Chetzemoka

certain kinds of antidepressants can drive some alcohol users to drink more.

I think that's particularly interesting in light of recent evidence that GLP-1 agonists appear to reduce alcohol cravings. I think (I hope) we're going to see a lot more medical management for substance use disorders instead of insisting on only behavioral interventions in the future with this kind of evidence adding to the pile.

https://www.medicalnewstoday.com/articles/could-the-diabetes-drug-semaglutide-also-help-reduce-alcohol-use

You are correct that this is still done in studies where efficacy is very clear.

In fact, this just happened a few days ago in a new trial of semaglutide to treat kidney disease in diabetics. With diabetes being one of the two major causes of the need for dialysis (the other being hypertension), the drug was so successful at improving kidney function that it would have been unethical to withhold it from placebo recipients.

https://www.fiercepharma.com/pharma/novo-nordisks-unstoppable-semaglutide-ends-kidney-disease-trial-early-positive-efficacy

In studies where efficacy is more marginal or harder to demonstrate, then drugs are sometimes given for "compassionate use" to people who are almost guaranteed to die otherwise, so providing an unproven treatment that may work or may harm them is less ethically fraught. That was the basis for a lot of AIDS treatments being distributed back in the day, and in fact AIDS activists were crucial to getting compassionate use rules liberalized.

I actually just found the community tonight. Glad to see you here! Thanks for starting this!

(Sometimes I like to state the obvious out loud in comments because I know people don't read the rules lol. I find it's how development of a self-reinforcing community culture occurs organically. That was my experience with more niche communities on that other site anyway.)

Oh, that in no way means it's not going to be harmful in the context of life-threatening sepsis. One of the things the study authors checked for is evidence of oxalate crystals forming in the kidneys because high dose vitamin C can cause kidney stones.

In healthy kidneys, that's a survivable inconvenience. In a severely septic patient? Their kidneys are already not working. That could shut them down completely.

(I'm a critical care nurse. First thing I wondered about was kidney stones.)

I think this is important context that you don't see in that press release (and which is why I would advise the community to favor posting studies more than news reports):

"Our findings appear to differ from those of recent randomized controlled trials, which assessed the effect of very high dose vitamin C in patients with sepsis."

This is one 30-person trial in a sea of trials that have been pretty equivocal so far regarding high dose vitamin C in sepsis.

Also, as a critical care nurse, I'd probably be inclined to advise against using 24 hour urine output as a primary endpoint. Not that I'm saying we're not perfect! (Lol) But there are those days when everything is so busy that the exact urine count isn't the highest priority. Sometimes the urine output number sits in the back of your head with a binary "enough" or "not enough" tag and you might miss putting one of the times you emptied the urine bag into the computer.

I don't love that, but the state of hospital staffing and having extremely ill human beings trying real hard to die on you sometimes forces you to prioritize things that are all important. And of the important things, as long as urine output exceeds the "enough" threshold, it's not the most important important thing.

Not every day will be so swamped that it forces that kind of compromise, so the numbers will average out over the course of a few days, which appears to be reflected in this study.

The actual study, for reference: https://ccforum.biomedcentral.com/articles/10.1186/s13054-023-04644-x

I think it's important to remember that you're also talking about maybe or maybe not receiving an experimental, unproven treatment that has the potential to make things worse rather than better. If that's the case, you'd be happy to be the one receiving placebo.

Authoritarians exist without respect to any political beliefs. They exist to aggrandize themselves.

Oh man, let me dig deep into history for this gem:

Switchblade Symphony - Witches

After getting the reference in NOPE, I think Purple People Eaterdeserves a place on the list.

Personally I'd add PJ Harvey's Down By The Water for sheer creepiness factor.

Eels - Fresh Blood

Dead Souls Personally I like the NIN cover from The Crow soundtrack

Any of the many versions of Where Did You Sleep Last Night? I'm partial to the Sleigh Bells version

Toadies - Possum Kingdom

I don't think it's about being hurt, it's about stopping the waste of time and taxpayer money on this absurd and useless distraction theater so they can actually do their fucking jobs for once.

The traitor caucus really needs the distraction theater to keep their constituents from ever being able to figure out that they're completely incompetent at doing their actual jobs. Remove the distraction and make them put up some real votes on real issues.

Ah yes, those famously conservative Communist Party academics who were targeted during the Cultural Revolution.

I have no idea what you've been reading. Mao was unhappy that the existing Communist Party was doing things differently from the way he thought they should be done. He was a pure authoritarian dictator, not a social progressive, no matter what propaganda he used as an excuse for his egotism.

"The Cultural Revolution began as a struggle between Mao Zedong and other top party leaders for dominance of the Chinese Communist Party."

https://spice.fsi.stanford.edu/docs/introduction_to_the_cultural_revolution

They started in 3.11 and were nostalgia legacy for a couple more iterations of Windows