a thoughtful web.
Good ideas and conversation. No ads, no tracking.   Login or Take a Tour!
dunkellic's profile
dunkellic

x 3

stats
following: 14
followed tags: 16
followed domains: 0
badges given: 0 of 1
hubskier for: 4106 days

recent comments, posts, and shares:
dunkellic  ·  1901 days ago  ·  link  ·    ·  parent  ·  post: Everything You Know About Obesity is Wrong

Not finished the whole article yet, but at least the first paper that's cited has obviously not been read beyond the first few lines.

    But individuals are not averages: Studies have found that anywhere from one-third to three-quarters of people classified as obese are metabolically healthy

The author cites this meta-analysis for this: The prevalence of metabolically healthy obesity: a systematic review and critical evaluation of the definitions used (can't post link in comments)

To quote the conclusion of the full paper:

    The prevalence of the MHO phenotype has been widely

    debated. This systematic review showed that the overall

    prevalence of MHO varied from 6% to 75%. The preva-

    lence seems to be higher in women, young people and

    Asians. However, when only studies with at least a 70%

    response rate were considered, the overall MHO preva-

    lence ranged from 10% to 51%. Considering the marked

    heterogeneity of MHO definitions described in the litera-

    ture, it is clear that the establishment of a common MHO

    definition is urgently needed, although this may not be

    an easy task because we still do not know the precise

    mechanisms that are involved with this phenotype and its

    clinical implications in the long term.

  
A) there's no widely accepted definition for being metabolically healthy in obese people, this also ignores all non-metabolic issues, i.e. having a good HbA1c but arthrosis due to your joints being overwhelmed.

  
B) with rising trial/study quality, the rate of MHO obese people dropped

C) young people are more likely to be MHO, meaning that they simply haven't developed damage yet. Asian people are more likely to be MHO, because some of the trials in asian populations "define obesity was a lower

BMI cut-off point ≥25 kg/m² (22% of the studies)", whereas in trials with caucasian/western populations it was a BMI >30kg/m².

Another poignant quote from the original meta-analysis:

    On one hand, high prevalence estimates (arbitrarily set in ≥ 33%) were obtained when the definition was based on less strict criteria, for example, that proposed by Meigs et al . (37) using only HOMA-IR. On the other hand, low prevalence estimates were found when a more stringent definition of MHO was used, for example, that proposed by Karelis et al . (36), which is based on five cardiometabolic factors: blood pressure, HDL-c, low- density lipoprotein cholesterol, total cholesterol and HOMA-IR.

  
Again, HMO prevalence is tied to low trial quality.

Unlike the HuffPos authors conclusion, mine is that MHO is by and large a myth and for most people, for most individuals, obesity equals being unhealthy.

dunkellic  ·  4065 days ago  ·  link  ·    ·  parent  ·  post: Sick.

    Does the NTT being high for healthy adults (which is what the study measured) necessarily mean that there is no benefit for those who cannot get vaccinated?

Sorry, my reply lacked a little bit of structure.

    If vaccination does not confer benefits to children and elderly, wouldn't that imply that the herd effect from mass vaccination would in fact be good for them and those who cannot get the vaccine?

Yes, this is correct (but of course it also implies that we have an effective vaccine for healthy people).

If the vaccine is a perfect match, than the NNT might actually suffice when there would be a high amount of vaccination (I've found a study that got a NNT of 25 to achieve a protective herd effect)...perhaps I've been a little to rash in my statement.

Right now I think it's safe to say that vaccination rates are not nearly high enough to provide herd immunity, but it may perhaps be actually possible with very high rate of vaccination (I'm no epidemiologist, so don't take my word as gospel).

Added-before-I-pressed-reply: I actually found a study where children around the age of 3-15 were vaccinated and there was a significant herd immunization effect. The study says that you'd need about 80% of the children (because they are the main early vectors for spreading the virus) in a society vaccinated to achieve this. --> I'm most likely wrong

As for the article you've linked..I'm afraid pharmaceutical companies are a necessary evil...but sometimes it's really depressing.

dunkellic  ·  4066 days ago  ·  link  ·    ·  parent  ·  post: Sick.

Yeah, but it does that badly, that's the problem. It has a potential NNT of 100, which is a high number for such a common disease (in the case of a NNT of 36 in a perfect case, it's not that bad though).

The high NNT also means that it is less likely to achieve any kind of herd protection. Compared to for example the measles vaccine with a NNT of ~7, a 100 seems quite high (disclosure: but this is actually a tricky comparison and may not be fair for the flu vaccine. The NNT is heavily influenced by the baseline risk of actually getting the disease. If the baseline risk is very high to get sick in the first place, which is often the case for classic childhood disease like measles or varicella, the NNT is usually much lower even with a less effective vaccine. The NNT for the HPV vaccine against cervical cancer is somewhere in the range of 5000-8000 because of the low baseline risk of getting the disease).

Furthermore, even the wikipedia article (which I object somewhat to) agrees on the fact, that for at least for the elderly, it's not very effective:

    The group most vulnerable to non-pandemic flu, the elderly, is also the least to benefit from the vaccine.
which probably isn't to blame on the vaccine alone, but also on the less robust immunologic response of the elderly.

And citing from the Cochrane review:

    In children under the age of two the data are extremely limited, but vaccination appeared to confer no measurable benefit.

In the end, these results are most likely to be too optimistic, (at least) half the studies were funded by pharmaceutical companies and while I don't want to say you cannot trust them at all, you have to take them with a pinch of salt, especially in regard of how much money they make with flu-vaccination.

    Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines

I do not want to say: "DO NOT GET VACCINATED", especially if you are somehow immunocompromised, be it age (old or very young) or due to some underlying disease (diabetes, etc.), the benefits easily outweighs the risks.

dunkellic  ·  4068 days ago  ·  link  ·    ·  parent  ·  post: Sick.

Usually I'm heavily in favour of vaccines, but I honestly cannot recommend flu vaccination. Before you burn me as a heretic, this is the reason I don't get flu shots (even though I would get them for free):

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001269...

    Authors of this review assessed all trials that compared vaccinated people with unvaccinated people. The combined results of these trials showed that under ideal conditions (vaccine completely matching circulating viral configuration) 33 healthy adults need to be vaccinated to avoid one set of influenza symptoms. In average conditions (partially matching vaccine) 100 people need to be vaccinated to avoid one set of influenza symptoms. Vaccine use did not affect the number of people hospitalised or working days lost but caused one case of Guillian-Barré syndrome (a major neurological condition leading to paralysis) for every one million vaccinations. Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions and because the harms evidence base is limited..

    This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in light of this finding.

Hope you get better mk ;)

dunkellic  ·  4069 days ago  ·  link  ·    ·  parent  ·  post: The World’s Most Depressing Tech Infographic Says You’re Dead In 9 Years

As cliché as it sounds, but at least part of the journey is the reward, why should I feel bad for spending 3 1/2 years learning when I consider all the great things I know because of it? What's the problem with eating and drinking adding up to four years, if I get to taste and enjoy great foods? Why should I feel bad for spending 10 1/2 years at work, if that work is what I find fulfillment in?

Well, he did the exact opposite to Star Trek, then again both franchises have different vantage-points. I wonder what he is going to do with Star Wars. Trek was a complete reboot and pretty much kicked the established lore in the ass (I personally think it was an entertaining popcorn movie, but the setting was hardly Star Trek, it really was quite interchangeable..). But the franchise was basically dead at that point and it didn't go peacefully with Nemesis as the last movie.

But Star Wars? There's no need for a reboot - in my opinion at least, yet there's no obvious starting-point for a story to tell. True, the lat three movies weren't really critically acclaimed, but Star Wars is far from the shape Trek was in during Nemesis. There are a lot of stories that could be turned to films, the whole extended universe thing and the comic book series, which feature a few rather gritty plots (beloved characters die, Luke turning to the dark side, etc...).

dunkellic  ·  4080 days ago  ·  link  ·    ·  parent  ·  post: What would happen if North Korea launched a missile at the United States?

What would be detected is a ballistic missile launch; while there's no "law" that every ballistic missile is nuclear, it is certainly the rule and there is no way to determine what kind of warhead an ICBM/SLBM carries in-flight.

As soon as the launch is detected, countermeasures are imitated. The launch/boost time window is ~ 5 minutes long and without prior warning the U.S. would have to hope that by chance there's missile destroyer nearby, in order to try to intercept it. During midcourse the missile is almost undetectable, because it doesn't have an exhaust. So once the last booster falls off, the first window for interception closes. Once the warhead reenters the atmosphere the second, shorter (approx. 2 minutes), time window would open. Terminal interception is very difficult because the warhead enters at terminal velocity with ~ 14000km/h (~8700mph). If the warhead would split up into several reentry warheads (socalled "MIRVs), a proper interception is almost impossible, even for the U.S. (but afaik the North Koreans are far from having that technology).

Here are two videos from the old and discontinued Nike-Sprint interceptor missile, just to give an impression of how damned fast these things are (and the Sprint goes "only" 12000km/h!). In the second video you can see how the missile turns from black to white due to the enormous friction.

dunkellic  ·  4080 days ago  ·  link  ·    ·  parent  ·  post: Hubski Update: The Return of Tags

    If you mute a user, that user cannot comment on your posts.

What was the rationale behind that? This could be a little bit "problematic", what happens when someone spews bullshit about something or someone and you cannot correct him? (Most obvious example: user A claims something untrue about user B, user A has muted user B; now user B cannot comment on the accusations, not without making his own post at least. While it could be said "well, let B ignore A, then his or her problem is null", everyone else would still see and read that comment without hearing the opposing view)

dunkellic  ·  4087 days ago  ·  link  ·    ·  parent  ·  post: Germany to transfer its gold from NYC to Frankfurt

I'm sorry but:

>quotes american constitution in debate about german sovereignty >does not address a single point

This is equivalent to putting your fingers in your ears and shouting "lalalalalalalalalalalal"

dunkellic  ·  4087 days ago  ·  link  ·    ·  parent  ·  post: Australia Banned Assault Weapons. America Can, Too. - NYTimes.com

I don't get it, how does this make killing-sprees any harder?

    A semiautomatic rifle that has an ability to accept a detachable magazine and has at least two of the following characteristics:  A folding or telescoping stock  A pistol grip that protrudes conspicuously beneath the action of the weapon  A bayonet mount  A flash suppressor or threaded barrel designed to accommodate a flash suppressor  A grenade launcher

Those are basically ALL cosmetic criteria, in none of the recent killing sprees did the perpetrator need any of these things. Grenade launchers are almost impossible to get for civilians in the U.S. this way or another, bayonet mount? When was the last person killed by a bayonet. Flash-suppressors make the muzzle-flash less noticeable, the gun is still as loud as before and huge flames gushing out of your barrel are a Hollywood-fantasy anyway. The folding stock only makes it easier to carry the rifle close to your body, heck - if someone would really want to shorten his rifle, he'd simply saw it off

dunkellic  ·  4087 days ago  ·  link  ·    ·  parent  ·  post: Australia Banned Assault Weapons. America Can, Too. - NYTimes.com

What are the current criteria for an assault weapon in NY state?

Judging from the wiki-article on the AWB, the criteria are/were mostly/entirely cosmetic.

Edit: there's no strikethrough on hubski?

dunkellic  ·  4088 days ago  ·  link  ·    ·  parent  ·  post: Germany to transfer its gold from NYC to Frankfurt

The reason for depositing the gold abroad was, that if - for one reason or another - the german currency tanked really really hard, it could instantly get liquidity by exchanging the gold for a foreign currency (british pounds, american dollars, french franc). Because France has the Euro as well, this tactic does not make sense anymore (as also explained in the article).

This begs the question though, why the move from NYC to Frankfurt then? And why move the money out of France now and not much earlier?

dunkellic  ·  4088 days ago  ·  link  ·    ·  parent  ·  post: Germany to transfer its gold from NYC to Frankfurt

| It has no sovereignty.|

Yeah, no.

Cessation of hostilities between the United States and Germany had been proclaimed on 13 December 1946 by United States President Harry S.Truman. End of state of war with Germany was granted by the U.S. Congress on 19 October 1951, after a request by President Truman on 9 July. Since German civilians were legally still considered enemy nationals for a long period this resulted in some peculiar effects, such as that marriages between white U.S. soldiers and white German women were not permitted until December 1946. (The U.S. army at the time still prohibited interracial marriages, so black soldiers had to wait until 1948) In January 1946 the Swedish Red Cross was permitted to send food to Germany, but earlier attempts to send food by relief agencies had been blocked by the US Treasury Department under the Trading with the Enemy Act 1917, and U.S. troops had been under orders not to share their food rations with German civilians.

In the Petersberg Agreement of November 22, 1949, it was noted that the West German government wanted an end to the state of war, but the request could not be granted. The U.S. state of war with Germany was being maintained for legal reasons, and though it was softened somewhat it was not suspended since "the U.S. wants to retain a legal basis for keeping a U.S. force in Western Germany". At a meeting for the Foreign Ministers of France, the United Kingdom, and the United States in New York from September 12 to December 19, 1950, it was stated that among other measures to strengthen West Germany's position in the Cold War that the western allies would "end by legislation the state of war with Germany". During 1951, many former Western Allies did end their state of war with Germany: Australia (9 July), Canada, Italy, New Zealand, The Netherlands (26 July), South Africa, and the United Kingdom (9 July) The state of war between Germany and the Soviet Union was ended in early 1955. Sovereignty of the Federal Republic of Germany was granted on May 5, 1955, by the formal end of the military occupation of its territory. Special rights were however maintained, e.g., vis-à-vis West Berlin.

Under the terms of the 1990 Treaty on the Final Settlement with Respect to Germany, the Four Powers renounced all rights they formerly held in Germany, including Berlin. As a result, Germany became fully sovereign on March 15, 1991. After Germany joined the United Nations, there had been disagreement as to whether articles 53 and 107 of the UN Charter, which named Germany as an "enemy state", still applied, but these articles became irrelevant when the Four Powers renounced their special rights in the 1990 treaty,and they were formally recognized as irrelevant by a UN General Assembly resolution in 1995.