Week of September 4, 2023
It is challenging to stay engaged while your second kid gets comfortable driving a car in an empty parking lot. We will see what psychological scars emerge from me calling him Iceman, making him call me Maverick, and playing the Top Gun soundtrack while going in circles at 8 miles per hour. Between my son suggesting the song Danger Zone was "thematically inappropriate" for driving lessons and my exaggerated jerking (like an F-14 landing on a carrier while pulling into a parking spot), I may have crossed the line from witty father-son bonding to being abandoned in a nursing home in my later years.
P.S. I am traveling this week and next - no newsletter on September 11.
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COVID-related hospitalizations are up 30% from last week. The rate of rise of wastewater samples nationally may be leveling off. COVID cases are surging (mostly likely due to XBB variants for now, given the wastewater genotyping). The question is, how bad will this surge get?
The N.Y. Times COVID Tracker uses only CDC-gathered hospital data as a surrogate (lagging) indicator of case rates.
https://www.nytimes.com/interactive/2023/us/covid-cases.html
Wastewater monitoring is more of a LEADING indicator.
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COVID articles
Dr. Jeremy Faust uses his latest Substack post to discuss his experiences at the U.S. Open. It is a good discussion on people who use the phrase "I have A flu," and the value of wearing masks in intermittently and in high-risk situations.
https://open.sub-stack.com/pub/insidemedicine/p/a-flu-at-the-us-open-hmm-and-why
CNBC offered an article reviewing CDC guidance on when to wear masks. Using reported case rates for a geographic area (the county level ) ignores:
- The delay in reporting.
- The reliance on self-identification of symptoms and testing.
- Situations like traveling.
Nevertheless, it is a good reminder to protect the immunocompromised and elderly.
Medical Trends and Technology
A.I. continues demonstrating value in screening for subtle and early disease detection. A recent study looking at breast cancer screening from 3-dimensional mammography is an excellent example of how to successfully demonstrate the utility of artificial intelligence - a good data set spanning many years, known outcomes, and a goal to augment human judgment, not replace it.
https://pubs.rsna.org/doi/full/10.1148/radiol.211105
and
https://twitter.com/isciverse/status/1698167865139232795
In contrast, Harvard and Sloane Kettering oncologists recently tested Chat GPT 3.5's performance to provide breast, prostate, and lung cancer treatment recommendations compared with the National Comprehensive Cancer Network (NCCN) guidelines. The results were disappointing and speak to A.I.'s difficulty with clinical support of more open-ended questions (as opposed to looking for subtle patterns in dense, narrow data sets - like radiology images). It will be interesting to see how these data change as LLMs evolve. "Researchers found that 34 percent of the responses also included one or more non-concordant recommendations, which were sometimes difficult to detect amidst otherwise sound guidance. A non-concordant treatment recommendation was only partially correct; for example, for a locally advanced breast cancer, a recommendation of surgery alone, without mention of another therapy modality. Notably, complete agreement occurred in only 62 percent of cases, underscoring both the complexity of the NCCN guidelines and the extent to which ChatGPT's output could be vague or difficult to interpret."
https://jamanetwork.com/journals/jamaoncology/fullarticle/2808731
Infographics
The chemistry of Barbie. She is a complex lady made from polyvinyl dichloride, ethylene-vinyl acetate, PVC, and acrylonitrile butadiene (ABS - the same stuff as Legos!). To be sure, Barbies (and Lego) will be around long after humans are extinct.
https://www.compoundchem.com/2023/08/18/barbie
Things I learned this week
It was a week of clickbait learning.
There is such a thing as a scorpion farm. On such farms, "workers use a pair of tweezers and tongs, 'milking' tiny drops of scorpion venom (each one produces 2 milligrams per day) into a receptacle." The venom is frozen, powdered, and sold to various industries for about $10 million per liter. Serious Meet the Parents vibes here.
and
https://www.youtube.com/watch?v=6kVOancKOrY
and
Meet the Parent's cat-milking scene for reference
https://www.youtube.com/watch?v=bXNwzKo5Yps
One example of scorpion venom's medical utility:
https://news.stanford.edu/2019/06/10/healing-compounds-scorpion-venom/
I found this piece on the origins of the brand Hidden Valley Ranch fascinating. A guy named Steve invited Ranch Dressing (in the 1950s), who resorted to selling the ingredients in mail-order packets in the 1960s after his California dude ranch failed. Of the many weird facts in the article, the 2017 limited sale of 5-liter kegs of ranch dressing was the most intriguing. You can still buy them on eBay.
https://www.mashed.com/254830/the-untold-truth-of-hidden-valley-ranch/
and
https://www.ebay.com/itm/186023596272
Living with A.I.
Yale's Center for Teaching and Learning director, Jenny Frederick, is interviewed in Technology Review. Frederick offers many insights about the changing education landscape and the role of LLMs - "It's a moment in society that's challenging how we think about humans, how we think about knowledge, how we think about learning and what it means."
https://www.technologyreview.com/2023/09/04/1078932/elite-university-chatgpt-this-school-year/
Contrast the above with the Washington Post's Hollywood writers' strike overview. It is all about A.I.
https://www.washingtonpost.com/lifestyle/2023/09/04/writers-room-hollywood-strike/
A.I. art of the week
"Van Gogh-style painting of two scorpions wearing sunglasses driving a car with wings while drinking glasses of milk"
Clean hands and sharp minds,
Adam
Look for the next update on 9/18/23
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