Association of Stress-Related Disorders With Subsequent Autoimmune Disease | JAMA | JAMA Network
> Findings  In this Swedish register-based retrospective cohort study that included 106 464 patients with stress-related disorders, 1 064 640 matched unexposed individuals, and 126 652 full siblings, exposure to a clinical diagnosis of stress-related disorders was significantly associated with an increased risk of autoimmune disease (incidence rate was 9.1 per 1000 person-years in exposed patients compared with 6.0 and 6.5 per 1000 person-years in matched unexposed individuals and siblings, respectively).

Meaning  Stress-related disorders were significantly associated with risk of subsequent autoimmune disease.
immunology  psychiatry  autoimmune 
26 minutes ago
Mal de debarquement - Wikipedia
> Mal de debarquement (or mal de débarquement) syndrome (MdDS, or common name disembarkment syndrome) is a neurological condition usually occurring after a cruise, aircraft flight, or other sustained motion event. The phrase "mal de débarquement" is French and translates to "illness of disembarkation". MdDS is typically diagnosed by a neurologist or an ear nose & throat specialist when a person reports a persistent rocking, swaying, or bobbing feeling (though they are not necessarily rocking). This usually follows a cruise or other motion experience. Because most vestibular testing proves to be negative, doctors may be baffled as they attempt to diagnose the syndrome. A major diagnostic indicator is that most patients feel better while driving or riding in a car, i.e.: while in passive motion. MdDS is unexplained by structural brain or inner ear pathology and most often corresponds with a motion trigger, although it can occur spontaneously. This differs from the very common condition of "land sickness" that most people feel for a short time after a motion event such as a boat cruise, aircraft ride, or even a treadmill routine which may only last minutes to a few hours. The syndrome has recently received increased attention due to the number of people presenting with the condition and more scientific research has commenced to determine what trigg
boat  neurology  psychiatry  dizziness 
6 hours ago
Impeachment of Bill Clinton - Wikipedia
A much-quoted statement from Clinton's grand jury testimony showed him questioning the precise use of the word "is". Contending that his statement that "there's nothing going on between us" had been truthful because he had no ongoing relationship with Lewinsky at the time he was questioned, Clinton said, "It depends upon what the meaning of the word 'is' is. If the—if he—if 'is' means is and never has been, that is not—that is one thing. If it means there is none, that was a completely true statement"
vocab  presidency  law 
16 hours ago
WE_Coyote73 comments on Lawsuit: School officials forced 12-year-old who killed herself to hug bullies
> Up until the early 90's it was relatively easy for school administrators to deal with bullies by means of suspensions and expulsion for continual behavior. Then the lawyers started getting involved and started suing school districts and principals. They argued, among other things, that even violent students still had a right to an education and that out-of-school suspension/expulsion deprived them of that right. They also argued that because they are public school students the rights to procedural due process applied to them. The courts agreed with these and other arguments. The result was that it became exponentially more difficult to suspend/expel a student. For instance, in most cases it can take up to a year or more to expel a student from an individual campus due to the various procedures and hearings that have to be held in order to comply with the right to procedural due process and if the district loses the case they are on the hook not only for their legal expenses but also the expenses of the student.
education  US  2018  school  lawfare  law 
Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians | The BMJ
> The increased incidence of cancer after CT scan exposure in this cohort was mostly due to irradiation. Because the cancer excess was still continuing at the end of follow-up, the eventual lifetime risk from CT scans cannot yet be determined. Radiation doses from contemporary CT scans are likely to be lower than those in 1985-2005, but some increase in cancer risk is still likely from current scans. Future CT scans should be limited to situations where there is a definite clinical indication, with every scan optimised to provide a diagnostic CT image at the lowest possible radiation dose.
abdominal_pain  CT 
2 days ago
Water intoxication - Wikipedia
> Water intoxication, also known as water poisoning, hyperhydration, or water toxemia is a potentially fatal disturbance in brain functions that results when the normal balance of electrolytes in the body is pushed outside safe limits by overhydration (excessive water intake).

Under normal circumstances, accidentally consuming too much water is exceptionally rare. Nearly all deaths related to water intoxication in normal individuals have resulted either from water-drinking contests, in which individuals attempt to consume large amounts of water, or from long bouts of exercise during which excessive amounts of fluid were consumed.[1]
medicine  toxicology 
2 days ago
Chills - Wikipedia
> Chills is a feeling of coldness occurring during a high fever, but sometimes is also a common symptom which occurs alone in specific people. It occurs during fever due to the release of cytokines and prostaglandins as part of the inflammatory response, which increases the set point for body temperature in the hypothalamus. The increased set point causes the body temperature to rise (pyrexia), but also makes the patient feel cold or chills until the new set point is reached. Shivering also occurs along with chills because the patient's body produces heat during muscle contraction in a physiological attempt to increase body temperature to the new set point. When it does not accompany a high fever, it is normally a light chill. Sometimes a chill of medium power and short duration may occur during a scare, especially in scares of fear, commonly interpreted like or confused by trembling. Severe chills with violent shivering are called rigors.
chills  illness  medicine 
3 days ago
Pathogenesis: A New Deck-Building Game | JAMA | JAMA Network
> In Pathogenesis, a deck-building game released in 2017, players assemble microbial pathogens and add virulence factors and microbial defense mechanisms through play to attack human body barrier defenses in tissue, respiratory, and gastrointestinal tracts. As the attacks proceed and players breach the barrier defenses, the body fights back using adaptive and innate immune responses like inflammation, complement, and T cells represented in cards that players also accumulate. Players win when they defeat the tracts’ immune responses (pathogen, virulence, and microbial defense cards overwhelm barrier defense and immune cards) and lose if game play takes too long and physiologic immunity develops.
games  medicine  microbiology 
3 days ago
LGBT rights in Pakistan - Wikipedia
> Under the Transgender Person (Protection of Rights) Act 2018, Pakistanis may choose to self-identify as male, female, both or neither. They may express their gender according to their own preferences, and they may have their gender identity of choice reflected on their documents, "including National Identification Cards, passports, driver's licenses and education certificates."[23]

The act defines "transgender person" as someone with a "mixture of male and female genital features or congenital ambiguities," or, a male who "undergoes genital excision or castration," or, more broadly, "any person whose gender identity and/or gender expression differs from the social norms and cultural expectations based on the sex they were assigned at the time of their birth," which allows people to self-identify as such. They are guaranteed the right to inherit assets and to run for public office.

Discrimination based on gender identity in employment and public accommodations is forbidden under the new law. The Government is assigned broad obligations to provide medical and psychological assistance, small business loans and vocational training, sensitivity training for police and helping professionals, separate prison facilities, and safe houses.
pakistan  LGBT  gay_rights  transgender 
4 days ago
Four Great Inventions - Wikipedia
> The Four Great Inventions (simplified Chinese: 四大发明; traditional Chinese: 四大發明) are inventions from ancient China that are celebrated in Chinese culture for their historical significance and as symbols of ancient China's advanced science and technology.[1]

The Four Great Inventions are:

china  invention  history 
5 days ago
Prefrontal cortex as a meta-reinforcement learning system | Nature Neuroscience
Hypothesis: > the dopamine system trains another part of the brain, the prefrontal cortex, to operate as its own free-standing learning system. This new perspective accommodates the findings that motivated the standard model, but also deals gracefully with a wider range of observations, providing a fresh foundation for future research
PFC  neuroscience  meta_learning  dopamine 
5 days ago
England used to have free colleges, then they got rid of them in the late 1990s because they found that they were actually hurting equality, and because the quality of the schools was going down.
UK  history  college  education  economics 
5 days ago
Genetic Attributions: Sign of Intolerance or Acceptance? | The Journal of Politics: Ahead of Print
> Many scholars argue that people who attribute human characteristics to genetic causes also tend to hold politically and socially problematic attitudes. More specifically, public acceptance of genetic influences is believed to be associated with intolerance, prejudice, and the legitimation of social inequities and laissez-faire policies. We test these expectations with original data from two nationally representative samples that allow us to identify the American public’s attributional patterns across 18 diverse traits. Key findings are (1) genetic attributions are actually more likely to be made by liberals, not conservatives; (2) genetic attributions are associated with higher, not lower, levels of tolerance of vulnerable individuals; and (3) genetic attributions do not correlate with unseemly racial attitudes.
genetics  politics  inequality 
5 days ago
Life-events-on-happiness.png (3000×2100)
Really interesting, shows that people's lives tend to get subjectively worse birth of child and better after a divorce (for a few years).
happiness  death  children  marriage 
5 days ago
China's mass indoctrination camps evoke Cultural Revolution
> Hour upon hour, day upon day, Omir Bekali and other detainees in far western China’s new indoctrination camps had to disavow their Islamic beliefs, criticize themselves and their loved ones and give thanks to the ruling Communist Party.

When Bekali, a Kazakh Muslim, refused to follow orders each day, he was forced to stand at a wall for five hours at a time. A week later, he was sent to solitary confinement, where he was deprived of food for 24 hours. After 20 days in the heavily guarded camp, he wanted to kill himself.
china  propaganda  2018  nationalism  islam 
5 days ago
Laws of Tech: Commoditize Your Complement - Gwern.net
> Joel Spolsky in 2002 identified a major pattern in technology business & economics: the pattern of commoditizing your complement, an alternative to vertical integration, where companies seek to secure a chokepoint or quasi-monopoly in products composed of many necessary & sufficient layers by dominating one layer while fostering so much competition in another layer above or below its layer that no competing monopolist can emerge, prices are driven down to marginal costs elsewhere in the stack, total price drops & increases demand, and the majority of the consumer surplus of the final product can be diverted to the quasi-monopolist. A classic example is the commodification of PC hardware by the Microsoft OS monopoly, to the detriment of IBM & benefit of MS. This pattern explains many otherwise odd or apparently self-sabotaging ventures by large tech companies into apparently irrelevant fields, such as the high rate of releasing open-source contributions by many Internet companies or the intrusion of advertising companies into smartphone manufacturing & web browser development & statistical software & fiber-optic networks & municipal WiFi & radio spectrum auctions & DNS (Google): they are pre-emptive attempts to commodify another company elsewhere in the stack, or defenses against it being done to them
economics  business  internet  gwern 
5 days ago
Born to Lead? The Effect of Birth Order on Noncognitive Abilities | The Review of Economics and Statistics | MIT Press Journals
> We study the effect of birth order on personality using Swedish population data. Earlier-born men are more emotionally stable, persistent, socially outgoing, willing to assume responsibility, and able to take initiative than later borns. Firstborn children aremore likely to bemanagers and to be in occupations requiring leadership ability, social ability, and Big Five personality traits.We find a significant role for the sex composition within the family. When investigating possible mechanisms, we find that negative effects of birth order are driven by postnatal environmental factors. We also find evidence of lower parental human capital investments in later-born children.
birth_order  children  personality  parenting 
5 days ago
Fraud - FindLaw
> While the exact wording of fraud charges varies among state and federal laws. the essential elements needed to prove a fraud claim in general include: (1) a misrepresentation of a material fact; (2) by a person or entity who knows or believes it to be false; (3) to a person or entity who justifiably relies on the misrepresentation; and (4) actual injury or loss resulting from his or her reliance.
fraud  law 
6 days ago
Theranos Founder and Former Chief Operating Officer Charged In Alleged Wire Fraud Schemes | USAO-NDCA | Department of Justice
> The indictment alleges Holmes and Balwani defrauded doctors and patients by making false claims concerning Theranos’s ability to provide accurate, fast, reliable, and cheap blood tests and test results, and through omissions concerning the limits of and problems with Theranos’s technologies.  The defendants knew Theranos was not capable of consistently producing accurate and reliable results for certain blood tests, including the tests for calcium, chloride, potassium, bicarbonate, HIV, Hba1C, hCG, and sodium.  The defendants nevertheless used interstate electronic wires to purchase advertisements intended to induce individuals to purchase Theranos blood tests at Walgreens stores in California and Arizona.  Through these advertisements, the defendants explicitly represented to individuals that Theranos’s blood tests were cheaper than blood tests from conventional laboratories to induce individuals to purchase Theranos’s blood tests. 
fraud  2018  law  theranos  lies  pathology 
6 days ago
Transgender Population Size in the United States: a Meta-Regression of Population-Based Probability Samples
> Extrapolating these results to 2016 suggested a current US population size of 390 adults per 100 000, or almost 1 million adults nationally. This estimate may be more indicative for younger adults, who represented more than 50% of the respondents in our analysis.
LGBT  transgender 
7 days ago
Alcohol and breast cancer risk: What to know | MD Anderson Cancer Center
> So, why does alcohol intake increase breast cancer risk specifically?

“We don’t really know, but we do have a few guesses,” Bevers says.

Reasons why alcohol consumption may lead to breast cancer include:

Alcohol is empty calories and can lead to unwanted weight gain. Excess fat can lead to increased cancer risk.
Alcohol can increase levels of estrogen and other hormones associated with breast cancer.
Alcohol users are more likely to have increased amounts of folic acid in their systems, which can lead to increased cancer risk.
alcohol  estrogen  breast_cancer 
7 days ago
Is socialism to blame for the crisis in Venezuela? Why or why not? : NeutralPolitics
> I would argue that framed this way, yes, socialism was a necessary component of the economic failure in Venezuela. If socialism were not instituted, the economy might still have failed due to corruption, but the type of failure would have been so different that it would be wholly unlike what is happening there now, and we wouldn't be able to predict exactly what it would look like. Maybe something like Russia or China where corrupt officials loot a nominally free market system at will, but theres no way to know for sure.

The reason I say this is that the total lack of production by factories and collapse of the economy could not have happened in a laissez faire capitalist system. In a free market, shortages of goods would cause prices to rise. Rising prices increases incentive for importers to bring more goods into the country and for manufacturers to produce more or produce substitute goods. Those same factories now have an incentive to hire more workers and consume more labor in order to meet the rising demand. While many might not be able to afford the goods at raised prices, the economy would at least continue to function. Stores would be stocked with goods, even if the prices were not affordable to some citizens.
politics  2018  venezuela  socialism  government  capitalism  economics 
7 days ago
History of coffee - Wikipedia
> The earliest substantiated evidence of either coffee drinking or knowledge of the coffee tree is from the 15th century, in the Sufi monasteries of Yemen.[1] By the 16th century, it had reached the rest of the Middle East, South India (Coorg), Persia, Turkey, Horn of Africa, and northern Africa. Coffee then spread to the Balkans, Italy and to the rest of Europe, to South East Asia and then to America
yemen  coffee  history  food 
7 days ago
Immune recognition of somatic mutations leading to complete durable regression in metastatic breast cancer | Nature Medicine
> In total, 11 TCR clonotypes recognized the four neoantigens
(SLC3A2, KIAA0368, CADPS2 and CTSB) for patient 4136. Only
two TCRs, both of which recognized mutSLC3A2 (TRBV7-9–
TRAV26-2 (TCR D) and TRBV19–TRAV9-2 (TCR H)) were detectable
in peripheral blood prior to treatment (0.003% and 0.002% of
all TRBV sequences, respectively). Following the cell infusion, we
evaluated the in vivo persistence of known neoantigen-reactive
TCRs in the peripheral blood. The median cumulative frequency
during weeks 3–12 was 2.83% of the peripheral repertoire, and the
known reactive clonotypes comprised 0.81% of the post-infusion
repertoire at 17 months after infusion (Fig. 4a). Eight of the 11 neoantigen-reactive
TCRs persisted in the patient’s peripheral blood at
least 17 months after treatment (Fig. 4b). In addition, the dominant
clonotypes that were identified 6 weeks after transfer persisted.
To better understand the heterogeneity of the nonsynonymous
mutations within the patient’s tumor, a clonality analysis was performed
on the resected tumor DNA. This analysis revealed that
20/62 (32%) mutations were clonal, 37/62 (60%) were subclonal,
and 5 (8%) mutations could not be determined. MutSLC3A2 and
mutCADPS2 were clonal (cancer cell fraction (CCF): 0.999, each),
whereas, mutCTSB and mutKIAA0368 seemed to be subclonal
(CCF: 0.669 and 0.489, respectively) (Fig. 4c).
car_t  immunotherapy  cancer  2018 
9 days ago
91 years later: Michigan's Bath School disaster remains...
> In 1927, the town of about 300 people was the victim of a gruesome attack at its school. The attack was executed by a former school board member, Andrew Kehoe, who was seeking revenge for losing an election. His rampage killed 45 and injured 58.
history  crime 
9 days ago
'I have definitely hit the jackpot.' Advanced breast cancer disappears after new immunotherapy
> In the all-hands effort to harness the powers of the immune system to fight cancer, scientists have reported a new approach that eliminated all evidence of advanced-stage breast cancer in a 49-year-old woman who had run out of treatment options.

The patient’s “complete durable cancer regression” followed a single infusion of her own immune cells, which were painstakingly chosen for their ability to recognize and fight her tumors — then expanded into an army of 82 billion identical cells.
cancer  car_t  immunotherapy 
12 days ago
Buy Lab Tests Online | Private MD Labs
These site are very much a thing > Avoid the hassle of setting an appointment, or spending the day in your doctor’s waiting room, by having one of our Representatives provide the lab tests and results you require to diagnose serious medical conditions and guide life-saving therapies. Our convenient, state-of-the-art lab testing services are both confidential and affordable.
labs  internet  hormones 
12 days ago
An oncologist who was diagnosed with breast cancer: "Cancer didn’t feel like a fight to me and I won’t be asking my patients to go into battle in future." : cancer
> I tell people all the time that it’s not a “fight”: it’s a bear attack. And you hope that the bear gets bored before it kills you, or maybe someone nearby has a shotgun.

> Pretty much this. My doctors and the cancer are the ones battleing, my body is the battlefield and I just show up.
cancer  analogy  medicine 
14 days ago
Sucking carbon dioxide from air is cheaper than scientists thought
> Assuming that CO2 is buried to offset vehicles’ emissions of the gas, a price of $100 per tonne would add about $0.22 cents to the price of a litre of fuel, Lackner says. That’s a substantial but not unprecedented price increase, he adds.

In the end, the economics of CO2 extraction will depend on factors that vary by location, including the price of energy and whether or not a company can access government subsidies. But the cost per tonne is still likely to remain above the market price of carbon for the foreseeable future. Carbon credits in the European Union's trading system are trading for around €16 (US$19) per tonne of CO2, for instance. But CO2-extraction technology could gain a foothold in markets where the CO2 can be sold at a premium, or converted into a useful product like fuel.
climate_change  CO2_capture  2018 
15 days ago
Bruno de Finetti - Wikipedia
> De Finetti emphasized a predictive inference approach to statistics; he proposed a thought experiment along the following lines (described in greater detail at coherence (philosophical gambling strategy)): You must set the price of a promise to pay $1 if there was life on Mars 1 billion years ago, and $0 if there was not, and tomorrow the answer will be revealed. You know that your opponent will be able to choose either to buy such a promise from you at the price you have set, or require you to buy such a promise from your opponent, still at the same price. In other words: you set the odds, but your opponent decides which side of the bet will be yours. The price you set is the "operational subjective probability" that you assign to the proposition on which you are betting. This price has to obey the probability axioms if you are not to face certain loss, as you would if you set a price above $1 (or a negative price). By considering bets on more than one event de Finetti could justify additivity. Prices, or equivalently odds, that do not expose you to certain loss through a Dutch book are called coherent.
probability  betting 
16 days ago
Problem of why there is anything at all - Wikipedia
I always trip out a little bit when I try to think about this. > David Hume argued that, whilst we expect everything to have a cause because of our experience of the necessity of causes, a cause may not be necessary in the case of the formation of the universe, which is outside our experience.[28]
causation  universe  life  philosophy 
17 days ago
Kanye West Reveals He Was Diagnosed with Mental Condition at 39 | PEOPLE.com
> After clarifying that he was diagnosed with a “mental condition,” West added, “But like I said on the album, it’s not a disability, it’s a superpower.”

Although the musician declined to specify what he had been diagnosed with during the interview, West had already confirmed on his new album that he is bipolar, calling it his “superpower.”

Additionally, the album’s artwork — which West shot on the way to the listening party — features an image of the mountains with a lime green text overlay reading, “I hate being bipolar it’s awesome.”
kanye  celebrities  mental_illness  bipolar  art 
18 days ago
Beyond Legalization — Dilemmas Physicians Confront Regarding Aid in Dying | NEJM
> Second, physicians who lack experience with PAD might have difficulty determining which medications to prescribe to eligible patients. Evidence in this area is weak. There are no peer-reviewed publications on the effectiveness and proper dosages of new drug combinations being used for PAD or on the adverse effects associated with them. Barbiturates — which have traditionally been used for PAD in places where it’s legal — have become difficult to obtain or prohibitively expensive. Inexperienced physicians could try to identify a trusted colleague who is more experienced with PAD and willing to answer questions, provide advice, or comanage care for eligible patients. If such expertise is unavailable, physicians willing to participate in PAD need to contend with being early adopters.

Third, physicians who support PAD need to consider how to address the potential for adverse outcomes, including longer time to death than expected (up to 24 hours or more), awakening from unconsciousness, nausea, vomiting, and gasping.1 Reports of adverse outcomes don’t include specific information on drugs and dosages used, and how a drug will affect a particular patient is always uncertain.
PAD  euthanasia  2018 
19 days ago
Press Announcements > Statement from FDA Commissioner Scott Gottlieb, M.D., on the signing of the Right to Try Act
> This new law amends the Federal Food, Drug, and Cosmetic Act to establish a new pathway aimed at increasing access to unapproved, investigational treatments for patients diagnosed with life-threatening diseases or conditions who have exhausted approved treatment options and who are unable to participate in a clinical trial. Our implementation of the Right to Try Act will build on our long-standing efforts to help patients and families who are facing life-threatening diseases or conditions, in a way that seeks to protect their autonomy, their safety, and the safety of others following in their paths.
FDA  2018 
19 days ago
Is obstructive sleep apnea associated with ADHD? - PubMed - NCBI
> Attentional deficits have been reported in up to 95% of OSA patients. In full syndromal ADHD, a high incidence (20% to 30%) of OSA has been shown. All 6 interventional studies reported improvements in behavior, inattention, and overall ADHD after treatment of OSA.
ADHD  OSA  sleep  psychiatry 
19 days ago
Dementia And Physical Activity (DAPA) trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial | The BMJ
> A moderate to high intensity aerobic and strength exercise training programme does not slow cognitive impairment in people with mild to moderate dementia. The exercise training programme improved physical fitness, but there were no noticeable improvements in other clinical outcomes.
alzheimers  exercise 
19 days ago
As Uber and Tesla struggle with driverless cars, Waymo moves forward | Ars Technica
> Fleet Response Specialists possess valid driver’s licenses and are responsible for monitoring the status of all Waymo vehicles in real-time using a virtual tool. A separate Rider Support team provides customer support and is available to communicate with passengers at any point. Waymo specified that it had trained 70 Fleet Response Specialists and 23 Rider Support team members—suggesting that when a service does roll out, it will be on quite a significant scale.

So Waymo's recently announced car deals—20,000 cars from Jaguar Land Rover, another 62,000 from Fiat Chrysler—are just the latest sign that Waymo is assembling all the pieces it will need for a full-scale commercial taxi service in the Phoenix area and likely other places not long after that.

It would be foolish for Waymo to invest so heavily in all this infrastructure if its technology were still years away from being ready for commercial deployment. Those 23 rider support workers need customers to talk to. And, of course, Waymo needs to get those 82,000 Jaguar and Chrysler vehicles on the road to avoid losing millions of dollars on the investment.
self_driving  car  google  2018  waymo 
20 days ago
Cryopreservation: the field of possibilities
> In this country, the law is not clear on cryopreservation, neither authorising nor prohibiting it. Therefore, can a French citizen be cryogenised despite this legislative uncertainty? That is the question put to the government by the French senator Jean-Louis Masson in 2006. The answer was unambiguous: only burial and cremation are legal, so cryopreservation is prohibited. Therefore, despite the recognition of the freedom of funerals by an 1887 French law and the obligation to respect the deceased’s choices regarding his funeral provided by Article 433-21-1 of the French Penal Code, cryopreservation seems impossible to implement in France in the current state of the law.
burial  france  law  2018  cryonics 
21 days ago
A primer on fentanyl(s)
> For law enforcement, the parcel-post approach makes a hard problem nearly impossible. The volume of legitimate parcel post from China to the U.S. means that there’s no way to scan every package, or even a high enough fraction to make the traffic uneconomic. As more and more potent molecules appear, I’d expect another shift, from parcel post to regular international mail, moving the drugs in quantities of a gram or less, either just putting a tiny Baggie with the powder inside in the envelope, or perhaps dissolving the drug, soaking a sheet of ordinary paper in the solution, typing a letter on the paper, mailing it, and then extracting the drug at the other end of the process. So that’s why the fentanyls are a big factor now when they weren’t before. And I don’t see a snowball’s chance in Hell of stopping the flow. It’s possible that, with adequate urging from the U.S., the Chinese authorities might succeed in cracking down on illicit manufacture and sale. But there’s nothing magical about China. India also has skilled chemists and a huge flow of mail to the U.S. So, for that matter, does Canada. And so does the U.S.; if international sources dry up, the stuff will, once again, be made here.
opioid  2018  fentanyl  internet  mail 
21 days ago
Sustaining Health-Protective Behaviors Such as Physical Activity and Healthy Eating | Cardiology | JAMA | JAMA Network
> Furthermore, the 2015-2020 Dietary Guidelines for Americans recommends that adults should fill half their plate with fruits and vegetables at every meal and snacking occasion.2 ... Sustaining health-protective behaviors, such as physical activity and healthy eating over time, may be challenging due to daily and within-daily fluctuations in how people feel, persons with whom they interact, obstacles they encounter, and the environments in which they live and work. When the factors that influence health-protective behaviors vary over short time periods and across settings, maintaining consistency can be difficult. Strategies to promote long-term engagement in health-protective behaviors may be informed by understanding the microtemporal processes underlying these actions
behavior  medicine  psychiatry  weight 
22 days ago
Urban Dictionary: ethered
> Any situation where you think somebody won a battle, where it is open to discussion. But usually is only used when there is a clear cut winner.
22 days ago
P53 and Me | NEJM
> A mutation like mine threatens to consume your whole imagination, especially with regard to the future. You start making crazy calculations, guessing the likelihood of being around for this or that event. Your own graduation. Your own wedding. “What’s the 5-year survival for that breast cancer, again? But then there’s my other breast cancer. The lung should be cured. What if something new comes along?”

If I weren’t a physician constantly surrounded by other physicians, I’m sure it would be much harder to shoulder this knowledge. When a suspicious black spot sprang up on my palm, I could get a dermatologist to look at it within days and tell me I was right to be concerned. I had it excised within the week and heard by email that it was a benign mole. I’ve also been fortunate to have the help of an amazing psychiatrist and an amazing social worker, without whom I would not be able to manage.
genetics  p53  cancer  psychiatry  uncertainty 
23 days ago
Genetics, IQ, and ‘race’ – are genetic differences in intelligence between populations likely?
> Whether you buy any of the arguments I have made here with regard to the genetics of intelligence, the idea that such pressures would align with continental divisions remains inherently implausible in itself, to my mind. These pressures would have to be consistent across entire continents, each comprising hugely diverse environments, but different across different continents, and also sustained over thousands of years, in order to end up with stable differences between ‘races’. (That is without even going into details of the arbitrariness of such divisions, as discussed here or the environmental and cultural factors which are known to affect intelligence and IQ scores and which clearly do differ in systematic ways between the relevant population groups).
kevin_mitchell  race  IQ  genetics  evolution  history 
25 days ago
Home-Based Exercise Program Is Ineffective in Patients with Peripheral Artery Disease
> Two hundred PAD patients (mean age, 70) were randomized to a home-based exercise program or usual care. The intervention group received four weekly in-person coaching sessions during the first month, wearable activity monitors that provided activity data to a coach, and periodic phone calls from the coach for the remaining 8 months of the trial. Usual-care participants received no interventions. Both groups were contacted by telephone periodically to collect information on adverse events and physical activity.

At baseline, mean 6-minute walk distance was 330 m in both groups. At 9 months, mean walk distance did not change substantially in either group. More adverse events were reported in the intervention group, but none resulted in study termination.
wearable  fitness  RCT 
25 days ago
Evolution of “Nightmare Bacteria” | Infectious Diseases | JAMA | JAMA Network
> Between 2006 and 2015, the percentage of bacterial infections caused by Enterobacteriaceae nonsusceptible to extended-spectrum cephalosporins (ESBL phenotype) decreased 2% a year, while the percentage caused by carbapenem-resistant Enterobacteriaceae (CRE) decreased 15% per year, according to a recent CDC report.
antibiotics  MDR 
25 days ago
Oxybutynin for Hot Flashes Due to Androgen Deprivation in Men | NEJM
> After 2 weeks, he had abrupt onset of nightly drenching hot flashes that occurred every 20 to 30 minutes beginning at 2:30 a.m. The hot flashes were bothersome and intrusive and prevented sleep. The addition of extended-release venlafaxine (75 mg) did not help, nor did increasing the dose of gabapentin to 900 mg at night and 1500 mg a day in total. After more than 21 days of treatment with combined venlafaxine–gabapentin without benefit, oxybutynin (5 mg twice a day) provided relief from the sweating within 2 hours and allowed the patient to sleep through the night. He continued taking the oxybutynin (1.25 to 2.5 mg twice a day) for 40 days and had only transient hourly body warmth, which was far less intrusive than the hot flashes. He tapered and stopped the gabapentin and venlafaxine without a change in the control of his hot flashes. When he stopped taking oxybutynin because of insomnia, dry mouth, and the restless legs syndrome, the hot flashes returned; he restarted treatment with oxybutynin at 2.5 mg twice a day, and relief occurred within hours. The insomnia was managed with intermittent zolpidem treatment.
hot_flashes  menopause  gender  prostate  oxybutynin 
25 days ago
The GMC pursued Hadiza Bawa-Garba – and is losing doctors' respect | Healthcare Professionals Network | The Guardian
> Subsequently, Bawa-Garba and two nurses, sister Theresa Taylor and agency nurse Isabel Amaro, were charged with gross negligence manslaughter in December 2014. Taylor was acquitted; Bawa-Garba and Amaro were convicted the following November and given two-year suspended sentences.

The GMC’s own tribunal found Bawa-Garba to be at fault, recommended a 12-month suspended sentence, but did not suggest terminating her licence to practise as a doctor. However, in an unprecedented move, the GMC took her to the high court, where it was ruled this January that the appropriate sentence was , rather than suspension.

A matter that has become critical to the medical community is the extent to which her reflections were used against her.

This judgment has set medical training back decades. A trainee has been pursued without appreciation of the complexity doctors and nurses contend with in a , where there are serious problems with managing rotas, filling jobs, and coping with rising demand.
NHS  malpractice  law  medicine  2018  UK 
28 days ago
What are some things that are important to know about that few people know about? : slatestarcodex
> Dead hanging was originally promoted as a cure for impingement by John Kirsch, a shoulder surgeon. Since then, it's mostly spread by word of mouth. Kirsch claims to have presented a study at this symposium, but there's no archive of abstracts or presentations that I can find. It's not in PubMed, so I assume it wasn't peer-reviewed. To the best of my knowledge, there's been no follow-up study.

All of which smells like bullshit, I know, but...I had a debilitating rotator cuff injury for over a year, and a shoulder specialist told me that I just had to live with it because it's a normal part of aging (mid 30s :( ). I tried all the usual rehab exercises. Cable rotations, face pulls, arm pendulums, YTLW -- nothing helped, and some of them seemed to make it worse.

Within six weeks of hanging for ~90 seconds per day, it was practically good as new. I was able to military press pain-free for the first time in over a year, and do dips pain-free for the first time in ten years.
exercise  shoulder  impingement 
4 weeks ago
Oral vitamin B12: a cost-effective alternative | The College of Family Physicians of Canada
Oral B12 is just as good as intramuscular and review of data showing it is as good as sublingual.
B12  vitamins 
4 weeks ago
Negative income tax - Wikipedia
> In a negative income tax system, people earning a certain income level would owe no taxes; those earning more than that would pay a proportion of their income above that level; and those below that level would receive a payment of a proportion of their shortfall, which is the amount their income falls below that level.[7]
4 weeks ago
Short-Term, Intermittent Fasting Induces Long-Lasting Gut Health and TOR-Independent Lifespan Extension: Current Biology
> Pharmacological and genetic epistasis analysis showed that IF acted independently of the TOR pathway because rapamycin and IF acted additively to extend lifespan, and global expression of a constitutively active S6K did not attenuate the IF-induced lifespan extension. We conclude that short-term IF during early life can induce long-lasting beneficial effects, with robust increase in lifespan in a TOR-independent manner, probably at least in part by preserving gut health.
fasting  drosophila  TOR  aging 
4 weeks ago
The Perils of Having an EA Schedule All Your Meetings | Ben Casnocha
> Alternatively, exec wants to say “Yes” but it’s a momentary emotion. The exec genuinely believes the meeting request is worth doing in that moment. “Hey great to hear from you, it’s been a long time, yeah let’s definitely hang out soon!” The EA is immediately CC’d. But. If exec had only spent 2-3 minutes encountering logistical friction when trying to schedule it herself, she would realize that, upon reflection, the benefits do not outweigh the costs. If your desire to do something cannot withstand even the slightest amount of friction, it’s probably not something you actually want to do. I analogize this to seeing books for sale on Amazon. When I encounter a book on Amazon that looks interesting, I often want to buy it right away. Instead I add the book to my wish list. When I visit the book’s listing a day or two later, I oftentimes find myself less interested in buying it. The enthusiasm turned out to be temporary. Adding a little bit of friction to the buying process causes me to be more honest about my true interest level. Adding scheduling friction to your meeting requests has a similar effect.
5 weeks ago
Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents – assessment of adverse events in non-randomised studies - Storebø - 2018 - The Cochrane Library - Wiley Online Library
> In the comparative studies, methylphenidate, compared to no intervention, increased the RR of insomnia and sleep problems (RR 2.58, 95% CI 1.24 to 5.34; 3 studies, 425 participants) and decreased appetite (RR 15.06, 95% CI 2.12 to 106.83; 1 study, 335 participants).
methylphenidate  ADHD  appetite  sleep 
5 weeks ago
rkk2 comments on [Windhorst] The Supreme Court has just ruled 7-2 to overturn the federal ban on sports gambling. It's a historic day in American sport.
You need to remember two things .
1) if something exists there is probably someone who is pissed off about it.
2) if someone is pissed off about something someone will exaggerate the level of controversy the original thing created.
internet  2018  offensive  controversy 
5 weeks ago
Ordoliberalism - Wikipedia
> Ordoliberalism is the German variant of social liberalism that emphasizes the need for the state to ensure that the free market produces results close to its theoretical potential.[1] Ordoliberal ideals became the foundation of the creation of the post-World War II German social market economy and its attendant Wirtschaftswunder.
politics  germany  liberalism 
6 weeks ago
Pharma’s broken business model: An industry on the brink of terminal decline – Endpoints News
> Just as the pharma industry evolved from the chemicals industry, and the biopharma industry has evolved from the pharma industry, the pharma and biopharma industries together will evolve into something quite different, most likely continuing the historic trend of increasing complexity towards more complex biological solutions to pressing healthcare problems, such as cell & gene therapy, tissue engineering and regenerative medicine:
pharma  business  2018  economics 
6 weeks ago
Teens Cyberbully Themselves As A New Type Of Self-Harm : Shots - Health News : NPR
> “Researchers found that 9 percent of the teens had bullied themselves online”. Also: “She set up ghost accounts on Instagram and posted mean comments about herself, saying things like, ‘I think you’re creepy and gay’ and ‘Don’t sit next to me again,’…She said these things because she feared being mocked by her peers [and] thought their teasing wouldn’t be so bad if she beat them to the punch”.
psychiatry  adolescence  bullying 
6 weeks ago
Plague doctor contract - Wikipedia
> A plague doctor contract was an agreement between a town's administrators and a "doctor" to treat bubonic plague patients.[1] These contracts are present in European city archives.[2] A plague doctor was specifically hired by a European city or town to treat plague patients, rich or poor, in times of epidemics. They were especially designed for the poor that could not afford to pay. Their contractual responsibility was twofold: to treat plague patients and to refrain from treating other patients, the latter provision representing an attempt to prevent the spread of disease from plague victims to other patients via a shared physician.[2] In many cases these "doctors" were either volunteers, second-rate doctors, or new young doctors starting a career.[1] A plague doctor had to serve a long quarantine after seeing a plague patient in his plague doctor costume.[1] He was regarded as a "contact" who by agreement had to live in isolation to be quarantined.[2]
history  medicine 
6 weeks ago
Is It Safe to Take Expired Drugs?
> A report published in the Journal of Clinical Pharmacology in 2006 found that 88% of the tested drug lots were good for at least a year past their expiration date, with an average extension of five years. Some lasted far longer. One lot of the antibiotic ciprofloxacin, the drug of choice for treating anthrax, was still good nearly 12 years past date. Several lots of potassium iodide granules, part of the treatment for people exposed to radiation, were still good after 18 years.
drugs  expired 
6 weeks ago
Do Nasal Sprays Cause Glaucoma or Cataracts? | Fauquier ENT Blog
> Studies have already shown that there is no systemic absorption of steroids administered via nasal spray at normal use dosages. That's why such steroid nasal sprays are safe to use regularly even in young children. It's safety profile is so good that it's even available over-the-counter. You can even buy them on Amazon!

But what specifically does the evidence say?

Two large studies of patients using nasal sprays found NO association with glaucoma or cataracts. One was a case-control study of more than 9,700 patients and the other study was a retrospective observational study of more than 286,000 patients.

Other corroborating studies listed below under references.

To be fair, however, there are occasional case reports linking glaucoma with steroid nasal sprays. Only one study in particular with a study group of only 12 patients suggested steroid nasal sprays exacerbate glaucoma and stopping use may result in decreased intra-ocular pressure.

But overall, there is overwhelming support that steroid nasal sprays are safe for patients from a glaucoma and cataract perspective. BUT, if a patient has glaucoma that is not being easily controlled, than it may be worthwhile to try stopping the nasal sprays to see if it helps.
cataracts  glaucoma  fluticasone  allergies 
6 weeks ago
Avicii’s death is not an excuse to ignore ethical guidelines on suicide reporting - Vox
> The news of Avicii’s death is deeply painful and confusing for many. It’s shocking that someone with so much could be so sad: He was young, beautiful, talented, wealthy, and widely loved. But shock is not a good excuse to throw ethics out the window when it comes to reporting his death.
celebrities  2018  suicide  journalism  internet  social_media 
6 weeks ago
Press Announcements > Statement from FDA Commissioner Scott Gottlieb, M.D., on the public health benefits from enactment of menu labeling
> this is a driving factor for us at the FDA and for those in Congress who crafted the law: Americans currently eat and drink about one-third of their calories away from home. At the same time, rates of child and adult obesity in the U.S. are at historic highs. Research, including a recent RAND Corporation studydisclaimer icon, suggests that people choose menu items with fewer calories when they have access to calorie information and that such information does not affect their satisfaction with the choice they make or their ratings of the restaurant. Studies suggest that access to clear and consistent information about calories in restaurant items can help reduce calorie intake, which over time could make a difference in obesity rates.
FDA  obesity  calorie  nutrition  diet  2018 
6 weeks ago
David Goodall: 104-year-old Australian scientist flies to Switzerland for assisted suicide - The Washington Post
> “Once one is past the stage of middle life, one has paid back to society the debts that have been paid out,” Goodall told the Australian Broadcasting Corp. “One should be free to use the rest of his life as one chooses. If one chooses to kill oneself, then that’s fair enough. I don’t think anyone else should interfere.”

In most countries, euthanasia and physician-assisted suicide are illegal. However, a handful of nations — including Belgium, Luxembourg and the Netherlands — have legalized one or both of the practices, according to the nonprofit group ProCon.org. For years, Australia has banned such practices, but in November, the state of Victoria became the first to pass a euthanasia bill, which, by summer 2019, will allow terminally ill patients to end their lives.
euthanasia  2018  death  suicide  australia 
7 weeks ago
Is Direct Primary Care a Game Changer? | Health Care Delivery Models | JAMA | JAMA Network
> Whatever happens, Bliss said, “I can’t go back to fee for service. I can’t get on that treadmill again.”
fee_for_service  medicine 
7 weeks ago
New AAMC Study Examines Career Trends Among MD-PhD Program Graduates
> Nearly 80% of survey respondents are following career paths consistent with the goals of their training, including working as full-time faculty or for the NIH, research institutes, industry, and federal agencies.
More than 75% of survey respondents conduct research, and most have research grant support.
Time spent in the research and clinical settings for physician-scientists in academia varies widely, with more than 50% of survey respondents spending at least half their time conducting research and nearly 23% devoting most of their time to clinical activities.
post_mdphd  research  2018 
7 weeks ago
Who decides who is to live and who is to die? | The BMJ
> It is not as if there is anything new in this. I have called for a ban on my website (1) and one major contributor to the smoking debate, Dr Robert Proctor, has argued forcefully for tobacco abolition, pointing out, among much else, that ‘The most important reason to ban the sale of cigarettes, however, is that most smokers do not even like the fact they smoke; cigarettes are not a recreational drug.’ (2)
tobacco  cigarettes  ban  government  autonomy  drugs  fun 
7 weeks ago
The Bonus: Part fanatic, part wild man, Cameron Hughes is a professional fan | SI.com
> "My allegiance is to the fans. The better I perform, the more likely the fans are to have fun, the more likely the team is to make money, the more likely they are to bring me back ... and the more likely I am to not have to get a normal job."
sports  travel  career  entertainment  entrepreneurship 
7 weeks ago
Brain and eyes of Kerygmachela reveal protocerebral ancestry of the panarthropod head | Nature Communications
Carbon brain preservation of insects. > GUH 32048b, the counterpart of MGUH 32048a; a wavelength dispersive X-ray elemental map of carbon of the head region. Carbon-rich region (red), superimposed upon the topographic map (blue), representing the frontal appendage nervous tracts and the anterior neural projections.
brain_preservation  history  insects  evolution 
7 weeks ago
Defective cholesterol clearance limits remyelination in the aged central nervous system. - PubMed - NCBI
> In a model for demyelination, we found that old mice fail to resolve the inflammatory response initiated after myelin damage. Aged phagocytes accumulated excessive amounts of myelin debris, which triggered cholesterol crystal formation and phagolysosomal membrane rupture and stimulated inflammasomes. Myelin debris clearance required cholesterol transporters, including apolipoprotein E. Stimulation of reverse cholesterol transport was sufficient to restore the capacity of old mice to remyelinate lesioned tissue. Thus, cholesterol-rich myelin debris can overwhelm the efflux capacity of phagocytes, resulting in a phase transition of cholesterol into crystals and thereby inducing a maladaptive immune response that impedes tissue regeneration.
myelin  lipids  inflammation  apoe 
7 weeks ago
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