Week of November 20, 2023
Happy Thanksgiving (for the U.S. readers)
My iPhone beckoned me for the three hours and twenty-six minutes of watching Killers of the Flower Moon. The theater's reclining stadium seat put my phone at eye level (on the little table), taunting me to pick it up with notifications and alerts. It is surprisingly challenging to fight the dopamine-fueled desire to watch a movie while Googling background material. I am (apparently) late to learn the term 'second screening,' but I am comforted to know I am not alone in my operant conditioning.
Only a minority of people report rarely or never multi-tasking while watching media.
https://big-village.com/news/the-rise-of-second-screens/
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Hospitalizations are starting to rise, while wastewater RNA concentrations have leveled off. I suspect we will see an uptick in cases as people travel and gather for the holidays. I strongly recommend getting the latest COVID vaccine and, at least, strategic masking during holiday travel in planes and trains (and other enclosed, highly populated spaces)
The N.Y. Times COVID Tracker reflects only CDC-gathered hospital data. Hospitalization data are a (lagging) indicator.
https://www.nytimes.com/interactive/2023/us/covid-cases.html
Wastewater monitoring is more of a LEADING indicator.
The Inside Medicine COVID dashboard
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COVID articles
The Kaiser Family Foundation is also concerned about the holidays - "KFF COVID-19 Vaccine Monitor November 2023: With COVID Concerns Lagging, Most People Have Not Gotten Latest Vaccine And Half Say They Are Not Taking Precautions This Holiday Season."
And here are some of the COVID data I've seen in my news feeds:
"In its monthly Current Population Survey, the census asks a sample of Americans whether they have serious problems with their memory and concentration. (The census defines them as disabled if they answer yes to that question or one of five others about limitations on their daily activities. The questions are unrelated to disability applications, so respondents don't have a financial incentive to answer one way or another.)[...] In 2020, the survey estimated there were fewer than 15 million Americans ages 18 to 64 with any disability. By September 2023, the census estimated the number of disabled rose to about 16.5 million." The rise is most attributable to long COVID symptoms.
https://www.nytimes.com/2023/11/13/upshot/long-covid-disability.html
Dr. Eric Topol highlights (literally - click the link) how researchers are looking at drugs to slow brain aging (called senolytics and used most typically for dementia-like diseases) MAY be of use in COVID-19-damaged brain cells. I note the research is in-vitro - i.e., using brain tissue samples. Either way, this is how science works - and data like these point the way toward therapy for people at scale.
comments
https://twitter.com/EricTopol/status/1724102295040995350
and highlighted journal article images
https://twitter.com/EricTopol/status/1725573064736547237/photo/1
https://twitter.com/EricTopol/status/1725573064736547237/photo/2
A brief, related aside - The Census Bureau may be changing how it measures the concept of "disability" - moving from binary yes/no questions on its current disability survey tool to Lickert responses in a survey tool developed by a United Nations workgroup. Changing the survey tool presents many trade-offs, and this Science article offers a fantastic analysis of how data collection and analysis can impact public policy.
Texas has banned vaccine requirements for all private businesses, including hospitals. Immunocompromised and chronically ill patients are at greater risk.
https://www.texastribune.org/2023/11/13/texas-disabled-covid-vaccine-ban/
Medical Trends and Technology
STAT News published a thorough and easily understood article about the soon-to-be FDA-approved CRISPR-based therapy to treat sickle cell disease, Casgevy. The process is complex - a patient's stem cells are collected, the harvested cells' DNA is edited with CRISPR, patients receive a chemotherapeutic regimen to remove their remaining stem cells, and the edited cells are re-infused. It is, in essence, an autologous bone marrow transplant. However, Casgevy will be the first FDA-approved therapy of this kind. It will not be the last, for sure.
https://www.statnews.com/2023/11/16/crispr-vertex-sickle-cell-beta-thalassemia-casgevy-approval/
There are a lot of medical websites that offer summaries of posters and abstracts presented at various conferences. Posters and abstracts can be exciting but often don't merit a full journal article (perhaps due to the preliminary nature of the work or the lack of substantive or novel findings). Either way, this recent article caught my attention. The research uses machine learning to understand the patterns of hormonal metabolites in the urine to aid in a variety of endocrine-induced hypertension diagnoses, such as primary hyperaldosteronism, Cushing's disease, etc. In practice, hormonal causes of high blood pressure are difficult to diagnose. This abstract highlights an excellent example of how machine learning can aid physicians in more timely and accurate diagnoses. In this instance, a trained algorithm can (better than a human) detect subtle patterns of various proteins in the urine.
and the abstract
https://www.endocrine-abstracts.org/ea/0094/ea0094OC5.1
Infographics
Back to my friends at Compound Interest - here is the Chemistry of Cider: https://twitter.com/compoundchem/status/1726003507780575647/photo/1
Who amongst us does not enjoy the rich aroma of 2-methyl-4-pentyl-1,3-dioxane?
Things I learned this week
Thanks to HBO's Julia series, I learned about Judith Jones, the editor who discovered and then helped publish Mastering the Art of French Cooking. I love reading about people like Jones. She was a nexus of 20th-century intellectual, culinary, and literary culture. In addition to Julia Child and James Beard, Jones "discovered" The Diary of Ann Frank, translated Sartre and Camus, and was the long-time editor of John Updike, Ann Tyler, and Sylvia Plath. She is on my list of people I would have liked to have lunch with.
https://en.wikipedia.org/wiki/Judith_Jones
and
https://www.nytimes.com/2007/10/24/dining/24jone.html
According to her friend and biographer, there is a lot the show gets wrong about Jones.
and
https://www.goodreads.com/book/show/62918528-the-editor
Living with A.I.
ChatGPT now has the ability for any user to develop highly-tuned, single-topic GPTs, stand-alone mini versions of ChatGPT that are separate from the main program. Prepare to see an onslaught of new tools emerge.
https://openai.com/blog/introducing-gpts
and
https://pub.towardsai.net/using-gpts-openais-no-code-builder-of-personal-ai-apps-276d284c7f2a
Examples from healthcare: https://physiciangpts.com/
Wired published an interview with Sam Liang, CEO of Otter (an A.I. transcription company), who advocates for "allowing A.I. to record and transcribe your life" to expand your memory and, more forward-looking, your capacity. Here is a quote from the article that caught my attention: "For Liang, that's just the beginning. He tells me Otter is working on an avatar feature that "would enable him to run a meeting without bothering to attend. It's essentially a chatbot built around years of past data on his contributions in meetings. ''I'm often double-booked, so for those meetings, I can send my avatar, which can answer probably 90 percent of the questions people ask me," he says. I ask him if that might be risky-"What if the avatar okays a business plan that tanks the company? "We'd give it only a certain level of authority," he says after considering the concept. "Hey, maybe you can approve anything less than $10,000."
https://www.wired.com/story/the-case-for-using-ai-to-log-your-every-living-moment/
A.I. art of the week - based on the topics above.
A picture of smartphones sitting at a table having a meeting. On the screen are avatars of people. There are glasses of pixelated cider on the table. One of the Smartphones has a speech bubble that says, "The virtual board of directors approves the mass editing of DNA with CRISPR."
https://drive.google.com/file/d/1awq6e5tVQBFrWovEE-4cxU4yPt4j3CEM/view?usp=sharing
Creepy, and yet not quite right.
Clean hands and sharp minds,
Adam
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