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Corante Blogs examine, through the eyes of leading observers, analysts, thinkers, and doers, critical themes and memes in technology, business, law, science, and culture.

The Press Will Be Outsourced Before Stopped

Vin Crosbie, on the challenges, financial and otherwise, that newspaper publishers are facing: "The real problem, Mr. Newspaperman, isn't that your content isn't online or isn't online with multimedia. It's your content. Specifically, it's what you report, which stories you publish, and how you publish them to people, who, by the way, have very different individual interests. The problem is the content you're giving them, stupid; not the platform its on."
by Vin Crosbie in Rebuilding Media

Travels In Numerica Deserta

There's a problem in the drug industry that people have recognized for some years, but we're not that much closer to dealing with it than we were then. We keep coming up with these technologies and techniques which seem as if they might be able to help us with some of our nastiest problems - I'm talking about genomics in all its guises, and metabolic profiling, and naturally the various high-throughput screening platforms, and others. But whether these are helping or not (and opinions sure do vary), one thing that they all have in common is that they generate enormous heaps of data.
by Derek Lowe in In the Pipeline

Disrobing the Emperor: The online “user experience” isn't much of one

Now that the Web labor market is saturated and Web design a static profession, it's not surprising that 'user experience' designers and researchers who've spent their careers online are looking for new worlds to conquer. Some are returning to the “old media” as directors and producers. More are now doing offline consulting (service experience design, social policy design, exhibition design, and so on) under the 'user experience' aegis. They argue that the lessons they've learned on the Web can be applied to phenomena in the physical and social worlds. But there are enormous differences...
by Bob Jacobson in Total Experience

Second Life: What are the real numbers?

Clay Shirky, in deconstructing Second Life hype: "Second Life is heading towards two million users. Except it isn’t, really... I suspect Second Life is largely a 'Try Me' virus, where reports of a strange and wonderful new thing draw the masses to log in and try it, but whose ability to retain anything but a fraction of those users is limited. The pattern of a Try Me virus is a rapid spread of first time users, most of whom drop out quickly, with most of the dropouts becoming immune to later use."
by Clay Shirky in Many-to-Many

The democratisation of everything

Over the last few years we've seen old barriers to creativity coming down, one after the other. New technologies and services makes it trivial to publish text, whether by blog or by print-on-demand. Digital photography has democratised a previously expensive hobby. And we're seeing the barriers to movie-making crumble, with affordable high-quality cameras and video hosting provided by YouTube or Google Video and their ilk... Music making has long been easy for anyone to engage in, but technology has made high-quality recording possible without specialised equipment, and the internet has revolutionised distribution, drastically disintermediating the music industry... What's left? Software maybe? Or maybe not."
by Suw Charman in Strange Attractor

RNA Interference: Film at Eleven

Derek Lowe on the news that the Nobel Prize for medicine has gone to Craig Mello and Andrew Fire for their breakthrough work: "RNA interference is probably going to have a long climb before it starts curing many diseases, because many of those problems are even tougher than usual in its case. That doesn't take away from the discovery, though, any more than the complications of off-target effects take away from it when you talk about RNAi's research uses in cell culture. The fact that RNA interference is trickier than it first looked, in vivo or in vitro, is only to be expected. What breakthrough isn't?"
by Derek Lowe in In the Pipeline

PVP and the Honorable Enemy

Andrew Phelps: "Recently my WoW guild has been having a bit of a debate on the merits of Player-vs.-Player (PvP) within Azeroth. My personal opinion on this is that PvP has its merits, and can be incredible fun, but the system within WoW is horridly, horribly broken. It takes into account the concept of the battle, but battle without consequence, without emotive context, and most importantly, without honor..."

From later in the piece: "When I talk about this with people (thus far anyway) I typically get one of two responses, either 'yeah, right on!' or 'hey, it’s war, and war isn’t honorable – grow the hell up'. There is a lot to be said for that argument – but the problem is that war in the real historical world has very different constraints that are utterly absent from fantasized worlds..."
by Andrew Phelps in Got Game

Rats Rule, Right?

Derek Lowe: "So, you're developing a drug candidate. You've settled on what looks like a good compound - it has the activity you want in your mouse model of the disease, it's not too hard to make, and it's not toxic. Everything looks fine. Except. . .one slight problem. Although the compound has good blood levels in the mouse and in the dog, in rats it's terrible. For some reason, it just doesn't get up there. Probably some foul metabolic pathway peculiar to rats (whose innards are adapted, after all, for dealing with every kind of garbage that comes along). So, is this a problem?.."
by Derek Lowe in In the Pipeline

Really BAD customer experience at Albertsons Market

Bob Jacobson, on shopping at his local Albertsons supermarket where he had "one of the worst customer experiences" of his life: "Say what you will about the Safeway chain or the Birkenstock billionaires who charge through the roof for Whole Foods' organic fare, they know how to create shopping environments that create a more pleasurable experience, at its best (as at Whole Foods) quite enjoyable. Even the warehouses like Costco and its smaller counterpart, Smart & Final, do just fine: they have no pretentions, but neither do they dump virtual garbage on the consumer merely to create another trivial revenue stream, all for the sake of promotions in the marketing department..."
by Strange Attractor in Total Experience

The Guardian's "Comment is Free"

Kevin Anderson: "First off, I want to say that I really admire the ambition of the Guardian Unlimited’s Comment is Free. It is one of the boldest statements made by any media company that participation needs to be central to a radical revamp of traditional content strategies... It is, therfore, not hugely surprising to find that Comment is Free is having a few teething troubles..."
by Kevin Anderson in strange
In the Pipeline: Don't miss Derek Lowe's excellent commentary on drug discovery and the pharma industry in general at In the Pipeline

The Loom

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October 23, 2003

Consciousness and the culture wars, part 2

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Posted by Carl Zimmer

After years at a slow burn, the controversy over Terri Schiavo has hit the national news. Schiavo lost consciousness in 1990 after a cardiac arrest, and her husband recently won a lawsuit to have her feeding tube removed, over the objection of her family. Then on Tuesday, Governor Jeb Bush ordered that her tube be reattached, using powers given to him by the Florida legislature the day before.

If ever there was an argument for a living will, the Schiavo case is one. She supposedly told her husband she wouldn't want to be kept alive artificially, but never wrote anything down. If she had, the decision to give or withdraw care might have been a simple one. Instead, her husband and her family--and the country by proxy now--is in a muddled shouting match over life, death, the right to die, consciousness, and the soul.

There are several separate debates here, but people have been jumping back and forth between them as if they were all one. One argument is over the right for a surrogate to make a decision about whether someone should refuse not only medicine but even food. This is controversial no matter what state of mind a patient is in. (The Times points out today that the Florida legislature, by taking over the decision about whether Schiavo lives or die, has probably passed on unconstitutional law.)

The state of Schiavo's mind is the source of a second argument. Her family has posted videos on their web site that they claim shows she reacts to loved ones, smiles, and understands what they say. They also say that she could respond to therapy and improve.

The family claims to have testimony from 15 doctors backing up their claiims, but I can't find anything on their web site, so it's hard to know what these doctors are saying. But I do know that Dr. Joseph Giacino of the JFK Medical Center in New Jersey has taken a look at the videos and hasn't found them persuasive. (See his remarks in a story last week in Time.) Giacino is one of the top experts on the rehabilitation of people with impaired consciousness. He also developed an objective way to gauge the level of consciousness in people like Schiavo. When I interviewed him for an Sept. 28 article for the New York Times Magazine, he explained how people in vegetative states not only have their eyes open, but also can assume disconcerting facial expressions. He gave me a tour of the Center for Head Injuries, where he works, and I could see how easy it is to read into a face what we want to see.

Giacino and others have defined an intermediate stage of consciousness, called the minimally conscious state. It's for people who show fleeting signs of awareness. He and his colleagues have shown that people who are diagnosed in a minimally conscious state are more likely a year after their injury to have better functional outcome than those who were diagnosed in a vegetative state. But the longer a person like Schiavo is in a vegetative state, the less likely it is that any recovery will happen.

It can be hard to accept this. I've been surprised to discover this firsthand in the reactions to my article. In it, I wrote about how brain scans of people in minimally conscious states can show surprisingly complex responses to the sounds of voices and other stimuli. People in chronic vegetative states show no such responses. Yet I find my article keeps popping up as an exhibit in arguments that Schiavo is actually responsive and could recover. The latest example is a letter to the editor of the Tampa Tribune. In every case, people want to mix up the results from minimally conscious patients and people in a chronic vegetative state.

Living wills may help avoid future conflicts, but my talks with experts makes me think that more is needed. We need a lot more research on how to make accurate diagnoses for people with serious brain injuries. And then we need to use that research to make sure that patients are carefully observed for more than just a few weeks, with both rigorous bedside exams and with brain scans. All this will be expensive, but it's not as if our current state of neglect is a bargain. Hundreds of thousands of people are in vegetative or minimally conscious states, and their lifetime care can cost over a million dollars a piece. We can do better.

PS--Steve Johnson also muses on the strange paradox of the Schiavo case.

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