The World's Youngest Mother

 

 

World's Youngest Mother

Peruvian five-year-old Lina Medina, accompanied by her 11-month-old-son Gerardo, and Doctor Lozada who attended her son's birth, are shown in this 1940 file photo taken in Lima's hospital.

When her child was born by Caesarean section in May 1939, Medina made medical history, and is still the youngest known mother in the world.

Lina Medina's parents thought their 5-year-old daughter had a huge abdominal tumor and when shamans in their remote village in Peru's Andes could find no cure, her father carried her to a hospital.

Just over a month later, she gave birth to a boy.

Medina was born on September 27, 1933 in the small village of Paurange.  She was only 5 years 8 months old at the birth of her child on Mother's Day, May 14, 1939.

Born at full term at Lima's maternity clinic, her child was taken through a caesarian operation (Dr. Lozada and Busalleu, operators, Dr. Colretta, anesthesiologist). The child (boy), weighing 2,700 grams, was well formed and in good health. Child and mother were able to leave the clinic after only a few days.

Doctor Lozada has conducted very detailed studies since the diagnostic of the pregnancy which aroused much curiosity in the country; he took an x-ray of the child and her baby, established a diagnostic of the fetal situation, observed the state of functionality of the little mother who had begun menstruating at the age of 8 months. At four years old she had already developed breasts as well as pubic hair, her body proportions were a bit amazing and her bone hardening a bit advanced, things that are often observed in cases of such premature pregnancy.

After taunting from schoolmates, Medina's son, Gerardo - who was named after one of the doctors who attended Medina and who became their mentor - discovered when he was 10 that the person he had grown up believing to be his sister was in fact his mother.

Gerardo died in 1979 at age 40 from a disease that attacks the body's bone marrow, but it was said it was not clear there was any link with his illness and the fact his mother had been so young at his birth.

Medina herself married and in 1972 had a second son, 33 years after her first.  Her second child now lives in Mexico.

 

 

 

 

Bannister, 85, Reflects 60 Years After Breaking the Four-Minute Mile

 

By THE ASSOCIATED PRESS - MAY 3, 2014

 

Roger Bannister broke the four-minute mile on May 6, 1954. “It just didn’t seem to be capable of being broken,” he said. Credit Associated Press

OXFORD, England — Roger Bannister is busy reliving the four minutes that endure as a transcendent moment in sports history.

On a wet, blustery spring day, May 6, 1954, Bannister, then 25 and a lanky English medical student, became the first runner to break the four-minute barrier in the mile, a feat that many had thought was impossible.

Paced by two other runners, Bannister completed four laps around a cinder track here in 3 minutes 59.4 seconds, a milestone that captured the world’s fascination and still resonates.

“It was a target,” Bannister, now 85, said at his Oxford home, a short distance from the Iffley Road track where he made history. “University athletes had been trying for years, and it just didn’t seem to be capable of being broken. There was this magic about four symmetrical laps of one minute each.

“It was just something which caught the public’s imagination. I think it still remains something that is of interest and intrigue.”

Bannister’s record lasted only 46 days, and he considers his victory over his Australian rival John Landy a few months later as his greatest running exploit.

Yet, as the 60th anniversary attests, Bannister’s 3:59.4 remains part of track and field lore, a symbol of boundary-breaking endurance that stands the test of time.

It is only a slice of Bannister’s life story. He retired from running at the end of 1954 and pursued a long career in neurology that he considers more significant than anything he accomplished on the track.

“Medicine, without a doubt,” Bannister said when asked about his proudest achievement. “I wouldn’t claim to have made any great discoveries, but at any rate I satisfactorily inched forward in our knowledge of a particular aspect of medicine. I’m far more content with that than I am about any of the running I did earlier.”

Knighted in 1975, Bannister is slowing down as the years pass. He is coping with the effects of Parkinson’s disease, a neurological ailment that falls under his medical specialty.

“I know quite a bit about it, which is both helpful and unhelpful,” Bannister said, sitting in his living room lined with photos and mementos of his running and medical career. “But I’m 85 and something has to happen.”

Bannister’s right ankle was shattered in a car accident in 1975, and he has been unable to run since then. Now, he walks with crutches inside his home and uses a wheelchair outdoors.

Hundreds of athletes have run the mile in less than four minutes since Bannister did it, and the world record has been broken 18 times since then. The current mark of 3:43.13 was set by Morocco’s Hicham el-Guerrouj in 1999.

The next barrier in the sport? Bannister believes the two-hour mark in the marathon will be broken in the next few years. The fastest time is 2:03.23, by Kenya’s Wilson Kipsang in Berlin in 2013.

“It involves a 2 percent improvement,” Bannister said. “It has to be run on a day with the right temperature and on a course which isn’t too hilly, preferably a course which is a single line with the wind at your back all the way. It’ll be done.”

Bannister and his wife of 58 years, Moyra, will mark Tuesday’s anniversary at Oxford University with family and friends: a lunch at Exeter College, where Bannister enrolled in 1946, and a ceremony at Vincent’s Club, an elite 150-year-old sports club.

Missing will be Bannister’s pace runners, Chris Brasher and Chris Chataway. Brasher, who founded the London Marathon, died in 2003 at 74. Chataway died last January at 82.

“I miss them very much,” Bannister said. “We used to meet on the anniversary on May 6 with our wives, and sometimes with children, and have a kind of party and reflect.”

Bannister has published an autobiography, “Twin Tracks.” The book, which grew out of letters to his 14 grandchildren, traces his family’s origins in Lancashire in northwest England, his growing up in the London borough of Harrow, and his athletic, medical and academic life.

Bannister went to the 1952 Helsinki Olympics in Finland as a favorite in the 1,500 meters — the shorter metric mile run in the Olympics — but struggled with the addition of an extra day of heats and finished fourth.

Retirement plans were put aside, and Bannister decided to run for two more years and chase the four-minute mile. The Swedish runner Gunder Hagg’s record of 4:01.4 had stood since 1945. Landy and Wes Santee of the United States had each run 4:02 and were competing with Bannister to be the first under 4:00.

Bannister recalled: “At one point, Landy said: ‘It’s like a brick wall. I’m not going to attempt it again.’ I, as a medical student, knew there wasn’t a brick wall. If you could run it in 4 minutes and 2.2 seconds, then you would find somebody else somewhere who trained a little better, had better conditions on the day, was able to use the pace judgment better, and they could do it. That was the frame of mind in which I approached it.”

Nanotubes help healing hearts keep the beat

 

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Carbon nanotubes serve as bridges that allow electrical signals to pass unhindered through new pediatric heart-defect patches invented at Rice University and Texas Children's Hospital.

A team led by bioengineer Jeffrey Jacot and chemical engineer and chemist Matteo Pasquali created the patches infused with conductive single-walled carbon nanotubes. The patches are made of a sponge-like bioscaffold that contains microscopic pores and mimics the body's extracellular matrix.

The nanotubes overcome a limitation of current patches in which pore walls hinder the transfer of electrical signals between cardiomyocytes, the heart muscle's beating cells, which take up residence in the patch and eventually replace it with new muscle.

The work appears this month in the American Chemical Society journal ACS Nano. The researchers said their invention could serve as a full-thickness patch to repair defects due to Tetralogy of Fallot, atrial and ventricular septal defects and other defects without the risk of inducing abnormal cardiac rhythms.

The original patches created by Jacot's lab consist primarily of hydrogel and chitosan, a widely used material made from the shells of shrimp and other crustaceans. The patch is attached to a polymer backbone that can hold a stitch and keep it in place to cover a hole in the heart. The pores allow natural cells to invade the patch, which degrades as the cells form networks of their own. The patch, including the backbone, degrades in weeks or months as it is replaced by natural tissue.

Researchers at Rice and elsewhere have found that once cells take their place in the patches, they have difficulty synchronizing with the rest of the beating heart because the scaffold mutes electrical signals that pass from cell to cell. That temporary loss of signal transduction results in arrhythmias.

Nanotubes can fix that, and Jacot, who has a joint appointment at Rice and Texas Children's, took advantage of the surrounding collaborative research environment.

"This stemmed from talking with Dr. Pasquali's lab as well as interventional cardiologists in the Texas Medical Center," Jacot said. "We've been looking for a way to get better cell-to-cell communications and were concentrating on the speed of electrical conduction through the patch. We thought nanotubes could be easily integrated."

Nanotubes enhance the electrical coupling between cells that invade the patch, helping them keep up with the heart's steady beat. "When cells first populate a patch, their connections are immature compared with native tissue," Jacot said. The insulating scaffold can delay the cell-to-cell signal further, but the nanotubes forge a path around the obstacles.

Jacot said the relatively low concentration of nanotubes -- 67 parts per million in the patches that tested best -- is key. Earlier attempts to use nanotubes in heart patches employed much higher quantities and different methods of dispersing them.

Jacot's lab found a component they were already using in their patches -- chitosan -- keeps the nanotubes spread out. "Chitosan is amphiphilic, meaning it has hydrophobic and hydrophilic portions, so it can associate with nanotubes (which are hydrophobic) and keep them from clumping. That's what allows us to use much lower concentrations than others have tried."

Because the toxicity of carbon nanotubes in biological applications remains an open question, Pasquali said, the fewer one uses, the better. "We want to stay at the percolation threshold, and get to it with the fewest nanotubes possible," he said. "We can do this if we control dispersion well and use high-quality nanotubes."

The patches start as a liquid. When nanotubes are added, the mixture is shaken through sonication to disperse the tubes, which would otherwise clump, due to van der Waals attraction. Clumping may have been an issue for experiments that used higher nanotube concentrations, Pasquali said.

The material is spun in a centrifuge to eliminate stray clumps and formed into thin, fingernail-sized discs with a biodegradable polycaprolactone backbone that allows the patch to be sutured into place. Freeze-drying sets the size of the discs' pores, which are large enough for natural heart cells to infiltrate and for nutrients and waste to pass through.

As a side benefit, nanotubes also make the patches stronger and lower their tendency to swell while providing a handle to precisely tune their rate of degradation, giving hearts enough time to replace them with natural tissue, Jacot said.

"If there's a hole in the heart, a patch has to take the full mechanical stress," he said. "It can't degrade too fast, but it also can't degrade too slow, because it would end up becoming scar tissue. We want to avoid that."

Pasquali noted that Rice's nanotechnology expertise and Texas Medical Center membership offers great synergy. "This is a good example of how it's much better for an application person like Dr. Jacot to work with experts who know how to handle nanotubes, rather than trying to go solo, as many do," he said. "We end up with a much better control of the material. The converse is also true, of course, and working with leaders in the biomedical field can really accelerate the path to adoption for these new materials."

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Story Source:

The above story is based on materials provided by Rice University. The original article was written by Mike Williams. Note: Materials may be edited for content and length.

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Journal Reference:

1. Seokwon Pok, Flavia Vitale, Shannon L. Eichmann, Omar M. Benavides, Matteo Pasquali, Jeffrey G Jacot. Biocompatible Carbon Nanotube – Chitosan Cardiac Scaffold Matching the Electrical Conductivity of the Heart. ACS Nano, 2014; 140918182222001 DOI: 10.1021/nn503693h

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Interface surprises may motivate novel oxide electronic devices

 

"In highly correlated electron systems, physical properties are interconnected like a tangle of strings," said Albina Borisevich of the Department of Energy's Oak Ridge National Laboratory. "You don't always know what will happen when you pull on one string. Often one string takes others with it."

Borisevich led a project that made a surprising discovery -- that intrinsic electric fields can drive oxygen diffusion at interfaces in engineered thin films made of complex oxides. The study is published in the September issue of Nature Materials.

Increased understanding of the properties of complex oxides will improve the ability to predict and control materials for new energy technologies. Researchers can custom-build complex oxides to pull on specific strings by changing an oxide's chemical composition or layering it with metals or insulators. These novel materials may exhibit magnetic, electrical and mechanical properties, alone or in combination, that enable feats not possible today, such as electric-field-based data storage that is more energy-efficient than today's magnetic memory or more efficient fuel cells that alter the concentration of charged atoms, or ions, at sites of key chemical reactions.

"Add more metal types and you've added more functionality. But you've also added more complexity," Borisevich said. "At the interface between two materials, complexity goes through the roof."

Collaborating to conquer complexity

The surprising discovery that intrinsic electric fields can drive oxygen diffusion at interfaces of complex oxides may serve as a basis for design of new electronic devices utilizing both electrons and ions.

The researchers, from Korea, Norway, Ukraine and the United States, observed the effect in ferroelectrics, materials that exhibit switchable electrical polarization, or asymmetric distribution of positive and negative electrical charges. Ferroelectrics usually have regions, or domains, that can be as small as several nanometers, with different directions of polarization. Their properties are used in some memory devices, where domains with positive and negative polarization serve as "bits" that encode information. However, the longevity of these devices and the power required to "write" information is determined by what is happening at interfaces between the positively or negatively polarized ferroelectric domains and their metallic substrates.

The researchers examined metal-ferroelectric interfaces for positively and negatively polarized domains. Their major finding was that, depending on the charge, either purely electrical or combined electrical and chemical phenomena were at play.

When a ferroelectric is joined with another material, polarization causes charges to accumulate at the interface. This excess charge is called "polarization charge." The collaborators found that the interface of the ferroelectric material behaved differently depending on the sign of the polarization charge (positive or negative).

At the interface with positive polarization charge, negatively charged electrons were syphoned in from the metal to attenuate it. Surprisingly, for negative polarization charge, the opposite did not happen -- that is, electrons were not pushed out of the interface region. Instead, negatively charged oxygen ions left, creating defects called oxygen vacancies.

"With the change of polarization charge, not only the sign but the physical nature of the compensating chemical species changes," said Borisevich, who works in ORNL's Materials Science and Technology Division. "Charge compensation by oxygen vacancies highlights the important role of ionic phenomena in oxide electronics and opens a pathway for new device concepts." For example, someday engineers may design devices in which ions manipulate electrical response or vice versa.

Two compensatory mechanisms

On a substrate of strontium titanate (SrTiO3), the researchers layered a metallic oxide called lanthanum strontium manganite, or (La0.67Sr0.33)MnO3 (LSMO), an electrical contact providing a reservoir of electrons. Atop the metal layers they added layers of an insulator, a ferroelectric material called bismuth ferrite, or BiFeO3 (BFO).

To explore electronic and chemical effects induced by ferroelectric polarization at the interface of the metal and the insulator, the researchers coupled two techniques. First, aberration-corrected scanning transmission electron microscopy (STEM) mapped, at the atomic level, polarization changes throughout the ferroelectric material and its interface with the metal. It demonstrated structural distortions at the interface between the ferroelectric material and the metal on the side of the material with negative polarization charge but not on the side with positive charge.

Second, electron energy-loss spectroscopy (EELS), which provides chemical information, indicated sites of oxygen-atom depletion and oxidation-state changes of iron and manganese metals. This tool allowed the researchers to track the decrease in oxygen concentration occurring at the interface with negative polarization charge. It also demonstrated that the valence state, which gives an atom power to combine with other atoms, was different in the metal manganese at the two different interfaces. The experimental observations coupled with theoretical results built a strong case for oxygen vacancy compensation of charge for the side of the material with negative polarization and electronic compensation for the positive side.

The exact nature of the compensating species at ferroelectric interfaces can have a significant effect on switching behavior because not only electrons but also ions need to move at the interface when the polarization charge is switched. The study therefore suggests a promising role for electrochemical phenomena at oxide interfaces, opening possibilities for fine-tuning switching by engineering local oxygen concentration.

Said Borisevich, "In the future, we want to move beyond tracking different aspects of interface properties at the atomic scale and toward coming up with a desired static and/or dynamic behavior and then making it happen at the intersection of electronic and chemical/electrochemical phenomena characteristic of these systems."

The title of the study is "Direct observation of ferroelectric field effect and vacancy-controlled screening at the BiFeO3/LaxSr1-xMnO3 interface." Young-Min Kim of the Korea Basic Science Institute did imaging and spectroscopy at ORNL, conducting STEM/EELS study and data analysis; Anna Morozovska and Eugene Eliseev of the National Academy of Sciences of Ukraine did device-level modeling, Mark Oxley of Vanderbilt University did EELS profile simulations; Rohan Mishra of Vanderbilt University, who is a visiting scientist at ORNL, and S. T. Pantelides, who holds joint appointments at Vanderbilt and ORNL, conducted first principles calculations; Sverre Selbach and Tor Grande of the Norwegian University of Science and Technology provided solid-state chemistry reasoning; and Sergei Kalinin of ORNL and the Center for Nanophase Materials Sciences and Albina Borisevich of ORNL conceived and directed the project.

The nostalgia machine

 

http://bit.ly/1sqzpgC

 

 

'Brain Breaks' increase activity, educational performance in elementary schools

 

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A recent Oregon survey about an exercise DVD that adds short breaks of physical activity into the daily routine of elementary school students found it had a high level of popularity with both students and teachers, and offered clear advantages for overly sedentary educational programs.

Called "Brain Breaks," the DVD was developed and produced by the Healthy Youth Program of the Linus Pauling Institute at Oregon State University, and is available nationally.

Brain Breaks leads children in 5-7 minute segments of physical activity, demonstrated by OSU students and elementary school children from Corvallis, Oregon. The short periods of exercise aim to improve the physical health, mental awareness and educational success of children.

"We're increasingly recognizing the importance of physical activity for children even as the academic demands placed on them are cutting into the traditional programs of recess and physical education," said Gerd Bobe, an assistant professor in the OSU College of Agricultural Sciences, an expert in public health nutrition and behavior, and principal investigator with the Linus Pauling Institute.

"Kids need to move, they can't just sit all day long," Bobe said. "Given the time constraints and multiple demands that schools are facing, we really believe the concept of short activity breaks, right in the classroom, is the way to go."

Oregon law, for instance, mandates that by 2017 elementary schools will be required to have 30 minutes a day of physical education classes, in addition to recess periods. But a survey conducted by the Healthy Youth Program found that 92 percent of Oregon public elementary schools currently do not meet this standard. And sometimes, Bobe said, elimination of recess is used as a disciplinary tool, potentially taking activity away from those students who may need it the most.

Brain Breaks was created to bring more activity back into classrooms, especially when it may be most useful -- in the afternoon after lunch, for instance, when attention spans and concentration tend to waver. Research has shown that physical activity can increase academic performance, student focus and classroom behavior, Bobe said.

The program offers a variety of segments, including six based on stretching and relaxation, five on endurance, and one on strength, with imaginative concepts such as "space adventures" and "crazy kangaroos." No equipment is needed, other than a chair for the strength segment, and all activities can be done in a classroom setting. An abstract of the work has been published in the Journal of Nutrition Education and Behavior.

A recent survey of the Healthy Youth Program that was sent to participating Oregon school districts found that:

• Almost all teachers said the program was appropriate for their classes and well-understood by the class;

• More than 90 percent of teachers said the exercise segments had the right length, and that students were more focused after using the program;

• All of the segments were popular with more than 80 percent of students, but the stretching and relaxation activities had the highest approval, at 95 percent, and were also most frequently used by teachers;

• About three-fourths of the teachers were using the program two to three times per week, and more than 90 percent plan to continue its use.

"Longer periods of exercise have a place, but research shows that these short programs can be very valuable as well," Bobe said. "They can increase oxygen consumption, range of motion, endurance, and get kids in the habit of being more active. A little bit of exercise can go a long way."

A second edition of the DVD is being developed, Bobe said. More information on the DVD is available online at http://lpi.oregonstate.edu/healthyyouth/media/brainbreaks.shtml, including a video trailer and how to buy a copy.

"This survey shows a program that's working and is valuable," Bobe said. "We hope it becomes popular across the nation."

Sex Lies We're Told to Believe

 

Giorgio Majno/Photographer's Choice/Getty Images

The messages we receive about sex from our parents, the media, and our educational, social, and religious institutions tend to be contradictory, and often downright false. One way to combat the lies we’re told about sex is to start cataloging them.

Lie #1: Sex is all in the genes:  We are puppets, lucky to be getting our strings pulled now and then.
Because procreation is tied to our species survival, evolutionary scientists and pop psychologists alike argue that the most important understanding of sexuality is the one that links our sexual behavior to procreation. Thus we are told that male sexuality is voracious and dangerous, that female sexuality is a side effect of the need for women to have babies, and that the psychological, emotional, and spiritual aspects of sexuality are not as important as the genetic ones. And most disaterously, from the earliest lessons about sex, it's always tied to reproduction.  Of course there is a genetic component to sex, but that doesn’t mean that it is either the most useful, or “truest” perspective from which to think about our sexuality.

Lie #2: Sex is natural and simple: You should just know how to do it.
Sex is natural, we’re told, because we have to do it to survive. But this doesn’t accurately describe what human sexuality has become. Intercourse may be instinctual for some (but clearly not all) of us, but sexuality is much more than intercourse, and none of it actually comes easily. It’s it strange that we are taught how to perform most other basic human behaviors (how to eat, how to communicate, how to go to the bathroom) and as we get older we learn the more complicated ones (how to read, write, drive a car, work) and yet we’re just supposed to know how to have sex.

Lie #3: Sex is gender: Men are from sex-crazed Mars; women are from soft and romantic Venus.
This lie takes many forms:

• Women just want to cuddle, men want to have raunchy sex.
• Women are sexual communicators, men can’t talk about their sexual feelings.
• ”Real sex” takes place between a man and a woman.
• Men and women can’t ever be friends, sex always gets in the way.
• Men want sex all the time, and women don’t.
• Men are more visual than women when it comes to sexual arousal.

All of these are variations on the big double-shot sex lie: That sex is 100% tied to our gender, and each of us can fit neatly into one of two categories.  The fact is that how we think about, feel about, and actually have sex is infinitely more complicated than which door we walk through in a public washroom.

Lie #4: Sex is spontaneous: Don’t talk about it, just do it.
When you think of it, this lie about sex doesn’t make any sense. If sex is meant to be something fun and exciting, something that makes you feel good about your body and yourself, makes you feel loved and attended to, why would planning for sex ever be a bad thing? Wouldn’t it actually be nice to know you’re going to get to have sex at the end of a particularly hard day? Yet we’re told that the most exciting sex is the sex that “just happens”. In reality, sex rarely “just happens”. It’s true that many couples never talk about sex beforehand, but that doesn’t mean that one (or more likely both) partners aren’t thinking about it, wondering when they’re going to have it next, and fantasizing about what kind of sex it will be.

Lie #5: Bigger is better, more is better…better is better.
These statements are true for some people, some of the time. The specific lie we’re told is that these things are true for everyone, all of the time. In reality people have size preferences that change depending on their mood and what sort of sex they want to have. Similarly, we all have different levels of sexual desire, and these levels can change throughout the month, and over the years. Finally, there is a more contemporary lie that tells us we should always be reaching for better sex, trying new things, pushing ourselves and our partners to attain new heights of great sex. Some researchers have pointed out that this competitive attitude can have the opposite effect, making us anxious and on edge about the sex we’re having.

Lie #6:  Sex is special: It’s a rare transformative moment that only comes once in a while.
On one hand, it’s true that sex can be transformative and that some of us don’t get to have sex as often as we’d like, but on the other hand, sex is an incredibly common and regular occurrence. Yet many of us are raised to think of sex like it’s a non-renewable resource that’s about to dry up. If instead we put sex in its place among all our other activities of daily living and all the ways we communicate with the people around us, we might have a lot less anxiety about how we’re doing it, when we’re doing it, if we’re doing it right, and who we’re doing it with. Sex doesn’t need to be treated with kid gloves, it can take it, if we start to dish it out.

Lie #7: We can make it on our own: Sexual agency is the same as sexual independence.
We can thank the mostly positive influence of the women’s movement on sexual expression for this subtle lie. What’s true is that we all have a right to sexual agency -- to experience sexual pleasure on our own terms, think sexual thoughts, and have sexual desires separate from those around us. But the silent lie is that sexual agency equals complete independence. In truth, none of us are completely independent from those around us, and we rely on others in ways few of us acknowledge. Among the few people who have managed to really figure this out are folks living with disabilities who require assistance with regular daily activities. When you rely on others for some form of help, it becomes very apparent the way we are all connected. If you don’t, you can go through life imagining that you’d be fine without anyone around. Yet even masturbation, which is often fueled by sexual fantasy, requires some external stimulation (even if you’re only dreaming of the UPS guy or gal, they’re still involved to some extent).

Lie #8:  There’s a right way and a wrong way to have sex.
Whether we’re being told we have to do it with someone else (masturbation isn’t “real” sex), we have to do it with someone of the opposite sex, we have to do it in a bed, 2.5 times a week, or some other form of this lie, there are no lack of people who want to feed you the lie that there is only one (or two) right ways to have sex. The truth is that there are no rules (beyond age and consent) to how you can have healthy and fun sex. Whenever you catch someone feeding you this lie, call them on it.

Lie #9: Great sex is all about…
Is it about sexual technique? Is it sexual communication? Is it the “spark”, or the bed sheets, or the sex toys, or the weather system? Amazon lists over 150 books with great sex in the title, each one offering you an endless stream of advice on what constitutes great sex. It’s no lie that great sex can be had, but the lie is that one person’s great sex will be your great sex. Great sex probably isn’t like a great chocolate chip cookie recipe, which works best if you follow the directions to the letter. Learning more about sex can probably only add to your experience of good sex, but in the absence of any proof, I’m going to go out on a limb and suggest that great sex happens in the way you uniquely put it all together, not in following a step by step guide book written by someone whose main goal is to sell you a book.

Este Médico Vai Economizar Seu Dinheiro

 

Eric Topol está em uma missão para tirar os cuidados com a saúde da confusão na qual estão.

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• Por Jon Cohen
• Tradução por Elisa Matte (Opinno)

Imagem: Dados Médicos: Eric Topol falando em uma conferência em 2012 sobre os usos da tecnologia sem fio na medicina.

Eu visitei o cardiologista Eric Topol no Scripps Green Hospital em La Jolla, Califórnia, um dia neste verão. Ele teve uma manhã movimentada atendendo pacientes vendo e, por volta do meio dia, estava afirmando já ter poupado milhares de dólares para o sistema de saúde usando seu iPhone e uma máquina de ultrassom de bolso. Em seguida, ele apontou para o estetoscópio em seu bolso e disse que ele não o usa há três anos. "Eu deveria simplesmente jogá-lo fora", disse ele. "Este é basicamente um ícone inútil da medicina."

Topol é, talvez, o mais proeminente defensor nos EUA de como a tecnologia digital pode levar a cuidados com a saúde mais baratos e ele me convidou para ver suas economias em ação. Enquanto nos dirigíamos para a sala de exame, Topol, ligeiramente curvado e virando várias vezes para lidar com questões arremessadas a ele por sua equipe, parece um pouco abalado pela comoção e enxurrada de demandas, mas uma calmaria se instala no momento em que ele entra na sala de exame. Ele cruza os braços sobre o peito, enquanto um jovem colega o ataliza com o histórico do paciente. Topol se apresenta ao homem de 85 anos de idade, que tem se cansado facilmente ultimamente e, em seguida, o médico puxa imediatamente o seu iPhone.

Topol, que desde 2007 tem promovido agressivamente a digitalização da medicina, não verifica seu e-mail, não busca nada no Google, nem liga para uma farmácia. Ao contrário, ele coloca o que parece ser uma caixa de proteção no telefone. O exterior da caixa tem duas pastilhas de metal ovais que são eletrodos, e Topol pede ao seu paciente que coloque os polegares sobre eles.

"Ele está bradicárdico sem nenhuma boa razão para estar bradicárdico" Topol diz a seu colega, Hashim Khan, enquanto observa um gráfico de bips atravessa a tela do seu telefone. Ele olha para mim. "Nós economizamos USD$ 100 para cada um desses que fazemos."

O acessório para o iPhone é uma versão de 199 dólares de uma máquina de eletrocardiograma de grau hospitalar que é vendida por muito mais. Ao fazer a leitura do ritmo cardíaco ele mesmo, Topol diz que ele poupa o paciente de ir a uma estação especial com um técnico treinado que vai gastar 15 minutos para ligar fios a ele.

Momentos depois, Khan tira um Vscan, um aparelho de ultrassom feito pela GE Healthcare, que se assemelha a um grande telefone que abre e fecha antigo. Com Topol olhando, Khan esguicha gel no peito do homem e, em seguida, verifica as câmaras do seu coração com uma varinha conectado ao dispositivo. "Sua função não parece realmente tão ruim", diz Topol, acrescentando que a maioria dos médicos cobra USD$ 600 para fazer um ultrassom usando uma máquina de USD$ 350.000. Mas Topol não cobra nada quando ele é feito como parte de um exame físico de rotina como este. "Há 125 milhões de exames com ultrassom feitos nos Estados Unidos a cada ano", diz Topol, sacudindo a cabeça. Ele diz que "provavelmente 80 por cento" deles poderiam ser feitos com o Vscan sem nenhum custo extra.

Topol é um médico em uma missão e não pela primeira vez. Uma década atrás, ele estava no centro de uma outra batalha sobre evidências médicas e lucros bilionários. Aquela, envolvendo o medicamento para dor Vioxx, acabou com um medicamento que valia USD$ 2,5 bilhões por ano sendo retirado do mercado depois que Topol e outros levantaram preocupações com a sua segurança. Em 2007, quando Topol chegou ao Scripps, ele começou com a demagogia novamente, desta vez proselitisando contra o que ele chama de prática americana de vender "medicina por estaleiro" ou de favorecer as tecnologias que aumentam a receita.

Topol, que lidera o Scripps Translational Science Institute, tem muitos ferros no fogo. Um estudo com idosos saudáveis (Wellderly, como o chama) em andamento deverá analisar os genomas de 2.000 pessoas saudáveis ​​com mais de 85 anos, em busca de pistas para explicar por que eles ganharam na loteria da saúde. Outro estudo conduzido por Topol pergunta se o ZioPatch, um monitor cardíaco do tamanho de um Band-Aid que as pessoas usam por até duas semanas, pode detectar arritmias cardíacas mais facilmente do que o monitor Holter desajeitado usado por 50 anos. O monitor Holter depende que fios ligados a diferentes partes do peito enviem sinais a um dispositivo usado em volta do pescoço ou no quadril.

Em última análise, Topol prevê, que a tecnologia digital vá levar à "hiper personalização dos cuidados com a saúde" e a inovações que economizam bilhões e bilhões de dólares. "Pela primeira vez, talvez, na história da tecnologia na medicina, podemos ver que você pode melhorar os resultados para os pacientes e reduzir os custos", diz ele.

Topol firmou sua reputação de Dr. Digital em 2011, quando ele usou seu iPhone para diagnosticar um ataque cardíaco em um passageiro em um vôo comercial de Washington D.C. para San Diego, forçando o avião a pousar em Indianápolis. Mas nem todo mundo acredita que tecnologias menores, mais baratas e mais fáceis de usar vão economizar dinheiro. Céticos dizem que Topol não leva em conta que mais dados, mesmo que sejam confiáveis, simplesmente levam a mais intervenções médicas, muitas das quais podem ser desnecessárias.

Considere hospitais do sono. Topol diz que acessórios para smartphones que medem o uso de oxigênio e o pulso podem diagnosticar a apnéia do sono sem a necessidade de alguém passar uma noite em um hospital do sono, que custa milhares de dólares. "Falar de tirá-los do negócio", diz Topol. "Nós podemos fazer um teste de triagem que é basicamente grátis através de um smartphone".

Mas Steven Poceta, neurologista do Scripps que é especialista em distúrbios do sono, diz que Topol exagera seu caso. "Nós quase nunca colocamos alguém no laboratório do sono para 'triagem' ", diz Poceta, notando que as máquinas portáteis de diagnóstico há tempos permitem testes caseiros de baixo custo. Além disso, a apnéia do sono é "largamente subdiagnosticada", então a detecção por smartphones - à qual Poceta dá boas vindas - pode elevar os custos dos cuidados com a saúde. "Por uma questão de negócio, o maior número de pessoas sendo avaliada vai revelar um maior número de pessoas precisando de experts e do hospital do sono", diz ele.

Embora Topol esteja inclinado a ignorar seus críticos por terem pensamentos retrógrados, ele concorda que cada novo dispositivo terá que ganhar seu lugar no arsenal. "Você precisa provar para a comunidade médica que ele realmente gera um menor custo e melhora os resultados", diz ele. "Nós não queremos que esta fase da medicina sem fio e desconectada seja deixada no campo das inovações não validadas. Isso não vai ajudar ninguém."

Ele está liderando um novo estudo chamado "Conectados pela Saúde", que irá avaliar o valor econômico dos três dispositivos sem fio comerciais (AliveCor, o monitor de pressão arterial da Withings e um medidor de glicose para iPhone) em 200 pacientes com transtornos de diabetes, hipertensão arterial e do ritmo cardíaco, o tipo de doentes crônicos que correspondem a cerca de 80 por cento de todas as despesas médicas do país. O estudo controlado dará os dispositivos a apenas metade dos participantes e avaliará se rastrear ativamente sua saúde reduz os custos dos cuidados com a saúde.

Outro dos projetos de Topol, uma colaboração com a Caltech, pretende colocar um sensor sem fio em uma artéria. O sensor teria cerca de um terço do tamanho de um grão de areia e vai ficaria parado e iria potencialmente detectar um ataque cardíaco iminente. Se funcionar melhor, poderia prevenir ataques cardíacos - um resultado que Topol diz não necessitar de um estudo de custo-efetividade.

"Você sabe qual é o custo de ter um ataque cardíaco?" pergunta Topol, incrédulo com a noção de que alguém precisaria de evidencias para provar este ponto.

Esta história foi atualizada em 09 de setembro para corrigir detalhes sobre a pesquisa do ZioPatch, a colaboração de Topol com a Caltech e o preço de uma máquina de ultrassom.

Get into Action: 77 Thoughts on Motivation

 

You have a fire inside you, a frictional energy, read these thoughts, think about them and let them propel you into action.

1. “I paint very large pictures. I realize that historically the function of painting large pictures is painting something very grandiose and pompous. The reason I paint them, however – I think it applies to other painters I know – is precisely because I want to be very intimate and human. To paint a small picture is to place yourself outside your experience. However you paint the larger picture, you are in it.” - Mark Rothko

2. “Obstacles are those frightful things you see when you take your eyes off your goal.” - Henry Ford

3. “Only those who will risk going too far can possibly find out how far one can go.” -T.S. Eliot

4. “Great spirits have always encountered violent opposition from mediocre minds.” - Albert Einstein

5. “Knowing is not enough; we must apply. Willing is not enough; we must do.” - Goethe

6. “The best way out is always through.” - Robert Frost

7. “Work spares us from three evils: boredom, vice, and need.” - Voltaire

8. “We are all inventors, each sailing out on a voyage of discovery, guided each by a private chart, of which there is no duplicate. The world is all gates, all opportunities.” - Emerson

9. “When the water starts boiling it is foolish to turn off the heat.” - Nelson Mandela

10. “It's kind of fun to do the impossible.” - Walt Disney

11. "Stay Hungry. Stay Foolish." - Steve Jobs

12. "The distance between insanity and genius is measured only by success." - Bruce Feirstein

13. "In Italy for thirty years under the Borgias they had warfare, terror, murder, bloodshed - they produced Michelangelo, Leonardo da Vinci, and the Renaissance. In Switzerland they had brotherly love, five hundred years of democracy and peace, and what did they produce? - the cuckoo clock.
" -Orson Wells

14. "Many are stubborn in pursuit of the path they have chosen, few in pursuit of the goal." - Nietzsche

15. “Life is pretty simple: You do some stuff. Most fails. Some works. You do more of what works. If it works big, others quickly copy it. Then you do something else. The trick is the doing something else.” - Leonardo da Vinci

16. “It's not the size of the dog in the fight, it's the size of the fight in the dog.” - Mark Twain

17. “Life's a bitch. You've got to go out and kick ass.” - Maya Angelou

18. “Take calculated risks. That is quite different from being rash.” - George S. Patton

19. “Action expresses priorities.” - Mahatma Gandhi

20. “Live the life you've dreamed” - Henry David Thoreau

21. “It's a funny thing about life; if you refuse to accept anything but the best, you very often get it.” - William Somerset Maugham

22. "I hated every minute of training, but I said, 'Don't quit. Suffer now and live the rest of your life as a champion.' " - Muhammad Ali

23. “I am always doing that which I cannot do, in order that I may learn how to do it.” - Pablo Picasso

24. “What is not started today is never finished tomorrow.” - Goethe

25. “I do not think there is any thrill that can go through the human heart like that felt by the inventor as he sees some creation of the brain unfolding to success... Such emotions make a man forget food, sleep, friends, love, everything.” - Tesla

26. “Entrepreneurs are simply those who understand that there is little difference between obstacle and opportunity and are able to turn both to their advantage.” - Machiavelli

27. “Eureka! I've got it.” - Archimedes

28. “I owe my success to having listened respectfully to the very best advice, and then going away and doing the exact opposite.” - G. K. Chesterton

29. “The young do not know enough to be prudent, and therefore they attempt the impossible — and achieve it, generation after generation.” - Pearl S. Buck

30. “A business has to be involving, it has to be fun, and it has to exercise your creative instincts.” – Richard Branson

31. "There is a tide in the affairs of men
Which, taken at the flood, leads on to fortune;
Omitted, all the voyage of their life
Is bound in shallows and in miseries.
On such a full sea are now afloat;
And we must take the current when it serves,
Or lose the ventures before us" - William Shakespeare

32. “Hell! There ain't no rules around here! We're trying to accomplish somep'n” - Thomas Edison

33. “There are those who are so scrupulously afraid of doing wrong that they seldom venture to do anything.” - Vauvenargues

34. “Our belief at the beginning of a doubtful undertaking is the one thing that assures the successful outcome of any venture” - William James

35. “Man cannot discover new oceans unless he has the courage to lose sight of the shore.” - André Gide

36. “Age considers; youth ventures.” - Rabindranath Tagore

37. “Forget past mistakes. Forget failures. Forget everything except what you're going to do now and do it.” - Billy Durant

38. “The two important things I did learn were that you are as powerful and strong as you allow yourself to be, and that the most difficult part of any endeavour is taking the first step, making the first decision.” - Robyn Davidson

 

39. “It's not because things are difficult that we dare not venture. It's because we dare not venture that they are difficult.” - Seneca

40. “Most people can do extraordinary things if they have the confidence or take the risks. Yet most people don't. They sit in front of the telly and treat life as if it goes on forever.” - Phillip Adams

41. “Small opportunities are often the beginning of great enterprises.” - Demosthenes

42. “A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty.” - Winston Churchill

43. “In Ourselves are Triumphs and Defeats.” -Longfellow

44. “It matters not the number of years in your life. It is the life in your years.” - Abraham Lincoln

45. “Keep away from people who try to belittle your ambitions. Small people always do that, but the really great make you feel that you, too, can become great.” - Mark Twain

46. “As soon as the fear approaches near, attack and destroy it.” - Chanakya

47. “The ones who want to achieve and win championships motivate themselves.” - Mike Ditka

48. “Motivation is simple. You eliminate those who are not motivated.” - Lou Holtz

49. “You have to expect things of yourself before you can do them.” - Michael Jordan

50. “One of the things that my parents have taught me is never listen to other people's expectations. You should live your own life and live up to your own expectations, and those are the only things I really care about.” - Tiger Woods

51. “Men give away nothing so liberally as their advice.” - François de La Rochefoucauld

52. “I still feel like I gotta prove something. There are a lot of people hoping I fail. But I like that. I need to be hated.” -Howard Stern

53. “It's funny how all the magazines can dwell on my race, but they could never say that my shit is whack because they know my shit is tight!” - Eminem

54. “Actors search for rejection. If they don't get it they reject themselves.” - Charlie Chaplin

55. “No great discovery was ever made without a bold guess” - Newton

56. “Where ambition can cover its enterprises, even to the person himself, under the appearance of principle, it is the most incurable and inflexible of passions.” - David Hume

57. “Anyone can dabble, but once you've made that commitment, your blood has that particular thing in it, and it's very hard for people to stop you.” - Bill Cosby

58. “Learning is not child's play; we cannot learn without pain” - Aristotle

59. “I have no special talents. I am only passionately curious.” - Einstein

60. “Clarity of mind means clarity of passion, too; this is why a great and clear mind loves ardently and sees distinctly what he loves.” - Blaise Pascal

61. “When you set yourself on fire, people love to come and see you burn. ” - John Wesley

62. “One person with passion is better than forty people merely interested.” - E. M. Forster

63. “Take our 20 best people away, and I will tell you that Microsoft will become an unimportant company” - Bill Gates

64. “When you innovate, you’ve got to be prepared for everyone telling you you’re nuts.” -Larry Ellison

65. “A man should not strive to eliminate his complexes but to get into accord with them: they are legitimately what directs his conduct in the world.” - Sigmund Freud

66. “Respect your efforts, respect yourself. Self-respect leads to self-discipline. When you have both firmly under your belt, that's real power.” - Clint Eastwood

67. “Confront them with annihilation, and they will then survive; plunge them into a deadly situation, and they will then live. When people fall into danger, they are then able to strive for victory.” - Sun Tzu

68. “Do not sleep under a roof. Carry no money or food. Go alone to places frightening to the common brand of men.” - Miyamoto Musashi

69. “He who fears he shall suffer, already suffers what he fears.” - Michel de Montaigne

70. “All that counts in life is intention.” - Andrea Bocelli

71. “Nobody can give you wiser advice than yourself.” - Cicero

72. “The first principle is that you must not fool yourself - and you are the easiest person to fool.” - Feynman

73. “We should not teach children the sciences; but give them a taste for them.” - Jean Jacques Rousseau

74. “Our greatest glory is not in never failing, but in rising up every time we fail.” - Emerson

75. “Opportunity is missed by most people because it is dressed in overalls and looks like work.” - Thomas Edison

76. "The greater danger for most of us lies not in setting our aim too high and falling short; but in setting our aim too low, and achieving our mark." - Michelangelo

77. “Your work is to discover your world and then with all your heart give yourself to it.” - Buddha

After readers' requests, we have made "77 Thoughts on Motivation" into a poster! You can now get that extra boost of motivation on your wall.

 

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