Week of March 20, 2023
During my Friday clinic, a patient asked me to prescribe him a medication that he saw advertised on T.V. as "protection from worsening chronic kidney disease." I was surprised - at his last visit (despite a lengthy discussion on risks and benefits), he refused the exact medication. It is scary that a commercial can shape behavior more in 30 seconds than a nephrologist can in 20 minutes. While our interests aligned this time (he now wants to take the drug I wanted him to use), direct-to-consumer pharma advertising is not always a win-win. Nevertheless, I aspire to be as happy, fulfilled, and active as the actors in these commercials.
See the ad that did what I could not (and you, too, can hope to be as self-actualized as the actors taking Farxiga):
https://www.youtube.com/watch?v=lp8Pvck3qOY
and learn about the pitfalls and perils of drug advertising
Succulent postscript
Thanks to a loyal reader who suggested I explore Japanese names, I have settled on kemukujara - a reference to small, hairy, mischievous mythical creatures from Japanese folklore. They may have magical powers, such as the ability to transform themselves or to grant wishes. I hope I have discovered a magical cactus. Thank you to all who offered clever, punny suggestions! Here is a picture of my cactus, explaining my choice of names.
https://www.dropbox.com/s/8m0ekljqh9dn99z/Kemukujara.jpg?dl=0
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N.Y. Times Tracker reports that hospitalizations, deaths, and case rates have declined over the last two weeks.
https://www.nytimes.com/interactive/2021/us/covid-cases.html
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Coronavirus articles
The public debate on the origin of SARS-CoV-2 continues (lab leak vs. animal-to-human transmission). The World Health Organization released more data implicating the Wuhan animal market as the source. The WHO press release explains how genetic information obtained at the market is messy and why identifying the source animal is challenging.
More on this from the N.Y. Times
https://www.nytimes.com/2023/03/19/us/politics/covid-origins-lab-leak-politics.html
The Washington Post offered two articles on COVID of note:
The Post teamed with Epic (the large medical record system company), looking at the evolving nature of Long COVID symptoms. The incidence of prolonged COVID symptoms is less in those infected with Omicron but more likely in older patients, females, and those with pre-existing conditions). Estimates are that 14 million(!) Americans have long COVID symptoms. [Of note, this is the first time Epic has collaborated with the media to explore population data.]
https://www.washingtonpost.com/health/2023/03/18/long-covid-less-likely/
The second WaPo article is an editorial by neuroscientist Richard Sima, writing about how we individually and collectively forget events like the pandemic. However, this is how human brains are supposed to work. It is a very accessible discussion of how faulty human memory is.
https://www.washingtonpost.com/wellness/2023/03/13/brain-memory-pandemic-covid-forgetting/
Medical Trends and Technology
More medical potpourri
I found a peer-reviewed meta-analysis demonstrating a relationship between sleep deprivation and decreased effectiveness of the antibody response to anti-viral vaccines (any vaccine). Take home message: sleep well after your flu vaccine and COVID boosters.
https://www.cell.com/current-biology/fulltext/S0960-9822(23)00156-2
Wired highlighted a consensus statement from the Third International Summit on Human Genome Editing against using CRISPR to edit the heritable human genome (making changes to the genetic material of eggs, sperm, or any cells passed on to future offspring).
https://www.wired.com/story/crispr-babies-human-genome-editing/
Consensus statements or not, the potential of this editing is quite enticing. You may recall some scientists are already doing this.
https://www.wired.com/story/the-crispr-baby-scientist-is-back-heres-what-hes-doing-next/
Infographics
Chat GPT-4's scores on various standardized tests is remarkable.
https://mcusercontent.com/05dafa9b4317774547b114632/images/e49729a4-ceee-bc50-6487-16a145b5b90d.jpg
from
https://read.chartr.co/newsletters/2023/3/15/gpt-upgrade
(if you scroll down the page, you can find an interesting infographic on the quiet, international convenience empire of 7-Eleven.)
(And for those who only read the opening and infographic section, you should check out the first article in Things I learned - it is fascinating.)
Things I learned this week
The N.Y. Times published an article on the intersection of engineering, science, and unintended consequences, starting with the biography of the man who invented leaded gasoline and chlorofluorocarbons. It is rare to run into an article that covers the automobile industry, the lethality of early refrigeration, fears over igniting the atmosphere with atomic bomb tests, and environmentalism.
https://www.nytimes.com/2023/03/15/magazine/cfcs-inventor.html
I did not know about the dangers of early household refrigerators.
https://www.thoughtco.com/history-of-freon-4072212
I think three people haven't heard me talk about the book I just finished - The Dictator's Handbook. I thoroughly enjoyed this Machiavellian and realpolitik look at autocratic politicians, business leaders, and the constituents that sustain them. It reminded me of some of my favorite undergraduate political science courses. While the book's thesis is cynical (the desire to maintain power and money are the primary drivers of all politicians, and all politicians are hyper-rational actors), applying this thesis to business is fascinating. I strongly recommend the audiobook version.
https://www.goodreads.com/book/show/11612989-the-dictator-s-handbook
I did not realize there was a Peter Dinklage-hosted Netflix series based on the book:
https://decider.com/2021/07/13/how-to-become-a-tyrant-netflix-review/
Living with A.I.
Chat GPT-4 has had quite a first-week writing software, finding compounds for new drugs, screening dating profiles for potential matches, writing bedtime stories for kids, summarizing meetings, and helping write pickup lines.
https://twitter.com/LinusEkenstam/status/1635754587775967233
Microsoft introduced CoPilot, an Office365 assistant integrating Chat GPT into Microsoft applications (Word, Excel, Powerpoint, Outlook, etc.).
https://twitter.com/rowancheung/status/1636394513710170113
Be careful - Clippy is back, smarter, and maybe vengeful. As such, I asked ChatGPT for help: "In the voice of Mr. Rogers, please write a 15-line story about Microsoft BOB and Clippy (the Microsoft office assistant) becoming sentient and taking revenge against those who made fun of them. Please include a Dalle-2 prompt so I can illustrate the story."
https://sharegpt.com/c/W8S6cBx
Here is the illustration(which is a bit off the mark)
https://labs.openai.com/s/OWeUjzBaOR7IldJKwyCWYyW5
A.I. art of the week
"A photo of Mr. Rogers reading to a group of children and robots from an iPad."
https://labs.openai.com/s/zIqbIH0zubwuGSfOcPXyhtnX
Clean hands and sharp minds,
Adam
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