I’m writing a book about reverse psychology; please don’t buy it.
The judge said I had to keep 6 feet away from my ex-wife. So I buried her under the patio.
Robert Buxbaum: the above 3 jokes are from Jack Rappaport — He sometimes sells jokes. April 13, 2022. The ones below are from Gahan Wilson, and the one at right, I don’t know.
These last two are from Gahan Wilson
In this blog-post, I’d like to report on the first random study of patients with Atrial fabulation, A-Fib, and sleep apnea, comparing the health outcome of those who use a C-PAP, a “Continuous Positive Airway Pressure” device, to the outcome those who do not. The original study was published in May, 2021 (read it here) in the American Journal of Respiratory and Critical Care Medicine. The American Journal, Pulmonary Advisor published a more-popular version here.
As a background, if you are over 65 and overweight, there is a 25% chance or so that your heart rate will begin to surge semi-randomly, and that it will flutter. This is Atrial fabulation, A-Fib. It tends to get worse and tends to lead to heart attacks and strokes. People with A-fib tend to be treated with drugs, aspirin, warfarin, beta blockers, and anti arrhythmics. They also tend to be prescribed a C-PAP because overweight, older folks tend to snore and wake up a lot during the night (several times per hour: apnea).
A C-PAP definitely stops the snoring and the Apnea, and the assumption was that it would help your heart as well, if only by giving you a better night’s sleep. As it turns out, the C-PAP seems to decrease heart health — significantly.
For this study, adult patients between 18 and 75 years old diagnosed with paroxysmal A-Fib (that’s occasional AF) were screened for moderate to severe sleep apnea. Those who agreed to participate were randomly assigned to either a treatment of C-PAP plus usual care (drugs mostly) or just usual care for the next 5 months. Of the 109 who enrolled in the study, 55 got the C-PAP plus usual care, 54 got usual care alone. The outcome was that there were 9 serious, adverse heart events (strokes and heart attacks); 7 were in the C-PAP group.
The CPAP pressure was, on average, 6.8 cm H2O; mean time of use was 4.4±1.9 hours per night. The C-PAPs did their jobs on the apnea too, reducing residual apnea-hypopnea to 2.3±1.9 events per hour for those in the C-PAP group.
There was a non-statistically significant reduction is AF among the C-PAP group. They reduced their time in AF by 0.6 percentage points compared to the control group (95% CI, -2.55 to 1.30; P =.52). That not a statistically significant difference, and is most likely random.
There was a statistically significant decrease in heart health, though. A total of 7 serious adverse events occurred in the C-PAP group and only 2 in the control group. A total of 9 is a relatively small number of events, but there is a strong statistical difference between 7 and 2.
The authors conclude: “CPAP treatment does not seem to reduce or prevent paroxysmal AF.” They should also have concluded that it reduced heart health with a statistical confidence of ~82%: (1-2(36+10)/512) =82%. See more on this type of statistics.
A possible explanation of why a C-PAP would would make heart health worse is an outcome of the this recent sleep study (link here). It appears that the C-PAP helps restore breathing, but by doing so, it interferes with a mechanism the body uses to deal with A-fib. It seems that, for people with A-Fib, their bodies use breathing stoppages to get their heart back into rhythm. For these people, many of their breathing stoppage are not obstructive, but a bio-pathway to raise the CO2 level in the blood and thus regulate heart rate. The use of a C-PAP prevents this restorative mechanism and this seem to be the reason it is destructive to the heart-health of patients with A-fib. On the other hand, a C-PAP does improve the sleep those patients whose apnea is obstructive. It seems to me that sleep studies should do a better job distinguishing the two causes of apnea. C-PAPs seem counter-indicated for patients with A-fib.
Robert Buxbaum, March 30, 2022. I was diagnosed with apnea and A-Fib some years ago. The sleep doctor prescribed a C-PAP and was adamant that I had to use it to keep my heart healthy. There were no random studies backing him up or contradicting him until now.
I’m not sure why this is, but a quick look at the death statistics shows that it is no lower today than it was a year ago. Vaccines seem to help the individual, but they don’t seem to do much for society as a whole.
That the death rates are the same as last November is bad, especially since one major effect of COVID has been to wipe out nearly all our old folks, decreasing the lifespan of US men by 2-3 years. With a 70% vaccination rate (adults, 60% overall), and few old people, you ‘d expect our death rate this year would be lower than last.
Currently, at least, the trend-line looks positive, but that’s likely a mirage. It is common to add more deaths to the tally, retroactively a few weeks out as many deaths take weeks to report and more weeks to be counted as COVID. For what it’s worth, I’m vaccinated, two shots and a booster. I also take aspirin, and have gotten a pneumonia shot. I think it helps. What do I know?
Robert Buxbaum, November 18, 2021
As we discuss the effectiveness of the various COIVD vaccines, and ask if we will need another booster in a year, this time for the delta variant, or epsilon, it’s worth noticing that none of these is that deadly, especially if you’ve had a previous version. There are far worse viruses out there, like Ebola-Zaire, for example. This virus kills 60-90% of the people infected, typically by causing the body’s connective tissue to dissolve. Now that’s a deadly virus; imagine an ebola pandemic.
We live surrounded by many really deadly viruses, most of them incurable. In general our protection from them is that they usually show a slow infection rate or a slow progress to death. Drug resistant leprosy is one of these. Here’s the beginnings of a list of deadly viruses we could worry about: Lassa, Rift Vally, Oropouche, Rocio Q Guanarito, VEE, Marburg, Herpes B, Monkey Pox, Dengue, Chikunguanya, Hantavirus, Machupo, Junin, Rabies-like Mokola, drug-resistant leprosy, Duvenhage, LeDantec, Kyasanur, Forest Brain virus, HIV-AIDs, Simliki, Crimean-Congo virus, Sindbis, O’nyongnyong, Sao Paulo, SARS, Ebola Sudan, Ebola Zaire, Ebola Reston, Mid-East Respiratory (MERS), Zika, Delta-COVID. (I got 2/3 of this list from a 1993 book called “The Hot Zone” about the first US outbreak of Ebola — Washington DC in 1989 — a good book, worth a read).
As an ilk, these viruses are far older than we are, older than the first cellular creatures, and far tougher. They are neither dead nor alive, and can last for years generally without air, water or food if the temperature is right. Though they do not move on their own, nor eat in any normal sense, they do reproduce, and they do so with a vengeance. They also manage to evolve by an ingenious sexual mechanism. In a sense, they are the immune system of the earth, protecting the earth from man or any other invasive life form. We humans have only survived the virus for 100,000 years or so. Long term, the viruses are likely to win.
Some viruses are string shaped; Marburg and Ebola are examples. Such viruses can crystalize and live virtually forever on dry surfaces. Other viruses are ball-shaped, COVID and Zika, for example. These are more easily attacked on surfaces, e.g. by iodine. They become inactive after just a few minutes in air– and are killed instantly by iodine, alcohol, bleach, or peroxide.
Most viruses enter by cuts and body fluids. This is the case with AIDS and herpes. Others, like measles, shingles, and Zika, enter by way of surfaces and the hands. Virus-laden droplets collect on surfaces and are brought to a new host when the surface is touched and hand-transported to the nose or eyes. A few viruses, like SARS, Ebola, and COVID-19 can enter the body by breathing too. I’ve collected some evidence in favor of Iodine as a surface wipe, a hand wipe and as mouthwash in this previous essay.
Dr. Robert E. Buxbaum, November 3, 2021. The US has three facilities where they deal with the most deadly, contagious viruses. One is in Washington DC; they had leak in 1989, a part of the ebola outbreak. China has only one such facility, in Wuhan, China. It’s one block from where the COVID-19 outbreak supposedly originated. Have a nice day.
There is a joke: what is the opposite of speaking?
It’s waiting to speak.
Most people find it uncomfortable to sit still and be quiet. Even listening is a pain. People sit brewing in their thoughts of what they are going to say. Silence is uncomfortable enough that solitary confinement for a few days is torture.
But what about a few minutes. Almost everyone can sit still and listen for 15 minutes as their friend drones on, especially if they are paid for it. Still, it’s uncomfortable, and a study set out to understand how uncomfortable. It turns out that a majority of men, 67% would rather give themselves electric shocks than sit and think or listen. Women, too find it unpleasant; some 25% of women preferred to give themselves electric shocks rather than sit and think. You’ll find a brief review of this and similar work copied above, or you can read the full study: Wilson et al 2014, “The challenge of the disengaged mind“.
The effect of the COVID-19 lockdowns has been massive. Those involved in government discussions don’t seem to realize how massive, perhaps because they’re in constant contact with people, speaking and being spoken too. Most of us were not so lucky. We experienced partial isolation. A recent study suggests that almost every measure of happiness disappeared during the summer months of 2020: US agreeableness, extroversion, conscientiousness, and openness all declined dramatically, see data above. Decisiveness too; a lingering effect is an inability to make decisions. My hope is that government officials can resist the temptation for more lockdowns and mandates; mental health is health too.
If lockdowns do come, or if you are depressed for any other reason, you might consider exercise, or lithium, or counseling. At least decide to wake up at a fixed time every morning. Under COVID watch conditions, depression is the new normal. Here’s a joke on marriage counseling.
Robert Buxbaum, October 27, 2021
I may be paranoid, but that doesn’t mean I’m crazy. COVID-19 shows a remarkably low death rate in Asia, particularly Eastern Asia, compared to the US or Europe or South America. As of this month, there have been 734,600 US deaths from COVID-19, representing 0.22% of all Americans. Another way of stating this is 2.2 deaths per thousand population. In one year, COVID has lowered the life expectancy of US men by 2.1 years; with the decline worst among hispanic men. The COVID death rate is very similar in Europe, and higher in South America (in Peru 0.62%), but hardly any deaths in East Asia. In China only 4,636 people, 0.003% of the population. That’s 1/700th the rate in the US, and almost all of these deaths are in western China. They no longer bother with social distancing.
The low death rate in East Asia. was noted by the BBC over a year ago. Based on today’s data from Worldometer, here, the low death rates continue throughout East Asia, as graphed at right. In Hong-Kong the death rate is 0.03 per thousand, or 1/70th the US rate. In Taiwan, 0.04 per thousand; in Singapore, 0.01 per thousand; in S. Korea 0.04 per thousand; Cambodia and Japan, 0.1 per thousand. The highest of these countries shows 1/20 the death rate of the US. This disease kills far fewer East Asians than Westerners. This difference shows up, for example in a drop in the lifespan of male Americans by 2.16 years. The lifespan of male Hispanics dropped more, by 4.58 years. In China, Japan, and Korea the lifespans have continued to increase.
My suspicion is that this was a racially targeted bio-weapon. But perhaps the targeting of westerners reflects a cultural lifestyle difference. Mask use has been suggested, but I don’t think so. In many high mask countries the death rate is high, while in low mask Taiwan and Korea it’s low, only 0.04 COVID deaths per thousand. Even Sweden, with no masks reports only 1.4 per thousand deaths; that’s 2/3 the death rate of the US. Masks do not seem to explain the difference.
Another lifestyle difference is obesity; Americans are fat. Then again, Peru was hit far worse than we were, and Peruvians are thin. Meanwhile, in Hong Kong, folks are fat, but the death rate is small. Another cultural difference is medicine, but I don’t believe Sweden, Germany, and France have worse healthcare than Taiwan or Cambodia. Cambodia saw 1/20 the US COVID death rate.
My suspicion is that this disease targets by race because it was designed that way. If it isn’t a bio weapon, it certainly behaves like one. I may be paranoid here, but that’s the way it seems.
As a side issue, perhaps related, I note that China keeps pushing for the to close its manufacturing in the interest of CO2 abatement, while they keep building coal burning power plants to fill the manufacturing need that we abandon. I also notice that they hit us with tariffs while protesting our tariffs, that they steal our intellectual property, and that they are building islands in the sea between China and Japan. There is war-tension between our countries, and Western-targetting virus appears right outside of China’s top-security virus lab — their only level 4 lab — I’m guessing it’s not a total coincidence.
Robert Buxbaum, October 12, 2021
With the sun setting earlier, and the threat of new COVID lockdowns, there is a real threat of a depression, seasonal and isolation. A partial remedy is exercise; it helps fight depression whether you take other measures not. An article published last month in the Journal of Affective Disorders reviewed 22 studies of the efficacy of exercise, particularly as an add-on to drugs and therapy. Almost every study showed that exercise helped, and in some studies it helped a lot. See table below. All of the authors are from the University of British Columbia. You can read the article here.
For those who are willing to exercise, there are benefits aside from mental health. Even a daily walk around the block helps with bone strength, weight control, heart disease, plus the above mentioned improvement in mood. More exercise does more. If you bicycle without a helmet, you’re likely to live longer than if you drive.
For those who can’t stand exercise, or if exercise isn’t quite enough to send away the blues, you can try therapy, medication, and/or diet. There is some evidence that food that are high in lithium help fight depression. These food include nuts, beans, tomatoes, some mineral waters, e.g. from Lithia springs, GA. The does is about 1/100 the dose given as a bipolar treatment, but there is evidence that even such small doses help. Lithium was one of the seven ingredients in seven up — it was the one that was supposed to cheer you up. See some research here.
Robert Buxbaum, October 7, 2021.
My last post included a rather gruesome bit of poetry by Rudyard Kipling where he describes the Afghani women coming to kill the wounded British soldiers in the first Afghan war. It’s sexist, or anti-sexist, if you like. Since it reverses a stereotype of the non-violent, female home-body. Then again the Afghanis had wiped out an entire British army, killing virtually everyone including civilians.
What follows is The Betrothed, one of Kipling’s first published poems, appearing in “the civil and military gazette”, Lahor, India (near Afghanistan), November, 1888. Kipling was an assistant editor). It has a more traditional view of women, or of British women who do not go out murdering, but who do wish to control/ stop a British man’s cigar smoking. In a sense, such stoppage is murder. The inspiration was a breach of ‘Promise of Marriage’ case in Glasgow, August 1888, where a young woman, Maggie Watson, sued her fiancee because he continued to smoke cigars after she insisted he stop. Kipling explores the psychology of the choice between smoking and marriage. I think Freud would approve.
The Betrothed.
OPEN the old cigar-box, get me a Cuba stout, For things are running crossways, and Maggie and I are out.
We quarrelled about Havanas—we fought o’er a good cheroot, And I knew she is exacting, and she says I am a brute.
Open the old cigar-box—let me consider a space; In the soft blue veil of the vapour musing on Maggie’s face.
Maggie is pretty to look at—Maggie’s a loving lass, But the prettiest cheeks must wrinkle, the truest of loves must pass.
There’s peace in a Larranaga, there’s calm in a Henry Clay; But the best cigar in an hour is finished and thrown away—
Thrown away for another as perfect and ripe and brown— But I could not throw away Maggie for fear o’ the talk o’ the town!
Maggie, my wife at fifty—grey and dour and old— With never another Maggie to purchase for love or gold!
And the light of Days that have Been the dark of the Days that Are,
And Love’s torch stinking and stale, like the butt of a dead cigar—
The butt of a dead cigar you are bound to keep in your pocket— With never a new one to light tho’ it’s charred and black to the socket!
Open the old cigar-box—let me consider a while. Here is a mild Manila—there is a wifely smile.
Which is the better portion—bondage bought with a ring, Or a harem of dusky beauties, fifty tied in a string?
Counsellors cunning and silent—comforters true and tried, And never a one of the fifty to sneer at a rival bride?
Thought in the early morning, solace in time of woes, Peace in the hush of the twilight, balm ere my eyelids close,
This will the fifty give me, asking nought in return, With only a Suttee’s passion—to do their duty and burn.
This will the fifty give me. When they are spent and dead, Five times other fifties shall be my servants instead.
The furrows of far-off Java, the isles of the Spanish Main, When they hear my harem is empty will send me my brides again.
I will take no heed to their raiment, nor food for their mouths withal, So long as the gulls are nesting, so long as the showers fall.
I will scent ’em with best vanilla, with tea will I temper their hides, And the Moor and the Mormon shall envy who read of the tale of my brides.
For Maggie has written a letter to give me my choice between. The wee little whimpering Love and the great god Nick o’ Teen.
And I have been servant of Love for barely a twelvemonth clear, But I have been Priest of Cabanas a matter of seven year;
And the gloom of my bachelor days is flecked with the cheery light Of stumps that I burned to Friendship and Pleasure and Work and Fight.
And I turn my eyes to the future that Maggie and I must prove, But the only light on the marshes is the Will-o’-the-Wisp of Love.
Will it see me safe through my journey or leave me bogged in the mire? Since a puff of tobacco can cloud it, shall I follow the fitful fire?
Open the old cigar-box—let me consider anew— Old friends, and who is Maggie that I should abandon you?
A million surplus Maggies are willing to bear the yoke; And a woman is only a woman, but a good Cigar is a Smoke.
Light me another Cuba—I hold to my first-sworn vows. If Maggie will have no rival, I’ll have no Maggie for Spouse!
Robert E. Buxbaum, September 17, 2021. Kipling has a great sense of words, and an attractive sense of the subjects, great and small. For years he was the voice of his generation in Britain, but by the end of his life, his views were unacceptable. sexist. On the other hand, he remained staunchly anti-Nazi, anti eugenics, and anti Soviet. By comparison, George Bernard Shaw was a vocal fan of Stalin, of Hitler, and of the eugenic removal of Jews and other undesirables. Shaw’s words remain fashionable, while Kipling’s do not. Such is the nature of fame.
The toll of COVID-19 has been terrible: 660,000 dead by my count, based on excess deaths, graph below, or 620,000 according to the CDC based on hospital records. Death rates appear to have returned to pre-pandemic levels, more or less*, but folks are still getting very sick and going to the hospital, mostly for “the delta variant.”
As the following chart shows, severe symptoms of COVID are now almost entirely in the old, and unvaccinated. The risk to the young and middle aged is low, but even there, vaccination helps. According to the CDC, 72.2% of the adult US population is vaccinated with at least one shot. The vaccination, doesn’t prevent you from getting the delta variant nor from spreading it; it just protects from the most serious consequences of the disease. It seems a previous infection has the same effect, though less so.
If you’re over 60 and unvaccinated, I recommend getting vaccinated with at least one shot; the inconvenience and side-effects are few, and the benefit is large. The second shot seemswothshile too, and for all I know a third will too. Sooner or later there is a diminishing return. The benefit of masks seems is smaller, as I judge things. I notice that the disease is spreading at about the same rate in masked and unmasked states, and that the death numbers are as high, or higher in heavily masked, blue states as in red. New York and NJ are the top COVID death states, with Michigan not far behind. Masks seem to help, just not very much.
For those who want further advice, I can suggest dilute iodine gargle. I did this when I got a sore throat, I also suggest got a pneumonia vaccination, and take and adult aspirin every other day for COVID and heart-attack prevention. I also take a vitamin D tablet every few days.
If you wish to check my analysis, go here to get the raw data: https://gis.cdc.gov/grasp/fluview/mortality.html. Then, to calculate the COVID effect, I subtracted the weekly death rates in 2020 and 2021 from the corresponding week rates in 2019, correcting the deaths by 1%/year for population growth and aging. *I find that there are about 500 excess deaths per week, and I assume those are among the unvaccinated. If you are vaccinated, I’d worry about something else besides COVID-delta: heart attack, cancer, suicide, or Afghanistan.
Robert Buxbaum August 18, 2021. I made a video of cute iodine reactions, including the classic “iodine clock”, where I use vitamin C as as the anti-oxidant (reducing agent).
Some years ago I wrote a largely negative review of Brown’s gas, but the COVID crisis in India makes me want to reconsider. Browns gas can provide a simple source of oxygen for those who are in need. First, an explanation, Browns gas is a two-to-one mix of hydrogen and oxygen; it’s what you get when you do electrolysis of water without any internal separator. Any source of DC electricity will do, e.g. the alternator of a car or a trickle charger of the sort folks buy for their car batteries, and almost any electrode will do too (I’d suggest stainless steel). You can generate pressure just by restricting flow from the electrolysis vessel, and it can be a reasonable source of small-scale oxygen or hydrogen. The reaction is:
H2O –> H2 + 1/2 O2.
The problem with Brown’s gas is that it is explosive, more explosive than hydrogen itself, so you have to handle it with care; avoid sparks until you separate the H2 from the O2. Even the unseparated mix has found some uses, e.g. as a welding gas, or for putting in cars to avoid misfires, increase milage, and decrease pollution. I think that methanol reforming is a better source of automotive hydrogen: hydrogen is a lot safer than this hydrogen-oxygen mix.
The mix is a lot less dangerous if you separate the oxygen from the hydrogen with a membrane, as I show in the figure. at right. If you do this it’s a reasonable wy to make oxygen for patients who need oxygen. The electrolysis cell can be a sealed bottle with water and the electrodes; add a flow restriction as shown to create the hydrogen pressure that drives the separation. The power can be an automotive trickle charger. You can get this sort of membranes from REB Research, here and many other suppliers. REB provide consulting services if you like.
In a pinch, you don’t even need the membrane, by the way. You can rely on your lungs to make the separation. A warning, though, the mix is dangerous. Avoid all sparks. Also, don’t put salt into the water. You can can put in some baking soda or lye to speed the electrolysis, but If you put salt in, you’ll find you don’t make oxygen, but will instead make chlorine. And chlorine is deadly. If you’re not sure, smell the gas. If it smells acrid, don’t use it. This is the chlorine-forming reaction.
2NaCl + 2 H2O –> H2 + Cl2 + 2NaOH
Ideally you should vent the hydrogen stream out the window, but for short term, emergency use, the hydrogen can be vented into your home. Don’t do this if anyone smokes (not that anyone should smoke about someone on oxygen). This is a semi-patentable design, but I’m giving it away; not everything that can be patented should be.
Robert Buxbaum, May 13, 2021.