Welcome to a Hump Day (“Agew na Hump” in Pangasinan): it’s Wednesday, March 19, 2025, and National Chocolate Caramel Day. This is the most famous genus, with the species shown below, the Milky Way “Simply Caramel” bar having gone extinct in 2023:
It’s also National Poultry Day (pity the virus-afflicted chickens) and Certified Nurses Day.
Readers are welcome to mark notable events, births, or deaths on this day by consulting the March 19 Wikipedia page.
Posting will be light today as I have to go downtown to the Apple Store to get my iPhone battery replaced. Plus my insomnia is back big time (I woke up at 12:45 after 3.5 hours of sleep), and I am barely sentient. Bear with me; I do my best.
There’s a Google Doodle today; if you click on what’s below, you can play a Moon Game:
Da Nooz:
BREAKING NEWS: I watched the ducks at Botany Pond yesterday, and observed Esther and Mordecai doing their head-bobbing courtship behavior. Then then swam underwater together and surfaced side by side at the same time. After they did this three times, THEY MATED! (Ducks will copulate multiple times before the female nests.) But THERE WILL BE DUCKLINGS!
*The war between Hamas and Israel has started again. The cease-fire talks failed and phase 2 of the cease-fire never took off. Israel asked for 11 living hostages and some dead hostages to be released in return for release of Palestinian prisoners. No go. The U.S. tried to compromise, asking for 5 living hostages and 10 dead hostages to be returned. No go. Hamas’s “counteroffer” was to release a single living American hostage and 4 dead American hostages. The U.S. and Israel could not come to an agreement with Hamas, and so the fighting resumed:
Israel launched a series of attacks against Hamas targets across the Gaza Strip early Tuesday, killing more than 400 people, according to Palestinian authorities, and threatening a return to full-scale war after talks to release the remaining hostages held in the enclave stalled out.
Israeli Prime Minister Benjamin Netanyahu ordered the attacks after Hamas failed to release the hostages or accept U.S. proposals for extending a fragile cease-fire that had held for two months, his office said.
Gaza health authorities said 404 people were killed in the attacks, without specifying how many were combatants, making it one of the largest single-day death tolls since the war began in October 2023.
The strikes were aimed at what Israel said were dozens of targets among Hamas’s leadership, midrank military commanders and infrastructure. Israel said the effort would continue and would expand beyond airstrikes.
“From now on, Israel will act against Hamas with increasing military force,” the prime minister’s office said.
Hours later, the Israeli military issued evacuation orders covering a number of population centers in the enclave, particularly the northern city of Beit Hanoun and several neighborhoods of Khan Younis in the south.
An Israeli official said that President Trump gave Israel the green light to restart attacks on Hamas after the U.S.-designated terrorist group failed to give up hostages. Israel then gave the U.S. a heads-up before starting the operation, the official said.
White House press secretary Karoline Leavitt confirmed on Fox News that Israel had given advance notice of the attacks. She warned Hamas and other regional enemies of Israel and the U.S. “will see a price to pay.”
“All hell will break loose,” she said, repeating a threat often made by Trump.
Trump has pressed for the release of all remaining hostages and has repeatedly said Hamas would face a return to war if it doesn’t comply. The hostages include one remaining living U.S. citizen, dual national Edan Alexander, who was serving in the Israeli military when he was kidnapped by Hamas. Of the 59 hostages who remain in Gaza, Israel believes as many as 24 are still alive.
I suspect Hamas was stalling for time, offering a tiny number of hostages to keep the cease-fire going until it build up its strength. Neither the U.S. nor Israel is keen on buying into that. This war will not be over until Hamas is no longer in power, but the chance that they will give up power and release all the hostages is exactly zero, for that would be a loss for them. It’s a tough situation, but Israel will not, I think, accept any solution that leaves Hamas in power, and Hamas will not accept any situation that leaves it without any hostages.
*Dare one hope that Trump’s appeals to the Supreme Court, which are inevitable, might not always meet a kind reception? Well, at least John Roberts, who has proven himself less of a; hidebound conservative and more of a defender of the law than I expected, has rejected one of Trump’s claims—albeit not a formal legal appeal:
Roberts spoke hours after Trump said on social media that U.S. District Judge James E. Boasberg should be impeached for blocking the administration’s efforts to deport Venezuelan migrants without due process. It was the latest escalation by the new administration, which for weeks has been trying to cast doubt on the authority of courts to constrain the president.
Trump criticized Boasberg, the chief judge of the U.S. District Court for the District of Columbia, as a “Radical Left Lunatic of a Judge” and wrote: “This judge, like many of the Crooked Judges’ I am forced to appear before, should be IMPEACHED!!!”
Roberts is a fierce defender of the judiciary he oversees and has often expressed concern about criticism of its impartiality. In late December, Roberts emphasized in an annual report on the courts that personal attacks against judges had gone too far.
“Violence, intimidation, and defiance directed at judges because of their work undermine our Republic, and are wholly unacceptable,” the report said.
Oy! The man is seriously unhinged. But half of America loved him, though maybe they don’t now. A bit more.
Boasberg had blocked the Trump administration from using the Alien Enemies Act to speedily deport gang members. At the Monday hearing, the judge ordered the government to submit sworn declarations by noon Tuesday that explained how the incident unfolded.
Trump has a long history of criticizing judges, including in his own criminal trials. He unsuccessfully tried to remove the judge in his New York state trial, where he was convicted on charges of falsifying business records connected to a hush money payment to a porn star.
At the time, some Trump critics suggested that attacking the courts so directly would cost him swing votes. But Trump and his campaign hammered a message that he was being unfairly targeted by the justice system — a strategy the White House argues was, and is, a winning one.
I’m not so sure. None of the big-time cases against Trump’s EOs have yet made it to the Supreme Court, and if he can’t even push through his agenda executed through EOs, in a time when the entire Congress and Supreme Court are ideologically aligned with Trump, maybe the public won’t love him so much.
*More health foolishness from the Trump administration. KFF News (Kaiser Family Foundation, a nonprofit, independent health-related news organization) has a chilling announcement that may be a harbinger of an end to research on mRNA vaccines, a clever and, in the case of covid, very efficacious type of immunization.
National Institutes of Health officials have urged scientists to remove all references to mRNA vaccine technology from their grant applications, two researchers said, in a move that signaled the agency might abandon a promising field of medical research.
The mRNA technology is under study at the NIH for prevention and treatment of infectious diseases, including flu and AIDS, and also cancer. It was deployed in the development of covid-19 vaccines credited with saving 3 million lives in the U.S. alone — an accomplishment President Donald Trump bragged about in his first term.
A scientist at a biomedical research center in Philadelphia wrote to a colleague, in an email reviewed by KFF Health News, that a project officer at NIH had “flagged our pending grant as having an mRNA vaccine component.”
“It’s still unclear whether mRNA vaccine grants will be canceled,” the scientist added.
NIH officials also told a senior NIH-funded vaccine scientist in New York state, who does not conduct mRNA vaccine research but described its efficacy in previous grant applications, that all references to mRNA vaccines should be scrubbed from future applications.
Scientists relayed their experiences on the condition of anonymity for fear of professional retaliation by the Trump administration.
A senior official at the National Cancer Institute confirmed that NIH acting Director Matthew Memoli sent an email across the NIH instructing that any grants, contracts, or collaborations involving mRNA vaccines be reported up the chain to Health and Human Services Secretary Robert F. Kennedy Jr.’s office and the White House.
Memoli sent a similar message ahead of the agency canceling other research, such as studies of vaccine hesitancy.
Memoli’s email on that topic bluntly stated that NIH was not interested in learning why people shun vaccines or in exploring ways to “improve vaccine interest and commitment.”
I’ve already written about the scrubbing of studies on vaccine hesitancy and interest, but this is much worse. mRNA vaccines hold huge promise, and if RFK Jr. and his gang of antivax goons are going to come down on that kind of research, it’s an arrant and misguided effort that will stall progress in healthcare.
*The NYT reports new evidence, from a paper in PNAS, that iguanas made it on their own (surely on mats of vegetation) from the Americas to Fiji!
For decades, the native iguanas of Fiji and Tonga have presented an evolutionary mystery. Every other living iguana species dwells in the Americas, from the Southwestern United States to the Caribbean and parts of South America. So how could a handful of reptilian transplants have ended up on two islands in the South Pacific, over 4,970 miles away?
“The question has definitely captured the imagination of scientists and the public alike,” said Simon G. Scarpetta, an evolutionary biologist at the University of San Francisco.
In research published Monday in the Proceedings of the National Academy of Sciences, Dr. Scarpetta and his colleagues make the case that the ancestors of Fiji’s iguanas crossed on mats of floating vegetation. Such a voyage across nearly 5,000 miles of open ocean would be the longest known by a nonhuman vertebrate.
Rafting — the term scientists use for hitching a ride across oceans on uprooted trees or tangles of plants — has long been recognized as a way for small creatures on land to reach islands, said Hamish G. Spencer, an evolutionary geneticist at the University of Otago in New Zealand who was not involved in the study. Usually those are invertebrates, whose small size means they can survive a long way in an uprooted tree trunk. While examples from nonflying vertebrates are relatively rare, he added, lizards and snakes seem to be able to raft farther than mammals, perhaps because their slower metabolism allows them to fast for a long time.
Iguana species have proved adept at making shorter crossings. In 1995, Dr. Scarpetta said, scientists observed at least 15 green iguanas rafting nearly 200 miles on hurricane debris from one Caribbean island to another. And researchers have long agreed that the ancestors of the iguanas of the Galápagos Islands made the nearly 600-mile trip from South America on bobbing vegetation.
A crossing to Fiji, however, represents an almost unimaginable challenge. While some researchers suggested that the Fiji iguana’s ancestors had rafted there as well, Dr. Spencer said, others pointed to the vast distances as a reason for skepticism. They countered that the iguanas were the remnant of an extinct group, one that had possibly crossed over land from the Americas to Asia or Australia, and then made the relatively easier crossing to Fiji and Tonga.
This is the longest known dispersal event in terrestrial vertebrates. The paper says this:
We estimated the phylogenetic relationships and evolutionary timescale of the iguanid lizard radiation using genome-wide exons and ultraconserved elements (UCEs). Those data indicate that the closest living relative of extant Fijian iguanas is the North American desert iguana and that the two taxa likely diverged during the late Paleogene near or after the onset of volcanism that produced the Fijian archipelago.
This apparently happened 30-34 million years ago, and desert iguanas are probably the best lizards to make such a strenuous crossing, since they hibernate for a long time and thus would be more resistant to famine or desiccation. This shows the importance of phylogeny (evolutionary relatedness) in understanding weird patterns of distribution.
*The days of DEI aren’t even close to being over yet. Look what happened at Amherst College. First. Jeb Allen, a student from the Class of 2027, wrote a measured and respectful piece in the student newspaper called “Academia needs unco0mfortable, unpopular, but necessary debates on DEI.” Then the hammer came down on him, at least reported by the conservative sites The College Fix and Turning Point USA.
First, a big of Allen’s piece:
Lastly, while DEI initiatives may seem fair, to what extent do we make sure racial and gender imbalances are equalized to account for historical biases? Should we also be mandating 50% female diversity quotas in physically demanding fields such as construction and oil rig workers, loggers, coal miners, truck drivers, garbage collectors, and welders, where men make up the overwhelming majority of the workforce — a factor contributing to men accounting for 92% of workplace fatalities in 2023 and having a life expectancy nearly 5.8 years shorter than women in the U.S.? On the other hand, should we push for more men in female-dominated professions such as healthcare, psychology, education, and childcare, or is it only a one-way street? If your honest answer is that DEI policies should be a one-way street, is their true purpose to balance out the historical biases that have discriminated against employment? Or is it something else?
In a time characterized by heightened polarization and gridlock, academia should serve its intended purpose and pave the way for sincere dialogue on what is the most fair and effective way to right the historical wrongs committed against minorities in America, not shun those raising the unpopular, legitimate critiques that current DEI efforts may be inadvertently exacerbating our social divide. I don’t doubt for a second that such policies pushed by the Democratic Party have good intentions and are aimed to right our country’s wrongs, nor am I advocating to abolish any and all efforts to diversify our workforce where minority representation is sparse. But I maintain that uncomfortable dialogue recognizing biological realities between sexes, maintaining meritocracy, and rejecting performative gestures is necessary on college campuses across America to determine how we move forward with this essential task, and Amherst College should be the first.
It’s much longer than this, but this gives you a flavor of the call for free-discussion that imbues Allen’s piece. But the progressive left doesn’t want free discussion; they already know what they want and won’t be diverted. At any rate, you can’t get away with saying stuff at Amherst, like “academia should serve its intended purpose and pave the way for sincere dialogue.” Heresy! And the response, as the Fix notes, was harsh:
An Amherst College student who last month wrote an op-ed for his student paper criticizing DEI — diversity, equity, and inclusion — initiatives dealt with harassment, a death threat, and incurred the wrath of the school’s Title IX office.
. . . . In The New Guard, Allen relates how he “received hundreds of anonymous ad-hominem attacks” on the app Fizz following publication of his piece, which included the death threat: “dragging jeb allen on fizz isn’t enough I need a– [gunshot].”
Other comments included “Any white male who is not gay or trans is poison,” and “meritocracy is white supremacy.”
Even Amherst itself came down on Allen:
Allen also was slapped with a “No-Communications & Restricted Proximity Order” by the Amherst Title IX office due to a complaint by an aggrieved female student with whom Allen had never spoken.
According to Allen, this same student previously had argued the Amherst football team merely looking at her public Instagram post constituted “harassment” and was “indicative of ‘white fragility.’”
The Title IX office at one point told Allen he “potentially violated” the order by “non-verbally making [him]self present” at the same dining hall as the student who filed the complaint.
Oy! He has to scan the dining hall for a particular person, and if she’s in there he can’t eat. I’m glad I’m no longer immersed in such mishigas.
Meanwhile in Dobrzyn, Hili’s stolen Andrzej’s bookmark:
Andrzej: Give me back my bookmark.Hili: Get another one, this one will be mine.
Ja: Oddaj moją zakładkę.Hili: Weź sobie inną, ta będzie moja.
And a photo of the loving Szaron:
*******************
From Divy; with soap!
From My Cat is an Asshole. OY!!! But they stood there and just took a photo. . .
From Things With Faces: a d*g wall:
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Masih has a constant police escort (there have been three plans to assassinate her), but she still shows her house! I worry that the same fate that befell Salman Rushdie (thankfully not a fatal attack) will also befall her.
If I saw that much police presence in front of my house in Iran, it would definitely mean they came to arrest me, for simply showing my hair, singing, or exercising my right to speak freely.
I recorded this video just months after a man was arrested outside my Brooklyn home with… pic.twitter.com/HOPeN2osS2— Masih Alinejad 🏳️ (@AlinejadMasih) March 12, 2025
From Bryan; a math lesson using cats:
INFINITE rational numbers
Even between two any possible Irrational numbers, there are always INFINITE Rational numbers in between
The explanation to this FACT is pathetic
— Camarada Beijing🏘️📜 (@Fistroman1) March 18, 2025
From Luana, a study still cited as evidence for white racism. But it is not evidence for that; it is an artifact of which babies go to which doctors:
A famous study found that Black babies have higher survival rates if attended by Black doctors than White doctors. But a re-analysis of the data shows the effect disappears after accounting for the fact that low birth weight babies more often see White doctors.
[Link below.] pic.twitter.com/60JKFGg29C
— Steve Stewart-Williams (@SteveStuWill) March 16, 2025
From Malcolm; a bad-tempered kitten. Sound up.
attack : 10%
damage : 0%
cuteness : 1000000000% pic.twitter.com/w0P07FC3ni— Posts Of Cats (@PostsOfCats) March 12, 2025
From my feed. The kid can dance, but the cat don’t care:
This is perhaps the best thing produced by the internet in recent history. pic.twitter.com/YxYPQYQZif
— non aesthetic things (@PicturesFoIder) March 17, 2025
From the Auschwitz Memorial, one that I reposted:
This dapper little French boy was gassed to death upon arriving at Auschwitz. Then his body was burned. He was five.
— Jerry Coyne (@evolutionistrue.bsky.social) 2025-03-19T10:12:02.683Z
Two posts from Dr. Cobb. You have to love barnacles; Darwin did!
Watching barnacles sweep the ocean for food is so mesmerizing. They look like eyelashes opening and closing. I could watch this for hours. #barnacles #intertidal #marinelife 🦑
— Karyn Murphy 𓇼𓇼 🐙 (@staycurious.bsky.social) 2025-03-17T17:47:26.458Z
A ten-post thread on the inventor of the saxophone:
By 18, this man had survived falling down a 3 floor staircase, swallowing needles and acid he'd mistaken for milk, suffocating varnish fumes, serious burns, and a large brick being dropped on his head. Neighbours called him 'the ghost child'.This is the story of Adolphe Sax and his Saxophone /1 🧵
So glad for Esther and Mordecai, this will be wonderful!
It would indeed be ironic if, in the name of national defense, we would sanction the subversion of one of those liberties which make the defense of our nation worthwhile. -Earl Warren, jurist (19 Mar 1891-1974)
I predict that Amherst will have to pay.
I’ve been telling anyone who might listen that the GOP needs to shut up about judges and appeal, appeal, appeal. It’s not at all clear that that law is on these judges side. For instance the judge that ordered Trump not to deport the criminals last weekend did not allow the DOJ to even respond before making his ruling.
They can’t shut up about judges because they want the government entirely rigged for their side. Isn’t that obvious?
Just read “da nooz”. Now I can’t sleep. On sticking administration fingers into the mRNA research, I call folks attention to recent conversations on This Week in Virology (TWiV) and the newer videos of TWiV Beyond the Noise between Vincent, Dr. Dan, and Paul Offit which have migrated from “when you mix politics and science you always get politics” to “when you mix politics and science you get death”.
I just recalled that many years ago when visiting Jerry at Harvard, I saw a book, “Lysenko” on his bookshelf and asked him about who that was. I think this to be relevant here.
Jim, I think this (and the Lysenko ref below) is exactly what people are concerned about – Bill Gates, Klaus Schwab – unelected know-it-alls in love with their great ideas, somewhere in the chain of events that potentially leads to taking whatever medicine the government tells its citizens to take. Some of the ideas they put across freak people out.
Critics have usurped a political slogan : my body, my choice. I think they have a point – and I don’t need a tinfoil hat for that (yet).
Or to borrow an idiom, we need a semipermeable membrane between the State and … medical procedures, I guess.
The horse is out of the barn since the Supreme Court invented a rationale that essentially gives Trump carte blanche to do as he pleases. Roberts will find the leopard eating his face.
FWIW
BioNTech and Moderna value – with an absolute academic superstar SAB from inception in late 2018 – and a massive boost in 2019-2022 – have been missing, and their value has been on a downward slope since 2022. This says something about valuable products from RNA biochemical engineering – perhaps that it is hard, and needs more work – academic research work.
I’m just adding that in the discussion – I have no firm conclusion from that other than for all the years of R&D and demanding stockholders, .. and this is a serious question : where are the human cancer vaccines? They might have something, I just haven’t looked lately.
Here you go:
https://www.spiegel.de/wirtschaft/biontech-teure-entwicklung-von-krebsmedikamenten-fuehrt-zu-stellenabbau-a-23a1a698-7b5c-465d-bd3f-01032ea3288d
Super, thanks.
Just the local loudmouth here, not a clinician or scientist: but I’ve noticed some writings about an mRNA pancreatic cancer vaccine.
From what I’ve read about the technology it is extremely impressive.
D.A.
NYC
How delightful that Botany Pond is finally restored and you will have ducklings once again!
The fact that Esther and Mordecai are mating put me in mind of this Ze Frank video, which I watched recently, because it’s all about the sex lives of ducks. Most readers are probably well aware that ducks have interesting sexual anatomy. To say the least. But for the uninitiated, beware.
I had no idea. Thanks for the warning.
Oh, my, that was informative.
It falls off? Do people find them, like shark’s teeth?
German perspective: John Roberts is what I would call a “classic” conservative.
Not a Trump fanboy like Thomas or Alito or a neoconservative handpicked by Trump like Gorsuch, Kavanaugh or Barrett. But I also admit that the latter three judges have not always ruled to the complete satisfaction of Trump and his entourage in the past.
mRNA virus technology being flagged? That’s crazy!
I was glad to see Justice Roberts make that statement yesterday. It was measured but clear.
Very cool that we have some science today, in the form of the iguanas that made their way to Fiji. In the olden days—before plate tectonics (and well before my time)—paleontologists invoked land bridges, “isthmian links,” rafting (as per the iguanas), and other mechanisms to get animals and plants from place to place across great distances. How did mammals get to Australia, for instance? Of course, it wasn’t the animals that moved; it was the continents!
And, of course, the Wallace Line was a lot thinner back then.
It is my understanding and correct me if wrong, the Wallace line is and we’re talking mammals here, is the reason tigers never got to Australia and marsupials remained there. It is deep (avg 250m) and has a fast moving current. It IS a fault line but has not widened further over time…yet.
I reckon that your view of the real Wallace Line is correct. My comment was not intend as a learned comment, but just an oblique reference to the ridiculousness of land bridges.
Though it is possible that tigers got to Australia, didn’t like the joint, and jumped onto the first raft heading back north.
Speaking as one who was born by mistake in a human body but identifies as Iguana iguana, let me affirm our legendary voyage of discovery from the American continent to Fiji. Our traditions include other voyages to Florida, to New York City, and to Antarctica. We expect the inclusion of Iguanidae ways of knowing in all of Progressive education, and look forward to full legal recognition that a trans-Iguana is an Iguana.
Dory Previn wrote a song for you – Mythical Kings And Iguanas
https://youtu.be/YdtrTqZTt2A
And then there is those ghastly lyrics of “Mexican Radio”, worse than a microaggression:
I wish I was in Tijuana
Eating barbecued iguana
I took requests on the telephone
I’m on a wavelength far from home
It’s worth remembering that BioNTech, one of the pioneers of mRNA vaccine research and development, is based in Mainz, Germany and was founded by two Turkish scientists. Whilst it would indeed be a tragedy if mRNA vaccine research stopped in the U.S. during Tr*mp’s reign, it would continue elsewhere in the world.
Obviously, the brilliant scientist heading HHS has a better idea than vaccines (whether mRNA or others): natural immunity.
After claiming that the MMR vax kills as many people as measles (who needs denominators, anyway?), he wants to let H5N1 bird flu go unchecked…
https://www.nytimes.com/2025/03/18/health/kennedy-bird-flu.html
That worked so well for smallpox, right?
Quote:
Every infection is another opportunity for the virus, called H5N1, to evolve into a more virulent form. Geneticists have been tracking its mutations closely; so far, the virus has not developed the ability to spread among people.
But if H5N1 were to be allowed to run through a flock of five million birds, “that’s literally five million chances for that virus to replicate or to mutate,” Dr. Hansen said.
Large numbers of infected birds are likely to transmit massive amounts of the virus, putting farm workers and other animals at great risk.
“So now you’re setting yourself up for bad things to happen,” Dr. Hansen said. “It’s a recipe for disaster.”
Mr. Kennedy does not have jurisdiction over farms. But Brooke Rollins, the agriculture secretary, also has voiced support for the notion.
Thanks to Jerry and Luana for highlighting the “white racism” study.
Physician–patient racial concordance and disparities in birthing mortality for newborns
Brad N. Greenwood, Rachel R. Hardeman, Laura Huang, and Aaron Sojourner https://www.pnas.org/doi/10.1073/pnas.1913405117
As the tweet shows, low-birthweight babies, who are disproportionately (2.5X) born to black mothers, were somehow diverted away from black doctors. (Low birthweight includes prematurity and intra-uterine growth retardation — “small for dates” — both of which are attended by higher neonatal mortality.)
How could this diversion, invisible in the original study, have arisen? Greenwood et al. used an administrative database of de-identified hospital discharge abstracts in Florida. It wasn’t a randomized prospective trial and no individual patient charts were reviewed. They took pains to describe the process used at maternity hospitals that haphazardly (pseudo-randomly) assigned newborn babies to whichever pediatrician was on call that day, for women who did not already have their own pediatrician (or someone in his group practice) lined up to attend. (The method of ascertaining the race of the doctor was a bit dodgy. The Florida licensing regulator doesn’t record the race of doctors on its register, so the authors looked up each doctor’s photograph on various social media platforms to see if s/he “looked” black.)
If you have a full-term baby, it probably doesn’t matter if you are wealthy enough to have your own private or insurance-paid pediatrician. The perinatal mortality of full-term, normal-weight infants who have been screened during pregnancy against congenital anomalies is so low that it doesn’t matter much who does the well-baby assessment on your way out the door with your healthy newborn.
But low birthweight is different. The authors seemed to be unaware, or perhaps chose not to tell us, that both conditions — prematurity and IUGR — are easily diagnosed before birth, even if the mother has had no pre-natal care at all until she goes into labour. Mothers admitted in labour with a small or early fetus will be referred to a high-risk unit staffed by specialist obstetricians to do the delivery. Specialist pediatricians will hover in the delivery (or C-section) room to take the baby directly to a neonatal ICU, often resuscitating it en route. Because these specialty units are staffed not by the routine roster of primary care pediatricians, the women referred to them, and their infants, would have been cared for outside the pseudo-randomization protocol of the authors’ observational study. Had this been a randomized trial, we would call differential referral bias a randomization leak. This would be fatal to an RCT but in an observational study, the authors could have controlled for birth weight and possibly still have contributed to the knowledge on the topic. But it would have been less useful at the Supreme Court as an argument for retaining affirmative action in admitting black students preferentially to medical schools.
To the extent that these high-risk units are less likely to employ black pediatricians — “neonatologists” are registered as pediatricians in medical databases — black pediatricians will not have the opportunity to care for the infants in them. Since it is obvious from the tweet that this is indeed the case — only in normal birth weight did the proportion of black babies attended to by black pediatricians diverge from white babies — the white specialist doctors “wear” the mortality imposed by their sicker patient population.
The original authors tried to spin this as racism by postulating that white pediatricians haphazardly assigned to black babies were less attentive to early sepsis, say, than they were to white babies and delayed emergency care or referral to a specialist pediatrician where minutes count and seconds add up to minutes. But once you realize the impact of medically appropriate differential referral before birth in low birth weight, a more attractive hypothesis is that the general-practice doctors, white or black, never saw the preemies at all. Pure referral bias.
Sick babies (including the ones so callously ignored by white pediatricians until it was too late to save them) who were transferred out to a regional NICU were captured in the authors’ database but mothers transferred in labour were not, because the unit of analysis was the infant, who doesn’t exist until it is born. So an obstetrician who expeditiously transfers a black teenager in labour with prolonged rupture of the membranes with a small-for-dates fetus so she can deliver in a specialist centre gets no credit, while the poor white NICU pediatrician at the receiving end picks up the pieces.
A lot of us who looked at this study in 2020 figured it was fishy, that somehow the sicker black babies were being referred preferentially to white specialist doctors. But since the authors don’t share the birthweights in their database there is no way for us to adduce evidence that referral for low birthweight/prematurity was a confounding factor, until someone goes back into the original Florida database and controls for it. (Annoyingly, the authors mention birthweight once in the text of the Introduction as a mechanism for higher black infant mortality, yet never mention it again in their data and results!) You can’t meet all accusations of racism with bald denials and aspersions of bad faith without any evidence for an alternative hypothesis. Finally (in 2024) we have it.
Leslie, would it be reasonable to suppose that the study authors knew damn well that they should have controlled for birth weight, but chose not to?
Or even that, while analysing the data, they did try controlling for birth weight, and discovered that they then no longer got the “headline” they were looking for … and so decided not to report that in the study?
Or am I way too cynical?
I try not to speculate on motives.
I do want to mention another anomaly uncovered in the tweet by Steve Stewart-Williams, though. Note there is a gradient in Panel A. As birthweight rises above 1500 g, more and more black babies get black pediatricians. This suggests that there is some cheating of the hospital roster assignments as a form of mentoring: black doctors (perhaps less skilled and confident in their ability to look after even a moderately premature infant) are being excused by their white senior colleagues (at least temporarily) from taking the more challenging infants, regardless of the duty roster.
Instead of it being an experiment of nature where the roster doc is left to sink or swim and hope for the best, there is a degree of streaming going on. There is nothing wrong with this, of course, and everything right with it but it undermines the authors’ claim that the duty roster really was a “luck-of-the-draw” proposition. If an important prognostic factor influences the decision as to who is going to be most-responsible pediatrician even outside the special high-risk setting I mentioned in my first post, then obviously the results of the whole study can’t be trusted to be free of bias.
+1
Yes, Leslie. I recall there being a lot of furrowed brows about that study at the time. It didn’t seem to pass the smell test then.
Nearly all “of course (insert problem) is worse for mar-gin-al-iz-ed minorities” studies seem to be lacking in rigor or truth. The law enforcement ones are laughable. (see R. Frier, Lee Jussim et al)
But then truth isn’t the goal they’re working towards.
D.A.
NYC
(Just intended as an honest question without insinuation.)
Is Masih’s security detail private, or is it provided by the city/state? If the former, how does she manage to afford it?
The PNAS Fijian iguana study is paywalled and I haven’t gone through the contortions necessary to access it yet, but the authors don’t seem to have considered the possibility that their ancestors didn’t raft the whole distance from SW North America in one fell swoop. There may have been islands between Fiji and North America, now vanished beneath the waves, that the iguanas’ ancestors used as stepping-stones; the evidence would now be gone.
The NYT article is wrong about the Fijian iguana being the only Old World iguanoids; the Opluridae is restricted to Madagascar and the Comores, but they’re one of the families that used to be grouped together as the Iguanidae. Nobody knows how they got to where they are today.