In machine learning, efficiency can be improved if we pre-train algorithms on cheap and large datasets. This helps to pre-optimize the parameters for working with more expensive data. 

In the world of humans, efficiency of  medical research could be improved if cheap large datasets focusing on particular medical questions could be easily collected. If clinical trials were more engaging and convenient, generating outcomes clinically meaningful to participants; if the participants could properly design studies by themselves, guided by Software as a Medical Device (SaMD) platform and their own devices (BYOD model), we could collect enough data to get to the next level.  ​

The success of an N-of-1 trial methodology, hindered by the operational complexity, largely depends on the collaboration of  patients and knowledgeable parties. Large scale crowdsourced studies would need innovative software solutions inter-connecting participants and their treatment sequences.  And the impact of this platform would be no less important than the race to build an artificial intelligence for everything. ​

Science explains why some people smell worse than others despite keeping themselves squeaky clean. 

The body is crawling with microbes that have evolved with the person, depending on the innate metabolism, history of infections, microbiome swaps, diet and lifestyle. 

The body's ecosystem of microorganisms can increase the risk for dangerous diseases for which we have unreserved levels of sympathy. It can also lead to ​unlikable conditions such as unpredictable and embarrassing outbursts of odor emitting through the pores - odor so bad it ruins social lives and careers. 

There is no cure for conditions responsible for odorous microbiomes. A rare disease TMAU (Trimethylaminuria) - an inborn error of choline metabolism that leads to the excessive excretion of foul-smelling trimethylamine (TMA) in the sweat and breath  - can sometimes be managed by unhealthy diet very low in choline. A purely-microbiome-caused case of armpit odor may be fixed by microbial transplantation. But research is still in its early stages and is mostly unfunded. 

Our community-led clinical trial was the first study attempting to find what is in common among individuals suffering from odor unexplained by known medical conditions such as TMAU. 

​We have demonstrated that symptoms described by participants are real - as they correlate with a number of laboratory tests. We have also proposed that there are at least two groups of participants with different genetics/medical histories (hence different microbiomes) that may require different types of treatments. 

Unfortunately publishing these results is very difficult - with no funding to cover publication fees and no "sex appeal" to get support from peers. (The article was submitted to the Journal of Participatory Medicine in February, but peer-reviewers still have not returned their reviews)
 
The preprint is now available at bioRxiv and raw results at Mendeley. Study results will be also available on the clinical trials site. 

We hope that the scientific community will look into our findings and support the underserved by their attention. Any comments or suggestions would be of great help!

REFERENCE

I don’t mean to brag, but I’ve got irritable bowel syndrome, says a character of a sitcom, in the episode aired a few years ago. Irritable bowel syndrome, also known as IBS, used to be a rare condition, but - due to industrialization and urbanization - it is now one of the most common disorders in the world. The term is even used figuratively, in a derogatory sense. 

The numbers of new reported cases of irritable bowel syndrome (IBS) kept increasing into the 21st century when they reached almost epidemic proportions. As the amount of information available on the Internet exploded, so did the web searches about IBS.  But then the disorder "came out of the closet", and google searches for "irritable bowel syndrome" started to dwindle, reaching a quarter of what they used to be at the peak. This downtrend mirrored ambulatory data (National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey) showing that by 2010, the rate of IBS-related visits decreased roughly by 37%.

​Is IBS no longer a problem?

Online health communities, blogs and social networks have, over the years, changed the relationship between sufferers of IBS (and many other conditions) and their doctors. Clinical practice shifted from treatment to self-management and from medical specialists (secondary care) to primary care physicians and ‘expert patients’.

10-20 years ago, doctors were experimenting with many different medications to address IBS complaints (especially medicines used to alleviate depression and supplement fiber), but now they are more likely to prescribe non-medication therapies: diet/nutrition counseling, mental health counseling, and/or stress management. Among prescribed medications, there was increased use of gastrointestinal-specific antibiotics and probiotics, but also laxatives, proton pump inhibitors (for heartburn), antiemetics (against nausea), bile acid sequestrants (for diarrhea), opioid and non-opioid analgesics (p=0.001 for each). Prescription of fiber (p=0.001), antidepressants (p=0.002), antacids (p=0.010), and histamine-2 receptor antagonists (p=0.001) significantly decreased. 

Modern IBS patient is more informed. Modern doctors know more about IBS. They know it's not in your head and even started suggesting this is a disease, not a syndrome. But diagnostic tests confirming IBS are still lacking and so are answers to many questions.

As interest in ambulatory care for IBS was dropping, diets reducing IBS symptoms started to explode in popularity. So that sufferers of IBS-related symptoms have been even outpaced by the growing numbers of people following these trendy diets.

Gluten-free has been one of the biggest diet trends that made social events much less isolating for IBS sufferers with gluten and wheat sensitivities. Low sugar and Paleo were also helpful to many.  But low FODMAP diet seemed to be most beneficial for IBS. Yet, even this diet might not be a cure-all for IBS and can't be recommended in the longer term.

While there are dietary and stress management approaches along with a few drugs that can be used to treat IBS, what works best is when the sufferer can find a pattern of when their disease is at its worst, and can figure out ways to avoid these conditions. 

Social support is another important factor. Analyses indicated that it reduces severity of IBS symptoms, suggesting that the mechanism by which social support alleviates pain is through a reduction in stress levels.

And so IBS sufferers keep joining online support groups.  In the last 5 years, IBSgroup.org got 25 thousand more sign ups, growing from 41 to over 66 thousands. New IBS support groups on Facebook merged, some as large as 11 thousand members. Yet, as a new US survey reveals, IBS sufferers see healthcare providers and the public in general lacking in empathy and understanding. The condition is still difficult to diagnose and often even more difficult to treat.

Afraid no more, but still in search of empathy and cures.

REFERENCES

Mark Pimentel's Reddit Science AMA 2016
Health Union's “IBS in America” survey 2016

Elections are bad for your health.

More than half of Americans, independently of their party preference, are stressed about upcoming elections (see this August 2016 survey of over 3.5 thousand adults conducted by Harris Poll on behalf of American Psychological Association). Especially the oldest and the youngest voters (Traditionalists and Millennials). Social media is one of the major factors making this stress even worse. 
​
Election stress is higher than we think - judging by cortisol levels in saliva versus self-reported emotional distress. Stress is high at the ballot box - higher than when voting at home by mail-in ballot and significantly higher than on an average day and a few days after the election - unless we strongly dislike post-election media coverage. 

Elections may cause anxiety, obsessive compulsive behavior and even depression. And then there are post-election blues. Stock market always performs weaker. Supporters of the winning candidate go through withdrawal pains, although, research shows, they might get more interested in the Internet porn. Supporters of a losing candidate move through sadness and decreased levels of testosterone. 

Yet, anxiety can sharpen our eyes and help us learn. 

To vote is like the payment of a debt (R.B. Hayes, 19th US president). One who does not vote has no right to complain (novelist Louis L'Amour). Always vote for principle, though you may vote alone, and you may cherish the sweetest reflection that your vote is never lost (John Quincy Adams, 6th US president)

And no matter what happens, we should not feel powerless for we actually possess more power than ever before to control our own lives and make them what we want to be. 
​

REFERENCES