Tag Archives: drugs

Every food causes cancer, and cures it, research shows.

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Statistical analysis, misused, allows you to prove many things that are not true. This was long a feature of advertising: with our toothpaste you get 38% fewer cavities, etc. In the past such ‘studies’ were not published in respectable journals, and research supported by on such was not funded. Now it is published and it is funded, and no one much cares. For an academic, this is the only game in town. One result, well known, is the “crisis of replicability”– very few studies in medicine, psychology, or environment are replicable (see here for more).

In this post, I look at food health claims– studies that find foods cause cancer, or cure it. The analysis I present comes from two researchers, Schoenfeld and Ioannides, (read the original article here) who looked at the twenty most common ingredients in “The Boston Cooking-School Cook Book”. For each food, they used Pub-Med to look up the ten most recent medical articles that included the phrase, “risk factors”, the word “cancer”, and the name of the food in the title or abstract. For studies finding effect in the range of 10x risk factors to 1/10 risk factors, the results are plotted below for each of the 20 foods. Some studies showed factors beyond the end of the chart, but the chart gives a sense. It seems that most every food causes or cures cancer, often to a fairly extreme extent.

Effect estimates by ingredient. From Schoenfeld and Ioannides. Is everything we eat associated with cancer? Am J. Clin. Nutrition 97 (2013) 127-34. (I was alerted to this by Dr. Jeremy Brown, here)

A risk factor of 2 indicates that you double your chance of getting cancer if you eat this food. Buy contrast, as risk factor of 0.5 suggests that you halve your cancer risk. Some foods, like onion seem to reduce your chance of cancer to 1/10, though another study say 1/100th. This food is essentially a cancer cure, assuming you believe the study (I do not).

Only 19% of the studies found no statistically significant cancer effect of the particular food. The other 81% found that the food was significantly cancer-causing, or cancer preventing, generally of p=0.05 to 0.05. Between the many studies done, most foods did both. Some of these were meta studies (studies that combine other studies). These studies found slightly smaller average risk factors, but claimed more statistical significance in saying that the food caused or cured cancer.

0.1 0.2. 0.5 1. 2 5 10
Relative risk

The most common type of cancer caused is Gastrointestinal. The most common cancer cured is breast. Other cancers feature prominently, though: head, neck, genetilia-urinary, lung. The more cancers a researcher considers the higher the chance of showing significant effects from eating the food. If you look at ten cancers, each at the standard of one-tailed significance, you have a high chance of finding that one of these is cured or caused to the standard of p=0.05.

In each case the comparison was between a high-dose cohort and a low-dose cohort, but there was no consistency in determining the cut-offs for the cohort. Sometimes it was the top and bottom quartile, in others the quintile, in yet others the top 1/3 vs the bottom 1/3. Dose might be times eaten per week, or grams of food total. Having this flexibility increases a researcher’s chance of finding something. All of this is illegitimate, IMHO. I like to see a complete dose-response curve that shows an R2 factor pf 90+% or so. To be believable, you need to combine this R2 with a low p value, and demonstrate the same behaviors in men and woman. I showed this when looking at the curative properties of coffee. None of the food studies above did this.

From Yang, Youyou and Uzzi, 2020. Studies that failed replication are cited as often as those that passed replication. Folks don’t care.

Of course, better statistics will not protect you from outright lying, as with the decades long, faked work on the cause of Alzheimers. But the most remarkable part is how few people seem to care.

People want to see their favorite food or molecule as a poison or cure and will cite anything that says so. Irreplicable studies are cited at the same rate as replicated studies, as shown in this 2020 study by Yang Yang, Wu Youyou, and Brian Uzzi. We don’t stop prescribing bad heart medicines, or praising irreplaceable studies on foods. Does pomegranate juice really help? red wine? there was a study, but I doubt it replicated. We’ve repeatedly shown that aspirin helps your heart, but it isn’t prescribed much. Generally, we prefer more expensive blood thinners that may not help. Concerning the pandemic. It seems our lockdowns made things worse. We knew this two years ago, but kept doing it.

As Schoenfeld and Ioannides state: “Thousands of nutritional epidemiology studies are conducted and published annually in the quest to identify dietary factors that affect major health outcomes, including cancer risk. These studies influence dietary guidelines and at times public health policy… [However] Randomized trials have repeatedly failed to find treatment effects for nutrients in which observational studies had previously proposed strong associations.” My translation: take all these food studies with a grain of salt.

Robert Buxbaum, April 4, 2023

Our Jail Minimums are Huge, or non-existent

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The United States has more people in prison, per-capita, than any other developed nation, see graph below. Our rate is double Russia’s, and barely below Cuba’s. About 38% of our prisoners are black. That’s a sign of cultural differences or systemic racism; perhaps both.

A major reason for our high prison rate is our huge minimum sentences. In Michigan, as most states, if you possess a firearm when committing a felony or an attempted felony, two years minimum are added to your sentence. The judge’s only allowed input is to add time, or to drop the felony charge. By law, two years minimum have to be added before (not during) the sentence for the underlying felony. It increases to 5 years minimum if you have a prior conviction, and 10 years if you have two or more prior convictions – on top of whatever the Judge decides for the crime. Typically, for a repeat offender, the judge will sentence zero for the felony, because 10 years is enough. Or he will drop the felony charge. The standard penalty, is either the huge minimum, or zero. About 25% of those in Michigan prison, are serving this minimum. Many others who should have gotten a month, or a year, were let go with nothing to avoid giving the minimum -crazy.

Countries with the highest prison population per 100,000 as of January 2023 (from statistica). No country in Europe makes this chart, Russia included.

These laws are specific to guns. No other deadly weapon is treated this way. A knife assailant serves the sentence for the assault only with adding 2 to 10 years minimum. We could go a long way to reduce the prison population if this add-on were moved or severely shortened. I’d like it shortened to 3 months, and broadened to all deadly weapons.

Minimums serve a purpose, I think, preventing violent felons from going free with a good sob-story. But our minimums too long to prevent crime and now only prevent rehabilitation. After ten years in prison, released felons have no life to return to, and no family. The only life they have is crime. It’s been speculated that our huge minimums make felons more violent. Saint Thomas Moore theorized this in the 1500s: A criminal facing a long prison sentence might as well kill the witnesses and hope to escape.

The Michigan State shooter,who killed 3 last week was a felon whose charge was dropped to avoid sending a mentally unstable black man to prison for 2 years. Anthony McRae, had a history as “a hell-raiser,” and was known to be mentally unstable. He had been shooting his gun outdoors near his home, and upon arrest was in possession of a concealed, loaded gun with no permit. These could be changed as firearm felonies, punished by 2 years minimum, or the Judge could drop the case, leaving McRae with his gun. The judge dropped the case, and returned the gun. McRae went on to kill with it. If the minimum were lower, 3 months say, I believe the judge would have convicted Mr McRae’s to that minimum, and taken his gun.

As it was, the judge was faced with the choice of ordering 2 years or nothing.

Our drug sentencing minimums are too high too, especially for “bad drugs.” These carry a 5 to 10 year minimum sentence with no chance for parole. But “dad drugs” are often the ones black people take: LSD, Crack, Heroin, and Methamphetamine. The drugs white politicians take are treated leniently, e.g. mayor Ford of Toronto, or Hunter Biden. I think we’d do everyone a favor by reducing drug minimums, even for bad drugs; for this, too, 2-3 month minimums should do with the judge having discretion to add.

There should be a maximum sentence too, I think, to stop hanging judges. And there should be rehabilitation, but it’s not clear we can manage that. The unions have opposed work-rehabilitation, calling it slave labor. Leader Dogs for the Blind allow prisoners to train guide dogs; it does wonderfully, but something bigger is needed. Lacking good rehabilitation, the smallest sentence that serves as a deterrent is what we should aim for.

Robert Buxbaum February 22, 2023. The original design of Sing-sing included work-rehabilitation in many crafts. The unions complained, and rehabilitation was stopped. Sentencing is a tough balancing act.

Social science is irreproducible, drug tests nonreplicable, and stoves studies ignore confounders.

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Efforts to replicate the results of the most prominent studies in health and social science have found them largely irreproducible with the worst replicability appearing in cancer drug research. The figure below, from “The Reproducibility Project in Cancer Biology, Errington et al. 2021, compares the reported effects in 50 cancer drug experiments from 23 papers with the results from repeated versions of the same experiments, looking at a total of 158 effects.

Graph comparing the original, published effect of a cancer drug with the replication effect. The units are whatever units were used in the original study, percent, or risk ratio, etc. From “Investigating the replicability of preclinical cancer biology,”
Timothy M Errington et al. Center for Open Science, United States; Stanford University, Dec 7, 2021, https://doi.org/10.7554/eLife.71601.

It’s seen that virtually none of the drugs are found to work the same as originally reported. Those below the dotted, horizontal line behaved the opposite in the replication studies. About half, those shown in pink, showed no significant effect. Of those that showed positive behavior as originally published, mostly they show about half the activity with two drugs that now appear to be far more active. A favorite web-site of mine, retraction watch, is filled with retractions of articles on these drugs.

The general lack of replicability has been called a crisis. It was first seen in the social sciences, e.g. the figure below from this article in Science, 2015. Psychology research is bad enough such that Nobel Laureate, Daniel Kahneman, came to disown most of the conclusions in his book, “Thinking, Fast and Slow“. The experiments that underly his major sections don’t replicate. Take, for example, social printing. Classic studies had claimed that, if you take a group of students and have them fill out surveys with words about the aged or the flag, they will then walk slower from the survey room or stand longer near a flag. All efforts to reproduce these studies have failed. We now think they are not true. The problem here is that much of education and social engineering is based on such studies. Public policy too. The lack of replicability throws doubt on much of what modern society thinks and does. We like to have experts we can trust; we now have experts we can’t.

From “Estimating the reproducibility of psychological science” Science, 2015. Social science replication is better than dance drug replication, about 35% of the classic social science studies replicate to some, reasonable extent.

Are gas stoves dangerous? This 2022 environmental study said they are, claiming with 95% confidence that they are responsible for 12.7% of childhood asthma. I doubt the study will be reproducible for reasons I’ll detail below, but for now it’s science, and it may soon be law.

Part of the replication problem is that researchers have been found to lie. They fudge data or eliminate undesirable results, some more some less, and a few are honest, but the journals don’t bother checking. Some researchers convince themselves that they are doing the world a favor, but many seem money-motivated. A foundational study on Alzheimers was faked outright. The authors doctored photos using photoshop, and used the fake results to justify approval of non-working, expensive drugs. The researchers got $1B in NIH funding too. I’d want to see the researchers jailed, long term: it’s grand larceny and a serious violation of trust.

Another cause of this replication crisis — one that particularly hurt Daniel Kahneman’s book — is that many social science researchers do statistically illegitimate studies on populations that are vastly too small to give reliable results. Then, they only publish the results they like. The graph of z-values shown below suggest this is common, at least in some journals, including “Personality and social psychology Bulletin”. The vast fraction of results at ≥95% confidence suggest that researchers don’t publish the 90-95% of their work that doesn’t fit the desired hypothesis. While there has been no detailed analysis of all the social science research, it’s clear that this method was used to show that GMO grains caused cancer. The researcher did many small studies, and only published the one study where GMOs appeared to cause cancer. I review the GMO study here.

From Ulrich Schimmack, ReplicationIndex.com, January, 2023, https://replicationindex.com/2023/01/08/which-social-psychologists-can-you-trust/. If you really want to get into this he is a great resource.

The chart at left shows Z-scores, were Z = ∆X √n/σ. A Z score above 1.93 generally indicates significance, p < .05. Notice that almost all the studies have Z scores just over 1.93 that is almost all the studies proved their hypothesis at 95% confidence. That makes it seem that the researchers were very lucky, near prescient. But it’s clear from the distribution that there were a lot of studies that done but never shown to the public. That is a lot of data that was thrown out, either by the researchers or by the publishers. If all data was published, you’d expect to see a bell curve. Instead the Z values are of a tiny bit of a bell curve, just the tail end. The implication is that these studies with Z= >1.93 suggest far less than 95% confidence. This then shows up in the results being only 25% reproducible. It’s been suggested that you should not throw out all the results in the journal, just look for Z-scores of 3.6 or more. That leaves you with the top 23%, and these should have a good chance of being reproducible. The top graph somewhat supports this, but it’s not that simple.

Another classic way to cook the books, as it were, and make irreproducible studies provide the results you seek is to ignore “confounders.” This leads to association – causation errors. As an example, it’s observed that people taking aspirin have more heart attacks than those who do not, but the confounder is that aspirin is prescribed to those with heart problems; the aspirin actually helps, but appears to hurt. In the case of stoves, it seems likely that poorer, sicker people own gas, and that they live in older, moldy homes, and cook more at home, frying onions, etc. These are confounders that the study to my reading ignores. They could easily be the reason that gas stove owners get more asthma toxins than the rich folks who own electric, induction stoves. If you confuse association, you seem to find that owning the wrong stove causes you to be poor and sick with a moldy home. I suspect that the stove study will not replicate if they correct for the confounders.

I’d like to recommend a book, hardly mathematical, “How to Lie with Statistics” by Darrell Huff ($8.99 on Amazon). I read it in high school. It gives you a sense of what to look out for. I should also mention Dr. Anthony Fauci. He has been going around to campuses saying we should have zero tolerance for those who deny science, particularly health science. Given that so much of health science research is nonreplicable, I’d recommend questioning all of it. Here is a classic clip from the 1973 movie, ‘Sleeper’, where a health food expert wakes up in 2173 to discover that health science has changed.

Robert Buxbaum , February 7, 2023.

Almost no one over 50 has normal blood pressure now.

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Four years ago, when the average lifespan of American men was 3.1 years longer than today, the American Heart Association and the American College of Cardiology dropped the standard for normal- acceptable blood pressure for 50+ years olds from 140/90 to 120/80. The new standard of normal was for everyone regardless or age or gender despite the fact that virtually no one over 50 now reached it. Normal is now quite un-common.

By the new definition, virtually everyone over 50 now is diagnosed with high blood pressure or hypertension. Almost all require one or two medications — no more baby aspirin. Though the evidence for aspirin’s benefit is strong, it doesn’t lower blood pressure. AHA guidance is to lower a patients blood pressure to <140/90 mmHg or at least treat him/her with 2–3 antihypertensive medications.4 

Average systolic blood pressures for long-lived populations of men and women without drugs.

The graphs shows the average blood pressures, without drugs in a 2008 study of the longest-lived, Scandinavian populations. These were the source of the previous targets: the natural pressures for the healthiest populations at the time, based on the study of 1304 men (50-79 years old) and 1246 women (38-79 years old) observed for up to 12 years. In this healthy population, the average untreated systolic pressure is seen till age 70, reaching 154 for men, and over 160 for women. By the new standards, these individuals would be considered highly unhealthy, though they live a lot longer than we do. The most common blood-pressure drug prescribed in the US today is atenolol, a beta blocker. See my essay on Atenolol. It’s good at lowering blood pressure, but does not decrease mortality.

The plot at left shows the relationship between systolic blood pressure and death. There is a relationship, but it is not clear that the one is the cause of the other, especially for individuals with systolic pressure below 160. Those with pressures of 170 and above have significantly higher mortality, and perhaps should take atenolol, but even here it might be that high cholesterol, or something else, is causing both the high blood pressure and the elevated death risk.

The death-risk difference between 160 and 100 mmHg is small and likely insignificant. The minimum at 110 is rather suspect too. I suspect it’s an artifact of a plot that ignores age. Only young people have this low number, and young people have fewer heart attacks. Artificially lowering a person’s blood pressure, even to this level does not make him young, [2][3] and brings some problems. Among the older-old, 85 and above, a systolic blood pressure of 180 mmHg is associated with resilience to physical and cognitive decline, though it is also associated with higher death rate.

The AHA used a smoothed version of the life risk graph above to justify their new standards, see below. In this version, any blood pressure looks like it’s bad. The ideal systolic pressure seems to be 100 or below. This is vastly too low a target, especially for a 60 year old. Based on the original graph, I would think that anything below 155 is OK.

smoothed chart of deaths per 1000 vs blood pressure. According to this chart, any blood pressure is bad. There is no optimum.

Light exercise seems to do some good especially for the overweight. Walking helps, as does biking, and aerobics. Weight loss without exercise seems to hurt health. Aspirin is known to do some good, with minimal cost and side effects. Ablation seems to help for those with atrial fibrillation. Elequis (a common blood thinner) seems to have value too, for those with atrial fibrillation — not necessarily for those without. Low sodium helps some, and coffee, reducing gout, dementia and Parkinson’s, and alcohol. Some 2-3 drinks per day (red wine?) is found to improve heart health.

I suspect that the Scandinavians live longer because they drink mildly, exercise mildly, have good healthcare (but not too good), and have a low crime rate. They seem to have dodged the COVID problem too, even Sweden that did next to nothing. it’s postulated that the problem is over medication, including heart medication.

Robert Buxbaum, January 4, 2023. The low US lifespan is startling. Despite spending more than any other developed countries on heath treatments, we have horribly lower lifespans, and it’s falling fast. A black man in the US has the same expected lifespan as in Rwanda. Causes include heart attacks and strokes, accidents, suicide, drugs, and disease. Opioids too, especially since the COVID lockdowns.

The main building block of Alzheimer’s research was faked. Now, what.

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Much of health research is a search for simple, bio-molecular causes for our medical problems. These can result in pill-solutions. Diseases tend to be more complex, but Alzheimers seemed to work that way, until this summer when it turned out that the data supporting the simple theory was faked. Alzheimer’s is a devastating cognitive disease that is accompanied by a degenerating brain, with sticky, beta-amyloid plaques and tangles. About 16 years ago, this report, published in Nature seemed to show that a beta-amyloid, Aβ*56, caused the plaques and caused cognitive decline independent of any other Alzheimers indicators. 

The visual difference between an Alzheimer brain and a normal brain is that the former has shrunk. Maybe fat is relevant, fat body leads to a fat brain, and less AZ, maybe?

We were on the way to a cure, or so it seemed. Several studies by this group backed the initial results, and much of Alzheimer’s research was directed into an effort to fill in the story, and find ways to reduce the amount and bonding of this amyloid and others like it. Several other groups claimed they could not find the amyloid at all, or show that amyloids caused the symptoms described. But most negative results went unpublished. The theory was so satisfying, and the evidence from a few so strong, that the NIH poured billions into this approach, over $1B in this year alone. The FDA approved aducanumab, a drug from Biogen, on the assumption that it should work, even though it showed little to no benefit, and had some deadly side effects. Other firms followed, asking for approval of related anti-amyloid drugs that should work.

When news of the fraud came out, detected by Matthew Scragg and a few lone curmudgeons, stock prices plummeted in the drug companies. It now appears that the original work was made up, presented to journals and to the NIH using photoshopped images. For the group that did the fake work, it may mean jail time, for most other groups, the claim is that their work is still relevant. Doctors still prescribe the medications as they have nothing better to offer (Aducanumab therapy costs $50,000 per year). Maybe it’s time to start looking at alternative approaches and theories, sidelined over the last 16 years.

Some alternative theories posit that another molecule is responsible, particularly tau, associated with the tangles. Another sidelined theory is that amyloids are good. For example, that it’s the loss of soluble amyloids that causes Alzheimer’s. Alternately, that inflammation is the root cause, and that the amyloid plaques and tangles are a response to the inflammation, a bandage, perhaps. These theories could explain why the anti-amyloid drugs so often resulted in patient death.

It could be that high bmi protects from dementia. Either that or the diseases that cause weight loss cause dementia. It’s debated here.

It’s also possible that the inability of nerve cells to dispose of waste is the cause of AZ. In heathy people, waste is removed through acidic enzymes within lysosomes. Patients with decreased acid activity have a buildup of waste that includes amyloids. Perhaps the cure is to restore the acid enzymes.

My favorite theory is based on statistical data that shows that fat people are less likely to develop Alzheimers. This might lead to a junk-food cure. The fitness industry is very much against this theory–It’s debated here. They tend to support the inflammation model, claiming that diseases cause Alzheimer’s and cause patients to loose weight first. Could be. I note that Henry Kissinger is the only active politician of my era, the early 70s, still alive and writing intelligently.

Robert Buxbaum, November 17-19, 2022. I hope that Matthew Schragg comes out OK, by the way. Ben Franklin pointed out, that “No good deed goes unpunished.”

Tests designed so that the Ivies pick preppies.

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Elite colleges strive to be selective, and they are, just not for the hard-working scholars they claim to select for. They claim to be color-blind, income-blind, and race-blind, aiming for the best: the most intelligent, most ethical, and hardest working scholar-candidates. Then, to their surprise and satisfaction, all the ivies find that the vast majority of the chosen come from the same rich families and prep-schools as 100 years ago. That happens because the selection is crooked with measures tilted to the rich, Protestant, and preppy.

Through most of the 1900s, most of the ivies had a Jewish quota, enforced formally or informally. They also did their best to discourage middle class, black, and Catholic students in the interest of maintaining the proper student mix. Under Woodrow Wilson, Princeton went further and admitted not one black student. When quotas became illegal, schools began to rely on athletics and tests, with blatant cheating as revealed by the “Varsity Blues” sting operation. In that sting, a dozen or more athletic coaches and high-school administrators were caught taking SAT tests for their richer, connected students, and/or making up phony athletic achievements. The Ivies claimed shock after the cheating was revealed, but it is beyond belief that no one had noticed that these top brains and athletes were neither.

Many top athletes are diagnosed as asthmatic. Some actually are. With the right doctor, you can get an advantage

Another version of this is that richer kids can get extra time to do SAT and ACT tests. The extra time doesn’t show up on the SAT or ACT score, you need a doctor to certify that you are dyslectic or have severe ADHD. Most boys are diagnosed with ADHD these days, itself something of a scam, but most boys don’t get extra test time. You need the right doctor and the right documentation, plus enough money and connections to get the test given by certified test-giver in your own private room. It used to be that the SAT and ACT would report the extra time, but this changed in 2004. Now the extra time, and the disease is not documented, just the higher score. There have been complaints, but the scam goes on. Similar to this, top Olympic athletes can be diagnosed with asthma, and allowed to use performance enhancing, anti-asthma steroids. Again complaints, but no change.

Ivy League schools also tilt to the right families by requiring signs of the right sort of leadership as evaluated by an interview and an essay (see my post on John Kennedy’s essay). You score high on leadership if you helped your relative run for governor. By contrast, if you organized a ping-pong or basketball tournament at your Catholic or Jewish school, you’re the wrong sort of leader. Eagle Scout is sort-of the right sort, and speaking against climate change on TV is. Greta Thernberg and Chelsea Clinton are climate leaders; you, probably are not.

The Ivys explicitly state that they choose for athleticism, but not all sports are equal. All the Ivies claim to need a good women’s lacrosse team, a good crew team, and some good high-divers. Are these sports unavailable at your high-school? What a shame, you’re not a real athlete. You can still try to get in based on extreme leadership and academics.

The Princeton alumni of 1993-1994 were primarily white, rich and preppy. Favoring their children helps insure that the class of 2024 is that way too.

There is no real reason that Harvard needs a top crew team, or needs to excel at women’s lacrosse or high-diving. Sport was not an admission criteria in the 1800s. It was added in the 1900s to avoid admitting Catholics, Jews, and Asians who tended to score well but could not compete on the selected sports. The president of Harvard, Abbot Lowell wrote, “Somehow or other the enrollment of the Jewish students must be limited”. The method he chose, and that all the Ivies came to use, included these tests of leadership and sport, plus a preference for legacies. The children and grand-children of alumni are given significant preferential selection at all the ivies. At Harvard, the acceptance rate for legacy students is about 33%, compared with an overall acceptance rate of under 6%. Since legacies are mostly white, rich, protestant, and preppy, the next generation is guaranteed to be the same.

The Ivies’ methods have been challenged many times over the years. Quotas were found to be illegal as early as 1964. Since then there have been claims of effective quotas, a cause that was pushed under the rug until Donal Trump took it up. Most recently, Harvard, Princeton, and UNC were sued by Asians. One of these, from a poor background scored at the top of his class with a 4.4 GPA and had near-perfect SAT scores, but was rejected for no obvious reason beyond race. The Supreme Court is expected to hear the case in 2023. Ahead of this decision, all eight Ivies have decided to dispense with testing for at least for now. The ivies claim that, by making tests optional, they will avoid locking out students who are great (though somewhat illiterate and innumerate). The real purpose seems to be to lock out pushy Asians who might sue them or be so bright they make the legacies feel dumb.

None of the above would matter if the Ivies were not so wonderful, at least the better ones are. I went to Princeton grad school, see photos. It was great despite its waspy leanings. If you can go there, or to Harvard, Yale, Cornell or Penn, go. My feeling for Brown and Columbia are rather the opposite: they’ve gone to the extreme and voted for BDS, see the text here for Brown’s version. Not only did they vote to boycott Israelis and Israeli produce, the “B” of BDS, the’ve also committed to suppress Zionists everywhere. That’s Jews who support Israel. Several, non ivy schools, have committed to the same. In their view, for open debate to flourish anywhere, proud Jews must be excluded. These are no longer colleges, but Klavens.

Robert Buxbaum, October 20, 2022.

Eliquis, over-prescribed but better than Coumadin.

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Eliquis (apixaban) is blood thinner shown to prevent stroke with fewer side effects than Warfarin (Coumadin). Aspirin does the same, but not as effectively for people over 75. My problem with eliquis is that it’s over-prescribed. The studies favoring it over aspirin found benefits for those over 75, and for those with A-Fib. And even in this cohort the advantage over aspirin is small or non-existent because eliquis has far more serious side effects; hemorrhage, or internal bleeding.

Statistically, the AVERROES study (Apixaban Versus Acetylsalicylic Acid to Prevent Stroke in AF Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment) found that apixaban is substantially better than aspirin at preventing stroke in atrial fibrillation patients, but worse at preventing heart attack.

Taking 50 mg of Eliquis twice a day, reduces the risk of stroke in people with A-Fib by more than 50% and reduces the rate of heart attack by about 15%. By comparison, taking 1/2 tablet of aspirin, 178 mg, reduces the risk of stroke by 17% and of heart attack by 42%. The benefits were higher in the elderly, those over 75, and non existent in those with A-Fib under 75, see here, and figure. Despite this, doctors prescribe Eliquis over aspirin, even to those without A-Fib and those under 75. I suspect the reason is advertising by the drug companies, as I’ve claimed earlier with Atenolol.

The major deadly side-effect is hemorrhage, brain hemorrhage and GI (stomach) hemorrhage. Here apixaban is far worse than with aspirin (but better than Warfarin). The net result is that in the AVERROES random-double blind study there was no difference in all-cause mortality between apixaban and aspirin for those with A-fib who were under 75, see here. Or here.

To reduce your chance of GI hemorrhage with Eliquis, it is a very good idea to take a stomach proton pump drug like Pantoprazole. If you have A-Fib, the combination of Eliquis and pantoprazole seems better than aspirin alone, even for those under 75. If you have no A-Fib and are under 75, I see no benefit to Eliquis, especially if you find you have headaches, stomach aches, back pain, or other signs of internal bleeding, you might switch to aspirin or choose a reduced dose.

A Japanese study found that half the normal dose of Eliquis, was approximately as effective as the full dose, 50 mg twice a day. I was prescribed Eliquis, full dose twice a day, but I’m under 70 and I have no A-Fib since my ablation.

Life expectancy has dropped in the US to undeveloped world levels. Biden blames COVID and racism. I think it’s too much drugs, and too few opportunities.

I’m struck by the fact that US life expectancy is uncommonly low, lower than in most developed countries. Lower too than in many semi-developed countries, and our life expectancy is decreasing while other countries are not seeing the same. It dropped by about 3 years over the last 2 years as shown. I wonder why the US has suffered more than other countries, and suspect we are over-prescribed. Too much of a good thing, typically isn’t good.

Robert Buxbaum, September 16, 2022. As a side issue, low dose aspirin may forestall Alzheimers and other dementias. See current article here. Also another study here.

Atenolol, not good for the heart, maybe good for the doctor.

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Atenolol and related beta blockers have been found to be effective reducing blood pressure and heart rate. Since high blood pressure is a warning sign for heart problems, doctors have been prescribing atenolol and related beta blockers for all sorts of heart problems, even problems that are not caused by high blood pressure. I was prescribed metoprolol and then atenolol for Atrial Fibrillation, A-Fib, beginning 2 yeas ago, even though I have low-moderate blood pressure. For someone like me, it might have been deadly. Even for patients with moderately high blood pressure (hypertension) studies suggest there is no heart benefit to atenolol and related ß-blockers, and only minimal stroke and renal benefit. As early as 1985 (37 years ago) the Medical Research Council trial found that “ß blockers are relatively ineffective for primary treatment of hypertensive outcomes.”

End point. Relative risk. 95% CI. All-cause mortality Cardiovascular mortality MI Stroke Carlberg B et al. Lancet 2004; 364:1684–1689.

There lots of adverse side-effects to atenolol, as listed at the end of this post. More recent studies (e.g. Carlsberg et al., at right) continue to find no positive effects on the heart, but lots of negatives. A review in Lancet (2004) 364,1684–9 was titled, “Review: atenolol may be ineffective for reducing cardiovascular morbidity or all cause mortality in hypertension” (link here). “In patients with essential hypertension, atenolol is not better than placebo or no treatment for reducing cardiovascular morbidity or all cause mortality.” It further concluded that, “compared to other antihypertensive drugs, it [atenolol] may increase the risk of stroke or death.” I showed this and related studies to my doctor, and pointed out that I have averaged to low blood pressure, but he persisted in pushing this drug, something that seems common among medical men. My guess is that the advertising or doctor subsidies are spectacular. By contrast, aspirin has long been known to be effective for heart problems; my doctor said to go off aspirin.

The graph at right is from “Trial of Secondary Prevention with Atenolol after transient Ischemic Attack or Nondisabling Ischemic Stroke”, published in Stroke, 24 4 (1993), (see link here). a Thje study involved 1473 at-risk patients, randomly prescribed atenolol or placebo. It found no outcome benefit from atenolol, and several negatives. After 3 years, in two equal-size randomized groups, there were 64 deaths among the atenolol group, 58 among the placebo group; there were 11 fatal strokes with atenolol, versus 8 with placebo. There were somewhat fewer non-fatal strokes with atenolol, but the sum-total of fatal and non-fatal strokes was equal; there were 81 in each group.

“Trial of Secondary Prevention with Atenolol after transient Ischemic Attack or Nondisabling Ischemic Stroke”, published in Stroke, 24 4 (1993).

Newer beta blockers seem marginally better, as in “Effect of nebivolol or atenolol vs. placebo on cardiovascular health in subjects with borderline blood pressure: the EVIDENCE study.” “Nebivolol (NEB) in contrast to atenolol (ATE) may have a beneficial effect on endothelial function …. there was no significant change in the ATE and PLAC groups.” My question: why not use one of these, or better yet aspirin. Aspirin is shown to be beneficial, and relatively side-effect free. If you tolerate aspirin, and most people do, beneficial has to be better than maybe beneficial.

Among atenolol’s ugly side effects, as listed by the Mayo Clinic, there are: tiredness, sweating, shortness of breath, confusion, loss of sex drive, cold fingers and toes, diarrhea, nausea, and general confusion. I had some of these. There was no increase in heart stability (decrease in A-fib). My heart rate went as low at 32 bpm at night. My doctor was unconcerned, but I was. I suspected the low heart rate put me at extreme risk. Eventually, the same doctor gave me ablation therapy, and that seemed to cure the A-Fib.

Following my ablation, I was told I could get off atenolol. I then discovered another negative effect of atenolol: you have to ease off it or your heart will race. If you have A-fib, or modest hypertension, consider aspirin, eliquis, ablation, or exercise. If you are prescribed atenolol for heart issues and don’t have symptoms of very-high blood pressure, consider other options and/or changing doctors.

Robert Buxbaum, August 14, 2022

Girls are doing better, Boys are doing far worse.

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When I began college in 1972, the majority of engineering students and business students were male. They from the top of their high school classes, and from stable homes mostly; they went on to high paying jobs. Boys also dominated at the bottom of society. They were the majority of the criminals, drug addicts, and high-school dropouts. Many went off to Vietnam. Some, those who were handy, went to trade schools and a reasonable life, productive life. Society did not seem bothered by the destruction of boys in prison, or Vietnam, or by drugs, but there was an outcry that so few women achieved high academic levels. A famous presentation of the problem was called “for every 100 girls.” An updated version appears below showing the status as of October, 2021. A more detailed version appears further down.

From the table above, you can see that women are now the majority of those in college, the majority of those with a bachelors degree or higher, and a majority of those with advanced degrees. Colleges added special tutoring, special grants, and special programs. Each college had a Society of Women Engineers office, and similar programs in law and math. All of these explicitly excluded men or highly discouraged their presence. The curriculum was changed too; made more female-friendly. Dirty, and physical experiments were removed, replaced with group analysis of the social interactions — important aspects of engineers that boys were far-less adept at doing well. Perhaps society and engineering is better off now, but boys (men) are far worse off. This is particularly seem by the following chart, looking at the bottom. Boys/men provide the vast majority of the prison population, of those diagnosed as learning disabled, of those expelled, or overdosed, and among the war dead.

I’ve previously noted that a majority of boys in school are considered disruptive, and that these boys are routinely diagnosed as ADHD and drugged. It is not at all clear that this is a good thing, or that the drugs help anyone but the teacher. I’ve also noted that artwork and attitudes that were considered normal for boys are now considered disturbing and criminal like saying I wish the school was blown up. The cure here, perhaps is worse than the disease. I’m not saying that we should encourage boys to say such things, but that we should acknowledge a difference between an active and a passive wish. And we should find a way to educate boys/men so they don’t end up unemployed, addicted, or dead. Currently boy, particularly those at the bottom are on the scrap-heap of society.

Here is some source material for the above:

Robert Buxbaum, May 28, 2022

Exercise helps fight depression, lithium helps too.

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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.

From “Efficacy of exercise combined with standard treatment for depression compared to standard treatment alone: A systematic review and meta-analysis of randomized controlled trials.” by JacquelineLee1 et al.In virtually every study, exercise helps fight depression.

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.