CharonY

Oh there are absolutely cases where certain exposures in farming contexts can provide some form of immunity, especially to zoonotic diseases (though conversely, there is also a somewhat higher risk for agricultural workers to get sick). But I think TheVat might have been referring to the so-called Hygiene hypothesis (not to be confused with Semmelweis' hand hygiene concept). There, the idea is that childhood exposure is boosting the immune system provide overall better immune responses later in life. This is somewhat less well grounded. There is some potential link to things like autoimmune disease and allergies (especially asthma), but regarding net infections the jury is very much still out (at least to my knowledge). The main potential mechanism is low-level exposure to certain pathogens which then either provide immunity and/or cross-immunity. But for the most part it seems that with few specific exceptions, there really is no broad immunity to be gained from agricultural lifestyles and especially in poorer countries the above balance (protection against vs acquiring zoonotic diseases) seems to point to a higher, rather than a lower incidence of zoonotic infections.

I think that is somewhat more speculative or at least I have seen any particularly convincing data to this effect. What is known however is that many urban (but also some rural areas, later during industrialization) were heavily exposed to e.g. air, heavy metal and other pollution. These factors are known to adversely affect child development.

And just to reinforce a point made earlier- besides antibiotics, vaccines are probably the single largest contribution to population health. Treatments may or may not work, but they certainly do not prevent spread of infectious diseases and even if treated, they can still lead to significant health burdens. Vaccines on the other hand lower the overall risk of adverse health outcomes. Even just considering the last 50 years, where infant mortality has been cut down massively, vaccines have saved the lives in the order of 140 million children (each resulting on an average of 66 life years gained).

Absolutely- I forgot where I read it, but I believe that in the 1800s child mortality at birth was higher in urban centres (in rural areas, midwives were doing the work) and the hygiene findings after Semmelweis cut those down markedly.

Essentially you can extend the graphs from 1800 all the way back to the middle ages as seen in the second link. In the US, for example, child mortality hovered around 45% through the first half of the 1800s. So rather than asking why child mortality was so high in the middle ages, one could argue that our "normal" child mortality is around 50% and things only started to change around 200 years ago. I.e. the modern times are the anomaly in our history (though the US is trying really hard to reverse that).

No let me try to clarify this: Already approved use -> normal usage no additional paperwork Off-label use -> no "formal" paperwork but physician needs to demonstrate that they have at least informed consent from the patient Obtaining Approval for not yet approved use -> Investigational New Drug approval application, typically an Investigator IND if the physician is administering and monitoring the treatment.

Sorry I wasn't clear, it was just to re-affirm that for FDA (or equivalent) approved use it would be IND, but the other pathway (i.e. without formal approval), would fall under typical off-label-use. I.e. the physician has to be able to defend the use, but does not require formal approval.

I am sure the food culture plays a role, but it seems France is extra-different. Italy, is only a bit lower than UK (~ 28 UK to ~20 Italy or something around that), Spain a bit lower than that (maybe 19). Greece is on the high end, with 33 (similar to much of Balkan/Eastern Europe). The Netherlands, which is similar to Germany in many regards is below Spain. And then there is France with around 10%.

Overweight is a general problem, but with regard to obesity the UK is doing a bit better especially compared to the US, but also (slightly surprising to me, tbh) somewhat in European comparison. I believe France was always doing well in that regard.

In addition there is a rectal treatment (Rebyota). Both are human microbiome-derived. IND would be required for approved other uses, but otherwise it should not be different from "regular" off-label use. So using FDA-approved treatments, is obviously the easiest option due to the standardization and available safety information. Now if you want to use stool banks, the issue is more complicated as they would fall under biologic drug regulations, which will differ from jurisdictions. At minimum there must be documentation of the screening procedure and outcomes but there is bit of a regulatory gap in the FDA (or there was a decade or so ago) which basically allowed FDA discretion. It was only really catered for Clostridium difficile treatment, as they considered that more of an emergency situation and the risk/benefit was rather obvious there. But for other uses and given the relative paucity of trial data, I would assume IND or equivalent pathways would be necessary (AFAIK FDA and similar agencies only issued statements regarding C. difficile but have not mentioned other uses, but I may be wrong). I am vaguely aware of the struggle of OpenBiome, and the fight over regulations (though I think they submitted INDs by now). In Europe the legal framework is flexible, meaning that member states have significant discretion in how they regulate FMT. From what I have heard, it is a bit of a mess how FMT are classified and different monitoring criteria (e.g. donor selection vs microbial composition). From second-hand info it seems that at least in some countries it would be easier to conduct research studies on FMTs, but we really never got into details.

Well the check there is the senate which has to consent to the appointment. The founding fathers seemed to have envisioned a system where the executive, legislative and judicial system were all participating in governance. They did not expect that folks would simply cede their powers so willingly.

That is true in most parts in the world, but I believe that lack of calories is limited to a relatively small subset in Western countries (typically elderly and homeless folks). For most others it is more about having enough nutrients in the calories consumed.

Somewhat unrelated, but I started seeing that for google searches, the AI summary keeps pushing random posts from social media (e.g. Reddit) as part of the answers. We are putting a lot of effort into means to make us dumber it seems.

Interesting. I did now know that, but it seems intuitive. Only partially related, but that also reminds me that in rural areas, access to grocery stores is often poor and perhaps slightly counter-intuitively, in rural areas obesity rates are generally higher.

Another element is to look at the points of failure and perhaps consider a redesign.

That has also been brought up as an issue to the rise of dual-income families, where time for household jobs, including cooking, is diminished.

While the US has a a poor diet, especially among low income folks, it is a bit of an overgeneralization to state that these things are absent in Europe. Processed foods has been making inroads for some time unfortunately and obesity as well as diabetes rates in many European countries have been climbing. There is still a 10-point gap (30ish vs 40ish) among the high obesity European countries and the US, but it is a bit false to assume that there is nothing to worry about. And this is why video is a horrible way to spread information but a great source for misinformation. There are many farmer's markets in the US and in regular grocery stores there is always a vegetable section with loose vegetables. Not necessarily though, and it boils down to how much is being bought. In fact, buying directly from farmers can be more expensive as an individual, as you do not have the negotiating power, say, McDonald's has.

I believe the article is referring to a recent study in N Engl J Med and the issue pointed out in the study are a range of social factors including weaker social structures, but also diet. It is suggested that health care is a huge (known) driver of mortality among the poor, which is also seen in the much larger mortality gap between poor and rich in the USA compared to other countries. Other issues potentially affecting the wealthy in the US could also include environment, social mobility, and social attitudes. But the study also points out that they really are not able to tell with this specific study. It should also be noted that this study did things a bit differently than prior studies. Others often focused on income, where other studies showed similar survival rates between USA and Europe in the higher income brackets. But looking at wealth bins, the reduction in the US becomes visible. They speculate that this caused by income differences at a given wealth distribution. I.e. the US has a higher concentration of high-income individuals in the top wealth bin and argue that their approach might be better at finding the impact of socio-economic status on health. And just to show some additional maps of the US (all from HDPulse: An Ecosystem of Minority Health and Health Disparities Resources. National Institute on Minority Health and Health Disparities), which likely are going to vanish at some point:

And likewiese, BMI is inversely associated with socioeconomic incomes. A trend that is not only found in the US. However, in the US the impact (i.e. the level of obesity) is higher than e.g. in the UK or Germany.

Poverty is a big factor, as does being black. Especially in the south, access to health care is limited and in conjunction with poverty is a significant driver low life expectancy, for example.

Yes, which is why I am a bit skeptical that their off-label use would be illegal. Especially as the FDA-approved FMTs (such as Vowst, but I am sure the rectally applied one is similar) have no history of serious side effects, and there are far more critical (legal) off-label uses of more harmful medication. What could be the case is that some physicians don't like to make off-label recommendations, as there is more uncertainty. But again, I don't that legal nor board sanctions are likely in this case. That being said, I imaging that doing FMTs from donors is a bit different- after all physicians have no real experience in creating safe formulations. Unless they have a certified lab and provide all the documentation, QA/QC and permits, it is likely not allowed as treatment. There is a potential grey zone if they label it as supplement rather than treatment. That area is a bit a of a wild west out there.

Are there any specific statutes that apply to FMT? If not It seems to me that the risk is similar to other off-label prescriptions. While off-label use has led to sanctions from medical board in the past, they were usually careless administrations, without proper consideration of risk and/or lack of informed consent. Now, it is true that if there are negative outcomes, there could be consequences and the medical practitioner (such as lawsuit). However, liability insurance does cover off-label use there, too. The only exception I am aware of is if there was gross negligence involved. IOW, unless there are specific guidance of FMT in terms of off-label use, I think it should fall under the same. I am vaguely aware that Vowst has been tested outside of a clinicals to (unsuccessfully) improve inflammatory bowel diseases and I do not think that there were extra documentations as for clinicals required.

They didn't. As others already said, during the time of the founders, there were no parties. Moreover, impeachment requires action of congress and senate. In modern times, parties were more likely to protect their own from impeachment, but rarely as blatant as it has been done in case of Trump. Well, yes. Except, the party did not yet exist, as mentioned. Also the republicans were more different than one might imagine, especially considering the flip during the Southern strategy (https://en.wikipedia.org/wiki/Southern_strategy). Cult-like features did start to emerge at least during the tea party, where folks started to lose their minds that a person with mixed descent (who identified as black) could become president of the USA.

It is unlikely. There are few things were the President is actually doing things. While Trump signed executive orders which are against the law, the remedy is for the institutions to follow the law. So, for example the DHS might have deported folks illegally, and they are either obligated to not do that and/or to bring those deported back. If the officials fail to do so or their lawyers lie about it, contempt charges might be levvied against them. But as Trump is not the one in actual charge of the deportation, he is conveniently separated from those (I think, I am not a lawyer, but that is how I read the articles about it). But as others said, even if he was personally in charge of deportations for some reasons, the SCOTUS ruling has rendered him functionally immune, anyway.

Also, the contempt would not be levied at Trump- while he might (or might not, there are other folks like Miller who are more likely to be involved in the details) be in charge, it is ultimately lawyers from the DOJ who will argue in court. This is directly connected to the resignations of high level DOJ officials in a number of lawsuits, including in the Garcia case. I am also a bit confused as OP seemed to acknowledge the situation somewhat: But to summarize, AFAIK, contempt can be held against officials of the administration (other than Trump himself), but enforcing it is a different matter. It is also not trivial but in the case of unlawful deportation of folks to El Salavador, the judge specifically required officials to provide regularly updated and signed reports on high they facilitated their return. Lying on these documents could at minimum lead to contempt charges (and were likely to set up this way exactly for that purpose). This is actually still ongoing :https://www.reuters.com/world/us/abrego-garcias-return-should-not-end-trump-contempt-probe-lawyers-say-2025-06-09/ The only remedy against unlawful actions against the president according to SCOTUS is impeachment, which won't happen for as long as Reps are in charge.