There's a lot of interesting research on paramedics vs emts (I believe the term of art is basic life support vs advanced cardiac life support). In areas where there is a good ER, it's better to have low level basic life support and break the sound barrier to the ER than do significant intervention on site but slow arrival at the hospital, as far as I am aware.
- early recognition
- early administration of aspirin and/or nitro if indicated
- activation of, and transport to, a hospital with catheterization capabilities.
If medics can show up and do multiple ekgs to confirm and en route, thats even better. But critically the blockage needs to cleared, and they need definitive care (cath lab).
I hope you continue, friend. The best age to start is when you're young, but the second best age to start is today. Keep at it, and never struggle to get out of a chair.
Don't feel bad about your VO2 max, the baseline and ceiling are largely genetic. Most people can only bump VO2 max by about 10-15% even with absurd training regimens. Same goes with many of the markers people track - you can control them to an extent, but some people just have high blood pressure or poor lipid profiles and thus need intervention.
Thanks for saying that. Even when I ran every day — with the occasional VO2max sprint day —, my Apple Watch never placed me anywhere but Below Average for VO2max. It was disheartening. Some of these metrics actually put you off training.
We know definitively that active is strictly better than inactive in all respects unless someone has such severe end stage cardiorespiratory issues that they risk actual death, or some other unusual condition that makes exercise contraindicated, in which case, of course, speak to a doctor and obey their advice.
Even if it merely preserves function (which I would be skeptical about, humans are amazingly adaptive), the alternative is inactivity and thus gradual loss of function indefinitely over time until death.
Article misses the mark a little bit. "Outdoors" preventing myopia isn't about focusing distance, it's about light levels. Dimmer light makes the eye think it isn't done growing, so it grows more.
You can replicate those light levels indoors, if you're bloody minded enough to do so. It's somewhat expensive but for a tech-enabled crowd not too difficult.
You need about 10x to 100x the lighting most people are satisfied with indoors, and you need to turn it on whenever you're in the room and leave it on between sunrise and sunset. This is easiest with timers and automation.
The most important thing about all of this is to realize that children NEED outdoor recess sometime between the hours of 10am and 2pm every day. They don't have to be directly exposed to the sun, but they need to be in an environment with >1000 lux, more is generally better, for a number of hours. This will prevent their growing eyes from continuing to grow indefinitely.
We know this because there was an intervention in Taiwan, which has extremely high myopia levels in children (80%+ last I heard), and it dropped myopia from ~80% to ~35% in the intervention group. That's an astounding effectiveness for something free.
I've read a number of anecdotes about benefits of bright, full-spectrum indoor lighting and I'm increasingly sold on the idea.
The only thing that makes me hesitant is the extreme unpleasantness of direct high brightness artificial light. I wonder if an indirect lighting setup of similar brightness could be as effective.
I wonder, wouldn't this mean that in nordic countries, where in winter get less than 6 hours of sunlight in total, and where that sunlight is mostly obstructed by heavy clouds, would be the place with most myopia in the world? For example in Latvia where I grew up, winters last from november to march-april, the nights are long, and it can be months without any sunlight. And it gets darker once you go further north - Finland, Norway, Sweden. But back in my preschool, we had 1-4 kids per 30 in the class, with any eye problems. I myself was among those few who had hypermedia, some even got rid of it by age 10-13. And if I look at the my parents, and grandparents - even fewer had need for eye correction.
Valid point. I guess then in Canada they could have a lot of such cases, as it has been a major destination for migration. In any case, sounds like an good topic for a research paper
That's interesting. I seem to be the only one around my circle who like bright environments (my work area uses 2 2400 lux lamps).
I find most environments too dark.
And I'm the only one who doesn't wear glasses, lol
I can't find the site that I read a while ago, it was very similar to the myticker.com site that was posted the other day for heart disease but focused on myopia.
It's difficult for artificial light to compete with full-spectrum natural daylight from an infinitely distant light source (sun). See previous attempts at sunlight simulation indoors.
>> Dimmer light makes the eye think it isn't done growing, so it grows more.
Does that mean that populations in places with more sunlight (e.g. close to the equator) have less myopia than populations with less (e.g. close to the arctic)?
And I had fairly bad myopia before I could read or had ever seen a computer, would you like to reject the argument that reading or screens are relevant as well?
I'm not sure why you're convinced that focusing distance is irrelevant. Everything I've seen indicates that it is the combination of focusing distance and light level.
Also... 100x the lighting indoors strikes me as quite difficult? Do you have any examples of a realistic setup?
Think operating room or photo studio. 100w grow light panel for every 2-3 square meters - so for a typical office, 4 100w lights, with a scatter panel in front.
I really like this video for an example of how to make proper scattering effect, but you can buy similar materials that are more durable and lighter, for in e.g. a drop ceiling:
That's a cool video, but a custom 500W water-cooled setup does indeed strike me as "quite difficult" for your average person. It seems that the LED in the video is the $500 YujiLEDs BC270H, which is 20,000 lumens. In other words, to match midday sun at ~120k lux, for a small room of 100 sq ft /~10 m2, where all light fell directly onto you/the floor and none on the walls, you would need 1.2 million lumens, or _sixty_ of the setups in the video, or about 30 kW continuous ignoring all cooling needs and other losses.
I completely believe him when he says that it feels like sunlight (it's a high-quality, high-CRI, extremely bright light source at infinity!) but us humans are very bad at determining brightness levels. An iPhone flashlight in your face is unpleasantly bright and yet it is a completely insignificant amount of light on an absolute scale. We humans perceive brightness on a sort of relative log scale.
The steelman argument - where someone does indeed build one 500W water-cooled setup with large dish etc - and all of this light falls into a small corner of 2m x 2m - is still only ~5000 lux, roughly an overcast day. To even get to the level of standing in the shade on a clear day - 20k lux - for a regular room, you would need an obscenely powerful setup.
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The natural response to my comment, of course, is that "well, maybe they don't need those high levels!" The problem is that all of the research indicates that they do. You mention research on Taiwan, which I think is a perfect example. They already did try to brighten the indoors to prevent myopia - minimum government standard of 500 lux starting with a 1999 standard [1], and in many cases brighter than that. You say that they need a 1000 lux environment, which isn't much different than the current Taiwanese indoors. I, on the other hand, say they need a ~100k lux environment, which is orders of magnitude more light. The research agrees with me: it was not the 500 lux standard, but the later introduction of two hours outdoors daily that improved myopia rates [1,2.]
Mind you, this is two hours outdoors during school hours in Taiwan, which is near the Tropic of Cancer (think Mexico, Caribbean, North Africa) and thus has far sunnier winters (Taiwanese peak summer sun is 1.9x winter sun vs 4.2x in Boston, 3.7x in NYC, 10x in London [4]) despite total solar irradiation being similar to Western cities [3.]
Because studies that controlled for focus distance (ie compared children reading indoors v children reading outdoors) seemed to show that focus distance did not have an impact.
Late reply, but most of the pro-focusing-distance crowd agrees that it’s time in peak sun, plus a fairly small number of daily “reps” of near-far focusing that is sufficient. In other words, kids could spend 99% of the time outdoors just reading a book, and the handful of glances at a tree in the distance, stop sign, bird, etc would be sufficient. Furthermore, as I mentioned to a sibling comment, even if it is just the bright light, with no influence from the focusing (which I doubt!) the only practical way to get that light is outdoors.
The intervention that most advocate for is shifting kids’ breaks to be outdoors during peak sun hours. This is free ($0.) You get 100k lux, high CRI, flicker free light with no power or setup requirements. You also get birds, trees, buildings etc in the distance as “infinity” focus targets, also for free. (Reminder that “infinity” is actually fairly close!) This approach is also proven to improve myopia rates.
Custom water-cooled ultra-powerful indoor lighting setup as suggested by sibling comment: $30k/small room (far focus not included)
Or, as we're becoming aware with GLP-1 drugs, an injection. (For now!). It's better to help people behave better with drugs than moral condemnation. Almost infinitely better, as it turns out, regarding a lot of problematic behavior regarded as "untreatable" previously.
When I lived in a city proper, the grid was doing well to maintain 98% uptime. Multiple day long outages were the rule, not uncommon to lose power 3-5 days in a row.
Now I live in a rural area and it's uncommon to avoid outages more than a month. We have an automatic transfer switch and fuel generator from previous owners and it saves hundreds of dollars in frozen food.
This is in the US by the way. If you're investing in a transfer switch and generator now, the cost is going to quickly approach a modest solar + battery set up with a whole house inverter, and of course, you save money all year that way, not just in outages.
Yep I'm looking at used solar since I have a ton of roof space and land area, and the shipping is 50% of the price of a pallet of panels. Even if they're derated 25% and 20% fail, the racking and balance of system outweigh them to a silly degree. It's going to be 80% balance of system 20% panels.
They don't behave like a political party any more. It's not just the business of politics as usual and a generational shift, it's something different. I've been trying to coin a term for this internal takeover - I think nihilocracy, or nihilocratic populism, is the best I've come up with.
The party as a whole is uninterested in governing beyond seeking revenge and satisfying the charismatic eschatological movement that drives them. The leaders don't believe what they preach, they don't have policy goals besides "destroy what we hate", they don't have any conventional engagement with government beyond using it towards their own ends.
"Long term strategy" is a joke in this context. They're angry, they mobilize their supporters by promising revenge on a world that seems to be defying traditional structures and changing too fast. As with many reactionary movements aligned more by being "against" than "for", there's been little thought for what happens after the enemy has been defeated, and it's likely they'll continue seeking out new enemies until the movement dies from infighting or is ousted from power.
I see the supporter being nihilistic and purely out for revenge. I don’t see that with people in positions of power. They’re looking to line their pockets and they’ll take advantage of a vengeful constituency. True of both major parties. That’s why they focus on social issues and then pass legislation (or lack thereof) that allows them to all get rich.
Yep, I agree. I see the rank and file as being largely nihilistic but the leadership as being either pure ideologues or completely cynical. Either way, the stated values aren't the real ones, but they differ in whether they're working towards other goals or pure self-aggrandizement.
