, and so on. I'm tempted to say, "Yes, that's right, the robots are becoming intelligent so quickly that they may soon take control. In fact, here they come now! Run for cover!"

Let's do some not-too-painful sanity checking. What is the current state of robot technology? MIT is famous for cutting-edge work on robots (cf. Rodney Brooks), and they've got a robot that is getting better at identifying large objects like plates, as distinct from, say, a salad bowl.

Meanwhile in manufacturing, the latest three-hundred-pound gadget designed to grab and manipulate plastic components (I gather) is getting so smart than when a component topples over, it can move it's claw over to pick it up.

The serious point here is that the current state of robotics tells a different tale from robots "coming alive" in the near future and taking control of human society. The technical challenges to simulating actual human intelligence are vast and daunting. If fluff articles from no less than Nature must continue to bombard hapless readers with sci-fi fantasies about the coming intelligence revolution, I suggest they should first offer the simplest form of evidence apart from sheer rhetorical emotivism.

For example, let's have a URL to an article describing an actual robotic system, leveling with the reader on the actual capabilities of the system. I offer bonus points for explaining how apparently simple problems like moving around in a dynamic environment -- a street corner! -- confounds current systems. I offer even more bonus points for explaining why the supposedly smart robot can't understand your easy conversational banter with it -- at all.

AI systems (robots' brains) and full robotic systems suffer from two limitations that show no signs of going away, now or in any foreseeable future. First, there is the inability to keep track of aspects of their environment that become relevant as a function of time -- dynamic environments, where things change as the robot moves through it, in other words, the real world. Second, there is the inability to keep track of aspects of language that keep changing as a function of time -- conversation, in plain and simple everyday terms.

The Turing Test has been debated since the inception of AI in the 1950s, and to date it shows no sign of yielding to gargantuan increases in hardware performance via Moore's Law, or advances in algorithmic techniques, such as convolutional neural networks, or so-called Deep Learning. An enthusiast with the stripes of, say, Ray Kurzweil overwhelms the uninformed with scientific-looking graphs showing exponential progress toward superintelligence. Yet a simple graph of improvements on the Turing Test over the years would be decidedly flat, and downright embarrassing.

I wonder what Bill Gates or Elon Musk or any other luminary enthralled with the current rhetoric about a coming AI would say to such a graph? The smart money is on looking at the problem without sci-fi goggles, separating it from other, narrower problems where human intelligence is decomposable into a set of representations and algorithms that admit of automation, and clarifying the actual landscape so that other, serious scientists and interested parties can productively discuss the roles of computation and human thinking in society.

It's a myth that the dividing line between man and machine is essentially temporary, and that all problems once thought solely in the purview of human intelligence will eventually yield computational solutions. We're going backward with the Turing Test, for instance, as the latest Loebner Prize competition demonstrated: Eugene Goostman simulates a vapid, sardonic 13-year-old Ukrainian speaking broken English to fool a few people for a few minutes (who no doubt are performing backbends to reduce their own standards of conversation with actual persons, in hopes of a history-making moment with a mindless chatterbot).

There's no real response to what I've just said. I mean, no one seriously thinks computers are making substantial let alone exponential progress on actual natural language interpretation or generation in non-constrained domains -- yet by sleight of hand, ignorance, overenthusiasm, blurry vision, dyspepsia, or what have you, provision of seemingly related examples (chess, driverless cars, Google Now for recommendations, or Siri for voice recognition, perhaps) keeps the parlor tricks alive, and claims of inexorable progress continue.

There is progress on computation, of course, but it has little to do with the machines themselves acquiring actual intelligence. It has everything to do with researchers in computer science and related fields continuing to use their own creative intellects to find clever ways to represent certain tasks that admit of algorithmic decomposition, such that the tasks can be mapped onto digital computer hardware. Our intelligence itself does not appear to be so reducible.

And so these discussions are a tempest in a teapot. Who's really preparing for the robot future? And here let's avoid equivocating between an economy increasingly dominated by dumb automation, and a world inhabited by truly intelligent digital beings. Who's worried about the latter? I mean, beyond relatively uninformed, self-styled futurists (that most coveted of social roles), or nose-against-the-glass software junkies in the Valley, binge-watching digitally-remastered editions of Blade Runner, and speculating about "dating their operating systems," as director Spike Jones offered up, memorably, complete with the sultry voice of Scarlett Johansson in his 2013 hit movie Her.

Sci-fi fantasies dressed up as serious "What if?" discussions are not new, of course. Wormholes have a basis in actual science (but probably are still not possible). I'd rather see a perpetual shouting match about the coming of time travel, like back in the Star Trek days. It'd be sci-fi still, but actually closer to reality than the imminent-smart-robots palaver today. There's a discussion to be had about computation in society, certainly, but it's not the silly one we are having.

File under 'well said' VII

Frederick Douglas"It is easier to build strong children than to repair broken men"