Week of December 9, 2024
Last week, I advised a patient to go to the emergency room urgently. Unfortunately, this patient conflates good care and customer service - he dislikes and refuses medical advice that inconveniences him. Though his medical data pointed to a potentially life-threatening issue, he needed time to work through the Kubler-Ross stages of grief. Though he expressed gratitude for my concern (in between his rapid cycles through denial, anger, bargaining, depression, and acceptance), I felt exasperated. While I did not ask the question screaming in my head ("Are you seriously willing to die for this inconvenience?"), I felt the challenge of respecting patient autonomy in the face of ill-informed and poorly made choices.
P.S. He wouldn't let me speak with his wife, but he must have told her what was happening as he went to the ER (at her insistence) the next day. Thank goodness he did OK despite the delay.
Thanks to Quora, I learned that the proverb about 'leading a horse to water' has been continuously used since the 12th century. As our friends in the 1100s said, "Hwa is thet mei thet hors wettrien the him self nule drinken [who can give water to the horse that will not drink of its own accord?]."
https://www.quora.com/What-is-the-origin-of-the-idiom-You-can-lead-the-horse-to-the-water-I-have-heard-it-in-more-than-one-language-What-part-of-the-world-does-it-originate
---
I ran out of time to generate the podcast this week; the virtual hosts will return next week. (They needed a break? Are there AI work rules?)
------
Science and Technology Trends
Eric Topol's blog offered a review of 6 recent studies, all pointing to a new understanding of the relationship between the brain and the immune system. The "conventional scientific wisdom" is the brain is isolated from the rest of the immune system. Not only does recent research show this to be false, but there is now research suggesting the brain plays a role in up and down-regulating immune cells. Topol's post is an excellent example of how a broad reading of the medical literature demonstrates how scientific understanding changes incrementally.
https://erictopol.substack.com/p/guardians-of-the-brain
I found this editorial for Nature Biotechnology that demonstrates the value of the time-honored business practice of 1:1 meetings. "The paper suggests that talking to others, especially in groups of two people, improves scientific [and I would suspect other] creativity, including:
• Sharing information and ideas that individuals may lack on their own.
• Honing the logic of thoughts through the forcing function of articulating ideas verbally.
• [Safely] receiving feedback and new perspectives from others.
• Garnering encouragement and support that can boost morale and motivation."
https://x.com/ItaiYanai/status/1865614292587851836/photo/1
and
https://x.com/ItaiYanai/status/1865614292587851836
Anti- Anti-Science Articles of Note
"Vaccines, alongside sanitized water and antibiotics, have marked the epoch of modern medicine." While there are no trade-off-free choices in healthcare (meaning some will have side effects), the good outweighs the bad by a long shot.
https://www.vox.com/future-perfect/386215/trump-rfk-jr-vaccines-health-measles-chart
Quick follow-on
"This study found a steep decline in cervical cancer mortality among US women younger than 25 years between 2016 and 2021. This cohort of women is the first to be widely protected against cervical cancer by HPV vaccines. The findings from this study [along with other published research] suggest that HPV vaccination affected the sequential decline in HPV infection prevalence [and subsequent] cervical cancer incidence, and cervical cancer mortality."
From Journal of the American Medical Association
Dorali P, Damgacioglu H, Clarke MA, et al. Cervical Cancer Mortality Among US Women Younger Than 25 Years, 1992-2021. JAMA.
Published online November 27, 2024. doi:10.1001/jama.2024.22169
https://drive.google.com/file/d/1IWxBqIrWMc8WWd1JcZkKpxdwfY2plHwl/view
It is getting hard to find comprehensive obstetrics care in Texas.
https://www.newyorker.com/magazine/2024/12/02/the-texas-ob-gyn-exodus
Living with AI.
"GenAI has been adopted faster than personal computers or the internet. The technology has a 39.5% adoption rate after two years, beating the internet and PCs's adoption rate of 20% in the same period." While this is not an apples-to-apples comparison (PCs and the internet had a much steeper learning curve), these data are remarkable.
https://seekingalpha.com/news/4375521-genai-being-adopted-at-double-the-pace-of-pcs-or-internet
quoting
https://www.nber.org/system/files/working_papers/w32966/w32966.pdf
Microsoft supports various South American ecologic efforts using A.I.-analyzed rainforest sounds to measure absolute and relative Amazon rainforest biodiversity. While this article is biased (Microsoft is a tad self-congratulatory), the description of how AI is used to parse immense volumes of audio data is a fantastic example of dealing with large data sets.
https://unlocked.microsoft.com/bioacoustics/
Starting in January 2025, The L.A. Times will incorporate an AI-driven "bias meter" into its articles. The details of what this entails are slim; however, it has caused a lot of tension and backlash among L.A. Times staff. (FYI – here is coverage of the article through Ground News, a news aggregator with a non-AI bias meter.)
https://ground.news/article/la-times-to-publish-bias-meter-on-news-stories-owner-says
My younger son's roommate published one of his class papers about the urgent need for AI education as an editorial in the Baltimore Sun last week.
https://www.baltimoresun.com/2024/12/03/students-must-be-prepared-for-an-ai-dominated-future-guest-commentary/
Infographics
With only 15 shopping days till Christmas, I thought this Reddit thread would be helpful: "A Guide to States in Which You Can Legally Own an Alligator." While my kids could keep them at their colleges, they cannot bring them home. However, my Coloradan friends are good to go.
https://www.reddit.com/r/coolguides/comments/1h45u29/a_cool_guide_to_places_where_you_can_legally_own/
Things I learned this week
Another week of random animal facts.
I learned that there is a very robust online journal about fish farming and aquaculture called "The Fish Site." This online journal informed me that:
- Salmon (and trout) farms have a problem with aquatic lice that feed on the salmon.
- A Norwegian company, Stingray Marine, makes a laser that targets and kills said lice without damaging the fish.
- Of course, there are AI-driven fish biometrics and monitoring with centralized monitoring.
https://thefishsite.com/articles/lice-lasers-the-final-frontier-of-delousing-technology
and
https://www.stingray.no/delousing-with-laser/?lang=en
and
a very helpful YouTube explainer
https://www.youtube.com/watch?v=qGhy8nY7O6U
and a dramatic animation that could be from a SciFi movie, where the fish are starships.
https://www.youtube.com/watch?v=HBAXFN0yQVI
And, from the department of "Articles with headlines that commentary cannot improve," I offer you the following:
"How to survive a herpes-ridden monkey attack as feral rampaging beast terrorizes village - If confronted by an angry, herpes-carrying monkey that's on the attack your instinct might be to bolt from the beast, but a vet and animal behaviorist advises not to." I have so many questions.
https://www.dailystar.co.uk/news/world-news/how-survive-herpes-ridden-monkey-32816655
[I sent this article to my kids and apologized for not passing on this life skill prior to sending them to college.]
AI art of the week.
(A visual mashup of topics from the newsletter, now using ChatGPT to summarize the newsletter, suggest prompts, and make the images).
DALL-E would not let me generate monkeys in space suits, so I opted for "a spaceship shaped like a giant salmon firing lasers and surrounded by rainforest animals."
https://drive.google.com/file/d/1ZlPOiSQVDj-25mBrcgoNZw7k4A6Pjqws/view
---
Watching the curve of COVID cases plateau – with a likelihood of trending upward in the coming weeks.
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/
----
Clean hands and sharp minds,
Adam
Comments
Post a Comment