Friday, September 15, 2006

JICYMI

Just In Case You Missed It

Singapore: A David to Our Goliath?

The July 23 rd issue of Time magazine featured an article under the headline “Stem Cell Central.” A portion read as follows: “Just last week President George W. Bush used the first veto of his presidency to block a congressional action that would have lifted his 2001 ban on federal funding for most stem-cell research, ensuring that cell lines will remain scarce and money short at research centers lacking the state funding or private wealth to thumb their nose at dollars from Washington.”

It continued, “While Bush’s action infuriated U.S. scientists, political catfights aren’t the only things that make stem-cell research a challenge. The science is complex, the cost is high, and the efforts are scattered all over the world. Enter Singapore, which has begun offering itself as a combination sanctuary and think tank for scientists in the field.”

Most of the media coverage of the veto action dwelled on what was perceived as an effort to placate Bush’s core constituency—the religious right wing of the Republican Party. This was inferred from the fact that public opinion polls indicate that 70 percent of Americans favor stem cell research. Also covered was the fact that the vote that passed the original bill was 67 to 32 (only four votes short of the number required to overturn the veto), indicating that more than a few Republicans voted for it. What most of the media overlooked at the time however, was the reference to Singapore contained in the Time magazine article.

Despite the fact that Google has what it claims to be 86,700 links to the subject, it took almost four weeks for another major publication, The New York Times, to run an article on the “Singapore Biopolis.” So, what in the world is a “biopolis” and if there is that much information on the Internet about it, why isn’t it better known? I can’t answer the second question, but here is the answer to the first.

“Biopolis” is a play on the word “metropolis,” so it is a city-like environment devoted to biotech and biomedical research and development. Time magazine describes it as “A group of seven asymmetrical buildings with sci-fi names like Nanos and Proteus, all connected by transparent sky bridges. Biopolis is meant to be a self enclosed science city, housing government research institutes, biotech start-ups, and global drug companies.”

Currently it consists of two million square feet of space, 95% rented, with an additional 400,000 square feet to be completed by the end of this year. However, it is not just the space factor that makes this area so attractive to numerous multi-national scientific organizations, not only from America, but also from all over the world. The concept behind Biopolis is ingenious. The companies that have established R&D facilities there can share in a state-of-the-art infrastructure and specialized services at highly competitive rates, thus reducing their R&D costs significantly.

According to Time, “The facilities at Biopolis include a US $1 million Proteomics Laboratory for analyzing proteins and peptides; a Microarray Center to provide resources for printed and commercially produced chips; a 9.4T MRI machine housed at the Bioimaging Lab for animal imaging; a laboratory to provide routine and ultra-high speed confocal microscope; imaging solutions on animal samples; and a research facility with specific pathogen free research animals.” (I’m not sure what all that means but it sure sounds impressive.)

In addition to snaring some of the world’s leading clinical research organizations, the R&D operations of numerous multinational companies, and the research as well as the manufacturing facilities of many of the top pharmaceutical companies, Singapore has already attracted more than 50 of the best scientific minds in the world, especially those dealing with stem cell research. Researchers from such prestigious establishments as the National Cancer Institute, Massachusetts Institute of Technology, a husband wife team from the University of California, San Diego’s School of Medicine, and a Scotsman who helped clone Dolly the sheep have all been attracted to Singapore for multiple reasons.

The Time article is particularly discouraging to American’s as it states, “Given its small size, Singapore will never really threaten the U.S.’s overall biomedical muscle, nor is it trying to. But it’s impossible to witness the buzz at Biopolis or meet scientists who have chosen Southeast Asia over Stanford and not wonder how much the U.S. could achieve in stem-cell research if it were as science mad as this city-state of 4.4 million. For all the hundreds of millions of dollars Singapore has devoted to high-tech lab equipment and recruiting top scientists from around the world, it is spending just as much to educate a homegrown core of young Singaporean scientists to continue the work. Until they come of age, Yeo [a Singapore recruiter of scientists] will be just as happy to come shopping for talent in the U.S., and as long as the stem-cell debate stumbles on in the U.S., American scientists will be just as happy to go.” —a sad commentary on a sad state of affairs. David found a weakness in Goliath’s defense and attacked it. Singapore has used the same strategy on us. It seems that is happening all too often these days.

What in the World is a Wikipedia?

Several years ago, and then again last November, I described the ideas of the legendary economist Joseph Schumpeter who, almost 65 years ago, wrote about “creative destruction.” Elaborating on the subject in 1997, Clayton M. Christensen, Professor of Business Administration at Harvard, in his book The Innovator’s Dilemma, coined the phrase “disruptive technology” and subsequently renamed the phrase with the term “disruptive innovation,” both of which were a take on Schumpeter’s theory. The fine distinction aside, the definition is the same: a new technological innovation, product, or service that eventually overturns the existing dominant technology or product in the market.

There are numerous examples: steam engines and internal combustion engines; automobiles; minicomputers; container ships and containerization; digital photography; semiconductors. The question then arises, is Wikipedia a disruptive innovation?

Ah! You ask, what in the world is Wikipedia? As you might have gathered from the word, the simplest, but hardly the most complete definition would be that it is an online encyclopedia—with the added peculiarity of being open and interactive.

As described in the September 2006 edition of The Atlantic Online (www.theatlantic.com/doc/200609/wikipedia), “Instead of relying on experts to write articles according to their expertise, Wikipedia lets anyone write about anything. You and I and any wired up fool can add entries, change entries, even propose that entries be deleted.”

In what sounds like a rave review, The Atlantic enthuses that, “Wikipedia has the potential to be the greatest effort in collaboration gathering the world has ever known, and it may well be the greatest effort in voluntary collaboration of any kind. The English language version alone has more than a million entries [It’s 1.3 million as of July 1, 2006 compared to Encyclopedia Britannica’s 85,000 in print form and 120,000 online]. It is consistently ranked among the most visited web sites in the world. A quarter century ago it was inconceivable that a legion of unpaid, unorganized amateurs scattered about the globe could create anything of value, let alone what may one day be the most comprehensive repository of knowledge in human history. Back then we knew that people do not work for free; or if they do work for free, they do a poor job, and if they work in large numbers, the result is a muddle.”

While hardly a muddle, the Wikipedia effort is not without shortcomings and faults. Interestingly, its relative importance can not only be judged by its usage (launched in 2001, it is now the seventeenth most popular site on the internet, with the number of visitors doubling every month, receiving as many as a staggering fourteen thousand hits per second) but by the fact that at the same time that The Atlantic article appeared, The New Yorker (07/31/2006) published a very lengthy article on the same subject, both in print and online (www.newyorker.com/fact/content/articles/060731fa_fact).

The major downside to the Wikipedia concept is the opportunity for vandalism, in that the open interactive option could lead to deliberate misrepresentations. According to The Atlantic, “…it is a widely accepted view that Wikipedia is comparable to [Encyclopedia] Britannica. Vandalism also has proved much less of an issue than originally feared. A study by IBM suggests that although vandalism does occur (particularly on high profile entries like ‘George W. Bush’), watchful members of the huge Wikipedia community [200,000 registered members] usually swoop down to stop the malfeasance shortly after it begins.”

It is obvious from its huge popularity that Wikipedia could be a very valuable information resource. However, since there is a slight chance that a particular article could contain misinformation, it would be desirable to double check against a second source. Good hunting.

Dietary Supplements? Certainly—Not!

With more and more Americans focusing on health issues, industry marketers are not oblivious to this trend, and have developed a lexicon of words to impress, mystify, and perhaps confound consumers. At one point in what now seem to feel like the distant past, the word “vitamin” was adequate to describe products that might provide some health benefits and even prolong life—then came phrases “nutritional supplements” and “dietary supplements.”—that sounded more professional. Now we have “functional foods,” “phytochemicals,” “cosmacueticals,” and “neutraceuticals”—they sound more doctoral.

The Federal Drug Administration (FDA), the agency required to approve “real” drugs and pharmaceuticals, has proposed to permit health claims for dietary supplements without prior FDA approval on the same basis as for foods. In addition, a court decision held that the FDA musts allow a dietary supplement to make a health claim without it being based on an authoritative statement so long as the label bears an appropriate disclaimer. The dangers to consumers here are obvious.

That brings us to two different supplements that appear to be favorites of seniors here and elsewhere. Both have finally undergone rigidly controlled studies to determine their effectiveness. Results of both studies were recently reported in The New England Journal of Medicine. The first was reported as follows: “Saw Palmetto is used by over 2 million men in the United States for the treatment of benign prostatic hyperplasia and is commonly recommended as an alternative to drugs approved by the Federal Drug Administration (FDA).” The studies conclusions were quite brief and specific, “In this study, saw palmetto did not improve symptoms or objective measures.” Too bad guys!

The second is the popular combination of glucosamine and chondroitin sulfate. Until now, there was little in the way of empirical proof that this supplement actually provided relief from osteoarthritis. The few studies that had been done were suspect.

A National Institute of Health press release in February stated, “In a study in the New England Journal of Medicine, the popular dietary supplement combination of glucosamine plus chondroitin sulfate did not provide significant relief from osteoarthritis pain among all participants. However, a smaller subgroup of study participants with moderate-to-severe pain showed significant relief with the combined supplements.” However, it then stated, “Because of the small size of the moderate-to-severe pain subgroup the findings in this group…should be considered preliminary and need to be confirmed in a study designed for that purpose.” In other words, that part of the study is a maybe, but for the mild and severe pain group, Celebrex provided significantly greater relief.

The most puzzling aspect of the results was the fact that while Celebrex reduced pain by 20 percent or more (that was the benchmark) in 70 percent of the mild and severe pain groups, a placebo had that same result in 60 percent of the participants. Hey, you guys in the supplement business, there’s your next hot item, the neutraceutical placebo for osteoarthritis. Maybe I should patent the idea.

1 Comments:

At 2:57 PM, Anonymous Anonymous said...

Saw a documentary on Discovery HD Theatre over the weekend, called 'The History of Singapore.' Really amazing stuff what they've done with the country over the past 40 years, when they were unexpectedly kicked out of Malaysia and left to fend on their own (The Prime Minister, Lee Kuan Yew, the 'father' of Singapore who drove its development, actually cried on national television on the day of independence, and they were not tears of joy). Singapore is happy to pay for the college education of the best and brightest students abroad (while it builds its own education city to house satellite campuses of universities around the world), but bonds the students, ensuring they will work for a Singapore government firm for at least six years after they graduate. This is ingenious in the sense that the students are inbued with a sense of national pride, responsibility, and are eager and willing to pay back the country that gave it so much.

 

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