Tremendous

An angel investor's take on life and business

  • What If Homelessness Is Caused by Brain Injuries?

    A couple of months ago, a man approached me on the street near my home. He asked for a bit of money, and although I usually never do, for some reason I gave it to him. I later saw him on a regular basis near the neighborhood grocery. I found out his name was John* and he used to work in construction. Several times a week, I’d run into him and stop and chat for a few minutes.

    One day, I noticed he had large purple bruises on his forehead. He told me he had tripped over his shoelaces and gone down hard. Especially if someone is exhausted and cold, it’s easy to see how this could happen. He had been to the hospital, but they dismissed him quickly, perhaps because he was homeless.

    He had lived in our town for 48 of his 53 years, and only become homeless recently after losing his job, like so many others. It troubled me to think that after a lifetime of contribution, our town had cast him aside so readily.

    I was reminded of John yesterday when I heard that over half of homeless people may have brain injuries. Skeptical, I decided to do some digging. I found a metanalysis in The Lancet that confirmed this astounding figure:

    The lifetime prevalence of any severity of TBI [traumatic brain injury] in homeless and marginally housed individuals (18 studies, n=9702 individuals) was 53.1%

    This is much greater than the general population:

    The lifetime prevalence of TBI in homeless and marginally housed individuals is between 2.5-times and 4.0-times higher than estimates in the general population. Moreover, the lifetime prevalence of mo­derate or severe TBI in this population is nearly ten-times higher than estimates in the general population.

    It’s difficult to say whether the brain injuries are a cause or effect of homelessness. But, homeless people tended to have their first TBI at a young age. To me, this argues that brain injuries are a cause of homelessness:

    Age at first TBI ranged from 15 years to 19.9 years, and we calculated a weighted mean age of first TBI of 15.8 years.

    Perhaps the relationship works both ways:

    TBI could increase the risk for homelessness, and homelessness could increase the risk for incident TBI.

    It’s common for us to blame the homeless for their condition. After all, many are addicted to alcohol and drugs, aren’t they? But that too may be related to head trauma:

    several characteristics of homeless and marginally housed populations (eg, residential instability or substance use) were associated with sustaining TBI

    Another study from Canada found similar figures, and noted that the first TBI usually happened before they became homeless:

    The lifetime prevalence among homeless participants was 53% for any traumatic brain injury and 12% for moderate or severe traumatic brain injury. For 70% of respondents, their first traumatic brain injury occurred before the onset of homelessness.

    A British study found that homelessness was not a significant predictive factor for head injuries. However, it didn’t address the question of whether the homeless had a TBI before becoming homeless.

    Imagine two people, one with an stable and well-off family and one with a chaotic and impoverished family (or no family at all). They both hit their heads. One gets support and good medical care, but the other may wind up homeless.

    I sometimes wonder if that’s what happened to John. Did he get hurt, wind up homeless, and then find himself in a position to get hurt again?

    I haven’t seen him lately, despite looking for him over and over. I hope he found a nice place to stay this winter, and I hope to see him again.

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    *Not his real name

    Photo: “Thomas (Tomaso) is Homeless” by Franco Folini is licensed under CC BY-SA 2.0

  • Emergency Post: NYC Animals in Need of a Good Home!

    An employee getting COVID has forced the closure of an animal shelter in Manhattan. They are looking for foster families for the animals until the shelter can reopen.

    I just messaged them on Instagram here. If you can help, please contact them!

  • Could a New Class of Antibiotics Put an End to the Most Deadly Infections?

    When I worked in medical software, multidrug resistant bacteria were always a concern. But new research has created a class of antibiotics that may make even the most drug-resistant infections history:

    [They] focused on a metabolic pathway that is essential for most bacteria but absent in humans, making it an ideal target for antibiotic development. This pathway, called methyl-D-erythritol phosphate (MEP) or non-mevalonate pathway, is responsible for biosynthesis of isoprenoids — molecules required for cell survival in most pathogenic bacteria. The lab targeted the IspH enzyme, an essential enzyme in isoprenoid biosynthesis, as a way to block this pathway and kill the microbes. Given the broad presence of IspH in the bacterial world, this approach may target a wide range of bacteria.

    I found it fascinating that the scientists used computer modeling to winnow down millions of possible drug candidates to a few compounds most likely to work, then tested them for real. This reminds me of the CAD/CAM software that has revolutionized manufacturing.

    These drugs could be used for a wide variety of stubborn infections, per the original paper in Nature:

    they kill clinical isolates of several multidrug-resistant bacteria—including those from the genera Acinetobacter, Pseudomonas, Klebsiella, Enterobacter, Vibrio, Shigella, Salmonella, Yersinia, Mycobacterium and Bacillus—yet are relatively non-toxic to mammalian cells.

    This research is in its early stages in mice, but the early results are promising. I can only imagine the many more incredible drugs that may come from using this type of computer modeling for drug discovery.

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    Photo: “Salmonella species on X.L.D. agar.” by Nathan Reading is licensed under CC BY-NC-ND 2.0

  • What It’s Like to Be on Law & Order: SVU

    It was barely dawn when I walked into the squat brick building in Manhattan’s Little Italy. I wasn’t even sure it was the right place. I went through the heavy swinging doors to find a hive of hundreds, preparing to make one of the best known television shows on earth.

    In December 2019, I got the amazing opportunity to be a background actor on an episode of Law & Order: Special Victims Unit. My part was tiny, but the process of producing an episode of one of the longest running scripted shows on television was fascinating.

    From the moment I walked in, I noticed everything ran like clockwork. The sign-in process, which could be time consuming on other shows, was over in a flash and we were off to wardrobe. Clothes were an issue: the scene was supposed to be occurring in the fall, so we couldn’t wear heavy coats. But it was near Christmas and the temperature was barely 30. Wool and long underwear saved the day!

    As the sun rose, we left the staging area and headed to a real New York subway station, which had been shut down completely for filming. In the scene, the Special Victims Unit catches a notorious subway groper. The preparation was elaborate: production had even scored an actual NYC subway train!

    A Production Assistant told us where to sit in the car, and I found the scene’s main actress next to me. The groper touches her, unaware she is an undercover cop, and the actress jumps and cries out “What the…?” Then, I had to react.

    I thought to myself, how would I really react if this happened on the train? Because I know it does. I’d love to say I’d become Batman, clean up Gotham, and pound the worm that attacked her. But in reality, it would probably be unclear to me what had happened and I wouldn’t really want to get involved anyhow. So, I just looked up briefly and returned to looking at my phone.

    It occurred to me that we were playing out a common scenario and putting it in the face of a massive audience: look at this! For the women these things actually happen to, I wanted to play it accurately and well, however small my part may have been. My wife has told me countless stories of things like this happening to her friends, so I knew it was real.

    On a lighter note, I had no idea how hard it was to film an action scene! Every element has to be timed correctly. The police chased the groper on a moving train, and the crook was supposed to escape the moment the train stopped and the doors opened. But the doors kept opening too late, leading to him actually being caught! So the MTA driver hired for the show had to move the train back one station and we took it from the top, over and over. We must’ve done two dozen takes just to film this one scene lasting perhaps a minute.

    Every detail mattered. The Production Assistant told us to play around on our phones before the attack occurred. I turned my phone completely off and then pretended to tap around on the screen. I had just gotten the phone and I was sure it would erupt in a cacophony of beeps at the most inopportune moment, forcing dozens of people to re-do the scene yet again.

    I was amazed that the director could see the entire episode before it had even happened. As we were about to begin shooting, a cameraman exclaimed that he was “seeing red.” His camera was picking up the color red somewhere in the shot, which would mess up the footage. The director said “Your frame is from here to here,” gesturing with his hands. I found it incredible that he knew exactly where the camera should be pointing and what the scene would look like, despite never touching a camera.

    At one point, Ice-T plopped down in the train with a bunch of background actors who were waiting to do their next scene. He chatted amiably with everyone. I had heard he was a very friendly man, and it’s true! He also looked much younger than his 61 years. I was in the middle of another scene, so I didn’t have a chance to speak to him, but I hope to be back on the show when things return to normal!

    As we stood outside the subway station with the snowing coming down at the end of a long day, I felt a sense of accomplishment. We had filmed a complex scene. We had had a fascinating experience. And hopefully we had done justice to the difficult experiences many women have.

    P.S. If you’re interested in more about what it’s like behind the scenes of a TV show, check out this post about working on the show New Amsterdam.

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  • What is Quercetin and Can It Protect You Against COVID?

    At first, I couldn’t even spell it! I first heard about quercetin in this interview with Dr. Mark Gordon, and was intrigued that an over-the-counter supplement might help protect against COVID and even colds and flus. But I was a little skeptical, so I decided to do some digging.

    I found this widely cited study which concluded that although we can’t say to a certainty that quercetin can protect us from COVID, there is some good evidence for it, especially if taken with vitamin C. What’s more, the risks seem quite low:

    Quercetin displays a broad range of antiviral properties which can interfere at multiple steps of pathogen virulence -virus entry, virus replication, protein assembly- and that these therapeutic effects can be augmented by the co-administration of vitamin C. Furthermore, due to their lack of severe side effects and low-costs, we strongly suggest the combined administration of these two compounds for both the prophylaxis and the early treatment of respiratory tract infections, especially including COVID-19 patients.

    The study authors are careful to note that this is an “experimental strategy,” and I found another study that questioned whether using quercetin to protect against COVID is well-founded.

    That said, given the reasonable cost, low risk, and emerging evidence of efficacy, I decided to order some here. I’ll take it in conjunction with the vitamin C and vitamin D I already take and hope for the best!

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  • What Captain Sir Tom Meant to Me

    My wife was the first person to tell me about Captain Tom, a man in the UK nearing his 100th birthday who was walking across his small garden day after day to raise money for the NHS. At that time, things in the New York area, where we live, were at their worst.

    I remember the disturbing sights of that time. What was odd about them was I’d just catch a glimpse of what was happening. I would wonder if what I saw was what I thought it was. I seemed to see more hearses than I used to, but then who could be sure? I saw a large trailer outside a medical facility in Greenwich Village…was that one of the trailers that held bodies?

    Other things were less equivocal. I saw a white panel truck pull up in front of a funeral home in Lower Manhattan. They had evidently run out of hearses. And an ambulance seemed to pass our building almost every minute.

    I asked my wife if she had ever heard so many sirens. Was I just imagining things? She agreed she’d never heard so many at once. This made me realize I wasn’t imagining. I don’t know if that made it better or worse.

    At this time, I felt helpless to stop the catastrophe surrounding me, as I’m sure many did. But Captain Tom’s example from afar cheered me. Of all people, who would be in a worse position to help than someone who is 99 years old and frail? But he determinedly crossed his garden back and forth, unconcerned with whatever limitations he might face. He just kept moving. I think he gave a lot of us the courage to keep moving to.

    And bit by bit, his seemingly small act made a huge impact. He raised 33 million pounds ($45 million) for the NHS, perhaps saving many lives.

    At 99 years old, one would think he had already given all he had to give. He had served his country in World War Two and raised a wonderful family. Who would’ve thought that his greatest achievement was still ahead of him?

    When he started his walk, Captain Sir Tom was still recovering from serious injuries from a fall that included a punctured lung! But he saw what he could do, not what he couldn’t, and set about doing it for the good of others. And if someone could accomplish so much at age 99, imagine what we could do as well!

    Captain Sir Tom Moore showed me what one human being can do, even in the face of the worst things. He showed me that people cannot be stopped; that the human spirit can triumph over anything, if we try.

    It’s a shame to lose him, but he was here when we needed him most.

    Captain Sir Tom, we’ll miss you!

  • What If Social Networks Were Run on the Blockchain by…Us?

    Google owns YouTube. Facebook owns Facebook and Instagram. Who owns e-mail?

    Trick question: the answer is, no one! It’s an open protocol anyone can use. So are RSS feeds used to distribute podcasts and the Domain Name System that tells your browser where to go when you type in google.com.

    Many are concerned about the power that social media companies have, but what if social media were open and governed by the public at large? Blockchain technology may provide the means to do that, per a new article by top-flight venture capital firm Andreessen Horowitz:

    How do social networks decide which users to verify or ban? How do search engines decide how to rank websites? One minute social networks court media organizations and small businesses, the next minute they de-prioritize their content or change the revenue split. The power of these platforms has created widespread societal tensions, as seen in debates over fake news, state-sponsored bots, privacy laws, and algorithmic biases.

    That’s why the pendulum is swinging back to an internet governed by open, community-controlled services. This has only recently become possible, thanks to technologies arising from the blockchain and cryptocurrencies.

    If users collectively hosted a social network on their computers using blockchain-style distributed computing, they could govern the network outside any tech company. Algorithm changes and deplatforming would be their decision.

    I find this future intriguing and suspect it’s only a matter of time until such a tool arises. Perhaps you will build one!

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    Photo: “Bitcoin ‘Blockchain’ Necklace” by btckeychain is licensed under CC BY 2.0

  • The Mindset That Could Sink Wallstreetbets (And Others)

    As someone who makes a living from investing, I have watched the Gamestop/Wallstreetbets events with interest. Today, I decided to venture into the belly of the beast and try to find out what these traders are all about.

    I noticed two common patterns:

    1) Us-vs-them thinking. The individual trader versus the evil hedge fund industry.

    2) Determination to hold a position out of machismo

    Take a look at some examples below (usernames redacted). These are all from today alone:

    The backdrop to these conversations is the cratering of their most widely held stock, Gamestop:

    The initial buying of Gamestop and other heavily shorted stocks had some logic: Wallstreetbets wanted to engineer a short squeeze. A rapidly escalating price would force hedge funds that had shorted the stock to buy it to close out their positions. Otherwise, the hedge funds would face even worse losses. But, since all those hedge funds have to buy at once, the price can spiral higher and higher.

    Despite the logic of that move, I find many people’s judgment clouded by us-vs-them thinking and machismo. Whether hedge funds are morally good or bad has no bearing on whether a position is worth holding. And one should never identify with an investment emotionally. If one’s identity and manhood (something tells me these posters are probably mostly men) are wrapped up in holding Gamestop stock, how can you make a rational decision based on the facts?

    Will you choose to invest or not invest based on data, or will you just hold your position all the way down to 0 to show everyone how tough you are?

    Perhaps a lack of machismo is one reason why female investors tend to have a better track record:

    According to the Warwick University research, women’s outperformance can be attributed to the type of investment they tend to favour.

    The study revealed that men are more likely to take a risk on more speculative, “lottery style” stocks where they believe [they] have the potential to make a lot of money very quickly. Men also tend to hold on to lossmaking investments in the hope that they will come good.

    Financial Times

    Instead, I suggest adopting a philosophy of non-attachment. This is a concept often attributed to Buddhism. It has parallels in many other religions, including Christianity. If we detach from our opinions and possessions (including stocks), we can view things more dispassionately. That investment isn’t you. You are you. The investment is just an investment. And it either makes sense or it doesn’t on its own merits. What’s more, whether you made millions or lost everything, it doesn’t change who you are.

    I find meditation helps me in this process. It gives me a chance to get outside of the normal rushing freight train of thoughts and examine my opinions and beliefs from the outside. Or just simply take a break from them!

    Time will tell whether the likes of Gamestop make good investments, and whether Wallstreetbets remains a phenomenon or fades. But detaching from our emotions and opinions and viewing them from the outside is a useful strategy we can employ forever.

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    Photo: “Ship sinking in the Strait of Gibraltar” by ^ Johnny is licensed under CC BY-NC 2.0

  • This Video Will Make You Smile

    Last night, my wife and I watched the newest episode of the adorable Japanese video series Pui Pui Molcar. I’ve mentioned this series before here, and this week’s video was their best yet! The video is below. If you’re stressed, take a couple minutes and enjoy!

    Pui Pui Molcar, Episode #5

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  • What Is the Ideal Amount of Exercise?

    Above: Me sucking wind after a tough workout.

    We often hear what the minimum amount of exercise we need is, but what amount of exercise is actually optimal? At what point have we reaped all the benefits exercise has to offer, and possibly even gone over the edge into damaging overtraining?

    With the largest snowstorm in years lashing my apartment today, I thought it was as good a time as any to try to find an answer.

    The federal government recommends a minimum of 150 minutes of moderate activity or 75 minutes of vigorous activity per week. This establishes a useful lower bound we definitely shouldn’t dip below, but a highly cited study in JAMA Internal Medicine finds that you can get further longevity benefits by exercising a lot more:

    the longevity benefit threshold appears to be approximately 3 to 5 times the recommended physical activity minimum

    So, in order to be sure to get the maximum longevity benefit, you need to do five times the minimum recommended level of exercise. 5x the minimum recommended level would be 1 hour 47 minutes of moderate activity daily or 54 minutes of vigorous activity daily.

    Furthermore, the study found no danger from exercising even more than what it takes to get the full longevity benefit:

    there does not appear to be an elevated mortality risk with LTPA [leisure time physical activity] levels as high as 10 or more times the recommended minimum.

    Looking at the differences between moderate and vigorous activity, I also wondered if one is better than the other. There doesn’t seem to be solid data to say that either moderate or vigorous activity is superior from a health perspective:

    comprehensive reviews of the literature on physical activity and mortality report that overall volume of physical activity is associated with lower mortality risk but report mixed findings on the relative contributions of moderate- vs vigorous-intensity activities

    So am I doing enough? Looking at the pedometer app on my phone, I’ve averaged 2.75 hours per day of walking (moderate intensity exercise) over the past year. I also do about 3-4 hours a week of vigorous exercise (yoga and strength training, mostly), so about 30 min daily.

    So, I seem to be comfortably above the level needed to get the maximum longevity benefit. That said, counterintuitively, I sometimes find my mood is a little lower on days I don’t do vigorous activity. (You think you’d be happy for a rest day, but maybe not!) Just because I’m at the maximum amount of exercise to produce longevity benefits doesn’t mean that more exercise might not produce other benefits in terms of mental health, athletic ability, appearance, etc.

    Since there appears to be no harm from even very high levels of activity, I may add another vigorous workout (likely yoga or calistenics) to my routine some weeks, depending on my schedule and desires at the time.

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