Tag: medication

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Sponge Mofs

Many people might have come across “SpongeBob” as a TV-series. Well, in 2025 it is time for an update. The Nobel Committee has awarded the Chemistry prize not to SpongeBob, but the research linked to the sponge-like Mofs, i.e. metal-organic frameworks to Kitagawa, Robson, Yaghi. These Mofs have in fact properties  similar to a sponge or cages in some applications. They consist of porous materials, which have large surface areas in relation to their apparent volume. Due to the modelling of network structures the surface of a grid can be expanded drastically.
Due to the application of such modelling techniques, the combinations of materials/organics and, thereby, the applications to modern technological challenges have increased tremendously. The exponential growth of research papers based on these foundations largely justify this honourable award. Not only the potential of carbon capture, but also the storage capacity of batteries as well as medical applications might benefit from this basic research and findings, eventually.
Playing around with a sponge, doing your dishes – also for men, or watching Spongebob might be considered differently from now on. Maybe, just start with a virtual visit of the Nobel museum for further inspiration.

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Scienceploitation

Science can be exploited to make unjustified profits from referring incorrectly to it. Social sciences, like economics may be used by banks to sell you products that refer to science only as part of their arguments if the science based inference fits their purpose. Scienceploitation is very common in the field of para-medicine and para-pharmaceutical products. Health promises sell. The time until an ineffective treatment reveals the unrealistic promise to be unachievable considerable profits have accumulated on the side of the selling company. Science has a hard time to counter the perils of scienceploitation. Advanced knowledge can be used and abused as any other method of convincing people to buy or subscribe to a product. The responsibility of the scientific community consists also in finding ever new ways to counter scienceploitation. AI will pose additional challenges as well as opportunities.  

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Maison de santé 1861 Berlin

In the middle of the 19th century Berlin was a small city. The area of Schöneberg (pritty hill) was still perceived as the rural outskirts and featured the first botanical garden next to the town center. A little bit more outside of Berlin the “Maison de santé” was founded as early as 1861 to cure mainly respiratory diseases and what later became the first private clinic proposing a new way to treat psychiatric disorders. Dr. Eduard Levinstein was the founder and the clinic had continued its operations for almost 50 years with his wife and sons taking the lead later on. Prof. Wilhelm Griesinger, known for the scientific approach of psychiatry was a proponent of the non-restrained approach to psychiatric disorders, which allowed persons move more freely while being supervised. The documents and the publication (1877) shown in the exhibition at Museum Schōneberg demonstrate the scientific approach to the treatment of addictions, most notably morphine, which had been widely used during the war of 1870 as tranquilizer and pain relief. The wave of addictions needed hospitals and clinics to treat these addictions. The “Maison de santé” had been established as a retreat and cure for other addictions as well. The memory of the early scientific approaches is an inspiring place and reminder to take care of all forms of addiction. Taking care of body and mind is still the state of the art approach today.

The Exhibition catalog is forthcoming, but the visits and material on display of interest beyond the inhabitants of the „Pritty Hill“. Exhibition catalog is forthcoming

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Biased Results

The use of statistics in presenting results of research is common practice. Empirical studies are summarized using statistics and statistical methods based on samples of bigger populations are cost efficient. However, care needs to be exercised when interpreting results to guard against inappropriate conclusions derived from biased estimates. Since the topic has been highlighted and methods proposed to handle them, these methods were deemed worthy of a Nobel prize.  The basic problem of a bias due to a selective sample has been demonstrated by Stockwell et al. (2024). The authors investigate the old question, whether a little bit of alcohol consumption (per day) could be beneficial for our health. The statistical issue which needs careful examination is the construction of the control group against which the results are compared. Apparently many studies have biased control groups which included persons in the not drinking control group who had stopped drinking for bad health previously. Compared to those persons with other health conditions those drinking a little bit compared rather well. But of course such individuals should not be present in a control group. Of the control group is biased due to many persons with below average health the groups of interest consuming higher levels of alcohol do not perform so badly. Hence, interpretation of results from medical or social science studies has to consider carefully the actual or potential sources of bias. Not really a new results in statistics, but still not well known or understood by the public at large. Drug consumption as well as studies of this consumption could deserve the same sticker: handle with care. (Image: Extract from Tenier II David, Les fumeurs, also entitled Chanson à boire, 17th century, Paris Petit Palais).

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Guidelines Follow-up

The are many professional organisations which agree after thorough discussions on guidelines how to conduct professional services. As long as we have such guidelines, the adherence to the guidelines is an issue as well. This is part of a research program of organisational sociology, but there is a rather strange paradox in this field of compliance with guidelines. In the most highly educated professions like medical doctors, the rate of compliance to guidelines is below average. A study of 20+ years ago published in the JAMA Journal: Cabana et al. (1999) “Why Don’t Physicians Follow Clinical Practice Guidelines?” highlighted this paradox among medical doctors. The lack of awareness of existing or changed guidelines is one of the major reasons mentioned in this respect. Self-efficacy is also an issue, but mentioned less frequently for not following guidelines.
Besides a professional bias, related to the above average educational attainment of physicians, (believed) superior coping mechanisms compared to the average population might be at work. Mastering advanced technology might lead to a behavior that assumes to be able to handle higher risks as well.
For a profession that is used to confront issues of life and death on a regular basis some adherence to a very specific medical guideline might appear a negligible risk. However, maybe comparable to some cases among politicians or priests a logic: “rules or guidelines are for others to follow” rather than the physicians bear obvious risks to these persons themselves, but even to others in specific circumstances like the spreading of infectious diseases.
Drug or substance abuse has been evidenced before in relationship with specific professions or in historical time periods. We should take care to repeat similar studies (Cabana et al. (1999) every now and again.

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Law and Witches

Medical and chemical authorities have been questioned for many centuries. As far back as Friedrich Spee (1591-1635) in the early 17th century there were even among the clergy men with enlightened views on what might be helpful ways to assist people on their journey to better health or simply pain relief. This did include many unhelpful or detrimental methods as well. Scientific rigor was not well established at that time, which opened up many doors for alternative diagnosis and treatment. From a historical and sociological perspective the closing procedures of professional organizations are interesting as well as opposition to them. Early moderators between hardliner positions are rare at the times of forceful and fierce competition between opinions and doctrines that characterized medieval history. In the absence of an independent judiciary earlier moderation could be influential in specific instances. A testimony for can be found in a documentation of the biography of Friedrich Spee and the society that promotes the memory of such exemplary behavior.

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Law and Legality

Some persons consider themselves to stand above the law or push all interpretations of regulations beyond usual understanding of it. Even after a person has been dealing with pharmaceuticals or drugs used also for doping purposes, the conviction of such a person may take several years if not decades. In France, Mr Bernard Sainz seems to be a good example of such a relentless case of practicing para-medical consultations to assist mainly cyclists in endeavors to win championships or professional status. Le Monde  and Cash investigation have raised awareness of the public for such dubious practices. The “French Federation du cyclisme” and medical doctors association fight a continued legal battle against this persons exercising illegally such doping assistance. 

With apparently 56 legal procedures in connection with this person, the legal system has to bear the majority of costs of such illegal practices.

The reach of such dubious practices might be extended if the systems beyond doping, but for assisted euthanasia cannot be controlled effectively. Hence, the precursor cases of positive stimuli like doping pose similar challenges to the legal system as “negative stimuli” weakening persons as assistance to die. The end of a life course is not only a medical issue. Society-wide debates need to take place in order to organize a large consensus on the implications more liberal practices shall entail. 

(Image: Palais de Justice, Paris 2025)

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Synthetic opioids

Across the globe there are many tough lessons to be learned about synthetic opioids. These psychoactive substances fall under special legislation and can only be used with medical prescriptions. The strength of these substances is usually compared to heroin and the risk of addiction to these substances is very high.
A recent paper in International Review of the Armed Forces Medical Services (2024) has highlighted also “the abuse of the synthetic opioid U-47700” at times of military conflict. The power of these drugs to suppress the feeling of pain is helpful for medical operations. The abuse, however, may consist in the use of the drug to “keep fighting whilst pain is suppressed”. Such use of synthetic opioids increases the risk for addition and the fatal consequences of overdoses. The reporting of such occurrences in a specialized medical journal is an important warning against the conscious and willingness to abuse the drugs for war purposes.
The finding reminds us of the abuse that was already widely spread during the Nazi led 2nd World War (“Der totale Rausch“). The addictive potential was experiences even after the war time in terms of active combat was over. The costs to society of such abuse as well as use of supply chains of provision of opioids during peace times remain a problem for many years after the war. After a war, the war on drug abuse continues. Fighting addiction is a lengthy and painful process.

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Defence Spending

As in research there are many dual use products, which can be part of defence spending. Robotics in production or rockets to launch satellites for telecommunication are such examples. Much less known to the public is the amount of military spending that goes into medical developments that benefit both the military as well as the civil population. Countries build a whole ecosystem round the provision of medical services for defence purposes , which consists not only of a sufficient number of qualified persons, but also companies that provide specialised products. Most of them have civil applications as well after minor adaptations.
Oxygen provision was a prominent example of a product that has civil and military uses in treatment of respiratory infections or contaminations. A mobile transportable operation table is another element of daily rescue services as well as potential use in situations of conflict, just like anesthesia machines. An increase in spending on such infrastructure and the necessary long-term training of persons operating and maintaining these medical applications take time and considerable financial resources.
The current debate in Europe and NATO neglects the considerable time delays in production and provision of the equipment. Research on “Skill Needs in OECD countries” has shown the substantial delays between sudden skill needs and the time to train high-skilled persons.
The International Review of the Armed forces Medical Services is a journal dedicated to publish up-to-date information on needs of medical products and persons trained to use them in special emergencies. The need to safe lives in extreme and dangerous conditions needs preparation of thousands of specialists. Of course we hope that such an incidence will not happen. The persons and material have an obvious potential to serve the civilian population in more peaceful times as well. The unfortunate “hog cycle” in skill provision is not a problem for dual use products or services.
(Image: edited extract of a mobile operation table)

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Health Tech

Health technology assessment (HTA) is an interesting scientific field. The new digital opportunities allow people to participate in medical and medication trials in their homes or even in bed. Their health data and the administration of medication is also encouraged and sometimes supported through digital devices. The pharma and health industries have many devices ready to go. The differences to the traditional forms of medical trials, however, is an issue as we want to compare the results from both kinds of trials. Participants of trials, might prefer or struggle with these novel kinds of study designs. In any case the results will be impacted in several forms (Study Link). In the best of all worlds for the researcher the effects will cancel out each other, but is rather unlikely. Some participants will reach more positive effects with the use of digital tools, whereas others are challenged and might even abandon during the trial. Monitoring during the study (for example through digital inhalors) is another advantage of such distributed trials. Rather than taking adherence to a trial medication for granted, digital tools allow a more precise monitoring of subgroups as well. Data and effort invested in the trial is preserved through the easier access to person’s information, assuming continuous readiness to stay on in the trial.
Our own smartphones are still underexploited in terms of health monitoring and use in research designs. The possibilities to link data to other external data sources shall further advance the research potentials in many interesting ways. Data protection and data security become even more important with the ever smarter phones and connected devices.