Robert Buxbaum is a life-long engineer, a product of New York's Brooklyn Technical High School, New York's Cooper Union to Science and Art, and Princeton University where he got a PhD in Chemical Engineering. From 1981 to 1991 he was a professor of Chemical Engineering at Michigan State, and now runs an engineering shop in Oak Park, outside of Detroit, Michigan. REB Research manufactures and sells hydrogen generation and purification equipment. He's married with 3 wonderful children who, he's told, would prefer to not be mentioned except by way of complete, unadulterated compliments. As of 2016, he's running to be the drain commissioner/ water resources commissioner of Oakland county.
Sharrow Marine introduced a new ship propeller design two years ago, at the Miami International Boat show. Unlike traditional propellers, there are no ends on the blades. Instead, each blade is a connecting ribbon with the outer edge behaving like a connecting winglet. The blade pairs provide low-speed lift-efficiency gains, as seen on a biplane, while the winglets provide high speed gains. The efficiency gain is 9-30% over a wide range of speeds, as shown below, a tremendous improvement. I suspect that this design will become standard over the next 10-20 years, as winglets have become standard on airplanes today.
A Sharrow propeller, MX-1
The high speed efficiency advantage of the closed ends of the blades, and of the curved up winglets on modern airplanes is based on avoiding losses from air (or water) going around the end from the high pressure bottom to the low-pressure top. Between the biplane advantage and the wingtip advantage, Sharrow propellers provide improved miles per gallon at every speed except the highest, 32+ mph, plus a drastic decrease in vibration and noise, see photo.
The propeller design was developed with paid research at the University of Michigan. It was clearly innovative and granted design patent protection in most of the developed world. To the extent that the patents are respected and protected by law, Sharrow should be able to recoup the cost of their research and development. They should make a profit too. As an inventor myself, I believe they deserve to recoup their costs and make a profit. Not all inventions lead to a great product. Besides, I don’t think they charge too much. The current price is $2000-$5000 per propeller for standard sizes, a price that seems reasonable, based on the price of a boat and the advantage of more speed, more range, plus less fuel use and less vibration. This year Sharrow formed an agreement with Yamaha to manufacture the propellers under license, so supply should not be an issue.
Vastly less turbulence follows the Sharrow propeller.
China tends to copy our best products, and often steals the technology to make them, employing engineers and academics as spys. Obama/Biden have typically allowed China to benefit for the sales of copies and the theft of intellectual property, allowing the import of fakes to the US with little or no interference. Would you like a fake Rolex or Fendi, you can buy on-line from China. Would you like fake Disney, ditto. So far, I have not seen Chinese copies of the Sharrow in the US, but I expect to see them soon. Perhaps Biden’s Justice Department will do something this time, but I doubt it. By our justice department turning a blind eye to copies, they rob our innovators, and rob American workers. His protectionism is one thing I liked about Donald Trump.
The Sharrow Propeller gives improved mpg values at every speed except the very highest.
I’d written previously about Marcel Duchamp’s early work as a founder of the Dada school of modern art, a school that aims to say nothing about anything except about itself. Duchamp hung a urinal as art and called it “fountain.” It was comic, insulting, and engaging — an inspiration for many modern arts to follow , and much bad modern art, too — the collections of string and found objects and paintings of squares or squiggles. But the story of Duchamp is interesting. In 1925, M. Duchamp gave up on art, at least this type of art and became a chess player. As with art, he was very good at it, and became the French chess champion. Now that’s an unexpected turn.
What sort of chess did Marcel Duchamp play? Modern. Very modern. While tradition chess had focussed on the center. He developed at the sides, a strategy that was called an “Indian attack”, named (I assume) after American Indians attacking a stage-coach. Instead of attacking directly, the popular image of an Indian attack is attack from the sides, or behind trees. In chess, it involves typically a “fianchettoed bishop.” Other modern chess players of the time attacked from the side too (Réti, Alekhine) but they generally worked form one side or the other with some central presence. Duchamp worked from both, often with no center.
Position after white’s 13th move
Here is a dramatic example, a position from a game with an American great, GM George Koltanowski. It’s 13 moves in, with Duchamp, is black, generally considered the weaker side. He has fianchettoed both of his bishops, and given up the center to Koltanowski. It’s Duchamp’s turn to move/ He will win in three moves.
Notice that Koltanowsi’s bishops point outward, as a cowboys guns might point, or as from a British fighting square. Meanwhile, Duchamp’s bishops point inward, with his queen -bishop almost directly at the white king. The game proceeded as follows. 13…, Nxd5 14.Nxd7, Nxf4 15.Nxf8, Bd4, 0-1..
The full game, seen here,. It might prove instructive if you want to explore in Duchamp’s footsteps. While I play traditionally, I sometimes fianchetto, and do not find it racist that such side-attacks are called “Indian attacks.” Perhaps that’s because I’m old and used to such things, or because they very often work.
Please Touch. M. Duchamp 1947
Self-portrait, M. Duchamp, 1957 (torn paper on black velvet).
As M. Duchamp’s chess skills waned, he returned to the art world, going in the opposite direction of Dali. Duchamp’s last works are small, and simple. They are still arresting but more dream-like. Dali’s works grew bigger and busier as he got older.
Eliquis (apixaban) is blood thinner shown to prevent stroke with fewer side effects than Warfarin (Coumadin). Aspirin does the same, but not as effectively for people over 75. My problem with eliquis is that it’s over-prescribed. The studies favoring it over aspirin found benefits for those over 75, and for those with A-Fib. And even in this cohort the advantage over aspirin is small or non-existent because eliquis has far more serious side effects; hemorrhage, or internal bleeding.
Statistically, the AVERROES study (Apixaban Versus Acetylsalicylic Acid to Prevent Stroke in AF Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment) found that apixaban is substantially better than aspirin at preventing stroke in atrial fibrillation patients, but worse at preventing heart attack.
Taking 50 mg of Eliquis twice a day, reduces the risk of stroke in people with A-Fib by more than 50% and reduces the rate of heart attack by about 15%. By comparison, taking 1/2 tablet of aspirin, 178 mg, reduces the risk of stroke by 17% and of heart attack by 42%. The benefits were higher in the elderly, those over 75, and non existent in those with A-Fib under 75, see here, and figure. Despite this, doctors prescribe Eliquis over aspirin, even to those without A-Fib and those under 75. I suspect the reason is advertising by the drug companies, as I’ve claimed earlier with Atenolol.
The major deadly side-effect is hemorrhage, brain hemorrhage and GI (stomach) hemorrhage. Here apixaban is far worse than with aspirin (but better than Warfarin). The net result is that in the AVERROES random-double blind study there was no difference in all-cause mortality between apixaban and aspirin for those with A-fib who were under 75, see here. Or here.
To reduce your chance of GI hemorrhage with Eliquis, it is a very good idea to take a stomach proton pump drug like Pantoprazole. If you have A-Fib, the combination of Eliquis and pantoprazole seems better than aspirin alone, even for those under 75. If you have no A-Fib and are under 75, I see no benefit to Eliquis, especially if you find you have headaches, stomach aches, back pain, or other signs of internal bleeding, you might switch to aspirin or choose a reduced dose.
A Japanese study found that half the normal dose of Eliquis, was approximately as effective as the full dose, 50 mg twice a day. I was prescribed Eliquis, full dose twice a day, but I’m under 70 and I have no A-Fib since my ablation.
Life expectancy has dropped in the US to undeveloped world levels. Biden blames COVID and racism. I think it’s too much drugs, and too few opportunities.
I’m struck by the fact that US life expectancy is uncommonly low, lower than in most developed countries. Lower too than in many semi-developed countries, and our life expectancy is decreasing while other countries are not seeing the same. It dropped by about 3 years over the last 2 years as shown. I wonder why the US has suffered more than other countries, and suspect we are over-prescribed. Too much of a good thing, typically isn’t good.
A hydrogen molecule consists of two protons held together by a covalent bond. One way to think of such bonds is to imagine that there is only one electron is directly involved as shown below. The bonding electron only spends 1/7 of its time between the protons, making the bond, the other 6/7 of the time the electron shields the two protons by 3/7 e– each, reducing the effective charge of each proton to 4/7e+.
We see that the two shielded protons will repel each other with the force of FR = Ke (16/49 e2 /r2) where e is the charge of an electron or proton, r is the distance between the protons (r = 0.74Å = 0.74×10-10m), and Ke is Coulomb’s electrical constant, Ke ≈ 8.988×109 N⋅m2⋅C−2. The attractive force is calculated similarly, as each proton attracts the central electron by FA = – Ke (4/49) e2/ (r/2)2. The forces are seen to be in balance, the net force is zero.
It is because of quantum mechanics, that the bond is the length that it is. If the atoms were to move closer than r = 0.74Å, the central electron would be confined to less space and would get more energy, causing it to spend less time between the two protons. With less of an electron between them, FR would be greater than FA and the protons would repel. If the atoms moved further apart than 0.74Å, a greater fraction of the electron would move to the center, FA would increase, and the atoms would attract. This is a fairly pleasant way to understand why the hydrogen side of all hydrogen covalent bonds are the same length. It’s also a nice introduction to muon-catalyzed cold fusion.
Most fusion takes place only at high temperatures, at 100 million °C in a TOKAMAK Fusion reactor, or at about 15 million °C in the high pressure interior of the sun. Muon catalyzed fusion creates the equivalent of a much higher pressure, so that fusion occurs at room temperature. The trick to muon catalyzed fusion is to replace one of the electrons with a muon, an unstable, heavy electron particle discovered in 1936. The muon, designated µ-, behaves just like an electron but it has about 207 times the mass. As a result when it replaces an electron in hydrogen, it forms form a covalent bond that is about 1/207th the length of a normal bond. This is the equivalent of extreme pressure. At this closer distance, hydrogen nuclei fuse even at room temperature.
In normal hydrogen, the nuclei are just protons. When they fuse, one of them becomes a neutron. You get a deuteron (a proton-neutron pair), plus an anti electron and 1.44 MeV of energy after the anti-electron has annihilated (for more on antimatter see here). The muon is released most of the time, and can catalyze many more fusion reactions. See figure at right.
While 1.44MeV per reaction is a lot by ordinary standards — roughly one million times more energy than is released per atom when hydrogen is burnt — it’s very little compared to the energy it takes to make a muon. Making a muon takes a minimum of 1000 MeV, and more typically 4000 MeV using current technology. You need to get a lot more energy per muon if this process is to be useful.
You get quite a lot more energy when a muon catalyzes deuterium fusion or deuterium- fusion. With these reactions, you get 3.3 to 4 MeV worth of energy per fusion, and the muon will be ejected with enough force to support about eight D-D fusions before it decays or sticks to a helium atom. That’s better than before, but still not enough to justify the cost of making the muon.
The next reactions to consider are D-T fusion and Li-D fusion. Tritium is an even heavier isotope of hydrogen. It undergoes muon catalyzed fusion with deuterium via the reaction, D+T –> 4He +n +17.6 MeV. Because of the higher energy of the reaction, the muons are even less likely to stick to a helium atom, and you get about 100 fusions per muon. 100 x 17.6 MeV = 1.76 GeV, barely break-even for the high energy cost to make the muon, but there is no reason to stop there. You can use the high energy fusion neutrons to catalyze LiD fusion. For example, 2LiD +n –> 34He + T + D +n producing 19.9 MeV and a tritium atom.
With this additional 19.9 MeV per DT fusion, the system can start to produce usable energy for sale. It is also important that tritium is made in the process. You need tritium for the fusion reactions, and there are not many other supplies. The spare neutron is interesting too. It can be used to make additional tritium or for other purposes. It’s a direction I’d like to explore further. I worked on making tritium for my PhD, and in my opinion, this sort of hybrid operation is the most attractive route to clean nuclear fusion power.
Monty Python’s “Life of Brian” presents the fictional story of Brian, someone born in the stable next door on Christmas Day, who is repeatedly mistaken for the messiah by a crowd that never gets the message right. We follow Brain as he grows and preaches wisdom, like “Think for yourselves, work it out, you’re all individuals.” The crowd then answers, in unison, “Yes! We’re all individuals.” Eventually Brian joins the People’s Liberation Front of Judea and is crucified by the Romans. Brian’s thoughts aren’t bad, but the humor is how completely his followers mess them up. Another example, near the end of the film, happens with Brian on the cross. A band of fanatical followers comes to the rescue, his “suicide squad”. They proceed to commit suicide, See it here. Brian can only say, “You silly sots.” It’s comedy. It’s a funny/sad take on religious martyrs, and it provoked a united condemnation by the three great religions because the comedy is relevant, and thus dangerous.
The movie opened in the Us, and was called “blasphemous” by the Catholic Church, and “a crime against religion.” The Catholic film-monitoring office rated it “C” for Condemned. Among Jewish leaders, Rabbi Abraham Hecht of Chabad/Lubovich asked to have the movie banned as a danger to civic peace. Chabad/Lubovich was promoting their own leader as the messiah (he had not proclaimed himself) so the film must have touched a particularly sensitive nerve.
Brian, center top, is thought to be the messiah, and reluctantly accepts the role, only to have it screwed up.
Rabbi Hecht claimed, in The New York Times, Aug 28, 1979, “This film is so grievously insulting that we are genuinely concerned that its continued showing could result in serious violence.” He was joined by the Union of Orthodox Rabbis and the Rabbinical Council of Syrian and Near Eastern Sephardic Communities of America, asking to have the movie banned. They had not asked to have any other movies banned before or since.
The US protestant opposition was headed by Robert Lee of the Lutheran council, who called it “a profane parody” in a broadcast carried by 1,000 radio stations. The religions united to buy a 1 page protest in “Variety,” a rare show of unity. The movie was banned in Italy, Ireland, Chile, Norway, parts of Britain (as a health danger), and likely many other countries. Ireland waited 8 years for a showing; Italy waited twenty years; Aberystwyth, Wales waited thirty years. The ban hasn’t yet been lifted in any of these places, by the way, nor have the religious bans been lifted. It seems that all religions agree you should not think for yourself abut God, or imagine that the leaders might have got things wrong.
The bishop of Southwark, on TV, making the case that “Life of Brian” was an attack on Christianity. It was just an attack on leaders like him.
In Britain, the effort to ban the movie were spearheaded by the “Festival of Lights,” a Protestant group. A leader of that group, Malcolm Muggeridge, debated two of the Pythons on TV, joined by Mervyn Stockwood, bishop of Southwark. See the full Life of Brian 1979 Debate, here. Malcolm Muggeridge had been editor of Punch, Britain’s top humor magazine. He argued that the movie was unfunny. Bishop Stockwood was considered a liberal, known to favor homosexual marriage within the church. He would not tolerate religious deviance, though and argued that the movie was sacrilegious, especially the song at the end. Neither individual seems to listen to anything the Pythons say. Stockwood ended the debate by saying that the Pythons “would get their 20 pieces of silver, that’s for sure”.
Abraham Hecht before the man he claimed was the messiah-king; He called “Life of Brian” a grave danger, and called for Israeli assassinations.
Despite being banned in many countries and by all major religions, the movie was financial success, in part because of the controversy. Its enemies too, in part for their controversy. The Festival of Lights gained notoriety for the protests of sex and violence in the movies. The Catholic Church banned more movies: Shaft, Rambo, Friday the 13th, and all the Borat movies. Rabbi Hecht protested the Israeli rabbinate for making conversion too easy, then pushed the idea that gentiles have to live by a Lubovich interpretation of “The Laws of Noach.” And finally, in June 1995, Hecht pressed for the assassination of Israeli Prime Minister Yitzhak Rabin and Foreign Minister Shimon Peres: “Such people should be killed before they can perform the deed.” [the Oslo accords]. Rabin was assassinated five months later — after the accords were signed. Hecht was presented with a 6 month leave from his pulpit. There were no general condemnations of the banners within their sects, though. All seem to agree that religion is about loving your neighbor, and banning or assassinating those who are not loving enough.
The most contentious part of the movie is the song at the end. It has become popular at funerals and with the terminally ill: “Always look on the bright side of life.” It’s comforting without being preachy: “When you’re chewing on life’s gristle, don’t grumble, give a whistle, and this will help things turn out for the best. And always look on the bright side of life….” Bishop Stockton found this song the most offensive part, and my sense of why is that, as a bishop, he feels he must be seen to stand between you and God. No one like that wants a terminally ill person to look at him and “give a whistle.”
Every now and again a book or movie includes a chess game. Generally, it’s in a story where death is on the line. It’s a literary device used to indicate high mental acumen of the people involved, particularly the one who wins. As an example, in “Sherlock Holmes, A Game of Shadows”, 2011, Holmes plays Moriarty, each calling out moves far advanced for the 1800s. It emphasizes these individuals’ super-smarts. Holmes wins at the end, of course. The Ingrid Berman film, “The Seventh Seal” is similar, with the chess game played against death himself. The knight shows himself a more-than-worth opponent. And that brings us to Ron Weasley in Harry Potter and the Sorcerer’s Stone, book 1 of the series, and movie, Ron Weasley is presented as a sort-of fool throughout the series. He’s mostly as source of background information about wizarding, but in one episode standout, he plays brilliantly with giant-size chess men against a magical intelligence, and wins. After the game, one that is described as one of the best ever, Ron goes back to being the goof-ball he was throughout. His chess skills don’t come up again, or do they. It’s a well written series, so what’s the point of including the game?
Position of pieces in Harry Potter and the Sorcerer’s stone (movie).
To see how brilliant Ron’s play is, recall that Ron is eleven years old in book 1. He, Harry, and Hermione enter a mysterious room filled with menacing statues. Ron immediately realizes it’s a chess board, and infers that they must win as black to pass through. He further infers that the piece representing Harry must make the checkmate. Two or three pieces are missing, and Ron infers that Harry’s character must replace one of these and become the mating piece. If you’ve ever played a decent computer, you know it’s very hard to win as white (in the 90s you could still win). This ghost intelligence plays quite well, and it’s almost impossible to win if you need to have a particular minor piece make the mate. In the movie, Ron plays as black and reaches the position shown with Harry as the king’s bishop and Hermione as a rook. He is down in material, but has laid a very good trap. The white queen captures the “free pawn” on d3, violently threatening the Harry-bishop. Ron interposes the rook to c3 forcing the white queen to take the rook. At this point, Ron could win by B-c5+, QxB, N-h3 mate, but that would sacrifice Harry and leave Ron as the winning piece. Both Ron and Hermione realize this, and Ron causes Harry to make the checkmate by N-h3+, QxN, B-c5+, Q-f3, BxQ mate. Ron is injured when QxN — a sacrifice in both senses of the word.
Death plays chess, painting by Albertus Pictor, 1480
It’s an impressive display of chess skill, and Dumbledore is right in saying it’s one of the best games. No normal player could manage a game like that, certainly no eleven year old. Normally such a display would be used to present Ron as the group brain, or at least as a very deep thinker. If so, why does the author have Ron revert to his care-free, stupid persona with chess never showing up.
We see that Voldemort, the arch villain, won his game too, and only lost a few pieces doing it. That Voldemort is good at chess is no surprise; it goes with his deep-thinking persona. We don’t see Voldemort’s game, but I can infer that he won via the Trailer gambit. It’s a fairly tricky win, but the only way that I know where you win as black losing only a kings bishop, a rook, and a knight, the pieces that Ron and his friends replaced. The Queen is the winning piece, though, and that’s a lot simpler than winning with a bishop. Ron’s win is far more sophisticated, a surprise given Ron’s behavior and how he is treated.
Perhaps it’s just bad writing, or an effort to show Ron is good at something, but I thought to do a quick re-read of Ron’s early appearance in book 2. Here I find that Ron is bright and motivated, but overshadowed. Early in the book, we find 12 year old Ron picking a lock using a hat pin, and driving a flying car reasonably well. We don’t think this is exceptional because his brothers do all this first, but it is exceptional: imagine tryin to drive a regular car with no instruction at 12. Later we find that Ron learns the fine points of Quidditch without native skill or a coach, just using a book, and we find that Dumbledore picks him to prefect, instead of Harry, a job he does well. Finally, we find that Hermione prefers Ron to Harry. It’s a somewhat surprising turn because she’s supposed to be the brains of the trio. How could she stand to be with Ron? Perhaps she is one of the few people who sees that Ron is bright. Dumbledore is too.
Viewed this way, the chess game becomes the first of the examples of Ron’s brainpower, and becomes an important foreshadowing to a surprise at the end of the last book/movie, to the final battle against Voldemort. In that battle, while everyone else is throwing hexes, Ron is the one who realizes that, to win the war, he must go to the basement chamber and collect basilisk teeth. It’s chess thinking: he’s focused on the king, on Voldemort, while everyone else is dealing with side threats. In a sense, it’s Ron who defeats Voldemort. The chess game is a foreshadowing, and fits with Hermione’s choice of Ron over Harry.
Robert Buxbaum, August 26, 2022. If you like chess puzzles, find some here. And in “Bill and Ted’s Bogus Journey,” 1991, the brilliance idea is sort-of reversed. Bill and Ted play against death in battleship, twister, and clue, and win. It’s used to show that death is sort of random, and sort of stupid.
At the 1999 Copenhagen Climate Change Summit, Al Gore announced an inconvenient truth: “There is a 75 per cent chance that the entire north polar ice cap, during the summer months, could be completely ice-free within five to seven years.” It was a bold prediction, part of a campaign that got Mr Gore a Nobel Prize and motivated the US to devote billions to stopping global warming. Supposedly 98% of scientists agreed with Mr. Gore and his remedies. Prince Charles and Bill Gates too. Twenty three years later there is still arctic ice, 98.5% as much as in 1999. Two questions arise: 1. Is the ice loss bad? and 2. Why were those 98% of scientists so wrong?
Arctic sea ice extent when Al Gore spoke (1999) and since. Not much change, nor clearly for the worse
The second question is far easier than the first: the 98% number was bogus, a lie, like many other climate lies that followed. it was effective at stopping argument, and could not be checked immediately. It bullied scientists who argued that global warming wasn’t bad, or wasn’t man-made, and it gave do-gooders the ability to label their opponents “liars” and “science deniers”. The claim of 98% was used to silence scientists with long, prominent careers. Deniers lost their funding and were no longer published. Other scientists learned to keep quiet. Twenty years later, when the arctic ice wasn’t gone and antarctic ice hit a record extent, the deniers’ careers largely were gone.
Scientists are not stupid, nor independently rich, for the most part. They are dependent on government funding and their employers, the universities are too. As a group they (we) are incapable of stemming the tide of public opinion. This week Biden signed a nearly 1 trillion dollar bill to stop climate change. Every scientist with a chance to get the money will go for it. Whether or not they think a colder earth is good, they will claim it is in their proposals, and imply that their work can stop the natural chaos that is climate. They will ask for their share of the $1T to study the appropriate things: solar cells, corn-based power, and wind turbines. The proposals will not mention the huge costs in mining or land use. Scientists already know they can not get funded for nuclear power, though it works and produces no CO2, nor should can scientists benefit by criticizing China, as the largest source of CO2. That is seen as undermine the green effort at home. When we stop manufacturing at home, BTW, we end up buying the same materials manufactured in China, where they really generate lots of pollution. When asked about this, Biden’s climate chief said not to worry about it, we had to do our part, and Biden would speak to the Chinese. The result is the biggest buildup in coal-fired power plants in the world, with more coming on line.
This second question is at least as important as the first one: is less arctic ice bad? Or, asking more generally, is a warm earth bad? It’s an opinion question; it’s in no way science, impossible to answer definitively. Cold weather is bad for food production, and that’s bad for people, in general. Most people prefer to live where it’s warm, I find. Supposedly polar bears prefer it cold, but I don’t know for sure. I’m not keen to go back to the climate of the ice ages, 10,000- 100,000 years ago when ice covered Canada and you could walk from France to England. I’m not convinced that life was better when the world was 1°C colder. The sea was lower in 1900, but had been higher in the year zero. Less arctic ice means easier shipping. For all I know we may want to make a Northwest Passage. More food and a easier shipping are the convenient truths about global warming.
Robert Buxbaum, August 19, 2022. If you believe any of what I said about Gore/Biden’s green energy, you may like a movie by Michael Moore, Planet of the Humans, see it here. The political greens are not saving energy or cooling the planet, and they know it. It’s a money maker.
Atenolol and related beta blockers have been found to be effective reducing blood pressure and heart rate. Since high blood pressure is a warning sign for heart problems, doctors have been prescribing atenolol and related beta blockers for all sorts of heart problems, even problems that are not caused by high blood pressure. I was prescribed metoprolol and then atenolol for Atrial Fibrillation, A-Fib, beginning 2 yeas ago, even though I have low-moderate blood pressure. For someone like me, it might have been deadly. Even for patients with moderately high blood pressure (hypertension) studies suggest there is no heart benefit to atenolol and related ß-blockers, and only minimal stroke and renal benefit. As early as 1985 (37 years ago) the Medical Research Council trial found that “ß blockers are relatively ineffective for primary treatment of hypertensive outcomes.”
End point. Relative risk. 95% CI. All-cause mortality Cardiovascular mortality MI Stroke Carlberg B et al. Lancet 2004; 364:1684–1689.
There lots of adverse side-effects to atenolol, as listed at the end of this post. More recent studies (e.g. Carlsberg et al., at right) continue to find no positive effects on the heart, but lots of negatives. A review in Lancet (2004) 364,1684–9 was titled, “Review: atenolol may be ineffective for reducing cardiovascular morbidity or all cause mortality in hypertension” (link here). “In patients with essential hypertension, atenolol is not better than placebo or no treatment for reducing cardiovascular morbidity or all cause mortality.” It further concluded that, “compared to other antihypertensive drugs, it [atenolol] may increase the risk of stroke or death.” I showed this and related studies to my doctor, and pointed out that I have averaged to low blood pressure, but he persisted in pushing this drug, something that seems common among medical men. My guess is that the advertising or doctor subsidies are spectacular. By contrast, aspirin has long been known to be effective for heart problems; my doctor said to go off aspirin.
The graph at right is from “Trial of Secondary Prevention with Atenolol after transient Ischemic Attack or Nondisabling Ischemic Stroke”, published in Stroke, 24 4 (1993), (see link here). a Thje study involved 1473 at-risk patients, randomly prescribed atenolol or placebo. It found no outcome benefit from atenolol, and several negatives. After 3 years, in two equal-size randomized groups, there were 64 deaths among the atenolol group, 58 among the placebo group; there were 11 fatal strokes with atenolol, versus 8 with placebo. There were somewhat fewer non-fatal strokes with atenolol, but the sum-total of fatal and non-fatal strokes was equal; there were 81 in each group.
“Trial of Secondary Prevention with Atenolol after transient Ischemic Attack or Nondisabling Ischemic Stroke”, published in Stroke, 24 4 (1993).
Newer beta blockers seem marginally better, as in “Effect of nebivolol or atenolol vs. placebo on cardiovascular health in subjects with borderline blood pressure: the EVIDENCE study.” “Nebivolol (NEB) in contrast to atenolol (ATE) may have a beneficial effect on endothelial function …. there was no significant change in the ATE and PLAC groups.” My question: why not use one of these, or better yet aspirin. Aspirin is shown to be beneficial, and relatively side-effect free. If you tolerate aspirin, and most people do, beneficial has to be better than maybe beneficial.
Among atenolol’s ugly side effects, as listed by the Mayo Clinic, there are: tiredness, sweating, shortness of breath, confusion, loss of sex drive, cold fingers and toes, diarrhea, nausea, and general confusion. I had some of these. There was no increase in heart stability (decrease in A-fib). My heart rate went as low at 32 bpm at night. My doctor was unconcerned, but I was. I suspected the low heart rate put me at extreme risk. Eventually, the same doctor gave me ablation therapy, and that seemed to cure the A-Fib.
Following my ablation, I was told I could get off atenolol. I then discovered another negative effect of atenolol: you have to ease off it or your heart will race. If you have A-fib, or modest hypertension, consider aspirin, eliquis, ablation, or exercise. If you are prescribed atenolol for heart issues and don’t have symptoms of very-high blood pressure, consider other options and/or changing doctors.
Two years ago, I was diagnosed with Atrial fibrillation, A-Fib in common parlance, a condition where my heart would sometimes speed up to double its normal speed. I was prescribed metopolol and then atenolol, common beta blockers, and a C-Pap for sleep apnea. None of this seemed to help, as best I could tell from occasional pulse measurements with watch and a finger pulse-oxometer. Besides, the C-Pap was giving me cough and the beta blockers made me dizzy. And the literature on C-Pap did not impress.
So, some moths ago, I bought an iWatch. The current versions allows you to take EKGs and provides a continuous record of your heart rate. This was very helpful, as I saw that my heart rate was transitioning to chaos. While it was normally predictable, it would zoom to 130 or so at some point virtually every day. Even more alarming, it would slow down to the mid 30s at some point during the night, bradycardia, and I could see it was getting worse. At that point, I agreed to go on eliquis, a blood thinner, and agreed to a catheter ablation. The doctor put a catheter into my heart by way of a leg vein, and zapped various nerve centers in the heart. The result is that my heart is back into normal behavior. See the heart-rate readout from my iWatch below; before and after are dramatically different.
My heart rate for the last month, very variable before the ablation treatment, 2 weeks ago; a far less variable range of heart rates in the two weeks following the treatment. Heart rate data is from my iPhone and iwatch — a good investment, IMHO.
The reason I chose ablation over drugs or no therapy was that I read health-studies on line. I’ve go a PhD, and that training helps me to understand the papers I’ve read, but you should read them too. They are not that hard to understand. Though ablation didn’t appear as a panacea, it was clearly better than the alternatives. Particularly relevant was the CABANA study on life expectancy. CABANA stands for “Catheter ABlation vs ANtiarrhythmic Drug Therapy for Atrial Fibrillation – CABANA”. https://www.acc.org/latest-in-cardiology/clinical-trials/2018/05/10/15/57/cabana.
2,204 individuals with persistent AF were followed for 5 years after treatment, 37% female, 63% male, average age 67.5. Prior hospitalization for AF: 39%. The results were as follows:
Death: 5.2% for ablation vs. 6.1% for drug therapy (p = 0.38)
Serious stroke: 0.3% for ablation vs. 0.6% for drug therapy (p = 0.19)
All-cause mortality: 4.4% for ablation vs. 7.5% for drug therapy (p = 0.005)
Death or CV hospitalization: 51.7% for ablation vs. 58.1% for drug therapy (p = 0.002)
Pericardial effusion with ablation: 3.0%; ablation-related events: 1.8%
First recurrent AF/atrial flutter/atrial tachycardia: 53.8% vs. 71.9% (p < 0.0001)
I found all of this significant, including the fact that 27.5% of those on the drug treatment crossed over to have ablation while only 9.2% on the ablation side crossed to have the drug treatment.
I must give a plug for doctor Ahmed at Beaumont Hospital who did the ablation. He does about 200 of these a year, and does them well. Do not go to an amateur. I was less-than impressed with him pushing the beta-blocker hard; I’ll write about that. Also, get an iWatch if you think you may have A-Fib or any other heart problem. You see a lot, just by watching, so to speak.
Inheritability of traits is one of the greatest of insights; it’s so significant and apparent, that one who does not accept it may safely be called a dullard. Personal variation exists, but most everyone accepts that if your parents are tall, you are likely to be tall; If they are dark, you too will likely be dark, etc., but when it comes to intelligence, or proclivities, or psychological leanings, it is more than a little impolite to acknowledge that genetics holds sway. This unwillingness is glaringly apparent in the voice-over narration of a popular movie about three identical triplets who were raised separately without knowing of one another and who turned out virtually identical. The movie is “Three identical strangers”, and it recounts their separate upbringing, their meeting, and their lives afterwards.
Triplets, raised separately, came out near identical.
Although raised separately, one in a rich family, one in a poor family, and one middling, the three showed near identical intelligence, and near identical proclivities. Two of them picked the same out-of-the way college. All of them liked the same sort of clothes and had the same taste in women. There were differences too, showing that genetics isn’t everything: one was more outgoing, one less, and depressed, but in many ways, they were identical. Meanwhile, the voice-over kept saying things like, “isn’t it a shame that we never saw any results on nature/nurture from this study.” The movie looked at some twins, raised separately, saw the same commonalities, and restated that they saw nothing remarkable. My clear takeaway was genetics applies to psychology too. That it’s not all genetics, but it is at least as influential as upbringing/ nurture.
This movie also included pairs of identical twins, raised separately, they also showed strong personality similarities. It’s a finding that is well replicated in broader studies involving siblings raised separately, and unrelated adoptees raised together. Blood, it seems, is stronger than nurture. See for example the research survey paper, “Genetic Influence on Human Psychological Traits” Journal of the American Psychological Society 13-4, pp 148-151 (2004). A table from that paper appears below. Genetics plays a fairly strong role in all personal traits including intelligence, personality, self-control, mental illness, criminality, political views (even mobile phone use). The role is age-dependent, though so that intelligence (test determined) is strongly environment-dependent in 5 year olds, almost entirely genetic in 25-50 year olds. One area that is not strongly genetic, it seems, is religion.
In a sense, the only thing surprising about this result is that anyone is surprised. Genetics is accepted as crucial for all things physical, so why not mental and social. As an example of the genetic influence on sports, consider Jewish chess genius, Lazlo Polgar: he decided to prove that anyone could be great at chess, and decided to train his three daughters: he got two grand masters and an international master. By comparison, there are only 2 chess grand masters in all of Finland. Then consider that there are five all-star, baseball players named Alou, all from the same household, including the three brothers below. The household has seven pro baseball players in all.
Most people are uncomfortable with such evidence of genetic proclivity. The movie has been called “deeply disturbing” as any evidence of proclivity contradicts the promise of education: that all men are equal, blank slates at birth that can be fashioned into whatever you want through education. What we claim we want is leaders — lots of them, and we expect that education will produce equal ratios of woman and men, black and white and Hispanic, etc. and we expect to be able to get there without testing for skills, — especially without blind testing. I notice that the great universities have moved to have testing optional, instead relying on interviews and related measures of leadership. I think this is nonsense, but then I don’t run Harvard. As a professor, I’ve found that some kids have an aptitude and a burning interest, and others do not. You can tell a lot by testing, but the folks who run the universities disagree.
The All star Alou brothers share an outfield.
University heads claim that blind testing is racist. They find that some races score poorly on spacial sense, for example, or vocabulary suggesting that the tests are to blame. There is some truth to these concerns, but I find that the lack of blind testing is more racist. Once the test is eliminated, academia finds a way to elevate their friends, and the progeny of the powerful.
The variety of proclivities plays into an observation that you can be super intelligent in one area, and super stupid in others. That was the humor of some TV shows: “Big Bang Theory” and “Fraser”. That was also the tragedy of Bobby Fischer. He was brilliant in chess (and the child of brilliant parents), but was a blithering idiot in all other areas of life. Finland should not feel bad about their lack of great chess players. The country has produced two phone companies, two strong operating systems, and the all time top sniper.
