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Psychotic Samurai sword-wielding man dressed as Shaolin monk injured six police officers

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Six police officers in Vienna, Austria, were injured by a psychotic man dressed as a Shaolin monk and wielding a Samurai sword on Monday.

Police spokesman Roman Hahslinger said that the drama started when a woman in an apartment in Kudlichgasse, in the Favoriten district, heard a loud knocking on her door at 2:00am. She opened the door to find a bald-headed man she had never met before dressed in an orange monk’s robe, and armed with a large sword. He pushed his way into her home, and she ran out and called the police.



Three police officers arrived at the building shortly afterwards and found the 39-year-old man in the stairwell. They surprised him with pepper spray and managed to knock the sword out of his hand but all three officers were seriously injured in the scuffle. As the man seemed to be suffering from mental illness they took him to the Rufolfstiftung psychiatric hospital.

However, he managed to escape from the hospital just hours later and was spotted in Meidling cemetery wearing a white hospital gown. When three police officers arrived he karate kicked and punched them. Again, they had to use pepper spray to subdue him and then took him back to hospital.
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Evaluating milk and its substitutes

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"Milk"

“Milk” at my local grocery store

I knew milk alternatives were becoming mainstream when a new bakery/café appeared in my neighborhood. I ordered a latte latté and learned that they didn’t use milk. At all. Not only were the baked goods was this place vegan, organic, “natural” and some were gluten-free, they were completely dairy-free for their coffee beverages. dairy-free too. While everything looked and smelled great, I was shocked that they had no milk on the premises. The milk alternative made with soy almonds didn’t taste bad, but it didn’t taste like milk. I left with my coffee, wondering how long the place would survive. I was wrong. It’s been a few years and the shop is still here, suggesting there’s a sizable appetite (at least in my laid-back, coffee-shop-saturated neighborhood) for milk-free, wheat-free vegan food and drinks. I shouldn’t be surprised. The number of people on restricted diets seems to be growing, and so have the food choices to meet their dietary demands. There have dietary demands. There’s always been people that avoided milk, milk but the reason was traditionally lactose intolerance intolerance, or dairy allergies. Now more are simply choosing to avoid it. I’m often asked about the merits of milk and the multiple milk alternatives, as the assessments of dairy seems to take one of two positions: Either milk is the dietary equivalent of unicorn tears, a nearly perfect food, or it is poison that’s almost certainly killing us. What’s clear is that we have more choice than ever for milk-like beverages. My local grocery is pictured above, where cow’s milk is just one small section. Who knew you could milk cashews?

I can understand and appreciate why people might not drink milk, for cultural reasons alone. I grew up drinking milk and eating dairy products regularly, but married into a family that didn’t drink or eat any at all. When my kids were young, we went through a lot of milk each week. Now that they’re older, our consumption’s dropped, as they almost always opt for eggs instead of cereal each morning. Given juice is tightly restricted in my home, milk’s now mainly for coffee, cooking, and helping the kids meet their vitamin D requirements. Whether it’s society’s declining devotion to breakfast cereal, concerns about animal welfare, or recognition that consuming milk simply isn’t essential, habits have changed. In North America consumption is dropping steadily over time, something the dairy industry seems unable to reverse. With the decline of milk, there has there’s been a rise in the number and types of milk-like beverages, raising the question of the relative merits.

Whether milk is “good” or “bad” and how it compares to the alternative “milks” depends on the question being asked. Good for what? Chemically, milk is emulsified fat in water that’s a good source of protein and several nutrients. If studying the effects of medication is difficult, that’s nothing compared to studying dietary interventions, where it’s exceptionally challenging to tease out cause and effect from studies which lack randomization and blinding. Correlation is not causation, and addressing all of the potential confounders seems nearly impossible. The result is trials with often equivocal results that are used to support nearly any position. Milk may be a good source of calcium, but consumption doesn’t seem related to fewer hip fractures as we age. It’s cited as an important part of the DASH diet, but DASH didn’t look at dairy in isolation. Cancer is often attributed to milk, but there’s a lack of convincing data. Even autism has been blamed on milk, a claim that’s never been substantiated. On balance, from a strictly  strictly a nutritional perspective, milk is probably neither good nor evil, especially when you consider it’s just one component of a diet. When consumed in moderation, there are almost certainly other factors, many controllable, that can have more significant effects on overall health (e.g., regular exercise, not smoking, and maintaining a healthy weight).

The alternatives to regular milk seem to have grown in popularity for different reasons. Organic milk caters to dietary preferences, but there’s no convincing evidence organic food is healthier. Lactose-free milk makes milk tolerable to those that lack the ability to digest the sugar lactose. Raw milk (where it’s legally sold) seems to exist for those that prioritize taste over the risk of a food-borne illness. Others are concerned about what else might be in milk. Just yesterday there was a report that milk may not always be free of antibiotic residues. Nobody wants (or should accept) ciprofloxacin in their milk, especially when any detectable amount is forbidden.

Malk: Now with Vitamin R

Oh, my bones are so brittle. But I always drink plenty of…”malk”?

There are more and more “milks” on the market. The most common ones are soy and almond, but you can also find rice, oat, coconut, potato, and even hemp milks for sale. Each has its own nutritional profile. Many are fortified (to mimic milk’s content) and often contain added sugars and flavors, so the nutritional profiles vary widely. (This CSPI table is among the more comprehensive). It’s important to note that plant-based milks lack the nutritional and caloric density of real milk, and are not a safe substitute in young children (<2 year). While there are nutritional differences between the products, eating an otherwise-balanced diet with plenty of variety is the probably the best approach to minimize the risk of dietary gaps. Total calories is one area where these products can vary significantly, and given liquid calories don’t seem to satiate like food, it is reasonable to conclude that consuming in moderation is probably best.

Almond milk is one of more popular “milks” now. It’s made by soaking ground-up almonds in water and then removing the solid matter.  Almond milk leverages the health halo that almonds currently enjoy, offering “good fats” and vitamins. Nutritionally, almond milk has a fraction of the protein of milk. One cup of almond milk contains the protein equivalent of just four almonds. There are only about four almonds of protein per cup of almond milk. Almonds, not almond milk, are a much more convenient and nutritionally-dense source of energy. The rest is expensive water, often fortified with vitamins and sometimes added sugar.

Soy milk was one of the earliest milk substitutes. Soy comes closest to real milk from a nutritional perspective, and some are fortified with vitamins to closely mimic real milk. Soy contains alpha-linolenic acid (ALA), an omega-3 fatty acid too, but if if’ you’re not a vegan, you’d be better off eating other omega-3 sources. The relationship between soy and cancer is unclear.

Coconut milkis is a mix of coconut water and the thick coconut cream. Like other coconut products, there’s a fair amount of saturated fat.  They’re low in protein, and usually fortified with vitamins.

Rice milk is low in protein but usually has levels of calcium that approach real milk.  There are some concerns about arsenic levels, but the overall health impact isn’t clear.  Compared to the other milks, rice tends to come up short from a nutritional perspective.

Conclusion

If you enjoy drinking milk, milk. there’s no convincing evidence to suggest you’re doing your body badly. If you’re consuming milk strictly for the perceived health benefits, then it’s fine to omit it from your diet. Milk isn’t magical and it isn’t poison. The same applies to the milk substitutes. If you want a milk-like beverage to drink, then there are lots of choices, and you can probably find one that you find palatable and is also fortified to deliver many of the nutritional benefits of regular milk.

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What Is Brain Death?

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Of course, any story illustrating the issues surrounding brain death is going to be a sad and tragic tale. In December of 2013, Jahi McMath suffered bleeding complications following a tonsillectomy and tissue removal for sleep apnea. This resulted in a cardiac arrest with an apparent prolonged period of lack of blood flow to the brain. While her heart function was brought back, Jahi suffered severe brain anoxia (damage due to lack of oxygen) and was declared brain dead on December 12, 2013.

Jahi’s tragic story is not over, however, because her family refused to accept the diagnosis of brain death. They took legal action to keep the hospital from pulling life support, and eventually worked out a compromise where the family was able to remove Jahi to their own care. At present Jahi is apparently being cared for in an apartment in New Jersey, on a ventilator and fed through a feeding tube.

There is often some confusion as to what brain death actually is. The term is unfortunately often used to refer to a persistent vegetative state or other severe impairment of consciousness, but this is not accurate. Brain death refers to a complete lack of function of the brain, including basic reflexes in the brain stem. There is a specific protocol for declaring a person brain dead, requiring detailed examination by at least two attending physicians to document the complete absence of any brain function. If the slightest pupillary reflex is present, then the patient cannot be declared brain dead. The criteria also include provisions that there are no medications in the person’s system that can suppress neurological function and their core body temperature is sufficiently high (being too cold can also suppress neurological function).

There are also several types of supporting evidence that can be used when appropriate. These include electroencephalogram, which reads the electrical activity of the brain. A complete absence of electrical activity supports the diagnosis of brain death. Tests looking at blood flow to the brain can also be performed. A complete absence of blood flow to the brain also supports the diagnosis of brain death. These laboratory criteria are not necessary if the patient meets the clinical criteria for brain death, but they can be used if some parts of the exam cannot be done for practical reasons.

Overall the criteria are very conservative. They are designed to minimize the chance of declaring someone brain dead when they aren’t. These are universally-accepted criteria, established in 1995 by the American Academy of Neurology. Since then there hasn’t been a single case of a patient who was declared brain dead by the standard criteria who later recovered.

Legally a patient who is brain dead can be declared dead. They are then legally no longer a living person.

In the case of Jahi the hospital doctors declared her dead based upon brain death criteria, even though her heart was still beating. At that point no further medical intervention is warranted. In fact many consider it unethical and abusive to perform any medical interventions on a dead body. Because of the family’s protests, however, the judge in the case assigned an independent doctor, Graham Fisher, M.D., the chief of Child Neurology at Stanford University School of Medicine, to examine Jahi and make his own determination. He agreed with the diagnosis of brain death.

The family requested that their own doctor also independently examine Jahi, but the judge refused. They wanted Paul Byrne to examine Jahi. Byrne, however, is hardly an objective physician. He is a crusader against the very notion of brain death. He is a neonatologist, past president of the Catholic Medical Association, and an outspoken critic of organ donation based upon the concept of brain death.

As is often the case when declarations of either persistent vegetative state or brain death are controversial, the family or those opposing the diagnosis often claim that there are signs of brain activity the doctors say are not present. In this case the family, sometimes through their lawyer, claim that Jahi has moved her limbs in response to commands. They are also now claiming that independent examination has revealed electrical activity and blood flow to the brain, however this information is not available for independent review.

It is common for there to be spinal reflexes that can cause even dramatic movements in someone who is brain dead. These types of reflexes have been termed the “Lazarus effect” because they may create the impression of someone rising from the dead. Activity in the spinal cord, however, is compatible with brain death, and may be triggered either spontaneously or through mechanical stimulation (such as when a patient is turned or moved during care).

Jahi was moved from California to New Jersey for a specific reason. New Jersey allows for religious exemptions to the legal declaration of brain death. Jahi’s family claims that according to their religious beliefs, as long as her heart is beating she is still alive.

Similar issues arose in the Terri Schiavo case, which came to national attention in 2005. In that case Schiavo was in a persistent vegetative state (not brain dead) and her husband wanted to withdraw life support, while her family refused, resulting in a prolonged court battle. The husband eventually prevailed. At autopsy it was found that Schiavo’s brain weighed about half of what a healthy brain for someone her size should have weighed, evidence of the diffuse and catastrophic brain damage she had suffered.

In that case, as with this one, the family tried to appeal to a cherry-picked expert to give them the answer they sought, and they also claimed that Schiavo was exhibiting signs of brain activity that multiple independent experts concluded was not present.

Reporting on the Schiavo case was also particularly bad. A review found that only 1% of mass media reporting defined a persistent vegetative state, while 21% of articles falsely claimed that Schiavo had the potential to recover.

Conclusion

It is understandable that there would be ethical discussions and disagreements over how best to balance the rights of patients, the demands of dignity, the responsibilities of health care professionals and the state, and the religious freedoms of patients and their families. At the very least, however, such discussions, and their application to individual cases, should be informed by reliable scientific and medical information. Media reporting should also strive to be as scientifically accurate as possible.

Distorting the science and cherry picking evidence are unfortunately common when strongly-held ideological beliefs are at stake.

In the case of Jahi there is also a legal matter at stake. The family is suing the hospital for malpractice. In California there is a legal cap of $250,000 for the wrongful death of a child. There is no cap if the child is injured but still alive, which the suit is claiming. It is therefore likely that a California court will have to officially rule on whether or not Jahi is alive or dead.
 
 

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Colorado Lawmakers: Marijuana Edibles Must Look Different Than Regular Foods Even Without Packaging

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After taking on the form of brownies, cookies, candy and other normal foods for years, edible marijuana goods must now figure out their own identity in Colorado. A proposed bill to loosen the requirements that say edible pot products must look distinctly different from normal food was rejected by a Colorado panel of lawmakers.

This means that not only do foods and beverages infused with marijuana have to come in packaging that explicitly states what’s going on inside, THC-wise, but the actual products themselves must be clearly different than non-marijuana-filled foods.

The 0-5 vote by the panel in rejecting a bill from Sen. Owen Hill is a big defeat for proponents of edibles in the industry, with Sen. Hill calling it an example of “micromanagement” because it’s not easy to do for all different kinds of foods, reports the Associated Press.

As it stands now, unless lawmakers change their minds and write a new rule, edibles will have to be “shaped, stamped, colored or otherwise marked, when practicable, with a standard symbol indicating that it contains marijuana and is not for consumption by children.”

Those behind the bill to loosen that restriction are unsure of how this can be carried off — after all, you can shape a pot cookie like a marijuana leaf, sure, but what about tomato sauce, for example?

“How we distinguish liquids versus granolas versus candies versus cookies versus brownies?” asked Sen. Hill.

Critics of the bill included parents, health advocates and even teenagers who told lawmakers about classmates passing around pot candies with parents none the wiser.

It would also serve medical professionals in helping them find out what’s wrong with a person in the emergency room, to help identify what they ate if it’s suspected they accidentally ingested pot.

“The ability to rapidly identify a suspected agent … with or without the packaging, we believe is critical,” said a doctor representing Children’s Hospital Colorado.

But those in favor of loosening the rules say the packaging can be changed to create a clear difference, and that that should be enough.

“As an industry, there’s no real way to clearly mark every item that’s out there,” said the president of Incredibles, a company that makes marijuana-infused candies. “That is impracticable.”

Lawmakers: Edible pot must look different than regular food [Associated Press]

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Study: Alcohol Advertising Grew 400% In 40 Years — But Americans Aren’t Drinking More

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Since 1971, advertisers have churned out more and more content dedicated to pushing alcohol in its various forms. But just because we might see a galloping horse promoting beer in slow motion or a fun gang carrying a cooler of malt beverages on a beach every time we turn on the TV, computer or sit staring at a subway ad, that doesn’t mean Americans are drinking more booze than we did 40 years ago, according to a new study.

While marketing efforts on behalf of alcohol companies might bring in new customers or keep current fans loyal, it seems all that money spent on advertising isn’t turning the country into a nation of lushes, according to a new study from the University of Texas at Austin (via AdWeek).

Researchers led by advertising professor Gary Wilcox looked at alcohol sales between 1971 and 2011, and found that per capita consumption stayed basically flat. Over the same period, alcohol advertising in the U.S. climbed by more than 400%.

“Relating these findings to previous research reveals a consistency in that there is either no relationship or a weak one between advertising and aggregate sales,” the report states. “Over this time period, beer sales have exhibited a downward trend since the early 1990s, while wine and liquor have increased their share of total alcohol sales. This is despite large increases in advertising expenditures across all three categories of alcohol.”

While the boost in ads might not change how much we drink, marketers can still be assured that their ads are good at guiding brand preference, the study says.

You might be more likely to go out and buy a Miller High Life or a Bud Light after watching a good ad, but you’re probably not going to buy 24 of them and drink them all at once just because of a commercial, for example, or suddenly think it’s a good thing to go from three drinks a week to 30.

Instead, you’ll probably just be like, “Man, you’re right, cool, attractive person drinking on the beach! I really do like [X brand]!” or “Maybe I should try switching to [Y brand] because those horses are just so majestic.”

Beer, wine, or spirits? Advertising’s impact on four decades of category sales
Alcohol Ads Increased 400% Over 40 Years, but Americans Aren’t Drinking More [AdWeek]

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