Week of September 30, 2024
Recent plane trips provided the opportunity to finish editing and posting the entire archives of this newsletter at http://www.whatadamisreading.com/. While I never anticipated the newsletter could be a diary or memoir, I am glad to have saved my (first daily and now weekly) reflections on the pandemic, science, politics, and random readings. I enjoyed reading the evolution of my thinking, of things that piqued my interest, and of the small, easily forgotten details of life (especially during the Spring of 2020). Most of all, I am grateful to the many of you who tell me you look forward to starting Monday's email. The feedback and encouragement keep me writing.
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We are down to about 1 in 45 Americans currently infected, with projected daily infections still higher than almost any previous year. Be aware that October is a historic lull that rises again after Thanksgiving.
Mike Hoerger, PhD, director of the PMC (next paragraph), shared some commentary on recent CDC data revisions - which speaks to the many ongoing concerns about public health data.
https://x.com/michael_hoerger/status/1840252021644861894?s=42
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
Newly published nasal-spray COVID vaccine data indicates good efficacy and minimal side effects. (Woot!)
"An open-label, single-center, investigator-initiated trial was carried out on 128 health care workers who had never been infected with SARS-CoV-2 and had previously received 2 or 3 injections of inactivated whole-virus vaccines, with the last dose given 3–19 months previously (median 387 days, IQR 333–404 days). Participants received 2 intranasal sprays of NB2155 at 28-day intervals between November 30 and December 30, 2022."
and
"A 2-dose intranasal vaccination regimen using NB2155 was safe, was well tolerated, and could dramatically induce broad-spectrum spike-specific sIgA in the nasal passage. Preliminary data suggested that the intranasal vaccination may establish an effective mucosal immune barrier against infection and warranted further clinical studies."
https://insight.jci.org/articles/view/180784
and
https://x.com/kashprime/status/1838961919970967825
I've followed a small pharma company (BioXyTran) for about a year. Their product pipeline includes novel proteins that block multiple viruses from entering human cells. Recently published new data about a pectin-derived polysaccharide called "ProLectin M" or PL-M). P-LM has, so far, demonstrated significant, broad antiviral activity in small clinical trials. While this product is far from scaled or ready for use, I am amazed at how much the pandemic has taught us about viruses and viral infections. [For full disclosure, I own some of BioXyTran stock as part of a poorly performing biotech portfolio.)
https://x.com/enemyinastate/status/1838930051657609481
from
https://esmed.org/MRA/mra/article/view/5616
and
https://pubmed.ncbi.nlm.nih.gov/37112643/
Medical Trends and Technology
Last week, the FDA approved FluMist (the nasal flu vaccine that is a live, attenuated flu virus) for home administration. This approval allows children, home-bound, and other disabled individuals a broader opportunity to receive this vaccine. Previously, FluMist had to be administered by a healthcare worker. (FYI - live attenuated virus vaccines may not be safe for everyone, so speak with your doctor about whether this or the traditional injectable flu vaccine is better for you.)
https://www.webmd.com/cold-and-flu/news/20240923/fda-approves-first-at-home-nasal-flu-vaccine
In the last few years, I have seen an increasing number of studies examining how exercise types, volume, and duration impact cardiovascular risk. The most recent study (linked below) speaks to the intensity question - demonstrating that short, high-intensity workouts may reduce cardiovascular risk more than longer-duration workouts. (My gestalt takeaway from several studies is that about 30-40 minutes of daily intense mixed cardio and resistance training is most valuable).
https://x.com/mohammedalo/status/1836879343827460419
and
https://pubmed.ncbi.nlm.nih.gov/39276370/
More antiviral prophylactic nasal sprays are being developed, this time by Harvard researchers.
Abstract only
https://onlinelibrary.wiley.com/doi/10.1002/adma.202406348
and
Details from the paper
https://x.com/sailorrooscout/status/1840466656851546403
Infographics
The BMJ infographic looking at symptoms and referral advice for adults with suspected cancers is overwhelming and fascinating. If there were infographic police, they would surely arrest the designer for using overlapping, tangled (nearly metastatic?) lines. My apologies to readers who tend toward hypochondriasis - the Dr. Googles in the audience may find some rabbit holes here.
https://www.bmj.com/content/bmj/suppl/2015/07/17/bmj.h3044.DC1/adult_cancer_NICE_graphic_v3.1.pdf
Things I learned this week
I feel like Nat Geo writers are speaking directly to me when they title articles, "Why do octopus punch fish?" -- tantalizing headlines like checkout line tabloids for biology nerds. The hypothesis is that reef-dwelling sea creatures (a team of fish and an octopus) cooperatively work together when acquiring food. When a scavenging fish (certain types of grouper, for instance) disrupts inter-species cooperation, the octopus punches the non-team player fish. That makes octopuses a kind of Mad Max of the coral reef - an anti-hero struggling against the chaos in an amoral, Darwinian competition for food. (I realize coral reefs are not dystopian, post-apocalyptic landscapes, but there are reefs in Australia – hence, Mad Max.)
https://www.nationalgeographic.com/animals/article/octopuses-punch-fish-predators-red-sea
In my endless fascination with language, I learned about the prophetic perfect tense, a literary technique that describes future events with such certainty that past tense conjugations are employed, implying the events are preordained. This tense permeates religious writing, and thanks to ChatGPT, I can use the prophetic perfect tense to write banal stories about finding the perfect cantaloupe.
"You will have entered the bustling market, and your eyes will have scanned the vibrant display of fruits. The cantaloupes will have sat in a neat pile, and their warm, earthy scent will have filled the air. You will have known which one to choose, for the signs will have revealed themselves.
First, your hand will reach the nearest cantaloupe, and you will lift it gently, testing its weight. The ideal melon will have felt heavy for its size, a sure sign of juicy ripeness. Your fingers will have traced the skin, noting the slight give when pressed, signaling it will have been ready to eat. Next, you will have turned it in your hands, inspecting the web-like netting on its surface, which will have been raised and uniform, marking the best of its kind.
Finally, you will have lifted it to your nose, inhaling deeply. The sweet fragrance will have confirmed what you will have already known: this cantaloupe was the perfect choice, its flesh succulent and flavorful, awaiting only the moment the melon was sliced to enjoy its golden bounty."
Amen.
https://en.wikipedia.org/wiki/Prophetic_perfect_tense
Living with A.I.
In the spirit of the prophetic future tense, it is fun to look back at a 2017 Medical Futurist article that attempted to define healthcare's digital transformation future. Seven years is a long time, and a pandemic, value-based care, and A.I. were not on the author's mind. However, their trajectory is correct. The article has some lovely summary infographics, too.
https://medicalfuturist.com/digital-health/
Wordfreq is open-source software that uses various web-based resources (like certain websites, X and Reddit) to monitor English word usage. As of June, they are no longer updating the data due to the proliferation of generative A.I. text on the web. What is interesting is that LLMs must be intermittently updated with new information to stay relevant. But, if LLMs update on an increasing quantity of LLM-generated text, we may find LLMs start to drift toward an AI-generated mean - where new information used for training is, more and more, the output from other versions of generative language engines (and contain all the errors that generated text contains).
https://pivot-to-ai.com/2024/09/19/word-frequency-tool-wordfreq-stops-updates-overwhelmed-by-ai-spam/
and
https://github.com/rspeer/wordfreq/blob/master/SUNSET.md
A.I. art of the week (A visual mashup of topics from the newsletter).
An octopus is holding nasal spray bottles in each of its arms. Out of each bottle, a long string of colorful rope squirts upward. The ropes are getting tangled. The octopus is on a treadmill and appears sweating while hooked to a heart rate monitor.
https://drive.google.com/file/d/1lg6jO5B81vOOrG1cGT7RJToGhDjMdsVp/view?usp=sharing
Clean hands and sharp minds,
Adam
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