How to avoid unnecessary antibiotics without risk

The key biomarker is procalcitonin

Schizophrenia: a so characteristic behaviour is not mainly shared by culture but by a group of genes that determine synaptic plasticity

2. Etiology of schizophrenia

Genetics and epidemiological investigations have confirmed that both genetic and environmental factors contribute to schizophrenia etiology. Twin studies of schizophrenia suggest that genetic factors account for about 85 % of schizophrenia (Tsuang, 2000). However, schizophrenia is not caused by a single risk gene (Trubetskoy et al., 2022), and it does not show a simple pattern of inheritance. Each genetic variances result in only a small increase in risk. Until the threshold level is reached and clinical symptoms appear. Moreover, environmental influences during prenatal and postnatal brain development or across adulthood, such as uterine infection or pregnancy complications, psychosocial causes, amphetamine abuse, autoimmune disease and other brain trauma, also affect the risk of schizophrenia.

https://www.sciencedirect.com/science/article/pii/S2667242122000811?fbclid=IwAR0RVEghxrr2u4Rfy3kE2BEvgymEAR5OPuWpJTV5cKnIXIH-dBYVx1e1IJE 

The gap between words and actions in R&D: France's trajectory from 90 to 2020

 

Innovation is the main driving factor of growth

The last 20 years

Aude éternelle et tourisme

 https://www.aude-pays-cathare.fr/blog-pays-cathare-1/bon-plan-et-weekend-en-pays-cathare/?fbclid=IwAR0_ngGPcqHnso22HEeCm0vTmyko7SlMEwBi5QBhFeAJ7Kez6xFGQyy3MoY

Err is human: the covid-19 example about hydroxychloroquine

 April 2020
Dr. L. B. General practice in France

.

Covid19 treatment protocol in Algeria (thank Dr. Yasmin RAHALI).

ladies and gentlemen, here is a summary on the JEP of a COVID 19 case

• Clinical signs: research should be made:

1- Fever

2- Asthenia and myalgia (crowd)

3- Cough (dry or productive)

4- Dyspnoea: Effect or rest

Five-headaches

6- Diarrhoea, abdominal pain, nausea and vomiting

7- throat irritation

8- Anosmia (loss of smell)

9- Anorexia (bad smell in the mouth that gives disgust for food)

10- Hemoptysis

• Biology

1- Blood formula (NFS) to search for lymphopenia +++

2- Glycaemia, kidney balance

3- Hepatic assessment: AST, ALT, BT: increased

4- LDH (high), CRP high

5- Ferritin (high), VS and D-Dimeters (high), Procalcitonin (high)

6- ECG before plaquenil is introduced

• positive PCR or positive rapid test (if negative re-routing in 6 days)

• Radiology:

- Base pneumonia on Telethorax

- Basal and peripheral depoli glass

Lesions spread:

. Minimum less than 10 %

. Moderate: 10-25 per cent

. Severe: 50-70 per cent

Critics: exceeding 75 %

• Treatment:

1- Check plaquenil dose (xaria Cp 200 mg) 1 Cp 3 times a day for 10 days

2- Azithromycin 250 mg: 2 Cp/day on 1 Day and 1 Cp/day for 4 days

3- Claforan 1 g/ 8 h if the patient is hospitalized

4- Lovenox 0.4 / day

5- Vitamine C 1g: 1 cp twice daily

6- Zinc Cp: 1 cp twice a day

7- Treatment of comorbidities

NB: For CEC exacerbations of BPCO or asthma: avoid using the aerosol and privileges the inhalation chamber to avoid spreading the virus,( corticosteroids are not contraindicated?????? )

• Hygiendietetic councils:

1 - Sleep well at least 7 hours a night

2- Vitamine D: stay in the sun for 15 minutes

3- Maintain its microbiote: fermented foods: yogurt

4- Less stress if possible

5- Reduce sugar: a large amount of sugar slows down GB activity and imbalance microbiote

6- Eat certain foods:

Proteins that provide repair of cells

- Orange, lemon

- Cabbage, Brocoli, Peppers, Spinach

- Garlic +++

- Ognon

- Ginger

- Antioxidant

• Secondary effects of Hydroxychloroquin:

Cardiac:

- Lighting QT interval, peak torsades

- Branch block, syncopes.

2- Neurological:

- Psychotic episodes and neuropsychiatric

- Psychological (attention to corticosteroids that may induce these seizures)

3- Hepatitis: risk of fulminating hepatitis

4- Ocular:

- Retine and macula damage

- Visual field impacted

5- Digestive:

- Vomiting and anorexia.

cordially Dr. KADI.A

3

The tired brain

 The tired brain and glutamate.

https://www.nature.com/articles/d41586-022-02161-5 

How to write What to read to become a better writer

 How to write

What to read to become a better writer

Five texts that explain how to write simply and well

Sep 9th 2022

The first words are the hardest. For many of us writing is a slog. Words drip with difficulty onto the page—and frequently they seem to be the wrong ones, in the wrong order. Yet few pause to ask why writing is hard, why what we write may be bad, or even what is meant by “bad”. Fortunately for anyone seeking to become a better writer, the works recommended here provide enlightenment and reassurance. Yes, writing is hard. But if you can first grasp the origins and qualities of bad writing, you may learn to diagnose and cure problems in your own prose (keeping things simple helps a lot). Similarly heartening is the observation that most first drafts are second-rate, so becoming a skilled rewriter is the thing. These five works are excellent sources of insight and inspiration.

Politics and the English Language. By George Orwell. Available on the Orwell Foundation’s website

Starting with Orwell’s essay may seem as clichéd as the hackneyed phrases he derides in it. Published in 1946, this polemic against poor and perfidious writing will be familiar to many. But its advice on how to write is as apposite now as then. (Besides, it is short and free.) Orwell analyses the unoriginal, “dying” metaphors that still haunt the prose of academics, politicians, professionals and hacks. He lambasts the “meaningless words” and “pretentious diction” of his day; many of the horrors he cites remain common. To save writers from regurgitating these, Orwell proposes six now-canonical rules. The first five boil down to: prefer short, everyday words and the active voice, cut unneeded words and strive for fresh imagery. The sixth—“break any of these rules sooner than say anything outright barbarous”—displays the difficulty of pinning down something as protean as language. But this has not stopped others trying.

Style: Lessons in Clarity and Grace. By Joseph M. Williams and Joseph Bizup. Pearson Education; 246 pages; $66.65 and £43.99

In “Style”, Joseph Williams, who taught English at the University of Chicago, instructs writers on how to revise their scribblings into something clearer, more concise and coherent. (Aptly for a text about rewriting, it is the latest in a long line of reworkings of Williams’s teachings on the subject, which appeared under various titles.) Unlike Orwell, who devised high-level rules for writers to wield by instinct, Williams proposes nuanced “principles” and shows how to apply them. Whereas, for instance, Orwell exhorted writers to “never use the passive where you can use the active”, Williams explains how passives can sometimes help create a sense of flow. This forms part of his coverage of “cohesion” and “coherence”, which could upend the way you write. Insightful, too, is Williams’s guidance on pruning prose and on the ills and virtues of nominalisations—nouns formed from verbs (as “nominalisation” is from “nominalise”), which often send sentences awry. Such technical details, summary sections and practice exercises make “Style” the most textbook-like work on this list. It may also be the most useful.

On Writing Well: The Classic Guide to Writing Nonfiction. By William Zinsser. HarperCollins; 321 pages; $17.99 and £13.99

Less overtly practical than “Style” but far more fun to read is “On Writing Well”. William Zinsser, who was an American journalist and teacher, is a witty commentator on the writer’s craft with a talent for aphorisms (eg, “the secret of good writing is to strip every sentence to its cleanest components”). He embraces slippery subjects like “rhythm” and “voice” that tend to defy rules or principles. But he purveys practical wisdom, too, diagnosing stylistic blunders, exploring genres from memoir to business writing, and analysing passages from well-known works and his own journalism. Zinsser is always encouraging. Introducing a marked-up extract from drafts of “On Writing Well”, a spider’s web of self-edits, he counsels: “Very few sentences come out right the first time, or even the third time. Remember this in moments of despair.” Zinsser also gives fellow writers much to emulate. His paragraph-ending sentences are a marvel.

The Sense of Style: The Thinking Person’s Guide to Writing in the 21st Century. By Steven Pinker. Penguin; 368 pages; and $18 and £10.99

An expert on words and brains, Steven Pinker wants to help writers write better by getting them into the minds of their readers. The celebrated psycholinguist argues that “the curse of knowledge” is the biggest cause of bad writing: like children, writers forget that others often do not know what they know. Bad writers tend to dwell on irrelevant points and make logical connections that are logical only to them. Their prose—the type beloved of academics, bureaucrats and businessfolk—abounds in abstract nouns and luxuriates in long sentences. By contrast, good writing (“classic style”, in Mr Pinker’s phrase) assembles concrete words into straightforward sentences that readers find simple to grasp. Why should this be so? Using striking and funny examples, Mr Pinker shows how working memory, which stores syntactic constructions until they are complete, is easily swamped. In closing, he joins the battle over English usage, as our full review of “The Sense of Style” describes.

Merriam-Webster’s Dictionary of English Usage. Merriam-Webster; 989 pages; $29.95

Every writer needs a reference book to look up troublesome issues of grammar and usage; no one has memorised them all. The quality of such books has improved in recent years, but one from the 1990s has earned its keep since then. Merriam-Webster (mwdeu) is America’s best-known dictionary publisher. This guide contains not exactly definitions, though, but mini-essays: on individual words (can “data” be singular?), confusingly similar ones (such as “comprise” and “compose”) and grammatical conundrums (such as the split infinitive, dangling modifiers and so on).

What distinguishes mwdeu is its relentless empiricism. Where a debatable claim about correct usage is made, it surveys the history of other guides and their recommendations, as well as going to Merriam-Webster’s huge bank of citations from literature, non-fiction and journalism. In many cases, a proposed rule (such as the ban on split infinitives) is shown to be baseless. But in other cases, the guide is conservative. On the “comma fault” (joining two independent clauses with nothing more than a comma), mwdeu finds it in some great authors’ literary work, but warns readers that “you probably should not try the device unless you are very sure of what you want it to accomplish.” Good sense all round.■
_______________

The Economist proffers more advice on writing in its “Style Guide” and in the Johnson column on language. Our columnist, a co-author of this piece, also wrote much of Economist Education’s course on business writing.

Free tools can help. To discover whether your writing is “lean” or in “heart attack” territory, try The Writer’s Diet. This website tests how bloated passages are by adjectives, prepositions and so on. Or paste your prose into the oed Text Visualiser, from Oxford University Press, to uncover the origins of your words. Many of English’s most concrete and vivid words derive from Anglo-Saxon. These tend also to be short and punchy—echoing Winston Churchill, The Economist once argued (entirely in monosyllables) that “short words are best”.

https://www.economist.com/the-economist-reads/2022/09/09/what-to-read-to-become-a-better-writer?utm_campaign=a.22blackfriday_fy2223_q3_conversion-cb-dr_warm_global-global_auction_na&utm_medium=social-media.content.pd&utm_source=twitter&utm_content=conversion.content.non-subscriber.content_staticlinkad_np-betterwriter-n-nov_na-na_article_na_na_na_na&utm_term=sa.followers&utm_id=twq31809&twclid=2-13hlq829pbti9ef5y8n5tdc3j 

Life expectancy and healthcare spending, id est costs of care not of public health interventions.

We spend a lot of money on health care in general without effectiveness or efficiency.

Moreover, France's ranking in terms of life expectancy is worse than it was 20 years ago.

More than 90% of our spending goes to the health care system when the disease is clinically evident. This is massively inefficient. In addition, an ill-defined but above 30% is spent on unnecessary, inefficient or outright fraudulent care. 

Le peloton de tête de 1-10 (https://www.visualcapitalist.com/cp/healthcare-spending-versus-life-expectancy-by-country/?utm_source=Visual+Capitalist+Infographics+%28All%29&utm_campaign=065cf3f400-EMAIL_CAMPAIGN_2022_11_14&utm_medium=email&utm_term=0_31b4d09e8a-065cf3f400-44217945) 

In ten countries the LE is 82 years.
But there is a wide discrepancy in spending!
From 6221 to 2711 (USD 2019).

Glyphosate and thyroid cancer

 https://www.sciencedirect.com/science/article/pii/S0160412020321425?via%3Dihub 

https://www.sciencedirect.com/science/article/pii/S0160412020321425?via%3Dihub#t0015 

Glyphosate even after 15 years of use is NOT associated to an increase Hazard Ratio of thyroid cancer.

Healthcare in Europe: UK situation is not an exception

 Britons now have the worst access to healthcare in Europe, and it shows 

It seems to me a little bit exaggerated.
https://www.newsncr.com/business/britons-now-have-the-worst-access-to-healthcare-in-europe-and-it-shows/#:~:text=Business-,Britons%20now%20have%20the%20worst%20entry,in%20Europe%2C%20and%20it%20exhibits&text=For%20the%20previous%20few%20months,British%20staff%20into%20financial%20inactivity.

For the past few months, a fierce debate has been raging over the question of what exactly is behind the sudden, sharp exodus of older British workers into economic inactivity. Is it driven by rapidly worsening health or, more benignly, a flow of early retirements? There are two further, key questions here. First, where does one draw the line in determining whether ill health played a role in someone’s decision to leave the labour force? And second, is it preferable to have a trend of worsening health that drives people out of the workforce, or one that spares the working but condemns the already workless to stay put? One thing, though, is clear: the UK is now roughly three years into a steady march of chronic illness that is scything through the most vulnerable and marginalised in our population. Beginning shortly before the pandemic but then accelerating, there has been a steep climb in rates of chronic ill health among the long-term workless. Today there are half a million more working-age people in the UK with impairing health conditions than if pre-pandemic trends had continued, and 90 per cent of them are people who have not worked in several years. And the damage is by no means limited to the older cohort. Rates of chronic back and neck pain have risen among the over-50s, but there has also been a clear increase in mental health difficulties among the under-35s. Economic activity rates are lower for Britons with mental health problems than for any other condition. Seventy per cent are outside the workforce, and only half of those say they will probably or definitely work again. The data, while not conclusive, suggest a dynamic in which those whose position on the periphery of society had already exposed them to greater health risks suddenly found themselves high and dry when access to healthcare was curtailed, and are now some way down ballooning waiting lists. This week, the NHS announced that the length of its waiting list for hospital treatments has probably been overstated due to some patients being on it for multiple treatments. There may in fact be “only” 5.5mn people waiting for potentially life-changing treatment. Among them are 1.3mn people who have been referred to mental health services but are yet to receive their second contact. The international perspective is striking. Over the past year, one in six UK adults has had a pressing need for medical examination or treatment and been unable to get access, with almost half of these cases due to the length of waiting lists, according to data from YouGov and Eurostat. This is the highest figure out of 36 European countries and almost triple the EU average. With a lengthy recession looming and spending cuts on the agenda, the future for Britain’s peripheral class looks bleak, but bringing them back into the fold should be the country’s top priority. john.burn-murdoch@ft.com, @jburnmurdoch

1/ access to healthcare is a very biased concept. For instance access to vital treatments is counted with access to dental services, spa treatments or with cancelled appointments...

2/ access to ER may be very difficult if every one at every time anywhere is allowed to enter the ER for a treatment which is not urgent or  could be postponed...