Week of July 29, 2024
Excerpts from the not-quite-yet forthcoming book, Adam's Vignettes and Anecdotes from Healthcare, Volume IX, The 2020s:
July 2024 Nephrology Clinic
After the patient (a retired federal government worker) had finished his 6-sentence, cable-news-inspired screed against the outrages of "big government," he asked for my opinion about the tradeoffs of making his Federal Blue Cross health insurance secondary to the Medicare benefits for which he was now eligible. While I may be unable to keep patients alive forever, irony never seems to die.
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The July 26 PMC meeting report indicates stable, high transmission levels for the next four weeks. Currently, 1 in 52 individuals are infected in the U.S. (3-4 people per 737 800Max for those of us on planes a lot).
https://pmc19.com/data/PMC_Report_Jul26_2024.pdf
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
Undark is a politically neutral Science-focused online magazine. This article about recent long COVID publications using the Veterans Administration data set is an excellent example of how challenging it is to do good retrospective analysis when faced with ambiguous disease states (what defines long COVID?) marked primarily by symptoms. I strongly recommend reading the article with your favorite tea or coffee beverage.
https://undark.org/2024/07/25/long-covid-clash-of-definition-study-design/
Nature published a thorough and thoughtful review of knowns and unknowns about the H5N1 influenza virus currently (and mainly) found in birds and cows.
https://www.nature.com/articles/s41579-024-01087-1
Discussion
https://x.com/naturerevmicro/status/1816863206117130243?s=61&t=qjwdpjspQGX7XGY5jdBzKw
Medical Trends and Technology
While I cannot identify who "Cremieux Recueili" is (it is a pseudonym), I like his writing and analysis of various science topics. His review of the non-partisan National Bureau of Economic Research's (NBER) 2019 report is an excellent example of how to think about segments of the population driving healthcare costs. Essentially, 5% percent of Americans drive 25% of healthcare expenditure. (I also found it interesting that Elon Musk positively chimed into this thread, pushing me to research the report more. Anything he approves spawns a bit of intellectual bias in me.)
https://x.com/cremieuxrecueil/status/1817249178017321257
more from the author: https://www.cremieux.xyz/
About NBER https://en.wikipedia.org/wiki/National_Bureau_of_Economic_Research#Winners_of_the_Nobel_Memorial_Prize_in_Economic_Sciences
I am not the only person who finds the topic of semi-anonymous science writers interesting. Here is a podcast where Cremieux is interviewed (but still not identified).
https://www.jollyheretic.com/p/bad-science-vs-based-science-cremieux
https://www.bbc.com/news/articles/c28e2pvzn3lo
Infographics
Here is an on-point "Hotel Shower time" pie chart. Although I'm not too fond of pie charts, this is one of the better uses.
https://x.com/trungtphan/status/1817105518558843191?s=61&t=qjwdpjspQGX7XGY5jdBzKw
Things I learned this week - sports edition
Break Dancing is now an Olympic sport called Breaking. When recounting my failed childhood efforts at it, my son suggested that Breakin' would be a very apt descriptor for the outcome of any attempted age-49 break dancing. (Even 9-year-old Adam was better at watching than imitating 1984's Breakin' 2 Electric Boogaloo.)
https://olympics.com/en/news/breaking-paris-2024-faq
and learn about the anti-corporate tropes from the 1984 movie with Ice-T:
https://en.wikipedia.org/wiki/Breakin%27_2:_Electric_Boogaloo
I also found this gem on the _official_ Olympics website—only the French.
https://olympics.com/en/news/paris-2024-cute-olympic-branded-condoms
For reasons that are not clear to me, a series of Hog Showing competition videos started appearing in my social media feeds (I don't farm, I don't raise hogs, and culturally I should not be doing anything with pork). And yet, I now know about the rules and objectives of competitive Swine Showmanship. Like Finnish Hobby Horse riders, these competitors are strikingly serious about their craft.
https://extension.okstate.edu/fact-sheets/swine-showmanship.html
And for those who don't have the attention span to read
https://www.tiktok.com/@dadsonfarms/video/7357767570100931882?lang=en
I'll finish with this article - cocaine sharks are real. https://news.sky.com/story/sharks-off-brazil-coast-test-positive-for-cocaine-13183543
Living with A.I. - Medical Edition
As predicted, this section continues to overlap with medical technology articles. It is only a matter of time before they merge.
Dr. Eric Topol interviewed Dr. Faisal Mahmood (a pathologist who has evolved into a computational biologist) about his work in training A.I. to identify different disease states. I did not know about "spatial omics"—the use of serial images of proteins expressed in tissue over time to help train A.I. for staging and predictions on the rate of change (like tumor growth).
https://erictopol.substack.com/p/faisal-mahmood-ais-transformation
Here are the actual tools Dr. Mahmood is discussing. MIT and Swiss researchers released a study looking at AI-supported mammography. In this case, the A.I. tool helps radiologists improve the sensitivity and specificity of their diagnoses - minimizing false positives without sacrificing missed diagnoses. Because it is difficult for clinicians to determine the type and stage of DCIS, patients with DCIS are often overtreated.
In the spirit of the Olympics, here is an interview with Silvia Blemker, a UVA PhD biomedical engineer who studies the biomechanics of muscles and muscle health. Her startup, Springbok Analytics, uses A.I. reconstructions of MRIs to help athletes (apparently at least one of whom is a current Olympian) and disabled people improve their physical performance. On this podcast, Dr. Blemker focuses on women's health and physiology.
https://youtu.be/r7JBhBtB4ck?si=P405bHdPkkCK49Cs
and
https://www.springbokanalytics.com/solution
A.I. art of the week (A visual mashup of topics from the newsletter).
A shark is break dancing. Well-dressed hogs wearing suits are judging the event.
https://drive.google.com/file/d/1QmTozM_TYYOH19qBOz9sG6EmgfiU5LUR/view?usp=sharing
Clean hands and sharp minds, team
Adam
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