I would agree that they very much had business decisions around the fork - but calling them malicious is bizarre.
They used the software in a way that complied with the license. When the license changed to no longer suit them for future releases, they forked from the original license.
Remove the names here, and in context, every single person familiar with open source projects and licensing would think this is a nonissue. They used the software as the license was intended, and exercised the rights given to them by that license. That freedom to fork if they don't like where the project is going, or things change and the project is no longer viable for them with the new license, is one of the key freedoms enshrined in the whole FOSS movement.
> So has anyone managed to separate the effects of semaglutide from the effects of weight loss?
In general? Yes. For this specific thing? We haven't even really shown the effects matter for humans.
> If this is caused by the weight loss, it is a little disappointing that public health didn't act quicker - lots of people have been overweight for a century now, so literally 10's of millions of people could have been saved from dementia had action been taken 100 years ago.
Public health has been banging the drum on obesity for decades now. But humans on the whole aren't built to be able to resist hyper palatable calorie dense cheap foods.
As someone who has experienced so many different sides of this, you have zero clue the degree to which your appetite and ability to suppress it is hormonal until you get hormonally compromised (and then fix it, in my case, happily)
Blaming individuals for a public health crisis affecting 40% of the population is absolutely silly. There are a lot of individuals like me, who overeat behaviorally, but that doesn't explain the scale of the issue. maybe 8-10% of the population has some sort of eating disorder, the other 30% are just regular people eating an american diet.
Japan is literally the only country in the developed world that doesn't see their trends following the path of America. Even culturally similar countries like Korea are seeing a rise in overweight and obesity similar to the trends that happened in America and other countries in the west. And Korea has one of the largest shame-industrial-complexes around people being fat, with it being the norm for everyone from your friends and family to strangers pointing out the fact that you're overweight, one of the most insane beauty industries in the world, a 'show up and get GLP-1 medications same day' complex that puts America's compounding industry to shame when it comes to ease of access, etc.
If other countries avoid getting as fat as America was at her fattest, it will be because of GLP-1 medications, not because they are morally superior with a better work ethic.
I think this is easy to say as a healthy eater (I am one too, always have been). However, unlearning a lifetime of bad habits is hard. But yeah, it's costing nations billions that could be better spent.
It's not just habits. It changes the composition of your gut microbiome, hormones, etc. All of that can make changing your diet much harder than one might think.
Those are easier in many ways as you don't need heroin or alcohol to survive and can avoid it completely
If it's hard or not is more of a philosopical question about how much free will we have as people. Statistically they're all hard and not over-eating is the hardest.
Culturally and individually we do a lot of things that probably make the food one even harder
If you drink too much, the common answer is that you need to stop drinking. If you eat too much, we are very reluctant to talk about how you need to eat less. We prefer to talk about how it's someone else's fault and how powerless we are to do anything about it, including comforting lies about how eating less wouldn't work anyway, or how being overweight isn't bad really.
And it becomes even harder when you mix any of those two criteria, let alone more. Then factor in your environment. It is way easier to eat healthily in Italy than in the US. (Maybe that is what you meant with Food desert.)
Food Deserts are a concept that can exist anywhere but yes, I think they are more common in the rural USA. They are places that don't have nearby access to decent grocery stores, basically. Instead they have to buy all of their food from convenience stores. Imagine doing all of your food shopping at a gas station store because that's the only groceries around. That's a food desert.
I disagree on the “if you’re poor”. I find eating healthy cheaper.
You can prepare healthy meals from basic and cheap foodstuffs like vegetables, whole grains and legumes, eggs, low cost meat cuts etc. You can prepare delicious meals for under $1 each.
Buying prepared unhealthy foods is what is expensive.
And also are located near a grocery store with those kinds of cheap prices.
Many poor people literally do not live near a grocery store, the only place they can get foodstuff is a convenience store. Those always have high markups
Except this entire narrative is thrown off by the fact that obesity has been a problem before any of that and is a problem in countries without any of that. Even places like Korea where you are literally shamed constantly by friends and family for being even remotely overweight has obesity growing all while having basically the exact opposite culture of what you are complaining about.
Basically the only developed country where overweight and obesity have stayed flat is Japan.
Yeah, it's almost impressive how often hypotheses for what's causing rising obesity rates simply ignore actual data. I haven't been able to find it again, but a while back I stumbled on a journal article that was basically some epidemiologists ranting about this. IIRC there are whole categories of proposed causes that you can eliminate just based on the fact that that the rise is correlated across age groups.
South Korea's obesity threshold is much lower than western Europe and the US. There you're considered obese at 25 kg/m2 or above. In Europe and the US it's 30 kg/m2.
I didn't mean to say the cases I listed are exclusively the only ones, but I still maintain they are a major part of it.
Japan teaches accountability and taking personal responsibility -- it's a country where its capital city can get away with barely any places to dispose of your trash and not be littered. DEI is barely a thing, if at all. And it definitely does not celebrate mediocrity.
I'm going based off of set standards, not local. Plenty of international organizations track this and even before you replied to me here there were other links in the thread. But the absolute numbers aren't important either way, it's the trends. I don't care if it's the 25kg mark they're passing or the 30kg, and the numbers I'm basing this off of predate GLP-1 medications. What I care about is the trends for weight - and in Korea, just like everywhere else in the developed world, those trends were rising, and accelerating at the rate at which they rose.
As for Japan, uh, I love Japan, but you have a.... very interesting... view of it. No litter? Walk off the main streets, go down some back alleys. Tokyo is a big city. Japanese people aren't so inhuman compared to the rest of the world as to be perfect. Hell, go have some great craft beer at the Mikkeller bar in Shibuya or literally anything down one of those alleys. You'll find trash, you'll find garbage sitting out, you'll see rats. New Yorkers will stop feeling so claustrophobically clean and start feeling at home.
You're right about DEI, but it's also one of the most homogeneous cultures in the world, the poor treatment of women in the workforce for so long directly lead to a backlash that has precipitated and massively contributed their birth rate issues, and racism against people of Korean descent is still massive.
And the entire salaryman system is literally a "the vast majority of you will get promoted in near lockstep for time served" celebration of mediocrity.
Japan is a wonderful country. There's plenty of things they do better than anyone else. There's plenty of things they are awful at or about, too. Go look at their legal system - they have an absurd conviction rate of nearly 100%. And it's not because they're doing that much better of a job investigating, or having better prosecution, or only charge people they've got definitive proof. And there's a million things they are just as bad at.
Korea is just a perfect counterexample because they also are huge on accountability and personal responsibility, the cleanliness level is similar to Japan, they don't have DEI, and they celebrate mediocrity far less than Japan does.... and yet, still getting fat.
I can't explain Japan. But the explanations people give always have plenty of counterexamples.
Making this argument is a strong indicator that you are extremely under-educated on this subject or motivated to make dishonest arguments.
There are a variety of commercial reactor design families that CANNOT melt down. Literally impossible for have a Chernobyl or Fukushima from the designs. These are not new. There is no reason anyone feeling like they know enough to contribute to this sort of discussion should be unaware. HTGRs, MSRs, SMRs, LMRs, SFRs...
"Sometimes nuclear plants melt down and cause widespread problems for very long timescales" is a nonsense argument to use against "We should build new reactors" when the new reactor designs we would be building can't melt down.
But go look at the conviction rate in Japan - it's not because their police are just so much better than ours that they just never get the wrong person. I would never argue for the Japanese legal and police system in America.
Just google 'mortality data statins' and there's a mountain of it.
5 years studies show minimal or no benefit for people in low-risk groups.
High-risk groups see significant benefit
Follow up/longer term studies show increased benefit in low-risk groups but obviously not matching the high risk groups.
VLDL is worse than regular LDL but high LDL in general is an issue. The science here isn't "If your LDL is denser everything is just peachy and you can be fine with 100 LDL," it's "You might be anywhere between significantly worse and marginally better than your numbers suggest"
If your LDL is in the 80s, you are almost certainly progressing plaque buildup regardless of all other factors. It won't be particularly fast in most people, maybe not even enough to matter over your lifespan unless you have other risk factors. If everything is favorable, you might see a halt or slow regression in the 70s, but this is like perfect storm levels of factors.
Most people need to be below 60 to start see soft plaque begin to retreat, with under 55 being the general target for high-risk individuals that need regression.
Your endo is right that basically no one gets there without some form of medication. It sucks, but it's also reality.
> my dentist, who also has a bit of a fixation on cholesterol on a personal level and is educated on the matter, has said that a heart calcium scan is the best way to determine what someone's target cholesterol number should actually be, and that it should not be the same from person to person.
Your dentist is an idiot and very much obviously not educated on the matter and should stick to teeth. CAC is a huge trailing indicator because it shows only calcified plaque. Plaque exists and blocks arteries long before it is calcified. 5+ years. People regularly have massive arterial soft plaque buildup with minimal or 0 calcium scores. And soft plaque is almost always the part that ruptures and breaks away and you throw a clot resulting in a heart attack or stroke.
A CCTA will let you see soft plaque which could potentially help give you a better understanding of just how aggressive you need to be... But the problem there is that the target for everyone should still be keeping their LDL as lower than we have been targeting for years. And if they have other atherogenic particle load, like high Lp(a), then that numbers needs to be commensurately lower to account for the combined load.
I'm not telling you to go on statins. I'm not your doctor. I'm not a doctor at all. But I do have risk factors that require I pay careful attention to this sort of thing, and I spend a lot of time reading research here because I like being alive and want to stay alive in a generally healthy state for as long as I can. And if you are the same, then, well, I would suggest listening to your doctors. They're telling you to get your LDL to that level because they think it will improve your health outcomes, and the vast, huge, overwhelming majority of research over the past decades points towards lowering LDL as being hugely important for improving ASCVD outcomes in at-risk populations across a wide variety of study types, including MR genetic studies looking at health outcomes in people that effectively do not produce LDL in their liver (in fact these studies are what really inspired the class of medicine in the article to begin with) and they basically just don't die of ASCVD. You have other options besides statins, too. Ezetimibe. These new inhibitors - hopefully the small molecule version will be more accessible than the MAB version.
Significant inflammation reduction, which is another factor in ASCVD. More plaque sticks to you the more inflammation there is. It's a feedback loop, as well. There are some that will even claim inflammation is the real villain in ASCVD, not atherogenic particles. That's not the majority position and ignores a metric ton of research, but what both camps are in agreement on is that more inflammation makes the situation worse.
Another is that they help stabilize plaque - by calcifying it. Which sounds like a bad thing, until you realize some of the greatest risks here come from plaque breaking off, which soft plaque is way more likely to do. Calcified plaque restricts bloodflow, but doesn't throw bits of it off to cause even bigger issues.
> Low cholesterol production is an extremely serious condition.
This is correct, but not in the way you mean it. We know people can effectively produce no LDL cholesterol in their liver and have positive health impacts - these MR studies are a big part of what drove this entire class of cholesterol medications. And the monoclonal antibody versions of PCSK9 inhibitors have shown basically the same results.
Virtually all human cells can produce cholesterol locally de novo, including your brain.
The problem is if DDR4 was viable here it would also be absurdly expensive. There’s no world in which we survive this demand without a corresponding increase in supply. It’s not like there are zettabytes of spare cheap DDR4 sitting around.
They used the software in a way that complied with the license. When the license changed to no longer suit them for future releases, they forked from the original license.
Remove the names here, and in context, every single person familiar with open source projects and licensing would think this is a nonissue. They used the software as the license was intended, and exercised the rights given to them by that license. That freedom to fork if they don't like where the project is going, or things change and the project is no longer viable for them with the new license, is one of the key freedoms enshrined in the whole FOSS movement.