Radiology and the reading room consult

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Radiology used to have something that was almost invisible because it was so routine:

The reading room consult. Rounding teams came down. Surgeons pulled up their cases. Internists brought the scan that didn't quite fit the clinical picture. Sometimes the radiologist solved the problem. Sometimes the clinician supplied one piece of history that completely changed how the images were interpreted. And usually everyone simply walked away a little sharper. But something else was happening during all of those conversations. We were learning each other. As a radiologist, I learned what individual physicians cared about. I knew which findings mattered to a particular surgeon. Which measurements an oncologist was following. Which details a specialist wanted emphasized. What questions they were really asking, even when the order just said "pain." And they learned me. They knew who was reading their study. They knew they could walk in, point at something, challenge an interpretation, or ask, "What do you think?" That relationship created context. It created feedback. It created trust. And over years, it created a kind of institutional knowledge that never appears in the medical record. When radiology becomes a report produced by someone hundreds or thousands of miles away, we don't just lose proximity. We risk losing that entire feedback loop. The report may still be technically excellent. But the radiologist knows less about the physician. The physician knows less about the radiologist. The radiologist sees less of what happened after the report. And both sides lose opportunities to make each other better. The reading room was never just a room. It was where imaging became part of the clinical conversation. We should think very carefully before designing that conversation out of medicine. Inspired by a conversation yesterday with

@PaleoOnc

. Also

@909One

and

@brianchiong

.

Carl Sagan sat in front of the United States Senate

 In 1985, Carl Sagan sat in front of the United States Senate and described the weather of 2026.

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Not as prediction. As physics. Sitting across from him was a junior senator named Al Gore — who would later win the Nobel Prize, the Oscar, and build a climate investment fund worth over $36 billion repeating almost word for word what Sagan said that afternoon. Sagan opened with Venus. 470°C surface temperature. 900°F. Hot enough to melt lead. "Not because it's closer to the sun," he told the senators. "Venus actually reflects more light than Earth. It should be cooler." The reason it wasn't: carbon dioxide. A runaway greenhouse effect that turned a planet nearly identical to Earth into a furnace. Then he looked at the committee and said: we're running the same experiment here. The senators nodded politely. Then they went back to approving fossil fuel subsidies. What Sagan told Congress in 1985: Global average temperature will rise several degrees by mid-to-late next century. Local climates will redistribute. Glaciers will melt. Sea levels will rise. And the problem cannot be solved by any single nation — not even if the US and Soviet Union agreed on everything — without China. China, he said, had the world's largest coal reserves and was about to industrialize. Every sentence was correct. He also said something that got almost no coverage at the time: "The initial stages of global temperature increase — one region might benefit while another suffers." That is the sentence that explains the last 20 years of geopolitics. Canada's growing season expanding while Pakistan floods. Russia opening Arctic shipping lanes while Bangladesh disappears. The politics of climate was never going to be clean because the physics wasn't distributed evenly. Sagan mapped all of it from first principles, in a Senate hearing room, 41 years ago. The part nobody quotes: He didn't say stop burning fossil fuels immediately. He said: "That has such severe economic consequences that no one will take it seriously." So he proposed something else — remove government subsidies from fossil fuels, accelerate solar, develop safe nuclear fission, and begin building international frameworks before the crisis made them impossible. That's not an environmentalist's speech. That's an economist's. Carl Sagan wrote 20 books. Cosmos was watched by 500 million people across 60 countries. He won the Pulitzer. The ideas in this testimony became the scientific foundation for a carbon market now valued at over $800 billion annually. He said one line at the end that nobody remembers. "We are all in this greenhouse together." In 1985, that was poetic. Now it's a weather report. The full testimony is free on YouTube. 17 minutes. Almost nobody outside of climate policy circles has watched it as a complete predictive model — laid out in plain language before any of it happened.

More than 100,000 people in Japan are now aged 100 or older

When records began in 1963 there were only 153 centenarians in Japan - now there are 107,677

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Food science, lifestyle and life expectancy at their best

It's amazing: authorities in Japan are worried because life expectancy has increased and birth rates are lower than deaths.

In stand of cherishing the fact that more and more people become centenarians, the government calls this an existential crisis.

Mad?

                                

                                 

How nutrition and health claims shape cheese choices: insights for food fortification and new product development

 

Abstract

The purpose of this study was to investigate the effect of nutrition and health claims on willingness to try and perceived healthiness of multiple cheese product concepts. Consumers (n = 603) from Ireland and the UK completed an online survey on cheese attitudes and usage. Factor analysis was used to generate constructs related to innovativeness, habits and health. These constructs were used in cluster analysis. Two clusters were identified: the “healthy and curious” (n = 363, health-interested, innovative and externally influenced) and the “traditional users” (n = 240, cost and convenience). Data analysis was conducted using SPSS v29 (IBM, USA). Consumers were most willing to try full-fat cheese, despite being perceived as less healthy (P < 0.001). Low-fat cheese was regarded as a healthier (P < 0.0001) option but had a lower willingness to try (P < 0.005). The addition of nutritional claims relating to protein, vitamins and health claims for muscle and bone health increased the perceived healthiness (P < 0.001) but decreased willingness to try relative to full-fat cheese (P < 0.05). The “healthy and curious” were more willing to try cheeses with nutrition and health claims (P < 0.01) than “traditional users” (P < 0.001). A moderate to strong positive correlation was observed between perceived healthiness and willingness to try (r = 0.504 to r = 0.626, P < 0.001). This study offers original insights into how consumers balance health perceptions and preferences, particularly within segmented consumer groups. Unlike previous research, it specifically examines the differential impact of nutritional claims across consumer segments for cheese. The findings highlight the importance of targeted and segment-specific population health strategies.

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Encapsulated Salmon Polar Lipids Modestly Reduce Postprandial Platelet Sensitivity to PAF and Thrombin in Healthy Adults: A Pilot Study

 The postprandial effects of a novel food-grade extracted salmon polar lipids (SPL) supplement against platelet-activating factor (PAF) and thrombin-induced platelet aggregation in a human pilot study was evaluated. This study was double-blinded, crossover, and placebo controlled in design. Five healthy volunteers completed 4 h time-course trials on 5 separate days. Blood was drawn at baseline before subjects consumed a standardized breakfast with one of the following treatments: a low-dose (0.25 g) or a high-dose (0.5 g) of SPL encapsulated within a stomach resistant capsule (LDSR and HDSR respectively) or a non-resistant capsule (LDSNR and HDSNR, respectively), or placebo capsules containing food-grade glycerin (0.5 g; Placebo). Blood was analyzed at 1 h intervals for 4 h. Among the treatments tested, the high-dose non-resistant capsule (HDSNR) produced the clearest postprandial effects, inducing significant increases in EC50 (reduced platelet sensitivity) for PAF at 2–3 h and for thrombin at 3–4 h post-ingestion. Smaller or delayed effects were observed with the high-dose resistant capsule (HDSR), while low-dose formulations produced minimal changes. Postprandial plasma glucose, lipid profile (TC, HDL-C, LDL-C, TG), fibrinogen, prothrombin time, and activated partial thromboplastin time remained unaffected across all trials. This pilot study provides the first in vivo indication that SPL supplementation may modestly attenuate platelet responsiveness to both PAF and thrombin without altering standard haemostatic or metabolic biomarkers. Larger controlled studies are warranted to confirm these preliminary findings and define optimal dosing and formulation strategies.

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Outcomes of cardiovascular screening in men aged 60–64 years: the DANCAVAS II trial

What happened to 'statins save lives'? In this 31,000 person RCT over 7 years, CVD screening put 44.33% of people on statins (compared to 30.25% in non screening) but prevented neither deaths nor CV events (HR 0.96). Funny how I don't see this trial EVER being discussed by cardiologists. One major difference with this trial compared to so many other statin trials is that it is not funded by a statin maker.

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The paper:

Outcomes of cardiovascular screening in men aged 60–64 years: the DANCAVAS II trial

Conclusions

Invitation to a comprehensive CT-based screening for subclinical CVD did not decrease death over 7 years among men aged 60–64 years but did increase severe bleeding. Because the trial was powered for events over 10 years, further follow-up is needed.

Something you would need after a night out

         Purging was one of the hangover cures prescribed in the Middle Ages. Tacuinum Sanitatis manuscript

Anyone who has ever woken up with a hangover will recognise its physical and psychological effects: headache, nausea, self-loathing, regret, and perhaps even some shame at the uninhibited behaviour that accompanied the intoxication.

In these days of smartphones, any shame experienced by the foggy memory of drunken behaviour the night before is invariably worse when there is photographic evidence online forever for all to see and judge.

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it's true, isn't it?

Full article is here.