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Offlinemorrowasted
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PubMed: Both a blessing and a curse * 5
    #26858572 - 08/02/20 10:28 AM (3 years, 5 months ago)

Most of you probably know by know that PubMed is a massive index of articles from scientific journals that appear in the The National Center for Biotechnology Information (NCBI). At face value, it seems like an excellent idea- what better way to facilitate access to scientific truths than to make all research easily searchable in one index?

I first noticed the potential dark side of PubMed when I became a nurse. Sometimes I would have patients who would second guess the treatments that doctors prescribed them on the basis of having "done their research." This made my job very difficult, because a major function of nurses is to mediate conversation between doctors and patients.

Now, I have always been a very openminded person, and I always wanted to advocate for my patients as best as I could. So I would always hear them out, look into the articles their opinions were based on, and try to see if there was anything legitimate to their protests.

Unfortunately, it nearly always turned out to be the case that the reason the patient was second guessing the doctor on the basis of having done "research" involved either
A) A misinterpretation of the article in question,
B) An article from a highly disreputable pay-to-publish journal, which unfortunately often manage to make their way into the NCBI.
C) A failure to understand the article's conclusions within the context of a broader understanding in the field.
D) A failure to understand the logistical considerations of healthcare that frequently make the treatment they think is best for them impossible.

This often put me in the uncomfortable position of having to try to patiently explain why the treatment the doctor has ordered for the patient is the best one in spite of the "research" the patient has done. The end result of this is that most of these patients develop a sense of mistrust in the medical establishment, thinking that we have some kind of nefarious agenda causing us to "ignore the research they did."

Confirmation bias has always been a problem, but with a resource like pubmed, confirmation bias becomes even more sinister, because citing a scientific journal article as the basis for their opinion gives people much greater confidence in whatever opinion they set out to confirm.

A perfect example of this phenomenon was a recently indexed article entitled 5G Technology and induction of coronavirus in skin cells, which had been printed in the pay-to-publish journal "Journal of Biological Regulators and Homeostatic Agents", which claims to be "peer reviewed"- but which was actually released as a "pre-print" before actually being peer reviewed. As soon as it was actually peer-reviewed, the journal withdrew the article, but much of the damage was already done. Though it is difficult to decipher as a result of the horrible grammar, it appeared to be claiming that 5g wavelengths were capable of damaging cellular DNA, allowing it to re-organize itself into coronaviruses. Here are some gems that appeared in the article, which can now still be accessed using the WayBack Machine (a problem unto itself).

Quote:

In this research, we show that 5G millimeter waves could be absorbed by dermatologic cells acting like antennas, transferred to other cells and play the main role in producing Coronaviruses in biological cells. DNA is built from charged electrons and atoms and has an inductor-like structure.




Quote:

These waves produce some holes in liquids within the nucleus. To fill these holes, some extra hexagonal and pentagonal bases are produced. These bases could join to each other and form virus-like structures such as Coronavirus. To produce these viruses within a cell, it is necessary that the wavelength of external waves be shorter than the size of the cell. Thus 5G millimeter waves could be good candidates for applying in constructing virus-like structures such as Coronaviruses (COVID-19) within cells.




Despite the fact that the authors of the paper did not conduct any actual research, there was a "Materials and Methods" section that simply consisted of a bunch of absurdly complex math equations. The paper was filled with ridiculous schematics that were drawn in MSPaint. One simply had a picture of a skin cell with a circle around it and an arrow pointing to it that said "Antennae". It was riddled with graphs with ambiguously labeled axes.

Long story short, anyone with even a small amount of real education in these fields could see immediately that the paper was garbage. Nevertheless, people who wanted to confirm their biases that 5g radiation is somehow related to coronavirus circulated the article and their confidence in their opinion grew: "Look, the scientists agree with us."

Other common examples include people using PubMed to confirm their biases related to the use of hydroxychloroquine, homeopathic "medicines", accupuncture, reiki- many of these manage to make their way into the NCBI because the publishers simply take money from anyone who wants to publish and pretend they submitted the article for "peer review", or have it "reviewed" by other quacks.

Most armchair researchers can't even look at an article and tell you whether it's a literature review, a controlled clinical trial, or a meta-analysis. They can't tell you the difference between in vivo and in vitro research, and why that difference matters. They can't tell you what the letters in the article like "p" and "n" stand for- much less how those values are used to calculate significance and effect size. Most of them simply read the abstract and MAYBE the conclusion, see if it appears to confirm their biases, and look for a different one until they find one that does appear to.

Wanting to be well-informed is an admirable quality, but in order to properly get at the truth, it's necessary to have some humility. In the context of science, humility results from receiving background education in the field- this is when you realize how much you do not know. As you become more educated, your confidence begins to fade.

If you take away nothing else from this post, please understand this: medical personnel want the best for people who are sick. In the USA, we have to navigate through the logistics of health insurance and a highly unregulated profit-driven pharmaceutical industry. But we do want the best for you. We will frequently go above and beyond to help you access the resources you need to be treated, despite lack of resources or insurance. Many of us have taken paycuts during this pandemic specifically because the hospitals are losing money, not making it.

If you want to know the truth about a subject, but you lack significant education in that subject, please have the humility to use people you trust and know to be educated in that subject as a resource. When they suggest that your interpretation is incorrect, don't take it personally. They're not trying to hurt your feelings. Avail yourself of the help they offer you.


Edited by morrowasted (08/02/20 10:38 AM)


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InvisiblebodhisattaMDiscordReddit
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Re: PubMed: Both a blessing and a curse [Re: morrowasted] * 1
    #26858585 - 08/02/20 10:38 AM (3 years, 5 months ago)

Andrew wakefield and autism too. Anyone who read his paper could see that it was junk unless they were a moron.


--------------------
:whyyy:


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Invisiblepsi
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Re: PubMed: Both a blessing and a curse [Re: morrowasted]
    #26858591 - 08/02/20 10:44 AM (3 years, 5 months ago)

I've found that medical professionals generally respond positively to attempts to better understand the underlying science behind something. But I recognize the limitations of my high school level education in biology, supplemented with some later self-study. As you say, humility is required.


Better PubMed than Youtube though I will say.


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Offlinemorrowasted
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Re: PubMed: Both a blessing and a curse [Re: psi]
    #26858605 - 08/02/20 10:52 AM (3 years, 5 months ago)

Quote:

psi said:



Better PubMed than Youtube though I will say.


I am not so certain. I feel like people who use pubmed convince themselves their opinions are just as valid as those of any other scientist, because they are utilizing the same resource that a scientist would use to find information. Then again, many people do seem to be very confident in garbage opinions they got from watching youtube. Maybe it is just that people using pubmed to engage in confirmation bias fancy themselves educated, whereas casual youtube consumers dont concern themselves with maintaining that kind of self perception. In any case, both can be problematic in the same way.


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OfflineHamHead
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Re: PubMed: Both a blessing and a curse [Re: psi] * 1
    #26858608 - 08/02/20 10:53 AM (3 years, 5 months ago)

Dude, you're not even a doctor.

Are you some sore of scientists?

Some ego on you to discredit work of those who stood before you.

You stand on giants and act like you're our community doctor or some shit.

How long have you been in a medical profession?


--------------------
The Italian researchers’ findings, published by the INT’s scientific magazine Tumori Journal, show 11.6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020 had developed coronavirus antibodies well before February.

https://www.reuters.com/article/us-health-coronavirus-italy-timing-idUSKBN27V0KF

This online first version has been peer-reviewed, accepted and edited,  but not formatted and finalized with corrections from authors and proofreaders

https://www.icandecide.org/


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InvisibleThe Blind Ass
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Re: PubMed: Both a blessing and a curse [Re: HamHead] * 3
    #26858613 - 08/02/20 10:56 AM (3 years, 5 months ago)

HamHeads mad  :smilingpuppy:


--------------------
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OfflineHamHead
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Re: PubMed: Both a blessing and a curse [Re: The Blind Ass]
    #26858614 - 08/02/20 10:59 AM (3 years, 5 months ago)

Nah, a little upset science is being burned in favor of mask and vaccines.


--------------------
The Italian researchers’ findings, published by the INT’s scientific magazine Tumori Journal, show 11.6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020 had developed coronavirus antibodies well before February.

https://www.reuters.com/article/us-health-coronavirus-italy-timing-idUSKBN27V0KF

This online first version has been peer-reviewed, accepted and edited,  but not formatted and finalized with corrections from authors and proofreaders

https://www.icandecide.org/


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Invisiblepsi
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Re: PubMed: Both a blessing and a curse [Re: morrowasted]
    #26858617 - 08/02/20 11:01 AM (3 years, 5 months ago)

Quote:

morrowasted said:
Quote:

psi said:



Better PubMed than Youtube though I will say.


I am not so certain. I feel like people who use pubmed convince themselves their opinions are just as valid as those of any other scientist, because they are utilizing the same resource that a scientist would use to find information. Then again, many people do seem to be very confident in garbage opinions they got from watching youtube. Maybe it is just that people using pubmed to engage in confirmation bias fancy themselves educated, whereas casual youtube consumers dont concern themselves with maintaining that kind of self perception. In any case, both can be problematic in the same way.



I think people who look to PubMed at least have a better sense of where legit scientific info is likely to be found. The people who believe that "research" is measured in hours of Youtube viewing are more of a lost cause IMO.


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Offlineendtimes
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Re: PubMed: Both a blessing and a curse [Re: HamHead] * 3
    #26858621 - 08/02/20 11:02 AM (3 years, 5 months ago)

Quote:

HamHead said:
Nah, a little upset science is being burned in favor of mask and vaccines.



It’s not being burned. Masks and vaccines are supported by science.

The problem with PubMed is that even the bad studies are on there and people who use it don’t know how to interpret research papers. I think the concerns presented are valid.


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Re: PubMed: Both a blessing and a curse [Re: HamHead] * 2
    #26858633 - 08/02/20 11:09 AM (3 years, 5 months ago)

Scientific papers often require skilled reading comprehension. There’s a reason why reading comprehension skills account for such a large part of the MCATS. It is very easy to misinterpret what the author is saying if you’re not carefully parsing the words. People without scientific training are not well equipped to “educate themselves” through personal examinations of medical, sociological and other scientific literature


--------------------
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“if I believed she was 16 I would become unattracted to her”


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Re: PubMed: Both a blessing and a curse [Re: HamHead]
    #26858636 - 08/02/20 11:10 AM (3 years, 5 months ago)

Quote:

HamHead said:
Dude, you're not even a doctor.

Are you some sore of scientists?

Some ego on you to discredit work of those who stood before you.

You stand on giants and act like you're our community doctor or some shit.

How long have you been in a medical profession?




Control group scores: 82, 90, 95, 78, 98

Experimental group scores: 86, 99, 95, 85, 93


What is the effect size as expressed by cohens D?

This should take you no more than 4 or 5 minutes to calculate.


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OfflineHamHead
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Re: PubMed: Both a blessing and a curse [Re: endtimes]
    #26858638 - 08/02/20 11:11 AM (3 years, 5 months ago)

So, who's to say that those studies on mask and vaccines are good or bad?


--------------------
The Italian researchers’ findings, published by the INT’s scientific magazine Tumori Journal, show 11.6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020 had developed coronavirus antibodies well before February.

https://www.reuters.com/article/us-health-coronavirus-italy-timing-idUSKBN27V0KF

This online first version has been peer-reviewed, accepted and edited,  but not formatted and finalized with corrections from authors and proofreaders

https://www.icandecide.org/


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OfflineHamHead
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Re: PubMed: Both a blessing and a curse [Re: morrowasted]
    #26858641 - 08/02/20 11:12 AM (3 years, 5 months ago)

Quote:

morrowasted said:
Quote:

HamHead said:
Dude, you're not even a doctor.

Are you some sore of scientists?

Some ego on you to discredit work of those who stood before you.

You stand on giants and act like you're our community doctor or some shit.

How long have you been in a medical profession?




Control group scores: 82, 90, 95, 78, 98

Experimental group scores: 86, 99, 95, 85, 93


What is the effect size as expressed by cohens D?

This should take you no more than 4 or 5 minutes to calculate.




7.

:notyou:


--------------------
The Italian researchers’ findings, published by the INT’s scientific magazine Tumori Journal, show 11.6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020 had developed coronavirus antibodies well before February.

https://www.reuters.com/article/us-health-coronavirus-italy-timing-idUSKBN27V0KF

This online first version has been peer-reviewed, accepted and edited,  but not formatted and finalized with corrections from authors and proofreaders

https://www.icandecide.org/


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Offlinemorrowasted
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Re: PubMed: Both a blessing and a curse [Re: psi]
    #26858644 - 08/02/20 11:13 AM (3 years, 5 months ago)

Fair enough psi, but just look at hamhead. You frequently cites pubmed but his cause seems just as lost as any, if not more so. It is also more dangerous because other uneducated people are more likely to take him seriously than to take someone posting youtube videos seriously


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Re: PubMed: Both a blessing and a curse [Re: morrowasted]
    #26858646 - 08/02/20 11:15 AM (3 years, 5 months ago)

I agree.

People think being "peer-reviewed" is the end-all-be-all.  Even within this research, the strength of data varies considerably.  Recently, observational, cross sectional studies are being presented as absolute fact, and individuals don't understand their limitations.

In a separate thread here, someone didn't know what a placebo was.  Think about that for a moment...


--------------------
...the whole experience is (and is as) a profound piece of knowledge.  It is an indellible experience; it is forever known.  I have known myself in a way I doubt I would have ever occurred except as it did.

Smith, P.  Bull. Menninger Clinic (1959) 23:20-27; p. 27.

...most subjects find the experience valuable, some find it frightening, and many say that is it uniquely lovely.

Osmond, H.  Annals, NY Acad Science (1957) 66:418-434; p.436


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Offlinemorrowasted
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Re: PubMed: Both a blessing and a curse [Re: HamHead]
    #26858652 - 08/02/20 11:19 AM (3 years, 5 months ago)

Quote:

HamHead said:

7.

:notyou:


im tied up with family activites so I can't verify this atm but there is no way you legitimately calculated the real answer that quickly, the only way you might have is using a google effect size calculator, which i just realized exists. Your lack of shame at being intentionally intellectually dishonest is very sad. Calculating the d from those values is a multi step process involving the calcuation of mean and standard deviation. There is simply no way you did all of that that in 2 minutes


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Re: PubMed: Both a blessing and a curse [Re: morrowasted]
    #26858655 - 08/02/20 11:21 AM (3 years, 5 months ago)

Yeah I definitely see the pitfalls, especially you have a preconceived idea of a conclusion you want to find in the literature.


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Offlinemorrowasted
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Re: PubMed: Both a blessing and a curse [Re: badchad]
    #26858656 - 08/02/20 11:21 AM (3 years, 5 months ago)

Quote:

badchad said:
I agree.

People think being "peer-reviewed" is the end-all-be-all.  Even within this research, the strength of data varies considerably.  Recently, observational, cross sectional studies are being presented as absolute fact, and individuals don't understand their limitations.

In a separate thread here, someone didn't know what a placebo was.  Think about that for a moment...


oh i know exactly which thread you are talking about- it is where hamhead made it clear he didnt even know what normal saline is by claiming it doesnt count as a placebo


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Re: PubMed: Both a blessing and a curse [Re: morrowasted]
    #26858660 - 08/02/20 11:23 AM (3 years, 5 months ago)

I thought it was the other way around, he would only accept an example where the placebo was saline.


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Invisiblebadchad
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Re: PubMed: Both a blessing and a curse [Re: psi]
    #26858676 - 08/02/20 11:30 AM (3 years, 5 months ago)

Quote:

psi said:
I thought it was the other way around, he would only accept an example where the placebo was saline.




It was this.  There are several varieties of commercial saline solutions.  The bigger issue though, is that anything inactive can serve as a placebo.  The reality is if you aren't knowledgeable on what a "placebo" is, you probably shouldn't be discussing science.  At all.


--------------------
...the whole experience is (and is as) a profound piece of knowledge.  It is an indellible experience; it is forever known.  I have known myself in a way I doubt I would have ever occurred except as it did.

Smith, P.  Bull. Menninger Clinic (1959) 23:20-27; p. 27.

...most subjects find the experience valuable, some find it frightening, and many say that is it uniquely lovely.

Osmond, H.  Annals, NY Acad Science (1957) 66:418-434; p.436


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Re: PubMed: Both a blessing and a curse [Re: morrowasted]
    #26858680 - 08/02/20 11:32 AM (3 years, 5 months ago)

A placebo is an inert solution.

What it is not is a saline solution with added adjuvants.

When a placebo is used in vaccine trials, it is common knowledge that there will be some reactions at injection site at least. If a placebo, inert, saline solution with no activity is given and no reaction happens, people are likely to conclude that they recieved a placebo.

In order to have a placebo cause an reaction, chemicals are added such as aluminium adjuvants, which cross bbb (blood brain barriers).

And, OMG, Pubmed

https://pubmed.ncbi.nlm.nih.gov/21871940/

"Aluminium-based adjuvants should not be used as placebos in clinical trials"
Quote:

morrowasted said:
Quote:

HamHead said:

7.

:notyou:


im tied up with family activites so I can't verify this atm but there is no way you legitimately calculated the real answer that quickly, the only way you might have is using a google effect size calculator, which i just realized exists. Your lack of shame at being intentionally intellectually dishonest is very sad. Calculating the d from those values is a multi step process involving the calcuation of mean and standard deviation. There is simply no way you did all of that that in 2 minutes




:derp:

Oh shit, you thought I did math?

:slowreaction:

7 is my go to guess number.

I used to deal craps.


--------------------
The Italian researchers’ findings, published by the INT’s scientific magazine Tumori Journal, show 11.6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020 had developed coronavirus antibodies well before February.

https://www.reuters.com/article/us-health-coronavirus-italy-timing-idUSKBN27V0KF

This online first version has been peer-reviewed, accepted and edited,  but not formatted and finalized with corrections from authors and proofreaders

https://www.icandecide.org/


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Re: PubMed: Both a blessing and a curse [Re: morrowasted] * 1
    #26858682 - 08/02/20 11:33 AM (3 years, 5 months ago)

Thank you for this post man.  In the age of internet the loudest ones are often the ones who are followed, not the smartest.  I'm glad to see this post being loud AND smart.


--------------------

When we constantly pull things apart trying to see how it works, we may end up with only an understanding of how to destroy something
- nick sand


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Offlineendtimes
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Re: PubMed: Both a blessing and a curse [Re: morrowasted]
    #26858686 - 08/02/20 11:34 AM (3 years, 5 months ago)

My question would be then why do you engage him when you can verify they are less than reputable, would that not contribute to lending him undue legitimacy which is as you are concerned about?

I mean peer review is not iron clad, but science shows us nothing is. All we have is evidence, not proof (I’m told there is a difference) and any moment what we have can be overturned. We are fallible creatures and the best we can do is to be less wrong


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Re: PubMed: Both a blessing and a curse [Re: endtimes]
    #26858716 - 08/02/20 11:46 AM (3 years, 5 months ago)

Shiiiiit if I was a doc I'd say sure ok, and let them treat themselves(in that context) and when they come back I'll ask them if they feel any better and thank them for the free medical research :house:


--------------------
ERROR 418 IM A TEAPOT.....(this account is automated, all posts related to illegal activities or advice thereof are strictly from numerous online sites and are for informational purposes only)- Circa 2011
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Re: PubMed: Both a blessing and a curse [Re: spirit_shadow]
    #26858739 - 08/02/20 11:57 AM (3 years, 5 months ago)

https://www.facebook.com/409037702805561/posts/1175134802862510/

Del Bigtree understands placebo.

His channel, The Highwire, was recently pulled from YouTube.

He runs a nonprofit.

https://www.icandecide.org/


--------------------
The Italian researchers’ findings, published by the INT’s scientific magazine Tumori Journal, show 11.6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020 had developed coronavirus antibodies well before February.

https://www.reuters.com/article/us-health-coronavirus-italy-timing-idUSKBN27V0KF

This online first version has been peer-reviewed, accepted and edited,  but not formatted and finalized with corrections from authors and proofreaders

https://www.icandecide.org/


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Offlineendtimes
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Re: PubMed: Both a blessing and a curse [Re: HamHead] * 2
    #26858754 - 08/02/20 12:06 PM (3 years, 5 months ago)

That nonprofit seems hella sketchy


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Re: PubMed: Both a blessing and a curse [Re: morrowasted] * 1
    #26858796 - 08/02/20 12:35 PM (3 years, 5 months ago)

Quote:

morrowasted said:
Most of you probably know by know that PubMed is a massive index of articles from scientific journals that appear in the The National Center for Biotechnology Information (NCBI). At face value, it seems like an excellent idea- what better way to facilitate access to scientific truths than to make all research easily searchable in one index?

...........

If you want to know the truth about a subject, but you lack significant education in that subject, please have the humility to use people you trust and know to be educated in that subject as a resource. When they suggest that your interpretation is incorrect, don't take it personally. They're not trying to hurt your feelings. Avail yourself of the help they offer you.






That was wordy and complicated, too much technical jargon.
I just read the first and last paragraphs.

So you're saying that PubMed and ncbi are great resource for us lay-people to have the complicated science explained by trusted, educated professionals?


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Re: PubMed: Both a blessing and a curse [Re: endtimes]
    #26858804 - 08/02/20 12:38 PM (3 years, 5 months ago)

The placebo must share enough macroscopic properties that both the patient and the doctor cannot tell the difference visually


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Re: PubMed: Both a blessing and a curse [Re: koods]
    #26858811 - 08/02/20 12:41 PM (3 years, 5 months ago)

Quote:

koods said:
The placebo must share enough macroscopic properties that both the patient and the doctor cannot tell the difference visually




A placebo is an inert, sugar pill or saline solution with no additives.

Anything else should not be classified as a placebo.


--------------------
The Italian researchers’ findings, published by the INT’s scientific magazine Tumori Journal, show 11.6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020 had developed coronavirus antibodies well before February.

https://www.reuters.com/article/us-health-coronavirus-italy-timing-idUSKBN27V0KF

This online first version has been peer-reviewed, accepted and edited,  but not formatted and finalized with corrections from authors and proofreaders

https://www.icandecide.org/


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Invisiblebadchad
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Re: PubMed: Both a blessing and a curse [Re: foragedfungus]
    #26858816 - 08/02/20 12:43 PM (3 years, 5 months ago)

Quote:

foragedfungus said:

So you're saying that PubMed and ncbi are great resource for us lay-people to have the complicated science explained by trusted, educated professionals?




Generally, its the opposite.  Pubmed isn't intended for lay people.  It's what professionals use.  Laypeople can be prone to misinterpretation of results.


--------------------
...the whole experience is (and is as) a profound piece of knowledge.  It is an indellible experience; it is forever known.  I have known myself in a way I doubt I would have ever occurred except as it did.

Smith, P.  Bull. Menninger Clinic (1959) 23:20-27; p. 27.

...most subjects find the experience valuable, some find it frightening, and many say that is it uniquely lovely.

Osmond, H.  Annals, NY Acad Science (1957) 66:418-434; p.436


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Re: PubMed: Both a blessing and a curse [Re: HamHead]
    #26858826 - 08/02/20 12:48 PM (3 years, 5 months ago)

Above you explained the potential disadvantages to that though (absence of expected side effects tipping the patient or researcher off that the placebo was given, and sabotaging the double blind thing). It would seem there are pros and cons to both approaches.


The definition you gave may be the one you prefer, but from your own evidence it would seem actual scientists use the word placebo in a broader way.


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Re: PubMed: Both a blessing and a curse [Re: badchad] * 2
    #26858834 - 08/02/20 12:51 PM (3 years, 5 months ago)

I thought my trolling was obvious.

Only reading the first and last paragraph of the OP (as he claims folks do with papers on pubmed), misinterpreting his words, and coming to a conclusion that was the exact opposite of what he intended.


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Re: PubMed: Both a blessing and a curse [Re: psi]
    #26858870 - 08/02/20 01:06 PM (3 years, 5 months ago)

Quote:

psi said:
Above you explained the potential disadvantages to that though (absence of expected side effects tipping the patient or researcher off that the placebo was given, and sabotaging the double blind thing). It would seem there are pros and cons to both approaches.


The definition you gave may be the one you prefer, but from your own evidence it would seem actual scientists use the word placebo in a broader way.




Yes, very broad, as in testing vaccines against other vaccines, as placebo.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4157320/

3. General ethical considerations
Given the high burden of infectious diseases, especially in LMICs, there is an ethical imperative to develop and test new vaccines. The recommendations from the panel therefore aim to facilitate the conduct of vaccine research that is ethical, scientifically valid, and designed to meet important public health needs.

While this paper focuses specifically on the use of placebo controls, similar considerations apply to open designs in which a placebo is not used, but an unvaccinated control group is included. The following recommendations assume that other common requirements for ethical research are respected [4,5]. In particular: Investigators and sponsors consult and collaborate with local stakeholders in all phases of the research; research participants, or their legal representatives, give voluntary and informed consent to study participation; participants are free to withdraw from research at any time, for any reason, without penalty; the research addresses an important health problem and is responsive to local health needs; the study design used minimizes risks and enhances potential clinical benefits for participants; the benefits and burdens of the research are justly distributed; and sponsors, in consultation with national or local authorities, make provisions to ensure reasonable post-trial access to interventions proven most efficacious to the population from which the research participants were drawn.

4. Ethical framework for placebo use in vaccine trials
To navigate the difficult ethical terrain of using placebo controls in vaccine trials, it is helpful to identify the conditions under which placebo use is clearly acceptable and clearly unacceptable. The following considerations assume that placebo interventions (e.g. subcutaneous injections of saline solution) themselves pose negligible risks.

Placebo use in vaccine trials is clearly acceptable when (a) no efficacious and safe vaccine exists and (b) the vaccine under consideration is intended to benefit the population in which the vaccine is to be tested. In this situation, a placebo-controlled trial addresses the locally relevant question regarding the extent to which the new vaccine is better than nothing, and participants in the placebo arm of the trial are not deprived of the clinical benefits of an existing efficacious vaccine.

Placebo use in vaccine trials is clearly unacceptable when (a) a highly efficacious and safe vaccine exists and is currently accessible in the public health system of the country in which the trial is planned and (b) the risks to participants of delaying or foregoing the available vaccine cannot be adequately minimized or mitigated (e.g. by providing counselling and education on behavioural disease prevention strategies, or ensuring adequate treatment for the condition under study to prevent serious harm). In this situation, a placebo-controlled trial would not address a question that is relevant in the local context, namely how the new vaccine compares to the one that is currently in use, and participants would be exposed to unacceptable levels of risk from delaying or foregoing a safe and effective vaccine that is accessible through the public health system.

Between these two poles, the use of placebo controls in vaccine trials may be justified even when an efficacious vaccine exists, provided the risk-benefit profile of the trial is acceptable. This applies to situations where the existing vaccine is available through the local public health system, as well as to situations where the existing vaccine is not available locally, or it is only available on the private market. Specifically, the risk-benefit profile of a placebo-controlled vaccine trial may be acceptable when (1) the study question cannot be answered with an active-controlled trial design; and (2) the risks of delaying or foregoing an existing efficacious vaccine are adequately minimized or mitigated; and (3) the use of a placebo control is justified by the potential public health or social value of the research; and (4) the research is responsive to local health needs. Importantly, and contrary to many of the existing ethical guidelines on placebo use [4,5,7,9], the acceptable risks of withholding or delaying administration of an existing vaccine in the placebo arm of vaccine trials may be greater than minimal when the above conditions are met.


--------------------
The Italian researchers’ findings, published by the INT’s scientific magazine Tumori Journal, show 11.6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020 had developed coronavirus antibodies well before February.

https://www.reuters.com/article/us-health-coronavirus-italy-timing-idUSKBN27V0KF

This online first version has been peer-reviewed, accepted and edited,  but not formatted and finalized with corrections from authors and proofreaders

https://www.icandecide.org/


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Re: PubMed: Both a blessing and a curse [Re: HamHead]
    #26858912 - 08/02/20 01:21 PM (3 years, 5 months ago)

I'm confused about why you chose those portions to underline. Don't see them referring anywhere to real working vaccines as placebos. And in the case of Covid-19, it is not the case (or at least has not been demonstrated yet) that a highly efficacious and safe vaccine already exists. Why the underlining on the portions about this?


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Re: PubMed: Both a blessing and a curse [Re: morrowasted]
    #26858917 - 08/02/20 01:24 PM (3 years, 5 months ago)

Understanding how to analyze research is something that takes time and study to do properly. A whole lot of published research is junk, both intentionally biased, rushed to pad publication numbers, bought and paid for, unintentionally low-quality from amateur researchers, etc. There's a reason most research methods courses in college focus roughly 75% of the curriculum on critically analysing and picking research articles apart, and there's a very thorough and structured way of doing so that is not a quick or easy process.

The knowledge gained from these courses also comes from doing your own studies, typically meta-analysis' or scoping reviews, to get intimately familiar with the structure of papers, and understand just how easy bias and confounding variables can slip in unintentionally, when a professor or peer reviewer picks you apart. There's also a real need for an understanding of the statistics involved, which is not something intuitive and also takes some study.

Arguing over research papers with someone not trained to understand them is pretty futile, it's been this way forever. You can search "studies show ...." and fill in any wonky thought you'd like, and you'll find your news source stating that drinking wine helps you build muscle or nicotine cures the cornavirus or whatever. It's all either the media horribly misinterpreting the data or often even accurately reporting very flawed or incomplete data. Any correlation is a golden ticket to bias confirmation or to clicks and ad revenue.


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Re: PubMed: Both a blessing and a curse [Re: morrowasted]
    #26858982 - 08/02/20 01:49 PM (3 years, 5 months ago)

Quote:

morrowasted said:
Quote:

HamHead said:
Dude, you're not even a doctor.

Are you some sore of scientists?

Some ego on you to discredit work of those who stood before you.

You stand on giants and act like you're our community doctor or some shit.

How long have you been in a medical profession?




Control group scores: 82, 90, 95, 78, 98

Experimental group scores: 86, 99, 95, 85, 93


What is the effect size as expressed by cohens D?

This should take you no more than 4 or 5 minutes to calculate.





Control group sd = 8.473488066
Exp group sd = 5.983310121


Cohen's d = (91.6 - 88.6) ⁄ 7.334848 = 0.409006.

Glass's delta = (91.6 - 88.6) ⁄ 8.473488 = 0.354045.

Hedges' g = (91.6 - 88.6) ⁄ 7.334848 = 0.4090


--------------------
:whyyy:


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Re: PubMed: Both a blessing and a curse [Re: feevers]
    #26858991 - 08/02/20 01:52 PM (3 years, 5 months ago)

Quote:




That was wordy and complicated, too much technical jargon.
I just read the first and last paragraphs.

So you're saying that PubMed and ncbi are great resource for us lay-people to have the complicated science explained by trusted, educated professionals?



:lolsy:

Ps hamhead, your answer was way off.


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Re: PubMed: Both a blessing and a curse [Re: morrowasted]
    #26858996 - 08/02/20 01:53 PM (3 years, 5 months ago)

Cohens likes large sample size. Either way even with hedges its a small effect. Idk where the numbers came from tho


--------------------
:whyyy:


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Re: PubMed: Both a blessing and a curse [Re: morrowasted] * 1
    #26859002 - 08/02/20 01:56 PM (3 years, 5 months ago)

Bodhi, I also found the website you yanked those answers from. Our ability to type "effect size calculator" into google is equal! I should have realized when i asked the question that there would be one out there.


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Re: PubMed: Both a blessing and a curse [Re: psi]
    #26859037 - 08/02/20 02:15 PM (3 years, 5 months ago)

Quote:

psi said:

Better PubMed than Youtube though I will say.




People are too quick to judge youtube as shitty, I cant really understand studies very well, I only have a highschool equivalency, but I can watch youtubers who read and understand the studies better then me and break them down in laymen terms, that is pretty usefull IMO and a good thing

Right now im into watching Jason Fungs youtubes, hes a nerphrologist from Toronto, his theory is that Insulin is the biggest driver of weight gain, with cortisol being the second (by driving up insulin) I think I have watched all his youtubes so I bought his earlier book called the obesity code, I just read that in 2 days and thought it was great, he also has 2 other books, the diabetes code, and the complete guide to fasting, I might get the dibetes code, but the reviews on Amazon for his fasting book makes me not want to pay so much for it, they say he repeats the same shit in every chapter, all the studies referenced were mouse studies and the book dosnt have any information not already in the obesity code


--------------------
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Re: PubMed: Both a blessing and a curse [Re: gopher] * 2
    #26859057 - 08/02/20 02:26 PM (3 years, 5 months ago)

You really just have to make sure your source is credible and try to watch any videos arguing against them if there are any. When someone is putting content on youtube the majoriry of the time they're acting for a profit, which will nearly always influence their content and how they interpret data. The profit comes in selling a theory or narrative or whatever, not in detailing everything that's lacking in the studies you're citing or going over the evidence to the contrary of what you're promoting.


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Re: PubMed: Both a blessing and a curse [Re: HamHead] * 2
    #26859099 - 08/02/20 03:00 PM (3 years, 5 months ago)

Quote:

HamHead said:
Quote:

koods said:
The placebo must share enough macroscopic properties that both the patient and the doctor cannot tell the difference visually




A placebo is an inert, sugar pill or saline solution with no additives.

Anything else should not be classified as a placebo.




A proper vaccine placebo should probably contain the same ingredients as the real vaccine, except for the active ingredient.

And there’s nothing biologically inert about sugar or an electrolyte solution.

When you’re a senior, you’ll probably have a biology course. Pay attention.


--------------------
NotSheekle said
“if I believed she was 16 I would become unattracted to her”


Edited by koods (08/02/20 03:04 PM)


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Re: PubMed: Both a blessing and a curse [Re: koods]
    #26859129 - 08/02/20 03:14 PM (3 years, 5 months ago)

HamHead explained himself what the downsides of a completely inert placebo can be, yet he's holding up saline as a gold standard. And he provided a quote that seemed to be saying "it's unethical to do placebo trials if there is already a working vaccine" as evidence that researchers use a definition of "placebo" so broad that it includes working vaccines.


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Re: PubMed: Both a blessing and a curse [Re: morrowasted]
    #26859173 - 08/02/20 03:40 PM (3 years, 5 months ago)

Quote:

morrowasted said:
Bodhi, I also found the website you yanked those answers from. Our ability to type "effect size calculator" into google is equal! I should have realized when i asked the question that there would be one out there.



When I was in college the program everyone used was called spss but now websites do the same shit


--------------------
:whyyy:


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Re: PubMed: Both a blessing and a curse [Re: bodhisatta]
    #26859174 - 08/02/20 03:42 PM (3 years, 5 months ago)

wtf, we were forced to do the calculations on pen and paper :shrug:


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Re: PubMed: Both a blessing and a curse [Re: feevers]
    #26859226 - 08/02/20 04:26 PM (3 years, 5 months ago)

That might be being generous. Youtube is more like anyone who wants to broadcast their views and censor opposition. You can make profit sure, but most of my experience tends to be it being an echo chamber for anything.


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Re: PubMed: Both a blessing and a curse [Re: psi]
    #26859234 - 08/02/20 04:30 PM (3 years, 5 months ago)

Quote:

psi said:
HamHead explained himself what the downsides of a completely inert placebo can be, yet he's holding up saline as a gold standard. And he provided a quote that seemed to be saying "it's unethical to do placebo trials if there is already a working vaccine" as evidence that researchers use a definition of "placebo" so broad that it includes working vaccines.




There are no 'down sides' to a true placebo.

And you must not have read through that link, you might understand why it would be unethical to provide a placebo in an area with high risk disease, when an effective 'placebo control' is available to better protect test subjects than an actual placebo.


--------------------
The Italian researchers’ findings, published by the INT’s scientific magazine Tumori Journal, show 11.6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020 had developed coronavirus antibodies well before February.

https://www.reuters.com/article/us-health-coronavirus-italy-timing-idUSKBN27V0KF

This online first version has been peer-reviewed, accepted and edited,  but not formatted and finalized with corrections from authors and proofreaders

https://www.icandecide.org/


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Re: PubMed: Both a blessing and a curse [Re: HamHead] * 1
    #26859255 - 08/02/20 04:46 PM (3 years, 5 months ago)

Maybe I'm not reading your post right but you appear to be saying "true placebos don't have downsides" and then immediately saying "using a true placebo is unethical under circumstance XYZ...

am I missing something here??? how is that not a blatant self-contradiction?


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Re: PubMed: Both a blessing and a curse [Re: HamHead] * 1
    #26859256 - 08/02/20 04:46 PM (3 years, 5 months ago)

I agree with the op sad to see such disinformation at a time like this. Willful destruction by the sickest people on the earth.


--------------------
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Re: PubMed: Both a blessing and a curse [Re: HamHead] * 1
    #26859257 - 08/02/20 04:47 PM (3 years, 5 months ago)

Quote:

HamHead said:
There are no 'down sides' to a true placebo.





This is the downside you laid out. I'm not talking about side effects.

Quote:

HamHead said:
When a placebo is used in vaccine trials, it is common knowledge that there will be some reactions at injection site at least. If a placebo, inert, saline solution with no activity is given and no reaction happens, people are likely to conclude that they recieved a placebo..







Quote:

And you must not have read through that link, you might understand why it would be unethical to provide a placebo in an area with high risk disease, when an effective 'placebo control' is available to better protect test subjects than an actual placebo.




I read only your quote, not the link, but I have no trouble understanding the ethical consideration they're talking about regarding withholding a working treatment. I just don't think it supported your claim that accompanied the quote.

Quote:

HamHead said:
Quote:

psi said:
Above you explained the potential disadvantages to that though (absence of expected side effects tipping the patient or researcher off that the placebo was given, and sabotaging the double blind thing). It would seem there are pros and cons to both approaches.


The definition you gave may be the one you prefer, but from your own evidence it would seem actual scientists use the word placebo in a broader way.




Yes, very broad, as in testing vaccines against other vaccines, as placebo.




Your quote discussed testing vaccines against other vaccines, but it did not refer to the vaccines by the term "placebo". On the contrary it suggested not doing placebo trials when there is a working vaccine already. So they are not in fact using the word "placebo" so broadly as to refer to a working vaccine as you suggested.


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Re: PubMed: Both a blessing and a curse [Re: psi]
    #26859263 - 08/02/20 04:51 PM (3 years, 5 months ago)

the down side to placebos is when you are testing a diabetes medication, cause the placebo is a sugar pill so they are giving diabetics sugar in that case


--------------------
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Re: PubMed: Both a blessing and a curse [Re: HamHead] * 2
    #26859264 - 08/02/20 04:52 PM (3 years, 5 months ago)

Quote:

HamHead said:


There are no 'down sides' to a true placebo.

And you must not have read through that link, you might understand why it would be unethical to provide a placebo in an area with high risk disease, when an effective 'placebo control' is available to better protect test subjects than an actual placebo.




Yes there are.  In this case, breaking the blind is probably the most substantial downside, though of lesser concern in vaccine development.


Edited by badchad (08/02/20 04:53 PM)


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Re: PubMed: Both a blessing and a curse [Re: badchad]
    #26859267 - 08/02/20 04:53 PM (3 years, 5 months ago)

And HamHead himself acknowledged that consideration in the post I quoted.


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Re: PubMed: Both a blessing and a curse [Re: HamHead]
    #26859269 - 08/02/20 04:53 PM (3 years, 5 months ago)

Quote:

HamHead said:
Quote:

psi said:
HamHead explained himself what the downsides of a completely inert placebo can be, yet he's holding up saline as a gold standard. And he provided a quote that seemed to be saying "it's unethical to do placebo trials if there is already a working vaccine" as evidence that researchers use a definition of "placebo" so broad that it includes working vaccines.




There are no 'down sides' to a true placebo.

And you must not have read through that link, you might understand why it would be unethical to provide a placebo in an area with high risk disease, when an effective 'placebo control' is available to better protect test subjects than an actual placebo.



Omg the reason it’s not ethical is because all patients should be receiving a treatment with proven efficacy


--------------------
NotSheekle said
“if I believed she was 16 I would become unattracted to her”


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Re: PubMed: Both a blessing and a curse [Re: gopher]
    #26859277 - 08/02/20 04:58 PM (3 years, 5 months ago)

Quote:

gopher said:
the down side to placebos is when you are testing a diabetes medication, cause the placebo is a sugar pill so they are giving diabetics sugar in that case




I doubt actual placebos are sugar pills. They would be similar to the pills with the active ingredient. Polyethylene Glycol and methylcellulose


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NotSheekle said
“if I believed she was 16 I would become unattracted to her”


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Re: PubMed: Both a blessing and a curse [Re: psi] * 1
    #26859279 - 08/02/20 04:59 PM (3 years, 5 months ago)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4157320/

"Finally, as part of the discussions around trial design, investigators, sponsors and RECs should consider different types of “placebo” interventions. Rather than using a true placebo control (i.e. an inert substance), it may be appropriate to use a vaccine against a disease that is not the focus of the trial (e.g. an ongoing malaria vaccine trial provides non-malaria vaccines to participants in the control arm [21,22]). The motivation for using these types of “placebos” is to benefit participants in the control arm and avoid giving an injection with an inert substance."

Furthermore, it is important to recognize that trials using such “placebos” may provide a less perfect control if the effects of the comparator vaccine(s) confound the evaluation of the risk-benefit profile of the experimental vaccine. For this reason, use of such “placebos” may also be less acceptable to regulators or public health authorities and potentially delay approval or adoption of a new vaccine."

Just because they say they use a "placebo", does not mean it is a completely inert substance.

Oh, and you go read that link, they put those "" around "placebo", not me.


--------------------
The Italian researchers’ findings, published by the INT’s scientific magazine Tumori Journal, show 11.6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020 had developed coronavirus antibodies well before February.

https://www.reuters.com/article/us-health-coronavirus-italy-timing-idUSKBN27V0KF

This online first version has been peer-reviewed, accepted and edited,  but not formatted and finalized with corrections from authors and proofreaders

https://www.icandecide.org/


Edited by HamHead (08/02/20 05:00 PM)


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Re: PubMed: Both a blessing and a curse [Re: HamHead]
    #26859281 - 08/02/20 05:02 PM (3 years, 5 months ago)

Ok, I agree you have supported your claim. Would have saved us both a bit of time if you had quoted the relevant part in the first place.


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Re: PubMed: Both a blessing and a curse [Re: psi]
    #26859283 - 08/02/20 05:03 PM (3 years, 5 months ago)

Quote:

psi said:
Ok, I agree you have supported your claim.



:ohwow:


--------------------
The Italian researchers’ findings, published by the INT’s scientific magazine Tumori Journal, show 11.6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020 had developed coronavirus antibodies well before February.

https://www.reuters.com/article/us-health-coronavirus-italy-timing-idUSKBN27V0KF

This online first version has been peer-reviewed, accepted and edited,  but not formatted and finalized with corrections from authors and proofreaders

https://www.icandecide.org/


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InvisiblePrimal Glitch
literally just vibing
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Registered: 05/06/07
Posts: 4,854
Loc: 🌎 Flag
Re: PubMed: Both a blessing and a curse [Re: morrowasted]
    #26859287 - 08/02/20 05:04 PM (3 years, 5 months ago)

Quote:

Psicomvb said:
Thank you for this post man.  In the age of internet the loudest ones are often the ones who are followed, not the smartest.  I'm glad to see this post being loud AND smart.




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                                  make the changa you wish to see in the world
                                                                gnome sayin'?


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Offlinekoods
Ribbit
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Registered: 05/26/11
Posts: 106,049
Loc: Maryland/DC Burbs
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Re: PubMed: Both a blessing and a curse [Re: Primal Glitch]
    #26859304 - 08/02/20 05:14 PM (3 years, 5 months ago)

What is hamhead arguing about?


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NotSheekle said
“if I believed she was 16 I would become unattracted to her”


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InvisiblePrimal Glitch
literally just vibing
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Registered: 05/06/07
Posts: 4,854
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Re: PubMed: Both a blessing and a curse [Re: koods]
    #26859320 - 08/02/20 05:26 PM (3 years, 5 months ago)

he's some sore of scientist


--------------------

                                  make the changa you wish to see in the world
                                                                gnome sayin'?


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InvisiblefeeversM
Male

Registered: 12/28/10
Posts: 8,546
Loc: Flag
Re: PubMed: Both a blessing and a curse [Re: morrowasted] * 1
    #26859348 - 08/02/20 05:34 PM (3 years, 5 months ago)

Somewhat off-topic, but if you ever find an article on pubmed or elsewhere that doesn't have the full text for free, copy/paste the DOI into sci-hub.tw. It's a sketchy russian site aimed at open sourcing academic journals, they have full texts for almost everything on there. Got me through grad school because even with my uni's credentials there is still so much behind paywalls... the system of charging $30+ for an article is pretty disgusting imo


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