This is a phase 1 trial (usually just undertaken to check safety before larger trials are done to test efficacy and dose), so it seems all the more amazing that such a big improvement was seen.
Really depends on the person. I have very small sight problems (+.5/-.75) which don't affect me most of the time, but are a danger in traffic. The doctor that diagnosed that really didn't care to answer any of my questions.
Did i kick someone's puppy here or what? I could understand getting this level of disagreement if i claimed all doctors are psychopaths, but all i did was point out that not all eye doctors enjoy their job. Not like i give a shit about karma, but i am honestly curious what caused this seemingly extremely irrational reaction.
The tone of the thread was positive. Everybody knows there are doctors who don't care about their patients. It didn't add anything to the conversation and was needlessly negative. In other words: you peed in the pool. Don't pee in the pool.
I don't agree that that is a rational reaction, but it explains the reaction. Thanks for the explanation. Allows me to know i didn't do anything wrong.
I had a retinal tear 4 weeks ago and then then retina detached and started sagging in front of my lens, blocking half of my field of view. Seriously scary, especially since my mother has lost most of her vision after a similar problem.
I got a pneumatic retinopexy a couple of days later. Amazingly, it only took about 30 minutes in a (nice) back-room of the retina clinic with local anesthesia, and the retina re-attached itself in the course of the next few days. Now I am just waiting for the gas bubble to dissolve while my vision is getting better each day.
Its stories like yours that give me the (good) shivers. Just routine 30 minute operations we do now that would be considered miracles less than a century ago. It reaffirms a belief that humanity is capable of doing great things and solving insanely difficult problems.
In a very sincere and unironic way, "my faith in humanity is restored".
The one thing that drives me away is that while I feel like I am improving one's quality of life, much of my experience in medicine has been seeing my mentors and role models save one's life. It's probably the one thing I will miss most if I choose ophthalmology.
It's saving lives in a different way. Without my eyesight, everything would be difficult. I probably could no longer code, or at least in the same capacity. I love visual art.
I don't have much eyesight left, but a retinal detachment surgery helped make sure I did have some.
Strictly speaking, it's a big improvement because you're hearing about a phase 1 trial, and predictably so - not surprising at all.
Phase 1 trials typically get little publicity unless they either kill someone or turn in a statistically-significant improvement. (A phase 1 trial in which the controls do exactly as well as the experimentals and no side-effects are observed, which is highly likely for even excellent treatments because of the tiny sample size, will very rarely be written up because it's boring.) And because their sample sizes are always tiny, any statistically-significant improvement will always be an extremely large effect size. If the effect hadn't been improbably large, you would almost certainly not be reading about it now on HN.
And because of this selection bias, the effects you hear about tend to be massively overestimated. This is one of Andrew Gelman's points: the 'statistical significance filter' massively inflates effect sizes, a type M error, which then subsequently regress to the mean of the true smaller effect. This is why you're not supposed to take Phase I trials as meaningful estimates of the effect size, why statisticians emphasize they're supposed to be about safety, and why you don't do power analysis based on the observed results (either post hoc or for designing the next big ones). This is also part of why you hear about so many amazing pilot experiments in animals or humans but then the big followup trials are much more modest or nulls.
Interesting point. I was thinking about it in terms of dose, usually phase 1 trials seem to have significantly lower doses, to feel out any issues with safety. But perhaps that doesn't apply in this case, and you are left with the issues you mention about statistical significance, selection bias and regression to the mean.
I'd love to know if similar work is being done for loss of hearing/deafness. Is there an auditory equivalent to retinal pigment epithelium that nourishes the hair cell stereocilia?
I'm by no means experienced in this field, but wouldn't cochlear implants count to some extent? I know those sidestep the hearing loss rather than fixing it directly, but the end result is essentially the same. My mom has dealt with hearing loss since her early years of childhood, and peaking in total hearing loss about 15 years ago. Just a year or two later, she was included in a study and was able to get a cochlear implant for free. Not too long after, she was lucky enough to be offered a second one at no charge (the benefits of being a beta tester), and to this date, she's still being given new speech processors that constantly improve the quality of sound as well as adding new features. It honestly blows me away with what they've done already with hearing, and I won't be surprised if in 10-15 years, those implants surpass a normal human's capabilities, and people who still have perfectly working ears start getting them.
Alternative remedy groups recommend magnesium supplements to treat tinnitus. I know at least one person whose tinnitus improved and became more bearable after improving their magnesium status. I rapidly get noise sensitive when I become magnesium deficient due to fever or vomiting and it rapidly resolves with consuming magnesium rich foods.
If you are magnesium deficient, you may also need calcium, vitamin D and vitamin K to fully resolve the issue.
This lab at Stanford is working on some similar things (there are also other research centers I can't recall right now): https://hearinglosscure.stanford.edu/
I'm watching them like a hawk hoping that some day my 2 year old son might benefit from their work.
Most stem cell therapies produce benefits through the signaling of the transplanted cells, near all of which die off rather than integrate. This is an example of an approach that goes beyond that, providing a set of more organized cells in a thin tissue segment that looks more like the native tissue. When this was done for the heart, 10% of cells survived (this is a large number in the scope of stem cell therapies).
So it is interesting to speculate on the degree to which the benefits here are signaling versus cell integration. Clearly the big difference between past attempts is that a tissue-like set of organized cells are delivered rather than just free-floating unorganized cells.
My mother had macular degeneration. She lost almost all vision in a couple of years. She was a very active women all her life, a business woman when women had to ask permission to her husband to open a bank account.
It was devasting for such an independent person. She was deeply depressed and being in her early seventies her health deteriorated quickly, finally dying.
If researchers find a solution it will improve the quality of life of millions elder people.
I have had 4 retinal detachment surgeries on my left eye, with the last rendering it blind.
I had one retinal detachment surgery and a subsequent cataract surgery (since vitrectomy almost always results in a cataract) on my right eye. It's fairly stable but my vision is not great.
I'm hoping for stem cell therapy sometime in my life to help repair areas of my right eye that are no longer great (retinoschisis and general rod/cone dystrophy) and to make sure I'm seeing well into my later years of life.
About a year and a half ago, my wife was showing symptoms of early-onset macular degeneration, and it led to a rabbit hole of me searching for treatments, and I remember the earlier stages of this being discussed.
While it turned out that my wife's issue was (fortunately) something less severe, it still makes me happy to see that this treatment has had some success.
I'm really curious to see what the statistics of early-onset macular degeneration will be in 30-40 years, when a large portion of the population will have been looking at screens 10+ hours a day, for 30+ years. I suspect humans current eye-usage habits will affect the numbers.
results in this area of the field can't come fast enough!
Wow, that's pretty cool. One of the things I worked on a couple companies back was this: https://www.centervue.com/products/compass/ which is a system used to measure how much people are losing their vision from things like macular degeneration.
> Are they sure? They can now harvest stem cells from regular tissue and blood, as I understand it
There are adult stem cells which are differentiated or partly differentiated to particular systems, eyes, skin, blood etc, and there are induced pluripotent stem cells, where chemical or viral factors have been used to 'wind back the clock' for adult, differentiated cells back to completely non-differentiated (pluripotent) stem cells, equivalent to embryonic stem cells.
In the long run, it seems that embryonic stem cells won't be needed, but for the moment induced pluripotent cells are not 100% understood, everywhere apart from Japan clinical researchers are wary of using them in human trials, because they are not completely certain a particular preparation doesn't have abnormalities. Embryonic stem cells for the moment are the gold standard, and some work is needed to iron out the technology to standardize and check the process for inducing pluripotency.
But in principle any cure proven with embryonic stem cells could be 'ported' over to induced pluripotent stem cells once the iPSC process is standardized, it's just a question of whether you want to pursue these two research paths in parallel, or wait for the iPSC problems to be ironed out before even starting the process of running human trials.
Very well put. I would add that it could take decades to "iron out" the issues with iPSCs. It could also never actually happen. For example, the iPSC generation process induces oncogenic properties in the cells ( https://www.ncbi.nlm.nih.gov/pubmed/22998387 ). It could be that in the next few decades, iPSCs just turn out to be a lot less safe than embryonic stem cells.
Considering the hundreds of millions of dollars it could take to move stem cell therapies like this through the validation and regulatory approval process, it would be foolish to handicap the process by using "unproven" iPSCs in favor of "gold standard" embryonic stem cells.
>Both patients in the trial had "wet" age-related macular degeneration. This form of the disease is caused by abnormal blood vessels growing through the retinal pigment epithelium and damaging the macula. Dry age-related macular degeneration is more common and caused by the retinal pigment epithelium breaking down.
If this is a viable treatment method, it would help only the minority of macular degeration patients.
If I understand correctly, "wet" progresses much more rapidly than "dry". You're much more likely to unexpectedly lose your sight to "wet" (as opposed to just slowly having your sight deteriorate).
Feel free to correct if I'm wrong. I'm not an expert. This is just what I've gathered from having two family members with it.
If your _opinion_ conflicts with reality then the resulting comments are likely to be useless noise and get filtered out. And that is probably going to feel unfair to you, but it's actually valuable information.
HN readers find this unremarkable in many types of story. We don't find ourselves wondering if the comment "But five is an even number" for a number theory article might be signal that needs boosting, it's not, whoever wrote that either was joking or wrong, either way it's noise.
How does my opinion conflict with reality? Which of these is "in conflict with reality"? 1. The human embryo is human (this is true by definition); 2. The human embryo is innocent; 3. The human embryo is alive; 4. Murder is the intentional killing of an innocent human life.
Although "Murder is the intentional killing of an innocent human life" sounds like a reasonable definition out of context, you've presented a context in which "innocent human life" just means any human cells that you've arbitrarily judged "innocent". I'm going to guess this dodge is here because you support, or at least wish to avoid antagonising, people who believe that killing other people is a legitimate criminal punishment and so somehow it's not "murder" if the state chooses to do it. Although it's also possible you condone extra-judicial killing, with the same dodge, it's OK to torture somebody to death so long as you know, they're bad guys...
Anyway, a more reasonable definition of murder requires the victim to be a _person_ and an embryo is not a person.
Personhood is a strange phenomenon, and there's definitely room for a grey area. But embryos aren't in that grey area, not even close.
> I'm going to guess this dodge is here because you support, or at least wish to avoid antagonising, people who believe that killing other people is a legitimate criminal punishment and so somehow it's not "murder" if the state chooses to do it. Although it's also possible you condone extra-judicial killing, with the same dodge, it's OK to torture somebody to death so long as you know, they're bad guys...
I don't believe killing an embryo is murder, but this comment is a red herring. You're claiming it's possible that ¬innocent ∧ murder. But this is entirely consistent with mjh2539's claim that innocent → murder. See https://en.wikipedia.org/wiki/Denying_the_antecedent.
We've drifted far off topic here, but what's happened here is you've (hopefully by mistake) mistaken human natural language for a system of logical statements.
Human utterances in natural languages have a bunch of unspoken rules, breaking the rules is something that happens periodically by accident, and enables some amusing comedy (the late Ronnie Barker's most famous work "Four Candles" is a classic example) but on the whole honest participants in a conversation are not trying to break the rules. So. One of the rules is you mustn't mention things in the utterance that are irrelevant. For example:
"I've never been to Sweden in the summer" doesn't _logically_ preclude having never been to Sweden at all, but the rule means "in the summer" shouldn't appear in this utterance unless it's relevant, so it becomes a reasonable assumption for the listener that the speaker _has_ been to Sweden in some other season.
If a person says they believe "Innocent people should not be hanged" you're correct that _logically_ this offers no opinion on whether it's fine to hang guilty people. But the rule says it _does_ carry such an opinion implicitly, if innocence wasn't important it would not be mentioned.
When somebody is being very careful to define something in terms of other words and phrases they've used, we shouldn't assume they just threw some of them in for a laugh, they must all be part of the meaning intended - otherwise we can't communicate at all, just as we can't communicate with people who insist on Humpty Dumpty's rule (a word means whatever Humpty chooses it to mean).
You were wrong (and were also being uncharitable). The reason why I phrased the definition the way I did was so that I did not preclude the possibility of killing someone who was not innocent. This includes every instance of lack of innocence, but minimally, instances of self-defense.
I found your talking about implicature patronizing.
I agree, we can't communicate with people who insist on Humpty Dumpty's rule; what you fail to recognize is that you're happy to use Humpty Dumpty's rule in regard to 'human'. You have to make recourse to odd language like 'clump of cells'. The human fetus is a human being; that is, it is a human, and it doesn't really matter that you don't want to admit what is obvious to biologists, OB/GYNs, couples trying to conceive, people in parts of the world that haven't been colonized by Westerners and their ideologies, etc.
> an embryo is not a person
> but embryos aren't in that grey area, not even close.
You're begging the question. You haven't provided any reasons or arguments for your position. You've merely re-asserted it. It's akin to saying "It's true that x, because it's true that x".
How is my judgement that an embryo is innocent arbitrary? What crime has the embryo committed? What did it do to warrant being killed?
The trouble with your position is that you have to make an arbitrary judgement. You have to arbitrarily judge the fetus to be a person at some point. Is it at 12 weeks, 6 days, 32 weeks? The day before it is born? When, exactly? What criteria are you using for making that judgement? Why not the day before? Why not a day later?
My position doesn't require making an arbitrary judgement, or answering any of those silly questions. It requires making an intuitive, simple, straightforward observation: from the very moment that the sperm and the ovum meet and the genetic material between the two is exchanged (i.e., the egg is fertilized), a new human life is formed, with its own ends and identity. If nature takes its course, the person either dies naturally and the mother miscarries, or the embryo continues to develop and is subsequently born.
Further, I'm not just designating "any human cells" as innocent. I can't just designate "any human cells" and make them develop in the way that an embryo or a fetus develop. I'm talking about a specific group of spells, easily identifiable as distinct from the cells of the mother, that act in unison and coordination with one another through pregnancy to further develop the human being that has been there from the very beginning. If that is an arbitrary grouping of human cells, then I don't see how the same point can't be made to you, or to me (simply being an arbitrary collection of human cells), but everyone would recognize that this (you are an arbitrary collection of human cells, in contrast to a fully-fledged human 'life') would be absurd.
In addition, you seem to be implying that we need to use different definitions of murder in different contexts, but I don't see that's the case. How isn't the definition I provided inclusive of every instance of murder?
Something that deeply bother me about the "pro-life" stance is its hypocrisy.
They put advertisements about "protecting life" and use "life" and "humanity" all the time in their discourse, but that have nothing to do with what they think. What they think, normally, is in the line of "in the moment of the conception an immaterial entity take hold in the zygote".
For some reason, they refuse to discuss that. They believe in an immaterial soul but they hide their real beliefs in their discussion of the issue.
Of course, I don't know if this is so in your specific case, but I know other cases where it is.
a new human life is formed, with its own ends and identity.
And completely dependent upon the mother whose body it is parasitically feeding off of and canabalizing.
The problem with pro lifers is that they completely dismiss the lives of adult women as being less valuable and less important than a single celled organism incapable of surviving on its own.
If you don't want to talk about souls or spirituality, you are saying the rights of a blob of cells supersedes that of a grown woman. I find this monstrous.
>you are saying the rights of a blob of cells supersedes that of a grown woman.
There are many ways to philosophically argue against a 'life begins at fertilization' position. I don't know why you feel the need to assume things that were not said.
To me, this is not a philosophical argument. That is the de facto outcome of such a position. If you call it murder to end a pregnancy at any stage, as the GP does, then women are hostages of a life not yet able to survive on its own.
Why? Determining what is and isn't life is based on human reasoning, judgement, and morality. Have you found an alternate approach that was somehow missed by everyone else? :)
>If you call it murder to end a pregnancy at any stage, as the GP does, then women are hostages of a life not yet able to survive on its own.
Perhaps you missed the stem cell therapy treatment context that was being discussed. We're only talking about embryos, not pregnancy.
Assertion #1 is problematic here. As best I can parse it, you are saying, the human embryo is [of human origin]. That is very different from "the human embryo is a human." Most scientists and non-religious scholars and philosophers would disagree with the latter statement.
Assertion #3 is also problematic. You need a definition of alive that is both non-arbitrary and does not include skin cells, cancer cells (which can reproduce indefinitely), etc.
Assertion #4 is very interesting, and I think has been well-treated by other commentators.
Basically, you have asserted a syllogistic like statement that completely falls apart when examined closely. The attempt to save it by asserting that assertion number 1 is true by definition does not work. Assertion number 1 is only true by definition for trivial interpretations of assertion #1 (i.e., the human embryo is a collection of human cells).
I find how HN completely hides comments with a "[flagged]" replacement a bit insulting as a reader. We're all adults and I'm sure we can handle reading whatever he wrote. Instead we have to guess what you are responding to.
Moral indignity? Murder? Person? It looks like we have vastly different definitions of each of these words. Scaremongering with no basis in reality is closer to noise than it is to signal.
By that definition the usage of condoms is murder, too, as their usage means intentionally killing ovocytes, which are innocent, human, and alive.
But it doesn't stop there! Following that logic, not getting every single fertile girl and woman forcibly pregrant every 28 days is murder, too! Otherwise, all those ovocytes will die.
Somewhere in the syllogism you postulated has to be a logical flaw.
Misleading comment. You're talking about murder but this only involved embryos. Many/most people don't consider that murder any more than the spilling of seed is. If you want to push a political view don't couch it as a systemic complaint.
Killing embryos is more akin to abortion (before the 12th week, that's pretty much the definition of abortion). The topic of abortion is still widely debated (especially in the US), and your comment isn't doing it any more justice than your parent comment.
I would slightly disagree. Abortion requires removal/destruction of an implanted embryo. The scientific consensus in the field is that these "embryonic" cell masses used to make embryonic stem cells have no possibility of becoming a human being using current technology. In vitro fertilization techniques implant much earlier embryos than what are used here.
You're begging the question that one of the following two is false:
1. The embryos in question are human, innocent, and alive.
2. Murder is the intentional killing of an innocent human life.
I'm going to infer that you're begging the question that (1) is false. Your argument seems to be an appeal to popularity: most people disbelieve x, therefore x is false. But this doesn't follow. I'd like you to give your reasons as to why it's not true.
This is the fourth time in this thread that you have attempted to reiterate this argument.
Nearly everyone disagreeing with you is contesting your implication that an embryo is "a human" as opposed to "a potential human", and they further believe that "a potential human" does not have the same rights as "a human".
You don't appear to have a follow-up to that argument other than "isn't that just your opinion." In order to convince people, you will probably need a better answer.
> You don't appear to have a follow-up to that argument other than "isn't that just your opinion."
This is patently false. I have tried to give arguments but people are generally incapable of understanding what "begging the question" means. I cannot convince people that are not rational.
Something is either a human, or it isn't. If it isn't a human, it has to be something else. Assume that the embryo is not a human. It follows that it has to be something else. If it is something else, what is it?
If you say "an embryo", this is circular (the embryo is an embryo). If you say "not a human", you're begging the question. What's left? You have to attribute it as some other species of being, but if you do this, you're committing yourself to the absurd proposition that humans conceive something other than humans, and these non-humans then become humans. This is complex (and absurd) in a way that saying that human beings conceive other human beings is not.
This isn't remotely unsatisfying to you? Is E. Coli E. Coli, or a quark a quark, only when we pass a law that says that it is?
You don't see how this view (arbitrarily assigning personhood as a result of legal decree, rather than assenting to the plain natural, empirically verifiable fact) commits you to all sorts of morally untenable positions?
For example, "because they're human beings" is no longer a tenable objection to the person who wants to kill Jews on account of the law they passed precluding Jews from personhood. How would someone, like you, give a defense when you no longer have recourse to the plain, natural, empirically verifiable fact that they are human beings?
It's a test to see if they should bother moving forward. You don't want to gear up a big study just to find out that the treatment gives everyone cancer (which is a concern mentioned in the article) or that it doesn't work at all. You do a pilot study to see if there is potential before you waste a lot of work and maybe hurt people.
Anyway if the effect size is big enough, you don't need a really large study to get statistical significance. I mean, what are the odds of macular degeneration reversing by chance?
We do the same in web ergonomics. Testing you Ui on 3 people is enough to see the biggest flaws of the tool and engaging in more expenses. See the excellent book "don't make me think" for a quick and efficient write up on the topuc.
unfortunately that is all we have. There is nobody on earth with your exact genetic makeup (even identical twins, though then the random mutation is small enough to ignore: consider it an exception). As a result nothing exactly will behave correctly for you. A drug that causes death in 99% of those it is tried on might be the one you need, but because it is so deadly trials will ensure it never makes it to market.
It's a philosophical dilemma that demands rigour. When does a human person begin?
If a few cells cannot be a person, well, adults are only bigger clumps of cells. What is the threshold? If personhood begins when the cells are independently viable, well, most infants are not independently viable and some elderly aren't either. What is the threshold?
By contrast: The moment when it all begins and the DNA is first unique, and the potentiality for an adult is present is very simple and philosophically elegant. If personhood comes later, such as implantation, birth, 7th birthday, etc. it is difficult to give a basis in the philosophical sense. Many philosophers have struggled with this and it's no simple thing.
It's not a child. Even if you want to use a broad definition of child (and I do), this cell was not implanted in a women, and could not grow.
It's one thing to take positive action to stop a child from living (abortion).
It's quite another to simply do nothing. This type of stem cell research is done from cells that would otherwise be thrown out - you have not prevented a child from living.
It's really not what? Not a positive action that kills a child?
You have to see a difference between not saving someones life, even though you can, and actually going and killing them.
> You can’t make someone host a baby they don’t want
We are getting offtopic here, but sure you can. We make people take care of their children all the time. If they don't they go to jail for neglect or abuse.
Sure, we know that humans expect small pieces of human to be treated as irrelevant (e.g. you leave tiny skin particles and hairs basically everywhere and all you usually ask is that people vacuum them up to avoid the place being covered in dust) and that larger pieces (e.g. a toe, or in this case an embryo) should be treated with extra care and consideration of people's emotional reaction.
But it's not kidnapping if you keep someone's toenail clippings. It's creepy, but it's not kidnapping. It's not murder when the barber sweeps all the hair into a furnace, it's called tidying up.
Do you genuinely believed that a baby was killed to harvest stem cells? If the baby was already dead, are you morally opposed to using an unsaveable baby's stem cells?
