This board game, "Lizards and Lies" was briefly shown on a recent national news segment on disinformation and deep fakes and concerns about how social media disinformation might derail elections specifically and democracy in general. It is a PhD student creation, and looks interesting: "As a research project that grew out of classwork, Lizards & Lies works to clarify the idea that social media operates as an ecosystem, with many different actors and many different spaces, each influencing the other." "...the game explores the widely held supposition that the spread of conspiracy theories and misinformation online constitutes a new front in a global war on truth. It’s a precept that he feels is oversimplified and skims past the vitally important role human users play in propagating fake news, willingly or not." The print-and-play version is free. Very nice-looking physical copies are also available, but $$$. I thought it might be of especial interest to game-schooling boardies. I think I might print it out and play it through with my teens.

Paxlovid evidence: still very little reason to prescribe A summary and analysis of the current state of the evidence, by one of my favourite Canadian emergency medicine EBM people.

Max Kermanator is named for a member of a local band, who campaigned for the name on social media. Icekee Wee Wee is a play on the Hamilton Tiger-Cats Football team's traditional fan cheering chant "Oskee Wee Wee" HAMBONI is a portmanteau or Hamilton and Zamboni ice surfacer machine.

I remember when this was in the local news last year. The 10 winners of the plow naming contest. There is a new plow naming contest open for 2024. You all have a chance to name a Hamilton plow :)

My family is all boosted, and none of us have been sick. Plenty of exposure. At the hospital, we are admitting lots of elderly for covid. Very , very much disproportionately unboosted (relative to community fall-booster base-rate of 47% for >65 yo in my community). From what I am seeing, this booster is definitely working to keep vulnerable people out of hospital.

I had never heard of prolotherapy for knee OA until this thread. It seems to involve injecting sugar into the joint in order to purposefully induce an inflammatory response. I'm skeptical. Firstly, injecting bacteria-food into a space where bacterial infection can be catastrophic just seems like a bad idea. Septic arthritis is very, very serious. Secondly, inflammation is part of the pathology of OA; purposefully increasing inflammation seems backwards. Lastly, evidence-based clinical guidelines recommend against it. (I had heard of it for tendinopathy - totally different indication)

I thought that this treatment had gone out of fashion. It is my understanding that best available evidence shows that it doesn't work. Viscosupplementation for Osteoarthritis of the Knee: A Systematic Review of the Evidence Viscosupplementation for osteoarthritis of the knee: a systematic review and meta-analysis. " In patients with knee osteoarthritis, viscosupplementation is associated with a small and clinically irrelevant benefit and an increased risk for serious adverse events." 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee "Intraarticular hyaluronic acid injections are conditionally recommended against in patients with knee and/or first CMC joint OA and strongly recommended against in patients with hip OA."

'Try not to let moose lick your car,' warns Parks Canada The article, of course, makes perfect sense. But the headline got my attention for sounding just ridiculous!

Overkill, but absolutely excellent: Leatherman Raptor Rescue: Glass-breaker, belt cutter, ring cutter (also works on fishhooks) and the best trauma shears ever.

I agree that the paragraphs you've quoted are really bad advice. Stopping a statin is usually no big deal, but some other meds can't be safely stopped. And others might be OK to stop individually, one at a time, but stopping a combination of them all at once may turn out to cause harm. Especially since the evidence for paxlovid is so poor to start with --- the only population with RTC data that showed benefit pretty much no longer exists (unvaccinated and high-risk and no previous covid exposure) Stopping meds with known benefit in order to take a med with unknown/unproven benefit seems unwise. I do think it's worth making a distinction between meds taken for long-term prevention (statins for CAD to prevent future MI, thinners for a-fib to prevent future stroke, ace-inhibiter for long-term renal protection diabetics) and meds for treatment of active conditions (thinners for existing clots, anti-convulsants for active seizure disorders etc, antihypertensives for severe essential hypertension). I wouldn't be so worried about holding the former, but would be much more concerned about holding the latter, even though in some cases they might be the exact same medication, the very same meds can be used for different indications. The indication matters, I think.

Would a pastor let parishioners with housing insecurity use their address for mail? I really have no idea if this is a thing or not, but it came to mind as a potential explanation. Or renting a room. Or a family where spouse and kids all have different last names -- definitely not rare in blended families.

Adding to above post: DNA fragments in vaccines is not a new thing. Multiple vaccines have residual DNA from host cells, both human and animal. Live attenuated vaccines that contain DNA viruses (Chickenpox, mpox and smallpox vaccines) will also, by definition, have quite a lot of viral DNA in them. Philadelphia Children's Hospital has a nice info page on this, with some references. Vaccine Safety: Myths and Misinformation Our bodies deal with foreign DNA all the time. Every time you eat or have any kind of viral infection. It is true that some viruses are oncogenic, but this is in the context of infection. I haven't seen any robust evidence to support vaccine oncogenesis from approved vaccines. Quite the reverse, actually -- e.g. we vaccinate for HPV to prevent cancer, quite successfully. I am much more worried about covid infection as a cause of cancer than I am about covid vaccine. I think it's plausible that covid vaccine may actually turn out to prevent cancer if covid turns out to be oncogenic in the long run. We have no idea what this virus has in store for us in terms of long-term sequellae.

-2 R1, I think. dividend = divisor * quotient + remainder -5 = 3(-2)+1 (It's been a while since I've had to think about this!)

Additional points to consider: Surgery and anesthesia necessarily entail risk, even with the very best team -- even the very best surgeons, anesthesiologists and OR teams all have bad outcomes sometimes. It is wise to optimize non-surgical options (physio, bracing, medication) first, and then consider surgery only if/when they fail. Don't get too hung up on numerical outcome data. Surgeons with the very best outcome data tend to be surgeons who are choosiest about who they operate on in the first place; surgeons who only take easy cases have great looking data, but may not be the best fit for you. Surgeons who take hard cases have numbers that look worse, but might actually be better overall and may be a better fit for you. So take outcome data with a large grain of salt. Your PCP should be able to help you choose a surgeon who is the best fit for your particular needs.

Yes, it does work, thank goodness. My personal anecdotal evidence: I work in a very overcrowded ED and am steeped in resp virus every shift --- up close with sick people, doing high risk procedures etc. I am diligent with my n95, and I have not yet caught a viral resp illness from work. I lasted 3.5 years, and finally got covid during international travel, on a trip where eating indoors with others in crowded spaces and sleeping indoors in shared spaces was unavoidable. ETA: vast majority of colleagues can also trace their covid infections to outside-of-work social contact. Usually their kids bring it home from school, or acquired during travel.

Another strategy to add to masking is to ventilate assertively and filter the air. Open windows. Run a HEPA air cleaner or a Corsi-Rosenthal box. Tougher in winter, but still do-able -- even just cracking a couple of windows in common areas while you are together can make a big difference.

My kids are similar. During their busiest seasons, they have daily gym class, then 1.5 hour school team practice daily (longer on game days), then 2h club team practice. They also do workouts together on top of that. Plus tournament weekends about once a month, sometimes more. There are periods where their lives are pretty much nothing but school, exercise, feeding, and sleep. some kids just seem to need this. I don't think it's pathological. Older kid needs to move this much. Younger kid really loves his sport. It's a free choice for both of them. Both kids are happy. I would be concerned if I were picking up on body dismorphic disorder clues, or eating disorder clues. Neither of those seem to be an issue for my kids -- they just want to jump high and run fast and be strong and play their best, for the joy of it.

tl;dr version of post above: Of those who got sick with a resp viral illness and presented to care and were covid tested, those not boosted were more likely to be sick with covid than those boosted. Alternatively stated, those boosted were more likely to be sick with something else than those not boosted.

I had a look at the study posted above. It's a quick and dirty chart review study. One important point is that it only looks at people who 1) presented for care with acute resp illness symptoms and 2) received a diagnosis of viral respiratory infection and 3) were tested for covid Completely missing from this study are those who did not get sick in the first place. So maybe the booster works way better than reported - we have no idea how many in each group didn't get sick at all, or didn't get sick enough to present for care. Or, for the sake of arguement, maybe it doesn't change covid risk at all, but rather increases risk of getting sick with other viral illnesses, or those boosted are just more likely to present for care when ill with other viral illnesses (very extremely unlikely, but the data would look the same -- this study protocol could not tell the difference). My real world experience tells me that the booster is probably better than this study suggests, at least for elderly and vulnerable patients. We are seeing a lot of those in my ED needing hospital admission, almost all unboosted. Our community fall booster base rate for >65's is 45%. We aren't seeing the boosted ones. slightly older, but still relevant local data: My health unit reported 39 covid deaths Oct-Nov 2023. All but one >65, and all but one of those unboosted. The boosted case was <10 days post-booster. This booster is keeping seniors out of hospital and keeping them alive.

A game (Azul), a new wallet, and a ZOLL AEDplus (This last a weird gift, but great! Our little rural neighbourhood has a long ambulance response time. I will also cart it to scout camps and youth soccer and select other places with crowds that don't have a PAD.)

Presymptomatic and asymptomatic transmission happens for just about all viral infections. RSV and influenza and chicken pox and measles (and probably dozens of other respiratory viruses for which we just don't have the data, and others I just haven't bothered to specifically look up). Lots of other viruses can be transmitted while asymptomatic and presymptomatic too: HIV, Hepatitis A and B, Epstein-Barr (mono), polio, mpox, and on and on. A nice, short review article on asymptomatic and presymptomatic transmission of various pathogens. Covid is just really, really, really good at it. And really, really good at transmission in general.

What are the legal penalties for providing alcohol to minors in your state? Because that's what this 18yo has done. Here, the legal repercussions can be serious. I would be having a very hard conversation with the 18yo (legal adult). He needs to know that this is behaviour with potential real legal consequences, and it is behaviour that you will not tolerate. Especially in your home - as that may also cause legal repercussions for you.

We have snow. We got about 6 inches a few days ago. It's been warms ever since (hovering around 0C), so it's melting slowly. It will still be there tomorrow.

$50 around here would be a great deal! We paid $100 for a very average tree. Planting a bunch sounds like a great idea.

No, I did not! I've fixed the link to the CDC isolation recommendations page. Thanks. Also, taking the opportunity to add: I wish that covid were an "easily treatable virus", but it's not. We've had 644 deaths and 4212 hospitalizations in my province in the past 4 months (since Aug 27, 2023). And counting.