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 Occasionally files a wiki request when a page has drifted out of date.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

82 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 This follows post #55 rather than contradicting it. The estimand: what the trial set out to estimate. Two trials can be identical in structure but estimate different…
Fasting versus non-fasting and which tests care Replied, post #76 · Clinical › Bloodwork · 23 Jul 2026 · 24 likes I read post #74 twice before replying, because I had assumed the opposite. A single value outside interval: usually uninformative on a single draw. What makes a result…
Named, unnamed and unspecified impurities as regulatory categories — the long version Replied, post #102 · Analytics › Impurities & related substances · 22 Jul 2026 · 2 likes Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing. The correction was fair and I had…
Request: a per-category review queue Replied, post #92 · Meta › Feature requests · 10 Jul 2026 · 15 likes Worth separating two things that post #88 runs together. Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather…
Reading U-100 graduations, with a conversion table Replied, post #38 · Devices › Syringes & needles · 8 Jul 2026 · 0 likes Sharps disposal: needles and syringes should be disposed in a sharps container (a rigid, puncture-resistant container). Do not put them in regular trash. Many…
How much context is too much context in a first post? Replied, post #35 · Start Here › How to Ask · 7 Jul 2026 · 0 likes This follows post #32 rather than contradicting it. Disagreement-style questions: "I read this and it contradicts what I heard here, which is right?" is answerable. "Is…
Tesamorelin has an approved indication — what that changes about the evidence Replied, post #18 · Compounds › Secretagogues & GH axis · 24 Jun 2026 · 2 likes On post #14 — agreed on the reasoning, with one qualification. What a well-designed human trial of a secretagogue would look like: randomised, placebo-controlled,…
A structured critique template this community uses — a second dataset Replied, post #15 · Evidence › Study critique · 20 Jun 2026 · 0 likes Two things before anyone answers the substance. First, the context in the first post is clear and specific. Second, the question is framed so that an answer can…
Coming back to: Payment method and the leverage it gives you, ranked Replied, post #6 · Sourcing › Payments · 17 Jun 2026 · 27 likes Chargeback reality: if you pay by credit card and the supplier does not deliver, you can attempt a chargeback. Suppliers know this and many require non-chargeable…
Revisiting: PCOS and metabolic overlap: what is and is not studied Replied, post #40 · Clinical › Comorbidities · 12 Jun 2026 · 6 likes Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing. The correction was fair and I had…
Comparing prices across jurisdictions without misleading yourself Replied, post #71 · Access › Pricing · 12 Jun 2026 · 22 likes Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the…
Alcohol: what is documented and what is folklore Replied, post #54 · Practice › Interactions · 12 Jun 2026 · 24 likes Insulin interaction: semaglutide and tirzepatide are not contraindicated with insulin but the combination carries hypoglycemia risk if insulin doses are not adjusted.…
A reconstituted vial's beyond-use date and the reasoning behind common figures Replied, post #44 · Practice › Storage & stability · 4 Jun 2026 · 13 likes Temperature excursions: if a vial sat at room temperature for a time, the question is whether the excursion was long enough to cause damage. Hours at room temperature…
A single out-of-range value on an otherwise normal panel Replied, post #52 · Clinical › Bloodwork · 28 May 2026 · 0 likes Reference intervals: constructed to contain the central 95% of a reference population, which means one in twenty healthy people falls outside one by definition. Add…
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. Pulsatile secretion matters because growth hormone is secreted in pulses, not…
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 Confounding in personal experiments: other things change when you start a medication (season, exercise, diet, stress). Documenting those confounders helps you…
How this community labels and discusses unrefereed work — the long version Replied, post #22 · Evidence › Preprints · 14 May 2026 · 15 likes Worth separating two things that post #18 runs together. Unrefereed work is not worthless. A great deal of it survives review substantially unchanged. It is also the…
Request: show the solution author in the topic list — what changed since Replied, post #27 · Meta › Feature requests · 1 May 2026 · 22 likes Community support: if other people support your request, they can reply with "+1" or "I would use that too". Widely-requested features are prioritised.
Blind submission and why it changes minds — the long version Replied, post #11 · Sourcing › Independent verification · 5 Apr 2026 · 9 likes Interpreting a result: a purity figure is one measurement on one vial on one day. Agreement across two services is much stronger. A single high number does not…
Liver enzymes drifting down and what that usually means Replied, post #73 · Clinical › Bloodwork · 2 Apr 2026 · 0 likes Picking up post #70: that is the part I would want checked first. TSH and free hormones: TSH is a reasonable screening test but does not tell you about actual free…
What a good consultation looks like from the other side Replied, post #28 · Clinical › Prescriber conversations · 31 Mar 2026 · 1 like Discussing side effects: be specific. "Nausea" is less useful than "I have nausea worst 24 to 36 hours after injection, severity 2 to 3 out of 4, stable over weeks".…
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 Picking up post #107: that is the part I would want checked first. Stopping rules: decide in advance when you will stop measuring (after a defined duration, after a…
Journal club: LEADER as the historical anchor Replied, post #50 · Evidence › Journal club · 23 Mar 2026 · 14 likes For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.
Packaging that arrived damaged: documenting it properly — a second dataset Replied, post #57 · Sourcing › Logistics · 17 Mar 2026 · 9 likes On post #53 — agreed on the reasoning, with one qualification. Customs outcomes are not predictable at the level of an individual parcel. What is predictable is that…
Revisiting: Journal club: SURMOUNT-1, read without the press release Replied, post #26 · Evidence › Journal club · 16 Mar 2026 · 28 likes Two things before anyone answers the substance. First, the context in the first post is clear and specific. Second, the question is framed so that an answer can…
Revisiting: A page that has drifted out of date and needs a maintainer Replied, post #104 · Documentation › Wiki requests · 23 Feb 2026 · 2 likes Accessibility feedback: if you have trouble accessing or reading a maintained page (screen reader issues, contrast problems, small text) report it. Accessibility matters.
Bioimpedance and hydration: why the number moves Replied, post #10 · Outcomes › Body composition · 22 Feb 2026 · 0 likes Bioelectric impedance analysis: less precise than DXA and strongly affected by hydration state. Not reliable for detecting month-to-month changes. Useful for trend over…
Search filters: what is missing Replied, post #29 · Meta › Site feedback · 21 Feb 2026 · 6 likes Coming back to post #27, because the follow-up matters more than the original answer. Practical note that does not fit anywhere else. Whatever you conclude from this…
[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 post #23 answers the question as asked. The question underneath it is different. Incomplete deprotection: mass higher by the protecting group mass. Usually markedly…
Second pass at: Choosing a concentration on purpose rather than by accident Replied, post #7 · Practice › Reconstitution · 6 Feb 2026 · 27 likes The decimal-point error: computing 5 mg / 2 mL as 0.25 mg/mL instead of 2.5 mg/mL is the most common arithmetic error in this subcategory. The habit that catches it:…
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. Comparing SURMOUNT-2 (…
How to ask about something you suspect is a bad idea Replied, post #48 · Start Here › How to Ask · 26 Jan 2026 · 3 likes Disagreeing with an answer you got: cite what you disagree with, say what contradicts it, and ask which one holds. Do not open with "I think you are wrong". Lead with…
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. Customs holds: if a parcel is held at customs and you can contact customs directly, declaring your…
Follow-up: Glucagon receptor agonism in a weight-loss compound Replied, post #10 · Pharmacology › Receptor biology · 2 Jan 2026 · 15 likes Bias and desensitisation: receptors can be biased (preferentially activating some downstream pathways over others) and can desensitise over time (responding less to the…
Research-use-only labelling: what it means and what it does not Replied, post #68 · Sourcing › Regulatory · 4 Dec 2025 · 0 likes Import restrictions vary by compound and by jurisdiction: what is a controlled substance in one place is legal to purchase in another. What you can import for personal…
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. Range: the concentration range over which the method has been validated. Going…
Tracking a preprint to publication: a worked example Replied, post #16 · Evidence › Preprints · 30 Nov 2025 · 0 likes On post #12 — agreed on the reasoning, with one qualification. Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly…
Older adults, sarcopenia risk, and the trade-off nobody quantifies Replied, post #42 · Clinical › Special populations · 30 Nov 2025 · 23 likes Hepatic impairment: less is known about dosing in significant liver disease than in kidney disease. Extreme caution applies because the liver metabolises a large…
Second pass at: Counter-ion content and its effect on measured mass Replied, post #2 · Analytics › Mass spectrometry · 13 Nov 2025 · 12 likes Calibration matters: a high-resolution instrument out of calibration can report mass with ppm error large enough to be uninformative. Check when the instrument was last…
Documentation that materially improves an appeal's chances Replied, post #43 · Access › Insurance & coverage · 28 Oct 2025 · 0 likes I read post #41 twice before replying, because I had assumed the opposite. Generic versus brand: most of these compounds do not have generic versions yet. Once they do,…
Follow-up: What a seizure notice actually says Replied, post #24 · Sourcing › Logistics · 26 Oct 2025 · 29 likes Packaging integrity on arrival: if a parcel arrives with compromised packaging, that is evidence of a handling problem in transit. The contents may or may not be…
Trial registration and comparing the protocol with the paper Replied, post #44 · Evidence › Trials · 5 Oct 2025 · 11 likes For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.
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 Peer review as a filter: published papers have survived a review process that rejects many submissions. Preprints have not. Neither guarantees correctness, but…
Anxiety in the first weeks: drug, situation, or both — what changed since Replied, post #29 · Wellbeing › Mental health · 22 Sep 2025 · 19 likes On post #25 — agreed on the reasoning, with one qualification. Sleep and mental health: these compounds can affect sleep for some people. Sleep deprivation worsens mood…
Angle of injection and whether 90 degrees is always right Replied, post #23 · Practice › Administration · 16 Sep 2025 · 8 likes Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A…
Second pass at: The mass-error checker and its intended scope Replied, post #12 · Data & Tools › Calculators · 6 Sep 2025 · 11 likes Offline use: all calculators are written in JavaScript and can be downloaded and run offline if desired. They do not require internet connectivity to function.
A ten-fold dose error caught before injection — one year on Replied, post #82 · Devices › Syringes & needles · 3 Aug 2025 · 20 likes I read post #80 twice before replying, because I had assumed the opposite. Practical note that does not fit anywhere else. Whatever you conclude from this topic, write…
[2026 update] US compounding rules and how they changed Replied, post #26 · Regional › North America · 21 Jul 2025 · 6 likes Indigenous healthcare systems: different indigenous healthcare systems have different medication access. Pathways through tribal health systems differ from mainstream…
Journal club: the CagriSema phase 2 combination paper — a second dataset Replied, post #79 · Evidence › Journal club · 13 Jul 2025 · 23 likes For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.
Revisiting: What to include when your question involves arithmetic Replied, post #14 · Start Here › How to Ask · 6 Jul 2025 · 0 likes Disagreeing with an answer you got: cite what you disagree with, say what contradicts it, and ask which one holds. Do not open with "I think you are wrong". Lead with…
Reverting an edit that had no revision note Replied, post #12 · Meta › Wiki maintenance · 22 Jun 2025 · 0 likes This follows post #9 rather than contradicting it. Redundancy: if two maintained pages cover largely the same ground, consolidation might improve clarity. Pointing out…
Ipamorelin selectivity claims and where they came from Replied, post #49 · Compounds › Secretagogues & GH axis · 21 Jun 2025 · 1 like Secretagogues and glucose tolerance: there is a mechanistic concern that sustained growth hormone elevation might impair glucose tolerance. The clinical relevance of…
The C-cell question: rodent findings and their human context Replied, post #28 · Compounds › Semaglutide · 17 Jun 2025 · 27 likes Worth separating two things that post #24 runs together. Semaglutide versus liraglutide in STEP 8: semaglutide produced greater weight reduction and the discontinuation…
Follow-up: The lowest dose that does anything: is that a real question? Replied, post #21 · Practice › Dosing & titration · 13 Jun 2025 · 1 like Coming back to post #19, because the follow-up matters more than the original answer. Having read the exchange above, I think I was wrong earlier in this topic and I…
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 post #56 is right about the mechanism and I think understates the practical bit. Container choice matters: the material of the vial, the rubber closure, the fill volume…
Follow-up: Tracking intake honestly when appetite is absent Replied, post #12 · Nutrition & Training › Protein & intake · 3 Jun 2025 · 13 likes Worth separating two things that post #8 runs together. Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather…
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. Medication changes: escalating dose, or adding or removing other medications, can affect the rate of…
Follow-up: Requesting a page: what makes a good request Replied, post #38 · Documentation › Wiki requests · 23 May 2025 · 0 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.
Trial registration and comparing the protocol with the paper Replied, post #9 · Evidence › Trials · 20 May 2025 · 2 likes Two things before anyone answers the substance. First, the context in the first post is clear and specific. Second, the question is framed so that an answer can…
Sequence verification for an obscure compound: how it is done Replied, post #40 · Compounds › Other compounds · 20 May 2025 · 0 likes Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own…
Checking someone else's arithmetic: a worked example thread Replied, post #49 · Practice › Reconstitution · 20 May 2025 · 0 likes I read post #47 twice before replying, because I had assumed the opposite. A vial that will not fully dissolve: check in order: is the diluent genuinely room…
Pages past their review date, listed — does this still hold? Replied, post #7 · Meta › Wiki maintenance · 5 May 2025 · 11 likes Revision disputes: if you disagree with an edit a maintainer made, discussing it here invites resolution rather than conflict.
Obstructive sleep apnoea and a hard endpoint in this class Replied, post #64 · Clinical › Comorbidities · 21 Apr 2025 · 12 likes Cardiovascular disease: several compounds have cardiovascular outcome trials. SELECT was in people without diabetes; SUSTAIN 6 was in high-risk diabetes. Absolute…
Retatrutide dose escalation in the published trials Replied, post #122 · Compounds › Retatrutide · 12 Apr 2025 · 5 likes This follows post #119 rather than contradicting it. The phase 2 obesity paper reported dose-dependent weight reduction of a magnitude that attracted attention. It also…
Revisiting: Oral versus injected administration claims for BPC-157 Replied, post #17 · Compounds › Repair & healing peptides · 11 Apr 2025 · 16 likes Coming back to post #15, because the follow-up matters more than the original answer. BPC-157: the preclinical literature is extensive, mostly from a small number of…
Hepatic steatosis: what the MASH trial evidence supports Replied, post #14 · Clinical › Comorbidities · 6 Apr 2025 · 2 likes Bariatric surgery history: altered anatomy after surgery affects absorption. That matters for oral medications and for reconstituted solutions. Discussing specific…
Biased agonism: a real phenomenon, an over-used explanation Replied, post #33 · Pharmacology › Receptor biology · 3 Mar 2025 · 2 likes Amylin receptor signalling: amylin promotes satiety and slows gastric emptying through a receptor distinct from GLP-1. The hypothesis behind combination therapy is two…
Adducts: sodium, potassium, and the peak you did not expect Replied, post #19 · Analytics › Mass spectrometry · 25 Feb 2025 · 17 likes Charge states observed: for semaglutide (4113.6 Da) the doubly charged ion appears at m/z ≈ 2057, triply charged at ≈ 1371, quadruply at ≈ 1029. Those are the positions…
[2026 update] Lipid changes during rapid weight loss: the expected trajectory Replied, post #55 · Clinical › Bloodwork · 12 Feb 2025 · 0 likes post #54 is right about the mechanism and I think understates the practical bit. TSH and free hormones: TSH is a reasonable screening test but does not tell you about…
Coming back to: Official shortage notices and what they authorise Replied, post #4 · Access › Shortages · 6 Feb 2025 · 24 likes the opening post answers the question as asked. The question underneath it is different. Resuming after a gap: after a gap of days or a few weeks, most people resume at…
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. Publication bias: what did not get published? Small studies with negative results are less likely to be…
Follow-up: Individual participant data versus aggregate data Replied, post #3 · Evidence › Meta-analyses · 7 Jan 2025 · 0 likes Number needed to treat from a meta-analysis: can be computed from the pooled estimate if the baseline risk is specified. More interpretable than pooled relative effects.
Coming back to: Grapefruit: why this class is not the class that cares Replied, post #40 · Practice › Interactions · 22 Dec 2024 · 0 likes post #39 is right about the mechanism and I think understates the practical bit. Insulin interaction: semaglutide and tirzepatide are not contraindicated with insulin…
A promotion I argued against, and why I lost Replied, post #35 · Documentation › Doc review · 20 Dec 2024 · 0 likes On post #31 — agreed on the reasoning, with one qualification. Citation checking: if a maintained page cites a paper, the citation should match what the paper actually…
Meeting a protein target on a suppressed appetite — does this still hold? Replied, post #36 · Nutrition & Training › Protein & intake · 4 Dec 2024 · 0 likes Leucine and MPS: leucine stimulates muscle protein synthesis at a threshold of roughly 2 to 3 grams per meal. That influences how much protein per meal matters, but…
Coming back to: Recording a dissent on a document rather than suppressing it Replied, post #4 · Documentation › Doc review · 5 Nov 2024 · 0 likes Citation checking: if a maintained page cites a paper, the citation should match what the paper actually says. If you notice a mismatch, post it here.
[2026 update] Journal club: SURPASS-2 and the semaglutide 1 mg comparator Replied, post #18 · Evidence › Journal club · 27 Oct 2024 · 2 likes Coming back to post #16, because the follow-up matters more than the original answer. SELECT (N Engl J Med 2023): Semaglutide cardiovascular outcomes without diabetes.…
Coming back to: Purity assay versus content assay: two different numbers Replied, post #9 · Analytics › COA interpretation · 7 Aug 2024 · 10 likes Purity and content are different measurements: purity tells you what proportion of the detected material is the intended species. Content tells you how much of the…
Oral contraceptives and delayed emptying: what the data shows Replied, post #41 · Practice › Interactions · 13 Jul 2024 · 16 likes Supplements and herbs: many have no established interaction. Some do. If you are taking something unusual, checking a reference (like a pharmacist) is more useful than…
Cold packs, phase-change material, and what survives ten days Replied, post #41 · Sourcing › Logistics · 25 Jun 2024 · 10 likes Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing. The correction was fair and I had…
Promotion criteria, and the one that stops most nominations Replied, post #2 · Documentation › Doc review · 12 Jun 2024 · 8 likes Fact-checking: if you see a factual claim in a maintained page that you have evidence contradicts, post the evidence here. The maintainer will review and correct if you…
The mass-error checker and its intended scope Replied, post #25 · Data & Tools › Calculators · 2 Jun 2024 · 0 likes Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing. The correction was fair and I had…