I wonder whether Biden’s visit hurt Macron. So many old people palling around.

@Xanne I doubt Biden's visit will affect people's opinions about Macron.

SpaceX wants to build 1 Starship megarocket a day with new Starfactory

@M.A.R. haha! The same practice is widespread here - IV fluids during hospital stays, even when the person can easily just drink something.

When I landed in the ICU with tick borne encephalitis, I was given IV drips of saline while I could just easily eat and drink.

Word of the day: palling around - to spend time with (someone) as a friend

Hmm are there vaccines?

@Cerberus There are, and I had had a full course, and a booster shot, that's why I came out without major damage

Oh, dear.

Only bouts of headache and weakness

But you were still taken into intensive care.

Yes - because they told me that sometimes vaccines fail

Oh, so it was kind of preventative, the intensive care?

Resumptive(-ish? kind of?) pronoun of the day, from an alleged murderer:

> Everyone constantly, constantly, constantly blames me, that I am the reason why I am supposedly going on attorney number eight, which I am not the reason for any of them.

Truly a strange relative clause.

A relative clause without a gap is like a suitcase without an air hole.

Not sure how to classify this one, since it's unclear what the intended antecedent of that relative clause is.

For some background: whatever she did with that sentence, she didn't do it intentionally.

Also don't click those links unless you want to fall down a disturbing true crime rabbit hole.

@alphabet Which refers to the previous clause/fact, not to a specific word.

If you remove any of them, the syntax is OKish.

So what happened is that the particle for (or the remote postposition?) was mistakenly reinterpreted as a praeposition, by adding an object to it.

If you correct the sentence by removing "any of them," the word "for" is still a preposition; it's just a stranded one.

In "the reason for X," "for X" is just a prepositional phrase modifying "reason."

I think you're right that "which" was intended to refer to the entire preceding clause, but then she tried to add the "any of," at which point the sentence went off the rails.

Also she is absolutely the reason. But I digress.

@alphabet I wouldn't call that a praeposition, but it isn't important.

Sildenafil (‘Viagra’) improves brain blood flow and could help to prevent dementia

@CowperKettle meh. Improving brain blood flow and preventing dementia are two very different, mildly overlapping goals

It no doubt does the former, it's very compatible with its main mechanism of action

(PDE inhibition)

But 1) the resulting orthostatic hypotension makes it a suboptimal choice, especially in the elderly population, and 2) dementia is very broad and multifactorial, and "improving brain blood flow" has repeatedly proven disappointing for prevention of neurodegenerative diseases

As the study itself indicates, vascular dementia is usually a sequel to an acute coronary syndrome (MI or stroke), or accompanied by other neurodegenerative diseases, such as Parkinson's

@CowperKettle well, ICU is different. IV access is a must in every medical ward, so it doesn't really matter whether it's used or not, unless it was uncomfortable. If they had reason to follow some protocol to control your intake, it could make sense. An outpatient clinic administering isotonic dextrose saline for presumably abdominal cramps is absurd though

@M.A.R. I'm taking l-arginine now, in hope to 'improve my brain flow' after a stroke-like episode on 4 to 5 June. But I know that it must be just placebo. I just don't have access to any doctor who would investigate what's up there.

@CowperKettle I should eat breakfast to improve my brain blood flow

I'm in a lab for routine tests

I have repeated bouts of my right ear being suddenly blocked, through the day.

After that attack.

I hope you find out what's going on with you

I think I should go to a radiologist and pay him in cash so that he sits for a longer time over the scans, and maybe explains something. Just go to a random one.

@CowperKettle a stroke-like episode should be much easier to diagnose, BTW.

[ SmokeDetector | MS ] Bad keyword in body, bad keyword in title, pattern-matching website in body, potentially bad keyword in body, potentially problematic ns configuration in body (289): Translation Services in India‭ by Simultaneous Interpretation‭ on english.SE

@M.A.R. Maybe it was an epileptic episode then, I don't know.

I've ridden 2200 km on bicycle this year, but find it hard to concentrate and do mental activity. To switch from one line of thinking to another and to plan my actions.

@CowperKettle That word looks weird in pint because it is verbing a noun and the spelling rules around that kind of sequence confuses things.

Perhaps, @CowperKettle your body is trying to tell you to slow down on the physical activity.

If two people are pals /pælz/ (a common enough word), then when they hang out together one might call it 'palling around'. /pæl iņ .../

Chumming around works also.

But if you didn't realize that was what was meant in context, that spelling looks like it should be pronounced /pal iņ/ which sounds like it means ... well... it looks more like 'pall' which doesn't make sense.

re: curse of knowledge

@M.A.R. Wha?? vascular dementia tends to come -after- MI or stroke? I would have thought there would be a systemic common cause of all of those. Maybe it's just that an MI or stroke is a big event that is super noticeable but the same cause (narrowing of vasculature) only appears slowly with dementia.

Also, are those two (MI and stroke) in the group 'ACS'?

Would Raskalnikov have sought redemption by volunteering for the Special Military Operation? Discuss.

@user85795 But remember that chumming without 'around' is "the blue water fishing practice of throwing meat-based groundbait called "chum" into the water in order to lure various marine animals (usually large game fish) to a designated fishing ground, so the target animals are more easily caught by hooking or spearing"

@user85795 No, these special effects arise when I eat carb-containing food without using insulin. Although I don't need insulin, and thus it is weird.

@Mitch Turns out that 'silent brain infarcts' constitute at least 30% of the cases. Basically, mini-strokes of the occlusive kind, in which you don't feel anything, because they are in 'silent' areas of the brain matter - not producing any sensory symptoms

After finding that white spot in my brain stem on the MRI, I've been trying to read up.

Turns out many silent infarcts become invisible on MRI as soon as 90 days after the event.

@jlliagre I've been there, so ... otherwise I'd have had no idea.

@Robusto Makes sense. Should you have used Sherlock Holmes' magnifier, you could have done better with #2 ;-)

@jlliagre Yeah, that was me not paying attention. Sheesh.

But I got the year almost exactly!

@alphabet I wonder why some clients prefer to have their orders placed at the door, instead of taking them personally, since they are at home.

@CowperKettle Some people don't like to answer the door. Some just don't want to interact with people, others fear crime.

America's love-affair with guns stems from fear. And thereby propagates more fear. A vicious cycle.

@CowperKettle I do that since (a) the order often arrives when I'm in the middle of something that can't be interrupted right away and (b) I don't want to keep the delivery guy waiting while I walk down the many flights of stairs from my apartment to the door.

@CowperKettle I will always associate that usage of "chum" with SpongeBob

> The use of names is rare in the animal kingdom, and it typically works by imitation. Dolphins refer to other dolphins by mimicking their signature sound. Parrots identify each other in similar fashion. Elephant calls are unusual in that they do not rely on imitation. e360.yale.edu/digest/elephant-names-study

> He was frequently given to fits of temper which occasionally led to collapse. Devrient mentions that on one occasion in the 1830s, when his wishes had been crossed, "his excitement was increased so fearfully ... that when the family was assembled ... he began to talk incoherently in English. The stern voice of his father at last checked the wild torrent of words; they took him to bed, and a profound sleep of twelve hours restored him to his normal state".

A composer who died in his 30's to a series of strokes, probably part of CADASIL syndrome

@Mitch yeah. AFAIK ACS: stable and unstable angina, MI and stroke.

You have two types of MI: One where the ST segment in an ECG is elevated, and one where it isn't. The former is the more severe type of attack that tends to lead to immediate cardiac arrest and death.

In Non-ST elevation MI (NSTEMI), it's roughly like 70% of some coronary vessels being occluded, but in STEMI, it's close to 100%. This occlusion is often the result of the narrowing of the walls due to cholesterol, which also greatly accelerates clot formation. So clot (thrombus) + cholesterol plaque

@M.A.R. I get that angina would be included but stroke?

@Mitch well, strokes are either ischemic, like most heart attacks, or hemorrhagic, so certainly a vascular event.

I guess the term 'acute coronary syndrome's is confusing me.

@M.A.R. yeah but it's not -coronary-

Vascular sure, but not coronary

Unless all clotting starts in the heart

@Mitch it's probably more like it's not officially part of ACS but studies prefer to include it rather than say "ACS and stroke"

@Mitch Oh yeah? Who pumps all that blood to your brain, huh? You brainiacs are always trying to take credit for what the heart is solely responsible for.

@Mitch a lot of the clotting does, yeah.

Aren't there ischemic 'accidents' in other organs from aortic blood? Kidney, liver, GI?

@M.A.R. Thank you! (On behalf of your circulatory system, which starts with the heart.)

@Robusto that reminds me of a joke.

Punchline: it's the asshole who's in charge.

I remember that one.

It's ... haha... #32 on the joke list

Clearly the asshole is not that in charge.

snort

When fibrillation happens, electrically connected muscle tissue in the heart sort of just trembles in place instead of pumping and relaxing rhythmically. Ventricles and atria are separate. Ventricular fibrillation happens right before cardiac arrest (the long beep at the monitoring system), you only have seconds to save the individual.

You could make the case that the #1 joke is a supreme asshole.

You'd have to be, to climb over all those others.

@Robusto he could of been in charge.

There not gonna say otherwise.

When atrial fibrillation happens, the heart certainly weakens, because atria pump good volumes of blood to the ventricles to be pumped to the body, but a person can live with no major problems with atrial fibrillation.

@M.A.R. vfib would cause pulmonary embolus though right? It just would carry all the back to the heart.

But the major concern is, since the atrial muscles are shivering in place instead of pumping blood, there is momentary stasis of the blood in the atria before the valves open and the ventricles fill up. This is when clots have a high chance of forming.

@M.A.R. What causes Pre-Atriacl Contractions (PACs), if you know?

That clot will be pumped somewhere narrow where it wilk stick. The pulmonary capillary bed (Pulmonary Embolism), or the brain (Ischemic Stroke), are major sites

So, bear with me if you will, the term ACS is somewhat like COPD in the sense that COPD has two seemingly very different ... things (asthma and emphysema) but might as well be treated the same way?

@Robusto the heart's conducting tissue is imprecise. The reason the heart has a natural pacemaker as opposed to other neural or muscular tissue is it has a leaky sodium channel so sodium is constantly entering the cell, depolarizing it and eventually crossing the threshold for an action potential.

Now the thing is, all of that conducting tissue is leaky.

But the fastest cells are usually in the sinus node. Thus they constantly reset the whole heart's voltage.

@M.A.R. Is that a result of too much sodium in the bloodstream?

The troughs are right after an action potential. Potential immediately reaches the threshold (-40 mV) and the next action potential automatically begins

@M.A.R. Stupid hearts.

Compare it with this, which happens in, say, the neuromuscular junction, causing a bunch of muscle fibers to contract.

Sodium doesn't leak in, so it doesn't automatically reach the threshold for an action potential.

Ah.

@Robusto in the interstitial space, yeah. Sodium levels are always higher outside cells, and potassium levels are always much higher inside cells.

So, to answer your question, the sinus node is normally the fastest pacemaker, the leakiest cells. However, when this is not the case, other cells may start pacemaker activity of their own.

This can be very dangerous, because there are no neurons and synapses in heart tissue, and an electric signal only diffuses to the whole muscle of atria or ventricles. So disrupting its harmony is often seen in dangerous arrhythmias when ectopic pacemaker activity is in the ventricles.

So do you have any clue about this: After a long ride on a hot day, like yesterday's 50-miler (~80 km) ride, I was relaxing on the couch and when I contracted my hamstrings to get up they started to spasm like they wanted to contract all the way. I countered this by stretching my legs all the way, but I'm wondering is this could be kind of electrolyte imbalance.

@M.A.R. Eek.

Since atria are separate electrically, and they're not nearly as important as ventricles, an extra pacemaker is less dangerous in atria.

@Robusto the most likely cause is your blood pH had dropped a bit due to lactic acid buildup. Acidosis can lead to cramps

@M.A.R. How best to balance the pH?

In a healthy person, it shouldn't be much of a concern. A person with hepatic dysfunction should be a bit worried about lactic acid levels. People with weak kidneys (actually very old people automatically count) and people on diuretics should be wary of hypomagnesemia

@Robusto well after an 80 km ride, it's inevitable. As long as you're not worried about any other causes, just make sure to hydrate.

Doctors sometimes prescribe magnesium and vit B1. I don't know how much it helps.

Both are water-soluble and not toxic, so they're safe at least.

@Mitch COPD is a totally different thing. It can overlap with asthma in severe cases. Emphysema is only marginally related

@M.A.R. Thanks.

Most causes of asthma make it a sort of severe allergy that involves an exaggerated response to allergens lower in the respiratory tract than normal.

COPD is a different beast entirely. The whole tissue of the lower airways has totally been remodeled due to exposure to irritants, genetics, and some other factors.

Narrow airways with thicker muscles with a large volume of thick discharge.

@Robusto sure. If you notice more cramps than before, a general checkup is worth it. Muscle relaxants can help but they'll make you dizzy so I don't recommend going for them straight away

@M.A.R. It's not a critical issue. I generally can save the cramp before it takes hold. I was just wondering what the mechanism for that is.

There is probably some truth to the stereotype of a child with a privileged background with an inhaler at the ready. Helper T cells are sort of like managers that direct immune activity. A kid exposed to more exogenous antigens (think making mud pies) will have more helper T cells differentiate at an early age to counter pathogens, and a kid with a silver spoon will have more helper T cells differentiate to kinds that cause exaggerated immune responses

Of course, genes play a huge role still.

@M.A.R. BTW, @M.A.R., you're a valuable asset to this chat. Don't ever leave!

@M.A.R. "there are no neurons and synapses in heart tissue" ??? Wha??? For real? There's just a nerve to one end of the heart and then the muscle tissue takes over?

@Robusto pianist bow

@Mitch that middle layer full of muscle has no synapses, yeah. There's just lots of gap junctions where cells are connected and ions flow. There is of course innervation to the heart, but it doesn't cause the contractions, only controls their rate and strength.

Also, your 'activation potential' graph looks just like the one for nerves. And presumably has the same mechanism - pumping out sodium, pumping in potassium linearly along the ... well for muscle tissue I have no idea... and then the repolarization (pumping the other way).

When someone faints after seeing something shocking, it's because it immensely activated their parasympathetic system. The huge vagal discharge suddenly drops the heart rate to very low levels, blood pressure falls rapidly, and they faint.

@M.A.R. but also that mud pie kid is more likely to get tetanus.

@Mitch thanks Pasteur

@M.A.R. It sounds like you're suggesting constant surprise as a treatment for high blood pressure.

@M.A.R. I like modern medicine but I bet the needles in those days were pretty scary.

Well it's not guanranteed that they'll recover from that . . .

@M.A.R. I believe it's called vaso-vegal syncope. I had that once after a very punishing ride on a very hot day when I ran out of water mid-way.

@Mitch an action potential happens in one cell, neuron or muscle, as a result of something (like a neurotransmitter binding a receptor)

@Robusto yeah. There are lots of interesting syncopes. A rare form of syncope is swallow syncope. Cases look like this: 50-yo guy complains of dizziness that has happened every time during meals for six years.

That person will be cautioned against drinking cold beverages in large amounts. So if you're wondering where that comes from, "Don't drink cold water after exercise", yeah.

@M.A.R. I didn't know that muscle cells and neurons were so similar.

They're not, they just have action potentials.

And they're long

They both do the sodium potassium pumping thing, right?

And there's the whole extra calcium signaling

Okay they're pretty similar

sure, muscle cells do this contraction thing which neurons don't.

and neurons... learn?

@Mitch Na+/K+-ATPase exists on every cell. It's just its existence on neurons and muscles was very important in the biology exam

@M.A.R. If it's not on the exam it's not in the biology.

@Mitch neurons store memory by sorta reshaping their nerve terminals with new connections and what-not.

Yeah so after the stimulus genes are transcribed and the cytoskeleton drags these ribosomes to the designated place so they make new cytoskeleton and expand the synpase yadda yadda. It's really interesting but I can't seem to connect it to metaphysics

@M.A.R. Whoa! And that is precisely what you crave after exercise!

@Robusto I mean, if your heart rate doesn't drop while swallowing food (damn must be horrible) I don't know how much truth there is to that advice.

Heh.

My syncope was because my blood pressure dropped to about 90/50 from dehydration. Also because I didn't stop for coffee mid-way. Coffee always helps. (Yes it does!)

@Robusto Sorry to hear about that!

@M.A.R. I remember reading somewhere that one must stress their muscles, for instance in the legs, in order to lessen the chances ofa syncope of this kind.

I had a friend who tended to faint at the sight of blood, although she was not afraid to jump with a parachute several times

@CowperKettle Better to faint when seeing blood than when skydiving!