Week of January 13, 2025
One of my patients, a retired engineer, debates every detail of his care - from data interpretation to suggested treatments. Recently, and for the first time, his wife of 30+ years accompanied him to the office. I was grateful for her presence. Recounting the details of his care allowed me to speak to her while chiding him for his tedious discussions and persistent decision delays. I recognize his struggle as (partially) an existential crisis of aging - an attempt at maintaining an illusion of control in the setting of chronic disease and limited therapeutic choices. However, he is not acting in his best health interest - and weaponizing his spouse is one more tool in my arsenal of persuasion (she was clearly the decisive side of the relationship). It still amazes me that caring for adults is 10% science and 90% coaching.
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Listen to a Google Notebook LM A.I.-generated podcast of the newsletter with two virtual "hosts."
This week, the hosts breeze through the articles and offer a 6-minute 101-level college analysis of the themes. It is both amateurish and entertaining.
https://drive.google.com/file/d/1U9W6W6H7Ta-4t0NmKQ6JLMTijQx8TBYE/view
About NotebookLM: https://blog.google/technology/ai/notebooklm-audio-overviews/
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Science and Technology Trends
I only recently found this November 2024 Wired editorial from Jennifer Doudna ("I discovered CRISPR gene editing and received a Nobel Prize" Jennifer Doudna). The article is an easy-to-read, snack-sized discussion of the impact of A.I. on the foundational life sciences. It is one of the reasons I am excited about the future of medical technology.
https://www.wired.com/story/combining-ai-and-crispr-will-be-transformational/
Here is a follow-up to last week's coffee-is-good-for-you articles. (See http://www.whatadamisreading.com/2025/01/what-adam-is-reading-week-of-1-6-25.html). It appears WHEN you drink coffee matters - "Compared with non-coffee drinkers, those who mostly drank coffee in the morning had a lower risk of all-cause and cardiovascular mortality when followed over a median 9.8 years."
https://www.medpagetoday.com/primarycare/dietnutrition/113684
Canadian engineers and scientists published a well-written summary of the data and practicalities of portable air filters in combating airborne illness and pollution. These data are not new, but a good reminder - "Portable Air Filters (PAFs), composed of a HEPA or MERV-13 filter and a fan, are low cost, easy to maintain, can be moved to respond to changes in occupancy and activity level, and do not generate harmful pollutants. Strong and long-standing evidence demonstrates that PAFs help reduce the risk of airborne disease transmission, and designing a trial that leaves some people without this protection would be unethical and lack equipoise. [The authors are unaware of] any compelling published counter-evidence that suggests that PAFs do not reduce transmission of airborne diseases and PAFs offer considerable co-benefits, such as filtering allergens and wildfire smoke." I am a big fan of air filter use.
https://www.sciencedirect.com/science/article/pii/S1876034124003848
commentary on X from one of the authors
https://x.com/vicleungiddoc/status/1877594365213720684
An A.I. summary of the article:
https://claude.site/artifacts/114a8279-761e-4b8e-b6e8-5ffec011e591
Anti- Anti-Science Articles of Note
Last week, The Journal of the American Medical Association (JAMA) published a meta-analysis of the data linking fluoride exposure to decreases in children's IQ. The article and related editorials are a great example of what I wrote about last week - presenting complex relationships from scientific data is far more challenging than simply making a broad claim. The study analyzed 74 studies - 45 were from China, with others from Canada, India, Mexico, and other countries (but none were from the U.S. Sixty-four out of 74 studies found higher fluoride exposure linked to lower IQ scores. The authors deemed 52 of the studies had a high risk of bias, and 22 had a low risk. The meta-analysis reported that exposure to fluoridated water between 4 mg/L and 2 mg/L had the most significant relationship to a lower IQ (by an average of 1-2 points - which is meaningful in populations of individuals). No studies demonstrated an IQ change when water fluoride levels were below 1.5 mg/L in water. (FYI - in the U.S., water is typically fluoridated at 0.7 mg/L). And yet, these data are not easy to interpret. How was IQ measured across the 74 studies? What is the impact on the well-being of children who grow up with non-fluoridated water and worse dental health? (Poor dental health is linked to various diseases - including heart attacks.)
To further confuse the story, the meta-analysis noted that in the small number of studies that measured urinary fluoride (as opposed to only the concentration of fluoride in the water), there were more consistent IQ changes, even at fluoride levels lower than 1.5 mg/L. Thus, there may be something to the assertion, but more research is needed to understand what is happening.
Here are my takeaways:
- Too much fluoride appears to be associated with lower IQs.
- Based on this study, I would NOT remove fluoride from water systems in the U.S., nor would I avoid fluoridated water for my family – at typical 0.7 mg/L doses.
- Those who blithely claim "fluoride = bad" are foolish - they do not convey the more complex relationship of tradeoffs and nuance.
- This topic is an excellent example of why it is so difficult to meaningfully discuss data with those who espouse anti-science points of view. Simple, pithy statements are far more appealing than paragraphs of text describing complex data sets.
The meta-analysis and editorials:
https://jamanetwork.com/journals/jamapediatrics/fullarticle/2828425
An A.I. summary of the meta-analysis
https://claude.site/artifacts/30bd91dc-e116-4e61-bbc9-8e712cc2cac1
The data on the value of fluoridation on dental health:
https://www.cdc.gov/fluoridation/about/index.html
and
https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/art-20047475
Related
I learned the USDA has a National Milk Testing Strategy (NMTS) that facilitates comprehensive H5N1 surveillance of the nation's milk supply and dairy herds. In other words, our government offers a way to identify the worst places to drink raw milk.
https://www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/hpai-confirmed-cases-livestock
While we are on this topic, here is a consumer-focused, evidence-based article addressing the many false claims about the benefits of raw milk:
https://www.healthline.com/nutrition/drinking-raw-milk
Living with A.I.
I love to see what is coming out of the Consumer Electronics Show each year. Last year's show featured a plethora of lithium-ion battery tech. This year saw the addition of A.I. to anything and everything - including an array of "adult toys" (seriously - and you will have to search for those on your non-work device).
First, the good and interesting - including holographic displays and a rollable LED screens:
If you want a more TLDR version of interesting things from CES, here is a good thread from Twitter:
https://x.com/rixhabh__/status/1878330480724197695
Now the bad - a thoughtful Inc. article discussing the many poorly designed products and data risks associated with incorporating A.I. into an endless array of things.
https://www.inc.com/associated-press/experts-name-worst-in-show-products-at-ces-2025/91105162
Lastly, a device that feels like "a solution looking for a problem" is the A.I.-enabled brisket grill. I am skeptical that "The first and only generative A.I. enabled grill" can improve the best brisket I've had.
https://www.theverge.com/2025/1/6/24336539/brisk-it-zelos-450-smart-grill-generative-ai-price-availability
Brisk It (the smart grill company above) should collaborate with Throwflame (maker of Thermonator - a robot dog with a flame thrower) for more dramatic A.I.-driven BBQ experiences.
https://throwflame.com/products/thermonator-robodog/
You will note the absence of A.I. in my choice of brisket.
An example of my favorite Jewish holiday brisket:
https://thestoriedrecipe.com/jewish-brisket-recipe/
My favorite non-Jewish holiday brisket:
https://www.martinsbbqjoint.com/menu
Infographics
Grammarcheck.net offers numerous language-related infographics. Check out "16 Cases of Uncommon Pleurals." I have never encountered the need to refer to multiple "appendixes," but if I did, I would have said "appendices." The more you know.
https://www.grammarcheck.net/tricky-plurals/
Things I learned this week
Ants can learn to hold a grudge - researchers demonstrated ants display increased aggression when encountering previously encountered odors of nearby competitor ants compared to odors of more distant or never encountered ants.
https://www.sciencedaily.com/releases/2025/01/250108144025.htm
Related - moderate doses of caffeine facilitate faster learning in ants. "Ants who receive a caffeine-laced sugary reward become more efficient at navigating back to the reward's location compared to ants that only receive sugar. Caffeinated ants move toward the reward via a more direct path but do not increase their speed, suggesting that caffeine improved their ability to learn. [...] Incorporating caffeine into ant baits could aid efforts to control the ants by improving bait uptake."
https://www.sciencedaily.com/releases/2024/05/240523112447.htm
Here is an A.I. summary of the two articles. The combined data suggests well-caffeinated ants could efficiently learn to be angry neighbors - the insect equivalent of the old man screaming to get off his lawn.
https://claude.site/artifacts/5c286a17-08f7-47b1-b674-22dda62f58ed
I have been listening to the latest two episodes of, IMO, the best history podcast made, Dan Carlin's Hardcore History. In each 4-6 hour episode, Carlin combines a vast array of sources, paints a picture of the life and times of historical figures, and offers a fantastic multi-dimensional view of events. He also comments on the bias of his sources, both primary and other historical writers. In the episodes I am currently listening to (A History of Alexander the Great), Carlin highlights the many historical sources from the early 20th century that portray Alexander's mother as a beguiling, temperamental witch. (A literal witch). Carlin uses a highly entertaining quote from a 1970 history book by Peter Green I was able to find:
"[In] the autumn of 357 BC, Philip (Alexander's father) married an [Ionian] princess, and for the first time in his life, found he had taken on rather more than he could handle. Olympias, though not yet eighteen, had already emerged as a forceful, not to say eccentric, personality. She was, among other things, passionately devoted to the orgiastic rites of Dionysus and her Maenadic frenzies, can scarcely have been conducive to peaceful domestic life. One of her more outrageous habits (unless, as has been suggested, it had a ritual origin) was keeping an assortment of large tame snakes as pets. To employ these creatures on religious occasions could raise no objections. Still, their intermittent appearance in Olympias's bed must have been a hazard calculated to put even the toughest bridegroom off his stroke."
(from https://archive.org/details/in.ernet.dli.2015.226469/page/n59/mode/2up)
Remember, stories from ancient historical writings (like Plutarch, the source behind this anecdote) often reflect various agendas. Whatever the truth, I suspect Olympias's herpetologic interests were less dramatic than advertised.
Dan Carlin's podcasts:
https://www.dancarlin.com/hardcore-history-series/
A review of Plutarch's bias - he skewed toward moralist messages rather than historical accuracy.
https://newcriterion.com/article/plutarch-the-issue-of-character/
A.I. 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).
"A scene at a futuristic tech convention where tiny, apron-wearing ants are running a coffee shop, brewing coffee, and gossiping while showcasing holographic snake pets at their booth. In the background, a flame-throwing robot dog assists with BBQ brisket grilling, creating dramatic flair. The setting is vibrant and playful, with holographic displays and futuristic gadgets adding a surreal touch."
https://drive.google.com/file/d/1ME6gZPC1tQHuIJP1zDBR3Eah9rRV6CPz/view
Open AI's Sora is a text-to-video generator I now have access to. It generates 5-second animations. Here is the above prompt animated via Sora:
https://sora.com/g/gen_01jhbx2f95enfv9eeawz274441
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The post-holiday surge in COVID rates is starting to trend down, per CDC data, but the PMC projections are still predicting rising rates.
https://x.com/jpweiland/status/1877862989770133814?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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Clean hands and sharp minds,
Adam
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