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ADA asks Treasury Department, Small Business Administration to clarify intent of interim rule

The Association continues to wait for clear guidance from the U.S. Department of Treasury and Small Business Administration on the best way to help dentists considering applying for Paycheck Protection Program 7(a) loans and Economic Injury Disaster Loans.




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Small Business Administration: Dentists can apply for both economic injury disaster and paycheck protection program loans

Dentists can apply for both Economic Injury Disaster Loans and Paycheck Protection Program 7(a) loans, the Small Business Administration told the American Dental Association on April 6.




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Webinar on Small Business Administration loans available online

The ADA webinar, Small Business Administration Loans: Understanding the Options for Dentist Owners, is available online.




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ADA asks Congress to increase funding, extend dates for Small Business Administration loans

The ADA is urging Congress to continue supporting small businesses during the COVID-19 pandemic by increasing funding and streamlining the application process for Small Business Administration loans.




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Index shows that dentists slowly but surely embracing electronic means of doing business

Despite the ADA Council on Dental Benefits’ efforts, the practice of using automated electronic means for verifying eligibility and benefits, checking claim status or receiving and reconciling payment remains underutilized by many dental providers according to an index, said Dr. Randall Markarian, council chair.




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ADA FDC Annual Meeting postpones registration

The American Dental Association and Florida Dental Association have postponed registration for the ADA FDC Annual Meeting from April 22 to early summer, in light of the COVID-19 pandemic.




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Senate votes to expand small business aid

The Senate passed new coronavirus relief legislation April 21 calling for much-needed funding for depleted federal loan programs that could help businesses nationwide, including dentists and dental practices, recover from the economic fallout of the pandemic.




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Agencies submit final rule extending ERISA deadlines during pandemic

The U.S. Department of Labor said April 28 that it is extending the Employee Retirement Income Security Act of 1974 filing deadlines for certain notice and disclosure requirements in the wake of the COVID-19 pandemic.




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Foodborne illnesses rise 15% in U.S. in 2019, CDC says

Infections caused by contaminated food are up 15 percent across the United States, according to preliminary data from the U.S. Centers for Disease Control and Prevention's Foodborne Diseases Active Surveillance Network.




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U.S. rural areas soon might be on front lines in COVID-19 pandemic

The COVID-19 pandemic has left a path of destruction in urban centers throughout the northeastern United States, but the next outbreak hotspots could have even deadlier effects in rural areas.




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Clinical and Public Health Implications of 2019 Endocrine Society Guidelines for Diagnosis of Diabetes in Older Adults

OBJECTIVE

Screening for diabetes is typically done using hemoglobin A1c (HbA1c) or fasting plasma glucose (FPG). The 2019 Endocrine Society guidelines recommend further testing using an oral glucose tolerance test (OGTT) in older adults with prediabetic HbA1c or FPG. We evaluated the impact of this recommendation on diabetes prevalence, eligibility for glucose-lowering treatment, and estimated cost of implementation in a nationally representative sample.

RESEARCH DESIGN AND METHODS

We included 2,236 adults aged ≥65 years without known diabetes from the 2005–2016 National Health and Nutrition Examination Survey. Diabetes was defined using: 1) the Endocrine Society approach (HbA1c ≥6.5%, FPG ≥126 mg/dL, or 2-h plasma glucose ≥200 mg/dL among those with HbA1c 5.7–6.4% or FPG 100–125 mg/dL); and 2) a standard approach (HbA1c ≥6.5% or FPG ≥126 mg/dL). Treatment eligibility was defined using HbA1c cut points (≥7 to ≥9%). OGTT screening costs were estimated using Medicare fee schedules.

RESULTS

Diabetes prevalence was 15.7% (~5.0 million) using the Endocrine Society’s approach and 7.3% (~2.3 million) using the standard approach. Treatment eligibility ranged from 5.4 to 0.06% and 11.8–1.3% for diabetes cases identified through the Endocrine Society or standard approach, respectively. By definition, diabetes identified exclusively through the Endocrine Society approach had HbA11c <6.5% and would not be recommended for glucose-lowering treatment. Screening all older adults with prediabetic HbA1c/FPG (~18.3 million) with OGTT could cost between $737 million and $1.7 billion.

CONCLUSIONS

Adopting the 2019 Endocrine Society guidelines would substantially increase the number of older adults classified as having diabetes, require significant financial resources, but likely offer limited benefits.




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Cost and Cost-Effectiveness of Large-Scale Screening for Type 1 Diabetes in Colorado

OBJECTIVE

To assess the costs and project the potential lifetime cost-effectiveness of the ongoing Autoimmunity Screening for Kids (ASK) program, a large-scale, presymptomatic type 1 diabetes screening program for children and adolescents in the metropolitan Denver region.

RESEARCH DESIGN AND METHODS

We report the resource utilization, costs, and effectiveness measures from the ongoing ASK program compared with usual care (i.e., no screening). Additionally, we report a practical screening scenario by including utilization and costs relevant to routine screening in clinical practice. Finally, we project the potential cost-effectiveness of ASK and routine screening by identifying clinical benchmarks (i.e., diabetic ketoacidosis [DKA] events avoided, HbA1c improvements vs. no screening) needed to meet value thresholds of $50,000–$150,000 per quality-adjusted life-year (QALY) gained over a lifetime horizon.

RESULTS

Cost per case detected was $4,700 for ASK screening and $14,000 for routine screening. To achieve value thresholds of $50,000–$150,000 per QALY gained, screening costs would need to be offset by cost savings through 20% reductions in DKA events at diagnosis in addition to 0.1% (1.1 mmol/mol) improvements in HbA1c over a lifetime compared with no screening for patients who develop type 1 diabetes. Value thresholds were not met from avoiding DKA events alone in either scenario.

CONCLUSIONS

Presymptomatic type 1 diabetes screening may be cost-effective in areas with a high prevalence of DKA and an infrastructure facilitating screening and monitoring if the benefits of avoiding DKA events and improved HbA1c persist over long-run time horizons. As more data are collected from ASK, the model will be updated with direct evidence on screening effects.




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Efficacy and Safety of 1:1 Fixed-Ratio Combination of Insulin Glargine and Lixisenatide Versus Lixisenatide in Japanese Patients With Type 2 Diabetes Inadequately Controlled on Oral Antidiabetic Drugs: The LixiLan JP-O1 Randomized Clinical Trial

OBJECTIVE

To assess the efficacy and safety of a 1:1 fixed-ratio combination of insulin glargine and lixisenatide (iGlarLixi) versus lixisenatide (Lixi) in insulin-naive Japanese patients with type 2 diabetes mellitus (T2DM) inadequately controlled on oral antidiabetic drugs (OADs).

RESEARCH DESIGN AND METHODS

In this phase 3, open-label, multicenter trial, 321 patients with HbA1c≥7.5 to ≤10.0% (58–86 mmol/mol) and fasting plasma glucose (FPG) ≤13.8 mmol/L (250 mg/dL) were randomized 1:1 to iGlarLixi or Lixi for 52 weeks. The primary end point was change in HbA1c at week 26.

RESULTS

Change in HbA1c from baseline to week 26 was significantly greater with iGlarLixi (–1.58% [–17.3 mmol/mol]) than with Lixi (–0.51% [–5.6 mmol/mol]), confirming the superiority of iGlarLixi (least squares [LS] mean difference –1.07% [–11.7 mmol/mol], P < 0.0001). At week 26, significantly greater proportions of patients treated with iGlarLixi reached HbA1c <7% (53 mmol/mol) (65.2% vs. 19.4%; P < 0.0001), and FPG reductions were greater with iGlarLixi than Lixi (LS mean difference –2.29 mmol/L [–41.23 mg/dL], P < 0.0001). Incidence of documented symptomatic hypoglycemia (≤3.9 mmol/L [70 mg/dL]) was higher with iGlarLixi (13.0% vs. 2.5%) through week 26, with no severe hypoglycemic events in either group. Incidence of gastrointestinal events through week 52 was lower with iGlarLixi (36.0% vs. 50.0%), and rates of treatment-emergent adverse events were similar.

CONCLUSIONS

This phase 3 study demonstrated superior glycemic control and fewer gastrointestinal adverse events with iGlarLixi than with Lixi, which may support it as a new treatment option for Japanese patients with T2DM that is inadequately controlled with OADs.




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Acrylamide Exposure and Oxidative DNA Damage, Lipid Peroxidation, and Fasting Plasma Glucose Alteration: Association and Mediation Analyses in Chinese Urban Adults

OBJECTIVE

Acrylamide exposure from daily-consumed food has raised global concern. We aimed to assess the exposure-response relationships of internal acrylamide exposure with oxidative DNA damage, lipid peroxidation, and fasting plasma glucose (FPG) alteration and investigate the mediating role of oxidative DNA damage and lipid peroxidation in the association of internal acrylamide exposure with FPG.

RESEARCH DESIGN AND METHODS

FPG and urinary biomarkers of oxidative DNA damage (8-hydroxy-deoxyguanosine [8-OHdG]), lipid peroxidation (8-iso-prostaglandin-F2α [8-iso-PGF2α]), and acrylamide exposure (N-acetyl-S-[2-carbamoylethyl]-l-cysteine [AAMA], N-acetyl-S-[2-carbamoyl-2-hydroxyethyl]-l-cysteine [GAMA]) were measured for 3,270 general adults from the Wuhan-Zhuhai cohort. The associations of urinary acrylamide metabolites with 8-OHdG, 8-iso-PGF2α, and FPG were assessed by linear mixed models. The mediating roles of 8-OHdG and 8-iso-PGF2α were evaluated by mediation analysis.

RESULTS

We found significant linear positive dose-response relationships of urinary acrylamide metabolites with 8-OHdG, 8-iso-PGF2α, and FPG (except GAMA with FPG) and 8-iso-PGF2α with FPG. Each 1-unit increase in log-transformed level of AAMA, AAMA + GAMA (UAAM), or 8-iso-PGF2α was associated with a 0.17, 0.15, or 0.23 mmol/L increase in FPG, respectively (P and/or P trend < 0.05). Each 1% increase in AAMA, GAMA, or UAAM was associated with a 0.19%, 0.27%, or 0.22% increase in 8-OHdG, respectively, and a 0.40%, 0.48%, or 0.44% increase in 8-iso-PGF2α, respectively (P and P trend < 0.05). Increased 8-iso-PGF2α rather than 8-OHdG significantly mediated 64.29% and 76.92% of the AAMA- and UAAM-associated FPG increases, respectively.

CONCLUSIONS

Exposure of the general adult population to acrylamide was associated with FPG elevation, oxidative DNA damage, and lipid peroxidation, which in turn partly mediated acrylamide-associated FPG elevation.




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Dietary Manganese, Plasma Markers of Inflammation, and the Development of Type 2 Diabetes in Postmenopausal Women: Findings From the Womens Health Initiative

OBJECTIVE

To examine the association between manganese intake and the risk of type 2 diabetes in postmenopausal women and determine whether this association is mediated by circulating markers of inflammation.

RESEARCH DESIGN AND METHODS

We included 84,285 postmenopausal women without a history of diabetes from the national Women’s Health Initiative Observational Study (WHI-OS). Replication analysis was then conducted among 62,338 women who participated in the WHI-Clinical Trial (WHI-CT). Additionally, data from a case-control study of 3,749 women nested in the WHI-OS with information on biomarkers of inflammation and endothelial dysfunction were examined using mediation analysis to determine the relative contributions of these known biomarkers by which manganese affects type 2 diabetes risk.

RESULTS

Compared with the lowest quintile of energy-adjusted dietary manganese, WHI-OS participants in the highest quintile had a 30% lower risk of type 2 diabetes (hazard ratio [HR] 0.70 [95% CI 0.65, 0.76]). A consistent association was also confirmed in the WHI-CT (HR 0.79 [95% CI 0.73, 0.85]). In the nested case-control study, higher energy-adjusted dietary manganese was associated with lower circulating levels of inflammatory biomarkers that significantly mediated the association between dietary manganese and type 2 diabetes risk. Specifically, 19% and 12% of type 2 diabetes risk due to manganese were mediated through interleukin 6 and hs-CRP, respectively.

CONCLUSIONS

Higher intake of manganese was directly associated with a lower type 2 diabetes risk independent of known risk factors. This association may be partially mediated by inflammatory biomarkers.




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Federal judge declines to block COVID-19 abortion ban in Arkansas

A federal court on Thursday denied a motion to block an Arkansas directive preventing patients from receiving abortion care.




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Climate change is influencing where tropical cyclones are formed

Over the last 40 years, climate change has been influencing where tropical cyclones form, according to a new study.




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Neanderthals preferred bovine bones for leather-making tools

When it came to selecting bones for leather-making tools, Neanderthals were surprisingly choosy. New archaeological analysis shows Neanderthals preferentially selected bovine rib bones to make a tool called a lissoir.




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Business as Usual? Regularizing Foreign Labor in Costa Rica

With the growing urbanization and consolidation of Nicaraguan immigrants in sectors such as construction and domestic service, Costa Rica has shifted its focus from immigration enforcement to integration. Tension has emerged between the government and private sector as a new mechanism for regularizing unauthorized immigrant workers has failed to gain traction.




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Poland postpones its presidential election

Poland announced a delay of its Sunday presidential election, Europe's first planned vote during the coronavirus pandemic.




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Judge declines to dismiss Lori Loughlin, Mossimo Giannulli's college admissions case

A federal judge on Friday declined to dismiss charges filed against Lori Loughlin and 13 others in a national college admissions case based in Massachusetts.




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AccuWeather increases number of hurricanes predicted for 'very active' 2020 Atlantic season

Based on the newest forecasting models, AccuWeather forecasters have extended the upper range of hurricanes predicted for the Atlantic hurricane season.




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Practicing Emotional Awareness During the COVID-19 Pandemic

When COVID-19 emerged as a clear and present public health threat, most people felt the same range of emotions: somewhere along the spectrum of fear and anxiety. People are still...




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[ Cell Phones & Plans ] Open Question : What is the closest android equivalent to the 1st generation iPhone SE?

I am torn, I know it is time to upgrade my phone, but I don't know whether to upgrade to just accept the larger phone size and go with the 2nd gen SE or go with an android. I'd be interested to know what the closest equivalent android device there is to the 1st gen SE. I am open to a bigger screen size, but not a bigger phone. So, if there was an andriod that was all screen on the front, but was similar size to the original SE, I would be open to that.




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[ Other - Business & Finance ] Open Question : Can I apply for unemployment as a gig worker?

If so, can you do it online? I don't want to catch COVID-19 waiting in some packed line, as I live with an 80 year old.




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Chinese Immigrants in the United States

Nearly 2.5 million Chinese immigrants lived in the United States in 2018—the third largest foreign-born population in the country. Chinese immigration has grown nearly seven-fold since 1980, and China became the top sending country of immigrants in the United States in 2018, replacing Mexico. Chinese immigrants tend to be highly educated and employed in management positions, as this Spotlight article explores.




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Signs of Modern Human Cognition Were Found in an Indonesian Cave

Painted images of intriguing human-animal hybrids are signs of modern thought

-- Read more on ScientificAmerican.com




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Science Confirms: You Really Can't Buy Happiness

When Warren Buffett announced last week that he will be giving away more than $30 billion to improve health, nutrition and education, people all over America reflected on his remarkable generosity, pondered all the noble things the gift would achieve and asked themselves what they would do if...




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A Game of Magical Thinking Leaves Reality on the Sidelines

The 58 fans sitting before the big-screen television were watching the Super Bowl. Psychologist Emily Pronin was watching the fans.




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Almost Everyone Lies, Often Seeing It as a Kindness

The perjury trial of I. Lewis "Scooter" Libby goes to the jury this week. The case speaks to several issues -- how the Bush administration deals with critics of the war in Iraq, and the games that Washington's reporters and politicians play with each other. As far as the jury is concerned, however,...




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Wariness, Not Hatred, Keeps Civil Wars Raging

Here is a measure of the state of the war in Iraq: The number of Iraqis dying each month now rivals the total number of people who died in the Sept. 11, 2001, attacks.




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Out of Unenforceable Laws, Amnesties Are Born

The ambitious immigration overhaul package that Congress is studying has drawn criticism from conservatives who say it offers amnesty to lawbreakers, and from immigration advocates who say it will not do enough to bring millions of people out of the shadows.




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Financial Hardship and the Happiness Paradox

The United States is awash in gloom. Overwhelming majorities of Americans say they are dissatisfied with the country's economic direction, and the intensity of unhappiness is greater than it has been in 15 years, according to a recent Washington Post-ABC News poll. The answer, pundits, politicians...




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Happiness on the Medal Stand? It's as Simple as 1-3-2.

Nearly a century ago, American middle-distance runner Abel Kiviat entered the Stockholm Olympics as the odds-on favorite to win the 1,500-meter race, an event in which he held the world record. Kiviat had the lead 1,492 meters into the race but was passed in the final eight meters by Britain's...




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Cracked Foundation, Uncertain Future: Structural Weaknesses in the Common European Asylum System

During the 2015–16 migration crisis, European asylum systems were stretched to a breaking point. Yet many of the structural issues that contributed to failures to register newcomers, insufficient reception capacity, and growing backlogs of asylum cases existed before—and many remain unresolved. This report critically evaluates Common European Asylum System legal and operational shortcomings at a time when reform is on the table.




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Invertir en el vecindario: Cambios en los patrones de migración entre México y Estados Unidos y oportunidades para una cooperación sostenible

La migración entre México y Estados Unidos ha cambiado dramáticamente en los últimos años, pero las políticas y la retórica política en ambos países no se han actualizado a este contexto a la misma velocidad. Este reporte explora esta nueva realidad migratoria y cómo los dos gobiernos podrían trabajar juntos para abordar los desafíos de políticas públicas que tienen en común.




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Minnesota’s Superdiverse and Growing Dual Language Learner Child Population

Dual Language Learners (DLLs) are a growing segment of the Minnesota young child population, and a particularly "superdiverse" one with myriad origins, cultures, and languages—a new reality other states and communities will face. Drawing on interviews with policymakers and service providers, as well as analysis of census data, this report examines what this incredible diversity means for the state’s early childhood policies and programs.




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As European policymakers take stock of seasonal worker programmes, MPI Europe brief outlines principles to improve these schemes for all parties

Findings will be discussed during 25 February MPI Europe – SVR webinar




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Okonomiyake - Japanese pizza with soy, honey and ginger sauce

Referred to as a Japanese 'pizza', okonomiyaki is probably best described as a cabbage fritter. There are many versions that can include seafood, pork belly, kimchi or cheese, and either served with the sauce described or with Japanese mayonnaise. Delicious snack food, which can also be a meal.




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Puttanesca pasta

8 garlic cloves, peeled 1 red chilli, deseeded and roughly chopped 1 teaspoon sea salt 8 anchovies 1/3 cup olive oil 2 punnets cherry tomatoes, cut in quarters 4 tablespoons kalamata olives, chopped 2 tablespoons baby capers, rinsed 1 cup flat leaf parsley, chopped 30g butter 500g spaghetti pasta Shaved parmesan to serve




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MY MUM'S PUMPKIN & DATE SCONES

I have clear memories of being about four year's old standing on a little stool next to my mum while she made batches of these golden scones. I always loved being in the kitchen with her and she was endlessly patient, letting me help mix, stir, roll and shape all manner of things (in this case turning a blind eye when I smuggled little nuggets raw dough and dates into my mouth.) We would chat away as we went and she would explain to me what she was doing. I remember to this day her telling me the secret to making good scones was to use the lightest touch possible when you're mixing the dough together...we had no food processor then so everything was mixed by hand and I loved rubbing the flour and butter together, lifting my hands high as she had taught me to help keep the scones light. Although I whiz these up in a processor now, every so often I make a batch by hand, and am immediately whisked back into that childhood kitchen and can almost feel and see Cooee, my mum, beside me in her wonderful cinch-waisted 60's polka dot dress...it's a wonderful image.




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Japanese sweet ginger meatballs

1 bunch of spring onions, finely chopped 250 g minced beef 250 g minced pork 20 g grated ginger 1 egg 2 tsps. roasted sesame oil 1 tbsp. cornflour, plus extra for dusting sunflower oil, for shallow frying 1 tbsp. white sesame seeds salt and ground white pepper For the sweet ginger sauce: 30 g grated ginger 3 tbsps. soy sauce 125 ml dashi stock or 1 tsp instant dashi powder mixed with water 2 tbsps. sugar 3 tbsps. mirin 3 tbsps. rice vinegar 1 tsp cornflour




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Pakistan shines on pitch with series win

Pakistan highlighted its talent on the pitch to draw the third and final Test against Sri Lanka in Sharjah and win the series 1-0, just days after three former team-mates were jailed for spot-fixing.




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Association of BMI, Fitness, and Mortality in Patients With Diabetes: Evaluating the Obesity Paradox in the Henry Ford Exercise Testing Project (FIT Project) Cohort

OBJECTIVE

To determine the effect of fitness on the association between BMI and mortality among patients with diabetes.

RESEARCH DESIGN AND METHODS

We identified 8,528 patients with diabetes (self-report, medication use, or electronic medical record diagnosis) from the Henry Ford Exercise Testing Project (FIT Project). Patients with a BMI <18.5 kg/m2 or cancer were excluded. Fitness was measured as the METs achieved during a physician-referred treadmill stress test and categorized as low (<6), moderate (6–9.9), or high (≥10). Adjusted hazard ratios for mortality were calculated using standard BMI (kilograms per meter squared) cutoffs of normal (18.5–24.9), overweight (25–29.9), and obese (≥30). Adjusted splines centered at 22.5 kg/m2 were used to examine BMI as a continuous variable.

RESULTS

Patients had a mean age of 58 ± 11 years (49% women) with 1,319 deaths over a mean follow-up of 10.0 ± 4.1 years. Overall, obese patients had a 30% lower mortality hazard (P < 0.001) compared with normal-weight patients. In adjusted spline modeling, higher BMI as a continuous variable was predominantly associated with a lower mortality risk in the lowest fitness group and among patients with moderate fitness and BMI ≥30 kg/m2. Compared with the lowest fitness group, patients with higher fitness had an ~50% (6–9.9 METs) and 70% (≥10 METs) lower mortality hazard regardless of BMI (P < 0.001).

CONCLUSIONS

Among patients with diabetes, the obesity paradox was less pronounced for patients with the highest fitness level, and these patients also had the lowest risk of mortality.




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Genetic Susceptibility Determines {beta}-Cell Function and Fasting Glycemia Trajectories Throughout Childhood: A 12-Year Cohort Study (EarlyBird 76)

OBJECTIVE

Previous studies suggested that childhood prediabetes may develop prior to obesity and be associated with relative insulin deficiency. We proposed that the insulin-deficient phenotype is genetically determined and tested this hypothesis by longitudinal modeling of insulin and glucose traits with diabetes risk genotypes in the EarlyBird cohort.

RESEARCH DESIGN AND METHODS

EarlyBird is a nonintervention prospective cohort study that recruited 307 healthy U.K. children at 5 years of age and followed them throughout childhood. We genotyped 121 single nucleotide polymorphisms (SNPs) previously associated with diabetes risk, identified in the adult population. Association of SNPs with fasting insulin and glucose and HOMA indices of insulin resistance and β-cell function, available from 5 to 16 years of age, were tested. Association analysis with hormones was performed on selected SNPs.

RESULTS

Several candidate loci influenced the course of glycemic and insulin traits, including rs780094 (GCKR), rs4457053 (ZBED3), rs11257655 (CDC123), rs12779790 (CDC123 and CAMK1D), rs1111875 (HHEX), rs7178572 (HMG20A), rs9787485 (NRG3), and rs1535500 (KCNK16). Some of these SNPs interacted with age, the growth hormone–IGF-1 axis, and adrenal and sex steroid activity.

CONCLUSIONS

The findings that genetic markers influence both elevated and average courses of glycemic traits and β-cell function in children during puberty independently of BMI are a significant step toward early identification of children at risk for diabetes. These findings build on our previous observations that pancreatic β-cell defects predate insulin resistance in the onset of prediabetes. Understanding the mechanisms of interactions among genetic factors, puberty, and weight gain would allow the development of new and earlier disease-management strategies in children.




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Mental Health Risks and Resilience among Somali and Bhutanese Refugee Parents

Somali and Bhutanese refugees are two of the largest groups recently resettled in the United States and Canada. This report examines factors that might promote or undermine the mental health and overall well-being of children of these refugees, with regard to factors such as past exposure to trauma, parental mental health, educational attainment, social support, and discrimination.




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The Digital Transformation Playbook: Rethink Your Business for the Digital Age

Every business begun before the Internet now faces the same challenge: How to transform to compete in a digital economy? This is the leadership challenge examined by BRITE founder and Columbia Business School faculty member David Rogers in his newest book, The Digital Transformation Playbook (April 5, 2016; Columbia Business School Publishing). In the book, […]




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Reflections on Business, Leadership, and Branding: Shelly Lazarus ’70

Much has changed in the world of advertising from the picture painted by Mad Men. Shelly Lazarus ’70, Chairman Emeritus, Ogilvy & Mather, was one of the women helping pioneer these changes. Making the journey from ‘the only woman in the room’ to CEO and Chairman of Ogilvy gives Lazarus a lot to reflect on […]




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Heroic Consciousness: What it is and How to Acquire it

By Scott T. Allison This blog post is excerpted from: Allison, S. T. (2019). Heroic consciousness. Heroism Science, 4, 1-43.   The philosopher Yuval Noah Harari (2018) recently described consciousness as “the greatest mystery in the universe”. What exactly is heroic consciousness? It is a way of seeing the world, perceiving reality, and making decisions … Continue reading Heroic Consciousness: What it is and How to Acquire it




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Robustness and Locke's Wingless Gentleman

Our ancestors have made decisions under uncertainty ever since they had to stand and fight or run away, eat this root or that berry, sleep in this cave or under that bush. Our species is distinguished by the extent of deliberate thought preceding decision. Nonetheless, the ability to decide in the face of the unknown was born from primal necessity. Betting is one of the oldest ways of deciding under uncertainty. But you bet you that 'bet' is a subtler concept than one might think.

We all know what it means to make a bet, but just to make sure let's quote the Oxford English Dictionary: "To stake or wager (a sum of money, etc.) in support of an affirmation or on the issue of a forecast." The word has been around for quite a while. Shakespeare used the verb in 1600: "Iohn a Gaunt loued him well, and betted much money on his head." (Henry IV, Pt. 2 iii. ii. 44). Drayton used the noun in 1627 (and he wasn't the first): "For a long while it was an euen bet ... Whether proud Warwick, or the Queene should win."

An even bet is a 50-50 chance, an equal probability of each outcome. But betting is not always a matter of chance. Sometimes the meaning is just the opposite. According to the OED 'You bet' or 'You bet you' are slang expressions meaning 'be assured, certainly'. For instance: "'Can you handle this outfit?' 'You bet,' said the scout." (D.L.Sayers, Lord Peter Views Body, iv. 68). Mark Twain wrote "'I'll get you there on time' - and you bet you he did, too." (Roughing It, xx. 152).

So 'bet' is one of those words whose meaning stretches from one idea all the way to its opposite. Drayton's "even bet" between Warwick and the Queen means that he has no idea who will win. In contrast, Twain's "you bet you" is a statement of certainty. In Twain's or Sayers' usage, it's as though uncertainty combines with moral conviction to produce a definite resolution. This is a dialectic in which doubt and determination form decisiveness.

John Locke may have had something like this in mind when he wrote:

"If we will disbelieve everything, because we cannot certainly know all things; we shall do muchwhat as wisely as he, who would not use his legs, but sit still and perish, because he had no wings to fly." (An Essay Concerning Human Understanding, 1706, I.i.5)

The absurdity of Locke's wingless gentleman starving in his chair leads us to believe, and to act, despite our doubts. The moral imperative of survival sweeps aside the paralysis of uncertainty. The consequence of unabated doubt - paralysis - induces doubt's opposite: decisiveness.

But rational creatures must have some method for reasoning around their uncertainties. Locke does not intend for us to simply ignore our ignorance. But if we have no way to place bets - if the odds simply are unknown - then what are we to do? We cannot "sit still and perish".

This is where the strategy of robustness comes in.

'Robust' means 'Strong and hardy; sturdy; healthy'. By implication, something that is robust is 'not easily damaged or broken, resilient'. A statistical test is robust if it yields 'approximately correct results despite the falsity of certain of the assumptions underlying it' or despite errors in the data. (OED)

A decision is robust if its outcome is satisfactory despite error in the information and understanding which justified or motivated the decision. A robust decision is resilient to surprise, immune to ignorance.

It is no coincidence that the colloquial use of the word 'bet' includes concepts of both chance and certainty. A good bet can tolerate large deviation from certainty, large error of information. A good bet is robust to surprise. 'You bet you' does not mean that the world is certain. It means that the outcome is certain to be acceptable, regardless of how the world turns out. The scout will handle the outfit even if there is a rogue in the ranks; Twain will get there on time despite snags and surprises. A good bet is robust to the unknown. You bet you!


An extended and more formal discussion of these issues can be found elsewhere.