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We are experiencing a fundamental paradigm shift in our relationship to knowledge. From the ‘information age’, we are moving towards the ‘reputation age’, in which information will have value only if it is already filtered, evaluated and commented upon by others. Seen in this light, reputation has become a central pillar of collective intelligence today. It is the gatekeeper to knowledge, and the keys to the gate are held by others. The way in which the authority of knowledge is now constructed makes us reliant on what are the inevitably biased judgments of other people, most of whom we do not know.

Let me give some examples of this paradox. If you are asked why you believe that big changes in the climate are occurring and can dramatically harm future life on Earth, the most reasonable answer you’re likely to provide is that you trust the reputation of the sources of information to which you usually turn for acquiring information about the state of the planet. In the best-case scenario, you trust the reputation of scientific research and believe that peer-review is a reasonable way of sifting out ‘truths’ from false hypotheses and complete ‘bullshit’ about nature. In the average-case scenario, you trust newspapers, magazines or TV channels that endorse a political view which supports scientific research to summarise its findings for you. In this latter case, you are twice-removed from the sources: you trust other people’s trust in reputable science.

Or, take an even more uncontroversial truth that I have discussed at length Claudie Pierlot Woman Tiefront Printed Cottonjersey Tshirt Sky Blue Size 3 Claudie Pierlot Get Authentic Sale Online Explore Cheap Online Fake Sale Online Cheap Wholesale Price Outlet Eastbay 99JSVEn
: one of the most notorious conspiracy theories is that no man stepped on the Moon in 1969, and that the entire Apollo programme (including six landings on the Moon between 1969 and 1972) was a staged fake. The initiator of this conspiracy theory was Bill Kaysing, who worked in publications at the Rocketdyne company – where Apollo’s Saturn V rocket engines were built. At his own expense, Kaysing published the book We Never Went to the Moon: America’s $30 Billion Swindle (1976). After publication, a movement of skeptics grew and started to collect evidence about the alleged hoax.

According to the Flat Earth Society, one of the groups that still denies the facts, the Moon landings were staged by Hollywood with the support of Walt Disney and under the artistic direction of Stanley Kubrick. Most of the ‘proofs’ they advance are based on a seemingly accurate analysis of the pictures of the various landings. The shadows’ angles are inconsistent with the light, the United States flag blows even if there is no wind on the Moon, the tracks of the steps are too precise and well-preserved for a soil in which there is no moisture. Also, is it not suspicious that a programme that involved more than 400,000 people for six years was shut down abruptly? And so on.

The great majority of the people we would consider reasonable and accountable (myself included) will dismiss these claims by laughing at the very absurdity of the hypothesis (although there have been serious and documented Marinière Knickers Set of 2 Petit Bateau Sale Explore 100% Guaranteed Cheap Online Discounts For Sale Y0P5920h3
by NASA against these allegations). Yet, if I ask myself on what evidentiary basis I believe that there has been a Moon landing, I must admit that my evidence is quite poor, and that I have never invested a second trying to debunk the counter-evidence accumulated by these conspiracy theorists. What I personally know about the facts mixes confused childhood memories, black-and-white television news, and deference to what my parents told me about the landing in subsequent years. Still, the wholly secondhand and personally uncorroborated quality of this evidence does not make me hesitate about the truth of my beliefs on the matter.

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Abstract

Context:

Testosterone (T) is commonly administered intramuscularly to treat hypogonadal males and female-to-male (FTM) transgender patients. However, these injections can involve significant discomfort and may require arrangements for administration by others.

Objective:

We assessed whether T could be administered effectively and safely subcutaneously as an alternative to intramuscular (IM) injections.

Design:

Retrospective cohort study.

Setting:

Outpatient reproductive endocrinology clinic at an academic medical center.

Patients:

Sixty-three FTM transgender patients aged >18 years electing to receive subcutaneous (SC) T therapy for sex transition were included. Fifty-three patients were premenopausal.

Intervention:

Patients were administered T cypionate or enanthate weekly at an initial dose of 50 mg. Dose was adjusted if needed to achieve serum total T levels within the normal male range.

Main Outcome Measurements:

Serum concentrations of free and total T and total estradiol (E2), masculinization, and surveillance for reactions at injection sites.

Results:

Serum T levels within the normal male range were achieved in all 63 patients with doses of 50 to 150 mg (median, 75/80 mg). Therapy was effective across a wide range of body mass index (19.0 to 49.9 kg/m 2 ). Minor and transient local reactions were reported in 9 out of 63 patients. Among 53 premenopausal patients, 51 achieved amenorrhea and 35 achieved serum E2 concentrations <50 pg/mL. Twenty-two patients were originally receiving IM and switched to SC therapy. All 22 had a mild (n = 2) or marked (n = 20) preference for SC injections; none preferred IM injections.

Conclusions:

Our observations indicate that SC T injections are an effective, safe, and well-accepted alternative to IM T injections.

Issue Section:

Testosterone (T) therapy is commonly administered to hypogonadal men and female-to-male (FTM) transgender patients. Since its introduction in the 1930s, parenteral T has typically been administered intramuscularly ( 1 , 2 ). However, intramuscular (IM) administration of T has drawbacks such as pain, bruising, and the frequent necessity to arrange injections by a medical provider or other person. T undeconoate provides an option for IM injections at 10-week intervals but is available only through a risk evaluation and mitigation program because of the risk of pulmonary oil microembolism ( 3 5 ). Transdermal T formulations (patches and gels) can also have limitations such as local reactions, poor adhesion, fear of skin-to-skin transmission ( 6 ), unpleasant odor ( 7 ), lack of insurance coverage or high copays, and limited patient acceptance ( 8 ). Subcutaneous (SC) insertion of T pellets is available but has been limited by the need for surgery, the possibility of infection, fibrosis or pellet extrusion, limited data regarding efficacy, inflexibility of dosing, and limited acceptance ( 9 ).

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