Week of April 22, 2024
My clinic patients seem to be living through a pandemic of pessimism. Comments that the world is "dangerous" and filled with "bad people" are common. (On Friday, one patient told me he believes 50% of the world's 7.9 billion people are evil!) Unsurprisingly, many of these patients consume massive amounts of news (from across the political spectrum). While I am unsure how to shift my patient's worldview, my more positive patients seem to feel better, irrespective of their degree of illness.
A quick web search introduced me to "doomers and doomerism." For example, in 2023, Vox offered a series of articles about staying optimistic. https://www.vox.com/the-highlight/23632673/against-doomerism
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Hospitalizations and death rates are currently low, but increasing wastewater concentrations suggest rising case numbers in the coming weeks.
The Pandemic Mitigation Collaborative (PMC) website uses wastewater levels to forecast 4-week predictions of COVID rates.
based upon https://biobot.io/data/
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
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COVID articles
Eric Topol's latest blog post covered the data suggesting a new wave of COVID toward June, data explaining the mechanisms of more severe coronavirus symptoms and worse outcomes in older adults, and a new type of low-dose, skin-injected self-amplifying mRNA (SAM) COVID vaccines. If nothing else, Topol's discussion of the SAM vaccine boosters and the ongoing work on nasal vaccines is worth reading.
https://erictopol.substack.com/p/are-we-flirting-with-a-new-covid
Here are a few direct links:
About SAMs
https://www.nature.com/articles/s41591-024-02955-2
Update on mucosal (including nasal) vaccines
European researchers published an interesting article examining COVID transmission by correlating COVID-19-positive patients and their credit card purchasing history. "We estimate transmissions by comparing the infection rate of exposed customers, who made a purchase within 5 min of an infected individual, and nonexposed customers, who made a purchase in the same store 16 to 30 min before. We find that exposure to an infected individual in a store increases the infection rate by around 0.12 percentage points (P < 0.001) between day 3 and day 7 after exposure." This study has some logical flaws but validates that retail environments are associated with airborne illness transmission.
https://www.pnas.org/doi/10.1073/pnas.2317589121
and excellent discussion of the data:
https://twitter.com/MichaelSFuhrer/status/1781874980692910540
Medical Trends and Technology
A loyal reader shared this politico article about physician malpractice in an era of AI-driven decision-support tools and risk scores. Who is responsible if a patient receives too little (or too much) care due to inappropriately being identified as low-risk (or high-risk) by a machine-learning algorithm? What is a sound regulatory framework to protect patients, physicians, and medical device/software developers? While none of these questions are new (drug-drug and drug-allergy alerts have been around for 15+ years), the topic is increasingly urgent, given the rapid innovations we are seeing.
https://www.politico.com/news/2024/03/24/who-pays-when-your-doctors-ai-goes-rogue-00148447
If you have never explored structural biology, look at Prashant Singh's post and paper about the biological motor powering Salmonella's flagellum. The molecular motor offers different gear ratios. It is striking how biology and engineering converge on a common mechanism for efficiently translating energy into motion.
https://twitter.com/prash_singh/status/1780522588873040316
and
https://www.nature.com/articles/s41564-024-01674-1
I could not resist sharing an article entitled "Mutated Strains of Unknown Drug-Resistant Bacteria Found Lurking on International Space Station." It is a bit concerning to learn that astronaut scientists have found multidrug-resistant Enterobacter present and evolving under the pressures of low gravity and other challenges unique to a space-based environment. Aside from the potential for yet another terrible Amazon Prime horror movie (Maybe Galactic Enterobacterpocalypse in the spirit of Sharknado and Llammageddon), this is a fascinating validation of my often-used favorite Michael Crichton quote, "Life finds a way."
https://pubmed.ncbi.nlm.nih.gov/38521963/
and
https://gizmodo.com/mutated-strains-drug-resistant-bacteria-iss-1851416863
Infographics
Ancestry.com for robots?
https://s10251.pcdn.co/wp-content/uploads/2024/04/2024-humanoids-viz-mv3-scaled.jpeg
from https://lifearchitect.ai/humanoids/
Things I learned this week
I learned about sequential grading bias- when teachers lower grades as time passes during a grading session. When teachers grade in alphabetic order (by last name), students whose last name starts with letters beyond E receive lower grades, on average.
"[R]esearch uncovered a clear pattern [- grades declined] as graders evaluate more assignments. According to Wang, students whose surnames start with A, B, C, D, or E received a 0.3-point higher grade out of 100 possible points than compared to when the [same students] were graded randomly. Likewise, students with later-in-the-alphabet surnames received a 0.3-point lower grade—creating a 0.6-point gap.
[F]or a small group of graders (about 5%) that grade from Z to A, the grade gap flips as expected: A-E students are worse off, while W-Z students receive higher grades than when graded randomly. Such observations confirm their hypothesis that the grading order leads to a grade gap."
https://twitter.com/pitdesi/status/1781711023319502921
and
https://phys.org/news/2024-04-grades-students-surnames-alphabetical.html
I learned about John Bauer, a Swedish artist who died at age 36 in 1918. Bauer pioneered a unique fantasy artwork style that inspired much of the art found in today's animation and video games.
https://twitter.com/culturaltutor/status/1778076683527918032
and
https://en.wikipedia.org/wiki/John_Bauer_(illustrator)#Legacy
Living with A.I.
Boston Dynamics has retired the hydraulic-actuated Atlas robot and introduced electric-actuated models. They should juxtapose a disconcertingly flexible robot (it articulates 360 degrees at all its joints) with a friendly smile and a British accent.
https://twitter.com/lexfridman/status/1780703587947180175
Interview with the former Boston Dynamics CEO, who is now working on adding A.I. to robotic frames at the company. This podcast is excellent and worth watching - with the idea that building robots is about understanding humans.
https://www.youtube.com/watch?v=5VnbBCm_ZyQ
I learned that last week was National Robotics Week.
https://www.designnews.com/industry/robots-are-advancing-quickly
The U.S. Air Force is testing AI-driven fighter jets that successfully engage in dogfighting. I await Tesla's upgrade of this functionality for my car.
https://theaviationist.com/2024/04/18/ai-flew-x-62-vista-during-dogfight/
A.I. art of the week
"A 12-armed, 2-headed teacher grading papers with each arm."
https://drive.google.com/file/d/12Bd8NlrRuhPhYoXyOPgGEz40LoQymN_1/view?usp=sharing
Clean hands and sharp minds, team
Adam
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