Week of September 1, 2025
We spent part of Labor Day weekend helping our younger son move into his sophomore dorm. This year's move-in felt less chaotic and exciting (and there was decidedly less packaging to discard). Dumpsters surrounded the upper-class dorms, and throughout the day, they filled with items that hadn't survived their summer storage. The whole scene felt like a capitalist liturgy—a sacrifice of last year's Target, Pottery Barn, and Walmart dorm goods to the gods of higher education. Our dumpster offering was a hand-me-down area rug that once lived in our house, (barely) survived last year's roommates, and then, we discovered, became unplanned housing for mice during summer storage. I felt a mix of sadness and irony in seeing discarded items used for attaining knowledge - chairs, plastic drawer sets, and organizers that buckled under the weight of climbing aspirations.
BTW, I have uploaded all of my previous newsletters to Claude and have it developing its "Adam Voice." Here is an attempt at the above opening by Claude, channeling my style.
https://claude.ai/public/artifacts/32e8abee-3232-411f-97cc-f1a74f837f9f
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Listen to a Google Notebook LM A.I.-generated podcast of the newsletter with two virtual "hosts."
https://drive.google.com/file/d/1t2-vVrEPqNmInKpOmdG9Iu1k5N8TpAi4/view
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Science and Technology Trends
Wired published an overview of China's brain-computer interface (BCI) research, which rivals Neuralink and other US companies. Tech advancement is rapid when you combine state-sponsored research and, typically, less stringent regulatory controls.
https://www.wired.com/story/china-is-getting-serious-about-brain-computer-interfaces/
Here is an AI summary and a comparison table of BCI companies:
https://www.perplexity.ai/search/summarize-this-rhpd1qOZS2i_H1aJNkTlZQ?login-source=oneTapThread#1&login-new=false
Eric Topol published a thoughtful analysis of the data that supports and refutes the high-protein diet. It is an excellent example of how challenging it is to make simple, blanket statements (more protein = good) that capture the nuance of scientific realities.
Blog:
https://erictopol.substack.com/p/our-preoccupation-with-protein-intake
AI Summary:
https://claude.ai/public/artifacts/d6e22aab-2628-4ce8-9d64-69a4aafc0f7e
Researchers (from several institutions) have developed an online, AI-based screening tool to identify potentially problematic journals (i.e., journals publishing flawed, misleading, and biased research. Using various characteristics (journal, author, and reference institution indicators), the article cited the ability to flag concerning journals with 79% accuracy, a 24% false positive rate, and significant agreement with three expert reviewers. This tool is a fantastic use of AI (complex, multivariate analysis from diverse and unstructured data) - essentially a complex risk score. As such, readers would be wise to use such a tool as another data point of critical analysis, not an end in itself. The online tool (linked below) is in private beta testing (which I signed up for).
Article:
https://www.science.org/doi/10.1126/sciadv.adt2792
AI summary:
https://claude.ai/public/artifacts/bfbde824-6c92-4602-a10e-824b8789d139
Online analysis tool (in beta), along with some blog posts and other commentary:
https://www.reviewerzero.ai/blog/announcing-reviewerzero
Anti-Science Articles of Note
I receive an enormous volume of doctor-oriented emails. Much of it is the medical equivalent of clickbait—stories that have sensational or provocative headlines yet often disappoint when read (think "underwhelming scientific correlation touted as new, causal understanding." Over the last week, however, my inbox has yielded a trend of concerning headlines that (unfortunately) fit well in the anti-science section. Here is a sample of what I am seeing:
Retsef Levi, a professor of business systems design at MIT, known for his criticism of mRNA vaccines, has been appointed to head the CDC's COVID-19 immunization workgroup, a subgroup responsible for reviewing vaccine safety and efficacy data and making recommendations to the CDC Advisory Committee on Immunization Practices (ACIP).
https://www.hcinnovationgroup.com/policy-value-based-care/news/55312544/vaccine-skeptic-to-head-covid-committee
Dr. Noc, one of the many science Instagram posters I follow, summed this situation up succinctly:
https://www.instagram.com/reel/DKzjvcWAdUm/?igsh=OXpwNjB4dHV2cjJv
US Department of Justice prosecutors recently sent a letter to the medical journal CHEST (and several other academically-oriented medical research journals), inquiring about how the journal handles "misinformation and competing viewpoints." Ethicist Arthur Caplan, professor of bioethics at New York University School of Medicine, wrote an editorial for Medscape discussing the implications and concerning threat to intellectual and scientific discourse.
https://www.medscape.com/viewarticle/fed-action-toward-medical-journals-dangerous-ethicist-says-2025a1000me6?ecd=WNL_trdalrt_pos1_250829_etid7678990&uac=68144FY&impID=7678990
Epidemiologist Katlyn Jetelina's blog discusses the recent resignations of several CDC leaders who refused to follow illegal orders to alter scientific evidence for political reasons (especially regarding vaccines). These CDC leaders chose to resign rather than compromise scientific integrity, even in the face of threats of "black listing" and the threat of personal violence (see articles on the recent CDC shooting).
https://yourlocalepidemiologist.substack.com/p/courage-at-cdc
The Cato Institute (a libertarian think tank) published an article on how ICE is (mis)using medical claims data to identify undocumented migrants and eroding trust in the public health system. It is critical to bear in mind that Medicaid recipients must document all the members of their household when applying to capture their financial burdens (and thus eligibility . One clear consequence of using these data for non-medical purposes will be the disincentive for individuals with family members of varying immigration status to 1) apply for Medicaid, and 2) will likely further incentivize the use of emergency or urgent services, after not receiving primary and preventative care, thereby further increasing healthcare costs (far cheaper to treat many illnesses early).
https://www.cato.org/commentary/why-ice-spying-us-citizens-medical-data
Living with AI.
The Washington Post tested nine AI search tools (including Google AI Mode, ChatGPT, Claude, Perplexity, Bing Copilot, Grok, Meta AI, and others) on 30 challenging questions, with scores judged by three professional librarians. The research found "Google's AI Mode was the most reliable AI bot overall, especially with trivia and recent events. However, it can be slow and inconvenient to access. Cha GPT (especially GPT-4) also performed strongly, with GPT-4 sometimes beating its successor (GPT-5) in key areas like sourcing and bias. Many qwAIs made factual errors ("hallucinations"), provided incomplete or outdated information, or gave citations that didn't support their answers."
"AI tools struggled most with: obscure trivia (Google and Perplexity did best), questions requiring specialized sources (Bing Copilot excelled here), and very recent events (Google AI Mode, Copilot, and Perplexity adapted best)." However, the librarians emphasized that basic Google web search still answered 64% of the questions more reliably—but AIs excelled at finding "needles in a haystack and complex queries not easily solved by standard search."
https://wapo.st/4n27hgv
AI Summary
https://claude.ai/public/artifacts/9506a75d-b48f-4421-8a8a-f8fa27a64957
Ethan Mollick (an AI-focused professor at Wharton) wrote about the Age of "Mass Intelligence," a mid-year look at the impact and ubiquity of cheap, accessible, and increasingly accurate AI tools.
https://www.oneusefulthing.org/p/mass-intelligence
AI summary and review:
https://www.perplexity.ai/search/summarize-this-highlight-steng-y3zrTyM5SuyLfwfQzg_gNw#0
Infographics
Impact of Tariffs on various products
https://drive.google.com/file/d/1i9-iCD1ljdLSESzdNoMZLMk-0Dr4Rkj9/view
downloaded from
https://www.hinrichfoundation.com/research/wp/trade-distortion-and-protectionism/how-us-tariffs-will-hit-prices-and-consumers/
Things I learned this week
It was a good week for articles about more animal oddities.
While familiar with the mantis shrimp's rapid, powerful punching, I learned that the pistol shrimp's outsized claw snaps quickly, generating a shockwave strong enough to stun its prey. The surrounding water cavitates—that is, the snap creates a bubble that collapses faster than heat can dissipate, generating light and appearing to violate the laws of thermodynamics (i.e., it seems to be a crude form of nuclear fusion). While the phenomenon is not directly translatable to scaled energy creation, research emanating from this has spawned new thinking around fusion.
A PR-style article about how the pistol shrimp inspired nuclear fusion research:
https://www.raconteur.net/design-innovation/the-story-of-shrimp-inspired-nuclear-fusion
AI review
https://claude.ai/public/artifacts/1fe64d5b-3545-4f97-9862-5bd5054324cc
FYI, Mantis shrimp deliver a punch with the same force as a boxer (and break aquarium glass and injure divers), but they do not approximate the forces of nuclear fusion. There are case reports on mantis-shrimp-related injuries:
2021 survey of Brazilian fishermen:
https://pmc.ncbi.nlm.nih.gov/articles/PMC8083892/
AI summary:
https://www.perplexity.ai/search/summarize-this-rhpd1qOZS2i_H1aJNkTlZQ#10
2001 ABC article on Mantis shrimp found in the Monterey Bay Aquarium with anecdotal "shrimp hit diver and diver lost finger" comment.
https://abcnews.go.com/US/story?id=94488&page=1
And, of course, there are human-made shrimp-related concerns in the news: "FDA recalls more radioactive shrimp"
https://ground.news/article/fda-recalls-more-shrimp-due-to-radioactive-threat_994658?utm_source=headline-link&utm_medium=share
I am grateful that none of my patients have asked this question (yet), but I am now prepared to address this critical clinical topic: "Are Fish Pedicures Safe and Are There Benefits?" Here is my advice (as a kidney doctor with over 20 years of medical experience): don't pay for tiny fish to eat the dead skin off your feet. My highly-detailed clinical assessment is "this is icky", and the little fish can give you what they nibbled off other people's feet. [Or, put in the framing of 1980s STI education, "When you let fish nibble your feet, you expose yourself to all the feet the fish have nibbled from"]
https://www.healthline.com/health/beauty-skin-care/fish-pedicure
Of course, I found a journal article on Ichthyotherapy (AKA fish pedicures). While the authors highlight some benefits of fish pedicures for patients with psoriasis, they also note that maintaining sanitary conditions for the fish (beyond just filtering the water) is challenging. (Plus, think of the poor fish exposed to all those human feet!)
https://pmc.ncbi.nlm.nih.gov/articles/PMC7398691/
Spotify find of the week: Sitarist Ronobir Lahiri and his well-done covers of 90s grunge hits (on the sitar): https://open.spotify.com/artist/6IQyRXngfe86T4AxdSNaX6?si=6dlrnjLPT0q7G4jhV_DKEw
AI art of the week
A visual mashup of topics from the newsletter.
I use ChatGPT to summarize the newsletter, suggest prompts, and make the images.
A black-and-white street photography scene, shot with a 28mm lens at f/3.5 on Ilford Delta 3200 film. Dumpsters overflow with broken dorm furniture — chairs, plastic drawers, and torn rugs — while students walk past carrying boxes. In the shadows of the dumpsters, shrimp-like forms appear: a pistol shrimp mid-snap, a mantis shrimp claw striking as if it were part of the refuse. The photo is grainy, high-contrast, and documentary in style — blending the chaos of moving in with surreal, ghostly hints of underwater violence. The atmosphere feels raw, candid, and slightly uncanny.
Grok:
https://drive.google.com/file/d/1zmCw01Zaph6Qk_Prt8IFQ5l6Qd8cLZr-/view
Gemini:
https://drive.google.com/file/d/1kvGx_oDMDynIWoH0mpStgl0BMqG2w_X4/view
ChatGPT:
https://drive.google.com/file/d/12xEMBJlfzOaEHxGE_O8-7Ws-rUT_6-5V/view
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PMC is upgrading its website and will not offer updates until next week.
The CDC website is updated https://covid.cdc.gov/covid-data-tracker/#datatracker-home
Rates of COVID + testing are rising. Hospitalization rates typically lag by 2-3 weeks after COVID rates begin to spike.
The Pandemic Mitigation Collaborative (PMC) utilizes wastewater viral RNA levels to forecast four-week predictions of COVID-19 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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