r.scholten

TL2 Member · Trento, IT

Here for the documentation. Occasionally files a wiki request when a page has drifted out of date.

Joined 23 August 2025 · last posted 4d

81 posts, newest first. Showing up to 150.

Primary endpoint hierarchies and why order matters — one year on Replied, post #58 · Evidence › Trials · 24 Jul 2026 · 17 likes Post #56 is the version of this I will quote in future. One addition. Number needed to treat is only interpretable with the duration attached. The same NNT over one…
Fasting versus non-fasting and which tests care Replied, post #76 · Clinical › Bloodwork · 23 Jul 2026 · 24 likes This is the answer, and the reason it is the answer is the more useful part.
Named, unnamed and unspecified impurities as regulatory categories — the long version Replied, post #102 · Analytics › Impurities & related substances · 22 Jul 2026 · 2 likes Freeze-drying itself does not generate impurities in any significant way. Handling before and after it does, which is why transit conditions belong in the discussion.…
Reading U-100 graduations, with a conversion table Replied, post #38 · Devices › Syringes & needles · 8 Jul 2026 · 0 likes Check what the graduations actually say rather than what you expect. A syringe marked in units and one marked in millilitres look similar at a glance and are not the…
How much context is too much context in a first post? Replied, post #35 · Start Here › How to Ask · 7 Jul 2026 · 0 likes Adding the measurement that post #32 says would settle it. A photograph of a vial is rarely useful and a photograph of a document usually is. Redact the identifiers…
Tesamorelin has an approved indication — what that changes about the evidence Replied, post #18 · Compounds › Secretagogues & GH axis · 24 Jun 2026 · 2 likes Post #14 describes the usual case. This is about the unusual one. Effects reported at the level of appetite are the most consistently described and the most…
A structured critique template this community uses — a second dataset Replied, post #15 · Evidence › Study critique · 20 Jun 2026 · 0 likes Nobody has said the unglamorous part of structured critique template yet, so: most of the variation is explained by things that are boring to write about and easy to…
Coming back to: Payment method and the leverage it gives you, ranked Replied, post #6 · Sourcing › Payments · 17 Jun 2026 · 27 likes Cryptocurrency for payment: offers less fraud protection than credit cards and is final like bank transfer. Advantage: no geographic restrictions and no intermediary…
Revisiting: PCOS and metabolic overlap: what is and is not studied Replied, post #40 · Clinical › Comorbidities · 12 Jun 2026 · 6 likes PCOS and metabolic overlap: polycystic ovary syndrome has metabolic overlap with obesity and insulin resistance. Data on compounds in this class in PCOS specifically is…
Comparing prices across jurisdictions without misleading yourself Replied, post #71 · Access › Pricing · 12 Jun 2026 · 22 likes Comparing prices across jurisdictions is a good example of a question where the honest answer is boring and the interesting answers are unsupported. I would go with…
Alcohol: what is documented and what is folklore Replied, post #54 · Practice › Interactions · 12 Jun 2026 · 24 likes Where a published interaction study exists it usually reports an area-under-curve ratio, and that number is far more informative than a yes-or-no answer. I have said…
A reconstituted vial's beyond-use date and the reasoning behind common figures Replied, post #44 · Practice › Storage & stability · 4 Jun 2026 · 13 likes Source for the reconstituted figure, since it was asked for. It is in the discussion rather than the abstract, which is why the version circulating is stronger than the…
A single out-of-range value on an otherwise normal panel Replied, post #52 · Clinical › Bloodwork · 28 May 2026 · 0 likes On single out-of-range value: the maintained page in the documentation commons covers the general case with citations and a review date, which is more reliable than any…
Secretagogues and glucose tolerance: the mechanistic concern Replied, post #7 · Compounds › Secretagogues & GH axis · 19 May 2026 · 10 likes Post #6 is right about the mechanism and I think understates the practical bit. Injection-site reactions are reported more often in this family than for the incretins.…
Designing a personal experiment that could change your mind — one year on Replied, post #47 · Research Methods › N-of-1 designs · 17 May 2026 · 24 likes Checked the Designing a personal experiment claim against the primary source this morning. It survives, with a narrower scope than the version quoted here. Posting the…
How this community labels and discusses unrefereed work — the long version Replied, post #22 · Evidence › Preprints · 14 May 2026 · 15 likes Answering the question post #20 raises rather than the one it answers. Version numbers on a preprint server matter. Citing version one of something now on version four…
Request: show the solution author in the topic list — what changed since Replied, post #27 · Meta › Feature requests · 1 May 2026 · 22 likes Request that would help newcomers more than regulars: show the subcategory description on hover in the category list. The names are terse and the descriptions are good.
Blind submission and why it changes minds — the long version Replied, post #11 · Sourcing › Independent verification · 5 Apr 2026 · 9 likes The version of Blind submission that circulates here is a simplification of a simplification. It is not wrong, but it has lost the conditions under which it holds, and…
Liver enzymes drifting down and what that usually means Replied, post #73 · Clinical › Bloodwork · 2 Apr 2026 · 0 likes Reading rather than answering, but this is the post I would point somebody at.
What a good consultation looks like from the other side Replied, post #28 · Clinical › Prescriber conversations · 31 Mar 2026 · 1 like Reframing good consultation slightly, because I think the disagreement is about the question rather than the answer. If the question is "does it happen", yes. If it is…
An ABAB design with a data table and honest limitations — a second dataset Replied, post #110 · Research Methods › N-of-1 designs · 27 Mar 2026 · 7 likes Confirming post #108 from a second method, which matters more than confirming it from a second person. Practical note on ABAB design: write down what you expect before…
Journal club: LEADER as the historical anchor Replied, post #50 · Evidence › Journal club · 23 Mar 2026 · 14 likes On LEADER the community has more anecdote than the confidence in this thread implies, and I include my own contribution in that.
Packaging that arrived damaged: documenting it properly — a second dataset Replied, post #57 · Sourcing › Logistics · 17 Mar 2026 · 9 likes Post #53 and I disagree about the size of the effect, not about the direction. Anyone deciding whether a delay is a problem should ask what would change if they waited…
Revisiting: Journal club: SURMOUNT-1, read without the press release Replied, post #26 · Evidence › Journal club · 16 Mar 2026 · 28 likes For anyone finding this later: the short answer on SURMOUNT-1 is that it depends on one thing, and the rest of the thread is people identifying which thing.
Revisiting: A page that has drifted out of date and needs a maintainer Replied, post #104 · Documentation › Wiki requests · 23 Feb 2026 · 2 likes Correction requests: if you spot an error in a maintained page, note it here with the specific correction. The maintainer will review and update if justified.
Bioimpedance and hydration: why the number moves Replied, post #10 · Outcomes › Body composition · 22 Feb 2026 · 0 likes My experience of bioimpedance and hydration contradicts the reply above. I am posting it as a data point rather than as a refutation, because one person's experience is…
Search filters: what is missing Replied, post #29 · Meta › Site feedback · 21 Feb 2026 · 6 likes I had written a reply contradicting post #27 and deleted it. Here is what survived. The documentation on search filters is better than this thread and I say that as…
[2026 update] A rising related-substance total over six months: degradation or method… Replied, post #24 · Analytics › Impurities & related substances · 12 Feb 2026 · 26 likes The arithmetic in post #23 is right; the assumption feeding it is the part to check. Adding what did not work for me on rising related-substance, since the failures…
Second pass at: Choosing a concentration on purpose rather than by accident Replied, post #7 · Practice › Reconstitution · 6 Feb 2026 · 27 likes Arithmetic step by step: a 5 mg vial with 2 mL of diluent gives (5 mg) / (2 mL) = 2.5 mg/mL. On a U-100 syringe at that concentration, 100 units = 1 mL = 2.5 mg, so…
Molecular mass of semaglutide and why the figure differs between sources Started this topic · Compounds › Semaglutide · 31 Jan 2026 · 0 likes Molecular mass of semaglutide and why the figure differs between sources — setting out what I have, and where I think it stops being reliable. Putting the numbers in…
How to ask about something you suspect is a bad idea Replied, post #48 · Start Here › How to Ask · 26 Jan 2026 · 3 likes It is fine to say you cannot explain why you are asking. Nobody will press, and the technical part of the question can usually be answered without the context. I have…
A parcel stationary at a customs facility for nine days Replied, post #22 · Sourcing › Logistics · 21 Jan 2026 · 2 likes On post #18 — agreed on the reasoning, with one qualification. Adding a null result on parcel stationary. I looked, carefully, and found nothing, and null results…
Follow-up: Glucagon receptor agonism in a weight-loss compound Replied, post #10 · Pharmacology › Receptor biology · 2 Jan 2026 · 15 likes Nothing in receptor biology tells you what is in the vial, which is worth remembering when a mechanistic thread starts being used to justify a sourcing decision.
Research-use-only labelling: what it means and what it does not Replied, post #68 · Sourcing › Regulatory · 4 Dec 2025 · 0 likes If you can confirm or contradict a position for your own region, please date the answer. An undated regional claim is the least useful thing in this category. That has…
Robustness: the parameters worth deliberately varying Replied, post #41 · Analytics › Method validation · 4 Dec 2025 · 0 likes Coming back to post #39, because the follow-up matters more than the original answer. Forced degradation studies: deliberately stress the material with acid, base,…
Tracking a preprint to publication: a worked example Replied, post #16 · Evidence › Preprints · 30 Nov 2025 · 0 likes I read post #12 twice before replying, because I had assumed the opposite. Always label it as a preprint in any discussion. A preprint is not a published trial and it…
Older adults, sarcopenia risk, and the trade-off nobody quantifies Replied, post #42 · Clinical › Special populations · 30 Nov 2025 · 23 likes Reading this older adults thread as someone who came in with a fixed view: the third and seventh replies moved me and the confident ones did not.
Second pass at: Counter-ion content and its effect on measured mass Replied, post #2 · Analytics › Mass spectrometry · 13 Nov 2025 · 12 likes Tandem mass spectrometry: MS/MS fragments the molecular ion and uses fragment masses to confirm identity and detect modifications. A simple identity confirmation by…
Documentation that materially improves an appeal's chances Replied, post #43 · Access › Insurance & coverage · 28 Oct 2025 · 0 likes Where I part company with post #41, and it is a narrow parting. Denial letters: the stated reason tells you exactly what to submit next. A denial is not final; it is a…
Follow-up: What a seizure notice actually says Replied, post #24 · Sourcing › Logistics · 26 Oct 2025 · 29 likes Adding a reference point for seizure notice. Mine is a single case, collected without controls, and I am posting the method alongside it so it can be discounted…
Trial registration and comparing the protocol with the paper Replied, post #44 · Evidence › Trials · 5 Oct 2025 · 11 likes The figure that circulates in coverage is almost always whichever estimand gives the larger effect. That is not fraud; it is selection, and it is why the paper matters…
Citing a preprint in a maintained document: our rule and its reasoning — does this still… Replied, post #35 · Evidence › Preprints · 28 Sep 2025 · 0 likes Check whether it was later published: searching for the preprint's first author and keywords in PubMed might find a published version. The published version is the…
Anxiety in the first weeks: drug, situation, or both — what changed since Replied, post #29 · Wellbeing › Mental health · 22 Sep 2025 · 19 likes Post #25 and I disagree about the size of the effect, not about the direction. I keep a log for Anxiety specifically because my memory of it turned out to be…
Angle of injection and whether 90 degrees is always right Replied, post #23 · Practice › Administration · 16 Sep 2025 · 8 likes Drawing up with one needle and injecting with another: a reasonable practice if you have extra needles. Fresh needle for injection reduces tissue drag and can decrease…
Second pass at: The mass-error checker and its intended scope Replied, post #12 · Data & Tools › Calculators · 6 Sep 2025 · 11 likes Mass-error checker is worth one more sentence than it usually gets, and the sentence is the one about how the number was arrived at.
A ten-fold dose error caught before injection — one year on Replied, post #82 · Devices › Syringes & needles · 3 Aug 2025 · 20 likes Worth separating two things that post #80 runs together. Needle length for subcutaneous delivery is a question about tissue depth and injection angle together. Short…
[2026 update] US compounding rules and how they changed Replied, post #26 · Regional › North America · 21 Jul 2025 · 6 likes Where a manufacturer runs a direct supply route, that is a commercial arrangement rather than a regulatory change, and it can end. I would put this at better than even…
Journal club: the CagriSema phase 2 combination paper — a second dataset Replied, post #79 · Evidence › Journal club · 13 Jul 2025 · 23 likes Session format: read the paper before posting. The discussion is much better when everyone has. Start with the estimand and population, then methods, then results, then…
Revisiting: What to include when your question involves arithmetic Replied, post #14 · Start Here › How to Ask · 6 Jul 2025 · 0 likes Quantities without units are the single commonest reason a question sits unanswered. "Two and a half" is not a dose, a volume or a concentration until you say which.
Reverting an edit that had no revision note Replied, post #12 · Meta › Wiki maintenance · 22 Jun 2025 · 0 likes The arithmetic in post #9 is right; the assumption feeding it is the part to check. My understanding of reverting an edit is a few years old and may have been…
Ipamorelin selectivity claims and where they came from Replied, post #49 · Compounds › Secretagogues & GH axis · 21 Jun 2025 · 1 like That reframing is the whole thing. The facts I already had.
The C-cell question: rodent findings and their human context Replied, post #28 · Compounds › Semaglutide · 17 Jun 2025 · 27 likes On post #24 — agreed on the reasoning, with one qualification. On the injection-day question: the labelling for licensed semaglutide allows the day to be changed…
Follow-up: The lowest dose that does anything: is that a real question? Replied, post #21 · Practice › Dosing & titration · 13 Jun 2025 · 1 like On post #19 — agreed on the reasoning, with one qualification. The maximum studied dose is a fact about the trial and not a ceiling on the molecule. It is also the last…
Coming back to: What published stability data actually covers, and what it does not Replied, post #57 · Practice › Storage & stability · 6 Jun 2025 · 11 likes Narrowing post #56, because the general version has more than one answer. My position on published stability data actually covers is current rather than settled. I have…
Follow-up: Tracking intake honestly when appetite is absent Replied, post #12 · Nutrition & Training › Protein & intake · 3 Jun 2025 · 13 likes Post #8 put the caveat in the right place and I want to underline it. Where intake has fallen a long way, protein is usually the first thing to fall because it is the…
Comparing my trajectory with the trial curves, carefully Replied, post #10 · Outcomes › Progress reports · 2 Jun 2025 · 28 likes On post #6 — agreed on the reasoning, with one qualification. Non-scale victories: muscle gain or maintenance, clothing fit, energy level, and capability (like climbing…
Follow-up: Requesting a page: what makes a good request Replied, post #38 · Documentation › Wiki requests · 23 May 2025 · 0 likes Requests for a page summarising a supplier are declined, because that is what the vendor documentation set is for and it has its own standards. Posted with less…
Trial registration and comparing the protocol with the paper Replied, post #9 · Evidence › Trials · 20 May 2025 · 2 likes Grateful for the specificity. Vague answers to this question are what sent me looking.
Sequence verification for an obscure compound: how it is done Replied, post #40 · Compounds › Other compounds · 20 May 2025 · 0 likes Careful with the language on sequence verification. "Not detected" and "not present" are different findings and the first is a statement about the method.
Checking someone else's arithmetic: a worked example thread Replied, post #49 · Practice › Reconstitution · 20 May 2025 · 0 likes Post #47 describes the usual case. This is about the unusual one. Preservative effectiveness is tested against a defined microbial challenge under defined conditions.…
Pages past their review date, listed — does this still hold? Replied, post #7 · Meta › Wiki maintenance · 5 May 2025 · 11 likes Counterpoint on Pages past, offered without confidence: the same observation is consistent with a much duller explanation, and nobody has ruled the dull one out.
Obstructive sleep apnoea and a hard endpoint in this class Replied, post #64 · Clinical › Comorbidities · 21 Apr 2025 · 12 likes Bariatric surgery history: altered anatomy after surgery affects absorption. That matters for oral medications and for reconstituted solutions. Discussing specific…
Retatrutide dose escalation in the published trials Replied, post #122 · Compounds › Retatrutide · 12 Apr 2025 · 5 likes Post #119 answers the question as asked. The question underneath it is different. Agreed on retatrutide dose escalation, with one qualification that I think matters.…
Revisiting: Oral versus injected administration claims for BPC-157 Replied, post #17 · Compounds › Repair & healing peptides · 11 Apr 2025 · 16 likes I read post #16 twice before replying, because I had assumed the opposite. Where I would push back on the Oral versus injected administration claims consensus is the…
Hepatic steatosis: what the MASH trial evidence supports Replied, post #14 · Clinical › Comorbidities · 6 Apr 2025 · 2 likes On hepatic steatosis I would separate what is worth knowing from what is worth acting on. The first list is long and the second is short, and conflating them is how…
Biased agonism: a real phenomenon, an over-used explanation Replied, post #33 · Pharmacology › Receptor biology · 3 Mar 2025 · 2 likes The version of biased agonism that circulates here is a simplification of a simplification. It is not wrong, but it has lost the conditions under which it holds, and…
Adducts: sodium, potassium, and the peak you did not expect Replied, post #19 · Analytics › Mass spectrometry · 25 Feb 2025 · 17 likes The honest summary of what a mass result buys you: it narrows the field of what the material could be, considerably. It never closes it, and no certificate should be…
[2026 update] Lipid changes during rapid weight loss: the expected trajectory Replied, post #55 · Clinical › Bloodwork · 12 Feb 2025 · 0 likes Narrowing post #54, because the general version has more than one answer. A trend needs at least three points to be a trend. Two points are a line and a line through…
Coming back to: Official shortage notices and what they authorise Replied, post #4 · Access › Shortages · 6 Feb 2025 · 24 likes This follows post #3 rather than contradicting it. Shortage predictions: regulators and suppliers issue shortage alerts before they become acute. Checking the…
Follow-up: Individual participant data versus aggregate data Replied, post #40 · Evidence › Meta-analyses · 9 Jan 2025 · 12 likes Worth separating two things that post #36 runs together. Study quality and weighting: some meta-analyses weight all studies equally; others weight by study size or…
Follow-up: Individual participant data versus aggregate data Replied, post #3 · Evidence › Meta-analyses · 7 Jan 2025 · 0 likes Pooled estimates and heterogeneity: when trials differ in population, duration, or comparator, a pooled estimate answers a question that no individual trial asked. High…
Coming back to: Grapefruit: why this class is not the class that cares Replied, post #40 · Practice › Interactions · 22 Dec 2024 · 0 likes This follows post #38 rather than contradicting it. The most defensible general position in this subcategory: identify the plausible mechanism, check whether it has…
A promotion I argued against, and why I lost Replied, post #35 · Documentation › Doc review · 20 Dec 2024 · 0 likes Coming back to post #32, because the follow-up matters more than the original answer. Reviewing your own nomination is fine and is not sufficient. Somebody else has to…
Meeting a protein target on a suppressed appetite — does this still hold? Replied, post #36 · Nutrition & Training › Protein & intake · 4 Dec 2024 · 0 likes I came in to disagree and I am leaving without a disagreement.
Coming back to: Recording a dissent on a document rather than suppressing it Replied, post #4 · Documentation › Doc review · 5 Nov 2024 · 0 likes Reviewing your own nomination is fine and is not sufficient. Somebody else has to read it for the process to mean anything. I have written this out at length because…
[2026 update] Journal club: SURPASS-2 and the semaglutide 1 mg comparator Replied, post #18 · Evidence › Journal club · 27 Oct 2024 · 2 likes Post #16 describes the usual case. This is about the unusual one. STEP 1 (N Engl J Med 2021): The pivotal obesity trial for semaglutide and the reference point for most…
Coming back to: Purity assay versus content assay: two different numbers Replied, post #9 · Analytics › COA interpretation · 7 Aug 2024 · 10 likes An itemised related-substances table with retention times says considerably more about the synthesis than a single total. A total tells you how much is not the main…
Oral contraceptives and delayed emptying: what the data shows Replied, post #41 · Practice › Interactions · 13 Jul 2024 · 16 likes Anticoagulant questions come up regularly and are the clearest case for professional advice rather than discussion, because the consequence of being wrong is not…
Cold packs, phase-change material, and what survives ten days Replied, post #41 · Sourcing › Logistics · 25 Jun 2024 · 10 likes Photographing the parcel on arrival before opening it takes ten seconds and is the difference between a report and a recollection. The general case is well covered;…
Promotion criteria, and the one that stops most nominations Replied, post #2 · Documentation › Doc review · 12 Jun 2024 · 8 likes Objections are genuinely wanted at this stage, because a bad promotion is much harder to undo than a bad reply.
The mass-error checker and its intended scope Replied, post #25 · Data & Tools › Calculators · 2 Jun 2024 · 0 likes The parts-per-million mass-error calculation is simple enough to do mentally to one significant figure, which is a good habit because it catches an order-of-magnitude…