nhaliday + cardio   22

Behaving Discretely: Heuristic Thinking in the Emergency Department
I find compelling evidence of heuristic thinking in this setting: patients arriving in the emergency department just after their 40th birthday are roughly 10% more likely to be tested for and 20% more likely to be diagnosed with ischemic heart disease (IHD) than patients arriving just before this date, despite the fact that the incidence of heart disease increases smoothly with age.

Figure 1: Proportion of ED patients tested for heart attack
pdf  study  economics  behavioral-econ  field-study  biases  heuristic  error  healthcare  medicine  meta:medicine  age-generation  aging  cardio  bounded-cognition  shift  trivia  cocktail  pro-rata 
december 2017 by nhaliday
Amish Mutation Protects Against Diabetes and May Extend Life - The New York Times
What Dr. Vaughan and his colleagues discovered was striking. Amish carriers of the mutation live on average to age 85, about 10 years longer than their peers. Among the Amish who did not have the mutation, the rate of Type 2 diabetes was 7 percent. But for carriers of the mutation, the rate was zero, despite leading the same lifestyle and consuming similar diets. Tests showed that carriers of the mutation had 28 percent lower levels of insulin, a hormone whose chronic elevation can lead to Type 2 diabetes.
news  org:rec  genetics  genomics  pop-diff  recent-selection  usa  midwest  longevity  health  hetero-advantage  cardio  metabolic 
november 2017 by nhaliday
Vioxx | West Hunter
The Vigor study was submitted in February 2001. The New England Journal of Medicine, a few months later, found that the authors had failed to mention some strokes and heart attacks near the end of the trial. The authors used a cutoff for cardiovascular effects (bad news) that was earlier than the cutoff for gastrointestinal effects (good news). why? Because they were weasels, of course. There was a lot of money riding on this drug’s success.

Other people began to notice the increased heart risks – looking at data from HMOs and such. Merck fought back. There was an MD at Stanford that was concerned about Vioxx: Merck called up the dean of Stanford Medical School at home and warned him about possible loss of financial support: he told them to go fuck themselves.

...

Now it is true that there were studies that showed greater efficacy: 21 such were reported by Scott S. Reuben, former chief of acute pain at Baystate medical Center in Springfield Mass. But as it turns out, he made them all up. There’s is no evidence that Merck knew about this, but it does perhaps say something about the general climate in big pharma.

Merck knew the gist of this for four years before they pulled the plug on the drug. They had their their drug reps lie about cardio risks, threatened researchers and sued journals that talked about the emerging cardio risks. Few physicians were aware of these risks, even though a close reading of the journals would have suggested it – because hardly any physicians read the journals.

Epidemiologists think that Vioxx caused something like 40,000 deaths.

...

In the 70s corporations were the bad guys, whether they were or not. Today, billionaires are your friend.
west-hunter  scitariat  discussion  reflection  stories  history  mostly-modern  drugs  medicine  meta:medicine  rent-seeking  cardio  public-health  epidemiology  vampire-squid  corporation  madisonian  domestication  pharma  track-record  randy-ayndy  aphorism  interests 
july 2017 by nhaliday
Epidemiology, epigenetics and the ‘Gloomy Prospect’: embracing randomness in population health research and practice | International Journal of Epidemiology | Oxford Academic
Despite successes in identifying causes, it is often claimed that there are missing additional causes for even reasonably well-understood conditions such as lung cancer and coronary heart disease. Several lines of evidence suggest that largely chance events, from the biographical down to the sub-cellular, contribute an important stochastic element to disease risk that is not epidemiologically tractable at the individual level. Epigenetic influences provide a fashionable contemporary explanation for such seemingly random processes. Chance events—such as a particular lifelong smoker living unharmed to 100 years—are averaged out at the group level. As a consequence population-level differences (for example, secular trends or differences between administrative areas) can be entirely explicable by causal factors that appear to account for only a small proportion of individual-level risk. In public health terms, a modifiable cause of the large majority of cases of a disease may have been identified, with a wild goose chase continuing in an attempt to discipline the random nature of the world with respect to which particular individuals will succumb.

choice quote:
"With the perception (in my view exaggerated) that genome-wide association studies (GWASs) have failed to deliver on initial expectations,5 the next phase of enhanced risk prediction will certainly shift to ‘epigenetics’6,7—the currently fashionable response to any question to which you do not know the answer."
study  bio  medicine  genetics  genomics  sib-study  twin-study  cancer  cardio  essay  variance-components  signal-noise  random  causation  roots  gwern  explanation  methodology  🌞  biodet  QTL  correlation  epigenetics  GWAS  epidemiology  big-picture  public-health  composition-decomposition 
march 2017 by nhaliday
INFECTIOUS CAUSATION OF DISEASE: AN EVOLUTIONARY PERSPECTIVE
A New Germ Theory: https://www.theatlantic.com/magazine/archive/1999/02/a-new-germ-theory/377430/
The dictates of evolution virtually demand that the causes of some of humanity's chronic and most baffling "noninfectious" illnesses will turn out to be pathogens -- that is the radical view of a prominent evolutionary biologist

A LATE-SEPTEMBER heat wave enveloped Amherst College, and young people milled about in shorts or sleeveless summer frocks, or read books on the grass. Inside the red-brick buildings framing the leafy quadrangle students listened to lectures on Ellison and Emerson, on Paul Verlaine and the Holy Roman Empire. Few suspected that strains of the organism that causes cholera were growing nearby, in the Life Sciences Building. If they had known, they would probably not have grasped the implications. But these particular strains of cholera make Paul Ewald smile; they are strong evidence that he is on the right track. Knowing the rules of evolutionary biology, he believes, can change the course of infectious disease.

https://www.theatlantic.com/past/docs/issues/99feb/germ2.htm
I HAVE a motto," Gregory Cochran told me recently. "'Big old diseases are infectious.' If it's common, higher than one in a thousand, I get suspicious. And if it's old, if it has been around for a while, I get suspicious."

https://www.theatlantic.com/past/docs/issues/99feb/germ3.htm
pdf  study  speculation  bio  evolution  sapiens  parasites-microbiome  red-queen  disease  west-hunter  🌞  unit  nibble  len:long  biodet  EGT  wild-ideas  big-picture  epidemiology  deep-materialism  🔬  spearhead  scitariat  maxim-gun  ideas  lens  heterodox  darwinian  equilibrium  medicine  heuristic  spreading  article  psychiatry  QTL  distribution  behavioral-gen  genetics  population-genetics  missing-heritability  gender  sex  sexuality  cardio  track-record  aging  popsci  natural-experiment  japan  asia  meta:medicine  profile  ability-competence  empirical  theory-practice  data  magnitude  scale  cost-benefit  is-ought  occam  parsimony  stress  GWAS  roots  explanans  embodied  obesity  geography  canada  britain  anglo  trivia  cocktail  shift  aphorism  stylized-facts  evidence  inference 
february 2017 by nhaliday
Links 1/17: Inaugurl Address | Slate Star Codex
“Fanatics got into the Capitol building and committed a mass shooting on Congress while it was in session, and you’ve never heard of them…people have completely forgotten that in 1972 we had over nineteen hundred domestic bombings in the United States” A review of Days Of Rage and history lesson on the 1970s underground. Highly recommended.

New Yorker: The Mosul Dam in Iraq could fail soon, potentially causing a flash flood and hundreds of thousands of deaths.

An ecologist denounces calls to “drain the swamp” as an insult to swamps: “Given the sea of misinformation we currently find ourselves swimming in, I feel this is as good a time as any to clarify what swamps actually are and why they should be regarded as wonderful and valuable parts of nature rather than objects of derision and hatred.” If any of you are oceanographers, can you troll the Washington Post for me by denouncing their use of the term “sea of misinformation”?

The Seasteading Institute announces a deal with French Polynesia to build the first seastead in a lagoon there. I’m still confused on whether they’ve got funding or anything else besides the location. Still a big step.

80,000 Hours’ guide to what charities to give to this season. A good supplement to GiveWell’s Top Charities list

Vox: Why the war on poverty failed, and what to do now. In the form of a long and detailed history of Brooklyn’s Bedford-Stuyveysant neighborhood. Not clear that anyone actually knows what to do now beyond a few good common-sense suggestions.

RIP utilitarian philosopher Derek Parfit: “When I believed the non-reductionist view [of personal identity], I also cared more about my inevitable death. After my death, there will [be] no one living who will be me. I can now redescribe this fact. Though there will later be many experiences, none of these experiences will be connected to my present experiences by chains of such direct connections as those involved in experience-memory, or in the carrying out of an earlier intention. Some of these future experiences may be related to my present experiences in less direct ways. There will later be some memories about my life. And there may later be thoughts that are influenced by mine, or things done as the result of my advice. My death will break the more direct relations between my present experiences and future experiences, but it will not break various other relations. This is all there is to the fact that there will be no one living who will be me. Now that I have seen this, my death seems to me less bad.”

Alex K. Chen on Quora on the speculation that Ritalin may be long-term safer than Adderall. See also this review article. This is definitely not yet psychiatric common knowledge or consensus.

Meta-analysis in the American Journal Of Nutrition: Red meat does not increase risk of cardiovascular disease.

Acemoglu and Restropo: Economic stagnation is not due to aging populations.

User dogtasteslikechicken at the r/slatestarcodex subreddit gives a good summary of the Flynn Effect. But it looks like he is confused about some of the same things I am. For example, rich people and the nobility probably had good nutrition and education in the past. So we might expect a Flynn effect based on nutrition and education not to affect them as much. But if this were true, we would expect a skewed or bimodal distribution in the past (un-Flynned poor people with bad nutrition + Flynned rich people with good nutrition), which I don’t think ever clearly showed up.

Some fallout from the Buzzfeed story on growth mindset I linked last week. The Spectator published what I think is a really nasty and evidence-free denunciation of the phenomenon. Mindset researcher David Yeager has tried to set the record straight and argues that growth mindset actually replicates just fine, eg in this paper, and that several other large and rigorous replications are being attempted. Dweck herself has a reply up here. And Timothy Bates put his failed replications online here. Looks like it will be an interesting year in this field.

Does pupil size correlate with intelligence? (blog post, paper)
ratty  yvain  ssc  links  politics  terrorism  history  left-wing  risk  trump  lol  randy-ayndy  thiel  announcement  effective-altruism  charity  checklists  news  org:data  class  inequality  philosophy  death  profile  dennett  drugs  nootropics  attention  safety  neuro  study  meta-analysis  cardio  nutrition  food  acemoglu  economics  growth-econ  stagnation  demographics  contrarianism  trends  reddit  social  discussion  iq  growth  psychology  social-psych  albion  critique  replication  org:lite  iraq-syria  MENA  biodet  commentary  multi  current-events  growth-mindset 
january 2017 by nhaliday
PLOS ONE: Moderate Alcohol Use and Cardiovascular Disease from Mendelian Randomization
Low to moderate alcohol use among men had the expected effects on most CVD risk factors but not fasting glucose. Larger studies are needed to confirm the null associations with IHD, CVD and fasting glucose.
study  methodology  longevity  health  ethanol  cardio  cocktail  habit  long-term  epidemiology  intervention  endo-exo  null-result  public-health  mendel-randomization  endogenous-exogenous 
september 2016 by nhaliday
Physical activity in adulthood: genes and mortality : Scientific Reports
Observational studies report a strong inverse relationship between leisure-time physical activity and all-cause mortality. Despite suggestive evidence from population-based associations, scientists have not been able to show a beneficial effect of physical activity on the risk of death in controlled intervention studies among individuals who have been healthy at baseline. On the other hand, high cardiorespiratory fitness is known to be a strong predictor of reduced mortality, even more robust than physical activity level itself. Here, in both animals and/or human twins, we show that the same genetic factors influence physical activity levels, cardiorespiratory fitness, and risk of death. Previous observational follow-up studies in humans suggest that increasing fitness through physical activity levels could prolong life; however, our controlled interventional study with laboratory rats bred for low and high intrinsic fitness contrast with these findings. Also, we find no evidence for the suggested association using pairwise analysis among monozygotic twin pairs who are discordant in their physical activity levels. Based on both our animal and human findings, we propose that genetic pleiotropy might partly explain the frequently observed associations between high baseline physical activity and later reduced mortality in humans.

https://www.reddit.com/r/slatestarcodex/comments/52xt13/physical_activity_in_adulthood_genes_and_mortality/
study  longevity  aging  genetics  fitness  idk  fitsci  variance-components  genetic-correlation  twin-study  evidence-based  🌞  org:nat  environmental-effects  c:**  biodet  intervention  cardio  hmm  null-result  human-study  model-organism  solid-study  multi  reddit  social  commentary  ssc  gwern  ratty 
september 2016 by nhaliday
Intermittent Fasting - Gwern.net
Our intuitive mental models are Aristotelian - strength or health are intrinsic qualities which can be developed by certain actions. But the reality is that exercise offers no intrinsic benefit to the body, no more than driving 10,000 miles in a car makes it more fuel-efficient or its tires more robust. Things wear down, in cars and cells. So why is exercise recommended? Because of the biological response to the damage caused by the exercise. Chemical pathways are activated, secretions unleashed, formerly silenced genes suddenly start expressing themselves, and things happen. Chemical cascades can be modified or interrupted by other chemicals, of course. We see proof of this in startling studies, like the consumption of antioxidants destroying the health benefits of exercise; why do antioxidants do that? Because the damage caused by exercise takes, in part, the form of oxidants, and the oxidants trigger some of those chemical pathways; the antioxidants neutralize & eliminate the oxidants, and so those pathways are muted or suppressed.

So much for exercise. Something similar is theorized about the much ballyhooed caloric restriction. It is not the number of calories that has any intrinsic meaning, which finesses any law of physics to enable greater longevity - it is the body’s reactions to the restriction that matters, the changing levels of sirtuin proteins. (Why would evolution not make this reaction the default reaction and would permit the organism to die before it absolutely had to? There are a number of models where aging helps genetic fitness, actually; just another reminder that Nature does not have our best interests at heart.) Presumably some of the pathways could be directly controlled by injecting additional enzymes even as calorie consumption remains intact, and for that reason a number of biotech/pharmacorps have been interested in the sirtuins and other chemicals linked to caloric restriction. All that matters is that the pathways get triggered. A little like a computer - it doesn’t care what a command or file means, it just cares whether the input satisfies whatever entirely arbitrary (from its point of view) criteria the computer holds at that moment.
longevity  health  food  analysis  gwern  aging  ratty  cardio  c:**  nutrition  fitsci  faq  diet  metabolic  chart  guide 
july 2016 by nhaliday

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