​Over the past four decades, maternal mortality in the United States has followed a troubling trajectory, diverging from the global trend of improvement seen in many other developed nations. This article examines the key factors and patterns in U.S. maternal mortality from the 1980s to the most recent data date.

In the early 1980s, the U.S. maternal mortality rate was relatively low, comparable to other high-income countries. However, while many nations continued to reduce their rates, the U.S. experienced a concerning shift.

From the late 1980s onward, maternal mortality rates in the U.S. began to rise. According to the Centers for Disease Control and Prevention (CDC), the maternal mortality rate more than doubled from 7.2 deaths per 100,000 live births in 1987 to 17.4 deaths per 100,000 live births in 2018.  The maternal mortality rate for 2021 was 32.9 deaths per 100,000 live births, compared with a rate of 23.8 in 2020 and 20.1 in 2019.

Key Factors Contributing to the Increase

1. Healthcare Disparities: Significant racial and socioeconomic disparities persist, with Black women facing a disproportionately higher risk of maternal death.
2. Chronic Health Conditions: Increasing rates of obesity, hypertension, and diabetes among women of childbearing age have contributed to higher-risk pregnancies.
3. Advanced Maternal Age: More women are having children later in life, which can increase the risk of complications.
4. Access to Care: Inadequate access to quality prenatal and postnatal care, particularly in rural areas, has exacerbated the problem.
5. Cesarean Sections: The rising rate of C-sections has been associated with increased risks of complications.

In recent years, growing awareness of this issue has led to increased research, policy initiatives, and community-based interventions. Several states have implemented maternal mortality review committees to better understand and address the root causes.

The rising maternal mortality rate in the United States over the past 40 years represents a significant public health challenge. Addressing this complex issue will require a multifaceted approach, including improved healthcare access, better management of chronic conditions, and targeted interventions to reduce racial and socioeconomic disparities.
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As we progress, continued research, policy reform, and community engagement will be crucial in reversing this trend and ensuring safer outcomes for mothers nationwide.

​Recent studies have reignited interest in the potential therapeutic applications of lysergic acid diethylamide (LSD) in treating alcoholism. While LSD is often associated with counterculture and recreational use, its effects on the brain and behavior have garnered attention from researchers seeking effective treatments for substance use disorders.

LSD is a powerful hallucinogen that primarily affects serotonin receptors in the brain. This interaction can lead to altered perceptions and thoughts, but it also has the potential to facilitate profound psychological experiences. Researchers hypothesize that these experiences could help individuals confront and resolve underlying issues related to addiction, including alcoholism.

Preliminary studies suggest that LSD may reduce alcohol consumption and cravings. A landmark study in the 1960s indicated that patients who received LSD as part of their treatment showed significant reductions in drinking behavior. More recent trials have reinforced these findings, showing that individuals who undergo guided LSD sessions report decreased alcohol use and improved psychological well-being.

The therapeutic effects of LSD in the context of alcoholism may be linked to its ability to induce altered states of consciousness. These states can promote introspection and emotional release, allowing individuals to understand their addiction better. LSD's impact on neuroplasticity— the brain's ability to reorganize and form new connections—may help individuals develop healthier coping mechanisms.

Despite promising results, the use of LSD in treating alcoholism faces challenges, including regulatory hurdles and societal stigma. Further research is necessary to understand the long-term effects and optimal therapeutic protocols fully. As interest in psychedelic-assisted therapy grows, LSD may develop as a significant tool in the fight against alcoholism and other substance use disorders.
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In conclusion, while more research is needed, the intersection of LSD research and alcoholism presents exciting possibilities for innovative treatment approaches. As scientists continue to explore this area, the hope is to develop effective interventions that leverage the unique properties of psychedelics to support recovery from addiction.

​The Dunning-Kruger effect is a variety of cognitive biases where a person believes they are more intelligent and capable than they are. When low-ability people are biased in this fashion, they do not possess the skills needed to see their ineptitude. Their poor self-awareness and low cognitive ability make them overvalue their expertise. While this used to be the province of the pontificating cocktail party expert, it now has entered the realm of political punditry, Internet shock jocks, and boors of all kinds.

In 1999, college professors David Dunning and Justin Kruger published the paper "Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments." In this treatise, they posit that people with little knowledge of a particular subject tend to be more confident and outspoken. The authors propose that people with lower cognition exhibit two behaviors. First, they have little idea of what they are talking about, and second, their overconfidence makes them less susceptible to self-doubt or auditing.

People tend to hold overly positive opinions of their abilities in many communal and academic realms. The authors suggest this overappraisal occurs because unskilled people in these domains experience a dual incumbrance. Not only do these people make erroneous inferences and make adverse choices, but their ineptitude robs them of the metacognitive capability to realize it.

The authors found that participants scoring in the lowest quartile on humor, grammar, and logic tests utterly overrated their test execution and capability. Although their test marks put them in the 12th percentile, they reckoned themselves to be in the 62nd. Several assessments linked this miscalibration to deficits in metacognitive skills or the capability to recognize accuracy from error. Not surprisingly, improving participants' skills and thus increasing their metacognitive competence helped them realize the constraints of their abilities.

Consider the cocktail party pontificator who provides authoritative knowledge about an area where they have little knowledge and, almost always, nothing from direct sources. In an era where most people get their news from social media, the Wild West is unrefereed, with no fact-checking or barriers to entry. 

So, what explains this mental consequence? Are some people simply too thick to identify their weaknesses? Dunning and Kruger propose that this occurrence stems from a "dual burden." People are not only inept; their lack of ability strips them of the mental aptitude to recognize their ineptitude.

Everybody is prone to this occurrence, and most of us probably experience it with astonishing regularity. Legitimate professionals in one area may erroneously think that their intellect and expertise carry over into other fields in which they are less familiar. Particularly susceptible to the Dunning-Kruger effect are people who are seldom challenged – corporate executives, experts, college professors, and, unfortunately, and all too often, men.

The biggest takeaway is to avoid this through a thorough analysis of the sources of one’s expertise.  Are they primary?  Are they confirmed through multiple resources?  Is the information provided through authoritative and refereed sources, or is it merely based on inuendo or even a borderline conspiracy theory?  It's also very healthy to encourage a personal environment where one is challenged by peers.

​Congenital penile anomalies (CPAs) are among the most common human hereditary disabilities. Reports of CPAs, which include hypospadias, chordee, micropenis, and ambiguous genitalia, have risen sharply in recent decades. The causes of these defects are complicated and cannot be tied to a specific reason. However, good science indicates these might be partly attributable to contaminant exposure in fetuses. These contaminants are primarily industrial discharges and water and wastewater treatment plant contaminants. 

Defects in penis development are becoming increasingly common, with hypospadias now affecting up to 1 in every 125 live male births. The most common CPA is hypospadias (68.3%), followed by chordee (8.6%) and hypospadias plus chordee (5%), and 14% are reported as unspecified penile anomalies. Hypospadias is a congenital disorder in males where the opening of the urethra is on the underside of the penis. Its occurrence has swiftly enlarged over latest decades, mainly credited to our increased exposure to endocrine-disrupting chemicals.
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Human contaminants in water pose risks to reproductive health. Most of these compounds are known as endocrine-disrupting chemicals (EDCs). EDCs can affect the endocrine system and harm animals' and humans' development and fertility. The sources of chemical contamination in water are varied, initiating from byproducts formed during wastewater treatment procedures, water treatment processes and chemicals, releases from industry, livestock sewage, and drugs that pass through human bodies and then are released into sewage.

About 686 compounds are classified as EDCs, consisting of seven broad groups: consumer products, farming and agricultural, industry, intermediates, natural sources, medicine, and health care contaminants.

Examples of anthropogenic compounds that are commonly present in surface water:

• Opioids.
• Hormones from birth control pills.
• Acetaminophen and ibuprofen.
• Caffeine.
• Diclofenac (anti-inflammatory).
• Carbamazepine (anti-seizure).
• Artificial sweeteners.

The disinfection of drinking water was one of the most critical public health accomplishments in the last century. Treating water with chlorine significantly reduced the incidence of water-borne diseases like cholera and raised life expectancy. The reaction between disinfection agents and organic or inorganic matter in water forms compounds called water disinfection byproducts (DBPs). The presence of DBPs in drinking water is a human health alarm because epidemiological studies have revealed connections between DBP exposure and an increased risk of cancer development and harmful reproductive effects.

Fluorinated substances are a broad group of organic and inorganic substances that include at least one fluorine atom. Fluorinated substances are used in various consumer products and are highly persistent in the environment. Fluorinated substances have been correlated with reproductive and fertility dysfunction in men and women.
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Bisphenol A (BPA) is a high-production volume chemical widely used in industrial polycarbonate plastics and epoxy resin manufacturing. Polycarbonate plastics are components in food and drink packaging like water and infant bottles, impact-resistant safety gear, and medical devices. Epoxy resins are lacquers that coat metal products (food cans, bottle tops, water supply pipes. BPA can bind membrane and nuclear receptors such as androgen, estrogen, and thyroid receptors, causing endocrine disruption, tumors, harmful reproductive consequences, and transgenerational effects.

​Various PCAs include:

• Absence of the penis, known as aphallia, is a rare congenital irregularity. It is a result of either the deficiency of the genital tubercle or its failure to form fully, and it is associated with the level of hormones and chromosomal changes.
• Pseudodiphallia, a rare kind of diphallia, is a small accessory penile-like tissue without a typical penile anatomy structure.
• Cryptorchidism, or undescended testes (UDT), is the most common disorder of the male endocrine glands in children. One-third of boys with true cryptorchidism have bilaterally cryptorchid testes, whereas two-thirds have only one testicle undescended.
• Megalopenis is when the penile length is more than two standard deviations above the mean average size for age.
• A sexual ambiguity or clitoromegaly frequently reveals true hermaphroditism. An individual with ovarian and testicular tissue is a true hermaphrodite. The phenotypical outer shell may be those of either sex, and the internal and external genitalia may range from those of an average female to those of a typical male.
• In the United States, the incidence of micropenis was 1.5 in 10 000 male children born between 1997 and 2000. The high prevalence of micropenis – not previously reported in the international literature – and the potential relationship between fetal exposure to pesticides and micropenis.

The growing body of epidemiological, clinical, and experimental studies clearly shows evidence of the impact of EDC exposure on penile development. Moreover, extensive epidemiological studies and studies on animals exposed in utero to EDCs point to the epigenetic effects of fetal exposure to EDCs that could be transmitted to future generations.

EDCs can be found in drinking water; the most common way to be exposed to them is by drinking treated water. Other ways to be exposed include consuming food and beverages prepared with treated water, inhalation, and dermal absorption.
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There are no regulatory discharge limits in the United States for EDCs to avert their possible negative impacts. Moreover, conventional treatment processes fail to remove the persistent EDC pollutants, leading researchers to develop alternative treatment methods. 

Much of the EDC load comes from wastewater treatment fluids, both industrial and municipal, that discharge into receiving bodies of water. Innovative wastewater treatment methods are vital to destroy EDCs. These techniques include advanced oxidation methods (photocatalytic and catalytic oxidation), phytoremediation, membrane separation, adsorption, and hybrid systems. These techniques can eliminate contaminants enabling clean water discharge into receiving bodies.

EDCs cost society because of disease and disability. Still, unlike other toxic chemicals such as carcinogens, they have yet to be codified into regulations as a hazard category.  Still, the first step to improving the situation is including EDCs in federally mandated water and air discharge limits. When the federal limits require treatment, the cost of treatment systems will drop to become feasible. 

In the meantime, some things you can do to limit your exposure to EDCs include:

• Minimizing consumption of processed foods.
• Using filtered water instead of bottled water.
• Keep away from storing canned or plastic-packaged foods in hot areas.
• Avoid microwaving and otherwise heating food in plastic containers.

 
Control of these materials and resultant human exposure would not be prohibitively costly or otherwise bothersome. Potable water treatment technologies exist to manage these complex molecules and can be implemented to manage exposures. Removing them at industrial point discharge sources is similarly practical. 
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Tolerating these persistent and hazardous substances is a subsidy to industry, as industrial concerns produce and profit from the compounds. The cost saved by the current unregulated status is nominal but the effects on human health are immense.  Unfortunately, the current regulatory climate is so business-friendly that regulation of EDCs is a faint hope.  

​Historically, there have been misguided and erroneous suggestions of the effectiveness of Vitamin C in promoting longevity, preventing, and treating the common cold, and a montage of other poorly evidenced health claims.  Unfortunately, follow-up studies failed to confirm these extravagant claims. For a fair amount of time, clinicians shelved Vitamin C as a therapy and existed only in the world of supplements, full of puffery and hyperbole, with little science behind the claims.  However, recent double-blind controlled studies point to its use for many chronic and acute conditions, leading to a renaissance for this crucial nutrient.

Humans rely solely on dietary intake to maintain the body pool of vitamin C. In most vertebrates, l-gluconolactone oxidase catalyzes the decisive step in ascorbic acid biosynthesis. Those vertebrates maintain a Vitamin C blood level equivalent to an incredible nine grams of Vitamin C dose per day for an average human.

Evolution has made the gene responsible for Vitamin C manufacture inactive in primates, flying mammals, guinea pigs, and some bird and fish species, thereby disabling its formation by the body. This evolutionary event may have resulted in an adaptational process where several physical adaptations have improved our ability to prevent Vitamin C deficiency.  These adaptations change the movement of drugs within the body, including more efficient absorption, recycling, and renal reuptake of Vitamin C compared to Vitamin C synthesizing species.
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The higher Vitamin C blood levels in other mammals prompted scientists to speculate similar blood levels might have beneficial effects.  From this came a microscience of megadosing Vitamin C, with little scientific evidence to support it, primarily anecdotal accounts.  However, some of the observations, particularly that of Vitamin C for allergy treatment, where good study evidence supports the conclusion that it alleviates the symptoms of allergic rhinitis by raising the plasma ascorbic acid levels.

Recent double-blind controlled studies indicate that Vitamin C has some positive uses in clinical treatments. Most studies focus on reducing blood pressure, helping with upper respiratory infections, treating sepsis, dealing with metabolic syndrome, healing bones, and managing periodontal disease.

Fast facts from recent double-blind controlled study meta-analyses:

• The administration of intravenous vitamin C may lead to a relaxation of blood vessels and a reduced need for mechanical ventilation in the critically ill, but it does not reduce overall mortality.
• A tendency towards a mortality reduction with intravenous high-dose vitamin C monotherapy.
• There is compelling evidence that vitamin C shortens the duration of mechanical ventilation, but the magnitude of the effect is a function of the duration of ventilation.
• Although scientists discovered no preventive effects, vitamin C intake reduced the duration of upper respiratory tract infection in children.
• For sepsis patients, an improved survival if they were treated with vitamin C treatment for three to four days.
• Studies demonstrated that vitamin C has the potential to accelerate bone healing after a fracture, increase type I collagen synthesis, and reduce oxidative stress parameters.
• Statistically, there is highly significant evidence that vitamin C can shorten the length of ICU stays.
• Vitamin C contributes to a reduced risk of periodontal disease.
• Observations suggest the importance of metabolic syndrome patients having an adequate vitamin C intake through food, beverages, or supplements to maintain its concentration in the systemic circulation and potentially reverse metabolic syndrome.
• Vitamin C has clinical benefits in patients with infections due to many herpes viruses.

​One problem is that the Recommended Dietary Allowance (RDA) of 90 mg/day for adult men and 75 mg/day for adult women is meager, and many people feel that amount results in a subclinical deficiency. Given the benign risk profile for Vitamin C, supplementation in greater quantities, and perhaps even much larger quantities, appears to have little hazard and possibly much benefit.  

​Poverty is a pressing issue in the United States that requires immediate attention. As an incredibly wealthy country with vast governmental resources, we must have minimal poverty rates. Unfortunately, poverty continues to claim its place as an international eyesore, a condemnation of hyper capitalism, and, worst of all, a public health problem. This study presents the status and implications for the future, urging us to act.

The Southern United States is characterized by poor governance and repressive policies, including explicitly racist policies intended to suppress the power of minorities. Economic growth and progressive governance are strongly correlated. Repressive governance keeps the American South poor and backward and is self-destructive at its core. 
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Thus, the correlation between economic growth and progressive governance cannot be denied.  A recent study of seven states in the south-central part of the United States, including Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Tennessee, and West Virginia, confirmed that they lagged the United States.  From 1997 to 2019, these states had a GDP growth of 1.3% annually, compared to the United States' rate of 2.3%, so they fall farther behind the rest of the United States annually.  After the end of Apartheid in South Africa, GDP growth rose to nearly 3% from 1.25% from 1980 to 1994.  

However, there is hope. Federal legislative action has the power to override this repressive governance, paving the way for improved outcomes for all Americans. There is precedence for addressing pockets of poverty, most notably the Tennessee Valley Authority (TVA) created in 1933. The TVA's purpose, authorized by the TVA Act, was to make cheap energy and provide it for environmental management and economic development. Civil works included power production, flood control, and reforestation. This is a testament to the transformative power of legislative action.

The penal system in the United States is a clear example of the pervasive resistance to social engineering. The prevailing ideology that individuals are solely responsible for their destiny and its consequences, regardless of what they are, is deeply ingrained. While this ideology is an American ideal, it is time to question its validity. Generational poverty is a national burden, and its significant economic and societal challenges hinder economic vitality and overall welfare. It is high time for a new ideology to inspire hope for a better future.
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Poverty rates fell through the 1960s but rose and fell with economic cycles since then. They did not fall measurably during the two expansions before the pandemic until between four and six years after the expansion. The current economic recovery has not broken this pattern: the most recent recession occurred from February to April 2020, and the current expansion began in May 2020. The official poverty rate did not show a year-to-year decline during the first two years. 

Between 2019 and 2020, the number of people living in poverty and the poverty rate increased in both the South and West. Among the regions, the South had the highest poverty rate, which increased to 13.3 percent, with 16.6 million individuals living in poverty. In the West, the poverty rate has increased to 10.6 percent, with 8.3 million people in poverty in 2020. In the Midwest and Northeast, neither the poverty rates nor the number of people living in poverty in 2020 were statistically different from 2019. In the Midwest, 10.1 percent and 6.8 million people were in poverty in 2020, while in the Northeast, the poverty rate was 10.1 percent, with 5.6 million individuals in poverty.

The official overall poverty rate for the United States experienced no statistically detectable shift between 2021 and 2022; the official poverty rates among most demographic groups remained steady. Notable exceptions were the decline in the official poverty rate among Black people to a historically low 17.1% or 8.6 million people and a rise among non-Hispanic Whites to 8.6% or 15.8 million people. The rising rates among whites partially explain the attraction of politicians, such as Donald Trump, as the future of this cohort continues to decline in various measures of prosperity and public health.
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People living in poverty tend to have higher disease burdens. Poverty at the county level is associated with death from many chronic conditions, such as heart disease, liver afflictions, and kidney problems. Other studies have also shown a correlation between low income and dental problems. During the COVID-19 pandemic, poverty became a predictor of infection risk, adverse health outcomes, and mortality.

Women have higher poverty rates than men: 12.5% compared to 10.5% in 2022 (no meaningful change from 2021). Historically, families with a female householder and no spouse (female-householder families) have had higher poverty rates than married-couple families and families with a male householder and no spouse (male-householder families). This remained true in 2022: the poverty rate among female householder families was 23.0% (not different from 2021), compared with 11.5% for male householder families and 5.0% for married couples.
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A significant issue here is the historic disparity between pay for women and men. An equal pay law would address this quickly, but business interests would object. Thanks to the Citizens United Supreme Court decision, wealthy interests control the United States legislative branch, making the passage of an equal pay measure problematic.

The Affordable Care Act (ACA) included Medicaid expansion nationwide. In June 2012, the Supreme Court ruled that states should not be compelled to increase their Medicaid programs. Each state determines whether to participate.

Before ACA, Medicaid was not available to non-disabled adults under the age of sixty-five, except if they had children under the age of 18 years. In addition, the income caps eligible as parent/caretakers were extremely low. By expanding Medicaid, the ACA created a feasible path to cover millions of low-income Americans.

The federal government finances most of the expenses of expanding Medicaid, and ten percent is paid by participating states. States that refuse to expand Medicaid still get their normal federal Medicaid funding rather than the 90% funding they would gain to cover the recently qualified people if they were to expand.

Just ten states have not expanded Medicaid – mainly in the American South, where Republicans dominate state legislatures. However, a decade after the Affordable Care Act made the option available, Medicaid expansion became more challenging to resist.

Fast facts about Medicaid expansion:

• Uninsurance rates would drop by 25% if the ten states expanded their Medicaid programs.
• Women of reproductive age would see a considerable reduction in uninsurance (a drop of 31%), older women would see a decline of 23.2%, and men would see a reduction of 22.4%.  
• Black women of childbearing age would see a 51.3% reduction in uninsurance.
• Non-Hispanic Black adults would see the most significant reduction in the uninsured rate of all racial or ethnic groups (43.2% reduction).
• Young adults ages 19 to 24 have the highest uninsured rate, with nearly one in five uninsured individuals (19.9%). They would see the most significant decrease in the uninsurance rate (a drop of 32.4%). 
• States that have expanded Medicaid found new spending counterbalanced by long-term savings in healthcare expenditures and new revenue.
• State spending on Medicaid in the remaining ten states would increase by $1.5 billion (a 3% increase).  
• Federal spending on Medicaid in these ten states would rise by approximately $24 billion (a 17.5% increase). 

 
States that have expanded Medicaid see sizable health and economic gains that impact all residents, not just those who would gain coverage.  The denial of Medicaid expansion is an example of self-destructive behavior. This proves that the existing oligarchy in these states prefers to keep people with low incomes and minorities as an underclass, even if it costs them money.  
 
Another remedy for poverty would be subsidized childcare, allowing parents freedom to work, and increasing family income.  The number of job openings in the United States was unchanged at 8.2 million on the last business day of June 2024.  Subsidized childcare would help fill some of those openings, and aside from lifting people from poverty, the additional employment would increase gross domestic product, help create wealth, and help lift the country's economy.
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There is a substantive argument that the American South is a failed experiment in nation-building.  Further, generational planning and implementation will be necessary in the long term to remove these hard-core poverty areas and improve national vitality.  Does the federal government have the moxy to implement such dramatic action?  Provided that the Democrats run the table in November’s election, gaining the presidency, house, and senate, progressive legislation stands a chance, but only that, given the power of dark money due to the Supreme Court’s Citizen United ruling.
 

​Taurine, a semi-essential micronutrient, is one of humans and other animals' most abundant amino acids. Many studies demonstrate that taurine levels are correlated with health status, with the most interesting being the association between high taurine levels and health and lifespan. This cheap amino acid is tailor-made for the supplement industry, which has been quick to cash in on the taurine craze. This investigation provides meta-studies results and discusses the wisdom of taurine supplementation.

Meta-study analyses provide intriguing results:

• Ingesting taurine in varying amounts can improve human endurance performance.
• Taurine intake was associated with a decrease in blood pressure.
• Taurine ingestion was associated with decreases in total cholesterol and triglycerides.
• Taurine administration was not associated with body mass index and body weight.
• A statistically significant reduction in HbA1C and Fasting Blood Sugar after oral supplemental taurine for diabetic patients was more substantial than that of a placebo.
• Taurine has modulatory effects on inflammatory and oxidative stress biomarkers.
• Taurine supplementation positively affects multiple metabolic syndrome-related factors, making it a potential dietary addition for individuals at risk of or already experiencing metabolic syndrome.
• Taurine enhances the effects of anticancer drugs while also reducing side effects.
• Taurine has anti-atherosclerotic and anti-thrombotic effects that may protect against cardiovascular disease.
• Taurine abundance decreases during aging, reversing this by taurine supplementation increases the health and life span in mice and worms.

​While the human body can synthesize taurine, dietary intake is essential to maintain optimal levels. Foods rich in taurine include meat, fish, poultry, and dairy products. Due to their dietary restrictions, vegetarians and vegans may have a lower taurine intake. 

Taurine may have a crucial role in cardiovascular physiology. Numerous studies have investigated the potential cardioprotective effects of taurine, focusing on its impact on blood pressure, cardiac contractility, and vascular function. It may help reduce blood pressure in individuals with hypertension and improve endothelial function, leading to enhanced vascular health.

Preclinical investigations have provided valuable insights into the cardiovascular effects of taurine. In hypertension, heart failure, and atherosclerosis models, taurine supplementation has consistently improved cardiac function, reduced blood pressure, and enhanced vascular health. Human studies investigating taurine's cardiovascular effects have also yielded promising results. Clinical trials indicate it may help reduce blood pressure, improve left ventricular function, and enhance exercise capacity in individuals with heart failure. Its antioxidant properties may also reduce the risk of cardiovascular diseases such as atherosclerosis and heart failure.

The endothelium, a single layer of cells lining the blood vessels, plays a crucial role in vascular health. Taurine may enhance endothelial function by promoting the creation of nitric oxide (NO) and easing endothelial dysfunction. Enhanced endothelial function contributes to better vascular relaxation, reduced inflammation, and improved blood flow, which may benefit cardiovascular health and reduce the risk of atherosclerosis and cardiovascular events.

Taurine abundance decreases during aging. Reversing this decline through taurine supplementation increases mice and worms' health and life spans. This identifies taurine deficiency as a driver of aging in these species.

Aging is associated with changes in circulating levels of various molecules, including taurine. Scientists demonstrated that circulating taurine declines with aging in mice, monkeys, and humans. Reversing this decline by dosing with taurine increased the health span (the period of healthy living), life span in mice, and health span in monkeys.

Taurine reduced cellular agedness, defended against telomerase deficiency, stifled mitochondrial dysfunction, decreased DNA damage, and reduced inflammation. In humans, lower taurine concentrations correlate with age-related diseases, and taurine concentrations increase after acute endurance exercise. Thus, taurine deficiency may be a driver of aging because its reversal increases the health span in worms, rodents, and primates and the life span in worms and rodents. Clinical trials in humans seem warranted to assess whether taurine deficiency might drive human aging.

Manufacturers market taurine as an adjunct in various products and supplements. People afflicted with different ailments induced by modern society snap it up to improve health. While dosing with taurine makes logical sense, one might consider other factors.

The most glaring weakness in the puffery about taurine is that there are few human studies and even fewer double-blind placebo-controlled evaluations.  In other words, the statistician’s mantra that correlation is not causation applies.
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A number of factors are empirically proven to improve health markedly. Stress reduction, exercise, strength training, a whole foods diet, avoiding alcohol, tobacco, ultra-processed food, and a good night's sleep will often almost immediately improve a person's health and well-being. Taurine supplementation without a prudent and healthy lifestyle seems pointless and wastes time and money.

A critical predictor of adult wellness is one's childhood experience, a period mythologized as happy but fraught with hazards. Unfortunately, America has a culture of child abuse - emotional, sexual, and physical. It creates generational illness by not addressing this problem. This investigation will review research on childhood sexual abuse and its impact on female victims.
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Nearly one in three women were sexually abused as minors, an incredible statistic indicating a sick society in need of fundamental reform.

Child sexual abuse is common, severe, is reported rarely, and the victims usually know their abuser. Preadolescent girls are at the most significant risk.

According to the American Psychological Association, sexual abuse is 'an undesired sexual activity, with perpetrators using force, making threats or taking advantage of victims not able to give consent.'

Sexual abuse takes different forms, such as fondling or sucking of sexual body parts, forced sexual intercourse, indecent exposure, and both oral sex and bodily penetration. Force includes coercion, manipulation, and threats where a person cannot consent.

Nearly one woman in three reported sexual abuse before the age of 16 years in the United States:

• A substantial number of these incidents (70%) involved genital contact or more severe abuse, and 12% of the victims were imperiled by sexual intercourse.
• The victims usually knew their abusers, with family members in 38% of cases and acquaintances in another 46%.
• Strangers accounted for 15% of all abuse experiences.
• Most of the abusers were young men.
•  Reporting of the abuse was infrequent, and only about 7% of all abuse was ever officially reported.

What the failure to report means is societal pressure using shame creates a perfect environment for serial predators,  thereby creating even more preventable injuries. 
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Major depressive disorders are affected by hereditary, environmental, and dispositional factors. For example, both routine life stressors and those linked plainly with abuse have long been considered leading contributors to the onset of depression, in which severe depression is strongly related to sexual, emotional, and physical abuse. 

Women tend to reveal more long-term changes in stress reactivity compared to males, which may be the reason for increased depression in females. Medical professionals diagnose women with depression twice as often as men, and are more likely to have suffered some form of abuse as a child. The proportion of women who faced depression during their lifespan was the highest among those who were victims of abuse.

Women who have experienced abuse or other types of trauma are more likely to develop a variety of different mental health illnesses. Males and females respond to sexual abuse differently.  Men tend to express their negatively charged sentiments, which can explain the high prevalence of hostility and outward-facing antisocial behavior. Women tend to turn their self-loathing inwards, with corrosive, life-altering results, anxious, distrusting, and carrying what they consider to be a shameful secret in their being.

Abuse revises how people identify themselves and the world around them, with prevalent adverse effects on self-esteem, physical and mental development, and social relationships.

Physical abuse occurs within a web of connected conducts, including authoritarian control, anxiety-provoking behavior, and bodily injuries or discomfort that is perpetrated by any person close to the victim. A meta-analysis with a total of over nine million participants found the global prevalence of childhood physical abuse to be 18%, with a material difference between studies based on the judgment of professionals relative to self-reported studies (0.3% vs. 22%, respectively). This points to the underdiagnosis of physical abuse, an immense problem.

Psychological abuse is behavior intended to undermine a person's well-being or self-esteem. The outcomes of psychological abuse differ depending on the circumstances and the age of the victim. In general, like other types of abuse, it is intentional behavior to convey to the victim that they have no merit (i.e., they are worthless or unwanted) or that something is wrong with them. Emotional abuse includes acts that disturb the emotional health of the individual. Such acts include restricting a person's movements, stigmatization, mockery, intimidation and bullying, prejudice, rejection, and other nonphysical forms of antagonistic action. Emotional abuse can represent an ongoing pattern of behavior occurring across many different situations or be limited to or triggered by a specific problem. It is the least registered type of abuse, and its occurrence is challenging to estimate. 

Studies that have examined the effects of multiple types of abuse have shown childhood emotional abuse to be more significantly linked to depression compared to sexual and physical abuse.

The anguished experiences of abuse can also affect mood regulation as the fundamental violations that live inside the person, often unreconciled and aching, can prompt uneven, difficult to understand, and unusual responses. Rumination and behavioral avoidance are both associated with emotional abuse during childhood and are strongly related to depression.

Experiences of early emotional abuse may be particularly damaging since primary attachment figures are often the source, lending credibility to irrational criticisms. These experiences increase attachment insecurity, avoidance, and isolation, which also play a significant role in the development of depression.

Victims of abuse often are unable to shake their anger, fear, shame, and guilt. Frequently, they attempt to cope by inhibiting all of these emotions. For example, a person who has difficulties revealing the concealed pain that resulted from abuse may also be unable to effectively understand and deal with their depression, concealing the history from therapists and resulting in poorer treatment and recovery outcomes.

The fracture that childhood abuse causes distances the victims from all of humanity, often condemning them to a tortured and lonely life.  The injury is more than a temporal injury, never forgotten, often simply buried, creeping out in inappropriate ways that further distance the victim from other people, and a joyful life.

Is there an answer to helping these victims? Visibility would help as often these people feel they are alone, and somehow they encouraged or caused the abuse. They were actually raped and had no guilt in the foul crime perpetrated on them. If they understood the frequency of this horror, perhaps they would feel more comfortable seeking treatment and opening up about their predicament.
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Creating a more open societal concept about the frequency of abuse could encourage victims to come forward, and aggressive enforcement of existing laws could help jail predators, interrupting serial abuse and reducing harm. Enforcement, interdiction, jail time, and treatment all would help change the story arc associated with this societal illness.

​Since the dawn of consciousness, humans have been searching for magical compounds and techniques to extend what can never be replaced - a person’s time on this planet. Many techniques, such as extended fasting, vitamin supplementation, exercise, and now pharmaceutical compounds, are tools to extend life, both lifespan and quality of life. One of these, rapamycin, has hit the mainstream, and doctors routinely prescribe it as a longevity drug despite incomplete evidence of its efficacy.

Human life expectancy constantly rises, and the median lifespan increases, but the maximum lifespan does not. Although the number of centenarians (100 or older) doubles every ten years, maximum longevity remains the same. The longest-living person died in 1997 at 122; this record has not been beaten.
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Researchers first isolated rapamycin from soil samples collected from Easter Island in the 1960s. This exciting find contained streptomyces hygroscopicus, a bacteria native to the island. Realizing that streptomyces hygroscopicus produced a compound that could kill fungi, they named it rapamycin after the island, Rapa Nui. 

When scientists discovered rapamycin inhibited the growth of eukaryote cells, research on rapamycin turned to rapamycin’s immunosuppressive and anticancer properties. A eukaryote is any cell or organism that possesses a clearly defined nucleus. 

The United States Food and Drug Administration (FDA) approved rapamycin in 1994 to help prevent organ rejection in liver transplant patients, marking a significant milestone in organ transplantation. Rapamycin is also used to avoid restenosis after coronary angioplasty, and it is being tested in many clinical trials as an antitumor agent. That research paid off when the FDA approved the use of rapamycin for treating pancreatic cancer patients in 2011.

In 1994, several scientists independently discovered several aspects of rapamycin’s mechanism of action. When rapamycin crosses a cell membrane and enters a cell, it binds with an enzyme named mTOR, the mechanistic target of rapamycin. In doing so, rapamycin partially inhibits mTOR activity, which enables the activation of autophagy. Rebalancing the mTOR/autophagy ratio may result in extraordinary vigor upgrades and pause aging initiation.
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In 2009, researchers found rapamycin could increase the lifespan of mice when administered later in life. This was the first evidence that a pharmacologic agent could lengthen life. Since then, there has been a surge in research investigating the effects of rapamycin on various diseases, biological functions, and organic processes in mice. However, the importance of further human studies to validate these effects cannot be overstated, underscoring the urgency and importance of our continued exploration in this promising field.   

Popular theory considers pharmaceuticals as the primary means of delaying aging. Over the past decades, various anti-aging drugs, such as the mTOR inhibitor rapamycin; antioxidants such as resveratrol, melatonin, and coenzyme Q10 (CoQ10); and especially senolytics such as dasatinib and quercetin (D + Q) or fisetin, have shown promising effects on longevity by targeting mTOR, mitochondrial and oxidative stress, and cellular senescence.  

When nutrients are available to a cell, mTOR initiates signals that activate cell metabolism, telling the cell to use the available nutrients to build new proteins, enzymes, and other cell components. mTOR is a crucial sensor of nutrient availability. When nutrients are available, mTOR activates cell anabolic (building) growth and proliferation processes.

Autophagy is a process within all cells that counterbalances mTOR’s activities. It occurs when the body breaks down damaged proteins, enzymes, and other cell components for reuse or elimination.

Most cells contain hundreds of mTOR sites. When a person takes rapamycin, it enters cells and binds to some mTOR sites. This results in partial inhibition of mTOR and the activation of autophagy, which promotes a wide range of health benefits in people constantly over-activating mTOR (most people).

Inhibiting mTOR and activating autophagy allows all cells in the body to detoxify more effectively and undergo regeneration and restoration. Results from animal models suggest that partially inhibiting mTOR with rapamycin might improve symptoms of continuing progressive diseases. This category includes metabolic syndrome and Type 2 diabetes, inflammatory conditions like arthritis and lupus, nerve ailments such as Parkinson’s and multiple sclerosis, macular degeneration, glaucoma, obesity, hearing loss, periodontal disease, cognitive decline, and Alzheimer’s disease.

Obesity is an escalating global health crisis with direct links to metabolic syndrome and cardiovascular disease. Because rapamycin inhibits mTOR, it mimics calorie restriction. In animal studies, rapamycin therapy decreases appetite and reduces body weight and fat mass.  Based on these results, rapamycin might be a potential tool for obesity treatment.
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Proponents point to rapamycin's benign side effect profile, which includes a variety of conditions like many other drugs. As physicians use the drug for various situations, including mitigating transplant rejection, scientists have closely defined these side effects, providing a risk profile for examination by physicians and potential users of the drug.  

It is almost certain that the FDA will never approve rapamycin for longevity. The agency doesn’t categorize aging as a disease, plus rapamycin’s generic status means there’s little financial incentive to run expensive clinical trials for aging or similar ailments.

Living a healthy and long life is achievable, provided genetic medical conditions are manageable and lifestyle conditions are healthy and supportive of such ambitions. The mix includes emotional wellness, sleep, exercise, diet, and environmental factors. Pills alone may support this endeavor, but they are in no way a magic bullet. Instead, they could help boost health and longevity.
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Unfortunately, the science about the efficacy and risks of longevity compounds, including rapamycin, is murky and unlikely to be resolved soon. Still, the temptation exists, particularly for older people who don’t wish to wait and choose to be their laboratory rat.  

Alcoholism, sometimes denoted as Alcohol Use Disorder, has been a curse on humanity since they created refined alcohol.  Alcoholism provides a binary choice: abstinence or a progressive march to death due to systemic poisoning and the resultant destruction of critical organs.   Alcoholism has ineffective treatments, and the syndrome affects as much as 11.2 % of the adult American populace. 
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Likely, alcoholism is a complex mix of genetic factors and trauma.  While alcoholics and other addicts do severe damage to families and friends, they are still human beings and deserve treatment and respect as such.  

The first step significant clinical consequence of alcoholism is cirrhosis. Cirrhosis is permanent scarring and damage to the liver, trading healthy tissue with scar tissue that prevents the liver from acting conventionally. The scar tissue can also partially block blood flow through the liver, and cirrhosis worsens, causing a condition known as portal hypertension.

Cirrhosis and portal hypertension are the commanding origins of ascites, accounting for about 80% of cases in Western countries.    That's when long-term alcohol abuse causes scarring of the liver tissues, which obstructs blood flow through the portal vein running through the liver.
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Clinical outlooks for liver cirrhosis have two phases: the symptomless stage, also named 'compensated cirrhosis,' and the phase of problems due to the advance of portal hypertension and liver dysfunction, also called 'decompensated cirrhosis,' where patients may develop ascites, the most frequent complication from liver cirrhosis.

When fluid from these enlarged veins leaks into the abdomen, it builds up inside the peritoneal cavity, causing ascites. Ascites cause uncomfortable swelling in the abdomen and can affect appetite and digestion. In severe cases, it extends into the chest cavity and interferes with breathing. It's also a risk factor for infection in the peritoneal cavity, resulting in peritonitis.
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The march towards ascites is straightforward.  A heavy drinker damages their liver through years of heavy drinking; scar tissue stiffens the organ, and then they develop uncomplicated ascites. Hepatic decompensation, defined by ascites, hepatic encephalopathy, and portal hypertensive gastrointestinal bleeding, is an essential landmark in the natural history of cirrhosis. 

Even patients who are ambulatory and have cirrhotic ascites have a 3-year mortality rate of 50%. Patients with refractory ascites have a 1-year survival of less than 50%. 
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A silent path characterizes the natural history of cirrhosis until decompensation when the progressive deterioration of liver function causes a rapid decline in life expectancy. The disease's early stage is 'compensated cirrhosis.' At the same time, the late one, defined by the appearance of ascites, bleeding, brain disease, or jaundice, is 'decompensated cirrhosis.' Due to the strikingly different survival rates, compensated and decompensated cirrhosis are considered two distinct clinical entities.

Management of Uncomplicated Ascites:

• Reducing dietary salt intake and increasing renal sodium excretion are the initial cornerstones of ascites management.
• Diuretics are used as symptomatic treatments, not affecting the general course of the disease, since they act downstream in the pathophysiological cascade.
• Large volume paracentesis (LVP) is the treatment of choice due to its effectiveness and low rate of complications.  LVP requires inserting a needle in the patient's abdomen and drawing excess fluid from the cavity, alleviating the pressure on the patient's body.
• All patients with cirrhosis should be evaluated for liver transplantation, as that is the only cure.

Refractory ascites (RA) is the term for a patient's progressive lack of response to diuretic therapy (diuretic-resistant RA).
Management of Refractory Ascites

• RA dramatically worsens patients' prognosis, reducing the median survival to about six months.
• Periodic execution of LVPs is agreed to be the treatment of choice for patients with RA.
• In a meta-analysis of randomized controlled trials, human albumin solution (HAS) was shown to reduce the risk of mortality compared to other strategies in patients undergoing LVP.
• Diuretic therapy is either reduced or withdrawn due to the high risk of diuretic-related complications.
• Trans-jugular intra-hepatic portosystemic shunts (TIPS) can address portal hypertension, a critical factor in decompensated cirrhosis. TIPS consists of creating an artificial shunt between the portal and hepatic vein, thus decreasing portal hypertension.
• A dreaded complication of advanced liver disease is hepatorenal syndrome (HRS). In its most lethal form (type I), there is a relentless deterioration of renal function, reflected in soaring creatinine and BUN, resulting in death. This syndrome always occurs with ascites.
• Liver replacement is the best treatment option because it is associated with 2-year survival rates of almost 85%.

Abdominal wall and inguinal hernias are common in patients with cirrhosis and ascites because of the incredible abdominal pressure from fluid buildup. Umbilical hernias grow in about 20% of patients with cirrhosis.  Increased abdominal pressure from ascites, weakened abdominal muscles, and poor nutrition can rapidly enlarge hernias.

​Bacterial infections are present in approximately one-third of patients with cirrhosis who are hospitalized, a much higher prevalence than in those without cirrhosis.   A familiar yet unique type of infection in this setting is infections that occur without an obvious source of infection. Bacterial translocation, the migration of bacteria from the gut to the bloodstream and other extraintestinal sites, and decreased host defenses have been implicated in the pathogenesis of these spontaneous infections.  Other common infections in cirrhosis are urinary tract infections, pneumonia, and soft tissue.

Liver replacement is the best treatment for cirrhosis and cirrhotic ascites. Experts have different opinions about the referral timing, but physicians should contemplate it when a cirrhotic patient first presents with difficulty from cirrhosis, such as ascites. Because refractory ascites portends imminent death, time is critical.
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Alcoholism offers a mortal choice to those afflicted – quit drinking or die a miserable death at a young age.  As it results from a complicated array of factors and is incredibly difficult to treat, it seems sad for humanity.  Despite that, formal education about the consequences and other public health measures are essential to implement and would result in significant positive outcomes.