Early in America's history, white Irish slaves outnumbered black slaves and endured worse treatment at the hands of their masters.

Explanation: What's true: Like impoverished people of other nationalities, many emigrated from Ireland to the Americas in the 17th and 18th centuries as indentured servants; a smaller number were forcibly banished into indentured servitude during the period of the English Civil Wars; indentured servants often lived and worked under harsh conditions and were sometimes treated cruelly. What's false: Unlike institutionalized chattel slavery, indentured servitude was neither hereditary nor lifelong; unlike black slaves, white indentured servants had legal rights; unlike black slaves, indentured servants weren't considered property.

History, American History, irish slaves, irish slaves myth

A facet of U.S. history largely unfamiliar to Americans themselves is the role of indentured servitude in the survival and growth of the original 13 colonies. The earliest settlers needed laborers, but only wealthy people could afford passage to the New World. This led to a system whereby those who lacked means were brought from Europe under contract to work off their passage, room, and board over a period of two to seven years, until they were considered to have earned their freedom. No fewer than half of the immigrants who came to the New World during the colonial period arrived as indentured servants. Among the many thousands of impoverished Europeans brought over in this fashion were men, women, and children from England, Ireland, Scotland, Germany, and elsewhere, but over the intervening centuries the notion has arisen that the Irish, in particular, were shipped to the New World as “white slaves.”  In fact, according to an article first published on the Internet in 2008 and endlessly recirculated since, Irish slaves were not only common in early America, they were more common than African slaves, and often treated more harshly. The article making these claims is usually credited to an individual named John Martin, who, in turn, found most of his “facts” in a 2003 article by James F. Cavanaugh called “Irish Slaves in the Caribbean.” It has gone by many names, but as of mid-2016, the most shared version of the Irish slave narrative was entitled “Irish: The Forgotten White Slaves,” and posted under the byline of a man named Ronald Dwyer. Regardless of who is or isn’t credited with writing it, nearly every iteration of the piece begins in exactly the same way: They came as slaves: human cargo transported on British ships bound for the Americas. They were shipped by the hundreds of thousands and included men, women, and even the youngest of children. Whenever they rebelled or even disobeyed an order, they were punished in the harshest ways. Slave owners would hang their human property by their hands and set their hands or feet on fire as one form of punishment. Some were burned alive and had their heads placed on pikes in the marketplace as a warning to other captives. We don’t really need to go through all of the gory details, do we? We know all too well the atrocities of the African slave trade. But are we talking about African slavery? King James VI and Charles I also led a continued effort to enslave the Irish. Britain’s Oliver Cromwell furthered this practice of dehumanizing one’s next door neighbor. The Irish slave trade began when James VI sold 30,000 Irish prisoners as slaves to the New World. His Proclamation of 1625 required Irish political prisoners be sent overseas and sold to English settlers in the West Indies. By the mid 1600s, the Irish were the main slaves sold to Antigua and Montserrat. At that time, 70% of the total population of Montserrat were Irish slaves. Ireland quickly became the biggest source of human livestock for English merchants. The majority of the early slaves to the New World were actually white. Woven throughout is the implication that the reason so few Americans know anything about the so-called “forgotten” history of Irish slavery is that it has been excluded from “biased” history books. Limerick-based research librarian and historian Liam Hogan takes aim at this notion in a series of papers debunking what he calls “the Irish slaves myth.” There were no Irish slaves in the Americas, Hogan says. People who claim there were are conflating indentured servitude with chattel slavery — two distinct forms of servitude with more differences between them than similarities:  “White indentured servitude was so very different from black slavery as to be from another galaxy of human experience,” as Donald Harman Akenson put it in If the Irish Ran the World: Montserrat, 1630-1730. How so? Chattel slavery was perpetual, a slave was only free once they they were no longer alive; it was hereditary, the children of slaves were the property of their owner; the status of chattel slave was designated by ‘race’, there was no escaping your bloodline; a chattel slave was treated like livestock, you could kill your slaves while applying “moderate correction” and the homicide law would not apply; the execution of ‘insolent’ slaves was encouraged in these slavocracies to deter insurrections and disobedience, and their owners were paid generous compensation for their ‘loss’; an indentured servant could appeal to a court of law if they were mistreated, a slave had no recourse for justice. Hogan pins a 2014 resurgence of the Irish slaves narrative to increasing racial tensions within the United States, situating it within a larger world view desirous of absolving white Europeans of blame for the transatlantic slave trade that brought an estimated 12 million Africans to the New World in lifelong bondage: From Stormfront.org, a self-described online community of white nationalists, to David Icke’s February 2014 interview with Infowars.com, the narrative of the ‘White slaves’ is continuously promoted. The most influential book to claim that there was ‘white slavery’ in Colonial America was Michael Hoffman’s They Were White and They Were Slaves: The Untold History of the Enslavement of Whites in Early America. Self-published in 1993, Hoffman, a Holocaust denier, unsurprisingly blames the Atlantic slave trade on the Jews. By blurring the lines between the different forms of unfree labour, these white supremacists seek to conceal the incontestable fact that these slavocracies were controlled by — and operated for the benefit of — white Europeans. This narrative, which exists almost exclusively in the United States, is essentially a form of nativism and racism masquerading as conspiracy theory. That the institution of chattel slavery in America was founded on race is undeniable. Beginning in the late 1600s, the colonies all adopted “slave codes” which, among other things, routinely defined slaves as “Negro” or “African,” according to the Encyclopedia Britannica:  In all of them the color line was firmly drawn, and any amount ofAfrican heritage established the race of a person as black, with little regard as to whether the person was slave or free. The status of the offspring followed that of the mother, so that the child of a free father and a slave mother was a slave. Slaves had few legal rights: in court their testimony was inadmissible in any litigation involving whites; they could make no contract, nor could they own property; even if attacked, they could not strike a white person. The Dred Scott decision handed down by the Supreme Court in 1857 reaffirmed that racialized definition of slavery. The 7 to 2 decision in Scott v. Sanford held that plaintiff Dred Scott, a black slave, did not qualify as an American citizen and had no standing to sue in federal court because, in part, persons imported as slaves “had for more than a century before been regarded as beings of an inferior order”: In the opinion of the court, the legislation and histories of the times, and the language used in the Declaration of Independence, show, that neither the class of persons who had been imported as slaves, nor their descendants, whether they had become free or not, were then acknowledged as a part of the people, nor intended to be included in the general words used in that memorable instrument … They had for more than a century before been regarded as beings of an inferior order, and altogether unfit to associate with the white race, either in social or political relations; and so far inferior, that they had no rights which the white man was bound to respect; and that the negro might justly and lawfully be reduced to slavery for his benefit. In terms of historical accuracy, the Irish slave story is a hodgepodge. For example, the “Proclamation of 1625” supposedly requiring all Irish prisoners to be sent overseas did not exist. You won’t find it in any history books. There was a 1603 proclamation by James I ordering that “rogues, vagabonds, idle, and dissolute persons” be “banished and conveyed” to “places and parts beyond the seas,” etc., but this was not directed at the Irish in particular. It was put to use decades later in the wake of the English Civil Wars, however, as a justification for forcibly shipping thousands of Irish prisoners, vagrants, and orphans to the Caribbean as indentured servants. More than any other, this historical fact inspired the notion that the Irish were enslaved. Still, the text wildly exaggerates the number of those treated in this fashion, falsely claiming that “300,000 were sold as slaves.” (Liam Hogan unravels these and similar statistical misrepresentations in “A Review of the Numbers in the Irish Slaves Meme.”)   That thousands of Irish people were carried across the sea against their will and indentured to serve on plantations isn’t disputed. It happened. What’s in question is whether or not they are rightly referred to as “slaves.” Some writers, such as genealogist and Irish Times columnist John Grenham, ask why not: The labor they did was slave labor, and their circumstances were much worse than those of the indentured workers who traveled at the same time and later, not least because indentured work, though often harsh, was voluntary and time-limited. Refusing to call them slaves is quibbling. Is it mere quibbling? Generically speaking, any form of forced labor can be called slavery. But what do we gain by doing so, besides blurring historical distinctions? Consider impressment, the 18th-century British naval practice of kidnapping young men and forcing them to serve on sailing vessels. That’s slavery, in a sense. So is being sentenced to hard labor in prison. But while these share features in common with the institution of chattel slavery in America, they are on a whole separate plane. It isn’t “bias” that keeps legitimate historians from substituting the term “slavery” for “impressment,” “hard labor,” or even “forced indentured servitude.” It’s a simple respect for the facts.


Britain backs GSK's gene therapy for 'bubble boy' syndrome.

Explanation: GlaxoSmithKline’s gene therapy for the so-called “bubble boy” disease was approved by Britain’s healthcare cost watchdog NICE, despite a price tag of almost 600,000 euros ($700,000).

Gene therapy is designed to deliver a one-off cure for the patient and drugmakers are typically asking a hefty price that is comparable to the combined costs of alternative life-long treatment. Britain’s National Institute for Health and Care Excellence (NICE) said in draft guidance published on Friday that Strimvelis gene therapy used against adenosine deaminase deficiency, or ADA-SCID, improves overall survival compared with standard stem cell transplant therapy. The inherited condition disables the immune system and without treatment, children with ADA-SCID need to be kept in isolation to avoid infections – hence it has become known as the  “bubble baby” or “bubble boy” syndrome. “Strimvelis represents an important development in the treatment of ADA-SCID, offering the potential to cure the immune aspects of the condition and avoid some of the disadvantages of current treatments,” NICE said. “Costing 594,000 euros, the treatment is usually given once only and the effects are thought to be life-long,” it added. The draft guidance marks the first time NICE has applied its new cost effectiveness limits for treatments for very rare conditions.


Queen Elizabeth II wore a Burmese Ruby Tiara as a slight against U.S. President Donald Trump.

Explanation: What's true: Queen Elizabeth II wore a Burmese Ruby Tiara while meeting President Donald Trump in June 2019. The 96 rubies that adorn this tiara are said to symbolically protect the wearer from 96 diseases. What's false: No evidence exists that the queen specifically chose this tiara as a slight against Trump, and the queen has worn this same tiara on several other occasions and in the company of a wide range of world leaders.

A rumor started circulating during U.S. President Donald Trump’s state visit to the United Kingdom in June 2019 that Queen Elizabeth II had “thrown shade” at the American leader by wearing a tiara that symbolically warded off evil and sickness:  The Burmese Ruby Tiara worn by the Queen on that occasion was commissioned in 1973 and included 96 rubies given to Elizabeth as a wedding present by the people of Burma. The House of Garrard, the jewelry company that made the tiara, recently posted an image of this bejeweled headpiece to their Instagram page and explained that the rubies were originally intended as a symbolic  protection against evil and illness: The Queen’s Burmese Ruby Tiara is one of the most symbolic and personal pieces created for Her Royal Highness by the House of Garrard. The 96 rubies mounted in the tiara were originally given to the queen as a wedding gift from the people of Burma, intended as a symbol of protection against illness and evil. #Garrard #royalfamily #heritage #ruby #queenelizabethii The Court Jeweler blog elaborated on that topic: The new ruby tiara was made by Garrard in 1973. The rubies used in the making of the new piece were also a wedding gift; Elizabeth received them from the people of Burma. The gift included precisely 96 rubies, all of which are now set in the tiara. The Burmese people believe that rubies help protect the wearer from the 96 diseases that can afflict the human body — they definitely wanted to ensure that Elizabeth remained hale and hearty. The rubies and diamonds were set in a series of rose motifs, and if you know your English history, you’ll recognize a heraldic rose that combines white and red petals as the Tudor rose. The House of Garrard also posted an image of Queen Elizabeth wearing this tiara during President Trump’s state visit in June 2019: HM Queen Elizabeth II wore a suite of ruby jewels by Garrard to the State Banquet hosted for the US President yesterday. The Burmese Ruby and Diamond Tiara crafted in 1973 was complemented by a magnificent ruby necklace and matching earrings. #Garrard #royalfamily #queenelizabeth #heritage #highjewellery #tiara A post shared by  House Of Garrard (@houseofgarrard) on Jun 4, 2019 at 4:30am PDT   If Her Majesty’s wearing the Burmese Ruby Tiara were a sign of disrespect, one would expect that headpiece to see infrequent use. However, Elizabeth has worn the tiara on numerous occasions since it was commissioned in 1973, including while meeting world leaders such as South Korean President Roh Moo-hyun, India’s President Pratibha Patil, Slovenia’s President Danilo Turk, King Abdullah II of Jordan, and French President François Mitterrand. The queen has also worn the tiara during celebratory events such as her silver jubilee in 1977:  In addition, the queen wore this tiara for an official portrait in 1992. That photograph would subsequently be used on the face of the £10 and £20 banknotes from St. Helena:  Given that Queen Elizabeth has worn this tiara in the company of a variety of world leaders and for a number of different special occasions, those claiming that she chose to wear it in June 2019 specifically as a slight against President Trump appear to be revealing more about their own political beliefs than the queen’s.


South Korea court strikes down abortion law in landmark ruling.

Explanation: South Korea’s Constitutional Court on Thursday overturned a ban on abortion that has stood for more than 65 years, saying in a landmark ruling that current law unconstitutionally curbs women’s rights.

In a statement, it said the ban, as well as a law making doctors liable to criminal charges for abortions done with the woman’s consent, were both unconstitutional. “The law criminalizing a woman who undergoes abortion of her own will goes beyond the minimum needed to achieve the legislative purpose and limits the right of self-determination of the woman,” it said in its ruling. Seven of the nine justices ruled the law unconstitutional, and two dissented. It had survived a challenge in 2012 when the court split evenly, four to four, as one seat was vacant then. “I believe this ruling frees women from shackles,” said Kim Su-jung, a lawyer representing the plaintiff, a doctor charged with conducting 69 illegal abortions. The ruling reflects a trend towards decriminalizing abortion, as cases of criminal punishment have fallen in recent years. Just eight new cases of illegal abortion were prosecuted in 2017, down from 24 in 2016, judicial data show. Of 14 cases  decided in lower courts in 2017, 10 postponed a ruling on condition that no crime be committed for a fixed time. A survey by polling firm Realmeter last week showed more than 58 percent of South Korean respondents favor scrapping the ban, but a little over 30 percent wanted it retained. Dueling demonstrations outside the courthouse highlighted persistent divisions in opinion. “How could you kill a baby that’s growing inside you? Abortion is a murder,” said Kim Yeong-ju, a 47-year-old mother of two who demonstrated in favor of the ban. But the ruling helps ensure pregnancy is a personal choice, said Lee Ga-hyun, who joined a protest against the law after she saw a friend risk her life using illegal medication for an abortion. “I welcome today’s ruling, which made it possible for women like me and my friend to live their lives freely,” added Lee, 27. The abortion ban dates from 1953, and has not changed materially since South Korea first adopted its criminal law after the 1950-1953 Korean War. Abortion numbers have been dropping, with 49,764 estimated for women between 15 and 44 in 2017, down from 342,433 in 2005 and 168,738 in 2010, as birth control measures spread and the population of women in that age range falls, says the Korea Institute for Health and Social Affairs. A 2017 petition urging the presidential Blue House to scrap the law against abortion and allow abortion medication drew more than 230,000 signatures. At the time, a senior government official said existing law was problematic because it only held women accountable for abortion. President Moon Jae-in, a liberal, has not stated clearly if he supports the law, but has called for more discussions to build consensus. The law prescribes jail for up to a year or fines of up to 2 million won ($1,756) for women who undergo abortion. It also sets terms of up to two years in jail and seven-year license suspensions for medical professionals, including doctors, who provide abortions at the woman’s request. Exemptions now allow abortions within 24 weeks of pregnancy for medical reasons, such as a hereditary disease or grave danger to the mother, or following rape. In all those cases, the law requires the spouse’s permission. “If the case does not fall under an exemption, the law forces the pregnant woman to maintain the pregnancy completely and uniformly, without exception,” the court said. But the law will stay on the books until the end of 2020, it added, to allow time for its revision. In a statement, the government said it would respect the decision and take steps to comply. ($1=1,138.9000 won)


Houston reports 3 teens treated for vape-related lung issues.

Explanation: Houston health officials say three teenagers have been hospitalized with serious lung illnesses following electronic cigarette use and vaping.

Health, Lung disease, General News, Houston

The Houston Health Department announced Tuesday the hospitalizations took place within the past month Dr. David Persse, who is health authority for the Houston Health Department and EMS medical director, says all three teenagers are doing well and improving. Two of the teenagers are no longer hospitalized. Persse declined to provide additional information about the three due to privacy laws. Health officials in Dallas County on Tuesday reported they had identified 14 probable or confirmed cases of severe respiratory illness related to e-cigarettes. The Centers for Disease Control and Prevention has identified over 450 possible cases in 33 states of lung disease related to vaping, including as many as five deaths.


Scientists look to stem cells to mend broken hearts

Explanation: It’s hard to know how a charity hoping to raise money for stem cell research could have achieved a better marketing coup than landing this story on the Reuters wire. Millions of readers worldwide were guaranteed to have seen the charity’s slogan about how stem cells can “mend broken hearts” right in the headline and lead of the story. Even the campaign’s mascot — the zebrafish — makes an appearance. What they did not see was any challenge to the extravagant claims made about cardiac cell regeneration, any discussion of the undoubtedly sky-high costs that would be associated with stem cell treatments, or any analysis by independent experts of the quality of the evidence supporting this line of research. Just about 1 in every 50 Americans has heart failure with about 400,000 diagnosed every year. The prevalence increases with age and the number of people with it will rise as a result of increased life expectancy. Heart failure symptoms can be managed with drugs and, in extreme cases, dysfunction can be helped with implantable assistive devices. But there is no cure. So, the announcement by the British Heart Foundation to raise and spend $80 million on research into cardiac cell regeneration is important and newsworthy. Stem cell therapy, gene therapy, nanotechnology and numerous other futuristic sounding medical treatments are beloved by researchers and health writers alike, and there are promising lines of inquiry to be pursued. The trouble comes when writers attempt to translate the very difficult, complicated and sometimes frustrating scientific process for a general readership. Instead of taking a very long view and writing about these treatments as one of many possibilities for how heart medicine might evolve in the future, stories like this one present the treatments as being tantalizingly available “within the next decade.”

The only cost information is the size of the research project. The story says, “Britain’s leading heart charity launched a 50 million pound ($80 million) research project on Tuesday into the potential of stem cells to regenerate heart tissue and “mend broken hearts”. The story later says, “At a briefing in London to launch a “mending broken hearts” fundraising campaign, scientists said research into stem cells and developmental biology may in future make this possible in people too.” It’s unclear whether they hope to raise $80 million or already have and are hoping to raise more, but what is clear is that there is not a single mention of how much this type of therapy might cost patients and insurers. Any story about an experimental procedure could at least mention that, while costs cannot yet be determined, such approaches will predictably be very expensive when/if they are in clinical use. What’s troubling about not even raising the issue is that stem cell therapy could easily become a treatment only available to those with money. Given that this story is primarily about a fundraising effort, we also think the story should have spent a bit of time explaining the administrative costs of fund raising. The BHF notes a 19% cost for fundrasing, a number comparable to the American Red Cross. There are no benefits quantified. This might be difficult given that there are no human studies for cardiac cell regeneration, but, at a minimum, the story should have quantified some of the benefits (and harms) that occurred in the mice studied or even in the cells. What happened to that tissue? And how many times did the researchers have to try before it worked? We might have given the story a pass on this criterion were it not for the overly optimistic tone and the series of summaries from lab research that are presented without the proper context. There is no attempt to even mention any potential harms of a stem cell approach. Any story that fails to challenge claims that mending hearts could be as simple as recovering from a broken leg – and that the approach might eliminate the need for heart transplants – certainly should at least nod in the direction of potential harms. Or an acknowledgement that it may take a long time to learn what the potential harms may be. The story’s first example for why regenerative cell therapy will work is the often cited zebrafish. “The ability of heart tissue to regenerate already occurs in some animals, such as zebrafish, which can regrow portions of their own hearts if they are damaged.” From there, we are given a menagerie of cellular and animal success stories, never with any discussion of the size of the study, the study design or the many steps in between these studies and human studies. The story says, “Scientists in the United States reported last year that they had been able to turn structural heart cells into beating cells by identifying genes that, in a developing embryo, turn an immature cell into a beating heart cell or cardiomyocyte.” This was done in a lab, not in humans. The same goes for the “thymosin beta 4” study that is referenced. It was done using mice tissue. The disconnected series of “facts” do not provide any context for the average reader and their relationship to the BHF effot remains uncler. Not applicable. The story provided no meaningful background on heart failure, so it can be neither satisfactory nor unsatisfactory on this criterion. The story does not quote a single independent expert. It provides quotes from Dr. Weissberg, the BHF medical director and Dr. Schneider, who runs a BHF research center. Dr. Riley, is noted as leading one of the British research teams. What is not noted is that Dr. Riley has conducted research in cooperation with RegeneRX, a company seeking to commercialize regenerative treatments. (see: http://www.news-medical.net/news/20100802/Thymosin-beta-4-is-essential-to-healthy-heart-development-embryonic-survival-Research.aspx ). The marketing materials actually provide more information about alternatives to regenerative therapy than the story. The British Heart Foundation’s website says, “We can encourage lifestyle changes to reduce risks of getting heart disease, and use surgery and drugs to minimise the effects of it, but the human heart cannot heal itself. At the moment, once your heart ‘breaks’, it stays that way. Although the story does not suggest that the treatments noted are available, it does provide the reader with a rather optimistic view of the possibility of such in the near term: “Scientists leading the work for the British Heart Foundation (BHF) said they hope that within the next decade they may have experimental drugs in development that would give certain kinds of cells in the heart the ability to regenerate tissue, repair damage and therefore combat heart failure.” Nearly a decade ago, in 2003, a story in the Chronicle of Philanthropy used the same animal – the zebrafish – to predict a therapy allowing humans to regenerate cells: “After all, our livers regenerate to the correct size, and his zebrafish rebuilt the right amount of heart tissue. Once you get cells started along the correct path, he hopes, the genetic instructions will take over, and a broken heart might just fix itself.” Nowhere does the story make it plain that none of the research being discussed has used human subjects and most of it hasn’t even been done in live animal subjects. There are many clinical trials and regulatory hurdles to overcome before a therapy like this would be on the market. The British Heart Foundation is slightly more realistic than this story, saying on its website, “Within five years we hope to begin early clinical trials. Within 10 years we aim to be running full trials. Within a further decade, people living with heart failure could look forward to a brighter future.” The story does a good job capturing the enthusiasm surrounding this field of study. Were a therapy to be developed that allowed people to regenerate their own heart tissue, this truly would be novel. The story, however, does not make it clear that regenerative medicine is a very broad field with a stack of literature a mile high, none of which has come close to doing anything as earth-shaking as regrowing a human organ in a patient. The suggestion that heart cells could theoretically be reprogrammed is not new, with the first publication now almost a decade ago. (see: http://www.nejm.org/doi/full/10.1056/NEJMoa012081 ) Although there is a much better understanding of the underlying biology, a treatment option is still not a foregone conclusion. None of this is clear from the story, and so the question of novelty is left unanswered. We don’t have any direct evidence that the story relied on a written news release, but it clearly relied heavily on a “briefing in London to launch a ‘mending broken hearts’ fundraising campaign”. There are no outside perspectives offered. This is essentially the same thing as relying on a news release.


Explanation: This brief newspaper report describes a test called the NMR LipoProfile, which is used to measure the number and size of LDL particles. The test maker says these particles provide a more accurate picture of cardiovascular disease risk than LDL numbers alone. As the rating for this news story suggests, it falls far short of most health journalism best practices. It fails to report on price, availability, medical need, alternative approaches, related research or potential harms. But the story’s most serious flaw is its failure to include independent sources’ assessment of the value of LDL particles in assessing heart disease risk–and of the LipoProfile test in particular. Depending solely on the views of the test maker’s former chief medical officer, who has collaborated in his research with a current company executive, was a bad journalistic decision.

The article fails to report how much the test costs. The article implies that people with "low" LDL particles are linked to a 27 percent reduced risk of heart attacks. But the sentence is so unspecific and garbled it’s hard to know what the claimed benefit is. And the story only gives this relative risk reduction figure, not the more helpful context of the absolute risk reduction. The story does not mention the frequency of the test’s false positives or false negatives, both of which could have serious consequences for the patient. The article refers to an article "recently" published in the Journal of Clinical Lipidology. It does not name the article or specify the date. It appears the study is a paper published in October 2007 based on data collected for the Framingham Offspring Study. This is an observational study, not a clinical trial. The article implies that people who are ignorant about their LDL particle numbers cannot know their true heart disease risk. This can make people needlessly fearful that they need to have this test. The article quotes only one source, William Cromwell, the former chief medical officer of LipoSource, which markets the LipoProfile test. While the story says that Cromwell no longer has financial interest in the company, his co-author on the published study is an executive with LipoSource. This calls into question the reporter’s assertion that Cromwell "no longer has a relationship with" his former employer. Under the circumstances, the lack of a clearly independent source is a serious failing. The story does not describe how heart disease risk can be assessed and managed by means other than using the LipoSource test. The article fails to report how and under what conditions the LipoProfile test is available. The article implies the LipoProfile test is a novel method of identifying otherwise hidden heart disease risk using lipid analysis. In fact, there are several tests available and under development that seek to link heart disease risk with a variety of lipid measures other than LDL and HDL numbers. The company’s most recent press release was issued on March 28. It’s not clear whether it triggered this story. No other media have written about the test or the company recently.


Scientists debate cause of dolphin deaths.

Explanation: Marine scientists are debating whether 80-plus bottlenose dolphins found dead along the U.S. Gulf Coast since January were more likely to have died from last year’s oil spill or a winter cold snap.

A bottlenose dolphin breaks the surface near Kennedy Space Center in this 2009 photo released by the United States Department of Fish and Wildlife March 3, 2011. REUTERS/USFW/Handout The National Oceanic and Atmospheric Administration declared “an unusual mortality event” last week when the number of dead dolphins washing up in Louisiana, Mississippi, Alabama and Florida had reached nearly 60, about half of them newly born or stillborn calves. The death toll along shoreline has climbed to at least 82 since then, many times the normal mortality rate for dolphins along the Gulf Coast this time of year. Although none so far showed outward signs of oil contamination, suspicions immediately turned to petrochemicals that fouled Gulf waters after a BP drilling platform exploded in April 2010, rupturing a wellhead on the sea floor. Eleven workers were killed in the blast, and an estimated 5 million barrels (206 million gallons) of crude oil spewed into the Gulf over more than three months. Scientists in the Gulf already were in the midst of investigating last year’s discovery of nearly 90 dead dolphins, most of them adults, when officials became alarmed at a surge in dead baby dolphins turning up on beaches in January. The latest spike in deaths, and a high concentration of premature infants among them, has led some experts to speculate that oil ingested or inhaled by dolphins at the time of the spill has taken a belated toll on the marine mammals, possibly leading to dolphin miscarriages. The die-off has come at the start of the first dolphin calving season in the northern Gulf since the BP blowout. But scientists at the independent Dauphin Island Sea Lab in Alabama suggested Thursday that unusually chilly water temperatures in the Gulf may be a key factor. “Everyone wants to blame toxicity due to the oil spill, said Monty Graham, a senior scientist at the Dauphin Island lab. “The oil spill ... very well could have been the cause of the dolphin deaths. But the cold weather could have been the last straw for these animals.”   He noted that water temperatures abruptly plunged from the upper 50s into the 40s off Dauphin Island in January, just before the first two stillborn calves found there were recovered. He said a second wave of dolphin carcasses washed ashore after temperatures dipped again. Fellow Dauphin Island scientist Ruth Carmichael called the arrival of the cold snap “incredibly compelling.”   “The timing of the cold water may have been important because the dolphins were late in their pregnancies, about one to two months from giving birth. That might render them more vulnerable to temperature shocks,” she said. But NOAA officials discounted the significance of chilly weather, saying a similar cold snap in February 2010, months before the oil spill, was accompanied by higher-than-normal mortality among a range of wildlife, including fish and sea turtles. They also cited research showing bottlenose dolphins tend to swim away from extremely cool waters. “These animals have the ability to move away from cold. They don’t stay around in cold water,” said Moby Solangi, director of the Institute for Marine Mammal Studies in Gulfport, Mississippi. Scientists on both sides of the argument agreed that if frigid weather were to blame, the end of the die-off is likely at hand as warmer temperatures return. But NOAA experts are bracing for the number of deaths to jump further as the bottlenose calving season reaches full swing in the coming weeks, said Blair Mase, a marine mammal scientist for the agency. Some 2,000 to 5,000 dolphins in the region typically bear their young this time of year.


A lot of the problems with forest fires ... is because of bad policy (not to clear out the forests) that was put in place by environmentalists.

Environment, Natural Disasters, Weather, PunditFact, Dana Perino,

America gets a lot of wildfires. Some of them hit grassy rangelands, some hit forests, most are small but some are huge. The 2011 Wallow forest fire in Arizona destroyed over half a million acres. Since 2000, the country has averaged nearly 75,000 fires a year with over 80 million acres lost. There are many causes but Dana Perino, former press secretary to President George W. Bush, focused on just one. Last week on Fox News’ The Five, the conversation turned to climate change and in the middle of making the case that economic growth had to be part of any solution, Perino made a passing reference to fires. "A lot of the problems with forest fires, the major raging ones that happen in the West," Perino said, "Is because of bad policy that was put in place by environmentalists and not clear out the forests." We tried to reach Perino to ask her what she meant by "a lot" and what policies she had in mind. We did not hear from her. In this fact-check, we dig into the rich debate over the role of environmentalists and wildfires. In particular, we aim to see if fire damage would have been substantially less if environmental  policies were different. This question is as vast as the nearly 200 million acres managed by U.S. Forest Service, but we found that extensive drought and vast amounts of combustible material played a key role. And what about governments failing to proactively clear out forests? The consensus suggests a mix of factors that include fire policies dating back to the early 1900s and limited budgets to reduce fire hazards. What’s less clear is the role of environmental activists and environmental policies. It is true that environmental regulations and legal challenges by environmental activists frequently delay the work of the Forest Service. It is difficult to say if these delays played a major role in the large fires the country has experienced. Let’s take a look at the big picture, starting with the role of environmentalists. The environmental factor To John Barnwell, director of policy for the Society of American Foresters, a professional education group, the lack of money to prevent fires is primary. But environmentalists and their actions play a role. Barnwell chafes at the long environmental review process and frequent litigation over Environmental Impact Statements that beset the Forest Service. A 2010 analysis from Western Michigan University found that no other agency tops the Forest Service for the number of suits under the National Environmental Policy Act. It averaged about 100 legal challenges each year. In some well-known cases (think of the Spotted Owl in the Pacific Northwest), logging ground to a halt entirely due to environmental protection rules under the Endangered Species Act. Timber harvests on federal land are a fraction of what they were in late 1970s. Ann Camp, a forestry scientist at the Yale School of Forestry and Environmental Studies, says national environmental groups seem to be intractable to compromise. "I can tell you from experience that local environmentalists and local chapters of national environmental organizations have been on board for some activities," Camp said. "But the national chapters nixed their involvement and had already decided to contest the outcome -- whatever it was if it included any level of harvesting." We found the case of a New Mexico fire where a Forest Service thinning project that might have reduced the damage was delayed by appeals from two environmental groups. On the other hand, we also found examples where environmental groups worked hand in hand with loggers and state and national officials to move many projects forward. And Camp noted that some large fires took place in remote areas where no logging of any sort had ever been planned. Plus, fires have struck in forests where extensive harvests took place. There is no question that environmental rules and lawsuits delay and sometimes block activities on federal lands, but it is difficult to prove that absent those moves that the western states would have avoided their mega fires. And there are several other factors that play a more prominent role, experts say. The paradox of too little fire When Congress wants an impartial analysis, it turns to its in-house think tank, the Congressional Research Service. In 2012, the CRS looked at the causes of wildfire damage. That report said the roots of recent mega fires are "excess biomass in the forests, due to past logging and grazing and a century of fire suppression, combined with an expanding wildland-urban interface — more people and houses in and near the forests — and climate change, exacerbating drought and insect and disease problems." A huge part of the reason we see huge fires today, the CRS report and experts say, is that we were too quick to put out fires. Around 1910 a series of massive fires wiped out entire towns. In two days, Washington, Montana, and Idaho lost 3 million acres of woodland. The fires led to a cry for the federal government to beef up its efforts to put fires out as quickly as possible. "Our forestry tradition comes from central Europe, which has always had a paradigm that fire was bad for forests," Camp said. Historically, periodic fires cleared out the undergrowth while allowing mature, healthy trees to survive. But with the focus on keeping fires small (the mantra was to put out every fire by 10 a.m. the day after it was reported), the amount of combustible material grew. The growth of grazing livestock also reduced naturally occurring fires by creating gaps in the terrain that stopped a fire from spreading. The result: In the 1800s, a natural stand of Ponderosa Pine, a common species in the West, might have a few dozen trees per acre. Today, hundreds of smaller trees might be squeezed into the same area. When fire hits, it burns hotter and moves faster. Instead of running along the ground, it jumps into the crown of the trees where the winds drive it even more. Many millions of acres of forest face this risk. It wasn’t until the 1970s that Forest Service policy began to shift in earnest toward viewing fire as a potential ally in managing the forests. But today, the Forest Service describes this legacy as the equivalent of a toxic dump. A hazard that built up over decades remains in place and is potentially lethal. Too little water The new millennium opened with an extended drought that left much of the western United States primed for fire. Peter Brown, a researcher at Colorado State University, has studied the fingerprints of fires over the centuries in the growth rings of trees. "Fire is driven by climate," Brown said. "The first thing you need, besides something like a lightning strike for ignition, is dry conditions." The years from 2000 to 2004 were spectacularly dry. Colorado State researchers said the drought was the strongest in 800 years. It killed trees, made the ones that lived more vulnerable to insects and turned the ground cover into tinder. The 2011 Wallow fire in Arizona came after a winter with little precipitation. The combination of dry ground, dry wood and grasses and strong winds produced a fire that in five weeks burned as many acres as had burned in the previous 25 years. Too little money, too much land The federal government has tried to come to terms with the legacy of a management policy that left too much fuel in the forests. Just as the nation was entering one its worst periods of fire, the Forest Service laid out an ambitious plan to clear away that excess scrub, brush and small trees. Called the 2000 Cohesive Strategy, it aimed to use controlled burns and physical removal to treat 6.9 million acres per year. An assessment by Northern Arizona University’s Ecological Restoration Institute highlighted the gap between that goal and the reality. In 2011, the agency planned to reduce the risk of fire in an additional 960,000 acres. "The number of acres treated in Fiscal Year 2011 is not even close to number of acres proposed per year in the 2000 Cohesive Strategy, or that are needed to reduce the threat of catastrophic fire at the landscape scale," the assessment said. At the heart of this problem is money. Barnwell said the Forest Service has been so busy fighting fires, it has needed to use the money that had been budgeted to prevent them. "Over the past 10 years, they borrowed $3.4 billion from other activities to pay for fire suppression," Barnwell said. "Congress will put some of that back, but they’ve missed a season to do really important work. They can never get ahead." We found wide agreement that these fire prevention projects need to take place on a very large scale if they are to tamp down on the mega fires. The Congressional Research Service advised that the odds make it unlikely that the land you clear will be the one where a fire will take hold -- there are just too many acres to cover. By the CRS’ count, the odds that any given acre will catch fire are no more than 1 out of 100. Thus, you have to treat a lot of acres and that has not happened. Lastly, Perino broadly faulted policies "put in place by environmentalists." But both the National Environmental Policy Act (1969) and the Endangered Species Act (1973) passed either unanimously or with overwhelming bipartisan support. President Ronald Reagan signed significant revisions into law. Perino’s characterization seems like an oversimplification. Our ruling Perino said, "A lot of the problems with forest fires is because of bad policy that was put in place by environmentalists." The crux of this fact-check really comes down to how you define "a lot." While the record shows that the need for environmental impact statements and legal challenges have a significant impact on Forest Service projects on federal lands, the connection to the extreme fires of the past 15 years is less certain. Where we found broad consensus is that decades of aggressively putting out every fire as quickly as possible, and the use of land for grazing, created circumstances where the forests are brimming with fuel. That in conjunction with extended dry periods have turned them into tinderboxes. The federal strategy to remove that fuel runs up against budget constraints. The limited money is a much greater constraint than environmental policies. In the end, experts acknowledge that environmental policies are an issue, but they generally tip the scale toward other factors when assigning blame. Perino’s statement contains an element of truth but ignores critical facts that would give a different impression. Update: The Forest Service drew funds from other programs over a 10-year period to pay for fire suppression. A previous version of this fact-check was unclear on this point..


United States President Donald Trump tweeted ""it is unbelievable that President Obama criticized me for the coronavirus response" and "he had 8 years to 'prepair' the next president for a pandemic and he failed.

Explanation: Did U.S. President Donald Trump Tweet That Obama Didn’t ‘Prepair’ for the Coronavirus Pandemic?

On May 12 2020, a screenshot of a purported tweet from United States President Donald Trump circulated — in which he purportedly lashed out at Barack Obama and said that his predecessor didn’t “prepair” for the coronavirus pandemic:First and foremost Mr Dumbass it's PREPARE NOT PREPAIR…. Second, Even if the most eloquent studious intelligent President in recent years did fail to prepare you for a pandemic you had four years to prepare yourself dumbass…A post shared by  Tijuan Craft (@crafttijuan) on May 12, 2020 at 3:09pm PDTFirst of all, every single iteration of the tweet we located on Facebook or Instagram showed a very high level of engagement — 92.1K retweets and 181.5K likes. They also all showed an identical number of retweets and likes.Had the tweet been both authentic and that popular, it was likely those numbers would vary as people took screenshots to share, and that some readers might have captured an image of the tweet on mobile or in “night mode.” But it seemed only one screenshot of the purported tweet existed.In it, the following statement was attributed to Trump on Twitter:It is unbelievable that President Obama criticized me for the coronavirus response. He had 8 years to prepair the next president for a pandemic and he failed. I have done a tremendous job. There are still more people alive than dead!In addition to a very mockable misspelling, the tweet displayed a date (May 11 2020). It also included a credulity-bending claim that there were still “more people alive than dead” in the United States. A search on Twitter revealed that people replied to Trump referencing the screenshot (or tweeted the misspelling in commentary about him):@realDonaldTrump @WhiteHouse @POTUS @gop #prepair😂😂😂😂😂😂spelling for dummies #DumpTrump2020 #DumbDonald #WorstPresidentEver #loser #spellingchallenged #embarrassing— Deetermined (@deems59) May 13, 2020Go prepair* some hamberders*, and stop talking.— Pamela Peitzman (@pammy_facepaint) May 13, 2020So @realDonaldTrump is saying President @BarackObama neglected to leave a prepair (LOL) a president who can’t spell, him for the pandemic! Well that’s a like he did PREPARE you for this you just ignored it and fired the Pandemic response team. This is ALL on YOU 45!— Lydia Jones (@LadyLakersfan) May 13, 2020How do you even know this? Everyone is angry!!! And at you ass!!! Always looking for a scapegoat!! 😂😂 and it’s spelled “prepare” not “prepair” 🤦🏻♀— J. Leslie Muratalla (@andimnotcrazy) May 13, 2020y’all really chose a guy that spelled prepare like “prepair” and used the wrong “than” in a tweet today. I know he’s done worse, but the spelling & grammar feels personal— kate huey (@katehuey1) May 13, 2020None of those tweets were a direct reply to the purported original “prepair … for a pandemic” tweet. Also, no manual retweets or other traces of any such tweet seemed to exist, which would be likely if the tweet was authentic (and had that high a level of engagement.) We checked ProPublica’s Politwoops page for Trump, which archives all of his (and other politicians’) deleted tweets, and did not find any indication that he had ever tweeted this to begin with.Screenshots of a purported tweet by President Trump indicating he thought it “unbelievable that President Obama criticized him for the coronavirus response” when Obama “had 8 years to prepair the next president for a pandemic and he failed,” and that there “are still more people alive than dead” continued circulating, but there was no evidence Trump actually tweeted the comment or anything of the sort. The source of the tweet was unknown, but it was not a legitimate tweet nor a legitimate misspelling.Comments


Artificial Pancreas Continues to Show Promise

Explanation: Not only does this story neglect to provide any caveats regarding research abstracts presented at conferences, it omits the number of subjects in the study. One of the most important pieces of context for this study was that it only had 12 subjects. That needed to be in the article. In general, the term "artifical pancreas" builds unrealistic hope for this technology for patients, and some balance and caution would’ve enriched the optimism with realism, doing a greater service to those with diabetes who are very interested in this topic. This story matters because hypoglycemia is dangerous and self-monitoring combined with use of insulin requires a patient to be an engaged and knowledgeable self-manager. The hope of this technology is that it would function more like a normal pancreas. But that’s it’s hope. Although the story provides little information about the risks and benefits observed in this small pilot study, it implies that it’s almost ready for prime-time, despite late hints at the end of the article that the technology is not there yet. The discussion of the Ritholz research on continuous glucose monitoring (CGM) compliance is somewhat disconnected and only loosely germane to the artificial pancreas. Research on CGM, which is approved and in use, has clinical relevance unrelated to the investigational "artificial pancreases," of which it’s a component. We can only assume this study was covered in the article because it was discussed on the teleconference call that was a source of information for the story.

Costs of the new approach or the currently available components, continuous glucose monitors and insulin pumps, are not described. The two components are not cheap and many insurance companies aren’t covering them except in special circumstances. We do receive one set of data on benefits, the 70% vs. 47% for time spent in target blood glucose. We’re unable to verify these numbers, as the abstract available online and MedPageToday coverage both cite "Time in Target" as 72% and 50%. Perhaps 70% and 47% come from a different source, such as the press teleconference or presentation. We cannot verify it. Regardless, as we said for the harms, the comparative benefits are not meaningful if we don’t know who the comparator group was. Furthermore, we feel than an independent voice should’ve been provided to tell us the meaning of the benefits. According to the abstract, the key benefits were a) reduced variability and b) reduced time duration and severity of hyperglycemia. What does that mean for patients, or even doctors? Why does glucose deviation matter if, as the abstract says, the average glucose levels were the same in both groups? Just giving us "70%" next to a lower number, without an explanation or an identity for the comparator group, says zilch about the value of this research. The investigator is quoted as saying that "We reduced hypoglycemia by half." There’s a dissonant choir of problems with this statement. First, it’s not clear from the sentence’s placement in the article if this result came in the prior study with children or in the current study with adults. (The rest of these points assume the latter.) Second, the article doesn’t identify the comparator group (those who just used the insulin pump), so a relative result is meaningless. So when the claim is made, "We reduced hypoglycemia by half," readers should be told "half of what?" Third, the fact that they used a relative risk reduction figure, not an absolute one, is important because this study was so short and small, using relative risk reductions masks the weight (or thinness) of the evidence, especially when we don’t have the statistical significance. Fourth, we’re not sure what data the investigator’s statement of reducing "hypoglycemia by half" is based on. In the abstract, it’s says that the time spent below target glucose was approximately half but the difference was not statistically significant, no doubt due to the small power and short duration of the study. If our interpretation is correct, the story’s author has touted a benefit that’s insignificant, statistically speaking. Fifth, it should’ve been clearer about what "reduced hypoglycemia" mean? The total time spent below target glucose range — which averaged out over the course of the study — is different than a (severe) hypoglycemic event, which some readers may read in this result. How dangerous is it to spend any time below the target range, if only temporary and possibly briefly? In other words, is it a harm or an efficacy issue? In the abstract, we read about 1 serious case of hypoglycemia  with the insulin pump, 0 with the closed-loop system; but again, with 12 patients using each for a night, statistically we’re not sure what that tells us. Regardless of the true intent of this statement, and the true harms that occurred in the study, an independent analysis may have clarified such confusions. No overt disease mongering. No sources appear to have been quoted besides those on the teleconference. We don’t know the basis for the call, but it sounds like a press briefing. Conflicts are mentioned for the people directly involved in the research. But readers can’t know or judge for themselves whether others who were quoted in the story were truly independent sources – with no funding connection to this research. The artificial pancreas approach isn’t compared to any other alternatives, if only because the article never identifies the comparator group as those using the insulin pump. One the one hand, the article tells us that the technology is emerging, the algorithm is still being developed, and the whole approach is still being researched in future studies. On the other hand, the article’s tone and unbalanced quotes from investigators make the ultimate availability seem like a foregone conclusion, which it isn’t after a 12-subject study. What’s missing is at least some emphasis, ideally early, that this research is quite experimental at this point, with some discussion of the steps between this small study and the technology potentially going to market. The article also takes until the third to last paragraph, after the discussion of the Ritholz study, to explain what an "artificial pancreas" actually is; burying that explanation and leading with an illustration of a real human pancreas does nothing but suggest to lay readers that an "artificial pancreas" is something like a prosthetic organ, instead of a computer link between extant devices. It could’ve been clearer about how the "closed loop" technology is supposed to improve on the available devices. In fact, we’re not sure that the description of the artificial pancreas as a single discrete "device" matches what was used in the study, which, according to the abstract, seems to have involved a glucose monitor, a computer, and a human being making adjustments to the patient’s insulin pump. The end of the article explains the artificial pancreas technology, implying that the computer linkage between monitor and pump is the novel part that is still under development. However, we give this criterion an Unsatisfactory rating because a) that explanation was buried in the end, after the Ritholz study summary; b) the article never explained that the aforementioned approach is the goal, not the one used in this study, which seems to have involved manual operators adjusting the patient’s insulin pump as they slept. Little information about how the "artificial pancreas" actually works, and what it consists of physically — e.g., how big is the "device"? — is provided. This story does not appear to rely overly on the ADA press release. However, we see no evidence of any sources used outside the cited teleconference, which seems like a press briefing. Because of our uncertainty about how much independently vetted reporting took place, we’ll rate this not applicable.


Health Care, Medicare, Virginia, Ed Gillespie,

GOP Senate candidate Ed Gillespie says Obamacare won’t help you grow old. "It’s a law that cuts seniors’ Medicare," Gillespie said in a campaign email listing reasons why  he opposes the health care law. This is a well-traveled claim that PolitiFact has met frequently over the years. Paul Logan, Gillespie’s campaign spokesman, backed up the statement, in part, with blurbs from fact checks written by our colleagues in two other PolitiFact bureaus. He pointed to a 2013 PolitiFact National article examining a claim by Scott Brown -- the Republican U.S. Senate nominee in New Hampshire -- that Obamacare "raises taxes and cuts Medicare.", saying the law "definitely raises taxes," to help pay for its costs. But our colleagues also said the claim that Obamacare cuts Medicare is a complicated issue that undercut the accuracy of Brown’s full claim. PolitiFact has looked askance at bare statements that Obamacare cuts Medicare, rating them either Half True or  depending on how they are worded. Obamacare, to help cover its costs, also imposed a series of savings. Among them are measures that will reduce the increase in Medicare by $716 billion from 2013 to 2022, according to a Congressional Budget Office estimate. It’s important to note that Medicare spending will continue to rise, but at a slower pace than they it would have without the law. And the savings are focused on lowering payments to hospitals and insurance companies -- not beneficiaries. Gillespie’s says that Obamacare cuts "seniors’ Medicare." That suggests the law isn’t just reducing Medicare spending but is actually slicing Medicare benefits. To support that line of reasoning, Logan pointed to a couple of PolitiFact articles in which experts suggested that the reduced payments the law calls for could affect patients’ access to services. PolitiFact Wisconsin noted in October 2012 concerns that slowing growth in Medicare payments might discourage some health care providers from accepting Medicare patients. One area of concern is the Medicare Advantage program, which is run by private insurers and offers greater benefits than traditional Medicare for things such as dental care, free eye glasses and gym memberships. About 30 percent of the 54 million Medicare beneficiaries in the U.S. are enrolled in those plans, according to Kaiser Family Foundation estimates. Those privately run plans cost more per beneficiary than traditional Medicare, and Obamacare  seeks to even out those costs. Some health care analysts have said the law’s Medicare Advantage cost savings might lead to its enrollees’ paying higher premiums or losing some of their extra benefits On the other hand, Gillespie does not mention that the health care law actually adds some new services: It gradually closes that gap in Medicare prescription drug coverage known as the "doughnut hole," funds illness prevention benefits and expands preventative care benefits. Logan also referred us to statements issued by for former U.S. Sen. Jim Webb, D-Va. In March 2010, Webb said said Obamacare would make "dramatic cuts in Medicare" and lamented the reductions in Medicare Advantage. Here’s a quick note on the timing of Gillespie’s email. Logan told us it was originally sent in January and was resent by the campaign on Aug. 25 after the Daily Press in Newport News -- which published a weekly PolitiFact Virginia digest --signed up recently to get automated email updates from the campaign. "Unless you want to single out that particular signup, it would be more accurate to refer to it as a January email rather than an Aug. 25 email," Logan said. Because the email is part of the campaign’s ongoing communications about Obamacare -- one that the Gillespie campaign feels free to resend -- we think it’s fair to judge it as a current line of attack from Gillespie’s campaign on the law. Our ruling Gillespie says Obamacare "cuts seniors’ Medicare," a statement that implies the law is reducing benefits across the board. There’s debate among analysts over how the law’s cost savings measures will impact some beneficiaries, particularly seniors enrolled in Medicare Advantage plans run by private insurers. Some of those seniors -- who comprise about 30 percent of Medicare recipients -- may lose some of the extra benefits they had before the law or could see higher premiums. Overall, the health care law slows Medicare’s growth, but spending will still rise significantly and some new services for seniors were added.


Evacuation plan 'out the window' when fire hit California town.

Explanation: When a “megafire” engulfed Paradise, California, officials and residents had to abandon their evacuation plans and improvise new ways to save lives, learning lessons that could help the growing number of U.S. communities at risk to wildfires.

As strong winds sent flames roaring into Paradise at 2 miles per minute, emergency personnel and locals realized their escape plans, crafted after a 2008 blaze, would not work. “The lessons we had learned in the past kind of went out of the window due to the sheer speed and intensity of this fire,” Paradise Emergency Operations Coordinator Jim Broshears said in a phone interview. The small mountain town was facing the so-called Camp Fire, one of a series of recent “megafires” fueled by drought, erratic winds and overgrown forests that quickly torch over 100,000 acres. A week after California’s deadliest blaze, which killed at least 71 people, residents were critical of the town’s alert system. Broshears said other towns could save lives if they taught residents to shelter from fire and got more of them to sign up for alerts. As Paradise was engulfed around 8 a.m. on Nov. 8, officials attempted a staggered evacuation using their CodeRED alert system to target a zone at a time. They wanted to avoid the panic and chaos that ensued in 2008 as all 27,000 residents tried to flee at once. With the fire toppling power lines and mobile towers, and residents jamming networks with calls, about 60 percent of CodeRED alerts were delivered, according to Troy Harper a spokesman for OnSolve, the company that provides the service. Between 25 and 50 percent of residents had signed up for the optional system, Broshears said, meaning 30 percent of households, at best, got alerts. As the town burned, officials abandoned the phased evacuation and told everyone to get out, Broshears said. “We felt we morally couldn’t do that and just had to go all out and hope for the best,” said the former Paradise fire chief, who has lived in the town since 1974. Locals like nurse Darrel Wilken said an old-fashioned siren system would have been better than CodeRED. “People who are not connected to the internet or phone need to know there is a fire,” said Wilken. Paradise widened, paved and straightened roads after the 2008 blaze to allow for a speedier evacuation. But the Camp Fire burned across all escape routes. “The flow plan didn’t work,” said Broshears. “We couldn’t flow huge amounts of traffic down an available highway because there was no available highway.”  The fire moved faster than anyone expected, throwing embers that reached 2 miles (3 km) ahead of the flames, Paradise Mayor Jody Jones said. “I don’t know that there’s a city or town in the entire world that could evacuate their entire population all at the same time and not overwhelm their roadway structure,” Jones told CNN in an interview on Saturday. On the ground, residents fought to escape the town. Wilken, 51, got word around 8 a.m. that the fire was 7 miles away. By 8:15 a.m. trees outside his window at the Feather River Hospital were on fire. There was no time to gather ambulances to evacuate the 67 admitted patients as staff had trained to do. “If your car was not on fire, you were the ambulance,” said Wilken, who loaded three patients into his Subaru WRX. His designated escape route was blocked by flames. He wove through back streets and a slalom of burning vehicles, his car exterior melting from the heat, trees and electricity poles falling on vehicles ahead, before reaching safety hours later. As Wilken fled, firefighters and volunteers including resident Mike Boggs tried to get into town. Police had turned all exit routes into contraflows, a move that sped up the evacuation, but obstructed first responders trying to enter Paradise. Boggs went off road and drove up a ditch in his pickup, followed by a fire truck. The 60-year-old iron worker credits a decision after the 2008 blaze with saving his and nearby homes in Butte Valley, near Paradise. He bought 40 cattle that grazed on grass that would have otherwise fed the fire. “Everywhere I put my cows it didn’t burn,” said Boggs. For Broshears, one of the biggest lesson from the Camp Fire was that residents facing a megafire might sometimes be better off sheltering in open spaces, like road intersections, than trying to outrun flames. “It would be ugly but you’d survive,” he said.


Treating First Time Shoulder Dislocations with Surgery Can Benefit Young Athletes, Study Shows

Explanation: This news release describes the results of a study presented at an annual meeting showing that athletes who dislocated their shoulders for the first time and underwent surgery had lower rates of postoperative instability and re-operation when compared with patients who had recurrent dislocations before undergoing surgery. It contains lots of numbers, which we applaud. These numbers are important because they add to the limited database available to help guide treatment for athletes who have suffered a shoulder dislocation. As one study put it in 2014, “there is no consensus on the optimal treatment of in-season athletes with anterior shoulder instability, and limited data are available to guide return to play.” But, in stating a causal relationship, the news release goes beyond what the data support. Specifically, the news release says that the study “demonstrated that surgery after a first-time shoulder dislocation lowered the re-injury risks and need for follow-up surgery when compared to those who were initially treated non-operatively and experienced a repeat dislocation prior to surgery.” The study, which was observational in nature, can only show associations between shoulder surgery and subsequent outcomes — not that surgery after a first-time dislocation was the cause of reduced risks. Also missing from the release: harms, alternative therapies, costs and study limitations. This matters because, in the 2014 prospective study, just 27% of athletes whose shoulders were made unstable due to injury “returned to play and completed the season without subsequent instability.” According to the study abstract, the shoulder is the most common joint dislocation, affecting 2% of the general population, most of them males. And there’s a 50% likelihood of another dislocation after a first one, according to the background into given by the study authors. According to the U.S. Centers for Disease and Control and Prevention, there were some 63 million visits to non-federally employed, office-based physicians specializing in orthopedic surgery in the United States in 2010. Shoulder symptoms ranked among the top four reasons given by patients for visiting orthopedic surgeons.

The news release does not mention costs. The news release encapsulates the differences observed: “The study examined 121 patients at an average of 51 months post-surgery,” it says. “Of this group, 68 patients had experienced their first dislocation, while 53 had recurrent dislocations after being initially treated non-operatively. After treatment with an arthroscopic bankart repair, the postoperative dislocation rate in the first-time injury group was 29%, compared to 62% in those who did not have surgery after their initial injury.” And 7% of those with surgery after the initial dislocation vs 32% after a recurrent dislocation had to have another surgery, according to the release. The news release does not say whether there were any drawbacks associated with undergoing surgery. This quote from the lead author appears to acknowledge their existence: “While young athletes and parents may be wary of surgery, our study shows the advantages of this treatment approach,” commented Marshall. But it does not spell out what those drawbacks might be. The study was based on a retrospective chart review to identify subjects. More than half of identified subjects (296 of 439) were then excluded for various reasons for the next phase of the study, which was a survey, with an 85 percent response rate reported. The study was not a randomized trial, which would have made the results more clear, and which would have allowed a more definitive statement about management of the problem. The release would have been stronger had it pointed out the limitations of retrospective studies and surveys. The news release doesn’t engage in disease mongering. Nor does it say how many people are affected by shoulder instability or even what “shoulder instability” is, how it’s caused, or what its impact is. Any or all of these would have provided useful context. It would have been helpful had the news release noted that Alabama Orthopedic Spine & Sports Medicine Associates carried out the surgeries. The news release refers to “non-operative” interventions, but does not say what they are. The news release does not say how available either procedure is. The release would have been stronger if it had clarified whether all orthopedic surgeons perform this procedure or if it is a specialized procedure only available at certain clinics. The news release does not say anything about the novelty of the surgical intervention or of the non-surgical approaches. Is this the first time this issue has been studied? The release gives no sense as to how this study fits into the wider body of research. The release doesn’t rely on sensational language or make overtly unjustified claims. However, as noted above under the summary and evidence headings, we have some concerns about the way the study findings were presented in the release. The news release says that the research “demonstrated that surgery after a first-time shoulder dislocation lowered the re-injury risks and need for follow-up surgery when compared to those who were initially treated non-operatively and experienced a repeat dislocation prior to surgery.” But the study abstract itself does not justify going that far. Instead, it says simply that “first time dislocators had lower postoperative instability rates and reoperation rates when compared to patients with recurrent dislocations prior to surgical intervention.” Association v. Causation 101. And a quote from the lead author offers a curious view of the role of the physician: “Deciding between a non-operative program or going forward with surgery can be a challenging decision for medical professionals treating shoulder injuries in young athletes,” says Dr. Marshall. That statement implies that treatment decisions are made by medical professionals alone. But the agenda paper offers a more inclusive take: “Young, athletic patients with shoulder instability should be offered early surgical intervention to lower the risk of postoperative instability and reoperation,” it says.


Novartis hopeful for novel heart drug, despite 'modest' benefit

Explanation: In contrast to the TIME article on this study (which we reviewed), and some others, the Reuters piece is appropriately skeptical and far more business-oriented, paying substantial detail to costs, harms, and regulatory challenges and cautions. It is skimpier than than the TIME article on some of the biological novelty of the new drug, but overall does a better job of informing readers and professionals of the slow slog many novel drugs must take before they are demonstrated safe, effective and affordable for those who may benefit. The anti-inflammatory scientific arc is littered with the consequences of less-than-stellar clinical results, overblown expectations and pharmaceutical industry high-stakes business gambles. That makes it especially important for news organizations to cover the subject area with the utmost care and context–this story took pains to do so.

This article does a great job of noting the cost and pricing issues inherent in the drug company’s efforts to develop, test and market novel biologicals. The headlong rush to “personalized” medicine, pharmacogenetic approaches to treatment, limited resources even in wealthy nations with gold-plated insurance policies, and the opacity of drug industry research costs make it imperative to explain to the public the realities of medicine’s pricing system. The thoughtful reader will understand that the benefits are modest, as indicated by the well-written headline and carefully worded opening sentence. However, missing from the story was a discussion of the study findings in absolute terms. The story says the study that “heart-attack survivors on one of three doses of canakinumab were 15 percent less likely to suffer another major cardiac event than those on a placebo.” What does this mean in absolute numbers? The way researchers measured it was in events per 100 person-years, and the “events” were non-fatal heart attack, non-fatal stroke, or death from a cardiovascular reason. In the placebo group, there were 4.50 cardiac events per 100 person-years. In the group receiving 150 mg doses of canakinumab, there were 3.86 events per 100 person years. Of the various doses given (50, 150 and 300 milligrams), the 150 mg dose was the only statistically significant result, and it was only because of non-fatal heart attacks. From the get-go, readers are told there are risks to keep in mind. This was entirely absent from the TIME story we reviewed. That said, we wish this Reuters story had discussed the harms more in-depth–how frequent were they? How severe? This was a randomized, placebo controlled clinical trial with a large number of patients. The story doesn’t explain this, nor any of the study’s limitations. No mongering here. This story, which is more of a “business of medicine” story, uses a drug industry analyst source to good effect, and included commentary from the study’s accompanying editorial. Both this story and the TIME story don’t mention that there are many effective and less expensive alternatives to secondary cardiac disease prevention, such as smoking cessation, aspirin, statins, blood pressure control, etc. The lede graph says “Novartis will seek regulatory approval” for the drug’s use against heart disease, “though some experts fear fatal infection risks and a high price may overshadow the medicine’s limited scientific benefits.” At least for now. The story does a pretty good job of explaining what is novel about the the drug’s effects and targeting. The story does not appear to rely on the news release.


People can fly with dogs, pot-bellied pigs, turkeys, monkeys, and miniature horses if they claim that their pets are emotional support animals.

Explanation: This claim has been rated “mostly true” because although passengers with emotional disabilities can travel with dogs or other support animals such as monkeys, miniature horses, or pigs, they are required to provide documentation from a mental health professional in order to do so (even if sometimes airlines accept nothing more than a simple verbal claim in allowing passage for a pet). To avoid the Wild West atmosphere of on-line certification and unruly animals being brought aboard, it seems that a national and standardized system of certification would be beneficial for all involved.

Critter Country, Air Apparent, Beastly Mishaps, emotional support animals

News stories abound of airline passengers traveling with all sorts of unusual animals under the premise that their non-human companions provide necessary emotional support, such as this one about a bereaved widow who flew with her turkey to San Francisco, where she would be spreading her late husband’s ashes: A Seattle woman who was flying to San Francisco to spread her husband’s ashes took her 25-pound pet turkey on the flight for emotional support. Jodie Smalley, 34, says her turkey, Easter, has been there for her since her husband passed away from cancer three months ago. She had a custom diaper made for Easter for their flight, and she has all the necessary documents that certify the turkey is a legitimate emotional support animal. “Hearing about a turkey on a plane sounds ridiculous,” she said. “But people have no idea what I’ve been through.” While service animals such as seeing-eye dogs have a long history and are familiar to nearly everyone, emotional support animals are a much newer phenomenon. Established law provides for the accommodation of service animals and emotional support animals in housing and other public facilities, but headlines start rolling off the presses when the human half of the pair attempts to travel on an airplane with a non-standard species such as a miniature horse, pig, or monkey. Pot-bellied pigs are often favored as emotional support animals by those who are allergic to dogs. However, pigs don’t always travel well, as illustrated in several news stories of recent years: in November 2014, for instance, a woman was escorted off of a USA Airways flight in Connecticut because her 70-pound pot-bellied pig was squealing uncontrollably, “three times louder than a child,” and defecated in the airplane aisle. In a 2001 incident (again on a USA Airways flight), the passenger informed the airline that her pig was “about a hundred pounds,” but staff were taken aback when the pig arrived and it proved to be closer to 300 pounds. The two women (the pig-owner was traveling with a friend) were assigned bulkhead seats in first class to provide as much space as possible, but they were still forced to plant their feet on the bulkhead for the duration of the six-hour flight to allow adequate space for their porcine companion. Although the pig was calm during the flight, it became frantic upon deplaning, squealing, urinating, and defecating in the close confines of the galley in a frenzied effort to get off the airplane after landing. In May 2003, blind passenger Dan Shaw traveled from Boston to Chicago with his seeing-eye miniature horse, Cuddles, to appear on an episode of Oprah Winfrey’s talk show. Shaw chose a miniature horse instead of a dog for his guide animal because horses have much longer lifespans than dogs, and he was afraid of getting emotionally attached to a dog who might have a relatively short life. Shaw purchased a first-class ticket for his horse because, at two feet high and 70 pounds in weight, Cuddles wouldn’t have fit under the seat in front of him in coach. Although American Airlines staff initially debated requiring that Cuddles wear a diaper, they relented when they were assured that Cuddles was housebroken and decided to forego the diaper requirement for the two-hour flight. That turned out to be an unfortunate decision, because Cuddles defecated on the carpet in front of the bulkhead. The fact that the flight’s take-off was delayed 45 minutes may have contributed to Cuddles’ discomfort. We didn’t find any instances of service monkeys being involved in disruptive incidents aboard airplanes, but perhaps that is because most service monkeys are six to ten pound Capuchins who can fit in a carrier under the seat in front of the passenger, just as more typical pets do. With incidents like these appearing in the news, and consumers experiencing the ever-closer confines of coach seating, air travel with unusual animals immediately grabs the public’s attention. In particular, air passengers have taken umbrage at other flyers who are seemingly trying to “game the system” and declare their household pets to be emotional support animals to get their animals on-board for free. In 1986, Congress passed the Air Carrier Access Act, a law intended (in part) to ensure that service animals would be allowed to fly on planes and could not be booted off simply because other passengers object to their presence. Service animals must be under the control of their owners (physically by a leash or cage, or verbally through commands), cannot roam around the cabin, and — contrary to the accidents described in the news stories mentioned above — must be trained not to eliminate on  airplanes. For flights of longer than eight hours, the owners must provide written plans for clean disposal of waste. Although the emergency exit rows with their expanded legroom might seem like a logical place to put a dog or other service animal, those rows must be kept clear at all times for emergencies, so service animals usually end up in the bulkhead rows if they are too large to fit under a seat. Monkeys are the only species permitted by the FAA to travel on a seat instead of the floor (although we’ve read of celebrities purchasing first-class seats for their pet pooches). Airlines, thankfully, are allowed to prohibit passage to unusual service animals such as snakes, rodents, ferrets, and spiders. They can also prohibit farm poultry, but Easter — the widow’s turkey mentioned at the beginning of this article — had been classified as a domesticated bird by Delta Airlines and was thus allowed to fly. (It should be noted that Easter flew without incident: he wore a diaper and reportedly “didn’t make a sound.”) There’s a legal distinction between service animals and emotional support animals. Service animals, usually dogs, are individually trained to assist their owners with disabilities. These include the well-known Seeing Eye Dogs, Hearing Dogs, Psychiatric Service Dogs, Seizure Response Dogs, and dogs who are trained to perform such tasks as pulling a wheelchair, picking up items that have been dropped, reminding a person to take medication, alerting their person to a sound, and so on. Service animals also occasionally include miniature horses such as Cuddles. Emotional Support Animals (ESA), also known as Comfort Animals, are supposed to be used as part of an emotional therapeutic treatment plan. They do not have specific training to provide tasks on behalf of their humans and are not considered service animals under the American Disabilities Act. They may provide companionship, relieve loneliness, and sometimes help with depression, anxiety, or other phobias. There is no national standardized certification to document the qualifications of an emotional support animal. Some pet owners have been accused of falsely claiming that their household pet is an emotional support animal to travel for free (since the Air Carrier Access Act prohibits the airlines from charging a fee for such animals) or to get around the limitations that airlines typically impose on the number of pets allowed to travel per cabin. Legally, getting an ESA on an airplane requires documentation from a mental health provider verifying the emotional benefit of the animal. The letter should be less than one year old, prescribe or endorse the animal as an ESA offering benefits for a particular mental disability, and the emotional/mental diagnosis must comply with the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). In practice, however, it is not difficult to find mental health providers who will provide supportive letters. In addition, numerous websites exist that promise to “certify” an owner’s pet as an emotional support animal, charging between $59 and $200 to provide the owner with an ID vest and a certificate — and sometimes the necessary mental health letters as well. While researching this story, we easily found websites that promised “Any dog may qualify,” “Take your pet everywhere. Instant Approval!”, and “It’s easy to register your pet as an emotional support animal!” Two Today investigative writers discovered first-hand the ease with which they could travel with their animals. Jeff Rossen filled out a questionnaire on a ESA web site and was sent an official letter from a mental health professional without ever seeing or speaking to her. He subsequently took two flights with his dog sitting in his lap, and no one from the airlines even asked to see the letter. His colleague, Lindsey Bomnin, received certification from the same web site for a borrowed pot-bellied pig, then took two flights with the pig on her lap. Although obtaining certification for a household pet may seem like a nifty way of avoiding the airlines’ pet fares — or sticking it to an industry which seems to find ever-more-numerous ways of nickel-and-diming their customers — faking a disability ultimately ends up hurting those who really do need their emotional support animals. In addition, claiming that a large and unruly animal is an ESA (like that 300-pound pig) presents a true safety hazard to passengers and crew alike if the animal panics or goes on a rampage.


Gabon president fires VP, forests minister over hardwood scandal.

Explanation: Gabon’s President Ali Bongo has fired his vice president and his forests minister, his office said on Wednesday, after hundreds of containers of illegally logged kevazingo wood that had been seized went missing.

The statement gave no reason for their removal, but said forests would be managed under the office of the prime minister for the time being. Bongo had promised to punish anyone implicated in the disappearance of a cache of 392 containers of the wood, which were seized at the port of Owendo in late February and early March. Two Chinese nationals are being held in relation to the case, and last week the head of customs Dieudonne Lewamouo was detained. Gabonese authorities said last month that they had recovered 200 containers. Illegal logging is ravaging the forests of West and equatorial Africa, most of it driven by Chinese demand, but rarely do governments take action against suspected culprits. Since taking over from his father in 2009 - continuing a family dynasty that has exceeded five decades - Ali Ben Bongo has cast himself as an environmental crusader. He has delighted conservation groups by banning raw wood exports, expanding protected zones and creating 13 new national parks. Despite those efforts Gabon remains a hub for poaching, illegal logging and the illicit wildlife trade. Bongo suffered a stroke last October while abroad, but returned home in March. Secrecy surrounding the state of Bongo’s health during his five-month absence has fueled instability in Gabon, where declining oil revenues and widespread poverty have dented his popularity.


Prince Harry joins Elton John to launch HIV campaign targeting men.

Explanation: Britain’s Prince Harry joined pop star Elton John on Tuesday to launch a campaign to raise HIV awareness among men, warning that “dangerous complacency” about the virus threatened the quest to wipe it out.

The billion-dollar project “MenStar” will target men living with or at risk of HIV in sub-Saharan Africa, which has been ravaged by AIDS since the 1980s. “The MenStar coalition is bravely tackling the root cause of this problem — the lack of awareness of HIV prevention amongst hard-to-reach young men,” Harry said at the 22nd International AIDS Conference in Amsterdam. Speaking at the launch, which also featured South African actress Charlize Theron and Ndaba Mandela, the grandson of late President Nelson Mandela, Elton John said: “If we want to end AIDS once and for all, we must make men part of the solution.”  Around 36.7 million people around the world have HIV, according to 2016 figures cited by the United Nations’ HIV/AIDS body UNAIDS. Fewer than half of men living with HIV receive treatment compared with 60 percent of women, it said. “It is time there was a global coalition to teach men to protect themselves. And in doing so, it will teach them to better protect not only their wives and girlfriends, their sisters and daughters, but also, critically, their brothers and their sons,” the British singer said. UNAIDS said this month that the fight against HIV/AIDS was “slipping off track” and while deaths were falling and treatment rates rising, rates of new HIV infections threatened to derail efforts to defeat the disease. Prince Harry said the campaign launch came at “a time when new energetic and innovative solutions are needed more than ever before”. “MenStar” is supported by the U.S. government’s PEPFAR program for tackling HIV/AIDS and by the Bill and Melinda Gates Foundation. Experts at the conference hope for the elimination of AIDS worldwide by 2030, but the United Nations warned last Wednesday of a funding gap of £4.6 billion that threatens efforts.


Suicide kills one person every 40 seconds, says WHO.

Explanation: Across the world, one person takes their own life every 40 seconds, and more people die by suicide every year than in war, the World Health Organization said on Monday.

Hanging, poisoning and shooting are the most common suicide methods, the WHO said as it urged governments to adopt suicide prevention plans to help people cope with stress and to reduce access to suicide means. “Suicide is a global public health issue. All ages, sexes and regions of the world are affected (and) each loss is one too many,” the WHO’s report said. Suicide was the second leading cause of death among young people aged between 15 and 29, after road injury, and among teenage girls aged 15 to 19 it was the second biggest killer after maternal conditions. In teenage boys, suicide ranked third behind road injury and interpersonal violence. Overall, close to 800,000 people die by suicide every year - more than are killed by malaria or breast cancer, or by war or homicide, the WHO said. Global rates have fallen in recent years - with a 9.8% decrease between 2010 and 2016 - but declines were patchy. In the WHO’s Americas region, for example, rates rose by 6% in between 2010 and 2016. The report also found that nearly three times as many men as women die by suicide in wealthy countries, in contrast to low- and middle-income countries, where the rates are more equal. “Suicides are preventable,” said the WHO’s director-general Tedros Adhanom Ghebreyesus. “We call on all countries to incorporate proven suicide prevention strategies into national health and education programs.”  The WHO said restricting access to pesticides was one of the most effective ways of reducing suicide numbers swiftly. Pesticides are commonly used and usually result in death because they are so toxic, have no antidotes, and are often used in remote areas where there is no nearby medical help. The WHO pointed to studies in Sri Lanka, where bans on pesticides have led to a 70% drop in suicides and an estimated 93,000 lives saved between 1995 and 2015.


Photographs show a boy having his arm crushed under a truck as a punishment for stealing bread.

Explanation: Photographs document a roadside stunt, not a Muslim boy having his arm crushed under a truck as a punishment for stealing bread.

Fauxtography, Gallery Of The Gruesome, islam

The above-displayed photographs have been circulating on the Internet since at least 2004, usually in e-mail forwards that set them in one of several Arab/Muslim areas (e.g., Iraq, Iran, Afghanistan, Palestinian territories) and claim that the boy pictured is being punished under a harsh Sharia  law system that imposes a penalty grossly out of proportion to the nature of the crime (i.e., having his arm crushed under a vehicle because he stole a loaf of bread). These pictures originated with the Iranian news site PeykeIran, who (along with persons who have witnessed similar scenes in other countries) confirmed that what the photographs actually depict is performers hustling money from onlookers by staging a common street act, one in which a subject seemingly allows himself to be run over by a heavy vehicle and then emerges unscathed. This a common act, variations of which are performed by many magicians and accomplished through a variety of means, with no lasting harm done. That the subject is a small boy who grimaces his way through the stunt is all part of the act, intended to elicit sympathy and extra cash from onlookers. (Despite his contorted facial expressions, the boy is not seriously or permanently injured by the process.) It’s difficult to make any definitive statement about Sharia/Islamic law since customs and enforcement can vary from region to region, but although the cutting off  hands may sometimes be the prescribed maximum penalty for cases of theft under the strictest interpretations of Sharia, Islamic law resources consistently note that such punishments shall not be applied to children who have not yet reached puberty (which is defined as the age of 15 for boys), nor for the theft of small-value items or food by the hungry:    The maximum sentence of any violation of law is not applied in every case. In the robbery and theft cases for example, the maximum penalty of hand-cutting applies after the consideration of many factors such as track record and whether the theft was made for profit. In some cases, such as stealing food because of severe hunger or to prevent death, there may not be a penalty. A person’s hand is not amputated when he steals less than the equivalent of 4.374 grams of gold [or] something that is useless. The penalty for the one who steals (when the above conditions are met) is that his/her right arm is amputated. The above photographs do not depict any form of amputation, and it is the child’s left arm which goes under the wheels. Moreover, there are no police, judges, religious authorities, or other officials evident in any of the pictures, just a huckster with a hand-held microphone who drums up business and describes the action for the onlookers visible in the background of the first photo. (Also note the blanket placed under the boy’s arm: something that is useful for a staged stunt but is unlikely to be provided or allowed by those intent on severely punishing a lawbreaker.) The versions of these photographs circulated via e-mail generally leave out the last pictures of the original series, which show the same boy after the conclusion of the stunt: