EvolutionMedicine

Joe Alcock talks about the Surviving Sepsis Campaign's recent recommendation to use acetaminophen in patients with COVID-19. Can we bring concept from evolutionary medicine to help us decide what to do in the pandemic? Spoiler alert: yes

This week, we get some background on co-host and polymath Coffee Brown. Coffee talks about his philosophy of teaching and a bit on evolution in education.

This episode introduces listeners of the Evolution Medicine podcast to a brand new podcast started by Athena Aktipis PhD, of the Department of Psychology at Arizona State University. Download Zombified and give it a review. Athena interviewed me for this episode. The topic? How gut microbes can make us into zombies. Listen and learn how the Zombified podcast came to be, along with the Zombie Apocalypse Medicine Alliance, and the bi-yearly conference the Zombie Apocalype Medicine Meeting, a radically interdisciplinary medical conference where fiction meets fact. http://www.zombiemed.org/ The next conference is planned for October 15th, 2020.

Coffee and Joe spend the day before the 4th of July talking about probiotics. Is there enough evidence to prescribe probiotics full time? Listen and find out.

Cars kill a lot of people. We see the consequences every day in the Emergency Department. These accidental deaths result from a mismatch between our brains and the modern environment. We routinely pilot 3500 lb automobiles at speeds in excess of 75 mph, a task the human brain was not evolved to perform, especially when drunk or while texting. Can we let the computer do the driving for us, and fix this mismatch problem? Does partial autonomy pose an even greater risk and mismatch for our brains and bodies? Coffee Brown and Joe Alcock explore these issues in this podcast.

This is a bonus podcast, a recording of a lecture from the 2019 Mountain and Emergency Medicine Conference March 22nd at Taos Ski Valley, new Mexico. At this high elevation location (10,200 feet) I discuss three high altitude people - Andeans, Himalayans, and Ethiopians - their genetic changes to altitude, and what that means for genetic lowlanders like me who like to spend time and recreate at high altitude. I also talk about the microbiome changes at altitude and some of the possible dangers of too much oxygen.

Is self deception a bug or a feature? Coffee Brown shares his thoughts on the topic, focusing on a paper co-authored by evolutionary theorist Robert Trivers. Coffee dissects this topic in a memorable and incisive fashion, with a few epic rants in between. Also, we discuss how modernity and new technology has offered myriad new opportunities for deception, exploitation, and manipulation. "When we changed the world to suit us, we were no longer suited to the world"

In this Evo Med podcast #39, Coffee Brown and I discuss Mary Jane West Eberhard's paper on the evolutionary function of fat and a developmental explanation for the obesity epidemic. Her paper lays the groundwork for understanding why some early life experiences make us more likely to have chronic diseases like heart disease, diabetes, and obesity.

Joe Alcock takes a time out for short podcast to talk about a paper published this month on fever. Paul Young's group looked for, and could not find, any group of patients who do better from aggressive fever control. This result fits with expectations from evolutionary medicine.

Coffee Brown and Joe Alcock talk about the recent paper by Mark P. Mattson, "An Evolutionary Perspective on Why Food Overconsumption Impairs Cognition" published in the journal Cell. Does overeating make us dumb as a culture? Can fasting make us smarter? We lay out the evidence and add our own thoughts. Plus Coffee talks about his new venture Interesting Conversations

Are our bodies the enemy in sepsis? I argue no. Decades of experiments in sepsis show that most interventions focused on the host have been either ineffective or harmful. With this track record of failure, it is time to consider the alternative hypothesis—regulation instead of dysregulation—and the possibility that the events of sepsis are adaptive.

Why we sleep is not well understood. The study of sleep is one of the last frontiers in human biology. In addition to smoking and bad diet, we can add sleep loss to the list of risk factors for chronic disease. But is modern sleep all that different from that of our ancestors? Joe Alcock, Kate Rusk, Coffee Brown, and Gandhi Yetish explore the mystery of sleep in this Part 2 of our discussion of sleep evolution.

Why do we sleep? Why did sleep evolve? How much is enough? Do we die if we don’t get enough? Kate Rusk, Joe Alcock, Coffee Brown and special guest Gandhi Yetish discuss these topics in this episode of the EvolutionMedicine podcast. Gandhi has studied the Tsimane, a hunter horticulturalist group in Bolivia. This group, as well as hunter gatherers in Africa - the Hadza and the San - sleep about the same as us: just over 6 hours. What does that result mean for us iPhone gazing city dwellers?

In this age of Marvel comics, superheroes with superpowers have attained a high degree of cultural fascination. But some superpowers exist in real life, courtesy of natural selection. In part two of this episode, originally livestreamed on Inertia TV, Kate, Joe and Coffee talk about the superpower of the Bajau, a sea nomadic people, to dive longer and deeper than other people. This ability is linked to a bigger spleen, a trait with a heritable signature. Sea Nomads live in the waters of Malaysia, Indonesia and the Philippines. We talk about some other stuff too.

In this episode, originally livestreamed on Inertia TV, Kate Rusk and Coffee Brown and Joe Alcock discuss whether humans can have actual superpowers. Some human groups have unique abilities to survive underwater, and at the highest altitudes, or deal with temperature extremes. We talk about Tibetans, Andeans, Ethiopian highlanders, and Sea Nomads. More at EvolutionMedicine.com

Kate Rusk and Joe Alcock discuss the evolutionary reasons why pregnancy is so dangerous, both for fetus and for mother. Genetic conflicts of interest between paternal and maternal genes may give rise to gestational diabetes and preeclampsia. Evolutioanry theorist David Haig came up with these ideas, inspired by Robert Trivers "parent offspring conflict." This hypothesis of genetic conflicts in pregnancy has held up over the years, yet these concepts still are not taught in medical school, remarkably. This episode was originally livestreamed on Inertia TV with Kate Rusk. Javier is a prop skeleton, by the way.

Kate Rusk and Joe Alcock recorded this for Inertia TV in March 2018. We talk about the reasons for resistance evolution, alternatives to antibiotics, and which drugs predispose to Clostridium difficile. What to do if no antibiotics work? Fecal transplants of course.

Does evolution matter in the emergency department? Joe Alcock describes why it does. This episode was recorded for Joe Tomkins Darwinian Revolution class in University of Western Australia on April 5, 2018 at the Inertia TV studio, thanks to Kate Rusk. Find more at https://evolutionmedicine.com/ and the EvolutionMedicine podcast on iTunes

In part two Joe Alcock, Coffee Brown, Paul Watson talk about how evolution might guide the treatment of patients with mood disorders. We talk about the evolution of sickness behavior, the utility of antidepressant drugs, and the role of the microbiome in depression and anxiety.

Coffee Brown and Joe Alcock are joined by evolutionary biologist and theorist Paul Watson to discuss whether depression is a feature or a bug. Paul Watson developed the social navigation hypothesis along with Ed Hagen, Paul Andrews, and others to explain depression as a unconscious way to break social contracts and make new ones. Watson now calls this the "niche change" hypothesis. This is part one of two.

Coffee Brown and Joe Alcock talk about the obesity paradox? Why do some obese patients live longer than normal weight patients? Why do we collect fat in massive quantities? Is obesity bad? Why did obesity evolve? Answers and more questions abound

Kate Rusk and I continue our discussion about food, vitamins, the iron supplements, and what happens to the microbiome of hibernating bears.

Kate Rusk and Joe Alcock discuss the evolutionary biology of food. This episode is part one, originally recorded by Inertia TV, a science channel on Twitch.

This is part two of a recording that originally appeared on Inertia TV https://www.twitch.tv/inertiatv_ Kate Rusk, Coffee Brown and I discuss why back surgery is the ultimate placebo, what makes our brains work the way they do, and how doctors can harness the placebo effect in our practice. We riff on martial arts, religion, and of course, evolution too

Kate Rusk of Inertia TV, along with Joe Alcock and Coffee Brown of the EvolutionMedicine podcast do a deep dive on the placebo effect. Why did this capacity evolve in the first place? How can we harness the placebo effect? This is part one. originally recorded and live streamed on Twitch on March 20, 2018. Also check out part 2. Show notes for all podcasts are at www.EvolutionMedicine.com

This year, evolutionary anthropologist Kate Rusk began a streaming video science channel, called Inertia TV, that streams great science programming, including this program: Evolutionary Medicine with Joe Alcock MD. This episode was an introductory conversation on EvoMed between me, Joe Alcock, and Kate Rusk, recorded and live streamed in February 2018. Kate, Coffee Brown and I live streamed several episodes since then. The audio versions of all episodes will be released periodically over the next few weeks (video excerpts too). The link to Inertia TV on Twitch is www.twitch.tv/inertiatv_

Coffee Brown and Joe Alcock discuss the perils and pitfalls of too much oxygen. We discuss the recent IOTA study - a metaanalysis done by Paul Young's team and the upcoming ICUROX trial. This evidence is going to change how we practice medicine. It also has insights for evolutionary biology - our bodies can be self destructive, as in heart attacks and strokes, but healing processes may rely on normal to low normal oxygen levels. Too much oxygen may indeed be a bad thing

Joe Alcock and Coffee Brown have a discussion about evolution, medical decision making, and cognitive biases. We focus on a few major cognitive biases - achor bias, attribution bias, immediacy bias, halo effect, among others. We consider how our cognitive and sensory apparatus evolved in ways that can lead us to make mistakes. We explore the idea that the smoke detector principle can affect doctors' behavior and make ER docs more risk averse. How can we make better decisions with these cognitive pitfalls?

This week Joe Alcock and Coffee Brown get into the weeds of the ADRENAL trial - a huge study designed to answer the question - does giving steroids to patients with sepsis help or hurt? I say it hurts, Coffee is not so sure. We talk about why anti-inflammatory treatments have always failed in patients with septic shock. The lesson, it turns out, is an evolutionary one.

Joe Alcock and Coffee Brown discuss evolution, creationism, race and plenty of other hot topics while trying to explain why evolution gets no love in medical school

This is a previously episode first recorded in early 2017. It is timely, though, because a major trial on the effects of corticosteroids - the ADRENAL trial - will soon be made public. In this podcast I make the case that steroids are no bueno for patients with sepsis. I also discuss trauma in Japan, New Zealand, and South Africa. Enjoy

Joe Alcock is joined by evolutionary anthropologist Kate Rusk of InertiaTV and Science Happy Hour to talk about a recent JAMA article studying fluids for adults with sepsis. Do we give too much fluids for these patients? The JAMA article suggests we do. In both randomized controlled trials, both performed in Africa, patients died more when given IV fluids. We discuss the implications for evolution and critical care in this episode

Coffee Brown and Joe Alcock return to talk about epigenetics. Does it pose a challenge to Darwinian evolution? Does epigenetics vindicate Lamarkism, the inheritance of aquired characteristics? We mix up Lamark and his most famous adherent, Trofim Lysenko, but get it straight by the end.

In this 13th episode of the EvolutionMedicine 'cast Joe Alcock discusses the recent New England Journal of Medicine article about intensive insulin treatment for hyperglycemia (high blood sugar) in critically ill kids. The failure of this trial has important implications for emergency and critical care, and for evolutionary medicine

Can a little vitamin C given IV help cure sepsis. Recently this idea got a lot of press, and a trial of hydrocortisone and vitamin C was published in the journal Chest. Does this make any sense? What can evolution tell us about this idea. The EvolutionMedicine 'cast is back to give this a critical eye, with your host, Joe Alcock

Coffee Brown MD joins Joe Alcock to discuss whether stress is good or bad for us. We also discuss the election and the idea that stress hormones play a role in political choices.

Joe Alcock and Melissa Franklin PhD explain why some diets cause inflammation and others don't. The answer, as usual, involves the microbiome, and in our evolutionary biology. We also discuss how the microbiome affects sleep, and implications of this for night shift workers.

Joe Alcock is joined by guest Darryl Macias who describes his recent expedition to Shishapangma to help with a body recovery at high altitude. We also discuss the brain at its limits in extreme environments, gut microbes, and zombies

Native people of the Andes can cope with high altitude better than the rest of us genetic lowlanders. How is this so? We cover the evolutionary biology of high altitude peoples of the Andes, Himalayas, and Ethiopian highlanders

How evolution can teach students healthy skepticism in medicine. Will robots replace doctors?

Are we a mammal-microbial collective? Is our interaction with our resident microbes as a harmonious, mutually helpful partnership, or a relationship gone sour?

Does poop from farm animals protect Amish kids from asthma? Apparently so. Too much hygiene is a bad thing

Can an evolutionary approach save us from the the epidemic of opioid overuse? Evolutionary medicine dovetails with evidence based medicine to provide a compelling case for change?

For doctors and nurses taking care of sick patients: can evolution inform the question: “when to intervene, and when to leave alone?”

Eli Lilly had a blockbuster drug for sepsis that would save millions of lives. 10 years later, the FDA recommended that Xigris be withdrawn from the market. Remarkably, Eli Lilly profited from this ineffective drug most of the time it was under patent. What lesson from Xigris’s failure can we learn about the immune system, about sepsis, and evolution?

Here is the inaugural EvolutionMedicine ‘cast: The State of the Science of Evolutionary Medicine. Many more to come.