vendredi 31 août 2018

Agnès Saal and France's etatism: when reality surpasses the darkest nightmare

There is a bureaucrat in France, in Paris, who has a job with this title:


"Senior Official at Equality, Diversity and Inequality Prevention at the Secretary General of the Ministry of Culture"


Which means


"Senior Equality Officer, Diversity and Prevention of Inequalities, with the Secretary General of the Ministry of Culture"


With such an exuberant bureaucracy, you do not need competitors.

But there is more, she was already at the Ministry of Culture in recent years where she paid more than 40k € of taxis with public money once at the INA and apparently about 90k € previously at the Center Georges Pompidou. She was taken, sentenced, but kept all his privileges in the French administration.


This example should be studied in school about moral hazard.

I am happier since I learnt that elephants masturbate too...

https://www.google.fr/amp/s/gizmodo.com/9-animals-that-masturbate-other-than-humans-1723592357/amp

jeudi 30 août 2018

Ceux que l’on n’appelle plus la droite: Ils critiquent mezzo voce les conséquences des causes qu’ils chérissent !

Comme ses prédécesseurs Macron  nomme ses amis. C’est son droit qui n’est que l’application d’une constitution qui lui octroie tous les pouvoirs et le protège alors qu’elle devrait protéger les individus contre les excès du pouvoir.
Les timides « opposants » s’en offusquent, confondant en pleine conscience les conséquences et les causes. Les causes sont cette Vème république qui est le pouvoir absolu du président et rien d’autre. Une constitution qu’ils chérissent en espérant en profiter la prochaine fois.
Le Macron bashing est pathétique tant il cache sous le tapis les médiocrités, les ambiguïtés, les trahisons, les catastrophes de ceux que l’on n’appelle plus par aucun qualificatif politique tant ils deviennent insignifiants: ceux qui ont trahi trop souvent (http://www.lefigaro.fr/vox/politique/2018/08/29/31001-20180829ARTFIG00279-luc-ferry-hulot-ecologiste-radical.php?redirect_premium#figp-author)... Et sur le sujet du climat, de l’énergie , des biotechnologies tant que les conservateurs n’auront pas une ligne claire c’est à dire nationale, pragmatique et conservatrice de notre potentiel économique et énergétique, ils finiront dans les bras des écologauchistes. Encore une fois ce n’est pas le diagnostic sur Hulot qui intéresse les électeurs ce sont les actions programmatiques, leur base idéologique et leur calendrier ! Apparemment Luc Ferry ne l’a pas compris.
Il faut le rappeler:
Juppé a été un fervent antiOGM.
Le funeste Hulot n’a pas eu de mal à convaincre Chirac du principe d’interdiction .
La funeste NKM et son compère Borloo, a moins que ce ne soit l’inverse ont durement sevi sous le faux président de droite nommé Sarkozy...
Plaire à la gauche et aux médias, trahir les gaulois en les paupérisant par l’impôt et en les diluant par l’immigration. Quel terrifiant programme qui s’est finalement réalisé.

Ce que l’on appelait la droite a fait des réformes de gauche pendant 40 ans, a entériné toutes les réformes de la gauche depuis la retraite, les 35 heures, les monopoles publics et les syndicats marxistes à la tête de l’ogre social, a endetté le pays à la même vitesse que la gauche et il faudrait maintenant applaudir aux piques de bambou microscopiques qu’ils envoient à Macron?
Personne ne suit à part quelques groupies sarkozystes qui ont loupé des épisodes depuis la défaite de leur idole.
C’est fini et cela ne reviendra pas.
Il faut tout changer et d’abord les caciques profonds, collectivistes et étatistes, qui ont détruit ce pays or ils sont plus nombreux chez LR que chez Macron c’est dire!
Cette destruction shumpétérienne est en cours et rien ne sera plus utile à la France.
(https://wattsupwiththat.com/2018/06/20/why-the-right-should-espouse-climate-realism/?cn-reloaded=1)

http://www.lefigaro.fr/vox/politique/2018/08/31/31001-20180831ARTFIG00031-eric-zemmour-l-insoutenable-legerete-des-verts.php


mercredi 29 août 2018

Negative externalities of plastics

https://www.frontiersin.org/articles/10.3389/fmars.2018.00039/full


The catastrophe of gender activism

https://www.ipetitions.com/petition/brown-university-and-plos-one-defend-academic

Concrete is not as durable as you may think: when cement degrade it’s sand

The World in a Grain: The Story of Sand and How It Transformed Civilization,

The gripping story of the most important overlooked commodity in the world--sand--and the crucial role it plays in our lives. 

After water and air, sand is the natural resource that we consume more than any other--even more than oil. Every concrete building and paved road on Earth, every computer screen and silicon chip, is made from sand. From Egypt's pyramids to the Hubble telescope, from the world's tallest skyscraper to the sidewalk below it, from Chartres' stained-glass windows to your iPhone, sand shelters us, empowers us, engages us, and inspires us. It's the ingredient that makes possible our cities, our science, our lives--and our future. 

And, incredibly, we're running out of it. 

The World in a Grain is the compelling true story of the hugely important and diminishing natural resource that grows more essential every day, and of the people who mine it, sell it, build with it--and sometimes, even kill for it. It's also a provocative examination of the serious human and environmental costs incurred by our dependence on sand, which has received little public attention. Not all sand is created equal: Some of the easiest sand to get to is the least useful. Award-winning journalist Vince Beiser delves deep into this world, taking readers on a journey across the globe, from the United States to remote corners of India, China, and Dubai to explain why sand is so crucial to modern life. Along the way, readers encounter world-changing innovators, island-building entrepreneurs, desert fighters, and murderous sand pirates. The result is an entertaining and eye-opening work, one that is both unexpected and involving, rippling with fascinating detail and filled with surprising characters.

Review


“[An] impassioned and alarming report on sand.... In Beiser's artful telling, the planet is caught up in a vicious, sand-fueled cycle.” — Washington Post 

“Beiser peppers research with first-person interviews in an engaging and nuanced introduction to the ways sand has shaped the world.... stunning.” —NPR 

“Beiser’s eye-opening study clarifies the science and the huge role of sand in heavy and high-tech industry. Perhaps most compelling is his exposé of sand mining, which obliterates islands, destroys coral reefs and marine biodiversity, and threatens livelihoods. A powerful lens on an under-reported environmental crisis.” — Nature 

“Whether in Chippewa Falls, Wisconsin, or India, [Beiser] exhibits a flare for detailing the human drama through prose.” — Los Angeles Review of Books 

“I thought I knew the basics of sustainability, but this lucid, eye-opening book made me feel like a dolt in the best possible aha-moment way: I'd simply never registered how much of the contemporary world—our concrete and glass buildings and asphalt roads and silicone-based digital devices and so much more—is entirely, voraciously sand-dependent. And the looming global sand crisis: who knew?” —Kurt Andersen, author of Fantasyland: How America Went Haywire: A 500-Year History
A fresh history of 'the most important solid substance on Earth, the literal foundation of modern civilization.' Books on a single, familiar topic (salt, cod, etc.) have an eager audience, and readers will find this an entirely satisfying addition to the genre.” — Kirkus Reviews 

The book is at its urgent best in chapters on the black market in sand and the sand mafias that brutally exercise control over resources... Breezily written and with insights on every page, this is an eye-opening look at a resource too often taken for granted.” — Publishers Weekly 

lundi 27 août 2018

Progestative pill and VTE

https://www.bmj.com/content/345/bmj.e4944

Uncertainty about aspirin: the need for comparison between responder and resistant patients

https://www.medpagetoday.com/meetingcoverage/esc/74766



MUNICH -- Daily aspirin reduced risk of a first cardiovascular event for high-risk diabetes patients but this was largely counterbalanced by bleeding risk in one randomized trial, while a second trial was inconclusive for low-to-moderate-risk individuals without diabetes.


In ASCEND, 100-mg aspirin reduced the composite of MI, stroke, transient ischemic attack (TIA), or death from non-intracranial hemorrhage vascular causes by a relative 12% compared with placebo in adults with diabetes of any type (8.5% vs 9.6% at a mean of 7.4 years, P=0.01).





But major bleeding was increased by 29%, Jane Armitage, FRCP, FFPH, of the University of Oxford, England, and colleagues reported at the European Society of Cardiology meeting and simultaneously online in the New England Journal of Medicine.





The net effect was to prevent six vascular events and cause three major bleeds per 5,000 person-years in patients with under a 5% predicted 5-year risk, while those at a 10% or greater predicted risk had 11 vascular events prevented at the cost of 10 major bleeds per 5,000 person-years.

Jane Armitage, FRCP, FFPH, presenting the ASCEND data

"There was no group in which the benefits clearly outweighed the risks," Armitage said at a press conference. The trial included 15,480 British patients ages 40 and older with any diabetes and no baseline cardiovascular disease.

Non-Diabetic Primary Prevention

In the ARRIVE trial, first occurrence of cardiovascular death, MI, unstable angina, stroke, or TIA at a median of 60 months was 4.29% on 100-mg aspirin vs 4.48% (HR 0.96, P=0.6038).

Accounting for the nearly 40% noncompliance rate in the underpowered trial, the per-protocol analysis was more on par with that of ASCEND, with a 19% relative reduction in the primary endpoint, albeit still not significant (3.40% vs 4.19%, P=0.0756), J. Michael Gaziano, MD, MPH, of Brigham and Women's Hospital in Boston, reported at the conference.



Again as expected, GI bleeding was more than twice as common on daily aspirin (0.97% vs 0.46%, P=0.0007), although overall serious adverse events and mortality were similar between arms.



J. Michael Gaziano, MD, MPH, presenting the ARRIVE data

"The event rate was much lower than expected, which is probably reflective of contemporary risk management strategies, making the study more representative of a low-risk population," the researchers cautioned in the paper simultaneously published in The Lancet. "The role of aspirin in primary prevention among patients at moderate risk could therefore not be addressed."


The 12,546 patients were age 55 or older for men, 60 and older for women, and were targeted to be moderate risk based on a number of major cardiovascular disease risk factors but no diabetes, prior vascular events, or high risk of GI or other bleeding.

Implications

An informal poll taken at the late-breaking clinical trial session showed that most participants have been using aspirin either only in high-risk patients or liberally across risk groups. More than half of respondents at the end said they were not going to change their practice patterns due to the findings.

The U.S. Preventive Services Task Force has recommended aspirin for primary prevention of cardiovascular disease and colorectal cancer for middle-age adults at increased cardiovascular risks, whereas the FDA has cautioned against aspirin use for primary prevention in general.

Steven Nissen, MD, of the Cleveland Clinic, who served on the FDA panel that recommended against a primary prevention indication for Bayer aspirin, saw vindication in the results.

"To me, this really does fully answer the question," he told MedPage Today. "From my point of view, we should really restrict the use of aspirin to secondary prevention patients and very high risk primary prevention patients based on these two large, well-done, and I think quite definitive trials."

Other prevention strategies have gotten so good that there's not much room for aspirin, suggested Armitage, although she didn't call for patients to quit taking it on their own.

"I think if you are well managed with diabetes, you've got your other risk factors under control, I think you need to consider very carefully whether or not for you the benefits of aspirin do outweigh the risks, and I think that's a decision that will have to happen between patient and doctor," she said at the press conference.

In ASCEND, 75% of the patients were on statins, a high proportion were on blood pressure medications, glycemic control was good overall, and a low proportion were smokers.

While calling it "a challenging calculus" to integrate ischemic, bleeding, and cancer risk, Gaziano said he believes there are patients whose risk is sufficient to warrant aspirin as part of the armamentarium.

While the pendulum on aspirin has swung from being liberal to being more careful in recent years, "this is maybe the start to look at this in a more detailed fashion and swing back to be a little bit more positive about aspirin in primary prevention, if it is done right," said Stephan Achenbach, MD, of the University of Erlangen, Germany, a moderator at the press conference.

Anthony DeMaria, MD, of the University of California San Diego, also argued for looking at the nuances in the study, particularly that vascular events and the type of bleeds seen in the studies (not intracranial) are not necessarily on par, and that bleeding may be given too much weight.

"You have intracranial bleeds and then everything else, because everything else is pretty treatable," he told MedPage Today. "I don't come away from that study saying you're trading one disease for another."

However, "you can manage heart attack," Nissen countered. "Keep in mind that a lot of these heart attacks are non-STEMIs, they're small, they're not hugely damaging, and people can die of gastrointestinal hemorrhage and have prolonged hospitalizations. It's not trivial."

Armitage cautioned too that the idea of finding high ischemic, low bleeding risk patients for whom daily aspirin would be appealing could be countered by the finding in her trial that bleeding risk goes up with vascular risk.

Cancer Prevention

For now, the findings in ASCEND also undermined another rationale for primary prevention with aspirin -- protection against colorectal cancer.

The trial had "large numbers of cancers reported" and no suggestion that aspirin reduced the risk of cancer (11.6% vs 11.5%) or that any effect was beginning to emerge over time, Armitage noted, although up to 10 years of follow-up is planned.

There also was no significant difference between aspirin and placebo in the incidence of GI tract cancer specifically (2.0% in both groups).

As to why observational studies have suggested reduced risk of cancer with aspirin use, Armitage noted that residual confounding and the era from which the data came might have been at play.

"I think we now have to educate the public that there are really not compelling reasons, that unless you've had a prior event and have a clear indication, that you shouldn't take aspirin for primary prevention," Nissen concluded.

And, in an editorial in The Lancet, Davide Capodanno MD, PhD, of the University of Catania in Italy, and Dominick Angiolillo, MD, PhD, of the University of Florida College of Medicine in Jacksonville, added, "the consistent trend in negative results from trials of aspirin in primary prevention, particularly in patients without diabetes, suggests that new avenues of research are needed for the prevention of cardiovascular events."

Never surrender

https://besacenter.org/perspectives-papers/lesson-1968-soviet-invasion-czechoslovakia-never-surrender/

One issue in this historical lesson: european countries from the west did not help people, in this part of europe, to recover freedom.
 
Paperblog