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Order in Disorder 失序中的秩序

  在少了醫學背景知識的狀況下,一個人會如何主觀的「認為」(或不認為)自己生病了?我對此感到很好奇。一個人是如何「認出」自己進入了失序的狀態? / 前幾天剛讀完波蘭作家Stanislaw Lem的科幻小說《索拉力星》。萊姆有四本小說的主題是地球太空船接觸外星球,遇見外星「生物」,分別是《Eden》、《Fiasco》、《Invincible》與《Solaris》,可以說都是挫敗的故事,各有不同的方式與原因。如果在挫敗的原因中強調缺乏了解、無法溝通等等,那麼《索拉力星》把了解與溝通的問題帶到更深的核心,因為在索拉力星的海洋裡,一直蒙著一層無法以「理」破解的紗。人類要溝通的外星生物竟是深藏在人內心之自我的一部份。科學家們雖然拚命想以理性思維去解讀現象與生命型態,扯後腿的卻是每個人自己內心深處、理性之光無法找到的黑暗。 我們有多麼了解自己,我們如何與自己溝通?《索拉力星》給人類提出了一個問題:如果不能先了解自己的內在世界,我們能夠真正了解外在宇宙嗎? 𓍯𓂃 ֶָ˖ ࣪⊹ 飲食失序(eating disorder)經常被視為是一種生活狀態(lifestyle)的選擇,事實上卻是多重成因且可能致命的疾病,這些疾病會導致個人受到飲食行為的高度困擾。對食物、體重、體型高度執迷也是飲食失序的警訊,常見的類型有厭食症、暴食症以及嗜食症。這些疾病可能造成患者低血壓、體溫過低、電解質失衡、心律不整、喉嚨受損、腸胃功能損壞、骨質疏鬆、牙齒腐蝕、脫水、腦部受損等,甚至可導致多重器官衰竭而死亡。 Eating disorders are often viewed as a lifestyle choice, but they are in fact multi-faceted and potentially fatal illnesses that cause significant distress in an individual's eating behaviour. An obsession with food, weight, and body shape is also a warning sign of an eating disorder. Common types include anorexia, bulimia, and binge eating disorde...
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Private bookroom | Stack#Folie à deux 私藏選書(持續更新)

  𖥗  社會時事/人性與集體行為   Social issues, Human nature, the Collective Behaviour   𖥗 《失控的憤怒機器》Outrage Machine;托比亞斯.羅斯—史塔克維爾(Tobias Rose-Stockwell) 《未來的犯罪》Future Crimes;馬克.古德曼 ( Marc Goodman ) 《不存在的績效:穩定報酬的真相解密! 馬多夫對沖基金騙局最終結案報告》No One Would LISTEN;哈利· 馬可波羅 ( Harry Markopolos ) 《AI底層真相》Code Dependent-Living in the Shadow of AI;穆吉亞(Madhumita Murgia) 《我們賴以維生的規則——從量尺、食譜、法律到演算法,人類如何確立和打破一切?》Rules: A Short History—of what we live by;洛林.達斯頓(Lorraine Daston)   𖥗  小說/人性與哲學    Literary fiction, Humanity, Philosophy   𖥗 《像這樣的小事》Small Things Like These;克萊爾.吉根(Claire Keegan) 《雪舞者》Dances on the Snow;盧基楊年科 ( Sergey Lukyanenko ) 《完美的一年》Dein Perfektes Jahr; 夏洛蒂.盧卡斯( Charlotte Lucas ) - 獻給對生活失去熱情、對自身的缺憾感到無助的你   𖥗  醫學人文/潛意識、集體、倫理與抉擇    Medical Humanities, Subconsciousness, Collective, Ethics and Choice   𖥗 《黎亞-從醫病衝突到跨文化誤解的傷害》 The Spirit Catches You And You Fall Down;  A Homng child, her American doctors, and ...

Countertransference Hate 反移情恨意

  反移情恨意是治療師在治療過程中,無意識的對患者產生了強烈的敵意、厭惡、憤怒、挫敗等負面情感。最初由精神分析師溫尼考特提出此概念,形容它是一種「厭惡」和「惡意」的混合體,想要與對方保持距離,並摻雜了某種殘忍、更具攻擊性的情感。 Hate in countertransference refers to the intense (often unconscious)  aversion, malice, rage, or frustration that a therapist experiences toward a patient during the course of treatment. First introduced by  Donald Winnicott  in 1949, counter-transference hate is described as a mixture of “aversion” —the desire to distance oneself, and “malice”—a more sadistic or aggressive feeling. 反移情恨意是治療師在面對特別棘手、強烈防衛,或有破壞性的患者時不可避免的反應。這些患者之所以一再挑戰治療師的底線,往往是出於內在的混亂或被拋棄的恐懼。因為他們認為,如果治療師能夠忍受他們的所作所為,而不會報復或拋棄他們,才能證明這位治療師是值得信任的。 Hate in countertransference is an unavoidable reaction for therapists when faced with particularly difficult and destructive patients. These patients often test the therapist's limits out of their inner turmoil or fear of abandonment. They think that if the therapist proves to survive their own hate without retaliating or abandoning them, it’s the on...

High Loop Gain 高環路增益

  在呼吸生理學中,「loop gain 環路增益」是用於衡量換氣的回饋調控機制的穩定性,它反映了身體對血中氣體濃度(主要是二氧化碳)的擾動產生反應的震盪程度。 它的定義是「controller gain(化學感受器敏感性—主要是腦幹的後斜方核)」與「plant gain(肺部呼吸換氣的效率)」的乘積。 Loop gain in the respiratory system is a measure of the stability of the feedback loop that controls ventilation, reflecting how heavily the ventilatory response to disturbances in blood gas levels (mainly PaCO2).  It is defined as the product of controller gain (sensitivity to blood gases, primarily driven by central chemoreceptors in the brainstem–retrotrapezoid nucleus, RTN) and plant gain (how effectively the lungs change blood gases).  Loop gain > 1 表示容易過度換氣(過度補償),導致不穩定、振盪的呼吸。 A loop gain >1 indicates that the respiratory system tends to overcompensate, leading to unstable, oscillating breathing. (Breathing tends to go off-balance and takes a long time for the body to regain balance.) Loop gain < 1 表示呼吸系統能維持穩定幅度的自我修正。 A loop gain <1 indicates a stable, self-correcting system. High loop gain是導致潮式呼吸及中樞型睡眠呼吸...

Psychology of Overeating and Consumerism 過度飲食心理學

  壓力與創傷和暴飲暴食以及其他飲食失調有關,然而比起生理和心理方面的討論,非人際創傷,也就是社會文化的論述,則相對較少。 只有當我們考慮到周遭環境與影響行為的經濟力時,才能了解此時此刻人類的處境:寂寞、憂鬱、無意義感,會促進消費與過度飲食行為。 Stress and trauma have been linked to overeating and other eating disorders. However, compared to discussions of physiological and psychological aspects, noninterpersonal factors, namely sociocultural factors, are relatively understudied. Only when we consider the surrounding environment and the economic forces influencing behaviour can we understand what humans are facing at this moment: loneliness, depression, and a sense of meaninglessness can promote consumption and overeating.  在過去,「生產」是判斷一個人身份地位的核心組織原則,而非消費能力。然而在今日,身份地位往往無關於我們生產了什麼,而是和我們消費了什麼更有關係。這是一種社會意識型態:建立階級差別,以物質商品來決定持有者的社會地位和聲望。 在消費主義之下,當我們想要整理自己的內心世界和自我時,「獲得」與「擁有」便成為深層的心理需求,消費變成了自我發展和自我實現的工具,因為能夠消費和擁有商品,就象徵著擁有選擇和自由。 In the past, "production" capacity, rather than consumption capacity, was the core organisational principle for determining a person's social status. However, in today's ...

Cicada Slough 蟬蛻

  今天自己試了蟬蛻,比想像的不臭耶,甚至可以說味道蠻好的,聞起來,涼涼香香的。 處方已經跟其他藥粉混在一起了,裡面還有佛手柑,不過很確定沒有一些動物類藥會有的腥味 室友說因為蟬只吃樹汁,所以會有樹木的香氣。然後說以前捉蟬,其實吃起來像蝦米,就是香香酥酥,但比較偏植物的香... 「也像炸豆腐的皮的那種脆皮」她邊說、彷彿開滿小花 「好喔,就是比蛇和青蛙好吃就對了」天然的洋芋片,我決定這麼理解 「現在這樣講起來還會回味無窮耶——」 我們以前也討論過「蟬蛻」到底算不算素的?我覺得是素的,因為是蟬不要的殼 蟬蛻對喉嚨是很好用的藥,以前在醫院和診所都沒有進這個(或是設在自費或鎖檔),那時候就心想,要是我有自己的診所就要有這個藥。所以我就進了 I tried cicada slough myself today, and they weren't as smelly as I expected; in fact, they smelled quite nice, cool and fragrant. The prescription is already mixed with other powdered medicines, including bergamot, but I'm pretty sure it doesn't have the funky smell that some animal-based medicines have. My roommate said that cicadas only eat tree sap, which is why they smell of trees. Then she said that when she used to catch cicadas, they tasted like dried shrimp—fragrant and crispy, but with a more plant-like aroma… “It's also like the crispy skin of fried tofu,” she said, her eyes sparkling with delight. “Okay, it's definitely tastier than snakes ...

Hypoxic burden 低氧負荷

低氧負荷(Hypoxic burden, HB)是睡眠醫學中一個新興且愈來愈被廣泛採用的指標,特別是對於阻塞性睡眠呼吸中止症(OSA),低氧負荷比目前臨床上最常用的呼吸中止低通氣指數(AHI)更能有效地衡量心血管疾病風險、器官受損嚴重程度(如腦部、心臟)和死亡率。 Hypoxic burden is an advanced, and increasingly used metric in sleep medicine, specifically for obstructive sleep apnea (OSA). It goes beyond traditional measurements,  the Apnea-Hypopnea Index (AHI), in evaluating cardiovascular disease risk, organ damage severity (such as brain, heart) and mortality. 傳統的AHI將每次呼吸事件視為相同,只統計呼吸事件的頻率;而低氧負荷則量化血氧飽和度下降的累積量(一個event從onset到恢復,底下面積的積分),綜合掉血氧的程度和持續時間,而不僅僅是頻率。 因此,低氧負荷能更精確地反映缺氧的實際嚴重程度。 AHI treats every event the same and only counts the frequency of breathing events, but hypoxic burden quantifies the cumulative amount of oxygen desaturation, which reveals the depth and duration of hypoxia, not just frequency. So the hypoxic burden provides a more precise look at the actual severity of oxygen deprivation. 一項研究發現27.5%的輕度阻塞性睡眠呼吸中止症的患者(AHI 5~14.9)實際上有較高的低氧負荷(> 88%min/hr),這解釋了為什麼一些「輕度」睡眠呼吸中止症患者症狀卻很明顯。所以即使AHI較低,低氧負荷也...