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anonymous

The Costly, Painful, Lonely Burden of Care - The New York Times - 0 views

  • The Costly, Painful, Lonely Burden of Care
  • Health care in the U.S. relies on an “invisible army” of caregivers — mostly women. For many, stunted careers, lost earnings and exhaustion are part of the fallout.
  • “If society wants us to keep caring for others, it’s going to have to show a little more care for us.”
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  • Her husband, Brad Buchanan, was late for family dinner. She found him in the bathroom, coughing up blood — a lot of it.
  • Doctors found that a tumor had ruptured in one of his lungs and he urgently needed chemo. As her husband became critically ill, Ms. Washington, a freelance writer, was thrust into the role of nurse.
  • “My hands were shaking,” she said as she remembered apprehensively pushing in the drugs for the first time and feeling the weight of keeping her husband alive.
  • Mr. Buchanan had a stem cell transplant that left him with graft-versus-host disease
  • they tend to do more personal care tasks like helping patients bathe and use the toilet than their male counterparts, who are more likely to oversee finances and arrangement of care.
  • When she explained that she had two children who also had needs, he said, “Well, usually family steps in, and it works out fine.”
  • Ms. Washington felt the burden of responsibility, but also the sting
  • The U.S. health care system relies on and takes for granted the “invisible army” of people — mostly women — who keep the system functioning by performing home care for the many people who are “too well for the hospital” but “too sick for home,” as well as for those on end-of-life care.
  • In 2017, AARP found that about 41 million family caregivers in America perform roughly $470 billion worth of unpaid labor a year.
  • Depending on the analysis, between 61 and 75 percent of caregivers are women
  • The historical roots are complex, but as Evelyn Glenn puts it in “Forced to Care,”
  • emale caregivers put in more hours — 22 to men’s 17
  • A doctor told Ms. Washington that her husband would need 24-hour care and “could not be left alone for even a moment.”
  • Many people who take on caregiving roles experience negative health impacts, but women are especially at risk of the fallout from caregiver stress.
  • Female caregivers are also 2.5 times more likely to live in poverty as non-caregiver
  • A 2011 study found that women who left their jobs to care for a parent lost an average of $324,000 in wages and benefits over their lifetimes.
  • Ms. Washington was able to dip into savings and a recent inheritance to help pay for supplemental in-home care, but it was still a struggle, causing stress, resentment and lost income.
  • It was hard to have my life put on hold. Everything kind of slipped away.
  • I lost a sense of who I was. I was going to pick up a prescription for myself, the only prescription I had when my husband was sick, and the pharmacist asked for my date of birth, and I gave his date of birth
  • People talk about how it’s the most important job in the world, taking care of our children or taking care of our vulnerable elders, and yet those are some of the worst paid jobs.
  • How much is a quarterback paid versus someone who is doing care for a vulnerable elderly person?
  • How did care work become so undervalued?
  • they are also more likely to stand by their partner through a serious illness
  • Western culture has long framed care work done by women as a moral duty or obligation, rather than an economic activity.
  • If your earnings are lower than they would normally be because you’re busy caring for a family member, and you can’t save and pay into social security, it can lock whole families into a cycle of lower wealth and economic instability.
  • And what should someone not do
  • Don’t tell someone to stay positive. For me, there was no staying about it, because I didn’t feel positive to start with. It brought up this feeling
  • My time isn’t my own, but surely my emotions can be
anonymous

Is Ringing in the Ears a Symptom of Coronavirus? - The New York Times - 0 views

  • When the Noise Never Stops: Coping With the Challenges of Tinnitus
  • Researchers are just beginning to untangle how Covid might be linked to a ringing in the ears. Here’s what we know.
  • Experts are beginning to learn how it may be linked to Covid
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  • the heart palpitations, headaches, stomach troubles, numbness and weakness in her hands and feet — the most frustrating one is the tinnitus, a condition that can cause sufferers to hear phantom ringing, buzzing, whistling, chirping or other sounds.
  • “It makes it hard to concentrate, it makes it hard to hold conversations with others, it makes it almost impossible to lie down and go to sleep. It’s maddening, and you can’t fully understand it unless you experience it yourself.
  • the most common cause of chronic tinnitus is age
  • As the hair cells inside your inner ear become damaged over time, she said, they may no longer send sound waves to your brain, so your brain tries to recreate them on their own, which is what might cause the ringing.
  • But experts have long known that some viruses can temporarily cause hearing loss or ringing in the ears, too. When the body fights an infection, the overall inflammation from the virus can damage the nerves or hair cells in the ear, Dr. Cosetti said.
  • “I was so depressed and scared I’d never get better,” Ms. Suarez said. “I speak and talk for a living — how was I going to be able to have a conversation with a client or present in court if it constantly sounded like bells were exploding on my left side?”
  • Tinnitus has been linked to several mental health conditions, including anxiety and depression, and mostly in women. “It can be particularly challenging for many people initially because it’s something they have absolutely no control over,”
  • “For most people with tinnitus, the worst time is the first six to nine months after it begins,” Dr. Tyler said. “After that, most people adjust and learn to live with it, especially if they’re given the right treatments.”
  • If you are diagnosed with Covid-19 and you experience tinnitus that lasts for more than two days, tell your doctor right away.
  • If your tinnitus persists after you’ve recovered from the virus, make an appointment with an ear, nose and throat doctor, who can check for blockages in your ear
  • If no blockage exists, you might be sent to an audiologist to check your hearing.
  • “It’s always there and with me all the time — I can never escape it,” she said, adding that she has to take sedatives now to fall asleep. “I have days when I don’t know if I can handle this anymore. But I have to go on being hopeful.”
ilanaprincilus06

New traumatic brain injury test is 'game-changing,' concussion experts say - ABC News - 0 views

  • In a world first, a newly authorized handheld device will allow doctors to detect traumatic brain injuries (TBIs) in under 15 minutes, potentially saving lives by dramatically shortening the time it takes to properly diagnose the issue.
  • Until now, health care providers have needed to rely on subjective measurements for TBIs, but we finally have a more objective tool to help evaluate patients.”
  • Unfortunately, many patients with mild TBI struggle to get an accurate and timely diagnosis, even as they grapple with ongoing symptoms. This ultimately results in delayed treatment.
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  • Abbott’s new blood test may serve as an objective tool to help doctors triage TBI patients, because it relies on molecular signatures in the blood rather than on murkier clues, such as patient interviews.
  • often use a series of screening questionnaires, physical examinations and CT scans to take pictures of the brain in order to evaluate TBI. However, experts agree these techniques aren’t perfect and there is no objective way to reliably evaluate TBI.
  • Aside from reducing health care costs, it can save people from unnecessary radiation that has been shown to increase the risk of cancer.
  • Despite the benefits, experts agree that physicians cannot rely entirely on this diagnostic test, stating it will only serve to supplement clinical judgment.
  • "The game-changing innovation of having a tool like this is that, as it becomes more widely used, I believe we will identify more people with TBI that’s more subtle, that could be life-altering."
ilanaprincilus06

Civil Rights Office At HHS Fights Discrimination Of Disabled People In Pandemic : NPR - 0 views

  • Civil rights officials at the Department of Health and Human Services issued a series of actions to protect people with disabilities from health care discrimination by medical providers during the pandemic.
  • start of a process to write regulations that explicitly prohibit medical workers from denying care to people with disabilities
  • to assure that people with disabilities and older people are not passed over for scarce care, like drug treatments and ventilator
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  • "People will not be subject to age or disability discrimination when the going gets tough."
  • The new OCR action makes clear that doctors cannot issue a blanket DNR and cannot substitute their subjective beliefs about the quality of a disabled person's life over the person's own wishes.
  • "that discrimination against persons with disabilities will be absolutely forbidden and stereotypes about their usefulness should never be part of a discussion when we allocate care."
  • it would become a significant expansion of disability civil rights law.
  • But a final rule exists in draft form, according to a source at HHS, with hopes that new Biden Administration officials will pick it up.
  • include language to guarantee doctors will not pressure patients to sign Do Not Resuscitate orders and not exclude people from treatment based on their disability alone.
  • The steps taken by OCR to stop medical discrimination reflect the findings of a series of papers on bioethics and disability, issued by the National Council on Disability,
  • "Disability discrimination in health care is among the most insidious — with life and death consequences — and it's hard to root out,"
  • "sends an unequivocally clear message that we will not accept health care that relegates people with disabilities to last in line or 'lost cause.'"
sanderk

Coronavirus Tips: How to Protect and Prepare Yourself - The New York Times - 0 views

  • The coronavirus continues to spread worldwide, with over 200,000 confirmed cases and at least 8,000 dead. In the United States, there have been at least 8,000 cases and more than 100 deaths, according to a New York Times database.
  • Most important: Do not panic. With a clear head and some simple tips, you can help reduce your risk, prepare your family and do your part to protect others.
  • That might be hard to follow, especially for those who can’t work from home. Also, if you’re young, your personal risk is most likely low. The majority of those who contract coronavirus do not become seriously ill, and it might just feel as if you have the flu. But keeping a stiff upper lip is not only foolhardy, but will endanger those around you.
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  • Avoid public transportation when possible, limit nonessential travel, work from home and skip social gatherings. Don’t go to crowded restaurants or busy gyms. You can go outside, as long as you avoid being in close contact with people.
  • If you develop a high fever, shortness of breath or another, more serious symptom, call your doctor. (Testing for coronavirus is still inconsistent — there are not enough kits, and it’s dangerous to go into a doctor’s office and risk infecting others.) Then, check the Centers for Disease Control and Prevention website and your local health department for advice about how and where to be tested.
  • Wash your hands, wash your hands, wash your hands. That splash-under-water flick won’t cut it anymore.
  • Also, clean “high-touch” surfaces, like phones, tablets and handles. Apple recommends using 70 percent isopropyl alcohol, wiping gently. “Don’t use bleach,” the company said.
  • To disinfect any surface, the C.D.C. recommends wearing disposable gloves and washing hands thoroughly immediately after removing the gloves. Most household disinfectants registered by the Environmental Protection Agency will work.
  • There’s a lot of information flying around, and knowing what is going on will go a long way toward protecting your family.
  • Right now, there’s no reason for parents to worry, the experts say; coronavirus cases in children have been very rare. The flu vaccine is a must, as vaccinating children is good protection for older people. And take the same precautions you would during a normal flu season: Encourage frequent hand-washing, move away from people who appear sick and get the flu shot.
  • Unless you are already infected, face masks won’t helpFace masks have become a symbol of coronavirus, but stockpiling them might do more harm than good. First, they don’t do much to protect you. Most surgical masks are too loose to prevent inhalation of the virus. (Masks can help prevent the spread of a virus if you are infected. The most effective are the so-called N95 masks, which block 95 percent of very small particles.)Second, health care workers and those caring for sick people are on the front lines. Last month, the surgeon general urged the public to stop stockpiling masks, warning that it might limit the amount of resources available to doctors, nurses and emergency professionals.
  • Stock up on a 30-day supply of groceries, household supplies and prescriptions, just in case.That doesn’t mean you’ll need to eat only beans and ramen. Here are tips to stock a pantry with shelf-stable and tasty foods
  • No. The first testing in humans of an experimental vaccine began in mid-March. Such rapid development of a potential vaccine is unprecedented, but even if it is proved safe and effective, it probably will not be available for 12 to18 months.
  • If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
  • That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.
johnsonel7

Opinion | Do heuristics help us make good decisions in uncertain times? - 0 views

  • Do heuristics, the shortcuts that the brain takes, support efficient decision making or does it impede efficient decision making?
  • Humans have neither unlimited resources nor unlimited time to take decisions. So, the brain has always developed smart heuristics, shortcuts to take efficient decisions.
  • One other key thought put forward by Gigerenzer is that there is a big difference between risk and uncertainty. We are dealing with risk when you know all the alternatives, outcomes and their probabilities. We are dealing with uncertainty when you don’t know all the alternatives, outcomes or their probabilities.
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  • It has been found that if doctors are trained how to translate conditional probabilities into natural frequencies, the ability of the doctors to communicate the risk to their patients goes up dramatically. Just imagine the huge difference this can make to customer satisfaction in the healthcare business.
katherineharron

Doctors disagree with White House adviser's statement that media is hyping need for pro... - 0 views

  • Multiple health care workers on Thursday debunked a statement from a White House adviser that the media is overstating the need for personal protective equipment in hospitals amid the novel coronavirus pandemic.
  • Their comments come after White House trade adviser Peter Navarro told CNN earlier Thursday the media should "not sensationalize this crisis" when asked about shortages in personal protective equipment.
  • "It's important for the American public to understand, and for the folks in politics to understand as well that we are already receiving guidance from the CDC on how to reuse our PPE. That is a deviation from the standard of care. Normally in what we would call conventional care, we would wear a different mask for every single patient," he said.
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  • Multiple health care workers on Thursday debunked a statement from a White House adviser that the media is overstating the need for personal protective equipment in hospitals amid the novel coronavirus pandemic.
johnsonel7

We're Being Bombarded by Ads for Drugs | Psychology Today Canada - 0 views

  • "Next time you see a TV commercial for a prescription drug, remind yourself that you know nothing about medical treatment and that everybody who made the commercial has a financial interest in your future behavior." —Eric Horowitz, Psychology Today, How Pharmaceutical Ads Distort Healthcare Markets
  • "According to Kantar Media, a firm that tracks multimedia advertising, 771,368 such ads were shown in 2016, the last full year for which data is (sic) available, an increase of almost 65 percent over 2012."
  • What catches my ears is the way in which drug presentations are made, often beginning with a personal story about someone suffering from a specific disease and how a particular drug helped them along. All well and good, until we learn that the players are usually fake patients called "actor portrayals" and fake doctors, often referred to as "actor portrayals" or "doctor dramatizations." After learning what a drug might be good for, the ads consist of rapid staccato-like talk about possible side-effects and lists in tiny text that are virtually impossible to read.
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  • The cost of the drugs also isn't given, although there has been a push that commercials offer this vital information. Furthermore, we're not offered quantitative information about risks or side-effects.
  • When you think about it, it’s actually the perfect cycle for the pharmaceutical companies whereby an increase in sales of one medication directly increases the demand of the other with the only losers being us, the consumers."
Javier E

AI is about to completely change how you use computers | Bill Gates - 0 views

  • Health care
  • Entertainment and shopping
  • Today, AI’s main role in healthcare is to help with administrative tasks. Abridge, Nuance DAX, and Nabla Copilot, for example, can capture audio during an appointment and then write up notes for the doctor to review.
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  • agents will open up many more learning opportunities.
  • Already, AI can help you pick out a new TV and recommend movies, books, shows, and podcasts. Likewise, a company I’ve invested in, recently launched Pix, which lets you ask questions (“Which Robert Redford movies would I like and where can I watch them?”) and then makes recommendations based on what you’ve liked in the past
  • Productivity
  • copilots can do a lot—such as turn a written document into a slide deck, answer questions about a spreadsheet using natural language, and summarize email threads while representing each person’s point of view.
  • before the sophisticated agents I’m describing become a reality, we need to confront a number of questions about the technology and how we’ll use it.
  • Helping patients and healthcare workers will be especially beneficial for people in poor countries, where many never get to see a doctor at all.
  • To create a new app or service, you won’t need to know how to write code or do graphic design. You’ll just tell your agent what you want. It will be able to write the code, design the look and feel of the app, create a logo, and publish the app to an online store
  • Agents will do even more. Having one will be like having a person dedicated to helping you with various tasks and doing them independently if you want. If you have an idea for a business, an agent will help you write up a business plan, create a presentation for it, and even generate images of what your product might look like
  • For decades, I’ve been excited about all the ways that software would make teachers’ jobs easier and help students learn. It won’t replace teachers, but it will supplement their work—personalizing the work for students and liberating teachers from paperwork and other tasks so they can spend more time on the most important parts of the job.
  • Mental health care is another example of a service that agents will make available to virtually everyone. Today, weekly therapy sessions seem like a luxury. But there is a lot of unmet need, and many people who could benefit from therapy don’t have access to it.
  • I don’t think any single company will dominate the agents business--there will be many different AI engines available.
  • The real shift will come when agents can help patients do basic triage, get advice about how to deal with health problems, and decide whether they need to seek treatment.
  • They’ll replace word processors, spreadsheets, and other productivity apps.
  • Education
  • For example, few families can pay for a tutor who works one-on-one with a student to supplement their classroom work. If agents can capture what makes a tutor effective, they’ll unlock this supplemental instruction for everyone who wants it. If a tutoring agent knows that a kid likes Minecraft and Taylor Swift, it will use Minecraft to teach them about calculating the volume and area of shapes, and Taylor’s lyrics to teach them about storytelling and rhyme schemes. The experience will be far richer—with graphics and sound, for example—and more personalized than today’s text-based tutors.
  • your agent will be able to help you in the same way that personal assistants support executives today. If your friend just had surgery, your agent will offer to send flowers and be able to order them for you. If you tell it you’d like to catch up with your old college roommate, it will work with their agent to find a time to get together, and just before you arrive, it will remind you that their oldest child just started college at the local university.
  • To see the dramatic change that agents will bring, let’s compare them to the AI tools available today. Most of these are bots. They’re limited to one app and generally only step in when you write a particular word or ask for help. Because they don’t remember how you use them from one time to the next, they don’t get better or learn any of your preferences.
  • The current state of the art is Khanmigo, a text-based bot created by Khan Academy. It can tutor students in math, science, and the humanities—for example, it can explain the quadratic formula and create math problems to practice on. It can also help teachers do things like write lesson plans.
  • Businesses that are separate today—search advertising, social networking with advertising, shopping, productivity software—will become one business.
  • other issues won’t be decided by companies and governments. For example, agents could affect how we interact with friends and family. Today, you can show someone that you care about them by remembering details about their life—say, their birthday. But when they know your agent likely reminded you about it and took care of sending flowers, will it be as meaningful for them?
  • In the computing industry, we talk about platforms—the technologies that apps and services are built on. Android, iOS, and Windows are all platforms. Agents will be the next platform.
  • A shock wave in the tech industry
  • Agents won’t simply make recommendations; they’ll help you act on them. If you want to buy a camera, you’ll have your agent read all the reviews for you, summarize them, make a recommendation, and place an order for it once you’ve made a decision.
  • Agents will affect how we use software as well as how it’s written. They’ll replace search sites because they’ll be better at finding information and summarizing it for you
  • they’ll be dramatically better. You’ll be able to have nuanced conversations with them. They will be much more personalized, and they won’t be limited to relatively simple tasks like writing a letter.
  • Companies will be able to make agents available for their employees to consult directly and be part of every meeting so they can answer questions.
  • AI agents that are well trained in mental health will make therapy much more affordable and easier to get. Wysa and Youper are two of the early chatbots here. But agents will go much deeper. If you choose to share enough information with a mental health agent, it will understand your life history and your relationships. It’ll be available when you need it, and it will never get impatient. It could even, with your permission, monitor your physical responses to therapy through your smart watch—like if your heart starts to race when you’re talking about a problem with your boss—and suggest when you should see a human therapist.
  • If the number of companies that have started working on AI just this year is any indication, there will be an exceptional amount of competition, which will make agents very inexpensive.
  • Agents are smarter. They’re proactive—capable of making suggestions before you ask for them. They accomplish tasks across applications. They improve over time because they remember your activities and recognize intent and patterns in your behavior. Based on this information, they offer to provide what they think you need, although you will always make the final decisions.
  • Agents are not only going to change how everyone interacts with computers. They’re also going to upend the software industry, bringing about the biggest revolution in computing since we went from typing commands to tapping on icons.
  • The most exciting impact of AI agents is the way they will democratize services that today are too expensive for most people
  • The ramifications for the software business and for society will be profound.
  • In the next five years, this will change completely. You won’t have to use different apps for different tasks. You’ll simply tell your device, in everyday language, what you want to do. And depending on how much information you choose to share with it, the software will be able to respond personally because it will have a rich understanding of your life. In the near future, anyone who’s online will be able to have a personal assistant powered by artificial intelligence that’s far beyond today’s technology.
  • You’ll also be able to get news and entertainment that’s been tailored to your interests. CurioAI, which creates a custom podcast on any subject you ask about, is a glimpse of what’s coming.
  • An agent will be able to help you with all your activities if you want it to. With permission to follow your online interactions and real-world locations, it will develop a powerful understanding of the people, places, and activities you engage in. It will get your personal and work relationships, hobbies, preferences, and schedule. You’ll choose how and when it steps in to help with something or ask you to make a decision.
  • even the best sites have an incomplete understanding of your work, personal life, interests, and relationships and a limited ability to use this information to do things for you. That’s the kind of thing that is only possible today with another human being, like a close friend or personal assistant.
  • In the distant future, agents may even force humans to face profound questions about purpose. Imagine that agents become so good that everyone can have a high quality of life without working nearly as much. In a future like that, what would people do with their time? Would anyone still want to get an education when an agent has all the answers? Can you have a safe and thriving society when most people have a lot of free time on their hands?
  • They’ll have an especially big influence in four areas: health care, education, productivity, and entertainment and shopping.
Javier E

Opinion | Chatbots Are a Danger to Democracy - The New York Times - 0 views

  • longer-term threats to democracy that are waiting around the corner. Perhaps the most serious is political artificial intelligence in the form of automated “chatbots,” which masquerade as humans and try to hijack the political process
  • Increasingly, they take the form of machine learning systems that are not painstakingly “taught” vocabulary, grammar and syntax but rather “learn” to respond appropriately using probabilistic inference from large data sets, together with some human guidance.
  • In the buildup to the midterms, for instance, an estimated 60 percent of the online chatter relating to “the caravan” of Central American migrants was initiated by chatbots.
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  • In the days following the disappearance of the columnist Jamal Khashoggi, Arabic-language social media erupted in support for Crown Prince Mohammed bin Salman, who was widely rumored to have ordered his murder. On a single day in October, the phrase “we all have trust in Mohammed bin Salman” featured in 250,000 tweets. “We have to stand by our leader” was posted more than 60,000 times, along with 100,000 messages imploring Saudis to “Unfollow enemies of the nation.” In all likelihood, the majority of these messages were generated by chatbots.
  • around a fifth of all tweets discussing the 2016 presidential election are believed to have been the work of chatbots.
  • a third of all traffic on Twitter before the 2016 referendum on Britain’s membership in the European Union was said to come from chatbots, principally in support of the Leave side.
  • It’s irrelevant that current bots are not “smart” like we are, or that they have not achieved the consciousness and creativity hoped for by A.I. purists. What matters is their impact
  • In the past, despite our differences, we could at least take for granted that all participants in the political process were human beings. This no longer true
  • Increasingly we share the online debate chamber with nonhuman entities that are rapidly growing more advanced
  • a bot developed by the British firm Babylon reportedly achieved a score of 81 percent in the clinical examination for admission to the Royal College of General Practitioners. The average score for human doctors? 72 percent.
  • If chatbots are approaching the stage where they can answer diagnostic questions as well or better than human doctors, then it’s possible they might eventually reach or surpass our levels of political sophistication
  • chatbots could seriously endanger our democracy, and not just when they go haywire.
  • They’ll likely have faces and voices, names and personalities — all engineered for maximum persuasion. So-called “deep fake” videos can already convincingly synthesize the speech and appearance of real politicians.
  • The most obvious risk is that we are crowded out of our own deliberative processes by systems that are too fast and too ubiquitous for us to keep up with.
  • A related risk is that wealthy people will be able to afford the best chatbots.
  • in a world where, increasingly, the only feasible way of engaging in debate with chatbots is through the deployment of other chatbots also possessed of the same speed and facility, the worry is that in the long run we’ll become effectively excluded from our own party.
  • the wholesale automation of deliberation would be an unfortunate development in democratic history.
  • A blunt approach — call it disqualification — would be an all-out prohibition of bots on forums where important political speech takes place, and punishment for the humans responsible
  • The Bot Disclosure and Accountability Bil
  • would amend the Federal Election Campaign Act of 1971 to prohibit candidates and political parties from using any bots intended to impersonate or replicate human activity for public communication. It would also stop PACs, corporations and labor organizations from using bots to disseminate messages advocating candidates, which would be considered “electioneering communications.”
  • A subtler method would involve mandatory identification: requiring all chatbots to be publicly registered and to state at all times the fact that they are chatbots, and the identity of their human owners and controllers.
  • We should also be exploring more imaginative forms of regulation. Why not introduce a rule, coded into platforms themselves, that bots may make only up to a specific number of online contributions per day, or a specific number of responses to a particular human?
  • We need not treat the speech of chatbots with the same reverence that we treat human speech. Moreover, bots are too fast and tricky to be subject to ordinary rules of debate
  • the methods we use to regulate bots must be more robust than those we apply to people. There can be no half-measures when democracy is at stake.
Javier E

Functional medicine: Is it the future of healthcare or just another wellness trend? - I... - 0 views

  • Functional Medicine is the alternative medicine Bill Clinton credits with giving him his life back after his 2004 quadruple heart by-pass surgery. Its ideology is embraced by Oprah and regularly features on Gwyneth Paltrow's Goop.
  • Developed in 1990 by Dr Jeffrey Bland, who in 1991 set up the Institute of Functional Medicine with his wife Susan, today the field is spearheaded by US best-selling author Dr Mark Hyman, adviser to the Clintons and co-director of the controversial Cleveland Clinic for Functional Medicine.
  • "Functional Medicine is not about a test or a supplement or a particular protocol," he adds. "It's really a new paradigm of disease and how it arises and how to restore health. Within it there are many approaches that are effective, it's not exclusive, it doesn't exclude traditional medications, it includes all modalities depending on what's right for that patient."
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  • Functional Medicine isn't a protected title and a medical qualification isn't a prerequisite to practice. The result is an unregulated and disparate field, with medical doctors, nutritionists, naturopaths and homeopaths among the many practitioners.
  • Some other chronic illnesses the field claims to treat include heart disease, type 2 diabetes, irritable bowel syndrome, ulcerative colitis, depression, anxiety and arthritis
  • ll kinds of different reasons, some might have gluten issues, gut issues, others might have a deficiency causing neurological issues, MS is a symptom."
  • "There are components of Functional Medicine that absolutely lack an evidence base and there are practitioners of what they call Functional Medicine, they charge people for intravenous nutritional injections, they exaggerate claims, and that is professionally inappropriate, unethical and it lacks evidence.
  • On Dr Mark Hyman's view of MS he says, "there are a lot of terms put together there, all of which individually make a lot of sense, but put together in that way they do not.
  • "What does FM actually mean? It means nothing. It's a gift-gallop of words thrown together. It's criticised by advocates of evidence-based medicine because it's giving a veneer of scientific legitimacy to ideas that are considered pseudoscientific. For example, it'll take alternative medicine modalities like homeopathy and then call them 'bio-infusions' or something similar, rebranding it as something that works.
  • "It's a redundant name, real medicine is functional."
  • Next month the third annual Lifestyle and Functional Medical conference will take place in Salthill, Galway on November 3. Last year's event was attended by more than 500 people and featured a keynote address by honorary consultant cardiologist Dr Aseem Malhotra, author of bestselling The Pioppi Diet (which was named one of the top five worst celebrity diets to avoid in 2018 by the British Dietetic Foundation).
  • Dr David Robert Grimes is physicist and visiting fellow of Oxford and QUB. His research into cancer focuses on modelling tumour metabolism and radiation interactions. For Dr Grimes, the lack of definition, or "double-speak" as he puts it, in FM is troubling.
  • As well as the cost of appointments, FM practitioners commonly charge extra for tests. An omega finger prick test is around €100. A vitamin D test can cost upwards of €60, full thyroid panel more than €150 and a gut function test €400. Prices vary between practitioners.
  • "If I, as a GP, engaged in some of these behaviours I would be struck off." Specifically? "If I was recommending treatments that lacked an evidence base, or if I was promoting diagnostic tests which are expensive and lack an evidence base.
  • GPs engage every year in ongoing continuous professional development, I spend my evenings and my weekends outside of working hours attending educational events, small-group learning, large-group learning, engaging in research. This is an accusation that was levelled at the profession 30 years ago and then it was correct, but the profession has caught up…
  • "Obviously promoting wellness and healthy diet is very welcome but going beyond that and stating that certain aspects of 'functional medicine' can lead to reduced inflammation or prevent cancer, we have to be very careful about those claims.
  • Often the outcome of such tests are seemingly 'benign' prescriptions of vitamins or cleanses. However, dietitian Orla Walsh stresses that even these can have potentially harmful effects, especially on "vulnerable" patients, if not prescribed judiciously.
  • FM has five basic principles. 1. We are all genetically and biochemically unique so it treats the individual, not the disease. 2. It's science-based. 3. The body is intelligent and has the capacity for self-regulation. 4. The body has the ability to heal and prevent nearly all the diseases of ageing. 5. Health is not just the absence of disease, but a state of immense vitality.
  • She began her Functional Medicine career while training as a medical doctor and now travels the world working with high-profile clients. Dr McHale charges €425 for an initial consultation and €175 for follow-up appointments. Straightforward lab tests are €250 to €750, for complex cases testing fees can be up to €2,000.
  • "The term [Functional Medicine] tends to be bandied around quite a bit. Other things people say, such as 'functional nutritionist', can be misleading as a term. Many people are Functional Medicine practitioners but don't have any real medical background at all... I think regulation is always probably the best way forward."
  • "There's an awful lot to it in terms of biochemistry and physiology," she says. "You do need to have a very solid and well ingrained bio-chemistry background. A solely clinical background doesn't equip you with the knowledge to read a test.
  • "Evidence-base is the cornerstone of medicine and that has to be maintained. It becomes problematic in this area because you are looking at personalised medicine and that can be very difficult to evidence-base."
  • GP Christine Ritter travelled from England to attend the Galway conference last year with a view to integrating Functional Medicine into her practice.
  • "It was very motivating," she says. "Where it wasn't perhaps as strong was to find the evidence. The Functional Medicine people would say, 'we've done this study and this trial and we've used this supplement that was successful', but they can't show massive research data which might make it difficult to bring it into the mainstream.
  • "I also know the rigorous standard of trials we have in medicine they're not usually that great either, it's often driven by who's behind the trial and who's paying for it.
  • "Every approach that empowers patient to work on their destiny [is beneficial], but you'd have to be mindful that you're not missing any serious conditions."
  • Dr Hyman is working to grow the evidence-base for Functional Medicine worldwide. "The future is looking very bright," he says. "At the Cleveland Centre we're establishing a research base, building educational platforms, fellowships, residency programmes, rotations. We're advancing the field that's spreading across the world. We're seeing in China the development of a programme of Functional Medicine, South Africa, the UK, in London the Cleveland Clinic will hopefully have a Functional Medicine centre."
  • For Dr Mark Murphy regulation is a moot point as it can only apply once the field meets the standards of evidence-based medicine.
  • "Despite well intentioned calls for regulation, complementary and alternative medical therapies cannot be regulated," he says. "Only therapies that possess an evidence-base can enter our standard regulatory processes, including the Irish Medical Council, the Health Products Regulatory Authority and Irish advertising standards. In situations where complementary and alternative therapies develop an evidence base, they are no longer 'complementary and alternative', but in effect they become part of mainstream 'Medicine'.
  • l What are the principles?
  • "There's a huge variation between therapists, some are brilliant and some are okay, and some are ludicrous snake oil salesmen."
  • He is so concerned that patients' health and wealth are being put at risk by alternative therapies that earlier this year he joined Fine Gael TD Kate O'Connell and the Irish Cancer Society in introducing draft legislation earlier this year making it illegal to sell unproven treatments to cancer patients. Violators face jail and heavy fines.
  • Dr Grimes says criticism of variations in the standards of traditional medical research can be fair, however due to the weight of research it is ultimately self-correcting. He adds, "The reality is that good trials are transparent, independent and pre-registered.
  • "My involvement in shaping the Bill came from seeing first-hand the exploitation of patients and their families. Most patients undergoing treatment will take some alternative modalities in conjunction but a significant portion are talked out of their conventional medicine and seduced by false promises
Javier E

Heaven Is Real: A Doctor's Experience With the Afterlife - Print View - The Daily Beast - 0 views

  • As a neurosurgeon, I did not believe in the phenomenon of near-death experiences. I grew up in a scientific world, the son of a neurosurgeon. I followed my father’s path and became an academic neurosurgeon, teaching at Harvard Medical School and other universities. I understand what happens to the brain when people are near death, and I had always believed there were good scientific explanations for the heavenly out-of-body journeys described by those who narrowly escaped death.
  • In the fall of 2008, however, after seven days in a coma during which the human part of my brain, the neocortex, was inactivated, I experienced something so profound that it gave me a scientific reason to believe in consciousness after death.
  • All the chief arguments against near-death experiences suggest that these experiences are the results of minimal, transient, or partial malfunctioning of the cortex. My near-death experience, however, took place not while my cortex was malfunctioning, but while it was simply off. This is clear from the severity and duration of my meningitis, and from the global cortical involvement documented by CT scans and neurological examinations. According to current medical understanding of the brain and mind, there is absolutely no way that I could have experienced even a dim and limited consciousness during my time in the coma, much less the hyper-vivid and completely coherent odyssey I underwent.
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  • What happened to me demands explanation. Modern physics tells us that the universe is a unity—that it is undivided. Though we seem to live in a world of separation and difference, physics tells us that beneath the surface, every object and event in the universe is completely woven up with every other object and event. There is no true separation. Before my experience these ideas were abstractions. Today they are realities. Not only is the universe defined by unity, it is also—I now know—defined by love. The universe as I experienced it in my coma is—I have come to see with both shock and joy—the same one that both Einstein and Jesus were speaking of in their (very) different ways.
  • Today many believe that the living spiritual truths of religion have lost their power, and that science, not faith, is the road to truth. Before my experience I strongly suspected that this was the case myself. But I now understand that such a view is far too simple. The plain fact is that the materialist picture of the body and brain as the producers, rather than the vehicles, of human consciousness is doomed. In its place a new view of mind and body will emerge, and in fact is emerging already. This view is scientific and spiritual in equal measure and will value what the greatest scientists of history themselves always valued above all: truth.
Javier E

The Data Vigilante - Christopher Shea - The Atlantic - 0 views

  • He is, on the contrary, seized by the conviction that science is beset by sloppy statistical maneuvering and, in some cases, outright fraud. He has therefore been moonlighting as a fraud-buster, developing techniques to help detect doctored data in other people’s research. Already, in the space of less than a year, he has blown up two colleagues’ careers.
  • In a paper called “False-Positive Psychology,” published in the prestigious journal Psychological Science, he and two colleagues—Leif Nelson, a professor at the University of California at Berkeley, and Wharton’s Joseph Simmons—showed that psychologists could all but guarantee an interesting research finding if they were creative enough with their statistics and procedures.
  • By going on what amounted to a fishing expedition (that is, by recording many, many variables but reporting only the results that came out to their liking); by failing to establish in advance the number of human subjects in an experiment; and by analyzing the data as they went, so they could end the experiment when the results suited them, they produced a howler of a result, a truly absurd finding. They then ran a series of computer simulations using other experimental data to show that these methods could increase the odds of a false-positive result—a statistical fluke, basically—to nearly two-thirds.
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  • “I couldn’t tolerate knowing something was fake and not doing something about it,” he told me. “Everything loses meaning. What’s the point of writing a paper, fighting very hard to get it published, going to conferences?”
  • Simonsohn stressed that there’s a world of difference between data techniques that generate false positives, and fraud, but he said some academic psychologists have, until recently, been dangerously indifferent to both. Outright fraud is probably rare. Data manipulation is undoubtedly more common—and surely extends to other subjects dependent on statistical study, including biomedicine. Worse, sloppy statistics are “like steroids in baseball”: Throughout the affected fields, researchers who are too intellectually honest to use these tricks will publish less, and may perish. Meanwhile, the less fastidious flourish.
Emily Horwitz

Supreme Court Takes Up Question of Gene Research - NYTimes.com - 0 views

  • WASHINGTON — The Supreme Court announced on Friday that it would decide whether human genes may be patented.
  • The patents were challenged by scientists and doctors who said that their research and ability to help patients had been frustrated.
  • ained the right to exclude the rest of the scientific community from examining the naturally occurring genes of every person in the United States,
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  • prevent patients from examining their own genetic information” and “made it impossible to obtain second opinions.”
  • he legal question for the justices is whether isolated genes are “products of nature” that may not be patented or “human-made inventions” eligible for patent protection.
  • “The isolated DNA molecules before us are not found in nature,” wrote Judge Alan D. Lourie, who was in the majority. “They are obtained in the laboratory and are man-made, the product of human ingenuity.”
Javier E

Doubts about Johns Hopkins research have gone unanswered, scientist says - The Washingt... - 0 views

  • Over and over, Daniel Yuan, a medical doctor and statistician, couldn’t understand the results coming out of the lab, a prestigious facility at Johns Hopkins Medical School funded by millions from the National Institutes of Health.He raised questions with the lab’s director. He reran the calculations on his own. He looked askance at the articles arising from the research, which were published in distinguished journals. He told his colleagues: This doesn’t make sense.“At first, it was like, ‘Okay — but I don’t really see it,’ ” Yuan recalled. “Then it started to smell bad.”
  • The passions of scientific debate are probably not much different from those that drive achievement in other fields, so a tragic, even deadly dispute might not be surprising.But science, creeping ahead experiment by experiment, paper by paper, depends also on institutions investigating errors and correcting them if need be, especially if they are made in its most respected journals.If the apparent suicide and Yuan’s detailed complaints provoked second thoughts about the Nature paper, though, there were scant signs of it.The journal initially showed interest in publishing Yuan’s criticism and told him that a correction was “probably” going to be written, according to e-mail rec­ords. That was almost six months ago. The paper has not been corrected.The university had already fired Yuan in December 2011, after 10 years at the lab. He had been raising questions about the research for years. He was escorted from his desk by two security guards.
  • Fang said retractions may be rising because it is simply easier to cheat in an era of digital images, which can be easily manipulated. But he said the increase is caused at least in part by the growing competition for publication and for NIH grant money.He noted that in the 1960s, about two out of three NIH grant requests were funded; today, the success rate for applicants for research funding is about one in five. At the same time, getting work published in the most esteemed journals, such as Nature, has become a “fetish” for some scientists, Fang said.
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  • Last year, research published in the Proceedings of the National Academy of Sciences found that the percentage of scientific articles retracted because of fraud had increased tenfold since 1975. The same analysis reviewed more than 2,000 retracted biomedical papers and found that 67 percent of the retractions were attributable to misconduct, mainly fraud or suspected fraud.
  • many observers note that universities and journals, while sometimes agreeable to admitting small mistakes, are at times loath to reveal that the essence of published work was simply wrong.“The reader of scientific information is at the mercy of the scientific institution to investigate or not,” said Adam Marcus, who with Ivan Oransky founded the blog Retraction Watch in 2010. In this case, Marcus said, “if Hopkins doesn’t want to move, we may not find out what is happening for two or three years.”
  • The trouble is that a delayed response — or none at all — leaves other scientists to build upon shaky work. Fang said he has talked to researchers who have lost months by relying on results that proved impossible to reproduce.Moreover, as Marcus and Oransky have noted, much of the research is funded by taxpayers. Yet when retractions are done, they are done quietly and “live in obscurity,” meaning taxpayers are unlikely to find out that their money may have been wasted.
Emily Horwitz

Could A 'Brain Pacemaker' Someday Treat Severe Anorexia? : Shots - Health News : NPR - 0 views

  • Many people who get anorexia recover after therapy and counseling. But in about 20 to 30 percent of cases, the disease becomes a chronic condition that gets tougher and tougher to treat.
  • Neurosurgeons from the University of Toronto tried a technique called deep brain stimulation to see if it might help patients with severe anorexia.
  • The results didn't meet the statistical tests for significance.
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  • "But since we don't have anything that works well for these individuals — that have a high risk of mortality – it warrants cautious optimism and further study."
  • doctors implant tiny electrodes next to a region of the brain thought to be dysfunctional. A device, similar to a heart pacemaker, then sends waves of electricity through a wire to the electrodes.
  • In the latest study, neurosurgeons in Toronto implanted the electrodes in the brains of six women with chronic anorexia. Five of them had been struggling with the disease for over a decade. All of them had experienced serious health problems from it, including heart attacks in some cases.
  • "My symptoms were so severe. I would wake up in the middle of night and run up and down the stairs for hours or go for a five-hour run," she tells Shots. "I became very isolated. I didn't want to be around anyone because they kept me from exercising."
  • "It was brain surgery! But I had had a heart attack at 28 and two strokes, " she says. "My mom was in the midst of planning my funeral. If I didn't take this chance, I knew my path would probably lead to death."
  • Rollins admits that the deep brain stimulation wasn't a magic bullet. She's had to continue her anorexia treatment to get where she is. "I still see a psychiatrist regularly and a dietitian. It [the deep brain stimulation] enables me to do the work that I need to do a lot easy."
  • Deep brain stimulation can cause serious side effects, Lipsman says, like seizures, and more milder ones, like pain and nausea. "This is a brain surgery – there's no sugarcoating that," he says. "The primary objective of this study was to establish that this a safe procedure for these patients who have been quite ill before the surgery. That's all we can say right now."
  •  
    an interesting article that seems to pose the question: can our habits/perceptions be changed by brain stimulation?
Javier E

Disruptions: Medicine That Monitors You - NYTimes.com - 0 views

  • researchers and some start-ups are already preparing the next, even more intrusive wave of computing: ingestible computers and minuscule sensors stuffed inside pills.
  • some people on the cutting edge are already swallowing them to monitor a range of health data and wirelessly share this information with a doctor
  • does not need a battery. Instead, the body is the power source. Just as a potato can power a light bulb, Proteus has added magnesium and copper on each side of its tiny sensor, which generates just enough electricity from stomach acids.
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  • People with heart failure-related difficulties could monitor blood flow and body temperature; those with central nervous system issues, including schizophrenia and Alzheimer’s disease, could take the pills to monitor vital signs in real time.
  • Future generations of these pills could even be convenience tools.
  • Once that pill is in your body, you could pick up your smartphone and not have to type in a password. Instead, you are the password. Sit in the car and it will start. Touch the handle to your home door and it will automatically unlock. “Essentially, your entire body becomes your authentication token,
  • “The wonderful is that there are a great number of things you want to know about yourself on a continual basis, especially if you’re diabetic or suffer from another disease. The terrible is that health insurance companies could know about the inner workings of your body.”
  • And the implications of a tiny computer inside your body being hacked? Let’s say they are troubling.
  • After it has done its job, flowing down around the stomach and through the intestinal tract, what happens next?“It passes naturally through the body in about 24 hours,” Ms. Carbonelli said, but since each pill costs $46, “some people choose to recover and recycle it.”
Dunia Tonob

Circumcision in Germany: Incisive arguments | The Economist - 0 views

  • The court decided that, although the doctor was innocent, circumcising an infant for non-medical reasons violates Germany's constitutional protection of every person's bodily integrity—and should thus be a crime.
  • As it happens, the movement against circumcision is spreading, from California, where “intactivists” have tried to ban it, to Israel, where some parents now opt for brit shalom (the “covenant of peace”) as a ritual alternative
  • Dieter Graumann, president of Germany's Central Council of Jews, asserted that the verdict, if it is upheld, would make Jewish life in Germany, just as it is blooming again, practically impossible
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  • ne one hand, Germany's constitution, written after the second world war to prevent any repeat of Nazi horrors, assures the rights of parents and of religious freedom. But on the other hand, it guarantees the physical inviolability of every person
  • The court felt that the boy's right to inviolability trumped the religious and parental rights of his mother and father.
  • it is wrong to make an exception for involuntary male circumcision when female circumcision is seen as barbaric. And he maintains that arguments which lean on tradition alone are inadequate, for the same reason that tradition cannot, nowadays, justify polygamy or footbinding.
manleyda

Yes, Your Opinion Can Be Wrong | Houston Press - 2 views

  • simply saying, "This is my opinion" does not preclude a connected statement from being dead wrong.
  • before you crouch behind your Shield of Opinion, you need to ask yourself two questions.1. Is this actually an opinion?2. If it is an opinion how informed is it and why do I hold it?
  • I’ll help you with the first part. An opinion is a preference for or judgment of something. My favorite color is black. I think mint tastes awful. Doctor Who is the best television show. These are all opinions.
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  • There’s nothing wrong with an opinion on those things. The problem comes from people whose opinions are actually misconceptions
  • If you think vaccines cause autism you are expressing something factually wrong, not an opinion
  • That’s where the second question comes in; is your opinion informed and why do you believe it?
  • What mucks it all up is when a narrow set of information is assumed to be wider than it is. There is a difference between a belief and things you just didn’t know
  • eventually you are going to venture out into the world and find that what you thought was an informed opinion was actually just a tiny thought based on little data and your feelings
  •  
    Thought this article was interesting because it shows how people often just pass a claim off as 'their opinion.' We tend to think that this makes the claim indisputable because it's a personal perspective. In reality there can be many things wrong with a so-called opinion. (Danny, 10/25/16)
oliviaodon

How Do We Learn Languages? | Brain Blogger - 0 views

  • The use of sound is one of the most common methods of communication both in the animal kingdom and between humans.
  • human speech is a very complex process and therefore needs intensive postnatal learning to be used effectively. Furthermore, to be effective the learning phase should happen very early in life and it assumes a normally functioning hearing and brain systems.
  • Nowadays, scientists and doctors are discovering the important brain zones involved in the processing of language information. Those zones are reassembled in a number of a language networks including the Broca, the Wernicke, the middle temporal, the inferior parietal and the angular gyrus. The variety of such brain zones clearly shows that the language processing is a very complex task. On the functional level, decoding a language begins in the ear where the incoming sounds are summed in the auditory nerve as an electrical signal and delivered to the auditory cortex where neurons extract auditory objects from that signal.
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  • The effectiveness of this process is so great that human brain is able to accurately identify words and whole phrases from a noisy background. This power of analysis brings to minds the great similarity between the brain and powerful supercomputers.
  • Until the last decade few studies compared the language acquisition in adults and children. Thanks to modern imaging and electroencephalography we are now able to address this question.
  • infants begin their lives with a very flexible brain that allows them to acquire virtually any language they are exposed to. Moreover, they can learn a language words almost equally by listening or by visual coding. This brain plasticity is the motor drive of the children capability of “cracking the speech code” of a language. With time, this ability is dramatically decreased and adults find it harder to acquire a new language.
  • clearly demonstrated that there are anatomical brain differences between fast and slow learners of foreign languages. By analyzing a group of people having a homogenous language background, scientists found that differences in specific brain regions can predict the capacity of a person to learn a second language.
  • Functional imaging of the brain revealed that activated brain parts are different between native and non-native speakers. The superior temporal gyrus is an important brain region involved in language learning. For a native speaker this part is responsible for automated processing of lexical retrieval and the build of phrase structure. In native speakers this zone is much more activated than in non-native ones.
  • Language acquisition is a long-term process by which information are stored in the brain unconsciously making them appropriate to oral and written usage. In contrast, language learning is a conscious process of knowledge acquisition that needs supervision and control by the person.
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    Another cool article about how the brain works and language (inductive reasoning). 
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