Week of June 24, 2024
A bear and its cub did not eat me on our family trip to Vermont last week. The bears ignored me - passing a few feet from our Airbnb, apparently more interested in knocking over and licking grills on other condo's porch. While I was grateful not to have been the bears' breakfast, I experienced a surprising and irrational sense of rejection - like being 13 and getting picked last in gym class. I am amazed at the hidden persistence of middle school's psychological scars.
See bears with grills (and not eating Adam).
https://drive.google.com/file/d/1IEAlcj7j7FdkWUemM34DDtnfut0dLkVU/view?usp=sharing
Yet again, the internet provides validation and community. In 2020, the N.Y. Times reviewed And Then They Stopped Talking to Me, a book about middle school trauma.
https://www.nytimes.com/2020/05/05/books/review/and-then-they-stopped-talking-to-me-judith-warner.html
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Without consistent public reporting of either COVID testing or hospitalizations, reliable quantitative data is not knowable. However, over the last seven days, anecdotal reports about COVID-19-infected individuals amongst those in my social and professional circles is increasing. RNA concentrations in wastewater are on an upward trend.
The Pandemic Mitigation Collaborative (PMC) website uses wastewater levels to forecast 4-week predictions of COVID rates.
https://pmc19.com/data/
based upon https://biobot.io/data/
Wastewater Scan offers a multi-organism wastewater dashboard with an excellent visual display of individual treatment plant-level data.
https://data.wastewaterscan.org/
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COVID articles
University of Lisbon Immunologist Dr. Marc Veldhoen reviewed a recently published paper by a group of known anti-vaccine/anti-science physicians. Dr. Veldhoen's review is a mini-class on scientific misinformation. Logical fallacies permeate the reviewed article - selection bias in the study group (older adults who received a COVID vaccine and then died), conflating association with causation (the COVID vaccine was temporally associated with the patients' demise, therefore the cause), and circular logic (we will look at recently deceased patients who received the COVID vaccine to demonstrate the vaccine is associated with death).
https://x.com/marc_veld/status/1804438068339810415
Here is a Wikipedia article about the senior author of the intellectually fallacious paper.
https://en.wikipedia.org/wiki/Peter_A._McCullough
In the last few weeks, Dr. Fauci released an autobiography, part of which The Atlantic published. Dr. Fauci captures the difficulty of translating scientific knowledge (or lack of complete knowledge) into urgent public policy. My favorite quote from the article was, "Admitting uncertainty is not fashionable in politics these days, but it is essential in my work. That's the beauty of science. You make a factual observation. If the facts change, the scientific process self-corrects. You gather new information and data that sometimes require you to change your opinion. This is how we better care for people over time. But too few people understand the self-corrective nature of science. In our daily press conferences, I tried to act as if the American public were my patient, and the principles that guided me through my medical career applied."
https://www.theatlantic.com/magazine/archive/2024/07/anthony-fauci-covid-trump-white-house-response/678491/?gift=wRB5v0WyIdmVLiiSUSDcYRkr3EfqQgd0iSWpvixj9tI&utm_source=copy-link&utm_medium=social&utm_campaign=share
Medical Trends and Technology
One of the many reasons I love the internet is for quick, timely deep dives on complex topics. Pediatrician Dr. Vipin Vashishtha reviews recent research on the link between the microbiome and food allergies. You will have a newfound love for your symbiotic relationships with the bacteria Anaerostipes caccae, the butyrate-generating friend you didn't know you needed. Please keep in mind that the University of Chicago researchers worked with mice. Based on this data alone, I would not advise my patients (or you) to take action.
https://x.com/vipintukur/status/180435581265317524
and
https://www.cell.com/cell-host-microbe/abstract/S1931-3128(24)00191-4#%20
Gilead published the first data from a phase 3 trial on a *twice-yearly* injectable drug, Lenacapavir, that offers Pre-exposure prophylaxis (PrEP) against acquiring HIV. None of the 2000 South African patients receiving Lenacapavir acquired HIV during the study. FDA approval is contingent on a repeat of the phase 3 trial, but the data so far is pretty amazing.
https://x.com/sailorrooscout/status/1804172445269790896
and
https://www.poz.com/article/twiceyearly-lenacapavir-prep-prevents-hiv-women
Infographics
There is nothing quite like a well-referenced infographic on the history of sewers and plumbing. Sadly, I can only find a full-size version on Reddit.
https://www.reddit.com/r/coolguides/s/G5wI25vtXH
Things I learned this week
Twitter doctors introduced me to phrase "Daughter from California Syndrome," - a reasonably common situation in which a previously disengaged relative challenges the care of an elderly patient, especially at the end of life. While I have experience with families like this, I never knew a named “syndrome” existed.
https://x.com/coffeeblackmd/status/1804230503819808780
The phenomenon is so common the syndrome has a Wikipedia page: https://en.wikipedia.org/wiki/Daughter_from_California_syndrome
For World Music Day, Science Magazine re-shared a 2019 study looking at the similarities in music across numerous human cultures. The researchers "[used] computational social sciences tools to answer six questions. Does music appear universally? What behavior is associated with song, and how do they vary among societies? Are the musical features of a song indicative of its behavioral context (e.g., infant care)? And, do songs' melodic and rhythmic patterns vary systematically, like those in language?" The results demonstrated that [aside from late 70s horror punk like Glen Danzig from the Misfits] music is surprisingly consistent amongst many ethnicities. The graphic in the Twitter link is quite striking.
https://www.science.org/doi/10.1126/science.aax0868
and
https://x.com/sciencemagazine/status/1804190065179934862
and
https://en.wikipedia.org/wiki/Glenn_Danzig
(I was joking about the Misfits - the research did not single out American punk in any way - my apologies to my readers who have a history of wearing black lipstick and spiked leather bracelets.)
Living with A.I.
Like crypto-mining, The processors powering artificial intelligence require an enormous and increasing amount of electricity. Forbes is one of many magazines covering this topic (as is Bloomberg and Reuters). [How and why stories make it into mass media is interesting in and of itself...] I saw several comments in discussions on this (and related) articles, recalling that a central premise of the Matrix movies was that humans were the power source for A.I. in some dystopian future.
https://www.forbes.com/sites/bethkindig/2024/06/20/ai-power-consumption-rapidly-becoming-mission-
critical/
Wharton professor Daniel Rock shared data from his recent Science paper that quantifies the impact of LLMs on various occupations. The paper is behind a paywall, but the second Twitter link has a critical graphic from the research demonstrating how impactful LLMs may be to the legal profession.
https://x.com/danielrock/status/1804163899513520256
and
https://x.com/emollick/status/1804376540349604314
A.I. art of the week (a text to visual mashup of topics from the newsletter)
A bear dressed as a 1980s punk rock musician, with spiked hair and spiked bracelets is playing the guitar and connected via wires to computers. The bear is surrounded by lab equipment, such as test tube racks, microscopes, Florence flasks, and burners. A hydrangea is in the background, and a Ben and Jerry's poster is on the wall behind the bear.
https://drive.google.com/file/d/1Kf0OOmki_6hvQHNV7Cirh7xcR6Y9Beei/view?usp=sharing
Clean hands and sharp minds, team
Adam
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