Microbiota and obesity: Is it all hype?
> We still don’t have compelling evidence that differences in the composition of the gut microbiota significantly impact body fatness in humans, and the best human evidence we have suggests that it may not be important.  New evidence also suggests that it may not be as important in rodents as we thought either.  That said, the case isn’t closed yet.  The human evidence we have is short-term, and given the staggering complexity of the microbiota and how it interacts with diet and lifestyle, there is still room for it to be important.  I look forward to further research on it, but in the meantime, let’s cut back on the hype.
microbiome  hype  weight  guyenet 
N−3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease | NEJM
> Among patients with dry eye disease, those who were randomly assigned to receive supplements containing 3000 mg of n−3 fatty acids for 12 months did not have significantly better outcomes than those who were assigned to receive placebo
fish_oil  dry_eye 
2 days ago
Health Care Employment Growth and the Future of US Cost Containment | Health Care Reform | JAMA | JAMA Network
> It is not surprising that employment growth should be a bellwether for rising health care expenditures because salaries and wages account for an average 55% of operating expenses for hospitals, physician offices, and outpatient care,4 and nearly 70% of hospital expenses.5 The problem is that the United States cannot reduce growth of health care costs without a corresponding moderation in the growth of health care employment.6 In the health care industry, this association is particularly strong because most hospitals have not-for-profit status. Unlike for-profit industries that will reduce employment and return profits to shareholders, not-for-profit entities cannot return their profits; instead they expand services. For example, a recent study7 found that hospitals experiencing an unexpected 10% boost in Medicare reimbursement rates added new technology, boosted nursing staff by 16%, and increased their payroll by nearly one-third.
economics  2018  healthcare 
2 days ago
Troubling Trends in Health Disparities | NEJM
> A recent report on mortality by the National Center for Health Statistics (NCHS)1 confirmed that life expectancy decreased in the United States for a second year in a row, from 78.9 years in 2014 to 78.7 years in 2015 to 78.6 years in 2016. Although these decreases were small, they indicate a change in the otherwise monotonically increasing life expectancy in recent decades. These decreases were the result of increasing mortality among persons between 15 and 64 years of age, with a marked increase in “unintentional injuries” (a 9.7% increase) and suicide (a 1.5% increase)
race  US  2018  suicide  lifespan 
2 days ago
Relationship between Clinic and Ambulatory Blood-Pressure Measurements and Mortality | NEJM
> Masked hypertension was more strongly associated with all-cause mortality (hazard ratio, 2.83; 95% CI, 2.12 to 3.79) than sustained hypertension (hazard ratio, 1.80; 95% CI, 1.41 to 2.31) or white-coat hypertension (hazard ratio, 1.79; 95% CI, 1.38 to 2.32)
hypertension  blood_pressure 
2 days ago
Measuring and Estimating the Effect Sizes of Copy Number Variants on General Intelligence in Community-Based Samples | Child Development | JAMA Psychiatry | JAMA Network
> For rare deletions, size, number of genes, and exons affect IQ, and each deleted gene is associated with a mean (SE) decrease in PIQ of 0.67 (0.19) points (P = 6 × 10−4); this is not so for rare duplications and frequent CNVs. Among 10 functional annotations, haploinsufficiency scores best explain the association of any deletions with PIQ with a mean (SE) decrease of 2.74 (0.68) points per unit of the probability of being loss-of-function intolerant (P = 8 × 10−5). Results are consistent across cohorts and unaffected by sensitivity analyses removing pathogenic CNVs.
CNV  genomics  psychiatry  IQ 
3 days ago
Calcitriol - Wikipedia
> The main adverse drug reaction associated with calcitriol therapy is hypercalcemia – early symptoms include: nausea, vomiting, constipation, anorexia, apathy, headache, thirst, pruritus, sweating, and/or polyuria. Compared to other vitamin D compounds in clinical use (cholecalciferol, ergocalciferol), calcitriol has a higher risk of inducing hypercalcemia.
vitamin_d  hypercalcemia 
7 days ago
How Profiteers Lure Women Into Often-Unneeded Surgery - The New York Times
> I am amazed at all the comments blaming the health care system for this. Barely a word about the legal system and predatory law firms that are the driving force behind it. These unnecessary surgeries occurred outside of our standard medical framework. I am no fan of our current health care system but the blame for this one has to go to the lawyers.
2018  law  medicine  money  finance 
8 days ago
The Political Landscape Is Not Even Close to Being What You Think - Niskanen Center
> First of all, the party represented by first-term presidents almost always takes a beating in the midterms. And those beatings have not served as reliable indicators for what is to come. Republicans were creamed in 1982, but Ronald Reagan won an historic landslide in 1984. Democrats were slaughtered in 1994, yet Bill Clinton went on to win decisively in 1996. Democrats were decimated in 2010, but Barack Obama broke little sweat in winning again in 2012. Republicans won’t be wrong to dismiss a blue wave in November as saying little about Donald Trump’s prospects in 2020.
politics  2018  trump 
9 days ago
F*ck Death | Nancy Hua
> That stuff shouldn’t happen and we should try to stop it if we can. That’s how I feel about death, about all injustice, all suffering. If it has to happen, then I’m going to be brave about it. But I’m not going to say the world is more beautiful because of ugliness.
nancy_hua  cryonics  death 
10 days ago
NeoSensory | Expanding Perception
> NeoSensory’s wearable devices take in information that is not easily accessible — for example, sound (in deaf individuals), light outside the visible spectrum, or information from connected devices — and translate them into patterns of vibrations on the body. With practice, these associations become automatic and a new sense is born.
sensory  start_up 
15 days ago
The richest 1 percent now owns more of the country’s wealth than at any time in the past 50 years - The Washington Post
> The wealthiest 1 percent of American households own 40 percent of the country's wealth, according to a new paper by economist Edward N. Wolff. That share is higher than it has been at any point since at least 1962, according to Wolff's data, which comes from the federal Survey of Consumer Finances.

From 2013, the share of wealth owned by the 1 percent shot up by nearly three percentage points. Wealth owned by the bottom 90 percent, meanwhile, fell over the same period. Today, the top 1 percent of households own more wealth than the bottom 90 percent combined. That gap, between the ultrawealthy and everyone else, has only become wider in the past several decades.
wealth  US  finance  2018 
16 days ago
Tolerance is not a moral precept – Extra Newsfeed
> Tolerance is not a moral absolute; it is a peace treaty. Tolerance is a social norm because it allows different people to live side-by-side without being at each other’s throats. It means that we accept that people may be different from us, in their customs, in their behavior, in their dress, in their sex lives, and that if this doesn’t directly affect our lives, it is none of our business. But the model of a peace treaty differs from the model of a moral precept in one simple way: the protection of a peace treaty only extends to those willing to abide by its terms. It is an agreement to live in peace, not an agreement to be peaceful no matter the conduct of others. A peace treaty is not a suicide pact.
tolerance  politics  morality  social_contract 
16 days ago
How Women Are Watching Porn Today, Because We're Viewing It On Our Phones More Than Men
> As of February 2017, Pornhub found that nearly 80 percent of female traffic comes from mobile phones in comparison to just 69 percent for men. That number increased by 10 percent for both men and women since 2014. However, women have consistently been watching porn on mobile than men for years.
pornography  gender  trends  internet 
18 days ago
How Congress Censored the Internet | Electronic Frontier Foundation
Really bad news following a 97-2 vote by the Senate. > SESTA/FOSTA undermines Section 230, the most important law protecting free speech online. Section 230 protects online platforms from liability for some types of speech by their users. Without Section 230, the Internet would look very different. It’s likely that many of today’s online platforms would never have formed or received the investment they needed to grow and scale—the risk of litigation would have simply been too high. Similarly, in absence of Section 230 protections, noncommercial platforms like Wikipedia and the Internet Archive likely wouldn’t have been founded given the high level of legal risk involved with hosting third-party content.
free_speech  law  internet  future  2018 
18 days ago
Fatebenefratelli Hospital - Wikipedia
> During the Nazi raid of the Jewish ghetto in Rome on October 16, 1943, Jewish escapees sought refuge at the hospital. Borromeo accepted them and declared that these new "patients" had been diagnosed with a contagious, fatal disease called Il Morbo di K ("the Syndrome K"), which could be interpreted as standing for "Koch disease" or "Kreps disease".[4][5] The name was suggested by physician and anti-fascist activist Adriano Ossicini.[3] The letter K was designated for the Jewish refugees to distinguish them from real patients. K was derived from the German officer Albert Kesselring, who led the troops in Rome, and from Sicherheitspolizei and Sicherheitsdienst chief Herbert Kappler, who was appointed as city police chief.[3] "Syndrome K" was purported to be a neurological illness whose symptoms included convulsions, dementia, paralysis, and, ultimately, death from asphyxiation.[6] While the symptoms of the disease were deliberately kept ambiguous, the Nazis were noted to refrain from investigating the hospital or even to conduct searches for Jews on the premises out of fear of contracting the disease.[4] The Jewish patients were advised to appear ill and to cough loudly, affecting symptoms similar to tuberculosis.[4]

Besides Fr. Maurizio and Borromeo, other doctors on staff assisted the Jewish patients and helped to move them to safer hideouts outside the hospital. In May 1944, the hospital was raided and five Jews from Poland were detained. However, the ruse saved approximately 100 refugees.[4]
history  holocaust  judaism  medicine  social_justice 
18 days ago
The abruptness of nuclear weapons
> I think the arguments for a nuclear discontinuity are really strong, much stronger than any other technology. Physics fundamentally has a discrete list of kinds of potential energy, which have different characteristic densities, with a huge gap between chemical and nuclear energy densities.
physics  technology  future  paul_christiano 
18 days ago
[OPEN QUESTION] Insect declines: Why aren’t we dead already? | Eukaryote Writes Blog
> My guess is that ecologists like to overstate the importance of charismatic animals to ecosystems, including flying insects. Maybe they feed some birds and stuff, but birds also aren’t that important to ecosystems. (Non-human vertebrates are generally tiny footnotes to Earth’s ecology, which is dominated by plants, bacteria, and fungi.)

The paper “A Comparative Analysis of Soil Fauna Populations and Their Role in Decomposition Processes” says: “The soil fauna appears generally to be responsible for less than about 5% of total decomposer respiration” (p. 288). I assume that fungi/bacteria/actinomycetes/etc. account for most of it. In many composting operations, invertebrate animals are minor contributors to decomposition, mainly helping to speed up the process by mechanical breakdown of large pieces of organic matter. So it seems you don’t really need insects for nutrient cycling.
insects  brian_tomasik  ecosystem 
18 days ago
No, I don't believe that "Reduction in Firearm Injuries during NRA Annual Conventions" story - Statistical Modeling, Causal Inference, and Social Science
> To return to a common theme: Publication of interesting data is a great thing to do. The mistake is to take a data pattern too seriously, just because:

(1) Some researcher somewhere did some analysis resulting in “p less and 0.05,” and

(2) Some legitimate journal somewhere happened to publish this result.
andrew_gelman  statistics 
18 days ago
Italy gov't formation talks to begin, one month after election - Xinhua | English.news.cn
Italian elections: "The inconclusive March 4 vote delivered two winners, the center-right bloc led by the right-wing and the anti-immigrant League party, which also includes former prime minister Silvio Berlusconi's Forza Italia party, and the populist Five Star Movement."
italy  elections  2018 
18 days ago
Luxuriating in Privacy
> Privacy is a component of well-being, a form of wealth, a luxury even, and the gains from supplying more privacy to a larger number of people must be weighed alongside alleged losses of social capital from atomization. What looks like a loneliness epidemic to a certain kind of observer may look like a golden age of privacy to another. Just as there are mental states that are only possible in crowds or with others, there are mental states that are only possible in privacy.
sarah_perry  privacy  2018  psychology  luxury 
20 days ago
Roman military diploma - Wikipedia
> the practice of granting Roman citizenship to non-citizen auxiliaries after 25 years' service (26 in the navy)
history  army  rome 
23 days ago
al-Razi (Rhazes), 865–925 | American Journal of Psychiatry
> As the director of the hospital in Baghdad, he established a special section for the treatment of the mentally ill. He treated his patients with respect, care, and empathy. As part of discharge planning, each patient was given a sum of money to help with immediate needs. This was the first recorded reference to psychiatric aftercare and, perhaps, to the existence of a psychiatric consultation service in a general hospital.
islam  psychiatry  history 
23 days ago
Distinct subtypes of Alzheimer's disease based on patterns of brain atrophy: longitudinal trajectories and clinical applications. - PubMed - NCBI
> We aimed to (1) validate the combined use of visual rating scales for identification of AD subtypes; (2) characterise these subtypes at baseline and over two years; and (3) investigate how atrophy patterns and non-memory cognitive domains contribute to memory impairment. AD patients were classified as either typical AD (n = 100), limbic-predominant (n = 33), or hippocampal-sparing (n = 35) by using the Scheltens' scale for medial temporal lobe atrophy (MTA), the Koedam's scale for posterior atrophy (PA), and the Pasquier's global cortical atrophy scale for frontal atrophy (GCA-F). A fourth group with no atrophy was also identified (n = 30). 230 healthy controls were also included. There was great overlap among subtypes in demographic, clinical, and cognitive variables.
4 weeks ago
Against All Odds: Genocidal Trauma Is Associated with Longer Life-Expectancy of the Survivors
> Cox regression yielded a significant hazard ratio (HR = 0.935, CI (95%) = 0.910–0.960), suggesting that the risk of death was reduced by 6.5 months for Holocaust survivors compared to non-Holocaust comparisons. The lower hazard was most substantial in males who were aged 10–15 (HR = 0.900, CI (95%) = 0.842–0.962, i.e., reduced by 10 months) or 16–20 years at the onset of the Holocaust (HR = 0.820, CI (95%) = 0.782–0.859, i.e., reduced by18 months)
4 weeks ago
The Personal and Social Value of Brain Preservation – One View: A Response to Sue Blackmore’s Guardian Article Questioning Its Value – The Brain Preservation Foundation
> Life is not just about growing diversity, and improving our individual and cultural memory of that diversity, it is also about growing useful diversity, also called adaptiveness, or perhaps, adaptive intelligence. Some of the most important things in life are not the things that change, but the things that stay the same in the midst of constant change. We might call those things truths, wisdom, or universals. Those parts will continue to be deeply useful, to ourselves and society. Recognizing those parts today, as best we can, can also greatly improves our lives here today. In other words, the better we understand and protect those parts of all living systems that usefully remain the same, as well as understand and protect those parts of us that are usefully different, the better we know ourselves and our societies, and the better the world gets.
4 weeks ago
WTF! No neurogenesis in humans??
Would be interesting to try to find newly born cells in the human brain using single cell RNAseq. > Thus, it is unlikely that there are false-positives in Sorrells work, but there could be false negatives since some DCX-only or PSA-NCAM-only cells might really be legitimate adult-born neurons, because they could downregulate expression of one marker before another. Previous studies have also used DCX as a marker of adult neurogenesis in the human hippocampus. For example, the images by Epp et al are some of the nicest I’ve seen. Are they a bit odd-looking? Sure, maybe. But no one has ever described the morphology of newborn human hippocampal neurons so I don’t know what is normal. Are their DCX neurons a bit more in the hilus than I would expect from rodent studies? Perhaps, but again, might it be that if there is a germinal zone in adult humans, it looks different than rodents? Some previous human studies (eg Boldrini 2009) have examined a band that extends more into the molecular layer and hilus. Which is correct? I don’t know.
4 weeks ago
Algal bloom - Wikipedia
Saw a couple of these in Point Reyes on our hike today. > Red tide is a term often used synonymously with HABs in marine coastal areas, however the term is misleading since algal blooms can be a wide variety of colors and growth of algae is unrelated to the tides. The term 'algal bloom' or 'harmful algal bloom' has since replaced 'red tide' as the appropriate description of this phenomenon.
algae  lake  water  plants 
5 weeks ago
Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. - PubMed - NCBI
> The intervention comprised withdrawal of antidiabetic and antihypertensive drugs, total diet replacement (825-853 kcal/day formula diet for 3-5 months), stepped food reintroduction (2-8 weeks), and structured support for long-term weight loss maintenance. ... Remission varied with weight loss in the whole study population, with achievement in none of 76 participants who gained weight, six (7%) of 89 participants who maintained 0-5 kg weight loss, 19 (34%) of 56 participants with 5-10 kg loss, 16 (57%) of 28 participants with 10-15 kg loss, and 31 (86%) of 36 participants who lost 15 kg or more. Mean bodyweight fell by 10·0 kg (SD 8·0) in the intervention group and 1·0 kg (3·7) in the control group (adjusted difference -8·8 kg, 95% CI -10·3 to -7·3; p<0·0001). Quality of life, as measured by the EuroQol 5 Dimensions visual analogue scale, improved by 7·2 points (SD 21·3) in the intervention group, and decreased by 2·9 points (15·5) in the control group
weight_loss  T2DM 
5 weeks ago
Glucocorticoid Signaling in Myeloid Cells Worsens Acute CNS Injury and Inflammation | Journal of Neuroscience
> Glucocorticoid stress hormones (GCs) are well known for being anti-inflammatory, but some reports suggest that GCs can also augment aspects of inflammation during acute brain injury. Because the GC receptor (GR) is ubiquitously expressed throughout the brain, it is difficult to know which cell types might mediate these unusual “proinflammatory” GC actions. We examined this with cell type-specific deletion or overexpression of GR in mice experiencing seizure or ischemia. Counter to their classical anti-inflammatory actions, GR signaling in myeloid cells increased Iba-1 and CD68 staining as well as nuclear p65 levels in the injured tissue. GCs also reduced levels of occludin, claudin 5, and caveolin 1, proteins central to blood–brain-barrier integrity; these effects required GR in endothelial cells. Finally, GCs compromised neuron survival, an effect mediated by GR in myeloid and endothelial cells to a greater extent than by neuronal GR.
steroids  brain  microglia  immunology 
6 weeks ago
Medical careers - Career review
> What if I’m already a doctor?
We recommend – especially for doctors early in their career – slanting your efforts more towards the promising areas within medicine (biomedical research, health policy work and public health, possibly healthcare management). Another approach, especially for later-career doctors who are in the ‘wrong’ field, is trying to maximise income for earning to give.

Can clinical practice be high-impact?
There is little data which can help answer the question, “Which medical specialty has the highest impact?” The best heuristic would be to try and look at where the need for medical care most greatly exceeds its supply. Within the developed world, this would suggest looking for ‘cinderella’ fields are neglected due to things like being stigmatized or poorly paid (psychiatry and mental health is a leading candidate). However, there are reasons to think – particularly in health systems like the UK – there should not be too great a discrepancy between the value of different specialties, or of working in different locations.
medicine  post_mdphd  psychiatry 
6 weeks ago
It’s not that your teeth are too big: your jaw is too small | Aeon Ideas
> The dental anthropologist Robert Corruccini at Southern Illinois University has seen the effects by comparing urban dwellers and rural peoples in and around the city of Chandigarh in north India – soft breads and mashed lentils on the one hand, coarse millet and tough vegetables on the other. He has also seen it from one generation to the next in the Pima peoples of Arizona, following the opening of a commercial food-processing facility on the reservation.
teeth  science  evolution 
6 weeks ago
Slowing Biological Time to Extend the Golden Hour for Lifesaving Treatment
> DARPA created the Biostasis program to develop new possibilities for extending the golden hour, not by improving logistics or battlefield care, but by going after time itself, at least how the body manages it. Biostasis will attempt to directly address the need for additional time in continuously operating biological systems faced with catastrophic, life-threatening events. The program will leverage molecular biology to develop new ways of controlling the speed at which living systems operate, and thus extend the window of time following a damaging event before a system collapses. Essentially, the concept aims to slow life to save life.

“At the molecular level, life is a set of continuous biochemical reactions, and a defining characteristic of these reactions is that they need a catalyst to occur at all,” said Tristan McClure-Begley, the Biostasis program manager. “Within a cell, these catalysts come in the form of proteins and large molecular machines that transform chemical and kinetic energy into biological processes. Our goal with Biostasis is to control those molecular machines and get them to all slow their roll at about the same rate so that we can slow down the entire system gracefully and avoid adverse consequences when the intervention is reversed or wears off.”
military  research  cryonics 
6 weeks ago
Opioid vs Nonopioid Medications on Pain-Related Function | Emergency Medicine | JAMA | The JAMA Network
Opioids weren't more effective over a year for hip or knee pain. > Question  For patients with moderate to severe chronic back pain or hip or knee osteoarthritis pain despite analgesic use, does opioid medication compared with nonopioid medication result in better pain-related function?

Findings  In this randomized clinical trial that included 240 patients, the use of opioid vs nonopioid medication therapy did not result in significantly better pain-related function over 12 months (3.4 vs 3.3 points on an 11-point scale at 12 months, respectively).
opioid  pain 
6 weeks ago
A New Beginning
> I am here, and my feet are planted firmly on this earth. I am alive—I am so wildly alive. I feel each beat of my heart, I sense every sound, the melody of voices so distant you can barely hear them, the gentle hum of traffic outside my window. In the morning it smells of bitter coffee, in the evening of lavender soap. I see every brilliant ray of light, I feel the soft warmth on my skin. The sun glows down on me as if it comes from heaven.

Most of all, I am afraid. I feel that hiccup every time my heart skips a beat. The terror in my throat that chokes me. Every time I cough I feel it, every breath I take I feel it. But I will live my life, anyway.
cancer  psychiatry  fear  life 
7 weeks ago
Health Information of Deceased Individuals | HHS.gov
> The HIPAA Privacy Rule protects the individually identifiable health information about a decedent for 50 years following the date of death of the individual.  This period of protection for decedent health information balances the privacy interests of surviving relatives and other individuals with a relationship to the decedent, with the need for archivists, biographers, historians, and others to access old or ancient records on deceased individuals for historical purposes.
HIPAA  death  trade_offs 
7 weeks ago
Prevention Project Dunkelfeld - Wikipedia
> The Prevention Project Dunkelfeld (PPD) is an effort founded in Germany to provide clinical and support services to individuals who are sexually attracted to children (pedophiles and hebephiles) and want help controlling their sexual urges, but are otherwise unknown to the legal authorities.[1][2][3] The term "dunkelfeld" is German for "dark field."[4] The project began in Berlin in June 2005 with a large media campaign to contact pedophiles and hebephiles who wanted help from clinicians. The campaign pledged medically confidential treatment free-of-charge. It was initially funded by the Volkswagen Foundation, and has been financially supported by the German government since 2008.[5] The project's slogan is "You are not guilty because of your sexual desire, but you are responsible for your sexual behavior. There is help! Don’t become an offender!"[6]
psychiatry  germany  paraphilia  pedophilia 
7 weeks ago
History of medical regulation in the United Kingdom - Wikipedia
> The earliest reference to medical regulation in the UK dates from 1421, when physicians petitioned parliament to ask that nobody without appropriate qualifications be allowed to practise medicine. The doctors said that unqualified practitioners caused "great harm and slaughter of many men".[1]:274

Despite agreement in principle from parliament, little more appeared to happen until 1511, when a statute placed regulation of the medical profession in the hands of the bishops. John Raach wrote that "the Church was apparently considered the one institution whose influence was extensive and potent enough to be effective in suppressing quacks and licensing the members of the medical profession". Raach further suggested that as a learned profession, medicine "could not be relegated to regulation by the average county official". Clerics, often the most highly educated members of society, were better suited to the task. Medicine and religion were also closely entwined: healing had long been associated with the supernatural, while the events of birth and death involved both medics and clerics.[1]:277–278

The purpose of the 1511 statute was to eliminate unqualified practitioners, and to that end it provided for a financial reward for those who reported them.

In 1518, the College of Physicians was founded and took over licensing of doctors in London. The College was founded by physicians themselves, meaning that in London the licensing of medicine was in the hands of the profession, rather than the bishop. Various disputes arose between the College, universities, and bishops over their authority to license and recognise each other's qualifications.

As doctors often covered large areas, crossing diocesan boundaries, they often required licenses from several bishops. At some point – it is unclear precisely when – archbishops were empowered to issue licenses for multiple dioceses. In the early seventeenth century, nearly a quarter of doctors received their licenses from archbishops.[1]:287
history  medicine  licensing  religion 
7 weeks ago
Betterhumans | Our Projects
Non-profit apparently running a trial on senolytics. > Senolytic Compounds: The question seeking to be answered by this Phase 0 pilot study is whether the senolytic compounds Dasatinib (CAS no. 302962-48-8) and Quercetin (CAS no. 117-39-5) will significantly eliminate senescent cells contained in the muscle and fat tissue of elderly individuals who have Metabolic Syndrome and/or Osteoarthritis, and will reduce levels of systemic inflammation, insulin resistance, improve their immunological responses, and in those having Osteoarthritis, reverse the progression of this disease.
senolytic  betterhumans  transhumanism  clinical_trial  aging 
7 weeks ago
Reduction in Firearm Injuries during NRA Annual Conventions | NEJM
Clever study.
> Among 75,567,650 beneficiary-period observations in the claims analysis, 14.3% occurred on NRA convention dates. The unadjusted rate of firearm injuries was lower during convention dates than during control dates (129 beneficiaries with a firearm injury among 10,883,304 persons [1.19 per 100,000] vs. 963 beneficiaries with a firearm injury among 64,683,254 persons [1.49 per 100,000]; P=0.004; relative difference, 20.1%; 95% confidence interval, 6.7 to 34.0). The findings were unaffected by adjustment for covariates (Figure 1).

Reductions in firearm injuries during convention dates were largest among men, in the South and West, in states in the highest third of gun-ownership rates, and among people who resided in the state hosting the convention. There was no difference in the proportion of crimes involving a firearm between convention and control dates.
guns  NRA  science 
7 weeks ago
FDA OKs Cognition as Sole Outcome Measure for Preclinical AD Trials | ALZFORUM
> “[The guidance] reflects acceptance of new approaches that are supported by research. … The acknowledgement that large effects in cognition may be important without a co-primary was refreshing,” ... The new guidance does not use the term “disease-modifying,” but instead suggests looking for an effect on disease progression by using a crossover design, in which the placebo group switches to active drug at a given point in time. If the placebo group fails to catch up to the benefit seen in the active group, this indicates a lasting effect of the treatment on the course of disease. The FDA emphasized that this benefit must be shown on clinical tests, not just on biomarkers.
alzheimers  FDA  cognition  clinical_trial 
7 weeks ago
Effects of changes in eating speed on obesity in patients with diabetes: a secondary analysis of longitudinal health check-up data | BMJ Open
People who eat slower are less likely to be obese, and vice versa. > The generalised estimating equation model showed that eating slower inhibited the development of obesity. The ORs for slow (0.58) and normal-speed eaters (0.71) indicated that these groups were less likely to be obese than fast eaters (P<0.001). Similarly, the fixed-effects models showed that eating slower reduced BMI and waist circumference. Relative to fast eaters, the coefficients of the BMI model for slow and normal-speed eaters were −0.11 and −0.07, respectively (P<0.001).
mindfulness  diet  lifestyle  japan  DM2 
7 weeks ago
Hydrocortisone plus Fludrocortisone for Adults with Septic Shock | NEJM
"APROCCHSS compared combined hydrocortisone and fludrocortisone – included to increase vascular tone – to placebo in 1,200 patients with septic shock. Treatment improved 90-day mortality compared to placebo (43% vs. 49%, respectively) and increased organ-failure free and ventilator-free days. Experts think a mortality benefit was evident in APROCCHSS because the trial enrolled more tenuous patients. Patients had higher rates of positive blood cultures, pneumonia, and overall mortality compared to ADRENAL participants."
sepsis  ICU 
7 weeks ago
pdf -- Death and the Self
Tibetan Buddhist monks are not less afraid of death -- in fact they are more so, in this study. > It is an old philosophical idea that if the future self is literally different from the current self, one should be less concerned with the death of the future self (Parfit, 1984). This paper examines the relation between attitudes about death and the self among Hindus, Westerners, and three Buddhist populations (Lay Tibetan, Lay Bhutanese, and monastic Tibetans). Compared with other groups, monastic Tibetans gave particularly strong denials of the continuity of self, across several measures. We predicted that the denial of self would be associated with a lower fear of death and greater generosity toward others. To our surprise, we found the opposite. Monastic Tibetan Buddhists showed significantly greater fear of death than any other group. The monastics were also less generous than any other group about the prospect of giving up a slightly longer life in order to extend the life of another.
buddhism  death  fear  philosophy 
7 weeks ago
Is Alcohol Abuse a Bigger Dementia Risk Than We Thought? | ALZFORUM
> A general decline in drinking has been seen since 1960, and further modeling will be required to determine if that explains falling dementia trends in developed countries, Schwarzinger added (Sep 2017 news; Nov 2016 news). Meanwhile, health care providers should be alert to the association between excessive alcohol consumption and cognitive decline. They could employ earlier and more aggressive screening and interventions to reduce its burden in the population, he said.
alcohol  dementia 
8 weeks ago
Deciding to quit medical school | Student Doctor Network
> Before proceeding consider this: I graduated medical school in 1981, residency, private practice, and wrote. It took seven years to get an agent, and another two to have my first novel published. That was over 32 books ago, 10 screenplays, and 2 features as executive producer. Fortunately I maintained the discipline of writing two-three hours a day, editing, and going across country frequently. Work in the arts is scarce, and dedication to my surgical practice (retired), rewarding, taxing, and fulfilling. Quitting medicine would have been foolish. Govern yourself accordingly.
medical_school  post_mdphd  writing  art 
8 weeks ago
Effect of Haloperidol on Survival Among Critically Ill Adults at High Risk of Delirium | Critical Care Medicine | JAMA | The JAMA Network
> Among critically ill adults at high risk of delirium, the use of prophylactic haloperidol compared with placebo did not improve survival at 28 days. These findings do not support the use of prophylactic haloperidol for reducing mortality in critically ill adults.
haloperidol  delirium 
8 weeks ago
Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections. - PubMed - NCBI
> the use of procalcitonin to guide initiation and duration of antibiotic treatment results in lower risks of mortality, lower antibiotic consumption, and lower risk for antibiotic-related side effects. Results were similar for different clinical settings and types of ARIs, thus supporting the use of procalcitonin in the context of antibiotic stewardship in people with ARIs
procalcitonin  antibiotics 
8 weeks ago
Lessons for human genetics from genetic screens in model organisms
> For many human traits or disorders, especially ones involving the human mind, that detailed understanding is lacking. Oftentimes the phenotype is simply a word on a form – like “schizophrenia”. Moreover, while in model organisms we can simply screen out the indirect and non-specific mutations and focus on the ones directly involved in the processes of interest, we don’t have that luxury in humans. The indirect and non-specific ones will contribute most of the variance in risk.

At one level, that’s okay – just identifying these genetic risk factors can be tremendously useful in a clinical setting. But it does make getting at the underlying biology much more challenging. Nature is under no obligation to make things simple for us. It is going to take a hell of a lot more work after the initial discovery of genetic variants to unravel the biology of complex traits and disorders.
kevin_mitchell  genetics  beyond_gwas  gene_expression  schizophrenia  causation 
8 weeks ago
Recent Genetic Studies Claiming a Slowing of Aging may be Largely Incorrect – Fight Aging!
> It is fair to ignore most studies showing extension of life span in laboratory species conducted much prior to the turn of the century. A majority failed to control for calorie restriction, and thus the (usually small) effects evaporate when more rigorously tested. The way this works is that an intervention makes mice nauseous or otherwise uncomfortable, they eat less as a consequence, and thus live longer solely due to lowered calorie intake.
aging  diet  animals  research  calorie_restriction 
8 weeks ago
Doctor with rare disease racing to save his own life - TODAY.com
> Actress Saoirse Ronan tells Sunday TODAY’s Willie Geist that she’s “always wanted to” be a director, but it wasn’t until watching Greta Gerwig direct her and her co-stars in “Lady Bird” that she realized her “pipe dream” could become a reality.
autoimmune  medicine 
8 weeks ago
Technological Unemployment: Much More Than You Wanted To Know | Slate Star Codex
Scott arguing that it's technologic *underemployment* (people training for things, and then the jobs ceasing to exist sooner than they expected) that we should worry about. > 1. Technological unemployment is not happening right now, at least not more so than previous eras. The official statistics are confusing, but they show no signs of increases in this phenomenon. (70% confidence)

2. On the other hand, there are signs of technological underemployment – robots taking middle-skill jobs and then pushing people into other jobs. Although some people will be “pushed” into higher-skill jobs, many will be pushed into lower-skill jobs. This seems to be what happened to the manufacturing industry recently. (70% confidence)

3. This sort of thing has been happening for centuries and in theory everyone should eventually adjust, but there are some signs that they aren’t. This may have as much to do with changes to the educational, political, and economic system as with the nature of robots per se. (60% confidence)
employment  economics  scott_alexander  future 
8 weeks ago
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 
9 weeks 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 
9 weeks 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 
9 weeks 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 
9 weeks 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 
10 weeks 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 
10 weeks 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 
10 weeks 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 
10 weeks 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 
11 weeks 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 
11 weeks 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 
11 weeks 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 
11 weeks 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 
11 weeks 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 
11 weeks 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 
11 weeks 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 
11 weeks 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 
11 weeks 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 
12 weeks ago
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