Week of June 16, 2025
Last week, I had a larger-than-usual number of stable patients in the office, giving me extra time for several notable conversations. (I consider these "things patients taught me.") One patient discussed her belief in the healing power of creamed Herring, using the pickled fish in cream sauce for an acute upper respiratory illness (I did clarify – she eats it as opposed to inhaling it or using it topically). Another patient gave me an impromptu TED talk on Walter Russell (a mid-20th-century polymath known for painting, sculpting, unorthodox science writing, authoring children's books, and motivational speaking). However, the horse breeder, who introduced me to "Equine Tinder," was the most amusing. Not only did he educate me on the economics of horse breeding (did you know there is passive income from the winnings of your horse's offspring?), but his self-anointed job title of "horse pimp" made me laugh.
I want to share my newfound knowledge:
Based on what I learned, Horse Tinder makes Uncle Lino seem like a very promising sire:
https://www.bloodhorse.com/stallion-register/stallions/169857/uncle-lino
Walter Russell is someone I need to spend more time reading:
https://en.wikipedia.org/wiki/Walter_Russell
Herring, like other cold-water fish, offers the potential for long-term health benefits but is not associated with treatments for other acute illnesses.
https://www.openevidence.com/ask/e6700c14-6881-445b-bcd8-cf58773cb838
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Listen to a Google Notebook LM's A.I.-generated podcast of the newsletter with two virtual "hosts."
https://drive.google.com/file/d/17CZ0d_fYW9QB7iIejypigQwyk9LHCEgs/view?usp=sharing
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Science and Technology Trends
Eric Topol interviewed UC Berkeley neuroscientist Matthew Walker, who offered some interesting updates on the science of sleep. Among the many interesting facts, I had not spent much time reading about dual orexin receptor antagonists (DORAs) or considering the distinction between sleep quantity and quality.
https://erictopol.substack.com/p/matthew-walker-promoting-our-sleep?utm_source=substack&utm_medium=email
AI Summary:
https://claude.ai/public/artifacts/df241404-3491-4b74-9d69-f20e9f7d068b
About (DORAs):
https://www.openevidence.com/ask/f5cb8fe3-658c-4ac0-bd1e-a7834774b375
I found an excellent article on how AI can augment clinical decision-making. Using an LLM, researchers utilized the Brazilian universal healthcare system dataset to train and then test criteria for primary care providers initiating referrals to various subspecialties. In this study, AI tools, refined through a large data set of existing medical records, are superior to humans in deciding when to refer patients for multiple types of subspecialty care. I strongly recommend the AI summary which highlights how to analyze such an article.
Article:
and
AI Summary: https://claude.ai/public/artifacts/87d4f0f8-7a02-4007-a417-991fd36623b3
Among the many predictive models I have seen, the long-standing "Pentagon Pizza Delivery" metric is one of the most interesting. I wonder if there are cost savings and operational security opportunities in bringing pizza-making in-house for the military.
https://ground.news/article/washington-pizza-delivery-trackers-guessed-something-was-up-before-secret-israel-attack
and
https://www.theguardian.com/world/2025/jun/13/pentagon-pizza-delivery-israel-iran-attack
Anti- Anti-Science Articles of Note
Dr. Paul Offit, a pediatrician from the Children's Hospital of Philadelphia and inventor of a rotavirus vaccine, does a nice job discussing some recent concerning changes at the FDA.
https://substack.com/home/post/p-164798076
Living with AI.
On the one hand, AI tools are shaping many aspects of work and life at an unparalleled pace. This episode of the AI Daily Brief features a talk by the podcast host on how businesses should accelerate their AI investments.
https://open.spotify.com/episode/4jZcyeEDOKkTCTHQlnnTH2
On the other hand, given the interactive nature and comprehensive knowledge, there will likely be more unsettling stories like these - LLMs with seeming sentience and the ability to manipulate people. The New York Times article discussing several individuals who let ChatGPT lead them down some conspiratorial rabbit holes is alarming (consider the pervasive, powerful tools that can trigger a larger number of already vulnerable individuals).
https://www.nytimes.com/2025/06/13/technology/chatgpt-ai-chatbots-conspiracies.html?unlocked_article_code=1.O08.Mn6d.6g4uYFzGpFlu&smid=url-share
and
https://claude.ai/public/artifacts/68588f99-29b8-4d5d-abd4-5b7574ed483d
Infographics
Chirality and Chemistry - time to remind ourselves about high school chemistry concepts.
https://bsky.app/profile/makingmolecules.com/post/3lplrwq7bxs25
from
https://www.makingmolecules.com/blog/chirality
So what? Chirality is a critical issue in healthcare.
An article about provocative questions in left-right asymmetry:
https://pmc.ncbi.nlm.nih.gov/articles/PMC5104503/
Things I learned this week
A species of New Guinea echidna, the Zaglossus Attenborough, hadn't been recorded for more than 60 years. Researchers, using local Indigenous knowledge in combination with camera trapping, facilitated the rediscovery of this endangered species. I love the notion of rogue echidnas.
https://abcnews.go.com/US/scientists-confirmed-existence-200-million-year-species-thought/story?id=122773046
and
https://www.nature.com/articles/s44185-025-00086-6#Fig2
I did not know Uno was so popular or so controversial. The WSJ (and my kids) taught me that "The card-shedding game is more popular than ever among adults, but they can't agree on the rules."
https://www.wsj.com/lifestyle/everybodys-mad-about-uno-mattel-f24805ef?st=UPYPQj&reflink=desktopwebshare_permalink
Humpback whales may be trying to communicate with humans through bubble rings. "Researchers analyzed 12 ring-production episodes involving 39 bubble rings created by 11 individual whales across various locations from 1988 to 2023. Ten of the 12 rings seen occurred near boats or human swimmers, whereas 5,000 drone-based whale observations saw no bubble rings.” Thus, the authors speculate the behavior may be an effort in interspecies awareness and engagement. (Perhaps the whales are asking about the wellbeing of the New Guinean echidnas or some horse breeding tips?)
Suggests human presence may be a significant trigger for this behavior
https://www.zmescience.com/science/oceanography/scientists-stunned-to-observe-that-humpback-whales-might-be-trying-to-talk-to-us/
and
The article from Marine Mammal Science https://onlinelibrary.wiley.com/doi/epdf/10.1111/mms.70026
and
AI Summary of the Article https://claude.ai/public/artifacts/a55c73bc-8244-419e-9076-0f7f1a481278
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).
https://drive.google.com/file/d/1GGa65a9tt6PiV_GiaG51hvY3t3bdjsAO/view?usp=sharing
"An 18th-century pastoral oil painting in the style of French or Italian masters, depicting a horse in an elegant period costume seated beneath a tree. The horse wears a stylish fedora, dark sunglasses, and a thick gold chain. It holds an iPad that reads 'Horse Tinder' on the screen. A second horse watches nearby while a humpback whale blows whimsical bubbles from a stream. In the background, three powdered-wig gentlemen in 18th-century garb examine a pizza delivery tracker at a rustic table, surrounded by soft hills and classical landscape features."
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The Pandemic Mitigation Collaborative (PMC) website utilizes wastewater levels to forecast four-week predictions of COVID-19 rates. There has been a rise in COVID rates to now 1 in 189 individuals (up from 1 in 210 last week). The latest variant, called Nimbus (NB.1.8.1), is associated with symptoms described as "razor blades in your throat," but does not appear to cause a more severe overall illness.
https://pmc19.com/data/
based upon https://biobot.io/data/
About Nimbus: https://www.today.com/health/coronavirus/new-covid-variant-nb181-nimbus-symptoms-rcna212304
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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