User talk:Pierre-Alain Gouanvic

Tasks: start a new article • add basic, wanted or requested articles • add definitions • add metadata • edit new pages

Welcome to the Citizendium! We hope you will contribute boldly and well. Here are pointers for a quick start, and see Getting Started for other helpful "startup" links, our help system and CZ:Home for the top menu of community pages. You can test out editing in the sandbox if you'd like. If you need help to get going, the forum is one option. That's also where we discuss policy and proposals. You can ask any user or the editors for help, too. Just put a note on their "talk" page. Again, welcome and have fun! --Larry Sanger 00:35, 17 August 2007 (CDT)

Interesting

Interesting bio on your userpage, Pierre. Nice to you around, and let me know if I can ever assist you with things around here. Stephen Ewen 16:51, 13 November 2007 (CST)

Welcome and thanks

I'm just spending some time this morning thanking the newer/returned people who have been doing work on the wiki lately. So, thanks, nice to have you here! --Larry Sanger 09:39, 17 November 2007 (CST)

good info

Hi Pierre, I just saw your discussion on Talk:Evidence-based medicine. That is a good analysis and good point that should be in the article. Why don't you see if you can squeeze it in somewhere. --D. Matt Innis 00:43, 18 November 2007 (CST)

Potassium

Pierre-Alain: Yes, the article needs a discussion of potassium and the metabolic syndrome. Thanks for starting and stimulating that topic. I haven't had a chance to look at Metabolic syndrome yet but will try to do so soon. --Anthony.Sebastian (Talk) 22:25, 22 November 2007 (CST)

I have been working intensely on the Vitamin C page and left the metabolic syndrome with many deficiencies... The reason why I put the MS article aside for a while?

Several competing definitions of metabolic syndrome are in use, and each is differently linked to the presence of insulin resistance. These definitions include that of the National Cholesterol Education Program (NCEP) Third Adult Treatment Panel (ATP III) (2), the International Diabetes Federation (IDF) (3), and the European Group for the Study of Insulin Resistance (EGIR) (4). The EGIR definition requires the presence of insulin resistance plus any two other metabolic traits; ATP III and IDF definitions require at least three metabolic traits but do not require the presence of insulin resistance. In studies of ATP III metabolic syndrome, as many as half of subjects do not have insulin resistance (5–7).

Impact of Insulin Resistance on Risk of Type 2 Diabetes and Cardiovascular Disease in People With Metabolic Syndrome. James B. Meigs & al, Diabetes Care 30:1219-1225, 2007.

I don't like that. This reminds me of some nightmares I went through as a terminologist. I think that I'll leave MS (and other "clusters" for that matter) for a while and focus on insulin (resistance), ascorbate, SOD, oxidative stress, magnesium, potassium, exercise, adipocyte, many other things, but mostly basic building blocks of knowledge.

I have read BMC Evol Biol. 2007 Apr 17;7:61. Evolutionary origins of insulin resistance: a behavioral switch hypothesis. Watve MG, Yajnik CS Very enlightening and challenging. Pierre-Alain Gouanvic 00:15, 23 November 2007 (CST)

I seriously consider the idea that the metabolic syndrome page should be a very concise page describing the current disagreement and pointing to related pages: insulin resistance, CHD, hypertension, etc. There might be no other way to be objective.

It seems more logical and ethical to cluster conditions in function of common pathophysiological features (magnesium, potassium deficiency, C-reactive protein, etc, etc.) than in function of power struggles between specialists fighting with statistics devoid of any underlying physiological meaning. Pierre-Alain Gouanvic 00:31, 23 November 2007 (CST)

Lavigueur family

Hi. I thought this article might be interesting to you. :-) -- Hugo Voisard 16:06, 1 December 2007 (CST)

Inspiring. ;-)

I'm getting a little worried about what people are going to think about quebecers... Let's write articles about Celine, Cirque du Soleil and Denys Arcand! Quick!

--Pierre-Alain Gouanvic 16:21, 1 December 2007 (CST)

Yeah. That's right, so far I've written articles that might that might give a bad opinion of Quebeckers (not my intention though!). So we should find something cool and positive to write about. There is this other article about terminological databases I wrote (including a section on GDT). I'll see what else I can do. :-) -- Hugo Voisard 13:58, 4 December 2007 (CST)

Vitamin C

Hi again, Pierre-Alain,

I removed the redirect from ascorbic acid per your comments at talk: vitamin C. So, come on over to the write-a-thon and start separating, else I'm going to look like an idiot! Aleta Curry 15:52, 4 December 2007 (CST)

Hi Pierre-Alain!

I'm new in Citiz and not very good in english language, so did You can to do all need procedures for CZ:New Draft of the Week - page? :-) Alexander N. Alexandrov 02:45, 5 December 2007 (CST)

Okay! for what page is it? --Pierre-Alain Gouanvic 10:25, 5 December 2007 (CST)

For Ascorbic acid in first case... Alexander N. Alexandrov 10:40, 5 December 2007 (CST)

I wasn't sure. I wonder if it would be possible to modify it a little bit more before it is submitted to the vote. I'll do as you ask me, but I'm worried that unmodified wikipedia content might be taken as a "non-draft". What do you think? Do I understand well the situation? I'm not totally sure what the draft of the week is about. I saw that the next vote will take place tomorow, and the other one the other thursday. This would leave some time to review and edit content. But again, this is only a sympathetic comment, not a "no"! --Pierre-Alain Gouanvic 11:29, 5 December 2007 (CST)

Of course You wright...

I think this is some about anonce for "together week-work on the article"

It's my fault... Festina lente :-( Alexander N. Alexandrov 09:49, 8 December 2007 (CST)

I'll do my best to help in the development of this article. I'm afraid, however, that some technical issues are beyond my grasp -- for now. However, I can help a little with style and syntax, etc. English is not my first language either, however... You go first (on the ascorbic acid article), okay? ;-) --Pierre-Alain Gouanvic 12:33, 8 December 2007 (CST)

Sociology

To fully comprehend the special perception that vitamin C enjoys, we must understand the role of Linus Pauling, one of the principal founders of modern chemistry, in the dissemination and popularization of information about this molecule.

Pauling, a two-time Nobel Prize winner who had received worldwide praise for his work on a common metabolic disease, sickle cell anemia, struggled for the recognition of an even more common metabolic disease, which was termed by OMIM our "public inborn error of metabolism." The response of the medical profession, by Pauling's account, was "astonishing." From being perhaps the major figure in modern chemistry, Pauling suddenly became, in the eyes of some, little more than a well-meaning but misguided eccentric or even a quack. Meanwhile, masses began to follow Pauling's advice in what became one of the most important movements of citizen science; when asked how to assess the value of the safety warnings and the skeptical responses issued by medical authorities, he responded: "I would trust the biochemistry of a goat over the advice of a doctor."

Galileo, a "dangerous enemy" of the elites, committed the crime of writing for the masses.

Goodwin and Tangum draw an interesting analogy with another case in the history of science. Based on the analysis by Giorgio de Santillana of Galileo's impact in XVIIth century Italy, Goodwin and Tangum proposed to their fellow doctors, in American Medical Association's Archives of Internal Medicine, that Pauling's crime, like Galileo's, was not so much that he proposed a new paradigm, but that he proposed it directly to the people. Pauling, by speaking to the population, just like he did when he fought to stop nuclear bomb trials (his success led him to receive his second Nobel Prize), committed the same crime as Galileo, who had chosen to write in the language of the masses (Italian), and who had to face the ire of the "scholarly elite, whom he had bypassed, usurped, and rendered irrelevant". They comment:

Of course, (speaking directly to the public) was precisely the course followed by many of the proponents of the benefits of micronutrients, the most famous of whom was Linus Pauling, the chemist who intruded into clinical matters. It is instructive to reread the review articles and editorials published in the 1970s ridiculing and condemning the ideas of Pauling. He was treated as a dangerous enemy, although a few years before his death, like Galileo, he was rehabilitated to the status of a genius with controversial ideas.

In effect, Pauling initiated one of the most significant critiques of the medical institution, perhaps even greater than Ivan Illich's critique.

By his own admission, Pauling's impetus was to communicate, as an educated citizen, the knowledge amassed by Irwin Stone, Abram Hoffer, Frederick Klenner and others before him. Pauling's "telescope" was his ability to read the literature that had been ignored by what could be called the pathocentric paradigm.

In the preface of The Healing Factor, Vitamin C Against Disease, Stone's main opus, Pauling summarized:

As man has spread over the earth and increased in number, the supplies of ascorbic acid have decreased. It is possible that most people in the world receive only one or two percent of the amounts of ascorbic acid that would keep them in the best of health. The resulting hypoascorbemia may be responsible for many of the illnesses that plague mankind.

to what Albert Szent-Gyorgyi, the discoverer of vitamin C, added:

The medical profession itself took a very narrow and wrong view. Lack of ascorbic acid caused scurvy, so if there was no scurvy there was no lack of ascorbic acid. Nothing could be clearer than this. The only trouble was that scurvy is not a first symptom of lack but a final collapse, a premortal syndrome, and there is a very wide gap between scurvy and full health. But nobody knows what full health is! This could be found out by wide statistical studies, but there is no organization which could and would arrange such studies.

While the debate about the most "luminously controversial of all biological, alternative cancer therapies" is slowly resolving, and as Pauling is regaining his reputation, the philosophical questions raised by the Nobel laureates, that every Human may ask, remain largely unaddressed: where is man coming from? what is health?

Replication of positive results (presently under revision)

Shortly after the discovery of vitamin C, Jungeblut provided evidence suggesting that it had a broad spectrum antiviral activity, notably against the poliomyelitis virus. Sabin, who later developed the famous oral vaccine against polio, attempted to replicate the studies but failed to replicate them, despite of the instructions provided by Jungeblut. It was interpreted as a therapeutic failure of vitamin C. Nonetheless, more than seventy years later, Jungeblut is remembered by specialists as an authoritative source on the antiviral activity of vitamin C, while Sabin is not.(ref: harakeh & jariwalla; fix this reference) In progress However, these specialists ...

Evidence-based medicine and the randomized controlled trial (RCT) are intended to free clinical practice from the empire of opinion. Moertel, who conducted the two RCTs designed to assess Pauling and Cameron's claims about vitamin C, anticancer effects, described himself as a researcher combatting/... "uncontrolled quackery", According to Pauling, who, like Jungeblut, tried to help his colleague, Moertel was unwilling to replicate the study. To be revised: "crude EBM practitioners (going) about using their favorite RCTs as clubs with which to beat up their supposedly less-informed colleagues." Still today, randomized controlled trials of controversial methodology abound, and allow "crude EBM practicioners" chasing quackery and self-medication to "avoid blame by wrapping themselves in the EBM mantle." Scientific criticisms based on strong pharmacokinetic evidence are responded to with non-scientific non-arguments ("(we are not) persuaded by the arguments of (...) critics that frequent large doses would necessarily result in substantially greater benefits"): in a paradoxical turn of events, the very behaviour that EBM was intended to minimize, guess work, is magnified and swiftly transmitted to the mass media as uncorruptible truth emanating from the golden standard of biomedical sciences.

The mass media, in turn, shape the opinion of the only stakeholders in vitamin C research, the citizens, who gradually cease to reclaim more research and abdicate to private interests the duty to determine what is best for them. And, since "the large quantities of trial data required to meet the standards of evidence based medicine are available for relatively few interventions" this restrictive or "crude" version of evidence-based medicine" does "introduce a systematic bias, resulting in allocation of resources to those treatments for which there is rigorous evidence of effectiveness, or towards those for which there are funds available to show effectiveness (such as new pharmaceutical agents)." and "impinges on the ethical principle of justice."

Citizens, philosophers of sciences and ethicists have been called to duty in the struggle for accountability in biomedical sciences. The contestation of EBM, which is reaching unprecedented intensity, is increasingly involving citizens and expert patients, as well as doctors who decide to publicly express their fear that "the next generation of doctors (is) being conditioned to function like a well-programmed computer that operates within a strict binary framework".

Future research

As noted above (see Therapeutic uses, Cancer), the study of vitamin C pharmacokinetics not only triggered changes in the recommended dietary allowance of this vitamin, but it also raised interest in the cancer-killing properties of the molecule when it is administered intravenously. Once again, however, a closer look at the past will allow to open "new" (forgotten) therapeutic perspectives. Levine declared, "Nobody ever realized the difference between intravenous and oral. It's a huge difference. It's a medical-student, pharmacology 101 kind of error" and underlined that it was justified to reopen the case about vitamin C in cancer because we are now aware of this "pharmacology 101 kind of error" that Pauling and Moertel altogether had committed.

However, a co-author of the same pharmacokinetic study disagrees: although Levine does not question the quality of the Mayo clinic study (and questions the value of Pauling and Cameron's study), Hugh Riordan declares the opposite: "The Mayo Clinic studies were done with the accepted experimental design used to clarify initial observations but did not truly replicate the Cameron and Pauling studies (used a lesser dosage,less time). This issue has been reviewed elsewhere (note: in Richardson, 1987 )." In other words, Riordan co-signed a government-funded research where it is said that Pauling and Moertel were both wrong and that oral vitamin C is uneffective, but declares in another journal, with different co-authors and independently (practically at the same time), that oral administration is not wrong per se, but that Mayo clinic's studies were, and refers to the famous sociological inquiry by Richardson published 15 years before to justify his claim. Manifestly, self-medication with (oral) vitamin C remains a politically sensitive issue.

Opportunity for major population-wide rises in vitamin C intakes

(CC) Photo: Rodrigo Junqueira
These acerola cherries contain more than 20 times more vitamin C than oranges by weight, and allow to reproduce the daily intake of other Higher Primates. According to current governemental recommendations, these doses (which are generally consumed in pill form) are "megadoses" and are either useless or dangerous.

In less favoured countries, the fear that the population could follow Pauling and colleagues and self-medicate with vitamin C is inexistant. While the myth that gram amounts of vitamin C are "megadoses" can be perpetuated in Northern countries where vitamin-C rich fruits are less common (worthy of note, rose hips, contain 20 times more vitamin C than commonly available fruits), in Southern Countries, fruits that provide such primate doses of vitamin C can be easily accessed. For instance, in Brazil, the nutritional data of a popular and affordable acerola juice indicates a content of vitamin C equivalent to 15720 % of the RDA per bottle (3144 % of the RDA per 100 ml). It is thus entirely possible that populations could raise their vitamin C intake by almost two orders of magnitude, without having to wait for any special permission or further costly studies.

Independent meta-analyses

The majority or trials with vitamin C use doses that are inferior to primate doses (less than a few grams, often a gram or less) and do not follow the proper dosing schedule (one or two admnistrations a day). Nonetheless, those are called trials of "high doses" because, from an anthropocentric and medicocentric point of view, these are doses that can only be afforded by the self-medicating populace -- galvanized by Pauling and his followers. Independent researchers will interpret the data for what they are worth, and take trials by Cathcart, Klenner, and others as the best currently available evidence. The fact that these authors were not made popular by the medico-academic industrial complex, is an interesting sociopolitical consideration, but it is not relevant in the assessment of vitamin C's therapeutic value. The advent of open access journals and, of course, authoritative online resources such as the Citizendium, allow researchers to bypass the taboos imposed by publishing conglomerates where conflict of interests, by their own admission, is the rule rather than the exception. It is interesting to note that the critique of the most recent meta-analyses on vitamin C in the common cold has entered the scientific discourse by the door of a PLoS (Public Library of Sciences) journal. Steve Hickey later blowed the whistle about the fact that the Journal of Orthomolecular Medicine, where Pauling and others published, is still rejected from the National Library of Medicine database, PubMed, with no valid explanations given by the referees of the database (ref,ref).

Neglected diseases and publications

The clinical and investigative works of Cathcart, Klenner, Jungeblut were made in a context of scarcity of resources that is not unlike the context in which the majority of clinicians throughout the world perform their work. The open access movement in sciences is viewed as an opportunity for clinicians and researchers to enter the scientific discourse by bypassing the systematic bias favouring the research agendas of developed countries(ref). A major part of the world's burden of disease and of world's mortality is represented by infant deaths. Multitudes of clinicians and researchers from the Third World and other poorer countries will be interested to know how Frederick Klenner was able to achieve an exceptional record in this respect (ref + cf obstetrics and gynaecology), in a context quite similar to present-day Africa and Asia -- in the post-segregationist United States.

Working on these parts of the Vit C article

The initial version of the vit C page sections being worked on can be found here.

All contributors can join the editing process, until this text looks less like my own editorializing and more like a fair report of the current critique! One may either edit directly, or raise problems here, in the talk page, preferably as a subsection. For example:

Eliminating "amateurism" and the like

"Consecration of amateurism is vitamin C research" becomes "Ethical problems in the appraisal of vitamin C in health and disease". Some may argue it is not exactly neutral yet... I'll look if there is some better way summarizing this (heavy) section. Pierre-Alain Gouanvic 13:39, 9 January 2008 (CST)

Party! You're invited!

Hi Pierre-Alain — Your neighbourhood Mistress of Ceremonies here. Don’t forget to come on over to the party and sign in at one of the categories! Aleta Curry 16:39, 9 January 2008 (CST) say ‘hi’ to me here.

CZ Live

Hi Pierre-Alain: I just noticed in your recent vitamin C edit summary that you were trying to add a CZ Live tag. To my knowledge, this is supposed to happen automatically once the metadata page is completed, so you may want to check with one of the admins if this isn't working properly. Aleta Curry 17:34, 12 January 2008 (CST)

Please see...

Pierre, please see Talk:Financing_human_rights_and_full_employment. If you like, I can help suggest some ways you can transform this along the lines spoken about there. Let me know. Otherwise, it is going to need to be deleted soon, as discussed there. Stephen Ewen 03:53, 13 January 2008 (CST)

Personality disorder cycle

The personality disorder cycle is now complete. Articles for all currently identified primary personality disorders have been added, along with internal references to the Personality disorder, the Cluster desriptions, and a template detailing both the clusters, and their associated disorders. Feel free to jump in! --Michael J. Formica 08:15, 17 January 2008 (CST)

reply

please see note on my talk page. Tom Kelly 14:19, 28 January 2008 (CST)

Thanks

... for your kind words about the latest addition to the DPD article. (I posted to the forum on this topic if you want to join in on the discussion.) It's nice to know my work is appreciated. :) And I need to return the thanks for collaborating and finding the article on cultural influences, as well as bringing up the philosophical connections. I look forward to continuing to work with you. --Richard Pettitt 13:22, 30 January 2008 (CST)

Mea culpa!

Pierre-Alain! I just thought you'd remember it was party day, but I don't see you in the crowd! Aleta Curry 22:06, 6 February 2008 (CST)

Internationalisation

Hi! I’m just letting people who have expressed an interest in CZ International know that there is now a proposal on the table.

Please discuss its feasibility at: CZ:Proposals/Internationalisation sandbox in the Discussion area.

Feel free to help develop the proposal, as well.

We'll also need "drivers".

If you've got no idea what I'm talking about, please refer to: CZ:Proposals/New and CZ:Proposals

Aleta Curry 17:43, 14 February 2008 (CST)

Hi again, Pierre-Alain. Thank you very much for participating! Aleta Curry 17:13, 15 February 2008 (CST)