Vulnerability to stress and cardiac outcomes

The BBC(British Broadcasting Corporation) “reports on a study”:http://news.bbc.co.uk/2/hi/health/4754658.stm measuring cardiovascular outcomes (blood pressure, levels of clot-forming platelets) against a patient’s vulnerability to stress. In the patients who were vulnerable to stress, apparently, their blood pressure took a lot longer to get back to normal after a stressful task than in the control group. More important, these patients had higher platelet levels. The platelet levels being high during stress is fine — after all, if the lion takes a chunk out of your arm, you want to stem the bleeding as quick as possible. The high platelet levels persisting afterwards is not fine, as they tend to form clots.

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Ahimsa and eating meat

I’ve been thinking a lot recently about what I’m eating, which eating habits I want to keep, and which I want to change. One question which I am dealing with is whether to give up meat. And I think I have an answer to this question, which appears to plague a lot of yogis.

Many take the discipline of _ahimsa_ to include avoiding the killing of animals for meat. Two interesting conflicting opinions on this can be found at the “Yoga Peeps”:http://www.yogapeeps.com podcast. (“Episode 2”:http://yogapeeps.com/main/2006/episode-2-interview-tracy-groshak-of-yogadivascom/11 and “Episode 3”:http://yogapeeps.com/main/2006/episode-3-interview-kelly-mcgonigal-phd/36 and “Episode 4”:http://yogapeeps.com/main/2006/episode-4-interview-nadia-toraman/40)

Also informing this are an article in the Feb 2006 issue of ??Yoga Journal?? about proper diet and other blog entries, links to which I can’t find at the moment, which discuss the issue. Some of the points they bring up are why do many mammals kill for food out of necessity if it is such a great harm? (I.e. killing for food is part of nature.)

I’ve decided I’m going to let my body tell me.

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A better heavy metal drug

We are now just discovering how gold and other heavy-metal drugs work against rheumatoid arthritis. These drugs have been in use for one indication or another since the 1890’s.

I wonder what pharmaceutical chemist “Derek Lowe”:http://pipeline.corante.com’s comments on this development are.

While other people contemplate the politics of this, I’ll contemplate the statistics

No doubt that the “ongoing tiff”:http://pipeline.corante.com/archives/2006/02/22/nejm_vs_its_contributors_round_two.php#comments between NEJM(New England Journal of Medicine) and the co-authors of the VIGOR study has analysts pontificating and pharma scientists scratching their heads. I’ll leave the political issues to people who are closer to them than I.

For me, the issue might involve a central practice in my field. There were three cardiovascular deaths that occurred after a prespecified cutoff date in the Vioxx™ arm, and one stroke in the naproxen arm. These four deaths were not reported in the publication of the VIGOR study.

We have a reason for this practice in statistics. We do it to avoid any “data-driven hypotheses”There actually is a statistical methodology called “data-driven hypothesis-testing.” However, to do this correctly you have to lay out _exactly_ what you are doing before the data comes in. We detail our analysis, including the main analysis, what cutoff dates are, how to handle missing data, and so forth _before_ we know who belongs to which treatment group, and then we follow that plan. This is to avoid saying “Gee, this other analysis will make our drug look better” after seeing the data.

So my question is this: will this practice become unethical? Are we going to be ethically bound to change some of the details of our analysis based on new data?

*Update 2/26*: So, I’ve been thinking about this some more. I realize that someone could say, “I believe we should amend ethical practice to report all deaths, even if they happen 20 min before paper submission deadline.” Why stop there, why not all serious adverse events (usually hospitalizations or medical intervention needed to avoid death, life-long sequelae, or birth defects)? How about anything adverse, especially if it makes the drug look bad? Isn’t that the more conservative approach?

I don’t think so. Data such as the three deaths get reported to the FDA as part of a submission, and gets updated periodically through safety reporting mechanisms already in place. For a paper, you’re looking for information dissemination, not marketing approval. I think in this case, as long as the cutoff dates were established before they knew who received what, they should stick with it.

PS Professor Stemwedel “states the point”:http://scienceblogs.com/ethicsandscience/2006/02/does_extra_data_always_get_you.php more clearly than I can.

Hey, they’re retractable now

Sharpies are now “retractable”:http://www.kk.org/cooltools/archives/001145.php
Cool Tool: Retractable Sharpie. I need to get a set!

!http://www.kk.org/cooltools/archives/retractable1.jpg!

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Standing on my head

Well, I’m trying a “sirsasana”:http://yogadancer.com/Pages/Sirsasana.shtml#Salamba1 practice. I’m at 2.5 minutes, and I plan to work up to 5 minutes a day. My main problem is breathing; for some reason my sinuses want to close up while I’m inverted.

So, if I’m able to do a yoga practice in the morning, I may just try 5 minutes of this (including balasana and some seated meditation), or I may try right before savasana.

We’ll see how this goes. Upside-down is a different way of looking at the world. You tend to notice a lot of things you haven’t noticed before.

Come to think of it, I never did well in those after-lunch classes in school

Now I know “why”:http://www.scienceblog.com/cms/learning_and_memory_stimulated_by_gut_hormone_10083.html.

However, I wonder if they considered the fact that before eating people are probably thinking about eating rather than trying to learn.

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