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==Colicky babies and probiotics==
[http://en.wikipedia.org/wiki/Baby_colic Wikipedia says]
<blockquote>
Baby colic (also known as infantile colic) is defined as episodes of crying for more than three hours a day for more than three days a week for three weeks in an otherwise healthy child between the ages of two weeks and four months.
<center>[[File:320px-Crying_newborn.jpg‎]] </center>
</blockquote>


Colicky babies have been around ever since the human race emerged.  [http://en.wikipedia.org/wiki/Probiotic Probiotics], a linguistic hybrid, almost as long: 
==Forsooth==
<blockquote>
The term probiotic is currently used to name ingested microorganisms associated with beneficial effects to humans and animals. Introduction of the concept is generally attributed to Nobel Prize recipient Eli Metchnikoff, who in 1907 suggested that "the dependence of the intestinal microbes on the food makes it possible to adopt measures to modify the flora in our bodies and to replace the harmful microbes by useful microbes." </blockquote>


==Quotations==
“We know that people tend to overestimate the frequency of well-publicized, spectacular
events compared with more commonplace ones; this is a well-understood phenomenon in
the literature of risk assessment and leads to the truism that when statistics plays folklore,
folklore always wins in a rout.”
<div align=right>-- Donald Kennedy (former president of Stanford University), ''Academic Duty'', Harvard University Press, 1997, p.17</div>


But do the "live micro-organisms which, when administered in adequate amounts, confer a health benefit on the host"?  Many current-day consumers of various versions of fermented milk products certainly believe this to be true.  As has been pointed out many times, adults may succumb to the placebo effect; but babies do not lie so it is only “natural” to do a randomized control trial to see if probiatics can reduce suffering in colicky babies.  Naturally, newborn babies can’t ingest items such as yogurt or kafir. Therefore, the probiotic used for babies is lactobacillus reuteri dsm 17938 administered via a dropper:
----


[http://www.minnpost.com/second-opinion/2014/04/probiotics-fail-soothe-colicky-babies-randomized-study-finds Susan Perry] observes
"Using scientific language and measurement doesn’t prevent a researcher from conducting flawed experiments and drawing wrong conclusions — especially when they confirm preconceptions."
<blockquote>
Over the years, parents — and pediatricians — have tried all sorts of remedies to quiet colicky infants. Probiotics is among the latest of these. It’s based on the supposition that promoting microbial diversity in the gut will reduce the formation of gas and intestinal inflammation.
<br><br>
For the current study, a team of Australian researchers recruited 167 breastfed and formula-fed infants (all less than 3 months old) with colic. Each baby met the criteria of a commonly used diagnosis of infant colic: An infant who cries or fusses for three hours or more daily, three or more times a week, and for at least three weeks.
<br><br>
About half of the babies were randomized to receive daily supplemental drops of the probiotic L. reuteri for one month; the other half received a placebo. The study was “doubled-blinded” so that neither the parents nor the researchers knew which babies were in which group.
The parents were also instructed to keep a daily diary of their baby’s behavior, including such measurements as how long the baby fussed, cried and slept. Other outcomes were also followed and measured, including the mothers’ mental health and the families’ ability to function and have a “quality of life.” </blockquote>


From [http://www.bmj.com/content/348/bmj.g2107.pdf%2Bhtml the Australian study by Sung et al] we obtain the following graphs and associated conclusions:
<div align=right>-- Blaise Agüera y Arcas, Margaret Mitchell and Alexander Todoorov, quoted in: The racist history behind facial recognition, ''New York Times'', 10 July 2019</div>
<blockquote>
Conclusions: L reuteri DSM 17938 did not benefit a community sample
of breastfed infants and formula fed infants with colic. These findings
differ from previous smaller trials of selected populations and do not
support a general recommendation for the use of probiotics to treat colic
in infants.
</blockquote>


There is a [http://www.bmj.com/multimedia/video/2014/04/02/treating-infant-colic-probiotic-lactobacillus-reuteri-double-blind-place short video] of Sung explaining the study. Below is the so-called “Baby Day Diary” taken from the video illustrating how data is recorded.
==In progress==
[https://www.nytimes.com/2018/11/07/magazine/placebo-effect-medicine.html What if the Placebo Effect Isn’t a Trick?]<br>
by Gary Greenberg, ''New York Times Magazine'', 7 November 2018


===Discussion===
[https://www.nytimes.com/2019/07/17/opinion/pretrial-ai.html The Problems With Risk Assessment Tools]<br>
1. What is misleading about the abscissa in the above Fig 2?
by Chelsea Barabas, Karthik Dinakar and Colin Doyle, ''New York Times'', 17 July 2019


2.  As is typical in the medical field, unanimity is hard to come by.  The above study by Sung for treating babies who already had colic, appeared in April, 2014 in the BMJ.  In January, 2014 [http://www.nvafp.com/downloads/winter2014/CrawfordFioreArticles/Probiotics%20and%20GI%20in%20newborns_JAMA%20Peds.pdf a paper by Indrio, et al] appeared in JAMA which concluded that on the basis of its randomized clinical trial:
==Hurricane Maria deaths==
<blockquote>
Laura Kapitula sent the following to the Isolated Statisticians e-mail list:


Prophylactic use of L reuteri DSM 17938 during the first 3 months of life reduced the onset of functional gastrointestinal disorders and reduced private and public costs for the management of this condition.
:[Why counting casualties after a hurricane is so hard]<br>
</blockquote>
:by Jo Craven McGinty, Wall Street Journal, 7 September 2018


The tables below indicate that statistical significance is obtained with respect to preventing colic at one month and at three months. Assume there were 238 in the treatment arm and 230 in the placebo arm; use whatever statistics package is available, and see what p-values you obtain regarding the difference (probiotic minus placebo) in colic minutes per day utilizing the numbers in Table 2 and Table 3.
The article is subtitled: Indirect deaths—such as those caused by gaps in medication—can occur months after a storm, complicating tallies
Laura noted that
:[https://www.washingtonpost.com/news/fact-checker/wp/2018/06/02/did-4645-people-die-in-hurricane-maria-nope/?utm_term=.0a5e6e48bf11 Did 4,645 people die in Hurricane Maria? Nope.]<br>
:by Glenn Kessler, ''Washington Post'', 1 June 2018
 
The source of the 4645 figure is a [https://www.nejm.org/doi/full/10.1056/NEJMsa1803972 NEJM article].  Point estimate, the 95% confidence interval ran from 793 to 8498.
 
President Trump has asserted that the actual number is
[https://twitter.com/realDonaldTrump/status/1040217897703026689 6 to 18].
The ''Post'' article notes that Puerto Rican official had asked researchers at George Washington University to do an estimate of the death toll.  That work is not complete.
[https://prstudy.publichealth.gwu.edu/ George Washington University study]
 
:[https://fivethirtyeight.com/features/we-still-dont-know-how-many-people-died-because-of-katrina/?ex_cid=538twitter We sttill don’t know how many people died because of Katrina]<br>
:by Carl Bialik, FiveThirtyEight, 26 August 2015


----
3.   In addition to the p-values in Table 2 and Table 3, Table 4 has lots of p-values, most of which are less than the magical .05. If a p-value less than .05 is noteworthy, why is this collection of p-values less impressive?
[https://www.nytimes.com/2018/09/11/climate/hurricane-evacuation-path-forecasts.html These 3 Hurricane Misconceptions Can Be Dangerous. Scientists Want to Clear Them Up.]<br>
[https://journals.ametsoc.org/doi/abs/10.1175/BAMS-88-5-651 Misinterpretations of the “Cone of Uncertainty” in Florida during the 2004 Hurricane Season]<br>
[https://www.nhc.noaa.gov/aboutcone.shtml Definition of the NHC Track Forecast Cone]
----
[https://www.popsci.com/moderate-drinking-benefits-risks Remember when a glass of wine a day was good for you? Here's why that changed.]
''Popular Science'', 10 September 2018
----
[https://www.economist.com/united-states/2018/08/30/googling-the-news Googling the news]<br>
''Economist'', 1 September 2018
 
[https://www.cnbc.com/2018/09/17/google-tests-changes-to-its-search-algorithm-how-search-works.html We sat in on an internal Google meeting where they talked about changing the search algorithm — here's what we learned]
----
[http://www.wyso.org/post/stats-stories-reading-writing-and-risk-literacy Reading , Writing and Risk Literacy]
 
[http://www.riskliteracy.org/]
-----
[https://twitter.com/i/moments/1025000711539572737?cn=ZmxleGlibGVfcmVjc18y&refsrc=email Today is the deadliest day of the year for car wrecks in the U.S.]
 
==Some math doodles==
<math>P \left({A_1 \cup A_2}\right) = P\left({A_1}\right) + P\left({A_2}\right) -P \left({A_1 \cap A_2}\right)</math>
 
<math>P(E)  = {n \choose k} p^k (1-p)^{ n-k}</math>
 
<math>\hat{p}(H|H)</math>


4. Note that if you were to do a search for the probiotic used in both of the studies discussed,“lactobacillus reuteri dsm 17938,” which is made by a Swedish company, BioGaia, you will find many positive hits.  On [http://en.wikipedia.org/wiki/BioGaia the Wikipedia BioGaia page] itself we find this cautionary note:
<math>\hat{p}(H|HH)</math>
"The neutrality of this article is disputed. Relevant discussion may be found on the talk page. Please do not remove this message until the dispute is resolved. (March, 2013)"


5.  There is an [file:///C:/Users/Paul/Downloads/Probiotics%20and%20Colic%20-%20William%20E%20Bennett%20Jr%20(2).pdf accompanying editorial] by Bennett to Sung’s article. Bennett says
==Accidental insights==
<blockquote>
Infant colic is a challenging problem for many parents, but the
cause and effective treatment remain elusive. As its name
suggests, colic was thought to arise in the gastrointestinal tract,
but after centuries of this supposition we still do not know if
this is true. A host of home remedies and drug treatments have
circulated over the years, ranging from whisky, to acid
suppression, to anticholinergic agents, and onwards to
medicine’s most recent “hammer looking for a nail,” probiotics.
</blockquote>


He poses the question
My collective understanding of Power Laws would fit beneath the shallow end of the long tail. Curiosity, however, easily fills the fat end.  I long have been intrigued by the concept and the surprisingly common appearance of power laws in varied natural, social and organizational dynamics.  But, am I just seeing a statistical novelty or is there meaning and utility in Power Law relationships? Here’s a case in point.


<blockquote>
While carrying a pair of 10 lb. hand weights one, by chance, slipped from my grasp and fell onto a piece of ceramic tile I had left on the carpeted floor. The fractured tile was inconsequential, meant for the trash.
“Should we be treating infant colic at all?” A great deal of accumulated clinical experience tells us that children with colic incur no serious long term effects from the disorder, and that symptoms abate with time. The potential harm associated with diagnostic testing and treatment of infants
<center>[[File:BrokenTile.jpg | 400px]]</center>
is likely to surpass the harm from colic itself. </blockquote>
As I stared, slightly annoyed, at the mess, a favorite maxim of the Greek philosopher, Epictetus, came to mind: “On the occasion of every accident that befalls you, turn to yourself and ask what power you have to put it to use.”  Could this array of large and small polygons form a Power Law? With curiosity piqued, I collected all the fragments and measured the area of each piece.


Bennett concludes with sage advice:
<center>
<blockquote>
{| class="wikitable"
As the old adage goes, “babies cry.” Parents and their babies may be better served if we devote more resources to studying the interventions recommended long before the discovery of probiotics: reassurance, family social support, and the tincture of time.  
|-
</blockquote>
! Piece !! Sq. Inches !! % of Total
|-
| 1 || 43.25 || 31.9%
|-
| 2 || 35.25 ||26.0%
|-
|  3 || 23.25 || 17.2%
|-
| 4 || 14.10 || 10.4%
|-
| 5 || 7.10 || 5.2%
|-
| 6 || 4.70 || 3.5%
|-
| 7 || 3.60 || 2.7%
|-
| 8 || 3.03 || 2.2%
|-
| 9 || 0.66 || 0.5%
|-
| 10 || 0.61 || 0.5%
|}
</center>
<center>[[File:Montante_plot1.png | 500px]]</center>
The data and plot look like a Power Law distribution. The first plot is an exponential fit of percent total area. The second plot is same data on a log normal format. Clue: Ok, data fits a straight line.  I found myself again in the shallow end of the knowledge curve. Does the data reflect a Power Law or something else, and if it does what does it reflect?  What insights can I gain from this accident? Favorite maxims of Epictetus and Pasteur echoed in my head:
“On the occasion of every accident that befalls you, remember to turn to yourself and inquire what power you have to turn it to use” and “Chance favors only the prepared mind.”


Look up the evocative phrase “the tincture of time” to determine its relevance to colicky babies.
<center>[[File:Montante_plot2.png | 500px]]</center>
My “prepared” mind searched for answers, leading me down varied learning paths. Tapping the power of networks, I dropped a note to Chance News editor Bill Peterson. His quick web search surfaced a story from ''Nature News'' on research by Hans Herrmann, et. al. [http://www.nature.com/news/2004/040227/full/news040223-11.html Shattered eggs reveal secrets of explosions].  As described there, researchers have found power-law relationships for the fragments produced by shattering a pane of glass or breaking a solid object, such as a stone. Seems there is a science underpinning how things break and explode; potentially useful in Forensic reconstructions.
Bill also provided a link to [http://cran.r-project.org/web/packages/poweRlaw/vignettes/poweRlaw.pdf a vignette from CRAN] describing a maximum likelihood procedure for fitting a Power Law relationship. I am now learning my way through that.


6.  A sample of size one is not impressive statistically.  Nonetheless, be sure to ask your parents whether or not you were a “fussy” baby.  If you weren’t, ask them what they did to prevent colic.  If you were, ask them what they did to treat you.
Submitted by William Montante


Submitted by Paul Alper
----

Latest revision as of 20:58, 17 July 2019


Forsooth

Quotations

“We know that people tend to overestimate the frequency of well-publicized, spectacular events compared with more commonplace ones; this is a well-understood phenomenon in the literature of risk assessment and leads to the truism that when statistics plays folklore, folklore always wins in a rout.”

-- Donald Kennedy (former president of Stanford University), Academic Duty, Harvard University Press, 1997, p.17

"Using scientific language and measurement doesn’t prevent a researcher from conducting flawed experiments and drawing wrong conclusions — especially when they confirm preconceptions."

-- Blaise Agüera y Arcas, Margaret Mitchell and Alexander Todoorov, quoted in: The racist history behind facial recognition, New York Times, 10 July 2019

In progress

What if the Placebo Effect Isn’t a Trick?
by Gary Greenberg, New York Times Magazine, 7 November 2018

The Problems With Risk Assessment Tools
by Chelsea Barabas, Karthik Dinakar and Colin Doyle, New York Times, 17 July 2019

Hurricane Maria deaths

Laura Kapitula sent the following to the Isolated Statisticians e-mail list:

[Why counting casualties after a hurricane is so hard]
by Jo Craven McGinty, Wall Street Journal, 7 September 2018

The article is subtitled: Indirect deaths—such as those caused by gaps in medication—can occur months after a storm, complicating tallies

Laura noted that

Did 4,645 people die in Hurricane Maria? Nope.
by Glenn Kessler, Washington Post, 1 June 2018

The source of the 4645 figure is a NEJM article. Point estimate, the 95% confidence interval ran from 793 to 8498.

President Trump has asserted that the actual number is 6 to 18. The Post article notes that Puerto Rican official had asked researchers at George Washington University to do an estimate of the death toll. That work is not complete. George Washington University study

We sttill don’t know how many people died because of Katrina
by Carl Bialik, FiveThirtyEight, 26 August 2015

These 3 Hurricane Misconceptions Can Be Dangerous. Scientists Want to Clear Them Up.
Misinterpretations of the “Cone of Uncertainty” in Florida during the 2004 Hurricane Season
Definition of the NHC Track Forecast Cone

Remember when a glass of wine a day was good for you? Here's why that changed. Popular Science, 10 September 2018

Googling the news
Economist, 1 September 2018

We sat in on an internal Google meeting where they talked about changing the search algorithm — here's what we learned

Reading , Writing and Risk Literacy

[1]

Today is the deadliest day of the year for car wrecks in the U.S.

Some math doodles

<math>P \left({A_1 \cup A_2}\right) = P\left({A_1}\right) + P\left({A_2}\right) -P \left({A_1 \cap A_2}\right)</math>

<math>P(E) = {n \choose k} p^k (1-p)^{ n-k}</math>

<math>\hat{p}(H|H)</math>

<math>\hat{p}(H|HH)</math>

Accidental insights

My collective understanding of Power Laws would fit beneath the shallow end of the long tail. Curiosity, however, easily fills the fat end. I long have been intrigued by the concept and the surprisingly common appearance of power laws in varied natural, social and organizational dynamics. But, am I just seeing a statistical novelty or is there meaning and utility in Power Law relationships? Here’s a case in point.

While carrying a pair of 10 lb. hand weights one, by chance, slipped from my grasp and fell onto a piece of ceramic tile I had left on the carpeted floor. The fractured tile was inconsequential, meant for the trash.

BrokenTile.jpg

As I stared, slightly annoyed, at the mess, a favorite maxim of the Greek philosopher, Epictetus, came to mind: “On the occasion of every accident that befalls you, turn to yourself and ask what power you have to put it to use.” Could this array of large and small polygons form a Power Law? With curiosity piqued, I collected all the fragments and measured the area of each piece.

Piece Sq. Inches % of Total
1 43.25 31.9%
2 35.25 26.0%
3 23.25 17.2%
4 14.10 10.4%
5 7.10 5.2%
6 4.70 3.5%
7 3.60 2.7%
8 3.03 2.2%
9 0.66 0.5%
10 0.61 0.5%
Montante plot1.png

The data and plot look like a Power Law distribution. The first plot is an exponential fit of percent total area. The second plot is same data on a log normal format. Clue: Ok, data fits a straight line. I found myself again in the shallow end of the knowledge curve. Does the data reflect a Power Law or something else, and if it does what does it reflect? What insights can I gain from this accident? Favorite maxims of Epictetus and Pasteur echoed in my head: “On the occasion of every accident that befalls you, remember to turn to yourself and inquire what power you have to turn it to use” and “Chance favors only the prepared mind.”

Montante plot2.png

My “prepared” mind searched for answers, leading me down varied learning paths. Tapping the power of networks, I dropped a note to Chance News editor Bill Peterson. His quick web search surfaced a story from Nature News on research by Hans Herrmann, et. al. Shattered eggs reveal secrets of explosions. As described there, researchers have found power-law relationships for the fragments produced by shattering a pane of glass or breaking a solid object, such as a stone. Seems there is a science underpinning how things break and explode; potentially useful in Forensic reconstructions. Bill also provided a link to a vignette from CRAN describing a maximum likelihood procedure for fitting a Power Law relationship. I am now learning my way through that.

Submitted by William Montante

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