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Beta Blockers for Heart Attack Survivors: May Have No Benefit for Most, Could Actually Harm Women

1 week 3 days ago
"A class of drugs called beta-blockers — used for decades as a first-line treatment after a heart attack — doesn't benefit the vast majority of patients," reports CNN. And in fact beta-blockers "may contribute to a higher risk of hospitalization and death in some women but not in men, according to groundbreaking new research..." Women with little heart damage after their heart attacks who were treated with beta-blockers were significantly more likely to have another heart attack or be hospitalized for heart failure — and nearly three times more likely to die — compared with women not given the drug, according to a study published in the European Heart Journal and also scheduled to be presented Saturday at the European Society of Cardiology Congress in Madrid... The findings, however, only applied to women with a left ventricular ejection fraction above 50%, which is considered normal function, the study said. Ejection fraction is a way of measuring how well the left side of the heart is pumping oxygenated blood throughout the body. For anyone with a score below 40% after a heart attack, beta-blockers continue to be the standard of care due to their ability to calm heart arrhythmias that may trigger a second event... The analysis on women was part of a much larger clinical trial called REBOOT — Treatment with Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction — which followed 8,505 men and women treated for heart attacks at 109 hospitals in Spain and Italy for nearly four years. Results of the study were published in Mem>The New England Journal of Medicine and also presented at the European Society of Cardiology Congress. None of the patients in the trial had a left ventricular ejection fraction below 40%, a sign of potential heart failure. "We found no benefit in using beta-blockers for men or women with preserved heart function after heart attack despite this being the standard of care for some 40 years," said Fuster, former editor-in-chief of the Journal of the American College of Cardiology and past president of the American Heart Association and the World Health Federation... In fact, most men and women who survive heart attacks today have ejection fractions above 50%, Ibáñez said [Dr. Borja Ibáñez, scientific director for Madrid's National Center for Cardiovascular Investigation]. "Yet at this time, some 80% of patients in the US, Europe and Asia are treated with beta-blockers because medical guidelines still recommend them...." While the study did not find any need to use beta-blockers for people with a left ventricular ejection fraction above 50% after a heart attack, a separate meta-analysis of 1,885 patients published Saturday in The Lancet did find benefits for those with scores between 40% and 50%, in which the heart may be mildly damaged. "This subgroup did benefit from a routine use of beta-blockers," said Ibáñez, who was also a coauthor on this paper. "We found about a 25% reduction in the primary endpoint, which was a composite of new heart attacks, heart failure and all-cause death."

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EditorDavid

Are AI Web Crawlers 'Destroying Websites' In Their Hunt for Training Data?

1 week 3 days ago
"AI web crawlers are strip-mining the web in their perpetual hunt for ever more content to feed into their Large Language Model mills," argues Steven J. Vaughan-Nichols at the Register. And "when AI searchbots, with Meta (52% of AI searchbot traffic), Google (23%), and OpenAI (20%) leading the way, clobber websites with as much as 30 Terabits in a single surge, they're damaging even the largest companies' site performance..." How much traffic do they account for? According to Cloudflare, a major content delivery network (CDN) force, 30% of global web traffic now comes from bots. Leading the way and growing fast? AI bots... Anyone who runs a website, though, knows there's a huge, honking difference between the old-style crawlers and today's AI crawlers. The new ones are site killers. Fastly warns that they're causing "performance degradation, service disruption, and increased operational costs." Why? Because they're hammering websites with traffic spikes that can reach up to ten or even twenty times normal levels within minutes. Moreover, AI crawlers are much more aggressive than standard crawlers. As the InMotionhosting web hosting company notes, they also tend to disregard crawl delays or bandwidth-saving guidelines and extract full page text, and sometimes attempt to follow dynamic links or scripts. The result? If you're using a shared server for your website, as many small businesses do, even if your site isn't being shaken down for content, other sites on the same hardware with the same Internet pipe may be getting hit. This means your site's performance drops through the floor even if an AI crawler isn't raiding your website... AI crawlers don't direct users back to the original sources. They kick our sites around, return nothing, and we're left trying to decide how we're to make a living in the AI-driven web world. Yes, of course, we can try to fend them off with logins, paywalls, CAPTCHA challenges, and sophisticated anti-bot technologies. You know one thing AI is good at? It's getting around those walls. As for robots.txt files, the old-school way of blocking crawlers? Many — most? — AI crawlers simply ignore them... There are efforts afoot to supplement robots.txt with llms.txt files. This is a proposed standard to provide LLM-friendly content that LLMs can access without compromising the site's performance. Not everyone is thrilled with this approach, though, and it may yet come to nothing. In the meantime, to combat excessive crawling, some infrastructure providers, such as Cloudflare, now offer default bot-blocking services to block AI crawlers and provide mechanisms to deter AI companies from accessing their data.

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EditorDavid

What Happened When Unix Co-Creator Brian Kernighan Tried Rust?

1 week 3 days ago
"I'm still teaching at Princeton," 83-year-old Brian Kernighan recently told an audience at New Jersey's InfoAge Science and History Museums. And last month the video was uploaded to YouTube, a new article points out, "showing that his talk ended with a unique question-and-answer session that turned almost historic..." "Do you think there's any sort of merit to Rust replacing C?" one audience member asked... "Or is this just a huge hype bubble that's waiting to die down...?" '"I have written only one Rust program, so you should take all of this with a giant grain of salt," he said. "And I found it a — pain... I just couldn't grok the mechanisms that were required to do memory safety, in a program where memory wasn't even an issue!" Speaking of Rust, Kernighan said "The support mechanism that went with it — this notion of crates and barrels and things like that — was just incomprehensibly big and slow. And the compiler was slow, the code that came out was slow..." All in all, Kernighan had had a bad experience. "When I tried to figure out what was going on, the language had changed since the last time somebody had posted a description! And so it took days to write a program which in other languages would take maybe five minutes..." It was his one and only experience with the language, so Kernighan acknowledged that when it comes to Rust "I'm probably unduly cynical. "But I'm — I don't think it's gonna replace C right away, anyway." Kernighan was also asked about NixOS and HolyC — but his formative experiences remain rooted in Bell Labs starts in the 1970s, where he remembers it was "great fun to hang out with these people." And he acknowledged that the descendants of Unix now power nearly every cellphone. "I find it intriguing... And I also find it kind of irritating that underneath there is a system that I could do things with — but I can't get at it!" Kernighan answered questions from Slashdot readers in 2009 and again in 2015...

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EditorDavid