Highly recommend this irreverent podcast by 2 engineers and former NASA contractors. They get out above their skies on some topics but the shuttle content is fun.
Critical care medic here. Adult CPR at least has some evidence in its favor on a population level, but only as a bridge to using electricity. CPR alone is merely slowing deaths arrival.
There is NO evidence to support any of the commonly used advanced cardiac life support drugs in terms of functioning brain leaving the hospital. Epinephrine (for arrest, not shock or anaphylaxis), atropine, lidocaine, amiodarone, procainamide, digitalis, etc. Its electricity or bust.
'Intuitive has been built by the efforts of great people from different walks of life. Our outstanding team, with diverse backgrounds, life experiences, and ideas, has helped pioneer—and continues to be a leader in—the market for minimally invasive, robotic-assisted surgery. Our surgical and endoluminal systems serve a diverse and global community of healthcare professionals and their patients.'
A vehicle with a similar external sensor array has been parked in a lot near my workplace every weekday at lunch time for the past several weeks. Given the proximity to AC3 at Central and Wolfe, my coworkers and I had all assumed it was an Apple test of some kind.
Accords with the rumor mill surrounding Apple leasing a former Pepsi bottling plant down the street.
For 8 years, this man had the option to walk humanity back from the threat of hair-trigger, launch-on-warning nuclear armageddon. An armageddon that would either destroy humanity in a single day...or perhaps merely starve a few billion in the resulting nuclear winter. From these facts alone, I know everything I need to know about his, and all US presidents, commitment to the health of their citizens, and humanity at large.
For evidence of the banality of these pseudo-intellectual studies compare how poorly Western militaries fare against impoverished, malnourished and illiterate insurgencies who lack a budget for scholarly research.
For each of items on the reading list, ask if it provides more or less justification for a growth in State power. Does it make Democide more or less likely?
On the AT up to a few weeks ago. A few hundred miles in a weekend hiker with one of these at a shelter let everyone recharge their devices and they were a modern Prometheus to us. If weight (33 oz + pot + utensil) were not such a crucial consideration to one's happiness when long distance hiking it would definitely be in my pack. It has worked very well for me when testing at home (boils 1 liter of water in ~4 minutes using a handful of wood fuel) and charges devices (subjectively) as fast as my wall outlet.
I plan on winter hiking thru some areas with re-supply locations > 7 days apart and may use the biolite in place of my solar external battery (9.4 oz) since it will also serve for melting snow. I did not cook anything while on the AT (just soylent and mainstay bars) but I anticipate that warm meals will make winter hiking more enjoyable.
Having to negotiate some paperwork is a small price to pay for not dying of an infection. The ER is required by law to provide you with care, regardless of your ability to pay, or immigration status. They do not 'turn in' or 'report' people without ID/passport/green-card/etc. Depending on the nature of your illness, just taking an oral antibiotic is unlikely to be curative.
In the sturm und drang that has resulted from this tragedy, and the weeks to come of hand wringing about terrorists/crazyfolk/etc across the major news networks, I hope against hope that we can stow our reptilian brains for a brief while… In the 3 hours that have passed since the top comment was made, 205 people in the US have died from heart disease(1), an almost entirely preventable disease. This observation may be construed as heartless, insensitive to the victims, and "if it were your X then it would be different"… but I contend that each time we act like chimps and allow our attention to be drawn to the latest epidemiologically insignificant tragedy we lose as a species. A van distributing a year's supply of aspirin to the fleeing masses would have been more helpful than any ambulance..
I'd like to again qualify my status as a non-expert with regards to the surgical aspects of trauma treatment and biochemistry. I have seen similar articles about the foam, and I must admit I am similarly skeptical. The ‘Golden Hour’ is one of those concepts in medicine that everyone praises (it originated @ Marylan’s Shock Trauma center if I recall), but it actually does not have an evidentiary basis.
There are 3 categories of trauma patient, people who will die no matter what you do (hole in the aorta), people who will live no matter what you do (fractured extremities), and people where the outcome may be influenced by treatment in the field. My non-evidence based opinion is that the people in this 3rd population who have the types of injuries that would benefit from this foam will be rather limited. The aorta, inferior vena cava, kidneys and parts of the duodenum, pancreas and rectum are all retroperitoneal. Thus, filling the peritoneal cavity with foam could put pressure on bleeding structures located in the retroperitoneal space, but I would be skeptical. So this foam is for people who have don’t have large hemorrhage of anything in retroperitoneal space and don’t have a fatal mesenteric, liver, or spleen injury, but do have an injury to one of these structures that is sufficiently bad to warrant the foam. The risk of exposing patients with liver and spleen lacerations that could have been managed non-operatively (again, not a surgeon by any stretch but I believe this is a growing trend) to an unnecessary laparotomy isn’t mentioned.
The target audience for this item is going to be armed forces medics with (in my opinion) highly variable clinical skills. Expecting these medics to accurately diagnosis these injuries under heavy stress and not sacrifice time that should be spent on proven therapies like blood administration, tourniquet placement, warm blankets, etc. seems unwise to me.
I am a former critical care medic, and lack the scientific training to judge the merits of their claims about mechanism of action, but if history is any guide regarding ‘miracle’ products it will not live up to the manufacturers claims.
The use cases I can think of and commentary:
-Hemostasis after non-emergent ear/nose/throat procedures.
-Packing of the wound + local epinephrine administration is currently used. It costs nothing, is well understood, and doesn’t have the potential for embolization or immune system interaction weirdness.
-Hemostasis of an extremity wound AFTER a tourniquet has been applied.
-After a tourniquet is properly placed, the arterial flow is halted. Trauma teams have learned from military and orthopedic surgeons that tourniquets are much safer than traditionally understood. Even an amputated limb has a warm ischemia team of 6 hours. The addition of a clotting agent would stop venous oozing, but wouldn’t affect hemodynamics of the patient. It might assist in the case of an inappropriately applied tourniquet.
-Hemostasis of an abdominal wound.
- I guess they envisage pouring this material into the abdomen? That seems like the place most fraught with danger of embolization distally to the mesentery and the generation of immune system interaction weirdness beyond my knowledge base.
A kaolin-based product (Quickclot) was similarly marketed as a wonder drug for treating massive hemorrhage on the battlefield, and it has been less than wonderful in practice. There are youtube videos attesting to its efficacy on the femoral arteries of swine, however these videos ignore the effect wind has upon the powder in a combat setting, and the exothermic reaction that takes place to create the plug. The only way to stop a large hemorrhage is to use copious amounts of the material, resulting in severe burns in some case reports. Concern over embolization of the clotted material led them to create a gauze-bag version.
The company’s claims that holding pressure over the wound is not required runs counter to basic trauma care recommendations. The single best way to halt life-threatening hemorrhage in an extremity is a tourniquet, and the only thing that halts thorax hemorrhage is a surgeon’s finger. The inclusion of this gel in the treatment algorithm would need to be as a last resort, and must never distract from the basics of direct pressure and rapid transport to a surgeon.
I don't know if this qualifies as an ad hominem on my part, but the article comes across as written by the journalist in close coordination with the companies PR firm. The 'hook' inherent in the choice of headline combined with the lack of any discussion of the limitations of the product or previous failures with regards to ‘miracle’ hemorrhage agents cements this in my opinion.
I should have fleshed out that thought more fully. I agree it's a mouthful, but I was trying to convey that we no longer have to believe in such strange (bad) ideas because we have a new set of strange (better) ideas (connectomes and such) that actually have evidence underlying them. The way the course described Sakarnas was as 'bad non-physical spirits/objects/states' that were generated by the body, and that meditation would enable one to "release" them, and prevent their development in the future. Obviously the more evidence-based interpretation of meditation is that it in some way re-wires certain neural connections in a manner that seems to be generally positive.
I'm not in favor of change for the sake of change, but when better reasons are available to describe a phenomenon, I think we should adopt those reasons. Surviving for thousands of years is not a virtue when it comes to the validity of ancient texts or the actions of (historical?) individuals (Buddha, Jesus, Big-Mo, etc.).