Health – Page 23 – artdiamondblog.com

Super Agers “Have a Purpose”

I have personally benefitted from Vernon Smith’s longevity, since he graciously wrote two drafts of a positive blurb for my Openness to Creative Destruction book.

(p. A5) Vernon L. Smith, 97, is a very busy man.

The economist at Chapman University just finished writing a book about Adam Smith and works about eight hours a day, seven days a week in his home office in Colorado Springs, Colo. He enjoys chatting with friends on Facebook and attending concerts with his daughter.

“I still have a lot of stuff to do. I want to keep at it,” said Smith, who won the Nobel Prize in economics in 2002.

. . .

(p. A10) Researchers studying “super agers,” people over 80 who have mental faculties of people decades younger, said strong social relationships are important for keeping brains sharp.

The same is true for people who live beyond 100, said Stacy Andersen, a behavioral neuroscientist at Boston University and co-director of the New England Centenarian Study.

“They have a purpose. They have things they want to go out and do every day,” Andersen said.

Smith says his work and his family keep him motivated and driven.

“I want to go to at least 106,” he said.

For the full story, see:

Dominique Mosbergen. “Several Factors Help Ward Off Mental Decline.” The Wall Street Journal (Friday, Feb. 16, 2024): A5.

(Note: ellipsis and bracketed year added.)

(Note: the online version of the story was updated Feb. 15, 2024, and has the title “How to Stay Mentally Sharp Into Your 80s and Beyond.” The last sentence quoted above appears in the online, but not in the print, version of the article.)

My book mentioned above is:

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.

FDA Delays Apple Offering Consumers Quick and Convenient Blood Pressure Readings

Doesn’t the FDA do harm by requiring that Apple watch blood pressure monitor be equal in accuracy to a standard clinical blood pressure monitor? Many people will not take the time and effort to get frequent readings from a standard blood pressure monitor in a clinic. But many of them would check their blood pressure conveniently on their watch. Isn’t a less accurate reading better than no reading at all?

(p. A1) Apple’s widening effort to turn its nine-year-old watch from a luxury timepiece into the ultimate all-in-one medical device is taking it into territory that is legally treacherous as well as potentially profitable.

. . .

(p. A2) “The studies that we’ve seen are not yet reassuring that they’re ready for prime time or for clinical use,” said Jordana Cohen, associate professor of medicine and epidemiology at the University of Pennsylvania.

To secure Food and Drug Administration clearance for selling a blood-pressure monitor, companies must demonstrate through the FDA’s 510(k) process that their device’s accuracy is comparable to an existing, already cleared device, she added.

Similarly, tracking glucose through noninvasive skin sensors is generally less precise than direct blood analysis, with factors such as skin tone and temperature affecting accuracy.

For the full story, see:

Dalvin Brown and Aaron Tilley. “Tech and Legal Hurdles Hinder Apple’s Quest for Medical Watch.” The Wall Street Journal (Friday, Dec. 29, 2023): A1-A2.

(Note: ellipsis added.)

(Note: the online version of the story has the date December 28, 2023, and has the title “Apple Keeps Chasing the Ultimate Health-Tracking Watch—but It Could Take Years.”)

“Adoption of Singular ‘Gold Standard’ Models” Closes “Off Other Important Avenues of Inquiry”

(p. A15) Ubiquitous and persuasive, models . . . drive decisions—one reason why, in Ms. Thompson’s view, they require our urgent attention. She tells us that, as a graduate student studying North Atlantic storms, she noticed how different models predicted different overall effects and produced contradictory results.

. . .

The problem is that Model Land is easy to enter but difficult to escape. Having built “a beautiful internally consistent model,” Ms. Thompson writes, it can be “emotionally difficult to acknowledge that the initial assumptions on which the whole thing is built are literally not true.”

There are all sorts of ways that models can lead us astray. A small measurement error on an input can lead to wildly inaccurate forecasts—a phenomenon known as the Butterfly Effect. Fortunately, this type of uncertainty is often manageable. Far more problematic are what Ms. Thompson calls “unquantifiable unknowns”—things that are left out of a model’s calculation because they can’t be anticipated, such as the unexpected arrival of a transformative technology or the abrupt collapse of a robust market. It is not always true, she observes, that the data we have now will be relevant to the future—as traders discovered in the stock-market crash of 1987, when their models catastrophically failed.

. . . We may be inclined to regard models as objective expressions of truth, yet they are deliberately constructed interpretations, imbued with the values and viewpoints of the modelers—primarily, as Ms. Thompson notes, well-educated, middle-class individuals. During the pandemic, models “took more account of harms to some groups of people than others,” resulting in a “moral case” for lockdowns that was “partial and biased.” Modelers who worked from home—while others maintained the supply chain—often overlooked “all of the possible harms” of the actions their models were suggesting. . . .

The promise and peril of models, Ms. Thompson recognizes, has deep resonance in biomedicine, where so-called model organisms, like yeast and zebrafish, have led to foundational insights and accelerated the development of therapeutics. At the same time, treatments that work brilliantly in Model Land often fail in people, devastating patients and disappointing drug developers. The search for improved disease models can be complicated when proponents of one model suppress research into alternative approaches, as the late journalist Sharon Begley documented in a powerful 2019 report. Ms. Thompson perceptively critiques the adoption of singular “gold standard” models, noting that the “solidification” of one set of assumptions can lock us into one way of thinking and close off other important avenues of inquiry.

For the full review see:

David A. Shaywitz. “BOOKSHELF; Seduced By Numbers.” The Wall Street Journal (Wednesday, Dec. 28, 2022): A15.

(Note: ellipses added.)

(Note: the online version of the review has the date December 27, 2022, and has the title “BOOKSHELF; ‘Escape From Model Land’ Review: Seduced by Numbers.”)

The book under review is:

Thompson, Erica. Escape from Model Land: How Mathematical Models Can Lead Us Astray and What We Can Do About It. New York: Basic Books, 2022.

Sharon Begley’s “powerful” 2019 report, mentioned above, is:

Begley, Sharon. “The Maddening Saga of How an Alzheimer’s ‘Cabal’ Thwarted Progress toward a Cure for Decades.” STAT; Reporting from the Frontiers of Health and Medicine, Posted June 25, 2019. Available from https://www.statnews.com/2019/06/25/alzheimers-cabal-thwarted-progress-toward-cure/.

Thiel Says British Public Supports National Health System Because They Suffer from the Stockholm Syndrome

Peter Thiel claims that the British public supports their National Health System because they suffer from the Stockholm Syndrome. The claim is amusing, thought-provoking, and may be partly true. But I suspect that there are other reasons for the British public’s support. I suspect they assume that future advances in health care inevitably will be more expensive than they will be able to afford. They do not understand that in a laissez-faire health system substantial incentives would exist to develop effective low-cost cures and therapies.

(p. 8) It began with a £1 contract.

In the hours after a pandemic was declared in March 2020, Palantir, the secretive American data analytics company, was invited to 10 Downing Street along with other tech groups, including Amazon, Google and Meta, to discuss how it could help the British government respond.

Within days, Palantir’s software was processing streams of data from across England’s National Health Service, with Palantir engineers embedded to help. The company’s services, used by the C.I.A. and Western militaries for more than a decade, were deployed to track emergency room capacity and direct supplies of scarce equipment.

Palantir charged the government just one pound.

The deal provided the company with a valuable toehold. Since then, Palantir, which is chaired by Peter Thiel, the billionaire investor and one of President Donald J. Trump’s major 2016 donors, has parlayed the work into more than £60 million in government health contracts. Its biggest reward may be yet to come: a seven-year contract worth up to £480 million — about $590 million — to overhaul N.H.S. England’s outdated patient data system.

. . .

Palantir declined to comment on its bid but said it was proud to support “the world’s most important private and public institutions.” The company defended the quality of its work and said, “We are now helping to reduce the N.H.S. backlog, cut the amount of time nurses and doctors need to spend on administrative tasks and speed up cancer diagnosis — all while rigorously protecting data privacy.”

. . .

Speaking at Oxford University in January [2023], Mr. Thiel went off script. The N.H.S. makes people sick and should embrace privatization, he said in response to a question. The British public’s support for the service, he said, was “Stockholm syndrome.”

For the full story, see:

Euan Ward and Adam Satariano. “Uproar in U.K. Over Data Giant’s Push for Heavier Role in Health Care.” The New York Times, First Section (Sunday, October 1, 2023): 8.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date Sept. 29, 2023, and has the title “How Peter Thiel’s Palantir Pushed Toward the Heart of U.K. Health Care.”)

Miracle Drugs Should Not Lead Us to Ignore Nutrition as a Driver of Health

(p. A15) More than 100 years after the miraculous discovery of insulin to treat diabetes, how are things going? More people are getting the disease. (Between 1959 and 2021, the number of Americans diagnosed with diabetes increased from 1.5 million to 29.7 million, according to federal government surveys.) Patients are doing worse. (Fewer than 1 in 5 Type 1 patients are achieving blood-sugar goals established by the American Diabetes Association.) Diabetes intensifies America’s economic and racial divide. (Type 2 diabetes disproportionately affects the poor, the undereducated and minorities.) And the epidemic is global. (According to the World Health Organization, diabetes is the ninth leading cause of death worldwide.)

If any disease needs to be rethought, it is surely diabetes, and that is the premise of Gary Taubes’s latest book.

. . .

The hero of “Rethinking Diabetes” is Dr. Richard Bernstein, an engineer-turned-doctor who also has Type 1. In the 1970s, he became the first person to use a home glucose meter; looking at his data, he realized that a low-carb diet minimized his glycemic swings. For the past 40 years, in his books, academic papers and other advocacy, he has been the leading low-carb evangelist for people with diabetes.

But Dr. Bernstein is also a controversial figure, and not just because his nutritional guidance defied the medical establishment. I interviewed Dr. Bernstein and wrote about him in 2007. He’s prone to hyperbole and absurdities, such as his claim that insulin-pump patients “all have complications.” More important, his low-carb diet is uncompromising, and his advice is not realistic for everyone. When I interviewed him, he hadn’t eaten an apple since the Nixon administration. Nonetheless, I believe that Dr. Bernstein’s insights about diet and diabetes—and Mr. Taubes’s central argument—are correct. Imperfectly, I follow Dr. Bernstein’s guidance, and I’m far healthier because of it.

Mr. Taubes’s larger point is that we have allowed pharmacological miracles in the treatment of diabetes, insulin being one of them, to supplant food and nutrition as the foundation of good health. He concurs with Dr. Arnoldo Cantani, a 19th-century Italian physician, who said that the remedy for diabetes “is not in the drugstore but in the kitchen.”

For the full review see:

James S. Hirsch. “BOOKSHELF; Beyond Insulin.” The Wall Street Journal (Monday, Jan. 8, 2024): A15.

(Note: ellipsis added.)

(Note: the online version of the review has the date January 7, 2024, and has the title “BOOKSHELF; ‘Rethinking Diabetes’ Review: Beyond Insulin.”)

The book under review is:

Taubes, Gary. Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments. New York: Knopf, 2024.

Britain’s Socialized National Health Service (NHS) Stripped Parents of Control, Leaving Indi No Choice but to Die

(p. A13) Indi was born with mitochondrial disease, a degenerative condition that prevents cells from producing energy. When her parents and the Queen’s Medical Centre in Nottingham, England, disagreed over whether she should be kept on life support, the NHS turned to the courts to strip the parents of decision-making authority. The U.K. High Court agreed, overrode the parents’ wishes, and ordered life support removed.

. . .

While the NHS thought continued treatment would be futile, other experts disagreed, including at the Vatican’s Bambino Gesù pediatric hospital. As part of its religious mission, Bambino Gesù specializes in treating children with rare diseases. Doctors there offered a treatment plan they thought could help Indi, free of charge. The Italian government even made her a citizen so that she could be airlifted from England.

. . .

For the U.K., the offer of free treatment by willing doctors ought to have been the end of the story. The government didn’t have to pay another penny. The grateful parents simply wanted the freedom to take their daughter to the experts in Rome.

Instead, the NHS went back to the same court and judge to insist it remained in Indi’s best interests to die in the U.K. The court again agreed and overrode the parents’ desire to take Indi to see the experts in Rome. The judge ordered that they could take her only to one place: to the hospice to die.

The parents had no choice but to comply. Lest they try anything else to save their daughter, the parents were sent to hospice with a security escort and police presence.

Deprived of treatment and with her parents forbidden to help her, Indi died within two days, under the watchful eye of the government that said all along it was looking out for her best interests.

For the full commentary, see:

Mark Rienzi. “Britain’s NHS Left Indi Gregory to Die.” The Wall Street Journal (Tuesday, Nov. 21, 2023): A13.

(Note: ellipses added.)

(Note: the online version of the commentary has the date November 20, 2023, and has the same title as the print version.)

New Longevity Drugs for Dogs Can Be Proof-of-Concept for Longevity Drugs for People

(p. A1) “When you adopt a dog, you’re adopting future heartbreak,” said Emilie Adams, a New Yorker who owns three Rhodesian Ridgebacks. “It’s worth it over time because you just have so much love between now and when they go. But their life spans are shorter than ours.”

In recent years, scientists have been chasing after drugs that might stave off this heartbreak by extending the lives of our canine companions. On Tuesday, the biotech company Loyal announced that it had moved one step closer to bringing one such drug to market. “The data you provided are sufficient to show that there is a reasonable expectation of effectiveness,” an official at the U.S. Food and Drug Administration informed the company in a recent letter. (Loyal provided a copy of the letter to The Times.)

That means that the drug, which Loyal declined to identify for proprietary reasons, has met one of the requirements for “expanded conditional approval,” a fast-tracked authorization for ani-(p. A19)mal drugs that fulfill unmet health needs and require difficult clinical trials. The drug is not available to pet owners yet, and the F.D.A. must still review the company’s safety and manufacturing data. But conditional approval, which Loyal hopes to receive in 2026, would allow the company to begin marketing the drug for canine life extension, even before a large clinical trial is complete.

. . .

. . . the letter, which came after years of discussion between Loyal and the F.D.A., suggests that the agency is open to canine longevity drugs, Ms. Halioua said.

. . .

Aging may be an inevitability, but it is not an unyielding one. Scientists have created longer-lived worms, flies and mice by tweaking key aging-related genes.

These findings have raised the tantalizing possibility that scientists might be able to find drugs that had the same life-extending effects in people. That remains an active area of research, but canine longevity has recently started to attract more attention, in part because dogs are good models for human aging and in part because many pet owners would love more time with their furry family members.

“There’s not a lot you wouldn’t do if you could stack the deck in your favor to preserve the life of your hairy, four-legged child,” said Ms. Adams, the Rhodesian Ridgeback owner.

For the full story, see:

Emily Anthes. “A Drug Aims to Extend Dogs’ Lives, Yes It Does.” The New York Times (Saturday, November 29, 2023): A1 & A19.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story was updated Nov. 29, 2023, and has the title “Could a Drug Give Your Pet More Dog Years?”)

Almost 50% of Modern Drugs Have Their Source in Folk Medicine

(p. 17) At the heart of “Most Delicious Poison” is an evolutionary oxymoron that sustains life as we know it: Poisons — in deserts or rainforests, at the corner bar or in your fridge — threaten life while offering possibilities for persistence, and the pleasures that we take from substances that would otherwise be deadly hint at the ways life on earth manages to thrive in a landscape of toxins. . . .

“Scratch beneath the surface of a coffee bean, a red pepper flake, a poppy capsule, a Penicillium mold, a foxglove leaf, a magic mushroom, a marijuana bud, a nutmeg seed or a brewer’s yeast cell, and we find a bevy of poisons,” Whiteman writes.

Caffeine is another natural wonder best approached with caution. “Caffeine and the human mind,” says Whiteman, can seem like a match made in heaven. “Taken in the appropriate doses, caffeine not only feels life-giving but is: Drink a few cups a day and you won’t live forever but a little longer.” Whiteman sorts through data suggesting as much, though, anecdotally, on a fall morning in the dark, it sure feels true.

But caffeine can be deadly. In October of this year [2023], the parents of a University of Pennsylvania student with a congenital heart condition sued Panera Bread over their “Charged Lemonade,” on the grounds that a substance containing three Red Bulls’ worth of caffeine should have been marketed as an energy drink, potentially saving their daughter’s life.

And yet used in moderation, the poison that we drink in pumpkin spice lattes blocks adenosine receptors — adenosine being a brain-produced neurotransmitter that would otherwise encourage you to rest.

. . .

Big Pharma’s relationship to Indigenous knowledge is a recurring motif. “Indigenous healers have yielded nearly 50 percent of all modern drugs we use today,” writes Whiteman.

For the full review, see:

Robert Sullivan. “Toxic Relationships.” The New York Times Book Review (Sunday, December 24, 2023): 17.

(Note: ellipses added.)

(Note: the online version of the review was updated Dec. 4, 2023, and has the title “All Things in Moderation, Especially When They’re Toxic.”)

The book under review is:

Whiteman, Noah. Most Delicious Poison: The Story of Nature’s Toxins―from Spices to Vices. New York: Little, Brown Spark, 2023.

Disabled Civil Rights Leader Removed from Audience of “The Color Purple” Because the Chair He Brought Fails to Comply with the Americans with Disabilities Act

Presumably the Reverend William J. Barber II knows what chair designs reduce the chronic pain he feels from the ankylosing spondylitis he has endured “for almost 40 years.” He has what Hayek called “local knowledge” that is not possessed by the government legislators and enforcers of the Americans with Disabilities Act. Regulations keep individuals from using their local knowledge, with results that can be outrageously unfair.

(p. A15) AMC Theaters has apologized to the Rev. William J. Barber II, a civil rights leader, after he was escorted from a Greenville, N.C., theater after employees refused to allow him to use a chair he needs to manage a painful medical condition, he said.

Mr. Barber, 60, was attending a Tuesday afternoon screening of “The Color Purple” with his mother, Eleanor Barber, 90. He said he tried to use the chair, which an assistant carried for him, by placing it in an area reserved for handicapped seating, saying he had done so before in theaters, at Broadway plays and even on a visit to the White House.

He said a theater employee told him that he would not be able to use the chair, which looks like a small stool, because it did not comply with guidelines in the Americans with Disabilities Act.

. . .

Mr. Barber has a condition called ankylosing spondylitis, and walks slowly with the aid of a cane. He said the disease attacks his joints “like a guided missile” and has forced him to live with chronic pain for almost 40 years. “I describe it like that because it’s a war to live with it,” he said.

He added that people with disabilities often fight invisible battles that can be difficult for people not living with disabilities to understand.

For the full story, see:

Clyde McGrady. “Rights Leader Gets Apology For Removal From Theater.” The New York Times (Saturday, December 30, 2023): A15.

(Note: ellipsis added.)

(Note: the online version of the story has the date Dec. 28, 2023, and has the title “AMC Theaters Apologizes to Civil Rights Leader Removed From Movie Theater.”)

Alleged Upper Bounds to Lifespans Continue to Be Surpassed

(p. A2) In a 2002 paper, “Broken Limits to Life Expectancy” the demographers Jim Oeppen and James Vaupel showed that for nearly 100 years, estimates of when life expectancy would hit its limit were proven wrong, often in just a few years. In 2020, Max Roser of the University of Oxford noted that this trend was still intact.

There is no guarantee, of course, that this trend will continue over time or everywhere. Perhaps pandemics, weather disasters or fentanyl deaths will become widespread enough to outweigh improvements in cancer treatment and so on. But I wouldn’t bet on it.

The better bet, according to demographers, is that children born this year will live longer than children born in any previous year.

For the full commentary, see:

Josh Zumbrun. “THE NUMBERS; The Good News About Life Expectancy.” The Wall Street Journal (Saturday, December 16, 2023): A2.

(Note: the online version of the commentary has the date December 15, 2023, and has the title “THE NUMBERS; The (Surprisingly) Good News on Life Expectancy: It’s Still Going Up.”)

The Oeppen and Vaupel article mentioned above is:

Oeppen, Jim, and James W. Vaupel. “Broken Limits to Life Expectancy.” Science 296, no. 5570 (May 10, 2002): 1029-31.

The 2020 article by Roser, updating the Oeppen and Vaupel paper, is:

Roser, Max. “The Rise of Maximum Life Expectancy: Predictions of a Maximum Limit of Life Expectancy Have Been Broken Again and Again.” Last updated March 1, 2020 [cited Sat., Dec. 16, 2023]. Available from https://ourworldindata.org/the-rise-of-maximum-life-expectancy.

If You Are Pained to Wait Over Two Years for Socialist Surgery in Britain, Seek Timely Free Market Surgery in Lithuania

(p. 4) For David Haselgrove, it was a battle each day to get out of bed, then another struggle to put on his socks. Stairs were often impossible, and the pain made him tetchy and difficult to live with.

But when he sought medical help for his arthritis, Mr. Haselgrove was told the wait for a specialist consultation was more than two years. It might be another two years before surgery.

“If I wasn’t the person I am, I would have been losing the will to live because the pain takes over your life,” said Mr. Haselgrove, 71, who is now fully mobile after a successful hip replacement.

His recovery has nothing to do with Britain’s National Health Service.

Instead, Mr. Haselgrove, who ran several small businesses during his working life, flew to a clinic in Lithuania to have surgery, becoming one of a growing number of Britons who have dipped into their own pockets to pay for procedures to which they are entitled free on the N.H.S.

. . .

Investment in buildings and equipment, including in vital diagnostic tools such as CT and M.R.I. scanners, has significantly lagged medical systems in other advanced economies, according to the King’s Fund, a health-focused think tank.

That contributed to a backlog of 4.6 million procedures even before the pandemic, a number that swelled to six million as planned procedures made way for emergency care during the Covid crisis. The line for treatment has only grown since. It is now about 7.7 million procedures, representing about a 10th of the population. Thousands have waited more than two years, often in pain.

Little wonder, then, that many Britons who can afford to pay to cut the line are doing so, while some of more limited means are dipping into savings or taking on debt. Yet that trend, some critics say, could undermine a health care system that has been a bedrock of British life for three-quarters of a century.

Private medical insurance is costly in Britain, and taxable when offered as a benefit by employers, so the shift is most visible when people pay for operations and other medical help out of pocket.

According to the Private Healthcare Information Network, which publishes data on the sector, there were about 50,000 “self-pay” medical admissions in a typical quarter before the pandemic. That figure is now steadily substantially higher; in the first quarter of this year, it was 71,000, close to a record.

That does not include patients who go overseas, like Mr. Haselgrove. At 7,000 euros, about $7,500, a hip replacement at the Nord Clinic in Lithuania was significantly cheaper than it would have been in a private hospital in Britain.

. . .

Britain is chronically short of health workers, with over 100,000 N.H.S. positions vacant.

. . .

. . . the deepest risk of the rise in self-pay patients, according to Chris Thomas, principal health fellow at the Institute for Public Policy Research, a progressive think tank, is not to the health service’s operations, but to its political underpinnings.

The British health system, he said, is built around the idea of “universalizing the best” — creating a system “as good for a rich person” as for a poor one, Mr. Thomas said.

If wealthier people increasingly opt out, Mr. Thomas said, the N.H.S. will become a second-class system for those who cannot afford to do so, resulting in “a slow erosion of support.”