Week of June 5, 2022
Last week, a patient asked me about our office's gun policy. The patient disclosed that "given the world today," he carried a handgun and wanted to bring it into the building - he worried someone would steal it from his car. (He did not seem to appreciate the mild irony of the gun "protecting" him from crime being a potential focus of a crime.) After my typical "well, I hope my care doesn't require a handgun" comments, I explained we do not permit guns in the office (though I am unsure how we would enforce such a rule, given the staff is unarmed, save for rapier wit). Of course, his illness is exponentially more likely to impact him than crime in our rural county - which is in the bottom 10% of all crime rates in Maryland. But, his choice of media informed his fear and several common logical fallacies - including generalization, inappropriate framing (taking data out of context), and declinism (the world is worse than in the past). So we spent our time talking about probability. But no matter the topic - and even when armed with data (which we most definitely allow in the building) - a few minutes in an exam room is never enough time for changing minds and massively altering behavior.
Check out the data - My office is in Queen Anne's County, Maryland - (which is really safe).
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The N.Y. Times is not updating the COVID Tracker as the underlying CDC data is on pause for reconfiguration after the end of the PHE.
https://www.nytimes.com/interactive/2023/us/covid-cases.html
Wastewater monitoring is trending down at all regional levels.
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COVID articles
Here is the problem with wastewater monitoring - it is a sensitive but not helpfully specific tool. It is difficult to act without good clinical correlates and other testing. Coronavirus RNA concentrations have risen in New York City wastewater over the last two weeks. We shall see if hospitalization rates start to rise.
https://gothamist.com/news/is-covid-back-in-nyc-wastewater-surveillance-shows-coronavirus-is-rising
As we have learned, COVID anywhere is COVID everywhere.
https://time.com/6283257/china-xbb-covid-outbreak/
This link is to a fantastic New York Times interactive article illustrating COVID lung damage. The article interviews three patients and integrates 3D reconstructions of their Chest CT scans to demonstrate the long-term scarring and lung damage.
https://www.nytimes.com/interactive/2023/05/31/health/covid-lung-damage.html
Dr. F. Perry Wilson wrote a thoughtful and technical commentary on the many variables required to understand vaccine effectiveness against infection, hospitalization, and severe illness. Our population has received multiple vaccine doses plus or minus one or more COVID infections. Medscape is a free registration, but this 10-15 min read will help you understand why typical media have difficulty discussing this topic. There is a video of Dr. Wilson speaking about this topic too.
https://www.medscape.com/viewarticle/992538
Medical Trends and Technology
Apple is (supposedly) announcing its augmented reality (A.R.) headset. I am excited about using A.R. in healthcare (and elsewhere). Here is a good reminder about the use cases published by the Medical Futurist blog in 2021. I suspect many other uses exist, but the article is a good start.
https://medicalfuturist.com/augmented-reality-in-healthcare-will-be-revolutionary/
June 5 Apple Developer Conference Keynote (this is a speculative article):
https://www.macworld.com/article/1939266/wwdc-2023-minute-by-minute-keynote-preview.html
Learn about antibiotic resistance! Scientific American's article on super parasites (hookworms) has it all - racing dog breeding farms, the unintentional evolutionary pressures created by indiscriminate antibiotic use, pan-resistant hookworms (transmissible to humans), an epidemiologic investigation, and DNA sequencing to solve a medical mystery. On the upside, multi-drug-resistant hookworms don't turn you into a zombie, but becoming infected with super worms is unappealing. The story exemplifies unintended consequences (or "nature finds a way") in response to human behavior.
Infographics
The Chemistry of Plant Flowering from my favorite Compound Chemistry artists:
https://cen.acs.org/content/dam/cen/99/9/WEB/09909-feature5-flowering.pdf
Things I learned this week
Beelzebufo is back! Last June, I wrote about the prehistoric giant Madagascarian "devil toad" depicted on Apple TV+'s Prehistoric Planet. (Beelezebufo was large enough to eat small dinosaurs.) I was not the only viewer interested since Prehistoric Planet Season 2, Episode 3, spent an extended time on this animal - this time hypothesizing its mating call (it takes a toad to love a toad, to be sure). But there is never not a good time to revisit my favorite extinct amphibian. This season Beelzebufo is depicted as more nuanced and complex, pining for companionship in a dangerous prehistoric world. Of course, it now doesn't entirely live up to its name, a portmanteau of the name Beelzebub (the demon) and bufo (Latin for "toad"). If only there were acting awards for extinct CGI animals.
https://en.wikipedia.org/wiki/Beelzebufo
The N.Y. Times featured Beelzebufo in a 2008 article.
https://www.nytimes.com/2008/02/19/science/18frog.html
Series review:
Episode guide:
Living with A.I.
Photoshop Beta with generative A.I. fill, and text-to-image functionality is amazing.
https://twitter.com/NathanLands/status/1663878082007281668
and
https://twitter.com/minchoi/status/1663936561568796674
NVIDIA's software that creates a 3D model from 2D video is called Neuralangelo - a portmanteau of neural network and Michaelangelo.
https://twitter.com/rowancheung/status/1664513520564592640
Google is offering free A.I. courses.
https://www.cloudskillsboost.google/course_templates/536
more details
https://twitter.com/akshay_pachaar/status/1665335120595922950
A.I. combined with synthetic biology
I found a thoughtful, peer-reviewed overview article from Communications of the Association for Computing Machinery that describes A.I.'s value-add to synthetic biology. The ability to more rapidly select potential gene alterations offers a huge advantage.
https://cacm.acm.org/magazines/2022/5/260341-artificial-intelligence-for-synthetic-biology/fulltext
And, of course, some consumer-readable reminders of synthetic biology's pitfalls:
A.I. art of the week
"an angry hookworm sitting on top of a bottle of pills, dogs in the background at sunset, photo with wide aperture and 400 speed film grain, snoot lighting on the worm's face"
and
And with a devil toad thrown in:
Clean hands and sharp minds team,
Adam
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