6166
Amy Holden Jones on Twitter: "There are always debates and we welcome them. Doctors are threatened. I’m glad. They are the third leading cause of death and hospitals are overbilling humans in pain. Patient safety activists are in my corner and I’m fin
> There are always debates and we welcome them. Doctors are threatened. I’m glad. They are the third leading cause of death and hospitals are overbilling humans in pain. Patient safety activists are in my corner and I’m fine with that.
media  TV  controversy  2018  medicine 
2 hours ago
Human service work, gender and antidepressant use: a nationwide register-based 19-year follow-up of 752 683 women and men | Occupational & Environmental Medicine
> The hazard of antidepressant use was higher among men working in human service versus all other occupations with the same skill/occupational level (1.22, 95% CI 1.18 to 1.27), but this was not the case for women (0.99, 95% CI 0.98 to 1.01). The risks differed between professions: male health and social care professionals (including medical doctors, nurses, practical nurses and home care assistants), social workers, childcare workers, teachers and psychologists had a higher risk of antidepressant use than men in non-human service occupations, whereas customer clerks had a lower risk.
gender  depression  healthcare 
4 days ago
Castle Leod | the Seat of Clan Mackenzie
> The castle has been lived in by the same family for well over 500 years and is the Seat of Clan Mackenzie, their Chief (Cabarfeidh), Earl of Cromartie, and his family.
mckenzie  history  castle  travel 
4 days ago
A New Year’s Wish on Opioids | Substance Use and Addiction | JAMA | The JAMA Network
> On opioids, it can sometimes seem that there are 3 bad ideas for every good one. Public officials have supported limiting the number of naloxone resuscitations and afterwards letting people die, requiring drug testing before enrolling in Medicaid, and launching stigmatizing public relations campaigns that can reduce the chance people will seek treatment. Can we leave such approaches behind in 2017? Worth holding on to are approaches by states like Rhode Island, where the governor asked a team of local experts to listen to the public, consult the evidence, and provide recommendations for priority strategies. As one Rhode Island expert told an assembled group, “Our goal here is not to make everybody in this room happy. Our goal is to cut down on overdose deaths.” Three years later, after developing a terrific dashboard, investing in access to effective treatment, developing programs to improve prescribing of opioids and benzodiazepines, and setting standards for hospital activities, the state is one of a few actually seeing a decline in overdoses.
opioid  addiction 
5 days ago
Attrition Rates Between Residents in Obstetrics and Gynecology and Other Clinical Specialties, 2000–2009 | Journal of Graduate Medical Education
The annual resident attrition rate in this paper (between 2000-2009) is highest in psych (7.9%) compared to other specialties. As shown in the figure, the annual proportion of residents who left was 4.0% for all clinical specialties, compared with 4.2% in Ob-Gyn. Attrition rates in Ob-Gyn were most similar to those in general surgery (5.1%), family medicine (4.7%), and anesthesiology (3.6%). Psychiatry was the only specialty with a higher mean attrition rate (7.9%), while much lower rates than Ob-Gyn were found in neurology (2.9%), pediatrics (2.9%), internal medicine (2.7%), and emergency medicine (1.5%).
residency  post_mdphd  psychiatry 
6 days ago
Closed-loop stimulation of temporal cortex rescues functional networks and improves memory | Nature Communications
> "In a proof-of-concept study, researchers used direct brain stimulation to improve memory performance in epilepsy patients. Electrodes implanted to block seizures were instead used to stimulate the lateral temporal cortex to help encode memory. When the devices were switched on, participants saw a 15% boost in memory performance without adverse effects or knowledge that the device was in use. The authors are hopeful that the technique can be adapted to a non-invasive approach."
memory  neuroscience  neurosurgery 
9 days ago
Drew Ramsey MD | LinkedIn
> Drew Ramsey is a psychiatrist, author, and farmer. He is one of psychiatry’s leading proponents of using dietary change to help balance moods, sharpen brain function and improve mental health. He is an assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons and in active clinical practice in New York City where his work focuses on the clinical treatment of depression and anxiety.

He currently serves at the Chairman of the Council of Communications at The American Psychiatric Association and is the co-creator of The Brain Food Scale, and co-founder of National Kale Day 501(c)3
nutrition  psychiatry  kale  vegetarian 
9 days ago
How Old is a Transplanted Organ? – Fight Aging!
> Recently, we studied the above mentioned miRs using single-miR real time-RT qPCR on blood serum samples from 34 recipients stratified on the basis of donor liver chronological age. No difference was observed, thus suggesting that the phenomenon previously found was tightly related to the organ itself without miR-specific exocytosis and changes at circulating level, at least for the identified miRs.

The possibility that a centenarian liver can still function properly may suggest not only the intrinsic peculiarity of this organ (slowed down ageing; regeneration phenomena), but also the interaction with the younger recipients.
aging  organ_donation  organs 
9 days ago
Philadelphia Eagles beat Patriots to win Super Bowl 52 | SI.com
> “Playing quarterback, watching a lot of teams, a lot of football,” he said. “You learn if you play passive, if you play conservative, if you call plays conservatively, you are going to be 8-8, 9-7 every year. Every year. Frank and I just having that collaborative spirit to talk about things and talk with our quarterbacks and just come up with ways of keeping this game fresh and fun and exciting for our players. And that's really where it all stems from.”
NFL  coaching  risk_reward 
13 days ago
David Ryon's answer to Why do some people hate talking about death? - Quora
> But for those fortunate enough to approach a normal life expectancy, people who are able to make plans and discuss death with loved ones will have an easier time with it. I can tell you from many people I have seen, those who are able to engage their mortality more deeply, and use this fact to inform and instruct their goals and decisions throughout their life, are more likely to be prepared and even content when the doctor has to tell them that their time is drawing near.
death  medicine  critcare  psychology 
14 days ago
My personal moonshot - Marginal REVOLUTION
> By the way, I love it when people describe writing a blog, or writing on the internet, as "popularizing" economics or something similar. That is a sign they don't understand what is going on, that they don’t understand there is such a thing as “internet economics,” and also a sign they will not be effective competition. It's really about "the internet way of writing and communicating" vs. non-internet methods. The internet methods may or may not be popular, and may or may not be geared toward a wide audience, so they are not the same as popularizing. One point of the internet is to find an outlet for super-unpopular material. What's important right now is to develop internet methods of thinking and communicating, and not to obsess over reaching the largest possible numbers of people.
tyler_cowen  internet  writing 
15 days ago
Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports | The BMJ
Good example of a study that got a lot of media attention and that I really don't believe, because of unmeasured confounders. In general, lack of dose-dependence should be *highly concerning for problems in your model*, not taken at face value.
statistics  research  cigarettes  heart_disease  2018 
16 days ago
Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age | eLife
> We compiled and analyzed a large compendium of historical naked mole-rat lifespan data with >3000 data points. Kaplan-Meier analyses revealed a substantial portion of the population to have survived at 30 years of age. Moreover, unlike all other mammals studied to date, and regardless of sex or breeding-status, the age-specific hazard of mortality did not increase with age, even at ages 25-fold past their time to reproductive maturity. This absence of hazard increase with age, in defiance of Gompertz’s law, uniquely identifies the naked mole-rat as a non-aging mammal, confirming its status as an exceptional model for biogerontology.
gompertz  aging  naked_mole_rat  mammals  calico 
16 days ago
Magic-mushroom drug lifts depression in first human trial : Nature News & Comment
> Researchers from Imperial College London gave 12 people psilocybin, the active component in magic mushrooms. All had been clinically depressed for a significant amount of time — on average 17.8 years. None of the patients had responded to standard medications, such as selective serotonin re-uptake inhibitors (SSRIs), or had electroconvulsive therapy.

One week after receiving an oral dose of psilocybin, all patients experienced a marked improvement in their symptoms. Three months on, five patients were in complete remission. 
psilocybin  depression 
17 days ago
Powerless Placebos | Slate Star Codex
The placebo effect is mostly regression to the mean... and: > Surfing Uncertainty had the the best explanation of the placebo effect I’ve seen. Perceiving the world directly at every moment is too computationally intensive, so instead the brain guesses what the the world is like and uses perception to check and correct its guesses. In a high-bandwidth system like vision, guesses are corrected very quickly and you end up very accurate (except for weird things like ignoring when the word “the” is twice in a row, like it’s been several times in this paragraph already without you noticing). In a low-bandwidth system like pain perception, the original guess plays a pretty big role, with real perception only modulating it to a limited degree (consider phantom limb pain, where the brain guesses that an arm that isn’t there hurts, and nothing can convince it otherwise). Well, if you just saw a truck run over your foot, you have a pretty strong guess that you’re having foot pain. And if you just got a bunch of morphine, you have a pretty strong guess that your pain is better. The real sense-data can modulate it in a Bayesian way, but the sense-data is so noisy that it won’t be weighted highly enough to replace the guess completely.
scott_alexander  placebo  psychiatry  medicine  statistics 
17 days ago
The right kind of fun?
> I don't know if playing Dungeons and Dragons (which was, from my perspective, mostly carefully reading books filled with charts and rules in anticipation of play, rather than playing) taught me to be able to study API documentation; but it might have. Playing with Hypercard and Cosmic Osmo and Myst might have taught me something about the simplicity of the secret text behind the world. Maybe people who play a lot of SpaceChem will do better in multithreaded programming. Maybe people who play a lot of FoldIt will do better in nanotech design. What I'm trying to say is the premise of "fun is what we do to recover from work" might not be the best place to start thinking about this.
fun  work  learning  D&D 
17 days ago
What Can Be Done About Pedophilia? - The Atlantic
> “Sexual orientation” means different things in different contexts. When they say “sexual orientation,” most people mean a sexual interest that is inborn and unchangeable. No one chooses to be sexually attracted to children, although people do choose whether they act on their sexual attractions. Therapists have been attempting to turn pedophiles into non-pedophiles for a very long time, but no one has presented any objective evidence of any enduring change in sexual interests. People can learn self-control, people can take sex-drive-reducing medications, and people can learn how to live more healthy and productive lives, but we do not appear to be able to change the pedophilia itself.
pedophilia  psychiatry  sex  paraphilia 
18 days ago
A LessWrong Crypto Autopsy
> I think Moldbug's comment aged the best of all the ones on the original thread. He said he had no idea what was going to happen, but recommended buying ten bitcoins. If Bitcoin flopped, you were out $10. If it succeeded, you might end up with some crazy stratospheric amount (right now, ten bitcoins = $116,000). Sure, this depends on an assumption that Bitcoin had more than a 1/10,000 chance of succeeding at this level, but most people seemed to agree that was true.

This reminds me of eg the argument for cryonics. Most LWers believe there's a less than 10% chance of cryonics working. But if it does work, you're immortal. Based on the extraordinary nature of the benefits, the gamble can be worth it even if the chances of success are very low.
cryonics  bitcoin  less_wrong  scott_alexander  risk_reward  probability 
20 days ago
The Genomic Health Of Ancient Hominins | bioRxiv
> On average, 312 ancient individuals had significantly lower genetic risk of cancers, miscellaneous 313 diseases, and neurological/psychological diseases than modern humans (Figure 5A; p- 314 values < 0.05). Table 1 lists summary statistics and p-values from Wilcoxon signed 315 ranked tests for each disease category. Only cardiovascular-associated diseases were 316 predicted to have greater risk in ancient hominins compared to modern humans (pvalue = 1.8´10-5 317 )
DNA  evolution  genetics  psychiatry  neanderthal 
21 days ago
Interventions for increasing fruit and vegetable consumption in children aged five years and under - Hodder - 2018 - The Cochrane Library - Wiley Online Library
Best evidence-based way to increase child veggie intake right now is what is called "child-feeding practices", an example of which is repeated food exposure. Parent education doesn't seem to help.
veggies  food  diet  childhood 
22 days ago
The Scholar's Stage: Modern Universities Are An Exercise in Insanity
> The average tenure track professor makes $40 an hour. If you were to employ her as a private tutor at the cost of $60 an hour, and had four hours with her a week, and did that for 14 weeks (that's the length of an average college course folks) that is about $3,400.

Were you to employ three such professor-tutors, that would be about $10,200, or a bit over $20,000 a year. In four years you would have racked up $80,000 in costs. But this is still $30,000 less than the total for the 'cost conscious' universities. It is a quarter of what you would pay for Trinity.

Remember: this $80,000 is for private tutoring, where individual attention would give you far and away a better and more thorough education than the 300-kids-in-a-lecture-hall style of classes that dominate undergraduate education today.
college  money  professor  tuition 
22 days ago
Fertility Preservation in Women | NEJM
> Even though cryopreservation of ovarian tissue for female patients with cancer remains experimental,2 for prepubertal girls at high risk for premature ovarian insufficiency, it is the only option. What needs to happen before ovarian-tissue cryopreservation for young girls with cancer at high risk for premature ovarian insufficiency becomes an established procedure? Although all female patients with cancer deserve counseling regarding future fertility prognosis, those at highest risk for premature ovarian insufficiency (e.g., as defined by the Edinburgh criteria) need to be identified before the initiation of treatment.3 The safety and efficacy of the procedure in immunocompromised and vulnerable young girls must be further defined.4 No live births have yet been reported from ovarian-tissue cryopreservation and transplantation from a prepubertal girl. However, cases of pubertal induction have been reported,5 which suggests that ovarian tissue will be a source of mature oocytes after orthotopic reimplantation.
cryopreservation  ovaries  tissue_engineering 
23 days ago
Association of Exposure to High Rates of Obesity With Overweight and Obesity | Obesity | JAMA Pediatrics | The JAMA Network
From TheScope summary: "A look at families living in military bases across the country found that individual BMI correlated with surrounding community obesity rates, even after controlling for shared (potentially unhealthy) environments. Prior studies could not control for self-selection (i.e. similar people living together), but since Uncle Sam controls the location and duration of residence in military family participants, the authors were able to tease out a role for social norms and community in obesity."
Conclusion: "Exposure to counties with higher rates of obesity was associated with higher BMI and higher odds of overweight and/or obesity in parents and children. There was no evidence to support self-selection or shared built environments as possible explanations, which suggests the presence of social contagion in obesity."
obesity  culture  military  social_contagion 
23 days ago
Impact of Photobiomodulation (PBM) on Biomarkers of Alzheimer's Disease - Full Text View - ClinicalTrials.gov
> Photobiomodulation (PBM) describes the use of near-infrared light (which is not visible to the eye) to heal and protect tissue that has either been injured, is degenerating, or else is at risk of dying. Research suggests that the light delivered during PBM enhances the body's biochemical ability to store and use energy and increase blood flow, which triggers the body's natural healing processes. The goal of this study is to determine if PBM administered transcranially (through the scalp and skull) and intranasally (inside the nose) has an effect on cognitive function and behavioral symptoms in people with Alzheimer's disease (AD). The study will also examine whether PBM has an effect on biomarkers of AD in the blood and spinal fluid of patients with AD. A biomarker is a specific physical trait used to measure the progress of a disease or condition.
alzheimers  clinical_trial 
26 days ago
Peter Thiel: Bet on Magic Mushrooms For Treating Depression Is Coming | Fortune
> Giving patients drugs that are based on the active ingredient in magic mushrooms, known for their hallucinogenic properties, could help reboot the brains of people who suffer from mental illness and who are otherwise resistant to treatment. That company, Compass Pathways, said on Wednesday that it plans to start clinical trials of its drug starting in the first three months of 2018. The tests, to be conducted in partnership with Worldwide Clinical Trials, will be conducted in a number of European countries including Germany, Finland, the Netherlands, Spain, and the United Kingdom. “We need a new approach to tackling mental health,” George Goldsmith, executive chairman and co-founder of Compass Pathways, said in a statement
peter_thiel  psilocybin  psychiatry  clinical_trial 
28 days ago
Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. - PubMed - NCBI
> Psilocybin's acute psychedelic effects typically became detectable 30-60 min after dosing, peaked 2-3 h after dosing, and subsided to negligible levels at least 6 h after dosing. Mean self-rated intensity (on a 0-1 scale) was 0·51 (SD 0·36) for the low-dose session and 0·75 (SD 0·27) for the high-dose session. Psilocybin was well tolerated by all of the patients, and no serious or unexpected adverse events occurred. The adverse reactions we noted were transient anxiety during drug onset (all patients), transient confusion or thought disorder (nine patients), mild and transient nausea (four patients), and transient headache (four patients). Relative to baseline, depressive symptoms were markedly reduced 1 week (mean QIDS difference -11·8, 95% CI -9·15 to -14·35, p=0·002, Hedges' g=3·1) and 3 months (-9·2, 95% CI -5·69 to -12·71, p=0·003, Hedges' g=2) after high-dose treatment. Marked and sustained improvements in anxiety and anhedonia were also noted.
psilocybin  depression 
28 days ago
Can you Overdose on Modafinil - Modafinil
As of 2016, there have been no known overdoses on modafinil. Toxic dose needed to kill a rat is at least 400x the therapeutic dose.
modafinil  overdose 
29 days ago
Interest in the Ketogenic Diet Grows | JAMA | The JAMA Network
> But there are hints that the ketogenic diet may be different. A meta-analysis of 13 randomized controlled trials suggested that people on ketogenic diets tend to lose more weight and keep more of it off than people on low-fat diets. People placed on these diets often report decreased hunger, according to Amy Miskimon Goss, PhD, RD, an assistant professor at the University of Alabama at Birmingham (UAB) Nutrition Obesity Research Center. The appetite-suppressing powers of the diet aren’t fully understood but could have to do with the satiating properties of fat and protein, changes in appetite-regulating hormones on a low-carb diet, a direct hunger-reducing role of ketone bodies—the body’s main fuel source on the diet—or other factors.
keto  diet  weight_loss  hunger 
4 weeks ago
Menopausal Hormone Therapy and Long-term All-Cause and Cause-Specific Mortality: The Women's Health Initiative Randomized Trials. - PubMed - NCBI
> Among 27 347 women who were randomized (baseline mean [SD] age, 63.4 [7.2] years; 80.6% white), mortality follow-up was available for more than 98%. During the cumulative 18-year follow-up, 7489 deaths occurred (1088 deaths during the intervention phase and 6401 deaths during postintervention follow-up). All-cause mortality was 27.1% in the hormone therapy group vs 27.6% in the placebo group (hazard ratio [HR], 0.99 [95% CI, 0.94-1.03]) in the overall pooled cohort; with CEE plus MPA, the HR was 1.02 (95% CI, 0.96-1.08); and with CEE alone, the HR was 0.94 (95% CI, 0.88-1.01).
estrogen  HRT  RCT  mortality  aging 
4 weeks ago
IVF Transfer of Fresh or Frozen Embryos in Women without Polycystic Ovaries — NEJM
No significant difference between fresh and frozen embryos (but non-significantly, slightly higher for frozen). > After the first completed cycle, ongoing pregnancy occurred in 142 of 391 women (36.3%) in the frozen-embryo group and in 135 of 391 (34.5%) in the fresh-embryo group (risk ratio in the frozen-embryo group, 1.05; 95% confidence interval [CI], 0.87 to 1.27; P=0.65). Rates of live birth after the first transfer were 33.8% and 31.5%, respectively (risk ratio, 1.07; 95% CI, 0.88 to 1.31).
IVF  cryopreservation 
4 weeks ago
Federal Right-to-Try Legislation — Threatening the FDA’s Public Health Mission — NEJM
> The bill passed by the Senate and sent to the House has three key provisions. First, it would enable a patient with a life-threatening disease to obtain an unapproved drug after phase 1 testing, as long as a physician in good standing certifies that the patient has exhausted approved treatment options and is unable to participate in a trial of the desired drug. Access would require a willing prescriber, the manufacturer’s agreement, and the patient’s or surrogate’s informed consent. Signoff from the FDA — which currently checks for adequate evidence of safety and efficacy to support the proposed use and affirms that providing access will not interfere with clinical trials — would no longer be required.4
FDA  clinical_trial  2018 
4 weeks ago
Killing death: Some implications of extending human lifespan indefinitely | ZIPAR
Long essay argues that ending death would be good for society from a utilitarian perspective.
> Most people fear death, or at least feel uneasy about death. Fear of death is a unique feeling that is, at once, both perfectly understandable and irrational21 22 23. Fear of death is probably one of the unique experience of us humans; so far, no other known sentient beings are able to reason about the concept of their own inevitable death. Even though there are attempts to positively reframe dying and death in order to remove the fear and dread that come with it24, it is highly improbable that overall attitudes towards death can become neutral or even positive. And neither should they: Death is a natural biological limitation, but it is not a pleasant one – death is a terminal event that happens without our consent.

Ending natural biological death would mean removing death dread, either completely or to a large degree. Fear of death is probably one of the most unpleasant negative feelings because, contrary to almost all other causes of negative feelings, we cannot do anything about death (yet). Death dread is an unnecessary, cruel burden of nature; humankind loses nothing by getting rid of it.
death  ethics  fear  philosophy  utilitarianism 
4 weeks ago
Tom Coughlin’s Return Coincides With Jacksonville’s Revival - The New York Times
> Coughlin’s penchant for precision and discipline are everywhere, including the focus on getting to meetings early and the way uniforms are worn. For a team that has had a reputation as one of the league’s most undisciplined organizations, little things like that matter.
ageism  coaching  nfl  discipline  age 
5 weeks ago
Lectins Could Become the Next Gluten - The Atlantic
> The publisher—the “health, wellness, lifestyle, and inspirational” division of HarperCollins called Harper Wave—elaborates that readers will learn to be wary of compounds found in “grains of all kinds (especially whole wheat), beans and legumes (especially soy), nuts (especially almonds), fruits and vegetables (eggplant, tomatoes, potatoes, peppers, etc.)” in addition to “dairy and eggs.” That doesn’t leave much on the table. In the midst of soaring rates of obesity and diabetes that many experts believe are clearly linked to an abundance of low-nutrient, low-fiber, sugar-enhanced, heavily processed foods, it could seem an odd time to be warning people against fruits and vegetables. ... the book seems to be a sort of culmination of a long-percolating hypothesis about the imminent dangers of lectins. It’s especially common among purveyors of dietary supplements. The story goes: We need nutrients to survive, but many plants makes us sick, so synthetic supplement pills and powders are the prudent approach.
lectin  diet  supplements  2018 
5 weeks ago
RIP: Serotonin Receptor 5-HT6 Antagonist | ALZFORUM
> Any last hopes for serotonin receptor 6-targeted cognitive enhancers ran into cold reality this week, with the publication of results from three failed Phase 3 trials of the 5-HT6 antagonist idalopirdine. In the January 8 JAMA, Alireza Atri of California Pacific Medical Center in San Francisco and colleagues present the wholly negative findings of the STARSHINE, STARBEAM, and STARBRIGHT trials. The program, involving 2,525 people with mild to moderate Alzheimer’s disease in hundreds of centers in 34 countries, came to naught when idalopirdine at any dose failed to produce improvement in cognitive symptoms over placebo.
idalopiridine  alzheimers  phase3  clinical_trial  serotonin 
5 weeks ago
President Reagan didn't have Alzheimer's while in office - CNN
This article claims that there is no evidence and that he wasn't diagnosed until 1994.
ageism  alzheimers  presidency  history 
5 weeks ago
Serum caffeine and metabolites are reliable biomarkers of early Parkinson disease. - PubMed - NCBI
Lower levels of caffeine increase the risk of PD. > Serum levels of caffeine and 9 of its downstream metabolites were significantly decreased even in patients with early PD, unrelated to total caffeine intake or disease severity. No significant genetic variations in CYP1A2 or CYP2E1, encoding cytochrome P450 enzymes primarily involved in metabolizing caffeine in humans, were detected compared with controls. Likewise, caffeine concentrations in patients with PD with motor complications were significantly decreased compared with those without motor complications.
caffeine  parkinsons 
6 weeks ago
Auditory-somatosensory bimodal stimulation desynchronizes brain circuitry to reduce tinnitus in guinea pigs and humans | Science Translational Medicine
Apparently this can treat tinnitus. > Take-home devices were programmed to deliver the bimodal or unimodal treatment protocols by control software and data were encrypted to ensure blinding. The sound stimuli were delivered through calibrated insert earphones, and the electrical (somatosensory) stimuli were administered using Ag-AgCl cups placed on the skin of the cervical spine or the cheek. Participants used the devices for 30 min once a day for two 4-week sessions with a 4-week washout period after each session.
neurology  tinnitus 
6 weeks ago
Bacteria and Cancer: Another Connection | In the Pipeline
> It’s been known for some time that stomach cancer is associated with H. pylori infection and there’s a less-well-known connection between Chlamydia infection and cervical tumors. I think that by now we can definitely add “bacterial infection” to the list of causes of cancer, just as viruses were added years ago. It’s surely not a coincidence that the known examples, when you think about it, are all associated with proximity to a large variety of different bacterial species (the digestive and reproductive tracts).
cancer  bacteria 
6 weeks ago
Phencyclidine - Wikipedia
> PCP was actually discovered by Victor Maddox, a chemist at Parke-Davis in Michigan, while investigating synthetic analgesic agents. Although unexpected, PCP was identified as potentially interesting, and as such, was submitted for pharmacological testing. The promising results of these pharmacological investigations led to the rapid development of PCP. It was approved for use as an investigational drug under the brand names Sernyl and Sernylan in the 1950s as an anesthetic, but because of its long terminal half-life and adverse side effects, such as hallucinations, mania, delirium, and disorientation, it was removed from the market in 1965 and limited to veterinary use.[4][63][64]
analgesia  pain  pharmacology 
6 weeks ago
Human skin color - Wikipedia
> Natural selection has led to females with lighter skin than males in all indigenous populations because women must get enough vitamin D and calcium to support the development of fetus and nursing infant and to maintain their own health.[7] The sexes also differ in how they change their skin color with age. Men and women are not born with different skin color, they begin to diverge during puberty with the influence of sex hormones.
gender  skin  vitamin_d 
6 weeks ago
Madalyn Murray O'Hair - Wikipedia
> She created the first issues of American Atheist Magazine. O'Hair is best known for the Murray v. Curlett lawsuit, which led to a landmark Supreme Court ruling ending official Bible-reading in American public schools in 1963. That case came just one year after the Supreme Court prohibited officially sponsored prayer in schools in Engel v. Vitale.
history  feminism  atheism  death  law 
6 weeks ago
Chile Designates 11 Million Acres of Land as National Parks | Smart News | Smithsonian
> Kris McDivitt Tompkins, former CEO of the clothing company Patagonia and her husband, Doug Tompkins, co-founder of the North Face and Esprit clothing lines, began buying hundreds of thousands of acres in the wild Patagonia region of Chile in the early 1990s, The Guardian’s John Vidal reported last year. Their goal, Vidal writes, was to “buy and restore as much land as they could, improve and protect it, and then return it to people as public, national parks.” After over two decades of work, they acquired 2.2 million acres of land, including the gifted land, Parque Pumalín and Patagonia, which together span roughly 1 million acres and represent the largest land donation from a private entity to a country.
patagonia  chile  parks  charity 
6 weeks ago
How (and Why) Athletes Go Broke
> "Chronic over allocation into real estate and bad private equity is the Number 1 problem [for athletes] in terms of a financial meltdown," Butowsky says. "And I've never seen more people come to me about raising money for those kinds of deals than athletes."

For the risk-averse investor, an adviser such as Butowsky would suggest allocating 5%to private equity, 7%-12% to real estate, 50%-65% to a mix of public securities(stocks, mutual funds and the like) and the rest to alternatives such as gold and hedge funds. Yet with athletes, who are often uninterested in either conservative spending or the stock market, those percentages are frequently flipped. Securities are invisible, after all, and if you don't study them,they're unintelligible. Not to mention boring. Inventions, nightclubs, car dealerships and T-shirt companies have an advantage: the thrill of tangibility.
finance  divorce  sports  stocks  private_equity  real_estate 
6 weeks ago
Adderall Risks: Much More Than You Wanted To Know | Slate Star Codex
My comment on Scott's post in case it gets deleted one day:

1) I think another key question in re: tolerance is whether people can go off them long-term and be basically OK after an initial washout period, without any psychologic dependence. If you’re starting people on the drugs when they are young and healthy it might make sense, but what happens when they get older and aren’t as healthy? If they aren’t able to stop it without losing their jobs, that seems to me like a big problem. But if they are able to stop, great.

2) As you know, the issue with hypertension is definitely not just heart attacks. Kidney disease, peripheral vascular disease, stroke, and risk of dementia later in life all come to mind. 3-8 mmHg is not nothing; for example, when it comes to stroke, one meta-analysis of 100+ RCTs found that a “blood pressure reduction of 10 mm Hg systolic and 5 mm Hg diastolic was associated with a 41 % (33 % to 48 %) reduction in stroke for all trials” [PMC3838588].

I know you posted links claiming a paradoxical lower risk of stroke in patients on stimulants, but I’d be really wary of relying on retrospective studies because of the massive confounding effects (healthy-person bias, etc). I basically wouldn’t trust them.

3) What do you t
blog_comment  scott_alexander  stimulants  ADHD  psychiatry 
7 weeks ago
digitalfrost comments on More US troops commit suicide than die in combat in the war in the Middle East
- Suicide rate is not higher in people returning from combat than in the general populace
- Suicide rate correlates with unemployment
- Even though there are less people being injured or dying from going to war compared with the past, PTSD rates are at an all time high in the US.
suicide  army  US  2017  employment  PTSD 
7 weeks ago
renegade_division comments on I don't understand, but I'm open to learning
> Internet has stopped evolving into the direction of real time communication because the ISPs voluntarily follow net neutrality. Working From Home sucks because video streaming sucks. Having remote coworkers is absolutely not the same as having in-office coworkers, this means companies don't hire remote workers. If Net Neutrality is gotten rid of, we can have more high definition real time video communication. Your company will pay for that priority data for the video feed (so it would be that your video chats with your fiance won't be of that high quality, unless you pay for it, but your company would consider the priority data costs as a business cost of hiring a remote worker, after all, because of that, you're now able to work from Kansas City for your NYC employer). Keep in mind, I am trying to paint a realistic picture here, not some rosy stuff to counter all the dystopian vision pro-NN supporters keep painting.
internet  2017  work 
7 weeks ago
A Generation in Japan Faces a Lonely Death
> Her cremated remains would be buried under the headstone. Her possessions, even her exhaustively chronicled autobiographies, would almost certainly be incinerated.
death  loneliness  japan  2017  children  writing 
7 weeks ago
Late Disseminated Lyme Disease: Associated Pathology and Spirochete Persistence Post-Treatment in Rhesus Macaques - The American Journal of Pathology
> We investigated the pathology associated with late disseminated Lyme disease (12 to 13 months following tick inoculation) in doxycycline-treated (28 days; 5mg/kg, oral, 2x/day) and untreated rhesus macaques (Rm). ... Rare morphologically intact spirochetes were observed in the brains of two treated Rm, the heart of one treated Rm, and adjacent to a peripheral nerve of an untreated animal.
lyme  infection 
7 weeks ago
Trial of Contralateral Seventh Cervical Nerve Transfer for Spastic Arm Paralysis — NEJM
> In this single-center trial involving patients who had had unilateral arm paralysis due to chronic cerebral injury for more than 5 years, transfer of the C7 nerve from the nonparalyzed side to the side of the arm that was paralyzed was associated with a greater improvement in function and reduction of spasticity than rehabilitation alone over a period of 12 months. Physiological connectivity developed between the ipsilateral cerebral hemisphere and the paralyzed hand.
neurology  nerve_transfer 
8 weeks ago
Nutrients and bioactives in green leafy vegetables and cognitive decline: Prospective study. - PubMed - NCBI
These studies are obviously biased because the type of people who eat green leafy vegetables are likely to be smarter at baseline, be better educated, have higher SES, receive better medical care, have a less sedentary lifestyle, and/or are less likely to be overweight/obese. That said, the effect is pretty large and there really might be something nutritious in green leafy vegetables. I would love to see a study that evaluated the role of green leafy vegetable intake while controlling for genetics and other factors.
> Consumption of approximately 1 serving per day of green leafy vegetables and foods rich in phylloquinone, lutein, nitrate, folate, α-tocopherol, and kaempferol may help to slow cognitive decline with aging.
cognition  aging  nutrition  alzheimers  diet  vegetables  genetics 
8 weeks ago
Diagnosis and Treatment of Hypertension: 2017 ACC/AHA Blood Pressure Guidelines and the Real World | Cardiology | JAMA | The JAMA Network
> Expanding the definition of disease to label more people as having medical conditions and in need of treatment has become more common. Many specialties want to increase their volume of patients. Industry also cherishes larger markets for its products through expansive definitions of illness.3 Guidelines are typically the final step to justify illness-by-committee and treatment overuse. However, this pattern does not seem to sufficiently explain the case of hypertension and the 2017 ACC/AHA guidelines. Hypertension is indeed a major risk factor for CVD and death. Starting at values as low as 115 mm Hg for systolic blood pressure (SBP), higher blood pressure linearly increases the risk of CVD events. Treatment of hypertension has substantially contributed toward increasing life expectancy in the 20th and 21st centuries. The goal of promoting a healthy lifestyle in millions of additional people who might be otherwise outside the scope of appropriate lifestyle modification is laudable.
john_ioannidis  lifestyle  2017  blood_pressure 
8 weeks ago
High-specificity neurological localization using a connectionist model - ScienceDirect
> This approach can reuse existing causal knowledge bases, works well in situations where multiple disorders can occur simultaneously, and does not require fully-connected sets of processing units. We demonstrate that the accuracy of this model is comparable to that of more conventional AI programs using the same knowledge base in determining precisely the site of brain damage in a group of 50 stroke patients. These results support the conclusion that connectionist models can effectively use pre-existing causal knowledge bases from AI systems, and that they can function accurately when handling actual clinical problems.
AI  medicine  stroke  stanley_tuhrim 
8 weeks ago
Press Announcements > FDA approves novel gene therapy to treat patients with a rare form of inherited vision loss
> Luxturna works by delivering a normal copy of the RPE65 gene directly to retinal cells. These retinal cells then produce the normal protein that converts light to an electrical signal in the retina to restore patient’s vision loss. Luxturna uses a naturally occurring adeno-associated virus, which has been modified using recombinant DNA techniques, as a vehicle to deliver the normal human RPE65 gene to the retinal cells to restore vision.
gene_therapy  retina 
8 weeks ago
California Republic - Wikipedia
> The California Republic was an unrecognized breakaway state that, for twenty-five days in 1846, militarily controlled an area north of San Francisco, in and around what is now Sonoma County State of California.[1]
history  California 
8 weeks ago
The FDA Just Made It a Lot Easier for DNA Health Tests to Hit the Market
> The newly proposed regulations will allow genetic health tests to make it to market without prior review. Companies seeking to sell such tests would have to come to the FDA for a one-time review. But after getting that initial FDA stamp of approval, any subsequent genetic health test the company develops will not face further regulatory hurdles. ... He noted that the goals of the new rules are similar to that of the “FDA Pre-Cert” program pilot that FDA unveiled in September to regulate digital health products. Instead of vetting each individual product before it hits the marketplace, the agency wants to assess the validity of a company’s methodologies and practices.
FDA  genetics 
8 weeks ago
E Pur Si Muove - Sam Altman
> Earlier this year, I noticed something in China that really surprised me. I realized I felt more comfortable discussing controversial ideas in Beijing than in San Francisco. I didn’t feel completely comfortable—this was China, after all—just more comfortable than at home. ... More recently, I’ve seen credible people working on ideas like pharmaceuticals for intelligence augmentation, genetic engineering, and radical life extension leave San Francisco because they found the reaction to their work to be so toxic. “If people live a lot longer it will be disastrous for the environment, so people working on this must be really unethical” was a memorable quote I heard this year.
SF  culture  free_speech  lifespan 
8 weeks ago
Blood pressure from mid- to late life and risk of incident dementia. - PubMed - NCBI
During the follow-up period, 107 participants (71 women) developed dementia. Using multivariable Cox proportional hazards models, we found that midlife systolic hypertension (hazard ratio [HR] 1.57, 95% confidence interval [CI] 1.05-2.35) and persistence of systolic hypertension into late life (HR 1.96, 95% CI 1.25-3.09) were associated with an elevated risk of incident dementia. However, in individuals with low to normal blood pressure (≤140/90 mm Hg) at midlife, a steep decline in systolic blood pressure during mid- to late life was also associated with a >2-fold increase in dementia risk (HR 2.40, 95% CI 1.39-4.15).
dementia 
8 weeks ago
Quantifying penetrance in a dominant disease gene using large population control cohorts
> We identified, for the first time, heterozygous N-terminal (residue ≤131) truncating variants in four ExAC individuals and were able to obtain Sanger validation (Figure S1) and limited phenotype data (Table S11) for three. These individuals are free of overt neurological disease at ages 79, 73, and 52, and report no personal or family history of neurodegeneration nor of peripheral neuropathy. Therefore, the pathogenicity of protein-truncating variants appears to be dictated by position within PrP’s amino acid sequence (Figure 4). Observing three PRNP nonsense variants in ExAC is consistent with the expected number (~3.9) once we adjust our model (69) to exclude codons ≥145, where truncations cause a dominant gain-of-function disease. Thus, we see no evidence that PRNP is constrained against truncation in its N terminus. This, combined with the lack of any obvious phenotype in individuals with N-terminal truncating variants, suggests that heterozygous loss of PrP function is tolerated.
neurology  prions  CJD  genetics  eric_minikel 
8 weeks ago
beholdmycape comments on Physicians, what are some strange complaints you've heard multiple times without a good explanation (and never seem to go on to cause a serious problem)?
This is probably why my heart pounds at night, which I've had anxiety about before. > Not sure what kind of patients you have had complain of heart pounding but it can be caused by relative bradycardia at rest, particularly in athletes and particularly in bed where there are few other distractions. Slower rate = longer diastole = higher EDV = higher contractile force per the Frank-Starling law. High respiratory BTBV can exaggerate this even further. This is the same reason that PVCs are perceptible, the PVC causes an extremely long diastole and powerful systole with the next beat, however presumably the cardiology workup would reveal PVCs.
cardiology  sleep  anxiety  palpitations 
8 weeks ago
NBA highlight videos: Are the Youtube clips legal? | SI.com
> ​It seems like the NBA could shutter all these channels pretty easily if they wanted. Their case is ironclad; people outside the Association using its telecasts for profit is strictly prohibited, that’s not exactly in the fine print. But remarkably, the Silver regime has been pretty progressive on the topic. At last year’s MIT Sloan Sports Analytics Conference, Silver was asked about the massive amount of unregulated content on YouTube.

“We’re incredibly protective of our live game rights,” said Silver. “But for the most part, highlights are marketing.”
nba  copyright  law  2017  youtube  marketing 
9 weeks ago
Convergent evolution of bilaterian nerve cords | Nature
> Here we study representatives of Xenacoelomorpha, Rotifera, Nemertea, Brachiopoda, and Annelida to assess the conservation of the dorsoventral nerve cord patterning. None of the studied species show a conserved dorsoventral molecular regionalization of their nerve cords, not even the annelid Owenia fusiformis, whose trunk neuroanatomy parallels that of vertebrates and flies. Our findings restrict the use of molecular patterns to explain nervous system evolution, and suggest that the similarities in dorsoventral patterning and trunk neuroanatomies evolved independently in Bilateria.
neuroscience  evolution  nerves 
9 weeks ago
Creative Minds: Designing Personalized Clinical Trials | NIH Director's Blog
> To find out, the clinical team did something unconventional: they designed for the boy a clinical trial to test the benefit of Ritalin versus a placebo. The boy was randomly assigned to take either the drug or placebo each day for four weeks. As a controlled study, neither clinical staff nor the family knew whether he was taking the drug or placebo at any given time. The result: Ritalin wasn’t the answer. The boy was spared any side effects from long term administration of a medication that wouldn’t help him, and his doctors could turn to other potentially more beneficial approaches to his treatment.
RCT  medicine  placebo 
9 weeks ago
Svalbard - Wikipedia
> The archipelago features an Arctic climate, although with significantly higher temperatures than other areas at the same latitude. The flora take advantage of the long period of midnight sun to compensate for the polar night. Svalbard is a breeding ground for many seabirds, and also features polar bears, reindeer, the Arctic fox, and certain marine mammals. Seven national parks and twenty-three nature reserves cover two-thirds of the archipelago, protecting the largely untouched, yet fragile, natural environment. Approximately 60% of the archipelago is covered with glaciers, and the islands feature many mountains and fjords.
island  travel  nature  climate 
9 weeks ago
Blood, the Secret Sauce? Focus on Plasma Promises AD Treatment | ALZFORUM
> The idea was put to the test in a placebo-controlled Phase 2 trial that treated 42 patients with 18 plasma exchanges over the course of six months (Boada et al., 2017). The exchanges decreased plasma Aβ42, and caused a borderline increase in CSF Aβ42 at the end of treatment that reversed after treatment stopped. Two cognitive measures, the Boston naming test and a semantic verbal-fluency test, improved from baseline in treated patients, and the ADAS-Cog and MMSE showed a trend in the right direction.
alzheimers  plasma_exchange  plasma 
9 weeks ago
At Least We Know These Don’t Work: Negative Trials at CTAD | ALZFORUM
> “Safety was good but we had no efficacy on cognition or function,” Pueyo said. The drug did get into the CSF and increased glutamate in the brain, Pueyo said in response to audience questions, but still achieved none of the desired benefit. Curiously, symptoms of depression improved in both drug and placebo groups, perhaps as a consequence of receiving the added care and attention that come with participating in a clinical trial.
depression  alzheimers  clinical_trial 
9 weeks ago
Cannabidiol (CBD) as an Adjunctive Therapy in Schizophrenia: A Multicenter Randomized Controlled Trial: American Journal of Psychiatry: Vol 0, No 0
> After 6 weeks of treatment, compared with the placebo group, the CBD group had lower levels of positive psychotic symptoms (PANSS: treatment difference=−1.4, 95% CI=−2.5, −0.2) and were more likely to have been rated as improved (CGI-I: treatment difference=−0.5, 95% CI=−0.8, −0.1) and as not severely unwell (CGI-S: treatment difference=−0.3, 95% CI=−0.5, 0.0) by the treating clinician.
schizophrenia  CBD  psychiatry  RCT 
9 weeks ago
The effect of vitamin D supplement on the score and quality of sleep in 20-50 year-old people with sleep disorders compared with control group. - PubMed - NCBI
RCT showing that vit D supplements help sleep. > Based on the results of the present study, at the end of the study sleep score (PSQI) reduced significantly in vitamin recipients as compared with placebo recipients (P < 0.05). This difference was significant even after modifying confounding variables (P < 0.05).
sleep  vitamin_d 
9 weeks ago
Origin and differentiation of human memory CD8 T cells after vaccination | Nature
Crazy long-term study. > The differentiation of human memory CD8 T cells is not well understood. Here we address this issue using the live yellow fever virus (YFV) vaccine, which induces long-term immunity in humans. We used in vivo deuterium labelling to mark CD8 T cells that proliferated in response to the virus and then assessed cellular turnover and longevity by quantifying deuterium dilution kinetics in YFV-specific CD8 T cells using mass spectrometry. This longitudinal analysis showed that the memory pool originates from CD8 T cells that divided extensively during the first two weeks after infection and is maintained by quiescent cells that divide less than once every year (doubling time of over 450 days). Although these long-lived YFV-specific memory CD8 T cells did not express effector molecules, their epigenetic landscape resembled that of effector CD8 T cells. This open chromatin profile at effector genes was maintained in memory CD8 T cells isolated even a decade after vaccination, indicating that these cells retain an epigenetic fingerprint of their effector history and remain poised to respond rapidly upon re-exposure to the pathogen.
immunology  vaccination  infection  t_cells  CD8 
9 weeks ago
High-Dose Gantenerumab Lowers Plaque Load | ALZFORUM
Still doing large anti-amyloid trials. > Roche is planning two new Phase 3 clinical trials, called GRADUATE 1 and 2. According to a company spokesperson, starting in early 2018 each trial will enroll 750 people with prodromal to mild AD, and treat them for two years with subcutaneous injections of antibody or placebo. Roche did not disclose the dose except to say it will be higher than in the previous trials, and the trials will employ a single titration scheme for both ApoE4 carriers and noncarriers.
amyloid  alzheimers 
9 weeks ago
Post-apocalyptic life in American health care | Meaningness
> Standardizing an interface between health care providers and insurance companies would be a huge win. No matter how badly designed, it would be better than the current mess, and save several percent of US GDP. That would need cooperation from most of the major players in the industry. Other industries manage that routinely: machine screws and futures contracts come in standard sizes, without which manufacturing and finance would be as inefficient as health care. The need for a standard insurer/provider interface is obvious. Since it’s lacking, I imagine some powerful group extracts enormous rents from the inefficiency. I know nothing about that, so I won’t speculate.
healthcare  US  2017  bureaucracy 
9 weeks ago
Verubecestat Negative Trial Data: What Does it Mean for BACE Inhibition? | ALZFORUM
> “Negative studies occur in most fields, and are necessary for learning,” said Maria Carrillo of the Alzheimer’s Association. She added, “We are trying to treat and prevent dementia, one of the most difficult things science is doing in this century. We have to work together and share negative and positive findings.” Many others agreed. “We can only advance the field if we do this kind of trial,”
BACE  verubecestat  alzheimers 
9 weeks ago
Amia Srinivasan reviews ‘Other Minds’ by Peter Godfrey-Smith and ‘The Soul of an Octopus’ by Sy Montgomery · LRB 7 September 2017
> Octopuses encountering divers in the wild will frequently meet them with a probing arm or two, and sometimes lead them by the hand on a tour of the neighbourhood. Aristotle, mistaking curiosity for a lack of intelligence, called the octopus a ‘stupid creature’ because of its willingness to approach an extended human hand. Octopuses can recognise individual humans, and will respond differently to different people, greeting some with a caress of the arms, spraying others with their siphons. This is striking behaviour in an animal whose natural life cycle is deeply antisocial. Octopuses live solitary lives in single dens and die soon after their young hatch. Many male octopuses, to avoid being eaten during mating, will keep their bodies as far removed from the female as possible, extending a single arm with a sperm packet towards her siphon, a manoeuvre known as ‘the reach’.
octopus  neuroscience  consciousness 
9 weeks ago
In cold blood: intraarteral cold infusions for selective brain cooling in stroke
Intra-arterial cold infusions as a way to treat stroke. > The idea of IACI as an emergency treatment in stroke patients is relatively new and current knowledge of effects and safety is only based on rodent experiments and computer simulations. However, many years of clinical and experimental experience with IACI during surgical procedures have shown the high effectiveness of IACI for the prevention of ischemic injury. In addition, IACI have already been successfully tested in large animals for hypothermia induction after CA. Clinical feasibility of IACI has also been shown in awake volunteers without acute brain damage.
stroke  hypothermia  endovascular 
9 weeks ago
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