Sepsis v antibiotics: the Doctor’s dangerous dilemma

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Anyone visiting the South Coast towns of England will know we have a huge sepsis awareness campaign on at the moment, as every ambulance you see is plastered with messages on the subject. And rightly so: sepsis is the cause of enormous suffering and mortality, not to mention its toll on NHS resources. Which is why today we are showcasing the NHS sepsis framework (published only yesterday, gentle readers-we sure do scoop ‘em these days!) [1]. because down in the appendix is a little section which impinges directly on the fons et origo of this whole humble blog: microbial resistance to antibiotics, as if you haven’t guessed already. Because sepsis affords the physician the most awful, excruciating, dilemma.

It’s one of those medical emergencies where every hour counts, truly. When bacteria invade the bloodstream and the immune system spirals out of control, doctors just can’t wait days for laboratory cultures. Broad spectrum antibiotics must be thrown in immediately, because delay will be truly deadly. Maybe it’s sepsis, maybe it isn’t: but the only logical decision at that stage is to assume that it is.

Thereby creating an acute paradox. Because prescribing the antibiotics exerts evolutionary pressure on the bacteria, increasing the strain’s likelihood of developing resistance. And as we know here (LSS passim) every unnecessary course of antibiotics puts the bacteria one step ahead. Modern medicine is trying to perform two contradictory tasks: treat, but avoid overtreatment So although the report puts it in the calm precise language of an official report, sepsis management and antimicrobial resistance must be seen as two sides of the same coin.

And our thoughts? Firstly, we are full of admiration for the medical staff who are dropped into this agonising situation, recognising that they possess levels of emotional and intellectual intelligence far beyond our own limited capacities. Secondly that to shout for “more antibiotics“ is cheap rhetoric, as it just begs the question. And we’re always doing it anyway. A more fruitful answer might lie in things like better DNA sequencing, molecular diagnostics and AI assisted decisions, all of which might better identify the invading pathogen more quickly. Thus opening the possibility of a bespoke antibiotic to be delivered to the right patient at the right time. Now that would be a creative step indeed.

[1] NHS England » Sepsis modern service framework

#antibiotic resistance #medicine #health #microbiology #bacteria #sepsis #treatment

Only evidence will do: book review from Nature Briefing

What happens when Belief triumphs over evidence? Here’s one example. For most of human history, childbirth was dangerous in a way modern readers struggle to imagine. In Europe in the early 19th century, maternal mortality in hospitals could reach 10–20% in bad years. Women died not from the birth itself but from the mysterious, terrifying scourge of puerperal fever. And the explanations? The usual cocky self-serving assertions like miasmas, divine wrath, atmospheric changes. Most Doctors were confident; they knew. When thinkers like Semmelweiss suggested that the cause was filthy medical practices which spread a lethal agent he called “germs,” he was hounded from his profession. The carnage continued until Pasteur and others were finally able to show the true causes, which they did using controlled experiments, rigorous data ,and logical interpretation of their findings.

Those who think such battles to be long won would do well to read the following book review from Nature Briefings. It’s called How we know: the rise of evidence based medicine, But it’s really a gateway to how we know about anything, as opposed to just believing our own first guess

In Beyond Belief, science journalist and Nature editor Helen Pearson charts the rise of evidence-based medicine and explores how rigorous research has transformed health and social policy. Pearson shares examples of success stories, in which solid evidence overturned bad practices, and the people behind them, many of whom were treated as mavericks for championing randomized trials. “Anyone can read and enjoy the book, yet there are nuggets for experienced readers,” writes public-policy researcher Peter John in his review. “The author writes as a believer, and her passion is engaging.”

Nature | 8 min read

At this blog we have tried many times that only reason and evidence will ultimately ameliorate the human condition. But nowhere have we done as well as this book does. And the need is not just in medicine, but in all areas such as climate physics, economics and what still passes for political life. The central problem m is that humans are wired for belief, not evidence. Intuition, anecdote, tradition, and authority shape most human decision‑making. Cognitive biases — confirmation bias, availability bias, motivated reasoning establish certainty long before any data has arrived. Yet the cost of ignoring evidence is enormous: this summer wildfires are again raging across Europe in a way unknown before 2020. Pearson’s remedy is the same old list our side has been pushing since the age of Sir Francis Bacon : demand clear causal claims, ask what the comparison group was, look for replication,, distrust single studies, favour interventions tested in real‑world conditions, accept that “what works” is often context‑dependent But try explaining all that in the bar of the Dog and Duck.

Beyond Belief: How Evidence Shows What Really Works by Helen Pearson (Princeton, 2026)

BBC – History – Francis Bacon

#medicine #science #evidence #reason #experiments #rationality #disease #climate change #politics

Alternatives to a World Government #1: the deep disease of inequality

Get the diagnosis right, or the ill will never be cured. Thus far, our LSS remedy for the current malaise– economic stagnation, mass migrations, ecological collapse, the utter alienation between rulers and ruled–is the institution of a World Government (LSS passim). But that is a Historian’s diagnosis. What if other viewpoints understand the problem better? If they are right and we are wrong, then our World Government will surely fail. Let’s look at some other possibilities then, starting with our number one candidate: economic inequality. And our Witnesses for the Prosecution, as t’were, are firstly, Thomas Piketty [1] [2] and secondly Richard Wilkinson and Kate Pickett.

In Capital in the Twenty‑First Century and Capital and Ideology, Piketty shows that when the rate of return on capital outpaces economic growth — — wealth concentrates faster than societies can redistribute it. The long arc of history is one of repeated “regimes of justification” for inequality, periodically interrupted by shocks (wars, depressions) that force elites to accept progressive taxation and broader social investment. Since the 1980s, most advanced economies have dismantled the egalitarian tax and welfare structures built after 1945, allowing inequality to surge back to levels last seen in the Belle Époque. This produces political fragmentation, democratic fatigue, and a sense that the social contract has frayed. For Piketty, rising inequality is not merely an economic issue — it is a political destabiliser.

Wilkinson and Pickett’s research focuses on the psychosocial consequences of inequality. Their central claim is that what matters for social wellbeing is not absolute wealth but relative position: societies with high income inequality exhibit higher rates of mental illness, mistrust, violence, poor health outcomes, and weakened community life. Inequality, they argue, acts as a chronic stressor, pushing individuals into status competition and eroding the sense of shared fate that healthy societies require They show that wealthy but unequal societies suffer from social pathologies that cannot be explained by poverty alone. Inequality corrodes the emotional infrastructure of everyday life — the ability to trust neighbours, feel secure, and imagine a common future. In their view, rising inequality is not just a symptom of malaise but a generator of it.

So any World Government that does not tackle these deep anomies would either become a castle built on sand, or quickly degenerate into a tyranny defending the same arrangements which have brought the Nations to this present sorry pass. Not an easy argument to overcome, especially when we thought we had it all worked out. And guess what, gentle readers-more demolitions will be inflicted in upon us in the next few episodes of this new series : don’t miss it!

[1]Piketty, Thomas. Capital in the Twenty‑First Century. Cambridge, MA: Harvard University Press, 2014.

[2]Piketty, Thomas. Capital and Ideology. Cambridge, MA: Harvard University Press, 2020.

[3]Wilkinson, Richard, and Kate Pickett. The Spirit Level: Why More Equal Societies Almost Always Do Better. London: Allen Lane, 2009.

[4]Wilkinson, Richard, and Kate Pickett. The Inner Level: How More Equal Societies Reduce Stress, Restore Sanity and Improve Everyone’s Well‑Being. London: Allen Lane, 2018.

#inequality #economics #history #world government# #politics #society #government

Will Global Warming be the final blow for the High Street?

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At LSS we bring our readers an eclectic range of stories: medical research, energy technologies, geopolitics, cocktails… all human life is here, you might say. Yet one subject dear to our heart has been a little neglected, even though we first covered it six years ago (LSS 6/4/20): the good old British High Street — those lines and streets of shops, cafés, community buildings, pubs and whatever else that once made us feel we belonged, had place, and time, and even, dare we say it?-a little agency. It’s had a battering lately: rising rents, falling business confidence since 2016, and of course online shopping, which has taken such a juicy slice of the retail spending pie. No wonder everyone complains about empty shops and “hollowed‑out High Streets”. No wonder so many political parties make hopeful promises to restore the old place to its 1960s glory.

So all the old place needed was a fresh blow — the latest British Retail Consortium figures for July, which showed a 3.4% fall in visitors to British shops in June. In fact the headline number masks a worse result for High Streets, with footfall down 6.2%, while retail parks and shopping centres got off more lightly (0.3% and 2.5% respectively). And the reason? The weather: the heatwave, which was England’s hottest on record and the UK’s second hottest. A grim explanation which nevertheless seems widely accepted.

Which made us wonder: what other parts of the economy are already starting to suffer losses due to climate change? A quick survey allowed our Research Department to suggest that winter sports, coastal leisure, outdoor festivals, gardening and horticulture, recreational fishing and boating, heritage tourism, wine production, and amateur community sport are all showing measurable economic losses as climate change disrupts seasons, damages landscapes, raises insurance costs, and forces cancellations across activities people once assumed were stable, perennial — and rather fun.

How ironic, then, that some parties who call most loudly for the restoration of the traditional High Street are also those demanding the reversal of policies designed to mitigate climate change! They argue that the projected costs of adaptation are too high to bear. But the actual costs are already very real — and rising. However, you have a remedy, gentle reader. The next time someone moans to you about the state of the High Street, you may agree that the Government must take action. Starting with policies to slow and reverse global warming.

[1] UK shopping trips fall in June as heatwave takes toll, BRC says

[2] Impact of climate change on global economy: A comprehensive review – ScienceDirect

#economics #climate change #global warming #high street #retail #shopping

A big thank you, an apology and a nod to a few old blogs

We’ve been having some technical problems particularly with e mails this week. These are now largely resolved, but the amount of time and energy involved meant that normal productive service has been largely impaired. To sort of make it up. We thought we’d do two things: repeat our normal thanks and apologies, and then take a quick look back at some of the blogs which we think you might like. Note: we didn’t claim the blogs were “good” “better” “our best” or anything like that. We just think they were different and we put together unrelated things in a new way: or we showcased some original work by somebody somewhere.

So thanks to all readers, followers subscribers and everyone else who makes this humble little blog possible.

Now forward to the past.

On medical research we have been stalwart champions of the cause of discovering new types of antibiotics : we’ve averaged at least one every couple of weeks on this, so back references are superfluous. But we’re also proud to have picked up on exciting new developments such as CRISPR Cas-9 and Base Pair editing (LSS 9 9 23 et seq) and our blogs provide a nice series of snapshots on whats been unfolding over recent years.

Conservation and sustainability has been a constant theme. We managed to combine it with antibiotics on a blog called No plants No antibiotics (16 6 26) But you’ll find climate change all over the place here: and rightly so in a site devoted to reason and evidence

World Government has been a more recent theme: not because we are necessarily in favour of it, but we do think someone needs to make its case. Which we did starting with our series of 8 1 25.

Contradictions have always fascinated us. Such as: what does it mean to be Right Wing in the modern world? You can be for Free Markets, or you can be for the traditional nations. But you can’t be both for long, as our two blogs The Kronenbourg Question (7 6 22) and Is Donald Trump a Socialist? (7 4 25) pointed out

And finally: our Roman obsessions: we seem to use that Empire to explain everything from modern geopolitics to cultural decay to climate change. Key to our modern understanding of this ancient Empire is the work of Professor Harper whom we first showcased in our blog 17 12 22

Please keep all your ideas and suggestions coming. Wew are deeply honoured to be noticed by so many people in so many different parts of the world. Above all: keep reading. That’s what makes our day

#climate change #politics# economics #medicine #health #history #dna

Heroes of Learning: The Master Kong (that’s “Confucius ” to you and me)

The most grievous defect of our Heroes of Learning series is that up to now, it has focussed almost entirely on subjects and thinkers from the Western Tradition. Which defect grows from our immersion in a cultural and educational system which has assumed that only Westerners ( and those being, largely, white men) have anything worthwhile to say on matters of philosophy and governance. A conceit cruelly exposed by current developments, especially in nations which have long nurtured independent traditions. Time then, with our world readership to look at other systems and thinkers. And we can think of no better place to start than The Master Kong(“Confucius” in the western tradition) who lived in the China’s Spring and Autumn Period probably between about 551 and 479 BC, making him a near predecessor of such western sages as Plato and Aristotle.[1]

Unlike those refined thinkers, Kong spent a lifetime in the dangerous hurly burly of government service, experiencing wars, coups and even a period of exile. It made him ask above all ”what is the basis for a stable social order? How can the state be made harmonious with the people?” To westerners all the way from Plato through Enlightenment philosophers to moderns such as Rawls, the answer has always been: “ reform the laws; and: institute a just constitution.” But for Master Kong, no set of laws, no constitution can long survive the actions of a venal and unstable ruler. For centuries, westerners seemed to have the answers. But recent experience of leaders who mistake authority for wisdom, bureaucracies that reward compliance over candour, and publics that lose trust when officials and private corporations behave without integrity, have shown this arrogance to be profoundly mistaken. Confucius inverts all: he insists that the State cannot exist without ethical leadership, truthful counsel and restraint. His Analects[2] [3] (actually compiled by his followers after his death exalt character, duty and wisdom as the basis for this stable State. And that these virtues must first of all be prized and cultivated by the leader and his counsel, before any other men will follow them

These teachings have been rediscovered and re-invented many times, becoming interwoven into the warp and weft of Chinese civilisation. They still inform the actions and thinking of leading statesmen to this day. The world has need of harmony and just order now. The prizes of attaining them are almost within grasp. The penalty of failing to do so will be lethal indeed. Has the world still time to learn from The Master Kong?

[1] Confucius – Wikipedia

[2]Confucio – Analectas, trad. Anne‑Hélène Suárez Girard, Editorial Trotta, Madrid, 2012.

[3]Edward Slingerland – Analects of Confucius: With Selections from Traditional Commentaries, Hackett Publishing, 2003.

#master kong #confucius #china #civilisation #order #law #governance #state #anarchy #politics

More on why everyone hates Keir (but this time we’ve got serious back up)

A few months ago(LSS 5 2 26) we offered a short piece called Everyone hates Keir-here’s why, in which we pondered the troubles of Sir Keir Starmer, Britain’s soon-to-be-former Prime Minister. And why this essentially dull, technocratic and overwhelmingly honest man seemed to inspire such depths of visceral hatred from so many of our fellow citizens. We tried to place it in the context of Britain’s economic decline. And our only conclusion was to liken poor Sir Keir to the sort of sensible family lawyer who tells a family of rakehell aristocrats that the family funds have finally run out. He’s not going to be welcome is he?

But today we are glad to bring you an explanation which we think goes far further, and has far more explanatory power than our own humble offering. For it comes from the sagacious Professor Ben Anderson of Durham University, in the Conversation, who places his own analysis in the context the post 2008 crash economic wasteland we all now inhabit. You should read the article for yourself; but to dare our own take, he argues that the politics of feeling have replaced the politics of coherent ideology. Poor Starmer offers reason, rationality and evidence in a world that longs for feelings of certainty, belonging and attachment.

And, we ask,what stronger feeling can there be than hatred? In some of the most memorable words we have read for some time, Professor Anderson tells us:

Hatred is intense, and that intensity is central to today’s politics of feeling. And so an apparent hatred of Starmer is about the experience of feeling something intensely – and the difference this makes to people’s everyday lives. Intense feeling interrupts boredom, loneliness and other kinds of ordinary malaise. And in uncertain and anxious times, hate offers the illusion of reassurance. It establishes an unequivocal position against something.

In such circumstances no rational centrist politician can thrive, nor even govern for long. Keynes noted that the whole world of Arts Sciences and Letters which he believed in were in mortal peril if the basic needs of ordinary people for security and food were not met. Thus he so accurately foresaw the raise of the dictators and the coming Second World War. Are we living through similar days again?

[1] https://theconversation.com/the-politics-of-feeling-why-did-boring-prime-minister-keir-starmer-provoke-such-visceral-reactions-286491?utm_medium=email&utm_c

#sir keir starmer #politics #uk #economics #jm Keynes #labour party #psychology #emotion #reason #unreason

Round up: Orcas, Grandparents, Traffic nuisances, and another hidden cost of global warming

Biology of Grandparenting

This story from Nature Briefing suggests that ovaries take on a second, post‑fertility role — a reminder that life’s purpose isn’t exhausted by reproduction, and that the quiet power of grandparenting may be biologically deeper than we thought:

After the ovaries ramp down their reproductive role, releasing eggs and sex hormones, they might become more important to the immune system. Evidence from people and mice suggest that genes and proteins associated with immune activity are more active and prevalent in postreproductive ovaries — though it’s unclear whether it’s a beneficial change. “We really owe it to women’s health to study this period of time,” says reproductive biologist and study co-author Francesca Duncan. Science | 7 min read
Reference: Molecular Human Reproduction paper

Global Premium We’ve had concerns before here about how the rising costs of climate insurance could damage the economy. Of course no single story is conclusive, but this piece from the Guardian appears to be another straw in the wind

Rising cost of insuring against climate crisis will have wider knock-on effects for UK economy | Heather Stewart | The Guardian

Does Traffic drive street crime? As if all that pollution and accidents weren’t enough, a new study suggests that road traffic may be adding to vandalism, burglary and violence., according to this study in The Conversation

https://theconversation.com/does-traffic-drive-street-crime-our-study-investigated-284977?utm_medium=email&utm_campaign=Burnhams%2010-year%20plan%20for%20Britain%20-%2038355391

Orcas in Northumbria Recently we penned some pieces about dolphins and other cetaceans for various outlets in Sussex. But the lucky folks up in the North East seem to have something much, much bigger as their prime tourist attraction- actual real life Orcas, reports the Guardian Let’s hope they thrive and maybe a few volunteer to swim south!

‘Exploratory and curious animals’: mysterious rise in orca sightings off Northumberland coast | Marine life | The Guardian

For the record here is our own humble offering

https://www.sussexexpress.co.uk/your-world/sussex-green-living-citizen-science-helps-dolphins-thrive-8646983?utm_source=Sussex+Green+Living&utm_campaign=89

AI isn’t quite ready to take over the world insisted our researchers when they put up this piece from the BBC about events at Ford Motors

Ford rehires human engineers after AI fails to match quality checks – BBC News

Quote of the week

Whoso boasteth himself of a false gift is like clouds and wind without rain.-Proverbs 25:14

#grandparent #insurance #economics #biology #climate change #orca #northumbria #Arificial Intelligence

We learn something new about cancer from a great website called The Scientist

One thing we value here is a well‑written science story that tells us something we didn’t know — and does so in a trustworthy, responsible way. Not the sensationalist, attention‑grabbing material that flashes across our screens all too often. So when our researchers came across Colorectal Cancer and Childhood Exposure to a Common Gut Bacterium by Laura Tran in The Scientist[1], we decided to look at the source itself, to see whether it deserves a place among the canon of science‑news providers we consider worthy of your attention, gentle readers.

As you might expect, The Scientist specialises in clear, sober reporting: across the biosciences, speaking very broadly. The style is terse and informative, closely aligned in spirit with the journals and institutions it covers. There’s a strong news section, a quarterly print magazine, topic‑based browsing, and a generous set of resources. Our test search — naturally, Antibiotics — produced several well‑illustrated, highly informative pieces.

If pressed, we’d say the ideal reader is intelligent, graduate or postgraduate, and probably working somewhere in the life sciences. But there is plenty here for teachers preparing a good science lesson too. Or even two.

Our verdict: not as bite‑sized as Nature Briefing, nor as magazine‑like as New Scientist, The Scientist nevertheless earns a worthy place alongside them as a provider of news and ideas for the educated and reasonable community (that’s us, gentle readers). And in an age when so much content is shaped for attention rather than understanding, that’s a very important thing indeed.

And having satisfied ourselves that The Scientist is indeed a sober and reliable chronicler of the biosciences, we can turn to the story that brought us there in the first place. It is a quietly important one: evidence that early‑life exposure to certain strains of that perfectly ordinary gut bacterium — Escherichia coli carrying a particular genetic island — may leave a mutational fingerprint that shows up years later in colorectal tumours. No melodrama, no scare‑stories, just the steady accumulation of data: mutational signatures, epidemiology, and the slow, careful work of linking mechanism to disease. This is exactly the sort of thing the scientific enterprise does well, and exactly the sort of thing we like to bring to your attention.

[1] https://www.the-scientist.com/childhood-exposure-to-bacterial-toxin-tied-to-early-onset-colorectal-cancer-72952?fbclid=IwY2xjawSxsvNleHRuA2FlbQIxMABicmlkETBVNUo0ekNo

#cancer #medicine #science #life science #research #laboratory #start up #biotechnology

Alternatives to a World Government: Part #1 of a new series

All the thinkers we admire say the same thing really: what is your alternative explanation? Bayes insists on always balancing two probabilities. Russell on always looking at the opposite point of view, Keynes on first establishing if your pet idea is general or just a special case. And Daniel Kahneman on checking which bit of your brain you’re thinking with anyway. Which brings us round to our universal panacea, a World Government. We’ve made the case for it a number of times here(LSS passim) so veteran readers will know our diagnosis: most of the problems of the world appear intractable because nation states can never work together with sufficient speed and co-operation to resolve them. Hence economic stagnation, growing xenophobia and a rapid breakdown of the ecological systems upon which we all depend for Life.

Hang on: because aren’t we muddling diagnosis with solution? In which case abolishing the nation state becomes a futile quest, and our World Government a mare’s nest. Are there other diagnoses of our ills which, if correc.t could address all these ills while safely retaining our systems of Governance.? We ought look at them : we owe our readers that much. And so we drew up a list of other possible root causes, which we cheerfully present below. We shall examine them in the coming weeks. Our candidates include Economic inequality. Institutional decay, Technological acceleration, and its concomitant, cognitive overload., Economic model exhaustion, Tribalism and Media systems and collapse of a common narrative

None of them are mutually exclusive and we will find overlapping themes, read similar authorities and consider facts more than once as we move through the series. So bear with us. But one thing we do know: one of you out there, maybe more than one, will have an idea we haven’t thought of. So if you want to put a candidate on the list let us know. In any case we look forward to all of you accompanying us on this next journey.

# bayes #jm keynes # bertrand russell #daniel kahneman #history #economics #politics #governance #technology