Comment by timenotwasted
12 days ago
I feel like I've been reading this exact same article for the last 15 years.. I find it very difficulty to parse what is real and what is vaporware in the medical breakthroughs community.
12 days ago
I feel like I've been reading this exact same article for the last 15 years.. I find it very difficulty to parse what is real and what is vaporware in the medical breakthroughs community.
Just 7% of studies that do a preliminary study on humans actually get through phase 3 and get approved for use. This is before even the preliminary point, its a tooth (or even a tooth analogue) in a petri dish. No idea if the material will be safe in a human mouth yet.
There is a lot of hyping of results in medicine papers in general but its not really their fault. The entire academic world is being forced to publish or die as governments look to measure results from the science they instead get what is measured and everyone has to embellish the importance of what they found and always find positive results.
Despite how obtuse the current administration views are, this has been true for decades. The churn of new papers and hype around medicine/biotech is nothing new.
Says nothing about endemic reproducibility crisis of the social sciences.
Since student loans have been basically guaranteed (bankruptcies can’t erase student loan obligations, in an attempt to push rates lower) and tuition steeply rose, academic institutions’ ratio of administrators to students has skyrocketed to a bureaucratic mess, leading to a flywheel of higher education costs and incentivizing research for money’s sake over impact to the field.
Real impact would be reproducing notoriously iffy studies, but that doesn’t bring in the dollars.
KPIism is the death knell of modern society. In the 90s and 2000s this mantra of "measure and improve" took hold like a virus. It is in all instances I observe a rats race where everybody just starts to look for the cheat-codes instead of "doing-the-right-thing".
Arguably America is the pinnacle of this right now, where (many) politicians and (many) business leaders now feel justified do whatever's legal just to score points. I would argue this type of thinking was birthed in the UK though under Thatcher who as a first step removed the general trust in (civil servants in her case) your fellow human beings. Blair then came up to replace that trust with KPIs.
We need to get back to a world where we trust people to do the right thing - without measuring their success in short-term KPIs.
MBAs are the source of KPIism. We have spent many decades minting them at scale in the USA and now the chickens are roosting. Anything can be ruined by pursuit of KPIs at all costs. The model is to optimize a particular KPI, get your bonus, use this story to get your next job at +$X, leave, repeat. The longer story of the company does not matter, you shipped and got paid, even if the village burned down after you left.
> The entire academic world is being forced to publish or die as governments look to measure results from the science they instead get what is measured and everyone has to embellish the importance of what they found and always find positive results.
It sounds like they're running it like a business.
Over time, any large business trends to increase in bloat and inefficiency, and focusing on inappropriate metrics is a big part of that.
This eventually leads to competitors taking over and those business failing, which usually results in people losing their jobs.
When governments get equally incapable, and competitors take over, it tends to be a lot more violent.
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That was my conclusion when I attended... 15 years ago. You're not a student, you're a product.
Is there a way I can search for the studies that recently got approved? Somehow setup an alert for it?
You could follow the NIH news feed that contains some of what gets funded but its actually quite difficult given the various institutions all over the world that all fund studies including charities and the universities themselves. On an individual topic with time you could learn who most of the major players are and follow their news but its unique to every topic.
The potentially easier way at least to get a lay of the land is to follow pubmed (https://pubmed.ncbi.nlm.nih.gov/) for the topic you are interested in, if you then look into those papers you will find funding statements as well as the place the research was conducted and use both to build up a picture of the origins of research in a field.
Afraid I don't know of an easier way not a generic one anyway. Sometimes you just have to follow the right person on twitter who announces trials or studies or be at the right conference. Start with pubmed and the output papers and that will get you started. Then also have a search on the NIH and that might lead you to some links to groups and institutions they fund.
You could look at ClinicalTrials.gov, you can quite easily search for completed, phase 3 trials example.
https://clinicaltrials.gov/search?aggFilters=phase:3,status:...
Publish or perish is more about status & careerism within academia than any sort of govt forcing function. If you don't publish, you are invisible to your peers and your career stagnates, regardless of the govt funding environment.
It is entirely their fault. If no one agrees to do performative research, the problem will be solved.
The problem is some people prefer an academic lifestyle in exchange for doing performative research.
Yes there are other actors eg politicians demanding performative productivity, but mostly it’s the inmates running the asylum.
Academia is one failed western institution amongst many, and those failures are ultimately directed by the actions of the individuals that comprise those institutions.
> It is entirely their fault. If no one agrees to do performative research, the problem will be solved.
Right, and the prisoner's "dilemma" isn't a real thing; everyone knows it's their own fault for not just all picking the decision that gives them all the best outcome. Every individual within a network effect is obviously responsible for the outcomes the entire system produces.
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It's not necessarily performative research just because a pop science author wrote a catchy, exaggerated headline about it
This is a fallacy: "If no one agrees to do performative research, the problem will be solved."
It is like saying, if everyone stops subscribing to OnlyFans or liking spicy pics on Instagram, it will go away.
There will always be sycophants willing to do "performative research" or ... other things.
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So long as funding is granted to do performative research, it will continue to exist.
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Enamelon Toothpaste from the 1990s:
https://www.ebay.com/itm/127083185095
"proven to strengthen tooth enamel" I remember researching the stock and deciding not to buy.
Patents from the 1990s https://patents.justia.com/assignee/enamelon-inc
It seems the company is still around https://www.enamelon.com
What about "Sensodyne Pronamel"? There is usually someone in the comments raving about its effects.
I think usually they rave about Novamin, which, at least in Canada, isn’t in the Pronamel line IIRC but in other Sensodyne branded toothpastes.
_EDIT: “repair and protect”_
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I can be that someone this time. The ”repair and protect” version has helped my low-level toothache.
I've actually been occasionally using Enamelon because it was recommended by my dentist for sensitivity and I think it actually works.
I'm going to try Boka as recommended above though, it seems like a more updated and modern solution.
Did you tried :D ?
Same feeling here. Dental seems particularly fraught (though maybe I just pay more attention to it out of interest). I know the cycle time between press releases/hype and actual application can be the better part of a decade, so I assume that's coloring my perception too.
re: dental in particular - It seems like enamel regeneration and stem-cell-based tooth replacement have both been in the news year-after-year without applications actually coming to market.
Does anyone know why casein phosphopeptide (Recaldent) hasn't had more success? https://pubmed.ncbi.nlm.nih.gov/9294493/ You can buy the Japanese gum with Recaldent online, but I expected it to be in the gum display in retail shops by now.
Everyone knows that teeth are luxury bones in the US. The market just isn't there for fancy treatments. The ultra-wealthy just get their teeth replaced with perfect veneers anyway.
> The ultra-wealthy just get their teeth replaced with perfect veneers anyway.
Na, that’s the working class turkey teeth crowd.
> stem-cell-based tooth replacement
Really? This sounds more like someone's plan to get grants to research stem cells than someone's plan to repair (or replace) teeth.
We already have a natural ability to grow new teeth that replace existing ones. Everybody does it... once. Where's the research into getting it to happen again?
Theet formation is a very early procces, even before the baby is born.
> Primary (baby) teeth start to form between the sixth and eighth week of prenatal development, and permanent teeth begin to form in the twentieth week.
So it's probably too late for you.
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There has been a ton of research in the area of re-growing teeth from stem cells. A cursory search-engining will turn up a ton of articles, some going back decades, and many giving the impression that it's close to happening. I've been following it for awhile because I knew I'd be in the market for a new tooth eventually.
Here's an example of one from earlier this year at King's College, London: https://www.kcl.ac.uk/news/lab-grown-teeth-might-become-an-a...
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A similar approach was reported in 2019,[1] but that produced thinner coatings, and the recovery of the architecture of inner layers of enamel was only partial.
[1]https://www.science.org/doi/10.1126/sciadv.aaw9569
While I 100% agree with what you wrote, I'd just add that it does seem in my own dental visits over my lifetime that there have been real advancements, too. But yes, I agree, hard for non-expert to parse.
Seeing SLA 3D printers at my dentist's office was pretty cool. Apparently they use them for a variety of fixturing and jigs, and have a workflow that includes a handheld scanning unit that SLAMs to generate a solid model of the patient's teeth.
I have 4 crowns, 2 done using moulds, 2 using the 3d scanner. Same doc, same office. The moulded ones were ok with some adjustments, but the 3d scanned ones were perfect since day 1. I'm happy with the progress in dentistry.
Can you share some specifics?
I'm surprised how many low-hanging fruit issues are still not solved. So many dentists use cold or tap water for their rinse sprayer despite the fact that many people have temperature sensitivity issues with their teeth. Having lukewarm water would be trivial but I've yet to go to an American dentist that does it.
This might be the dental equivalent of the "Groundbreaking New Battery Tech" type of article.
ART with HVGIC has basically solved dental caries since the 80s. But you aren't likely to get it in the US or most western nations because there is a massive industry around drilling and filling with resins and then solving the multitude of problems that such a destructive process creates. Crowns, root canal, periodontal disease etc.
https://www.sciencedirect.com/science/article/abs/pii/S03005...
Isn't ART also destructive? Just that it's done with hand instruments instead of a drill
Also the aspect of shooting in neuro toxins close to the brain when doing these procedures
exact same reaction. I remember hearing about "regrowing teeth through sound waves"... in 2006. https://www.cbc.ca/news/science/dentist-engineer-team-up-to-... Can't say I have heard it offered anywhere yet....
A better approach is to monitor FDA updates. When an FDA trial shows positive results for a new treatment and approval for public use appears imminent, that would qualify as news in that regard.
yup here is one from 2007
https://www.technologyreview.com/2007/02/22/272845/regrowing...
As it turns out, this is really hard to do. There are a lot required of teeth: they have to be extremely durable to resist repeated strain of chewing ,stay in the gums, not be rejected by body, etc. It's little surprise progress has been so slow.
or, solid state batteries, graphene, fusion, quantum computers, agi =)
I was expecting to see something along this storyline[0] which seems believable though not palatable.
[0] https://news.ycombinator.com/item?id=44922571
It is probably tough getting investment because this is ultimately cosmetic and not something covered by most dental insurance. Existing repair is probably good enough and I’d expect cheaper too.
> I feel like I've been reading this exact same article for the last 15 years.
I was about to comment the same thing, I feel like I've been seeing this talked about since the 90s
- HIV/AIDs
- Cancer
- Tooth regrowth
It feels like it won’t ever be done for some reason
Cancers have had extremely effective new treatments developed for in the last ten years.
Depending on the type of cancer, we now have cures or treatments that stave off death for years.
My wife has a rare type of cancer with not much research thrown at it, and even her type of cancer went from a median time of survival measured in months to several years.
Tooth regrowth is something I was really hoping for. I abused one of my molars. After years of efforts (repeated fillings, a crown) to stave off losing the tooth it finally had to come out last month. Now I'm waiting for the bone graft to "take" before getting an implant. I was hoping I'd waited long enough for tooth regrowth to become "a thing" but I have not.
(Should have taken better care of it when I was younger and not ignored the massive hole that was growing in it. Chalk it up to a bad dental experience as a child and 25+ years of avoiding dentists as a result...)
After a few years of bad mental health, I do have several dental problems, including two badly chipped front teeth. Sadly, my local dentist isn't taking any new patients at the moment so I can't get them looked at even though I now want to. It would be good if I could regrow the teeth but I think it's going to end up being an expensive procedure :/
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In the same boat as you, maybe less years behind you than I’d like to believe.
Just in case you need someone to, y’know, empathise with you.
I have a lot of people in my life who don’t understand why I don’t just go to the dentist
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I was reading your comment just as I was sat in the dentist office paying for my partner’s kid long due treatment. She was afraid of dentists and neglected treatment for too long but I took her to the same superb (and expensive) dentist I use for my own kids and she was happy and had everything done. Your comment reminded me why I do it. Thank you.
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While a cure remains elusive, HIV treatment is now extremely effective. Antiretroviral shots can keep people symptom free indefinitely.
Cancer treatment varies by type of cancer but many have dramatically improved outcomes.
I am confused by this comment about HIV/AIDS. Is it cynical? Are you confused why we have not "cured" HIV? I grew up during the AIDS Crisis. It was awful. People were dropping like flies. Today, you can be "technically" HIV positive, but test negative, give birth to HIV-negative children, and have unprotected sex (and not infect your partner). As far as I am concerned, the battle has been won. It is a miracle in my eyes.
HIV meds have a slew unpleasant but tolerable (certainly far superior to HIV itself) side effects, imo the battle isn't "won" until the treatment is entirely inconsequential.
That said, the progress has indeed been miraculous. A great example of the capabilities modern medicine.
i thought the first two have had huge improvements in the last decade?
HIV has become a manageable disease in my lifetime. The main issue today is access to medication as I understand it.
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it might be slow exponential thing, 60 years of low to medium improvements in cancer, and hopefully suddenly a few big cracks to turn it into a chronic liveable condition (or maybe cure it).
there are more articles about advanced tumors being shrunk to nothing than before (based on my personal monitoring)
HIV prevention has been reduced to a twice a year shot given mainly to MSM. It's pretty damn close to the original goal of a vaccine.
+ Male birth control
+ Alzheimer’s cure
+ Hair regrowth
Cancer immunotherapy . Only works in a handful of cases
+ weight loss pills
...they were persistent vaporware or scams, then suddenly they were real and everywhere. Hopefully that happens for the others too?
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Compared to the 1980s, HIV is a chronic manageable disease that does not even reduce your quality of life.
Plenty of cancers have become manageable with the advent of immunological treatments.
Tooth regrowth seems to be the most complicated of those three, which isn't even surprising, given that it is basically organ regeneration.
HIV/Aids have made huge progress and so did cancer. Also "cancer" isn't a single disease, they're quite different.
- hair regrowth
I find it interesting that we are closer to regrowing teeth than hair. At least there was human clinical test for TRG-035. Is it just cause hair transplant is "good enough" stopgap solution?
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>> I feel like I've been reading this exact same article for the last 15 years..
You must be new
I think 30-40 years at this point. Same thing with regrowing teeth.
I would say, maybe look at medical studies from the opposite end, epidemiological studies look at factors that reduce mortality/morbidity. Granted, it's less flashy, basically vaccines, alcohol/tobacco reduction, increase in active lifestyle, statins/ace inhibitors, monoclonals/oncology fanciness. although someone who actually is an MPH can probably correct me.
on the neuroscience side, off the top of my head, the most impactful things have been better anticoagulants and preventive care for stroke, monoclonal abs for autoimmune diseases like MS/myasthenia, , certain stereotactic brain surgeries, and such. But considering what ails most people, the overall population effect probably is minuscule compared to say better crash safety in automobiles.
Wait until you read that the scientific evidence for flossing doesn't really confirm the promised benefits.
Fortunately there doesn't seem to be any harm from flossing. At least from my anecdotal experience there are positive bad breath ramifications. (I've also been conditioned, by flossing regularly, to feel like my mouth is "cleaner" after flossing, to the point that it feels bad if I don't.)
Quite possible regular flossing causes microplastic contamination in the gums which quite readily then enters the bloodstream.
Many people are not honest about how much they floss, and those who do often don't floss correctly. We have a well understood mechanism for how tooth decay and gingivitis happen, and it's clear clinically that flossing can address these more effectively than brushing alone can. Furthermore, the subjective reduction in bad breath means harmful oral bacteria are reduced, which could have benefits beyond oral health.
This is the key issue. There is zero doubt whatsoever that flossing is essential, and the fact that the empirical evidence is equivocal shows the limitations of science to prove even the most obvious things.
I do floss, but I genuinely don't see that this is obvious. You can do a lot of damage with mechanical force, to both teeth and gums! Starting a flossing regimen after not having one tends to cause pain--isn't that a signal to stop? etc.
Furthermore, correlation is not causation and it could well be the case that flossing is associated with better outcomes without causing it. For example, people who can afford to go to the dentist regularly are therefore regularly told to floss. People who care about dental health in general probably floss more, but also may be doing other things, consciously or unconsciously, to improve outcomes. Gut (and perhaps mouth) bacteria have behavioral effects; perhaps flossing is caused by having healthy mouth bacteria!
(at least one study says mouthwash is better than floss. That seems obvious to me! liquids are smaller than floss.)
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Any chance you would be willing to summarize the research or provide information on some relevant studies? I've always been skeptical about flossing and would like to learn more.
The wikipedia article [1] suggests that there is no strong evidence for flossing being a good thing. However, that might just be because experts have not updated the article.
[1] https://en.wikipedia.org/wiki/Dental_floss#Efficacy
enjoy https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
Meta-analysis suggests flossing doesn't affect tooth decay. But it does seem to prevent gum disease.
I hear so many counter-logical ideas proposed with "scientific evidence". Poorly designed studies and P-Hacking has ruined the publics trust in science. I highly doubt flossing is a net negative for almost anyone.
tbf, it does require a technique otherwise you risk just pushing plaque underneath your gums
Where? Source please?
Wait what? Please share
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There was a period where my dentist would always ask do you floss in a check-up. They haven't asked for years at this point.