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You might already be following the Mediterranean diet with these easy food swaps

The Mediterranean diet has been an expert-recommended way of eating since it was first introduced in the 1990s, but it still holds its own with newer, trendier eating plans. And if you’re moving into plant-based eating and flexitarian eating, you might be following the Mediterranean diet already without realizing it.

“It’s lauded as one of the healthiest diets in the world,” said dietician nutritionist Michelle Dudash, author of “The Low-Carb Mediterranean Cookbook: Quick and Easy High-Protein, Low-Sugar, Healthy-Fat Recipes for Lifelong Health.”
“And it’s not an all-or-nothing set of rules,” Dudash said. “It doesn’t have to be all day; it doesn’t have to be every week.”
It’s not even a diet in the weight loss sense of the word. It’s a way of life for people in the countries surrounding the Mediterranean Sea.
In addition to incorporating foods and ingredients that are local to the region, the diet takes a broader, lifestyle-based approach that also emphasizes mindfully enjoying meals with family and friends and getting up and moving throughout the day. Walking and talking with a buddy instead of running nowhere on a treadmill? That’s the Mediterranean way.
The bulk of the Mediterranean diet focuses on plant-based ingredients, including fruits and vegetables, nuts, seeds, beans and grains, with seafood as the main animal-based protein source.
“While meat and dairy can be part of the Mediterranean diet, it’s heavily built on plants,” Dudash said, who first experienced this way of eating by cooking alongside her Lebanese grandmother and great-grandmother as a child.
As an adult, her travels throughout the Mediterranean, to countries like Italy, France, Croatia and Monaco, expanded her palate and solidified her love for the Mediterranean lifestyle.
The whole and less-processed ingredients recommended in the Mediterranean diet naturally lend themselves to a more low-carb way of eating. By incorporating these in larger quantities than starchy foods like white bread and rice, red meat, and sugar-added foods, you can start shifting your eating habits.
Dietitian nutritionist and cookbook author Michelle Dudash recommends a Mediterranean diet focused on plant-based ingredients.
Dietitian nutritionist and cookbook author Michelle Dudash recommends a Mediterranean diet focused on plant-based ingredients.
If you’re trying to reduce your carbohydrate intake, introduce more plants, fiber and good fat into your diet. Or simply eat fewer processed foods, it’s simpler than you might think to make your life more Mediterranean.
Here are Dudash’s top recommendations for ingredient swaps and everyday cooking habits you can incorporate into your routine using common pantry ingredients, along with recipes to try from Dudash’s new book.
Use extra-virgin olive oil on everything
If there is one switch to make your meals more Mediterranean, it’s to make extra-virgin olive oil your go-to cooking oil. “Use it liberally! I can’t tell you how many times I’ve walked into friends’ houses, and they have a little bottle of olive oil they only use on salads,” Dudash said.
Extra-virgin olive oil is low in saturated fat — the kind that can lead to high cholesterol — and high in monounsaturated fat — the kind that can help lower cholesterol. Polyphenols give extra-virgin olive oil its signature green-gold color and can help fight a host of diseases.
Olive oil labeled “pure” or “light” doesn’t have the same benefits as the extra-virgin kind. “That is not a healthier choice, and the name has nothing to do with calories. You’re getting the processed leftovers,” Dudash said.
She recommends that you reach for extra-virgin olive oil anywhere you’d use butter or canola oil in a recipe, not just as a finishing oil or salad dressing. In Mediterranean cooking, she noted, “Olive oil is the staple fat used in cooking and at the table, from sautéing seafood to drizzling over salads and cooked vegetables — even stirring into cake batter!”
Hummus isn’t just for snacks
Hummus has a lot going for it. The savory spread is made from fiber-rich ingredients like chickpeas and tahini. And it’s kid-friendly and pairs well with other vegetables. But Dudash thinks you need to think beyond snack time when considering hummus. “You’re dipping your carrots in it, but are you using it to its full potential? Probably not.”
Anywhere you’d typically turn to mayo, try hummus or tahini in its place. Dudash folds hummus into her tuna salad and uses tahini in Caesar dressing to give it a lush and creamy texture. She even uses hummus as a base for a Greek-inspired seven-layer dip that’s a refreshing change of pace from the usual refried bean-and-guac option.
COOK THE RECIPE: Greek 7-Layer Hummus Dip
Extra-virgin olive oil can be used for sautéing as well as drizzling over salads, cooked vegetables and this hummus dip, Dudash said.
Extra-virgin olive oil can be used for sautéing as well as drizzling over salads, cooked vegetables and this hummus dip, Dudash said.
Dudash also notes that “hummus in Middle Eastern countries isn’t served cold out of the fridge, it’s served warmed.” With this in mind, she stirs hummus into sauces and one-pan sautés to add moisture and flavor, as well as to sneak in some additional protein. She especially loves adding it to browned ground turkey for lettuce wraps.
Swap in nuts and seeds for bread
A simple way to get more plant-based protein and fiber into your meals is to replace breadcrumb fillings and toppings with nuts or seeds. “It’s an awesome way to add more plant protein to crusts, breadings or salads, and give them more texture and depth of flavor,” Dudash said.
She mixes chopped nuts with ground turkey as a stuffed pepper filling and hides almond flour in her Mediterranean meatloaf. Instead of panko, she dips cod fillets into crushed pistachios and bakes them to get a toasted crunch. Try Dudash’s recipe from from “The Low-Carb Mediterranean Cookbook” yourself.
COOK THE RECIPE: Lemon Baked Cod With Pistachio Crust
It’s easy to add plant-based protein and fiber into meals by replacing breadcrumb toppings with nuts, as in this cod dish.
It’s easy to add plant-based protein and fiber into meals by replacing breadcrumb toppings with nuts, as in this cod dish.
If you’re allergic to tree nuts or want to mix things up further, Dudash suggests using quinoa. “Most people are used to seeing it in salads or a pilaf,” she said, but this high-protein seed can replace breadcrumbs or oats in favorite recipes for meatballs, burgers and more.
You can use leftover cooked quinoa or dry quinoa as a binder. Soak dry quinoa for about 15 minutes, then drain well before mixing in.
Canned goods aren’t a cop-out
There are two types of canned ingredients Dudash always keeps in her pantry: beans and tomatoes.
Though multicooker appliances like the Instant Pot have made it easier to prepare dried beans, nothing is quicker than opening a can — and there is no shame in turning to that time-saver. “They’re one of the best inventions ever,” she said.
The best Dutch ovens in 2021 (CNN Underscored)
The best Dutch ovens in 2021 (CNN Underscored)
Maximize the nutritional potential in canned beans and minimize salt intake by buying the low-sodium option whenever possible, and draining and rinsing the beans before using them in recipes.
One exception: The liquid from chickpeas, known as aquafaba, can be used as a vegan replacement for eggs. If you’re interested in baking with aquafaba, strain and save the drained chickpea liquid, then rinse the beans.
Even when fresh tomatoes are in season, it always pays to have a few cans of tomatoes, whether diced, crushed or whole, at the ready. “Canned tomatoes are essential for Mediterranean cooking and all sorts of other cuisines,” Dudash said. They are a reliable meal-building staple for soups and stews, sauces and casseroles.
Canned tomatoes also can be more powerful cancer fighters than raw. All tomatoes are high in lycopene, an antioxidant that gives them their red color and has been shown to reduce cancer risk. “When you cook or can tomatoes, the lycopene content actually increases,” Dudash said.
For more tips, sign up for Eat, But Better, CNN’s eight-part guide to eating Mediterranean-style and see how easy it can be.

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Police Can Now Identify Your Eye Color from DNA

If they have a case with very few leads, police now have another tool in their arsenal that will at least provide one distinct factor. Eye color of the perp. Let’s say a bad guy left some DNA at a crime scene. That DNA can now be used to predict the suspect’s eye color, according to Manfred Kayser at Erasmus University Medical Center in the Netherlands. They have developed IrisPlex, which can predict with 94 percent accuracy whether a person has blue or brown eyes from a simple sample of DNA.

The government will likely approve it within weeks and this huge news for police since often times they have DNA, but can’t find a match on a DNA database. Right now it isn’t accurate enough to stand up in court, but one day soon it might be.

IrisPlex examines six single-letter variations in DNA, which are strongly linked to eye color, and categorizes them as blue, brown or “undefined.” Undefined is classified as meaning an intermediate color like green, grey, or a mix. They have already held tests on populations from seven different European countries, where it predicted blue or brown eyes with a high degree of accuracy. This should help them solve many more cases when they implement it.

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New MIT Cancer Treatment Jump-Starts the Immune System

The cutting-edge Earth science satellites launching in the next couple of years will give more detailed views of our planet than ever before. We’ll be able to track small-scale ocean features like coastal currents that move nutrients vital to marine food webs, monitor how much fresh water flows through lakes and rivers, and spot movement in Earth’s surface of less than half an inch (a centimeter). But these satellites will also produce a deluge of data that has engineers and scientists setting up systems in the cloud capable of processing, storing, and analyzing all of that digital information.

“About five or six years ago, there was a realization that future Earth missions were going to be generating a huge volume of data and that the systems we were using would become inadequate very quickly,” said Suresh Vannan, manager of the Physical Oceanography Distributed Active Archive Center based at NASA’s Jet Propulsion Laboratory in Southern California.

SWOT Satellite’s Science Instrument Payload

Part of the SWOT satellite’s science instrument payload sits in a clean room at NASA’s Jet Propulsion Laboratory during assembly. By measuring the height of the water in the planet’s ocean, lakes, and rivers, researchers can track the volume and location of the finite resource around the world. Credit: NASA/JPL-Caltech

The center is one of several under NASA’s Earth Science Data Systems program responsible for processing, archiving, documenting, and distributing data from the agency’s Earth-observing satellites and field projects. The program has been working for several years on a solution to the information-volume challenge by moving its data and data-handling systems from local servers to the cloud – software and computing services that run on the internet instead of locally on someone’s machine.

The Sentinel-6 Michael Freilich satellite, part of the U.S.-European Sentinel-6/Jason-CS (Continuity of Service) mission, is the first NASA satellite to utilize this cloud system, although the amount of data the spacecraft sends back isn’t as large as the data many future satellites will return.

NISAR Testing

Part of the NISAR satellite rests in a thermal vacuum chamber at NASA’s Jet Propulsion Laboratory in August 2020. The Earth satellite will track subtle changes in the planet’s surface as small as 0.4 inches. Credit: NASA/JPL-Caltech

Two of those forthcoming missions, SWOT and NISAR, will together produce roughly 100 terabytes of data a day. One terabyte is about 1,000 gigabytes – enough digital storage for approximately 250 feature-length movies. SWOT, short for Surface Water and Ocean Topography, will produce about 20 terabytes of science data a day while the NISAR (NASA-Indian Space Research Organisation Synthetic Aperture Radar) mission will generate roughly 80 terabytes daily. Data from SWOT will be archived with the Physical Oceanography Distributed Active Archive Center while data from NISAR will be handled by the Alaska Satellite Facility Distributed Active Archive Center. NASA’s current Earth science data archive is around 40 petabyes (1 petabyte is 1,000 terabytes), but by 2025 – a couple of years after SWOT and NISAR are launched – the archive is expected to hold more than 245 petabytes of data.

Both NISAR and SWOT will use radar-based instruments to gather information. Targeting a 2023 launch, NISAR will monitor the planet’s surface, collecting data on environmental characteristics including shifts in the land associated with earthquakes and volcanic eruptions, changes to Earth’s ice sheets and glaciers, and fluctuations in agricultural activities, wetlands, and the size of forests.

Explore this 3D model of the SWOT satellite by zooming in and out, or clicking and dragging the image around. Credit: NASA/JPL-Caltech

Set for a 2022 launch, SWOT will monitor the height of the planet’s surface water, both ocean and freshwater, and will help researchers compile the first survey of the world’s fresh water and small-scale ocean currents. SWOT is being jointly developed by NASA and the French space agency Centre National d’Etudes Spatial.

“This is a new era for Earth observation missions, and the huge amount of data they will generate requires a new era for data handling,” said Kevin Murphy, chief science data officer for NASA’s Science Mission Directorate. “NASA is not just working across the agency to facilitate efficient access to a common cloud infrastructure, we’re also training the science community to access, analyze, and use that data.”

Faster Downloads

Currently, Earth science satellites send data back to ground stations where engineers turn the raw information from ones and zeroes into measurements that people can use and understand. Processing the raw data increases the file size, but for older missions that send back relatively smaller amounts of information, this isn’t a huge problem. The measurements are then sent to a data archive that keeps the information on servers. In general, when a researcher wants to use a dataset, they log on to a website, download the data they want, and then work with it on their machine.

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Categories
Health

New England Journal of Medicine Study: No Risk of Pregnancy Loss From COVID-19 Vaccination

A new study published in The New England Journal of Medicine has found no correlation between COVID-19 vaccinations and risk of first-trimester miscarriages, providing further evidence of the safety of COVID-19 vaccination during pregnancy.

The study analyzed several national health registries in Norway to compare the proportion of vaccinated women who experienced a miscarriage during the first trimester and women who were still pregnant at the end of the first trimester.

Deshayne Fell

Study co-author Dr. Deshayne Fell, an Associate Professor in the School of Epidemiology and Public Health in the University of Ottawa’s Faculty of Medicine and a Scientist at the Children’s Hospital of Eastern Ontario (CHEO) Research Institute. Credit: University of Ottawa

“Our study found no evidence of an increased risk for early pregnancy loss after COVID-19 vaccination and adds to the findings from other reports supporting COVID-19 vaccination during pregnancy,” write the study authors, which includes co-author Dr. Deshayne Fell, an Associate Professor in the School of Epidemiology and Public Health in the University of Ottawa’s Faculty of Medicine and a Scientist at the Children’s Hospital of Eastern Ontario (CHEO) Research Institute.

“The findings are reassuring for women who were vaccinated early in pregnancy and support the growing evidence that COVID-19 vaccination during pregnancy is safe.”

Dr. Fell, currently leading an Ontario study on the effectiveness and safety of COVID-19 vaccines, and the international team behind the study found no relationship between the type of vaccine received and miscarriage. In Norway, the vaccines used included Pfizer, Moderna, and AstraZeneca.

“It is important that pregnant women are vaccinated since they have a higher risk of hospitalizations and COVID-19-complications, and their infants are at higher risk of being born too early. Also, vaccination during pregnancy is likely to provide protection to the newborn infant against COVID-19 infection in the first months after birth,” the study authors write.

Reference: “Covid-19 Vaccination during Pregnancy and First-Trimester Miscarriage” 20 October 2021, The New England Journal of Medicine.
DOI: 10.156/NEJMc2114466

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Categories
Health

Researchers Warn: Common Antidepressant Should No Longer Be Used To Treat People With Dementia

A drug used to treat agitation in people with dementia is no more effective than a placebo, and might even increase mortality, according to a new study.

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The research, led by the University of Plymouth and published in The Lancet, has shown that antidepressant mirtazapine offered no improvement in agitation for people with dementia – and was possibly more likely to be associated with mortality than no intervention at all.

Agitation is a common symptom of dementia, characterized by inappropriate verbal, vocal or motor activity, and often involves physical and verbal aggression. Non-drug patient-centered care is the first intervention that should be offered but, when this doesn’t work, clinicians may move to a drug-based alternative. Antipsychotics have proven to increase death rates in those with dementia, along with other poor outcomes, and so mirtazapine has been routinely prescribed. This study was designed to add to the evidence base around its effectiveness.

Funded by the National Institute for Health Research (NIHR), the study recruited 204 people with probable or possible Alzheimer’s disease from 20 sites around the UK, allocating half to mirtazapine and half to placebo. The trial was double-blind; meaning that neither the researcher nor the study participants knew what they were taking.

The results showed that there was no less agitation after 12 weeks in the mirtazapine group than in the control group. There were also more deaths in the mirtazapine group (seven) by week 16 than in the control group (only one), with analysis suggesting this was of marginal statistical significance.

Lead researcher Professor Sube Banerjee, Executive Dean of the Faculty of Health and Professor in Dementia at the University of Plymouth, explained why the results were so surprising, but important.

“Dementia affects 46 million people worldwide – a figure set to double over the next 20 years. Poor life quality is driven by problems like agitation and we need to find ways to help those affected,” he said.

“This study shows that a common way of managing symptoms is not helpful – and could even be detrimental. It’s really important that these results are taken into account and mirtazapine is no longer used to treat agitation in people with dementia.

“This study has added important information to the evidence base, and we look forward to investigating further treatments that may help to improve people’s quality of life.”

Reference: “Study of mirtazapine for agitated behaviours in dementia (SYMBAD): a randomised, double-blind, placebo-controlled trial” 21 October 2021, The Lancet.
DOI: 10.1016/S0140-6736(21)01210-1

The study was co-authored by:

  • University of East Anglia
  • Brighton and Sussex Medical School
  • LSE
  • University of Exeter
  • Birmingham and Solihull Mental Health Foundation NHS Trust
  • University of Manchester
  • UCL
  • Trinity College, Dublin
  • Surrey and Borders Partnership NHS Foundation Trust
  • Alzheimer’s Society Research Network
  • University of Cambridge
  • Cambridge and Peterborough Foundation Trust
  • Newcastle University
Categories
Health

Einstein-Developed Treatment Strategy May Lead To Cure for HIV and Other Chronic Viral Infections

Armed with a novel strategy they developed for bolstering the body’s immune response, scientists at Albert Einstein College of Medicine have successfully suppressed HIV infections in mice—offering a path to a functional cure for HIV and other chronic viral infections. Their findings were published on October 21, 2021, in the Journal of Clinical Investigation.

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The research involved proteins designed to selectively stimulate the immune system’s CD8+ “killer” T cells to multiply and specifically attack HIV-infected T cells. Co-corresponding author Steven Almo, Ph.D., developed the synthetic proteins, known as synTac (short for “synapse for T-cell activation”). Dr. Almo is professor and chair of biochemistry, professor of physiology & biophysics, the Wollowick Family Foundation Chair in Multiple Sclerosis and Immunology, and director of the Macromolecular Therapeutics Development Facility at Albert Einstein College of Medicine.

Harris Goldstein

Harris Goldstein, M.D. Professor of pediatrics and of microbiology and immunology and the Charles Michael Chair in Autoimmune Diseases at Albert Einstein College of Medicine and director of the Einstein-Rockefeller-CUNY Center for AIDS Research. Credit: Albert Einstein College of Medicine

HIV infects the immune system’s CD4+ T cells. For the past 25 years, people infected with HIV have been able to control their infection through antiretroviral therapy (ART)—a combination of several drugs that prevent HIV from infecting new CD4+ T cells and multiplying within them. “Although ART works remarkably well at keeping HIV in check indefinitely, it is a stalemate and not a checkmate,” said co-corresponding author Harris Goldstein, M.D., professor of pediatrics and of microbiology and immunology and the Charles Michael Chair in Autoimmune Diseases at Albert Einstein College of Medicine and director of the Einstein-Rockefeller-CUNY Center for AIDS Research.

“ART’s long-term use can cause substantial side effects,” noted Dr. Goldstein. “And once ART is halted, latent HIV viruses—which can persist for years in CD4+ T cells—invariably emerge from their hiding places to revive the infection. Our JCI paper shows that synTac proteins, by greatly boosting the quantity of protective HIV-specific CD8+ T cells, were able to eliminate these infected cells.

“It’s unlikely that any treatment strategy can remove all latently infected T cells,” said Dr. Goldstein. “Our goal with synTac is a ‘functional cure,’ in which the powerful immune response induced by synTac suppresses HIV to undetectable levels even after they discontinue ART.”

The researchers first tested their anti-HIV synTac proteins on human blood samples infected with either HIV or cytomegalovirus (CMV), a common type of herpes virus that can infect and kill immunosuppressed patients. For blood from human donors infected with either HIV or CMV, synTacs specific for mobilizing immune responses against those viruses triggered selective and vigorous multiplication of CD8+ T cells that exhibited potent HIV or CMV anti-viral activity.

Steven Almo

Steven Almo, Ph.D. Professor of biochemistry and physiology & biophysics at Albert Einstein College of Medicne and the chair of biochemistry, the Wollowick Family Foundation Chair in Multiple Sclerosis and Immunology, and director of the Einstein Macromolecular Therapeutics Development Facility. Credit: Albert Einstein College of Medicine

Next, the researchers intravenously injected synTacs specific for HIV or CMV into virus-infected mice with “humanized” immune systems that permit infection by viruses affecting people, such as HIV and CMV. The synTac proteins triggered human HIV-specific CD8+ T cells to increase 32-fold and increased human CMV-specific CD8+ T cells by 46-fold. In both the HIV- and CMV-infected mice, the large numbers of synTac-stimulated human CD8+ T cells potently suppressed the viral infections—suggesting that synTacs may offer new opportunities for functionally curing HIV and treating CMV and other viral infections.

“A key asset of the synTac platform,” said Dr. Almo, “is how easily we can program synTac proteins to combat any of the many diseases in which T cells play a role—including disease targets that extend well beyond viruses. For example, an ongoing clinical trial involving patients with head and neck cancer is assessing synTac’s ability to selectively activate anti-cancer T cells. And since synTacs can turn off, as well as activate T cells, they’re also under study for treating type 1 diabetes and other autoimmune diseases by turning off T cells that mistakenly attack people’s healthy tissues.” Dr. Almo is also co-leader of the cancer therapeutics program at the Albert Einstein Cancer Center.

Reference: “T-Cell Receptor-specific Immunotherapeutics Drive Selective In vivo HIV and CMV-specific T-Cell Expansion in Humanized Mice” by Mengyan Li, Scott J. Garforth, Kaitlyn E. O’Connor, Hang Su, Danica M. Lee, Alev Celikgil, Rodolfo J. Chaparro, Ronald D. Seidel, R. Brad Jones, Ravit Arav-Boger, Steven C. Almo and Harris Goldstein, 21 October 2021, Journal of Clinical Investigation.
DOI: 10.1172/JCI141051

Other authors involved in the research were Ph.D. student Mengyan Li, Scott J. Garforth, Ph.D., Kaitlyn E. O’Connor, Hang Su, Ph.D., Danica Lee, and Alev Celikgil, M.D., all from Einstein; Rodolfo J. Chaparro, Ph.D., and Ronald Seidel, Ph.D., from Cue Biopharma; R. Brad Jones, Ph.D., from Weill Cornell Medical College in New York; and Ravit Arav-Boger, M.D., from the Medical College of Wisconsin.

The underlying synTac technology, also referred to as Cue Biopharma’s Immuno-STAT™ (Selective Targeting and Alteration of T cells) platform, was developed in the laboratory of Dr. Almo.  It is patent-protected and licensed to Cue Biopharma, of which Dr. Almo, Dr. Seidel, and Dr. Chaparro are co-founders and stockholders. Einstein received financial support from Cue Biopharma for previous studies. Einstein’s HIV application (US Application:  16/603306) is patent-pending and the College of Medicine is currently looking for help in advancing its development further.

About Albert Einstein College of Medicine

Albert Einstein College of Medicine is one of the nation’s premier centers for research, medical education and clinical investigation. During the 2020-21 academic year, Einstein is home to 721 M.D. students, 178 Ph.D. students, 109 students in the combined M.D./Ph.D. program, and 265 postdoctoral research fellows. The College of Medicine has more than 1,900 full-time faculty members located on the main campus and at its clinical affiliates. In 2020, Einstein received more than $197 million in awards from the National Institutes of Health (NIH). This includes the funding of major research centers at Einstein in aging, intellectual development disorders, diabetes, cancer, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States through Montefiore and an affiliation network involving hospitals and medical centers in the Bronx, Brooklyn and on Long Island.

Categories
Health

Intuition Often Lets Us Down – How To Use Probability and Statistics To Find the Real Answers

Much of our thinking is flawed because it is based on faulty intuition, says Professor Leighton Vaughan Williams. But by using the framework and tools of probability and statistics, he explains how we can overcome this to provide solutions to many real-world problems and paradoxes.

Imagine, there’s a bus that arrives every 30 minutes on average and you arrive at the bus stop with no idea when the last bus left. How long can you expect to wait for the next bus? Intuitively, half of 30 minutes sounds right, but you’d be very lucky to wait only 15 minutes.

Say, for example, that half the time the buses arrive at a 20-minute interval and half the time at a 40-minute interval. The overall average is now 30 minutes. From your point of view, however, it is twice as likely that you’ll turn up during the 40 minutes interval than during the 20 minutes interval.

This is true in every case except when the buses arrive at exact 30-minute intervals. As the dispersion around the average increases, so does the amount by which the expected wait time exceeds the average wait. This is the Inspection Paradox, which states that whenever you “inspect” a process, you are likely to find that things take (or last) longer than their “uninspected” average. What seems like the persistence of bad luck is simply the laws of probability and statistics playing out their natural course.

Once made aware of the paradox, it seems to appear all over the place.

For example, let’s say you want to take a survey of the average class size at a college. Say that the college has class sizes of either 10 or 50, and there are equal numbers of each. So the overall average class size is 30. But in selecting a random student, it is five times more likely that he or she will come from a class of 50 students than of 10 students. So for every one student who replies “10” to your enquiry about their class size, there will be five who answer “50.” The average class size thrown up by your survey is nearer 50, therefore, than 30. So the act of inspecting the class sizes significantly increases the average obtained compared to the true, uninspected average. The only circumstance in which the inspected and uninspected average coincides is when every class size is equal.

We can examine the same paradox within the context of what is known as length-based sampling. For example, when digging up potatoes, why does the fork go through the very large one? Why does the network connection break down during download of the largest file? It is not because you were born unlucky but because these outcomes occur for a greater extension of space or time than the average extension of space or time.

Once you know about the Inspection Paradox, the world and our perception of our place in it are never quite the same again.

Another day you line up at the medical practice to be tested for a virus. The test is 99% accurate and you test positive. Now, what is the chance that you have the virus? The intuitive answer is 99%. But is that right? The information we are given relates to the probability of testing positive given that you have the virus. What we want to know, however, is the probability of having the virus given that you test positive. Common intuition conflates these two probabilities, but they are very different. This is an instance of the Inverse or Prosecutor’s Fallacy.

The significance of the test result depends on the probability that you have the virus before taking the test. This is known as the prior probability. Essentially, we have a competition between how rare the virus is (the base rate) and how rarely the test is wrong. Let’s say there is a 1 in 100 chance, based on local prevalence rates, that you have the virus before taking the test. Now, recall that the test is wrong one time in 100. These two probabilities are equal, so the chance that you have the virus when testing positive is 1 in 2, despite the test being 99% accurate. But what if you are showing symptoms of the virus before being tested? In this case, we should update the prior probability to something higher than the prevalence rate in the tested population. The chance you have the virus when you test positive rises accordingly. We can use Bayes’ Theorem to perform the calculations.

In summary, intuition often lets us down. Still, by applying the methods of probability and statistics, we can defy intuition. We can even resolve what might seem to many the greatest mystery of them all – why we seem so often to find ourselves stuck in the slower lane or queue. Intuitively, we were born unlucky. The logical answer to the Slower Lane Puzzle is that it’s exactly where we should expect to be!

When intuition fails, we can always use probability and statistics to look for the real answers.

Leighton Vaughan Williams, Professor of Economics and Finance at Nottingham Business School. Read more in Leighton’s new publication Probability, Choice and Reason.

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Categories
Health

Catastrophizing: Why We Wake Around 3am and Dwell on Our Fears and Failures

When I wake at 3 am or so, I’m prone to picking on myself. And I know I’m not the only one who does this. A friend of mine calls 3 am thoughts “barbed-wire thinking,” because you can get caught in it.

The thoughts are often distressing and punitive. Strikingly, these concerns vaporize in the daylight, proving that the 3 am thinking was completely irrational and unproductive.

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I’m a psychology researcher with expertise in mood, sleep, and the circadian system (the internal clock regulating sleep). Here’s what the research says about what may be behind this common experience.

What’s happening in your body at 3 am?

In a normal night’s sleep, our neurobiology reaches a turning point around 3 or 4 am.

Core body temperature starts to rise, sleep drive is reducing (because we’ve had a chunk of sleep), secretion of melatonin (the sleep hormone) has peaked, and levels of cortisol (a stress hormone) are increasing as the body prepares to launch us into the day.

Remarkably, all this activity happens independent of cues from the environment such as dawn light – nature decided long ago that sunrise and sunset are so important that they must be predicted (hence the circadian system).

Man Worried Insomnia

The 3 am thoughts are often distressing, punitive, and painful.

We actually wake up many times each night, and light sleep is more common in the second half of the night. When sleep is going well for us, we are simply unaware of these awakenings. But add a bit of stress and there is a good chance that waking will become a fully self-aware state.

Not surprisingly, there is evidence the pandemic is a sleep-disturbing stressor. So if you’re experiencing 3 am wakings at the moment, you’re definitely not alone.

Stress also impacts sleep in insomnia, where people become hypervigilant about being awake.

Concerns about being awake when one “should” be asleep can cause the person to jolt themselves into anxious wakefulness whenever they go through a light sleep phase.

If that sounds like you, be aware that insomnia responds well to psychological treatment with cognitive behavioral therapy. There’s also a strong link between sleep and depression, so it’s important to speak to your doctor if you have any concerns about your sleep.

Catastrophizing in the wee hours

As a cognitive therapist, I sometimes joke the only thing good about 3 am waking is that it gives us all a vivid example of catastrophizing.

Around this time in the sleep cycle, we’re at our lowest ebb physically and cognitively. From nature’s viewpoint, this is meant to be a time of physical and emotional recovery, so it’s understandable that our internal resources are low.

But we also lack other resources in the middle of the night – social connections, cultural assets, all the coping skills of an adult are unavailable at this time. With none of our human skills and capital, we are left alone in the dark with our thoughts. So the mind is partly right when it concludes the problems it’s generated are unsolvable – at 3 am, most problems literally would be.

Insomnia

The truth is, your brain isn’t really looking for a solution at 3 am.

Once the sun’s up, we’re listening to the radio, chewing our Vegemite toast, and pushing the cat off the bench, and our 3 am problems are put in perspective. We can’t believe the solution of just ringing this person, postponing that thing, or checking such-and-such was overlooked in the wee hours.

The truth is, our mind isn’t really looking for a solution at 3 am. We might think we are problem-solving by mentally working over issues at this hour, but this isn’t really problem-solving; it’s problem-solving’s evil twin – worry.

Worry is identifying a problem, ruminating about the worst possible outcome and neglecting the resources we would bring to bear should the non-preferred outcome actually occur.

So, what can we do about it?

Have you noticed the 3 am thoughts are very self-focused? In the quiet dark, it’s easy to slide unknowingly into a state of extreme egocentricity. Circling round the concept “I,” we can generate painful backward-looking feelings like guilt or regret. Or turn our tired thoughts to the always uncertain future, generating baseless fears.

Buddhism has a strong position on this type of mental activity: the self is a fiction, and that fiction is the source of all distress. Many of us now practice Buddhist-informed mindfulness to manage stress in the daytime; I use mindfulness to deal with 3 am wakings.

I bring my attention to my senses, specifically the sound of my breath. When I notice thoughts arising, I gently bring my attention back to the sound of breathing (pro tip: earplugs help you hear the breath and get out of your head).

Sometimes this meditation works. Sometimes it doesn’t. If I’m still caught in negative thinking after 15 or 20 minutes, I follow the advice from cognitive behavioral therapy, and get up, turn on dim light and read.

This action may seem mundane, but at 3 am it is powerfully compassionate, and can help draw you out of your unproductive thinking.

One last tip: It’s important to convince yourself (during daylight hours) that you want to avoid catastrophic thinking. For good reasons not to worry, you can’t go past the Stoic philosophers.

Waking and worrying at 3 am is very understandable and very human. But in my opinion, not a great habit to get into.

Written by Greg Murray, Professor and Director, Centre for Mental Health, Swinburne University of Technology.

Categories
Health

C. Difficile – Bacteria That Causes Severe Diarrhea – Is Everywhere

  • C. difficile is usually thought of as a hospital-associated infection. However, new research finds 26% of samples from both healthcare and non-healthcare sites tested positive for toxigenic C. difficile strains.
  • Shoe soles had the highest positivity rates, with 45% of samples testing positive for C. difficile.
  • Community stewardship efforts are needed to reduce the risk of C. difficile in communities.

Clostridium difficile or C. diff – a bacteria that causes inflammation of the colon and severe diarrhea – is widely prevalent in non-healthcare settings in the United States and around the world, according to University of Houston researchers who presented at IDWeek.

In a worldwide sample, 26% of environmental samples from health care and non-health care sites tested positive for C. diff strains. Shoe soles had the highest positivity rates, with 45% of samples testing positive for the bacteria.

C. diff is responsible for nearly half a million infections and 15,000 deaths in the United States each year. Until now, its presence in community settings has been largely overlooked.

Clostridium difficile

Clostridium difficile bacterium, 3D illustration.

“C. diff infection was known historically as a hospital-associated infection, and efforts to reduce the infection and control its spread have been focused on hospitals and long-term care facilities,” said Jinhee Jo, a postdoctoral infectious disease fellow at the University of Houston and presenting author. “Recently, cases of community-acquired C. diff have been increasing, which suggests the need for broader community stewardship.”

From 2014 to 2017, researchers collected samples from public areas, health care settings, and shoe soles in the United States and 11 other countries. They compared the rates of C. diff positivity between settings, including shoe soles, which were investigated for their potential role in environmental transmission.

“The results of this study shift our understanding of C. diff, including where it is found, how it is transmitted, and who it affects,” said Kevin W. Garey, professor of pharmacy practice at the UH College of Pharmacy. “We can no longer think of C. diff as only existing in health care settings, and the population at risk is no longer just the very sick patient in the hospital. Identifying that person at risk anywhere in the world should become a priority regardless of whether the person is in a hospital or the community.”

Kevin Garey

Kevin W. Garey, professor of pharmacy practice at the UH College of Pharmacy. Credit: University of Houston

Everyone can take action to prevent infection and reduce the spread of C. diff in the community. Simple measures include practicing proper hand hygiene, cleaning surfaces with chemical disinfectants, and removing shoes before entering a home or common space.

“The bottoms of your shoes aren’t clean,” said Jo. “They may introduce harmful bacteria into your bathroom or kitchen, which could make you sick. The next time you’re coming in from outside, take off your shoes before you enter a highly trafficked room and help reduce the risk of catching C. difficile.”

The study is part of an ongoing effort by University of Houston researchers focused on better understanding C. difficile prevalence worldwide and represents a promising first step toward more effective surveillance, stewardship, and protection.

In addition to Jo and Garey, Anne J. Gonzales-Luna is a co-author of the study.

IDWeek is the joint annual meeting of the Infectious Diseases Society of America (IDSA), Society for Healthcare Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP).

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