Category Archives: Health

Yiddish newspapers and talking cows, a case for Jewish education

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Jewish education is a mess according to the Times. Most anyone outside it, who’d look in would agree: Ancient books, pre-science outlooks, anti-inclusive, and taught in a garble of languages, Yiddish, English, Aramaic, Hebrew. The New York Times has runs regular editorials claiming that Jewish education robs children of a future, or an entrance to society, producing adults who know nothing of geometry or higher math, or modern history, incapable of voting intelligently in today’s elections (they often vote Republican). The Times’s experts, are often the products of this education, but claim to have risen above it, only because of extra work. As a proof, they often cite the Talmud as a source of useless knowledge of ancient Jewish law, rejected Bible history, and only the most basic views of math. By way of a response, I’d like to quote something I’d heard in synagog a couple of weeks back:

“I’m so glad that I learned geometry in school, and not taxes. It’s really come in handy this parallelogram season.“

The speaker was an accountant, and the point of the joke is that there is no parallelogram season. There is a tax season, though, and tax law follows a bizarre logic that is not geometric, but is somewhat talmudic. As for the useless languages, they are all in use, both as spoken languages and written languages, no less useful than Latin, and certainly more alive. There are currently 5 yiddish-language newspapers being published in New York alone, see below. They compete with each other for readers, while competing also with the Times, the Post, and with another ten or more Hebrew and English journals, several of them Jewish, either published on paper or as web-journals. People read them, though the Times prefers to ignore their existence.

There are five newspapers published currently in Yiddish in New York. The Forward (Tony Curtis and duck) and the Vort are left-leaning, the Algeminer, the Blat, and the Zeitung, are more right and center. There is a readership. Why a duck?

And that brings us to the subject matter, Talmud. Much of Jewish learning is Talmud, either distilled or pure, study of a set of books written between 1000 and 2000 years ago in Israel, Babylon, and France mostly, with commentaries from Spain, Morocco, Egypt, Germany, and Poland. Those who learned talmud tend to find it useful. The legal organization and approach resonates to them in the understanding of taxes, contracts, building, damage assessment, marriage, ethics, even in dealing with alcoholism. Talmud is so useful that it’s common for working, orthodox Jews to continue their learning it throughout their lives. A common practice is to learn a page every day in synchrony with other Jews. Today’s page, when I started writing this post, was Nazir 10. It includes a talking cow, just the sort of section that the Times likes to cite to show the uselessness of it all. I’ll forgive their lack of understanding, but not their laziness for not even bothering to try to understand.

Nazir 10 begins by saying: “If a cow says, ‘I will be a Nazir (that is, I will give up wine for a month) if I stand up’. Then, if it gets up, one school of rabbinic thought (Bais Shammai) says he is a nazir. Another school of thought (Bais Hillel) says he is not a nazir.” The page goes on to speak about taking doors, but I’ll stop here after the first 2 sentences and will try to explain what the Times does not care to examine.

Notice that cows are female, and they typically don’t speak, but here you find a “he” who might have to give up wine. This “he”, this male, is understood to be a person looking at the cow, likely a person with an alcohol problem. He sees a cow lying on the ground (in the mud figuratively) and identifies it to himself. That is, he sees himself lying in the mud. He thinks it’s impossible for the cow to get up because he imagines that he himself can not get up. (This is just the Talmud’s way of discussing things). According to Bais Shammai, the person is understood to have said to himself, “if that cow can get up, I will take it as a sign that I can get up, and I will take it on myself to avoid wine and wine products for a month.” Now, according to Bais Shammai, if the cow gets up, the man is obligated to stop drinking for a month.

“I love television, and find it very educational. When someone turns it on, I go read a book.” G. Marx

Bais Hillel says he is not obligated at all. They say that a drunk who wants to change, must do more than be inspired, he must make a real verbal commitment. He must verbally obligate himself to give up drink. We follow this latter opinion, but learn Bais Shammai’s view too, because there are important ideas about self-identity.

Those are just the first two lines of the page. In secular school, you learn stories too, sometimes stories with talking animals, but these are usually modern stories, where the challenges are external, bullying say, but in a sense such stories are sanitized. The internal demons are removed, and these are often the hardest to battle. Even dealing with external problems is often pushed on an external authority, a teacher usually. You are considered to be too weak to deal with a problem. Sometimes that’s true, usually there is at least some part you could deal with. The lack of self-obligation leaves modern school stories flat. Few kids enjoy them, or feel they get anything from them. A result in Detroit is that schools have <50% attendance. Kids leave barely literate with appalling math skills. We blame the teachers and the subject. It’s the book: Sally has 15 tomatoes and wants to give 4 to a friend, how many will she have left? is this relevant? Does this excite?

Talmud teaches some logic, some math, and some geometry, but only for measuring distances and volumes, the application that geometry was named for (geometry = measuring the earth). They learn the rest as needed, and often learn quite a lot.

As Groucho Marx said: “My education is self inflicted.”

The products of Jewish education become successful, often in business, hiring their better-educated brothers. Some become lawyers, accountants, writers, businessmen, or psychologists — more than our share in the population — or mathematicians and scientists. Some even excel in academics or journalism. The Times does not mention this.

Groucho, Chico, Harpo, and Karl Marx

My three children all went to Jewish, religious school and got the education that the Times calls abuse. So far, my son (31) has two masters degrees, both in artificial intelligence/ computer science. My older daughter (28) is getting her PhD in Psychology, and my younger daughter (23) is working on her masters in epidemiology. I suspect they benefited from the education. My suggestion to the Times, is in another Marx quote: “If you find it hard to laugh at yourself, I would be happy to do it for you.”

Robert Buxbaum, March 1, 2023. “History may not think with its feet, but it certainly doesn’t walk on its head.”– Karl Marx, the less-funny, Marx brother. Jewish educated, he became a journalist.

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.

Use iodine against Bad breath, Bad beer, Flu, RSV, COVID, monkeypox….

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We’re surrounded by undesired bacteria, molds, and viruses. Some are annoying, making our feet smell, our teeth rot, and our wine sour. Others are killers, particularly for the middle aged and older. Despite little evidence, the US government keeps pushing masks and inoculations with semi-active vaccine that does nothing to stop the spread. Among the few things one can do to stop the spread of disease, and protect yourself, is to kill the bacteria, molds and viruses with iodine. Iodine is cheap, effective even at very low doses, 0.1% to 10 parts per million, and it lasts a lot longer than alcohol. Dilute iodine will not dye your skin, and it does not sting. A gargle of iodine will kill COVID and other germs (e.g. thrush) and it has even been shown to be a protective, stopping COVID 19 and flu even if used before exposure. On a more practical level. I also use it to cleanse my barrels before making beer — It’s cheaper than the Camden they sell in stores.

Iodine is effective when used on surfaces, and most viruses spread by surfaces. A sick person coughs. Droplets end up on door knobs, counters, or in your throat, leaving virus particles that do not die in air. You touch the surface, and transfer the virus to your eyes and nose. Here’s a video I made. A mask doesn’t help because you rub your eyes around the mask. But iodine kills the virus on the surface, and on your hands, and lasts there far longer than alcohol does. Vaccines always come with side-effects, but there are no negative side effects to sanitization with dilute iodine. Here is a video I did some years ago on the chemistry of iodine.

Robert Buxbaum, February 1, 2023. I don’t mean to say that all bacteria and fungi are bad, it’s just that most of them are smelly. Even the good ones that give us yogurt, beer, blue cheese, and sour kraut tend to be smelly. They have the annoying tendency to causing your wine to taste and smell like sour kraut or cheese, and they cause your breath and feet to smell the same. If you’re local, I’ll give you some free iodine solution. Otherwise, you’ll have to buy it through REB Research.

Birth dearth in China => collapse? war?

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China passed us in life-expectancy in 2022, and also in fertility, going the other way. In China lifespan at birth increased to 77.3 years. In the US it dropped an additional 0.9 years, to 76.8. US lifespans suffered from continuing COVID and an increase in accidents, heart disease, suicide, drugs, and alcohol abuse. Black men were hit particularly hard, so that today, a black man in the US has the same life expectancy as he would in Rwanda. China seems to have avoided this, but should expect problems due to declining fertility and birth rates.

China passed us in life expectancy in 2022.

Fertility rates will eventually burden the US too, as US fertility is only slightly greater than in China, 1.78 children per woman, lifetime, compared to 1.702 in China. But China has far fewer people of childbearing ages, relatively, and only 47% are women. Three decades of one child policy resulted in few young adults and a tendency to abort girls. Currently, the birthrate in China is barely more than half ours: 6.77 per 1000, compared to 12.01 per 1000. And the proportion of the aged keeps rising. China will soon face a severe shortage of care-givers, and an excess of housing.

Years of low birthrate preceded the “Lost decades” of financial crisis in Japan and the USSR. Between 1990 and 2011, business stagnated and house prices dropped. China faces the same; few workers and more need for care: it’s not a good recipe.

Beginning about 1991, Japan saw a major financial collapse with banks failing, and home values falling. China seems over-due.

Few children also signals a psychic lack of confidence in the country, and suggests that, going forward, there will be a lack of something to work for. Already Chinese citizens don’t trust the state to allow them to raise healthy children. They have stopped getting married, especially in the cities, and look more to have fun.

Affluent women claim they can’t find a good man to marry: one who’s manly, who will love them, and who will reliably raise their standard of life. Women seem less picky in China’s rural areas, or perhaps they find better men there. However it goes, urban women get married late and have few children, both in China and here. China produces great, sappy, soap operas though: a country girl or secretary in a high-power job meets a manly, urban manager who lovers her intensely. A fine example is “The Eternal Love” (watch it here). It involves time travel, and a noble romance from the past. Japan produced similar fiction before the crisis. And a crisis seems to be coming.

While Japan and Korea responded quietly to crisis and “the lost decades,” allowing banks to fail and home values to fall, Russia’s response was more violent. It went to war with Chechnya, then with Belarus and Ukraine, and now with NATO. I fear that China will go to war too — with Taiwan, Japan, and the US. It’s a scary thought; China is a much tougher enemy than Russia. There is already trouble brewing over new islands that they are building.

Robert Buxbaum January 25, 2023. If you want to see a Korean soap opera on the Secretary – manager theme, watch: “What’s wrong with Secretary Kim”. (I credit my wife with the research here.) I suspect that Americans too would like sappy shows like this.

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.

Coffee decreases your chance of Parkinson’s, a lot.

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Some years ago, I thought to help my daughter understand statistics by reanalyzing the data from a 2004 study on coffee and Parkinson’s disease mortality, “Coffee consumption, gender, and Parkinson’s disease mortality in the cancer prevention study II cohort: the modifying effects of estrogen” , Am J Epidemiol. 2004 Nov 15;160(10):977-84, see it here

For the study, a cohort of over 1 million people was enrolled in 1982 and assessed for diet, smoking, alcohol, etc. Causes of deaths were ascertained through death certificates from January 1, 1989, through 1998. Death certificate data suggested that coffee decreased Parkinson’s mortality in men but not in women after adjustment for age, smoking, and alcohol intake. They used a technique I didn’t like though, ANOVA, analysis of variance. That is they compare the outcome of those who drank a lot of coffee (4 cups or more) to those who drank nothing. Though women in the coffee cohort had about 49% the death rate, it was not statistically significant by the ANOVA measure (p = 0.6). The authors of the study understood estrogen to be the reason for the difference.

Based on R2, coffee appears to significantly decrease the risk of Parkinson’s mortality in both men and women.

I thought we could do a better by graphical analysis, see plot at right, especially using R2 to analyze the trend. According to this plot it appears that coffee significantly reduces the likelihood of death in both men and women, confidence better than 90%. Women don’t tend to drink as much coffee as men, but the relative effect per cup is stronger than in men, it appears, and the trend line is clearer too. In the ANOVA, it appears that the effect in women is small because women are less prone Parkinson’s.

The benefit of coffee has been seen as well, in this study, looking at extreme drinkers. Benefits appear for other brain problems too, like Alzheimer’s. It seems that 2-4 cups of coffee per day also reduces the tendency for suicide, and decreases the rate of gout. It seems to be a preventative against kidney stones, too.

There is a confounding behavior that I should note, it’s possible that people who begin to feel signs of Parkinson’s, etc. stop drinking coffee. I doubt it, give the study’s design, but it’s worth a mention. The same confounding is also present in a previous analysis I did that suggested that being overweight protected from dementia, and from Alzheimer’s. Maybe pre-dementia people start loosing weight long before other symptoms appear.

Dr. Robert E. Buxbaum, and C.M. Buxbaum, December 15, 2022

Fauci, freedom, and the right to be wrong.

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Doctor Anthony Fauci has been giving graduate addresses at colleges around the country for the past few months, telling students about his struggles and successes in the medical research world, hammering a moral point that they should expect the unexpected and have no tolerance for “the normalization of untruth”, and for “egregious twisting and lies” as were leveled against his approach to COVID (and global warming, it seems). Untruths, racism, and lies spread by “some elected officials”, presumably his exboss. Here is his speech to the Princeton graduates, or see a brief summary of his talk st the University of Michigan.

Dr. Fauci may have the best intentions in criticizing others and deputizing students to enforce the truth.He certainly seems sure that his truth and intentions are 100% pure, but what if Fauci wasn’t quite right, or what if you thought his cure to the pandemic was less than marvelous. His truth may mot be real truth, or real truth for everyone. Beyond that, even if he were always 100% right on science, I believe that people have a fundamental right to make mistakes. “I have a right to be wrong,” as Joss Stone says (see music video). Freedom from imposed righteousness is a fundamental good. Even assuming that Fauci’s lockdowns were the height of righteousness, we have a right to take risks and to act against our own best interests, in my opinion. Consider a saint who really knows what’s right and only wants to do only what’s right. I doubt that even the saint wants a jailer to force it upon him and remove his free will. And the right of the rest of us may not want to do what’s ideal and healthy. We like ice cream even thought we know it’s fattening, and we should have the right to smoke too.

This right to our mistakes is something we deserve, even assuming that Fauci knows the truth for everyone, and that everyone has the same truth, and that all of his rules were for the best. But different people are different, and people’s preferences are different. “A sadist is a masochist who follows the golden rule,” as the saying goes, and Fauci may have been out-and-out wrong.

Humor from a time when one could tolerate hearing that their truths might not be true.

Concerning COVID, I’ve noted that, despite Fauci’s lockdowns and mask mandates, The US did worse than Sweden, and my home state of Michigan did worse than Sweden — worse in terms of deaths, and far worse economically. Michigan has the same size population as Sweden and the same climate and population density so it’s a good comparison. Florida did better than we did too, though they too didn’t close the schools or have mask mandates. Their economy did better too, and children’s education.

Was Fauci right to shut K-12 schools, or to send college students home? Maybe he was only half-right, or totally wrong and blinded by politics. The more Fauci and friends deny having political interests, the more they seem political. Many Fauci’s emails have become public, and he seems highly political, and very often wrong. He also does not take seriously the economic or mental or educational problems caused to the workers that he now blames on his critics. He also seems takes it as a given that those pushing hydroxychloroquine or surface disinfection were liars, despite scientific opinion on the other side.

Fauci’s push for masks went with his claim that surfaces were not major spreaders. I think the opposite is true, and used my blog and YouTube to push iodine as a surface sanitizer and hand wash. Most diseases are spread by surfaces, and I see no reason for COVID to be different. Iodine is known to kill COVID virus, and all virus, fungus, and bacteria. It’s far more lang-lasting than alcohol, too. Maybe I’m wrong, but maybe I’m right, and I have a right to express my science without fear of censure from Fauci’s deputies. As I see it, when an infected person coughs out-spews big droplets and small droplets. The big drops contain far more virus particles. They fall quickly and dry, ready to be picked up by someone who touches the residue. As for the smaller drops, some are certainly locked by masks, but these have fewer virus particles. Besides, the mask just becomes a new surface; you’ll touch your mask to adjust it or take it off. Unless you disinfect your hands with something strong like iodine the virus on your hands will go to your eyes or nose. Trump favored Chlorox for surfaces, and was skewered for it by Fauci and his experts. I think that was wrong, made worse by claims that he was not telling you to inject the Clorox.

On climate too, we do students a disservice by closing the discussion. It’s clear that Gore’s inconvenient truth isn’t completely true, nor are his remedies beneficial, in my opinion. To stop someone’s ability to make mistakes is to wrong him, and limit him. The same applies to many things; the fellow in power always thinks he’s right, and will always have allies to back him. When Robespierre was the enforced virtue and truth during the French Revolution, everyone agreed, but we now think he was wrong. Robespierre removed the head of France’s greatest scientist, Lavoisier. It would take another generation to grow another head like that.

In terms of interesting speeches to the graduates, As Marx said (Groucho), “I thought my razor was dull, till I heard his speech.” There here’s a speech against something.

Freedom is the right to be wrong, and stubborn, like Groucho. Now that’s a graduation speech!

Robert Buxbaum, October 28, 2022

How to tell who is productive if work is done in groups

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It is a particular skill of management to hog the glory and cast the blame; if a project succeeds, executives will make it understood that the groups’ success was based on their leadership (and their ability to get everyone to work hard for low pay). If the project fails, a executive will cast blame typically on those who spotted the problem some months early. These are the people most likely to blame the executive, so the executive discredits them first.

This being the dynamic of executive oversight, it becomes difficult to look over the work of a group and tell who is doing good and who is coasting. If someone’s got to be fired in the middle of a project, or after, who do you fire? My first thought is that, following a failure, you fire the manager and the guy at the top who drew the top salary. That’s what winning sports teams do. It seems to promote “rebuilding” it’s a warning to those who follow. After the top people are gone, you might get an honest appraisal of what went wrong and what to do next.

A related problem, if you’re looking to hire is who to pick or promote from within. In the revolutionary army, they allowed the conscripts to pick some of their commanders, and promoted others based on success. This may not be entirely fair, as there are many causes to success and failure, but it seemed to work better than the British system, where you picked by birth or education. Here’s a lovely song about the value of university education in a modern major general.

A form of this feedback about who knows what he’d doing and who does not, is to look at who is listened to by colleagues. When someone speaks, do people who know listen. It’s a method I’ve used to try to guess who knew things in a field outside my own. Bull-shitters tend to be ignored when they speak. The major general above is never listened to.

In basketball or hockey, the equivalent method is to see who the other players pass to the most, and who steals the most from the other side. It does not take much watching to get a general sense, but statistics help. With statistics, one can set up a hierarchical system based on who listens to whom, or who passes to whom with a logistic equation as used for chess and dating sites. A lower-paid person at the center-top is a gem who you might consider promoting.

In terms of overall group management, it was the opinion of W Edwards Deming, the name-sake of the Deming prize for quality, that overall group success was typically caused by luck or by some non-human cause. Thus that any manager would be as good as any other. Deming had a lovely experiment to show why this is likely the case– see it here. If one company or team did better year after year, it was common that they were in the right territory, or at the right time. As an example, the person who succeeded selling big computers in New York in the 1960s was not necessarily a good salesman or manager. Anyone could have managed that success. To the extent that this is true, you should not fire people readily, but neither worry that your highest paid manager or salesman is irreplaceable.

Robert Buxbaum, October 9, 2022

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

Curing my heart fibrillation with ablation.

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Two years ago, I was diagnosed with Atrial fibrillation, A-Fib in common parlance, a condition where my heart would sometimes speed up to double its normal speed. I was prescribed metopolol and then atenolol, common beta blockers, and a C-Pap for sleep apnea. None of this seemed to help, as best I could tell from occasional pulse measurements with watch and a finger pulse-oxometer. Besides, the C-Pap was giving me cough and the beta blockers made me dizzy. And the literature on C-Pap did not impress.

So, some moths ago, I bought an iWatch. The current versions allows you to take EKGs and provides a continuous record of your heart rate. This was very helpful, as I saw that my heart rate was transitioning to chaos. While it was normally predictable, it would zoom to 130 or so at some point virtually every day. Even more alarming, it would slow down to the mid 30s at some point during the night, bradycardia, and I could see it was getting worse. At that point, I agreed to go on eliquis, a blood thinner, and agreed to a catheter ablation. The doctor put a catheter into my heart by way of a leg vein, and zapped various nerve centers in the heart. The result is that my heart is back into normal behavior. See the heart-rate readout from my iWatch below; before and after are dramatically different.

My heart rate for the last month, very variable before the ablation treatment, 2 weeks ago; a far less variable range of heart rates in the two weeks following the treatment. Heart rate data is from my iPhone and iwatch — a good investment, IMHO.

The reason I chose ablation over drugs or no therapy was that I read health-studies on line. I’ve go a PhD, and that training helps me to understand the papers I’ve read, but you should read them too. They are not that hard to understand. Though ablation didn’t appear as a panacea, it was clearly better than the alternatives. Particularly relevant was the CABANA study on life expectancy. CABANA stands for “Catheter ABlation vs ANtiarrhythmic Drug Therapy for Atrial Fibrillation – CABANA”. https://www.acc.org/latest-in-cardiology/clinical-trials/2018/05/10/15/57/cabana.

2,204 individuals with persistent AF were followed for 5 years after treatment, 37% female, 63% male, average age 67.5. Prior hospitalization for AF: 39%. The results were as follows:

  • Death: 5.2% for ablation vs. 6.1% for drug therapy (p = 0.38)
  • Serious stroke: 0.3% for ablation vs. 0.6% for drug therapy (p = 0.19)
  • All-cause mortality: 4.4% for ablation vs. 7.5% for drug therapy (p = 0.005)
  • Death or CV hospitalization: 51.7% for ablation vs. 58.1% for drug therapy (p = 0.002)
  • Pericardial effusion with ablation: 3.0%; ablation-related events: 1.8%
  • First recurrent AF/atrial flutter/atrial tachycardia: 53.8% vs. 71.9% (p < 0.0001)

I found all of this significant, including the fact that 27.5% of those on the drug treatment crossed over to have ablation while only 9.2% on the ablation side crossed to have the drug treatment.

I must give a plug for doctor Ahmed at Beaumont Hospital who did the ablation. He does about 200 of these a year, and does them well. Do not go to an amateur. I was less-than impressed with him pushing the beta-blocker hard; I’ll write about that. Also, get an iWatch if you think you may have A-Fib or any other heart problem. You see a lot, just by watching, so to speak.

Robert Buxbaum, August 3, 2022.