What Adam is Reading

Week of August 7, 2023

One of my patient's abnormal heart rhythm (atrial fibrillation) becomes symptomatically worse at bingo. His wife, who accompanies him to the office visits, painted the mental image of an intense and competitive man's retirement - an array of bingo cards, two-fisted and feverish number marking, and stressful disappointment when someone else wins. Patient care can be so fulfilling. I have a newfound appreciation for bingo-associated illnesses and an unsettling vision of my retirement.

---

CDC reported hospitalizations are up 11% over the last 14 days.

Wastewater indicates rising amounts of RNA in all regions of the country.

The N.Y. Times COVID Tracker reflects the changing data quality - only CDC-gathered hospital data as a surrogate (lagging) indicator.

https://www.nytimes.com/interactive/2023/us/covid-cases.html

Wastewater monitoring is more of a LEADING indicator (though data is typically 7-10 days delayed).

https://biobot.io/data/

------

COVID articles

Axios reviews what it means to enter another COVID wave without a Public Health Emergency. No free testing and limited support for health systems is uncharted territory.

https://www.axios.com/2023/08/04/covid-uptick-cases-hospitalization-future

I recommend my patients think of COVID vaccines like the yearly flu vaccination - part of a good health maintenance regimen.

https://www.nbcnewyork.com/news/business/money-report/new-covid-vaccines-are-coming-to-the-u-s-this-fall-but-uptake-may-be-low-heres-why/4547080/

Two public health researchers from Canada published a thoughtful exploration of politicians who "follow the science" or don't. Speaking about science at either extreme of epistemology - as either 1) an absolute truth or 2) a total uncertainty is fallacious. Nevertheless, it is hard for political leaders to advocate for policies that reflect uncertainty and the hazy world of "best available evidence." I am sympathetic to politicians attempting to enact public policy in the face of rapid evolutions of what is

"known" and uncertainty.

https://theconversation.com/the-illusion-and-implications-of-just-following-the-science-covid-19-messaging-210786

Dr. Eric Topol sums it all up in his blog post:

"The Virus is Learning New Tricks and We Humans Keep Falling Behind"

https://erictopol.substack.com/p/the-virus-is-learning-new-tricks

Medical Trends and Technology

Last week LK99, the maybe room temperature superconducting material, garnered significant public attention. AOH1996, a cancer drug just out of Phase I trials, also received some attention with fantastic headlines like "Cancer Pill Annhilates all Solid Tumors." The drug blocks a protein called PCNA (Proliferating cell nuclear antigen - a protein that can repair DNA), which takes on some unique isoforms in cancer cells. Cancer-cell-specific PCNA is a marker of cancerous cells acquiring resistance to standard chemotherapy. Essentially, AOH1996 keeps cancer cells from repairing themselves when chemotherapeutic agents disrupt cancer cell DNA. The difference between the hype in the media, the Cell journal article, and some oncologists' analyses is striking.

Journal Article

https://www.cell.com/cell-chemical-biology/fulltext/S2451-9456(23)00221-0?rss=yes

Great Tweetorial from Mayo Oncologist Dr. Pashtoon Kasi

https://twitter.com/pashtoonkasi/status/1688197960721444864

Typical article/headline "City of Hope scientists develop targeted chemotherapy able to kill all solid tumors in preclinical research."

https://www.prnewswire.com/news-releases/city-of-hope-scientists-develop-targeted-chemotherapy-able-to-kill-all-solid-tumors-in-preclinical-research-301888576.html

Infographics

An article from 2014 on visualizing life's accomplishments is simultaneously fascinating and horrifying.

https://www.huffpost.com/entry/your-life-in-weeks_b_5366289

Things I learned this week

Work-life balance, embalming your dead relatives, brewing beer, and scorpions were excuses to miss work in ancient Egypt. While it is unclear what PTO rules were like during the reign of Ramses II, keeping attendance of who was working was a thing. How many millennia have bosses replied to their absent employee, "Horemwia, did you embalm that grandmother last month?"

https://mymodernmet.com/ancient-egyptians-attendance-record/

and

https://www.britishmuseum.org/collection/object/Y_EA5634

Civil War Wounds That Glowed. I learned about glowing bacteria that prevented gangrene at the Civil War battle of Shiloh and the high school students that won a 2001 science fair project explaining.

https://www.latimes.com/archives/la-xpm-2001-jul-02-he-17705-story.html

and

https://www.promegaconnections.com/angels-glow-bioluminescence-uncovered-on-the-battlefield/

Living with A.I.

I have been playing with A.I. text-to-speech tools with the voices of famous people and almost natural-sounding humans (this one https://filme.imyfone.com/voice-recorder/). However, it appears A.I.-driven "single shot" voice-to-voice cloning will be common. In other words, a small sample of a person's voice will be enough to use their voice to repeat anything without a text script and even when the original speaker and the target speaker use different languages (see the cross-language conversions at the bottom of the page).

https://hiervst.github.io/

and

https://twitter.com/asifrazzaq1988/status/1686653974743830528

and

https://twitter.com/dreamingtulpa/status/1686649903525584896

A.I. art of the week

8-armed physician wearing a stethoscope playing bingo with markers in multiple hands and many bingo cards at the table. In the style of Marc Chagall.

https://www.bing.com/images/create/8-armed-physician-wearing-a-stethescope-playing-bi/64d0c486a9154676be9707333dc5dd1b?id=6eF%2fFZb7YhJczekpPpYojQ%3d%3d&view=detailv2&idpp=genimg&FORM=GCRIDP&mode=overlay

Clean hands and sharp minds,

Adam