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Friday, November 28, 2008

German court rules big boobs are not a medical problem

A COURT has ruled that insurance companies do not need to cover the cost of breast reduction surgery.
The court ruled ruled that having a large bust is not a medical problem and as such insurers will only have to pay to correct breasts which are deformed.

The case was brought by a 38-year-old woman who suffered orthopaedic and physical problems due to the weight of her boobs, bild.com reports.

She had been advised by doctors to have breast reduction surgery.

But her insurance company didn’t see it as a necessity and therefore refused to cover the costs of the operation.

It claimed she was suffering from back problems because she was overweight.

The court agreed with the insurance company and the woman lost her case.

Two and a half years ago, the same court rejected the case of a woman who thought her breasts were too small.

She wanted her medical insurance to cover a breast enlargement operation and claimed that she was physically harassed for her small boobs. The court declared then that small breasts are not an illness.

Original here

10 Ways to Save Money on Health Costs During the Recession

By Scott Mowbray

health-cost-recession-save
Istockphoto

Whatever the prospects for health-care reform, the sick economy is going to put lots of pressure on Americans. Unemployment will be up, the number of uninsured will rise, companies will surely cut health benefits to employees, and all this stress will be, well, unhealthy.

Although there is some evidence that recessions can actually improve certain health trends (e.g., people may indulge in unhealthy behaviors less often when they have less money), it is surely true that health-related money anxiety will rise.

But there are ways to prevent and lessen health-money woes. Here are 10 to start with, along with links to more detailed explanations of how to make these changes.

1. Make a prevention resolution. If you’re overweight (millions of Americans are prediabetic and don’t know it), get your weight down to reduce your risk of diabetes. It will also help with hypertension and other problems that can cost you big. Prevention isn’t a cure-all, but it’s a good bet if you want to avoid situations that can lead to major health bills.

2. Stick to your meds. If you’re on regular medication—a statin for high cholesterol, or aspirin to prevent a heart attack, for example—take your medicine. Failure to comply (including skipping doses to save money) is a common behavior, but it can reduce drug efficacy. If you lose your insurance coverage, you may be able to find a cheaper version of the drug, and most drug companies have programs to help people who cannot afford their medicines. But don’t stop taking a med without consulting your doctor.

3. Go generic if you can. Always ask about costs when your doctor prescribes a medicine. Request the cheapest effective drug—an older formulation or generic may cost less and do the same good.

4. Find cheap, good sources of medication. There are safe Internet options, and stores like Wal-Mart offer significant savings. There are also money-saving strategies such as buying pills in bulk, splitting larger-dose pills into the prescribed dosage, and more.

5. Eat better, save more. Healthy eating and cheaper eating can dovetail nicely. Reduce portion sizes to healthy levels and move whole grains and vegetables to the “center” of your diet: You’ll save money and be healthier. Simpler, natural healthy foods—dry beans, inexpensive vegetables—are often cheaper than unhealthy processed foods. And less costly cuts of meat can have more flavor when cooked properly. For hundreds of easy, healthy recipes, visit Health.com’s new Recipe Center.

6. Commit to recovery. If you’re recovering from surgery and facing rehab, follow the recovery regimen diligently. Get your physical therapist to maximize your “homework” routine to save on clinic visits. But don’t put off the pain: Incomplete healing can lead to reinjury or permanent disability.

7. Know your rights. If you lose your insurance, study the COBRA rules and 62-day insurance “gap” rules to avoid a costly coverage error, particularly if you have a preexisting condition.

8. Fight claim denials. Experts say that 70% of health-insurance claim appeals are successful, and there are Web resources and people who can help.

9. Get organized. Many people are sloppy about keeping copies of prescriptions, test results, insurance claims, and the like. If you have your documents in order, it will be easier to win a disagreement with an insurance company, and it can lead to more efficient appointments with your doctor.

10. Bargain down costs. Both doctors and hospitals will actually negotiate, and sometimes adjust their bills based on patient needs, ability to pay cash, and other factors. And if you’re facing a hospital stay, there are things you can do before and after to avoid overcharges, including packing your own drugs, keeping a treatment log, and asking for an itemized statement.

Original here

Meet Millie, 7, who still smiles despite disease so rare it affects just FOUR people worldwide

By Daily Mail Reporter

Brave Millie Smith can still break into a beaming smile despite suffering from a medical condition which is so rare that it has no name and affects just four people in the world.

She was diagnosed at 16 months when tests revealed she had strands missing from her eighth chromosome.

The condition has left the seven-year-old with severe learning difficulties, low muscle tone and visual problems.

Millie Smith

Unique: Millie Smith has a lust for life, despite suffering from a rare genetic disorder that affects just four people in the world

But there is little chance of experts finding a cure as there are too few sufferers to justify wide-scale research.

Her mother Alex Smith, 37, who cares for her full-time at the family home in Linden, Gloucestershire, said it was not easy for her daughter but she was 'always smiling'.

'She's a lovely girl but it's quite hard for children like her because even though she enjoys talking to people sometimes they feel very awkward with her.

Millie Smith

Play time: Millie has no trouble amusing herself with one of her baby dolls

'She can't dress herself or do a lot of things we take for granted and because she doesn't look disabled people often don't understand why she can't respond.

'Unfortunately, there's not enough money to make it worth researching such a rare disorder. Hopefully it will be given a name when more sufferers are found.'

There are less than 100 people in the world who have problems with their number eight chromosome but only four with similar breaks and symptoms to Millie.

Millie Smith

Still smiling: Millie, pictured aged three, has always been a happy little girl

She has to be cared for full-time by her mother, but window-fitter father Andrew Smith, 37, and her brother Aaron, 13, also help out.

Millie's rare condition means she will require constant care for the rest of her life and doctors say she may never advance beyond the emotional age of a three-year-old.

Human cells normally contain 23 pairs of chromosomes and genetic problems such as Down's Syndrome - which occurs when there is an extra pair - are relatively common.

Millie's precise disorder is an 'inverted duplication with a partial deletion in the smaller half of her number eight chromosome, or inv dup del 8p'.

Beverly Searle, chief executive of Unique, an international charity for people suffering from rare chromosome disorders, said the problem is so rare it does not 'warrant a name'.

She said: 'All chromosome disorders can cause huge problems to those affected by them and even a tiny genetic change can lead to many different medical conditions.

'In this case the inverted duplication with a deletion of the number eight chromosome is an extremely rare condition.

'Our purpose as an organisation is to collate information on specific disorders and as more research is undertaken rare disorders like this will be named.

'But because there are so few children with this condition there is too little material to warrant doctors naming it like the more common Down's syndrome.'

Original here

Pig organs: Ready for humans at last?

Double lung transplant surgery, carried out in 2007
 at the Department of thoracic surgery, Foch hospital, Suresnes, France (Image: Foch/Phanie/Rex Features)

Double lung transplant surgery, carried out in 2007
 at the Department of thoracic surgery, Foch hospital, Suresnes, France (Image: Foch/Phanie/Rex Features)

by Andy Coghlan

IN THE not too distant future, a person in need of a heart transplant could be offered a pig's organ. That's the hope of a group that met in China last week to agree global guidelines for the first clinical trials of "xenotransplants".

The meeting of clinicians, researchers and regulators in Changsha, Hunan province, which was organised by the World Health Organization, resulted in the so-called Changsha Communiqué - a document that should eventually guide global regulation of xenotransplants.

It sets out principles for research, recommends how the WHO and individual countries should monitor such research, and includes guidelines for trials (see "Trials and transplants"). Perhaps most importantly, with human organs in desperately short supply, it reflects how far research has come since a decade ago, when some of the problems associated with xenotransplants seemed insurmountable.

For example, one big concern related to porcine endogenous retroviruses (PERVs). These are dormant viral DNA present in the pig genome that researchers feared would reawaken in an organ transplanted into humans, who, unlike pigs, might not be able to keep the viruses dormant. Pigs have now been genetically engineered either to lack PERVs entirely or to carry RNA interference molecules primed to sabotage any that become active. "Most of us now agree the risk is quite manageable," says Megan Sykes of Massachusetts General Hospital in Boston, who attended the meeting.

The first pig tissue to find its way into humans probably won't be an organ, but insulin-producing islet cells from the pancreas, to treat people with diabetes. Two years ago, Bernard Hering's team at the University of Minnesota in Minneapolis reported injecting unaltered pig islet cells into the livers of diabetic monkeys, along with immunosuppressive drugs. The monkeys were able to go without insulin injections for the duration of the 100-day experiment (Nature Medicine, vol 12, p 301). Hering is now in discussions with the US Food and Drug Administration (FDA) about how to proceed with a human trial.

David White and his colleagues at the Robarts Institute in London, Ontario, Canada, are also talking to the FDA about a possible trial next year. To make islet cells less likely to be rejected, White mixes them with Sertoli cells from pig testes, which contain a molecule that seems to damp down attacks by human T-cells. White explains that Sertoli cells are equipped with the cellular machinery to protect sperm, which would otherwise be vulnerable to attack by the immune system because they have half the chromosomes of other cells.

Rafael Valdés-González of the Children's Hospital of Mexico in Mexico City, who first pioneered the Sertoli cell technique, has already tested it in a small number of people and claims that one patient is still insulin-independent as a result (Clinical Transplantation, DOI: 10.1111/j.1399-0012.2007.00648.x).

Also some grounds for optimism come from a handful of trials of pig islet cells in countries where regulation is less tight. In Russia, the New Zealand company LCT claims to have had some success treating five patients with pig islet cells, which they disguised from the immune system by encapsulating them in alginate, a substance from seaweed that allows nutrients and hormones to diffuse in and out but prevents contact with immune cells. Last month, LCT won authorisation to begin a trial in New Zealand.

Sykes hopes that success with initial islet trials will bring greater public acceptance of xenotransplantation, leading to the really exciting prospect of transplanting full organs. These naturally pose greater problems, though, mainly because they must be hooked up to a blood supply and so face the full force of the immune system.

In 2002, researchers at Revivicor, a company based in Blacksburg, Virginia, found a possible way around this. Their "knockout" pigs lacked the gene for the alpha-gal protein - the molecule that indicates the presence of foreign cells to the human immune system. Other Revivicor researchers have inserted "complement regulator" genes into pig organs, which prevented monkey antibodies from attacking them.

One problem that is proving more difficult to solve is clotting. "We think antibodies bind to blood vessels of the pig graft, and these activate coagulation factors," says David Cooper, a pioneer of xenotransplantation at the University of Pittsburgh Medical Center in Pennsylvania who collaborates with Revivicor.

To deal with this, two groups have produced pigs carrying human genes for anti-clotting substances. Revivicor has inserted a gene for a protein called tissue factor pathway inhibitor, which neutralises tissue factor, a key trigger of clot formation. And at the University of Melbourne in Australia, Anthony d'Apice and his colleagues have bred pigs that make human CD39, a protein that stops platelets from aggregating into clots. The hope is that these substances will only be produced locally, preventing clots in the transplanted organ but not disrupting vital clotting elsewhere (Transplant Immunology, DOI: 10.1016/j.trim.2008.10.003).

Even with these interventions, powerful immunosuppressant drugs would still be needed, weakening the body to other invaders, including cancer. To minimise this problem another idea is taking shape: engineer the organ to make its own immunosuppressant. CTLA-4 Ig, for example, prevents T-cells being switched on, and is already used as an immunosuppressant for transplant patients.

One company is engineering pigs to produce an immunosuppressant in specific organs

Revivicor is now combining all these ideas in one animal by engineering pigs that make CTLA-4 Ig and an anticoagulant in specific organs, have the alpha-gal knockout and make the complement regulator throughout their bodies. D'Apice also claims to have created a pig with four added genes.

Because of the potential success of such experiments, guidelines are essential now. Peter Doyle, a delegate at the meeting and former secretary of the now-defunct UK Xenotransplantion Interim Regulatory Authority says: "Xenotransplantation has the potential to treat millions of people, but the threatened dangers are worrying unless it's properly regulated globally."

Trials and transplants

  • Global regulation of trials needed to monitor for dangers such as viruses

  • Trials banned in all countries incapable of effective regulation

  • All trials and recipients must be registered

  • Trial regulation must include scientific and ethical assessment, and "involve the public"

  • First recipients of xeno-organs must be carefully selected to ensure they and their families accept lifelong vigilance for any signs of novel disease

  • All source animals should be kept in closed colonies free from pathogens

  • "Compelling justification" needed for trials, including adequate evidence of safety and efficacy from animal studies

  • Original here

    Spotting a sociopath

    Mark Easton

    How could anyone do those unimaginably cruel, inhuman things?

    baby pThat is the question that, to most people, immediately flows from hearing the ghastly details of both the Sheffield man who fathered nine children by raping his two daughters and, of course, the tragic story of Baby P.

    We seem to have any number of inquiries and investigations now under way into trying to find what went wrong, but I wonder whether the real answer lies buried in that initial question.

    The 56-year-old Sheffield businessman who raped his children and the woman and two men who tortured a baby in Haringey would all appear to fit the definition of sociopaths: individuals with a deficit or absence of the social emotions (love, shame, guilt, empathy and remorse), but with a clear facility to deceive and manipulate others.

    Mr X, as the rapist was known, refused to attend court to hear his sentence but in a letter to his brother said: "I haven't got any regret over what has happened. It's too late for that. It shouldn't have happened."

    Also referred to as "anti-social personality disorder", the behaviour of such people is beyond comprehension to most people because it does not equate with our understanding of what makes us human.

    Academics calculate that sociopaths account for about 3-4% of the male population and less than 1% of the female population. Professor Robert Hare from the University of British Columbia is one the world's experts on sociopaths and psychopaths. He writes of people "completely lacking in conscience and in feelings for others".

    He describes how "they selfishly take what they want and do as they please, violating social norms and expectations without the slightest sense of guilt or regret".

    Such people are, however, very difficult to spot.

    In her book The Sociopath Next Door: The Ruthless vs. the Rest of Us, American clinical psychologist Dr Martha Stout explains why she thinks this is:

    Since everyone simply assumes that conscience is universal among human beings, hiding the fact that you are conscience-free is nearly effortless. You are not held back from any of your desires by guilt or shame, and you are never confronted by others for your cold-bloodedness. The ice water in your veins is so bizarre, so completely outside of their personal experience that they seldom even guess at your condition.

    The individuals that society puts in the front line to try and spot the threat from sociopaths could hardly be more different. Social workers, doctors and teachers are, usually, natural carers - people who empathise easily with others. They are wired to see the best in people, to develop trust.

    And most of the time, that is exactly what we want such professionals to do - to support and to help people through their difficulties. But we also demand that they retain a deep cynicism about the individuals they work with - constantly questioning and imagining the very worst.

    Sometimes they must make professional judgments about people who are wired completely differently to themselves - people who do not share the basic qualities that define humanity as they understand it.

    victoria climbie inquiryIn his report [pdf] into the death of Victoria Climbie in Haringey in 2000, Lord Laming wrote of the need for "respectful uncertainty" when dealing with a child's family and of "critical evaluation" of what professionals are told. He has spoken of the "over optimism" he encountered, the way in which social workers tend to "travel with hope".

    When one reads the appalling details of 25 years of abuse and suffering in the Sheffield case, it does seem incredible that it went on for so long and without anyone in authority noticing.

    But perhaps it is the very incredibility that explains why.

    Original here

    Electric MINI E Bows at LA Show

    MINI E Photo: Rod Hatfield
    By Mike Meredith
    New electric version of MINI Cooper offers MINI fun with zero emissions.
    Click image to enlarge
    MINI E Photo: Rod Hatfield
    MINI E Photo: Rod Hatfield
    Click image to enlarge
    MINI E Photo: Rod Hatfield
    MINI E Photo: Rod Hatfield
    Click image to enlarge
    MINI E Photo: Rod Hatfield
    MINI E Photo: Rod Hatfield
    Click image to enlarge
    MINI E Photo: Rod Hatfield
    MINI E Photo: Rod Hatfield

    Related Multimedia

    Already a lot of fun to drive and environmentally efficient, the popular MINI Cooper will soon gain even more favor with environmentally conscious drivers as the electric-powered MINI E debuted at the 2008 Los Angeles Auto Show.

    Based on the MINI Cooper and powered by a 150kW (204 horsepower) electric motor, the MINI E will boast a range of 150 miles due to the use of a high-performance rechargeable lithium-ion battery. The zero-emission vehicle is nearly silent, with power delivered to the front axle through a single-stage helical gearbox.

    Since entering the U.S. market as a 2002 model, the MINI Cooper has enjoyed tremendous popularity as a premium compact vehicle that delivers excellent fuel economy. Now, 500 select private and corporate customers in California, New York and New Jersey will have the opportunity to experience a completely emissions-free MINI.

    With 162 lb-ft. of torque on tap, the MINI E will accelerate from zero to 62 mph in 8.5 seconds on the way to a top speed of 95 mph. To match the handling and driving enjoyment of the MINI Cooper, the suspension has been tuned to match the even weight distribution of the MINI E, which weighs in at 3,230 lbs.

    MINI E will initially be available as a two-seater, with the latest lithium-ion battery technology specifically engineered for the MINI E. The battery unit combines high output and ample storage capacity in the form of three battery elements stored where the rear seat would normally be, leaving a small storage area behind.

    Using similar technology as the power supplies for mobile phones and portable computers, the MINI E can be plugged into any standard power outlet to charge. Charge time varies depending on voltage and amperage, and for U.S. owners all MINI Es will include a wall box that can be installed to enable higher amperage to allow the MINI E to be fully recharged in 2.5 hours.

    The BMW Group, which manufacturers MINI automobiles, plans to use the experience gained from 500 electric vehicles on the road in real-world driving conditions to move toward “medium term” series production of an all-electric vehicle as part of its Number One strategy.

    Original here

    Neal Stephenson

    Interviewed by Tasha Robinson


    Neal Stephenson became a hero to the science-fiction world in 1992 with Snow Crash, a jazzy, funny, prescient dystopic novel about a Mafia pizza-delivery boy caught up in a plot that crossed ancient cultures with virtual reality. It wasn't Stephenson's first novel, but it made him an instant name among the William Gibson crowd, drawing attention to his previous books—the collegiate send-up The Big U and the eco-thriller Zodiac—and guaranteeing an instant audience for his follow-up, The Diamond Age. Over the past decade, Stephenson's bestselling novels have gotten progressively denser, more ambitious, and more celebrated, from the monster techno-thriller Cryptonomicon to the three-volume historical series known as the Baroque Cycle to his new 937-page science-fiction outing Anathem. His books tend to range broadly across theoretical and intellectual topics, while delving deeply into one or two concepts: Anathem, for instance, takes place on a world where scientist-philosophers dwelling in monastery-like strongholds (small ones are "maths," large ones are "concents") avoid the secular world for periods marked and enforced by giant clocks, and devote themselves to logic and thought experiments, which Stephenson explores at length while building to a series of events that disrupt their system. Stephenson recently spoke to The A.V. Club about the soundtrack for Anathem, making up words, and reading philosophy so you don't have to.

    The A.V. Club: What started you writing Anathem?

    Neal Stephenson: It comes out of conversations I've been having with Danny Hillis, Stewart Brand, Alexander Rose, and others at the Long Now Foundation going all the way back to the mid-1990s on the subject of the Millennium Clock, a.k.a. the Clock Of The Long Now. In 1999, I sketched out an idea for a tall clock tower surrounded by a system of walls, with gates in the walls that would be opened by the clock mechanism at regular intervals, and "clock monks" who might live inside the walls, insulated from the distractions of the outside world. This was just me doodling for the hell of it—not a serious proposal. The Long Now Foundation guys have their own ideas as to what they want to build, and it looks nothing like what I'm talking about.

    At that time, I wasn't conceiving of this as a book idea, but in 2005, when I was looking for a next project, I found that I couldn't get this idea out of my mind, so I set to work on it.

    AVC: What sort of topics did you wind up researching before writing it? How organized or results-driven are you about research?

    NS: Depends on the book. For the Baroque Cycle, I just read lots of books and took notes without having much of a plan. In the case of Anathem, most of the research had to do with philosophy and metaphysics. Reading this sort of thing has never been my strong suit, so I actually had to be somewhat more "organized and results-driven" than is my habit. I just made up my mind that I was going to have to read some of these philosophy tomes, and I forced myself to read something like 10 pages a day until I had bashed my way through them.

    AVC: Why base a book in part on topics that you yourself aren't passionately interested in reading about?

    NS: I was trying to run something to ground that had come to my attention when I was working on the Baroque Cycle. That series, of course, was about the conflict between Newton and Leibniz. Leibniz developed a system of metaphysics called monadology, which looked pretty weird at the time and was promptly buried by Newtonian-style physics. Later I learned that some eminent 20th-century thinkers, including Bertrand Russell and Kurt Gödel, had been interested in Leibniz's work, and that Leibniz had been adopted as a sort of patron saint by some of the people working on Loop Quantum Gravity. When I finished the Baroque Cycle, I still felt as though this was a loose end. In part, Anathem is an attempt to tie up that loose end. To do this, I had to read Kant and Husserl and some other stuff that Kurt Gödel apparently thought of as light reading.

    AVC: Has this happened before with any of your books, where you had to fight your way through source material on some specific topic to get what you wanted for the book?

    NS: All the time. I read this so you don't have to. It's all part of the service.

    AVC: Do you tend to try to do all your research up front before starting to write a book?

    NS: No in general, and especially in the case of Anathem. At the beginning of the project, I wasn't certain that I could come up with an engaging storyline and cast of characters in this world, so I had a strong bias toward actually writing, and worrying about research later. In other words, I was afraid that I'd devote a year or two of my life to grinding through Kant and Husserl, then discover that there simply was no novel to be written here.

    AVC: Do you enjoy the actual process of research? Do books tend to be inspired by your reading, or do you start with the idea for a book and then do the reading to supplement the idea?

    NS: The story is everything, so it always begins with a story. Research is a kind of scaffolding built underneath the story as I go along. My enjoyment level varies, but in general, I'm writing about topics I find interesting, so I can't gripe too much.

    AVC: With that in mind, do you wind up with other ideas for books as you're researching or plotting? Are you the kind of writer who ends up with notebooks full of "maybe someday" plots and ideas as you're working?

    NS: No, I'd find that extremely distracting. I'm strictly a one-project-at-a-time kind of guy. If I came up with a compelling idea for a different book while working on a project, I'd probably abandon the first project and go with the new idea.

    AVC: Has that ever happened? Or, in keeping with your comment about starting Anathem before you knew there was a story there, have you ever gotten significantly into a project and decided not to pursue it?

    NS: I think it has happened so early in certain projects that I have long since forgotten about the originals. It would be quite unusual for me to get deep into a project and then shitcan it. One of the advantages of having done this for a while is that I have a better sense than I used to of when something is or isn't working. Until I developed that sense, this was a pretty dicey career for me, both in terms of paying the rent, and emotional wear and tear.

    AVC: You've addressed in other interviews the way some people have complain that Anathem starts slowly, that it's hard going at first for the first 100 or 200 pages, before the actual plot begins. What went into deciding where to begin it, and figuring out how much readers needed to know about the world before they could absorb the story?

    NS: It's easy to imagine writing a 250-page version of Anathem that ends before what you call "the actual plot" even begins. If I'd done that, it would have been more of a small literary novel, meant to be read as a statement about the relationship between the bookish and non-bookish parts of our society. But I'm not a small-literary-novel kind of guy, and once I'd developed the world in the first couple of hundred pages, I felt that there was potential here to go on and write an engaging story set in that world. So that's what I did. This probably ruins things both for the people who want small literary novels and for those who want action-packed epics, but anyway, it's what I wrote.

    AVC: Was the way you put the story together influenced by the fact that this was a first-person narrative? Was it more difficult getting exposition and description of the world into this book than others?

    NS: Early on, I settled on the first-person strategy as a way to deal with exposition and world-description issues. As long as the book is, it could have been far longer had I gone with an omniscient third-person narrator, or multiple point-of-view characters, since either of those would have enabled me to impart much more detailed information about the history and geography of the world. As it is, we see everything from the narrator's point of view, so exposition about the world is limited to what impinges directly on him and the story he's telling. Considering how old the world is, we learn very little about its history, which I think is a good thing.

    AVC: There are a lot of neologisms in your books in general—in Anathem, largely iterations of or plays on existing words, in Snow Crash and The Diamond Age, invented words for invented futuristic concepts. Do you have a method for making made-up words sound sensible, for avoiding the terrible-made-up-word disease that hits so much science fiction and fantasy?

    NS: "Method" is an awfully dignified word for it, but here goes: In the room where I work, I have a chalkboard, and as I'm going along, I write the made-up words on it. A few feet from that chalkboard is a copy of the full 20-volume Oxford English Dictionary, to which I refer frequently as a source of ideas and word roots. Whenever I get distracted or bored, my eyes wander over to that chalkboard and I read the words. Some of them grow on me, and others annoy me. I attack the latter with eraser and chalk, and keep nudging at them until I like the way they look and sound. Others never make the cut at all and simply get erased. Perhaps one day I will sell these on eBay to RPG players who need names for characters or alien races.

    AVC: Speaking of made-up words, did you see the xkcd strip about the book, or any of the subsequent discussions online?

    NS: I saw the strip, but not the discussions. Note that the dependent variable in the graph is "probability that the book will be good" and not "quality of book," which means that I still have some statistical chance of writing a good book even if it's full of neologisms.

    I'm alternately baffled and intrigued by all of the attention that has been paid to the made-up words in Anathem, since it seems to me that it doesn't have a hell of a lot more such words than most other fantasy and science-fiction books. To me, it's always been a normal part of reading F/SF that one encounters unfamiliar words and learns their meaning as the book goes on. Every kid in the world knows the meanings of "horcrux," "wizengamot," etc. Right now I'm reading Stephen King's Dark Tower series, which is stuffed with made-up words. So when I see discussion of neologisms in Anathem, I find myself considering a couple of hypotheses:

    1) Maybe Anathem is being read by a lot of people who are not in the habit of reading fantasy and science fiction and who simply aren't accustomed to encountering neologisms in literature.

    2) Maybe it's just another example of shortened attention spans. People don't have time to read. This is not me criticizing others—I'm exhibit A of someone who doesn't have time to read! Only reluctantly do they pick up a book as fat as Anathem. When they find it has new words in it, they get even more impatient.

    But those are just guesses. For me, it is still something of a mystery as to why people are so preoccupied with this. Maybe I'm just underestimating the difficulty of figuring these things out from context. My own tastes run toward the "just let me figure it out" end of the spectrum. The alternative is big chunks of naked exposition.

    AVC: Was the glossary in the back of Anathem your idea?

    NS: It wasn't my idea, but once I assembled the list of words, I saw that it was a good idea.

    AVC: You explore word evolution throughout the Baroque Cycle—the way the iterations of "fantasies" evolved, for instance—and in Anathem you expressly seem to be having fun iterating words. And linguistics has been a theme in your plots as well. Why is it such an interest for you?

    NS: Hmm, I think that this vein is close to being mined out already, but I'll say that my knowledge of and talent for linguistics are quite limited and I'm not aware of being a hell of a lot more interested in that topic than I am in others.

    AVC: Your books deal with pretty weighty concepts, but they're generally accessible to the layman—in some cases, like with cryptography in Cryptonomicon and logical thought in Anathem, it feels like you're presenting readers with a 101 course. Between that and the college lectures you've done, do you have any interest in teaching?

    NS: You must be talking about the Gresham College lecture that's up on the Internet. That's not a college lecture in the normal sense of the term. Gresham College doesn't have students; it's a public lecture series that's been going on in London since the reign of Elizabeth I.

    Coming up with lectures is a huge amount of work. I was willing to do one lecture for Gresham because I was honored to have been invited, but to create lectures for a class would probably require that I shut down everything else and concentrate on lectures for a couple of years. Then there would be many, many other skills that I'd have to learn, such as how to sit through a faculty meeting, how to deal with students, etc. It is really not in the cards for me. It's not who I am or what I do. I'm a novelist.

    AVC: Do you think about accessibility when you're writing? Do you worry about whether readers will be able to keep up?

    NS: Anathem is about as far as I'm willing to go in the direction of asking the reader to bear with me. Some of the especially technical stuff, I relegated to appendices. The appearance of technical appendices in a work of art is not necessarily a bad thing, but it's definitely a warning, like hitting the rumble strip on the edge of the highway.

    AVC: How conscious are you as you're writing of your style in general? Do you try to steer it?

    NS: I try to find a style that matches the book. In the Baroque Cycle, I got infected with the prose style of the late 17th and early 18th centuries, which is my favorite era. It's recent enough that it is easy to read—easier than Elizabethan English—but it's pre-Victorian and so doesn't have the pomposity that is often a problem with 19th-century English prose. It is earthy and direct and frequently hilarious. So a lot of what you see in the Baroque Cycle is me wanting to be one of those guys. In the case of Anathem, I needed something that was more formal, less flashy, as if it had been translated from the classical language of another planet, but enlivened with slang terms that a teenage narrator would enjoy throwing around.

    AVC: How do you go about finding the voice on the page once you've determined what it should be? Is there any trial-and-error process in the writing?

    NS: This is one of these questions that requires a higher level of self-scrutiny than is really good for me. In general I have difficulty answering any question that includes the word "process," partly because I'm not that self-aware, and partly because there is no process.

    AVC: Do you think of yourself as having messages to get across, or trying to educate your readers, or interest them in specific topics?

    NS: I really am just trying to tell stories. But stories are often grounded in larger events and themes. They don't have to be—there's a big literature of trailer-park, kitchen-table fiction that's just about goings-on in the lives of ordinary people—but my own tastes run toward stories that in addition to being good stories are set against a backdrop that is interesting to read and learn about. In Tale Of Two Cities, you have a good story set against the backdrop of the French Revolution. In Moby Dick, you have a good story that happens to take place in the context of a whaling ship. I think it would lead to a pretty bad relationship between author and reader if the latter felt that the former were tugging on their sleeve trying to impart a message or educate them, but it seems to work fine to set a story in a larger context that the reader can get interested in and learn about as they go along.

    AVC: When we last talked to you back in 1999, you said a lot about your method and how it had evolved since your earliest days as a writer. Has it changed since then?

    NS: Sorry, nothing new to report here! The only thing that has changed since 1999 is that I write with a fountain pen on paper.

    AVC: How did the music for Anathem on your website come about? Are there any plans to release it as a companion to the book?

    NS: Yes, I think it's available on iTunes and CDBaby.

    The music was composed by my friend David Stutz. He is retired from Microsoft. He sings bass in two local early-music groups, Cappella Romana and The Tudor Choir. When I was working on Anathem, I would go to concerts by these groups as a way of getting into the mood of the mathic world. I reckoned that the avout would have musical traditions that were similar to those developed in Europe during the Middle Ages, except that the themes of their music would be mathematics, philosophy, and science rather than religion.

    About a year and a half ago, David and I and our wives were going to a concert by Trio Medieval, which sings similar music. We had dinner beforehand. Over a bottle of wine, I told David about the book project, and we came up with the idea of actually trying to create the music that the avout would sing. I was thinking that I'd hear no more of it after we had sobered up, but David took the bit in his teeth and went to work on it in a serious way. My participation was minimal. We would cast about for ideas from the world of mathematics that might make good fodder for a work of music. Then David would disappear for a couple of months and get up to speed on the mathematics and figure out a scheme for translating the structure of the math into musical form. You can see some of David's liner notes at synthesist.net.

    In about March of 2008, David started to get singers into studios in Portland and Seattle to lay down tracks for the CD. A rough-cut CD was included with the galleys of the book in May. Over the course of the summer, some additional tracks were completed, and the CD was released on September 9, on the same date as the book. We got some of the singers down to San Francisco to perform at the launch event.

    AVC: What's next? Are you in that "looking for a new project" stage, or do you have a follow-up in mind or in progress?

    NS: At the moment I'm writing a short piece for a compilation volume. No plans after that.

    Front page image by Bob Lee

    Original here

    Remains of Slave Ship Found

    By Randolph E. Schmid, Associated Press

    This undated handout photo provided by NOAA shows the hull remains of the so-called "Black Rock Wreck" measured and compared to the dimensions of known shipwrecks off East Caicos. Credit: AP Photo/Search for the Slave Ship Trouvadore/NOAA

    WASHINGTON (AP) — Marine archaeologists have found the remains of a slave ship wrecked off the Turks and Caicos Islands in 1841, an accident that set free the ancestors of many current residents of those islands. Some 192 Africans survived the sinking of the Spanish ship Trouvadore off the British-ruled islands, where the slave trade was banned.

    Over the years the ship had been forgotten, said researcher Don Keith, so when the discovery connected the ship to current residents the first response "was a kind of shock, a lack of comprehension," he explained in a briefing organized by the U.S. National Oceanic and Atmospheric Administration.

    But after word got out "people really got on board with it," he said, and the local museum has assisted the researchers. He said this is the only known wreck of a ship engaged in the illegal slave trade.

    Keith and his co-researchers from the Texas-based Ships of Discovery organization came across a letter at the Smithsonian Institution that referred to the sinking and began their search for the ship.

    "The people of the Turks and Caicos have a direct line to this dramatic, historic event — it's how so many of them ended up being there. We hope this discovery will encourage the people of the Turks and Caicos to protect and research their local history, especially the history that remains underwater," he said.

    "It really is a mystery, it's a detective story," added marine archaeologist Toni Carrell.

    "We do all of this because we recognize the importance of history. This is an important part of the Turks and Caicos history," she said.

    The team was able to determine that authorities on the islands apprenticed the Africans to trades for a year and then allowed them to settle on the islands, many on Grand Turk. The Spanish crew was arrested and turned over to authorities in Cuba, then a Spanish colony.

    An 1878 letter refers to the Trouvadore Africans as making up the pith — meaning an essential part — of the laboring population on the islands.

    When the wreck was first discovered in 2004 it was named the Black Rock ship because the researchers were unsure of its identity. They have since become convinced by the timing and design of the vessel that it is the Trouvadore.

    "We were not fortunate enough to find a bell with 'Trouvadore' on it," Carrell explained. Useful parts of the ship had been salvaged before winds and currents carried it into deeper water.

    "It's rare and exciting to find a wreck of such importance that has been forgotten for so many years," said Frank Cantelas, marine archaeologist for NOAA's Office of Ocean Exploration and Research.

    The team also found the remains of the U.S. brig Chippewa, a ship built for the War of 1812 which was engaged in chasing pirates when it was lost in 1816. That vessel was identified by the unique type of cannons, called carronades, it carried.

    Indeed, the researchers said the Turks and Caicos now possesses one of the world's best collections of carronades.

    NOAA provided about $178,000 to assist the research.

    Original here