Health Technologies

AI Fatigue & Fake Futures: April Fool’s 2026

2026-04-01T18:36:00.000-07:00

Before surveying the internet’s annual carnival of fake innovation, we should confess: we contributed one of our own.

This year, we “launched” MnemoBiome™ - a probiotic that lets you learn through your gut. No classrooms, no webinars, no binders - just exposure, digestion, and subconscious skill acquisition. Absurd? Completely. But just plausible enough to make you hesitate for a second.

That hesitation is the whole game.

Because April Fool’s 2026 didn’t feel like one big, coordinated spectacle. It felt fragmented like a thousand in-jokes scattered across the internet, each tuned to a specific audience. The classic fake product launch is still alive, but it has evolved. Today’s pranks are sharper, more self-aware, and often indistinguishable from the real thing at first glance.

AI Fatigue Takes Center Stage

If there was one unifying theme this year, it was exhaustion with AI-everything.

The best example came from Razer, which introduced AVA Mini, an “AI companion for your AI companion.” A virtual pet… for your existing AI. Complete with personality traits, care requirements, and contextual awareness.

It’s a perfect joke because it doesn’t invent anything new—it simply extends current trends one step too far. In a world where every product now needs a co-pilot, why not give the co-pilot its own emotional support system?

Feature Creep as Comedy

Another reliable formula: take a normal product and overload it with features until it collapses under its own weight.

OPPO’s “smart umbrella” did exactly that. Flexible display, AI-assisted wind control, solar charging, self-drying fabric, even a built-in camera. Ridiculous—but also uncomfortably familiar. We’ve been trained to expect this kind of spec inflation.

That’s why it works. The joke isn’t that it’s impossible. The joke is that it’s almost believable.

AI-Powered… Everything

Food and lifestyle brands joined in by applying AI to things that absolutely don’t need it.

There were BBQ-focused AR glasses, coffee alarms that brew your drink automatically at 8:00 a.m., and other “smart” experiences that blur the line between convenience and parody. At this point, “AI-powered” has become less of a feature and more of a punchline.

Nostalgia Hits Different in 2026

Not all the best jokes were about the future. Some looked backward.

Monkeytype revived Clippy—the overly helpful Microsoft assistant—as a sarcastic typing coach. It’s a niche joke, but a precise one. If you’ve ever been annoyed by Clippy, or spent time optimizing typing speed, it lands perfectly.

That precision feels very 2026. The internet isn’t laughing together anymore—it’s laughing in clusters.

Community Humor > Mass Appeal

Some of the funniest pranks never trend widely at all.

Linux communities, developer circles, and niche forums produced hyper-specific jokes that reward insider knowledge. These aren’t designed for everyone—and that’s exactly why they work. They feel textured, cultural, and personal in a way big brand campaigns often don’t.

When the Joke Is Basically Real

A recurring theme this year: products that sound fake but also… inevitable.

A device that physically stops you from scrolling.
Sensor-packed smart clothing.
A nostalgic return to older operating systems.

These ideas hover in that uncanny space between satire and roadmap. The line between joke and product pitch is getting thinner every year.

The Meta Layer: AI Writing the Jokes

Here’s the twist: AI wasn’t just the subject of the jokes—it helped create them.

People openly used chatbots to plan pranks, generate scripts, and optimize reveal timing. April Fool’s is now a hall of mirrors: we’re joking about AI using AI to write the jokes about itself.

That doesn’t make it less funny. But it does make it stranger.

Why These Jokes Work

At their best, April Fool’s jokes function like satire. They exaggerate reality just enough to reveal what’s underneath.

And in 2026, what’s underneath is pretty clear:

We’re tired of over-engineered products
We’re skeptical of constant optimization
We don’t fully trust systems that claim to “know” us

So we laugh at AI pets, smart umbrellas, and probiotic learning hacks—not just because they’re ridiculous, but because they’re uncomfortably close to plausible.

The format may be fragmented. The jokes may be niche. But the underlying question hasn’t changed:

Is the future getting absurd… or are we just getting used to it?

REFERENCES

https://scifolio.blogspot.com/2026/04/when-ai-became-joke.html

https://aurabiome.blogspot.com/2026/04/introducing-mnemobiome.html

https://environment.aurametrix.com/2026/04/when-april-fools-jokes-become.html

https://www.indy100.com/viral/best-april-fools-day-pranks-2026

https://thestrugglingscientists.com/april-fools-lab-pranks/

https://www.tomsguide.com/news/live/april-fools-day-2026-live-best-jokes-pranks

https://www.thedrum.com/news/april-fools-day-2026-top-jokes-from-dude-wipes-tesco-babybel-and-more

Healthcare’s Knowledge Problem

2026-01-14T18:14:00.000-08:00

Healthcare is becoming a real test of how we sustain knowledge. The challenge is no longer just storing information, but keeping it usable, accurate, and current, while also cutting down the time clinicians spend reviewing charts and writing notes.

One of the clearest near-term benefits of AI is clinical summarization. Instead of digging through scattered notes, lab results, medication lists, imaging, and visit transcripts, clinicians can get a clear, unified picture of the patient. This is where tools from OpenAI and Anthropic are heading. OpenAI is positioning its healthcare offerings around patient-facing summaries and enterprise systems designed to meet privacy and compliance needs. Anthropic is developing similar healthcare-focused tools and infrastructure, especially for clinical and life-science workflows.

But research shows there is a catch. A recent study on AI-assisted report writing for chronic disease care found that the AI produced high-quality drafts with very few edits and no safety problems. Even so, clinicians spent about the same amount of time reviewing these drafts as they did writing reports by hand. The reason is professional responsibility. In medicine, clinicians feel obligated to check everything carefully, even when the AI is usually right. This creates what researchers describe as an accountability paradox: accuracy alone does not reduce workload if full verification is still required.

Because of this, the real challenge is shifting from asking whether AI can write well to asking how systems can support selective verification. The goal is to let clinicians quickly see what matters, what changed, and what evidence supports each statement, without forcing them to recheck everything from scratch.

Another important development is the push toward better medical memory. Patient information is often scattered across systems, making it hard to trust summaries or recommendations. Efforts to unify labs, medications, visit notes, and recordings into a single, traceable context aim to reduce this fragmentation. When data is well connected and clearly sourced, AI can organize and summarize it without guessing.

Open models are also entering the picture. Google’s medical models, including MedGemma and MedASR from Google, are notable because they support an open, developer-friendly ecosystem. This approach appeals to organizations that want strong medical AI capabilities while keeping local control over data and governance.

Taken together, the pattern is becoming clear. AI that simply drafts text is helpful, but AI that drafts and clearly shows where every claim comes from is far more sustainable. The most promising systems ground their outputs in linked evidence, make data sources and versions easy to audit, and reduce repeated work by improving search, organization, and de-duplication. In healthcare, the most sustainable knowledge is the knowledge clinicians do not have to recreate again and again.

REFERENCES

Lee C, Vogt KA, Kumar S. Prospects for AI clinical summarization to reduce the burden of patient chart review. Front Digit Health. 2024 Nov 7;6:1475092. doi: 10.3389/fdgth.2024.1475092. PMID: 39575412; PMCID: PMC11578995.

Zhang X, Yu J, Yan P, Jiang L, Shen X, Cheng M, Liu X. Human-in-the-Loop Interactive Report Generation for Chronic Disease Adherence. arXiv preprint arXiv:2601.06364. 2026 Jan 10.

https://openai.com/index/introducing-chatgpt-health/ "Introducing ChatGPT Health"

https://www.anthropic.com/news/healthcare-life-sciences "Advancing Claude in healthcare and the life sciences"

https://www.axios.com/2026/01/12/openai-acquires-health-tech-company-torch "OpenAI acquires health tech company Torch"

https://developers.google.com/health-ai-developer-foundations/medgemma/model-card? MedGemma 1.5 model card | Health AI Developer ..."

[TIME](https://time.com/7344997/chatgpt-health-medical-records-privacy-open-ai/)

[Axios](https://www.axios.com/2026/01/12/openai-acquires-health-tech-company-torch)

[Business Insider](https://www.businessinsider.com/anthropic-chases-openai-ai-heath-claude-2026-1)

[The Economic Times](https://m.economictimes.com/tech/artificial-intelligence/openai-acquires-healthcare-startup-torch-deal-pegged-at-100-million/articleshow/126495784.cms)

When Biology Learns to Test Itself

2025-10-12T12:24:00.000-07:00

If you’ve ever been sent down the rabbit hole of modern diagnostics - one test leading to another, each pricier than the last - you know medicine could learn a thing or two from electronics. In Electronic Design Automation (EDA), engineers have specific tests for specific faults: “stuck-at-1,” “timing violation,” “power leak.” Run the right diagnostics, and the chip tells you exactly where it’s broken.

In medicine, by contrast, we’ve got a galaxy of overlapping tests — blood panels, genomic assays, MRI sequences - and no consensus on which ones actually tell the whole story. It’s a field that still runs partly on intuition, luck, and insurance coverage.

Enter Dynamic Sensor Selection, a term that sounds like something you’d use to debug a Mars rover but is actually from a 2025 paper by Pickard et al., published last week in PNAS. The idea: treat the human body like a complex dynamical system (which, inconveniently, it is) and use mathematical “observability theory” to identify which few biomarkers tell you the most about what’s going on inside.

In plain terms, it’s a framework for choosing the right test points in a living system. Instead of wiring an oscilloscope to a circuit board, you’re “probing” gene expression, neural signals, or metabolic markers, and asking: Which measurements let me reconstruct the full picture?

The team behind this approach applied it across everything from bacterial genes to human brainwaves. In some experiments, the method could estimate unmeasured genes with about 50% error — impressive, considering biology’s noise makes Wi-Fi in a storm look stable. In brain studies, the algorithm even revealed that some EEG electrodes are basically freeloaders, contributing little to understanding what the neurons are up to. (So yes, even your neurons have that one coworker who never pulls their weight.)

The broader vision is seductive: "A medical system that diagnoses itself dynamically", focusing only on the sensors that matter most at a given moment. Imagine wearable devices that don’t just collect endless data but decide in real time which data is most informative - sparing us from both data fatigue and unnecessary costs.

It’s also a philosophical pivot: biology isn’t static. The “best” biomarker today might be irrelevant tomorrow, just as a stable circuit becomes unpredictable when the current spikes. Medicine, for all its imaging and sequencing power, still operates like a lab tech armed with every tool but no schematic. Pickard’s framework offers that missing circuit diagram.

So next time you’re overwhelmed by medical testing options, remember - the goal isn’t to measure everything, it’s to measure wisely. In the coming era of dynamic biomarkers, your body might finally come with its own built-in diagnostic dashboard.

And who knows? Someday your doctor’s favorite prescription might be:

> “Let’s check your observability matrix.”

REFERENCE

Pickard J, Stansbury C, Surana A, Muir L, Bloch A, Rajapakse I. Dynamic sensor selection for biomarker discovery. Proc Natl Acad Sci U S A. 2025 Oct 14;122(41):e2501324122. doi: 10.1073/pnas.2501324122. Epub 2025 Oct 7. PMID: 41055977.

The Case History (In Nine Circles)

2025-10-08T07:15:00.000-07:00

In a small provincial kingdom — which, for diplomatic reasons, I shall call The Hospital of Virtum — there lived a lady of eighty-some years: intelligent, sharp-tongued, and weary of her own body. Her heart no longer kept time; her legs sang hymns of pain day and night.

A vascular surgeon, learned and distinguished, examined those legs as though they were chapters in an old, dog-eared book. He sighed and said,

“This requires a team the size of an orchestra.”

But the orchestra was on tour — indefinitely — so he prescribed two instruments instead: antibiotics and morphine.

The lady was of the old school.

“I’ve lived long enough to know what kills me,”
she said, shaking her head at the powders and elixirs of the modern age.

After much persuasion came antibiotics and probiotics, soups of virtue, kefir consultations — and yet the pain stayed. So the second remedy was tried: the opioid Hemamorphane, a word that might have escaped from Dante’s descent itself. Still, no relief. The legs burned as before.

By Sunday evening, the pain had become a symphony of torment. Her heart danced arrhythmically; her blood pressure soared like an opera soprano. At last, an ambulance was summoned — and arrived in the form of two very young angels in polyester uniforms, still fragrant with the smell of textbooks. They performed their EKG, boarded her ceremoniously, and whisked her away.

Inside, the air was infernal. The caregiver fumed; the patient moaned.
It was the Fifth Circle — wrath and despair, both boiling in the same cramped river.

They reached the Emergency Department, where time flows differently — slowly, cruelly. The nurse suggested more painkillers. The lady refused.

“I want to understand the cause,” she insisted. “Perhaps there are clots.”

The nurses exchanged a look.
Cause? In this kingdom, causes are mythical beasts — rarely seen, never captured.

So they rolled her into the waiting room, sat her in a wheelchair designed by medieval torturers, and left her under the flicker of fluorescent light. Around her gathered the other souls of Limbo: a girl with sepsis, her mask pale against the blue light of her phone; two teenagers scrolling through pain.

Then came the receptionist, guardian of the Second Circle.

“You must pay,” she said, “before any service.”

The caregiver paid. She was also given half a forest of forms to sign — unreadable, urgent, and perhaps binding her soul. She signed anyway. The lady’s face was white, her legs swollen like bread dough left too long in the sun.

Hours slipped by.

The chair was unkind. The lighting, penitential. After much pleading, an orderly adjusted her footrest by two centimeters - a gesture toward mercy, if not toward Paradise.

When she asked for a bathroom, both were locked — relics of a more civilized age.

And so they lingered — between the Third and Fourth Circles of our modern Inferno: Bureaucracy and Indifference.

And as the caregiver looked at the suffering patient, she thought: “If Dante were alive today, he would need a Triage Department for the damned.”

The caregiver’s patience cracked. She made a speech. The sepsis girl joined her in chorus, a duet of despair. At last, the guardians of this realm took pity - or offense - and moved them to separate waiting rooms. The new chair was softer and a bathroom available.

Progress.

Then came blood tests, then more waiting.
Morning brought results: D-dimer high. Suspicion of clots. An ultrasound was ordered. But there was a line — always a line.

“Don’t call us,” said the clerk. “We will call you.”

The caregiver called anyway. By midday, they were summoned back — through a labyrinth of nurses, numbers, and barcodes. Payment required, but cash and cards not accepted. The caregiver, bent over her phone, tapped through endless screens until at last a barcode appeared — salvation by QR code.

After two more offices and an hour of silence, their number flashed — then vanished.

“The team went on break,”
said the receptionist, tearing the ticket.
“You’ll need to take another number.”

At last, an ultrasound. The machine was ancient, its sound like bones grinding. The technician pressed hard — pain seared through the leg.

“No clots,” she announced.
“What about the other leg?”
“We only do one at a time,” came the reply.

Back to the nurse. More waiting. She smiled kindly but said,

“I can’t show you the results. I’d go to jail.”

Such is the law of Virtum.

Back to the ER. More forms, more indifference. Finally, a doctor — harried, hollow-eyed — arrived.

“Just take Tylenol,” he said.
Then, to the caregiver:
“Maybe it’s heart failure. What else do you want?”

And so they were discharged — the patient in more pain than when she entered, the caregiver in despair.

How long could she endure?
No one could say.

Epilogue

Let us note, for the record, that the illness of our time is not only in arteries or veins.
It is in the system itself — a moral arteriosclerosis that clogs compassion and chokes the flow of sense.

Around the world, the same symptoms appear.

In New York, twenty-year-old Sam Terblanche died after two visits to Mount Sinai Morningside. Diagnosed twice with “a viral syndrome,” he was sent home. Days later, he was found dead. The autopsy revealed pulmonary hemorrhage of unknown cause. Experts suspected sepsis, or a post-COVID autoimmune storm. None could say for sure. What’s certain is this: the system missed him.

In Winnipeg, Chad Christopher Giffin waited eight hours in the ER — and never made it out.
In Quebec, Adam Burgoyne, 39, was told he wasn’t “dying” — and left after six hours, only to die the next day.
In Italy, Cristina Pagliarulo perished after forty hours in a Pronto Soccorso.
In Ontario, sixteen-year-old Finlay van der Werken, bright and kind, died after an ER visit that should have saved him.

Different nations, same pathology.

The modern hospital has become a paradox — a place meant for healing that too often serves as a sorting center for the living and the nearly dead. The causes are known:

Overstretched emergency rooms — overcrowded, understaffed, forced to “move the meat.”
Diagnostic haste — rare, lethal cases lost amid the ordinary.
Electronic record tyranny — notes for billing, not understanding.
Fragmented accountability — no one person responsible, everyone “following protocol.”
Cognitive bias — young and old alike dismissed because they don’t “look sick.”
No continuity after discharge — once you leave, you vanish from the system.
And towering above it all: administration - endless layers of approval, offices feeding offices, a machine designed to protect itself, not patients.

Transparency has evaporated — in places like Canada, you may not even be allowed to see your own test results. The system hides what it should reveal, and delays what it should decide.

Meanwhile, outside the hospital walls, people are already turning to tools that can do in minutes what bureaucracy and burnout stretch into weeks - AI systems that see patterns, synthesize, and recall what no overworked clinician has time to.

The Hospital of Virtum is not a fantasy. It is everywhere - New York, Winnipeg, Milan, Montreal, Toronto.

The cure? Not another protocol. Not another app.

What’s needed is time, staff, accountability, and the permission to care.
A culture where asking why is not seen as defiance.
Where a locked bathroom is not a metaphor for the entire institution.

Until then, the triage line is the new Inferno —
and the dead keep teaching the living what compassion once meant.

REFERENCES

https://www.nytimes.com/2025/10/05/well/sam-terblanche-virus-death-columbia.html

https://archive.is/MgWJH#selection-693.288-693.375

https://news.ycombinator.com/item?id=45487519

https://www.winnipegfreepress.com/breakingnews/2025/01/24/probe-into-death-of-man-in-hsc-waiting-room-weeks-from-completion

https://www.ctvnews.ca/montreal/article/this-montreal-man-died-of-an-aneurysm-after-waiting-in-the-er-for-six-hours/

https://en.cronachedellacampania.it/2025/09/Pagliarulo-case%3A-Cristina%27s-autopsy-could-have-been-saved-if-operated-on-in-time/

https://globalnews.ca/news/11296590/ontario-family-sues-hospital-staff-sons-death/

Is the Future of Medicine Just a Prompt Away?

2025-08-12T08:51:00.000-07:00

In Evaluating General-Purpose LLMs for Patient-Facing Use: Dermatology-Centered Systematic Review and Meta-Analysis (medRxiv, 2025), the data tells a fascinating story: large language models (LLMs) are improving in medical reasoning, empathy, and safety - but they’re not perfect, and trust takes time to earn. Which, come to think of it, sounds a lot like the long human history of hoping for miracle healers.

Long before stethoscopes, scalpels, and sterile gloves, our first “doctors” were magicians - or at least, that’s what everyone believed. Prehistoric healers waved bones, mumbled incantations, and applied sometimes questionable herbal pastes. Yet enough patients recovered to keep the legend alive.

Fast forward a few millennia and not much has changed… except the props. The bone rattle has been replaced by a diagnostic app. The “spirit-cleansing smoke” is now an MRI scan. And our new shamans? They’re called AI engineers.

Just like in the old days, we still crave the miracle cure, the instant fix, the all-knowing healer. Our dream is a tireless personal doctor who remembers every ache, every allergy, every bit of medical literature (plus the plot of every episode of Grey’s Anatomy).

When ChatGPT burst into the public spotlight in late 2022, some were fascinated and some were wary. Could a chatbot really diagnose a rash? Suggest a safe treatment? Explain it all in plain language?

Early studies, including those reviewed in the paper, painted a mixed picture. In 2022, the mood was skeptical. By 2023, optimism surged as newer models like GPT-4, Claude, and Gemini started showing measurable gains in accuracy, empathy, and communication. But by 2025, the mood had shifted again - not to cynicism, but toward a more critical view.

The truth is, AI in medicine is a lot like the magic of old: it works impressively well in certain contexts, but not always when or how you expect. LLMs are now better at interpreting images, offering solid medication safety advice, and even admitting when they don’t know - a kind of digital humility our ancestors probably wished their witch doctors had. But they still have limits. Even when an AI aces a medical board exam and offers great second opinions, patients using it alone don’t necessarily make better decisions.

That’s why the paper calls for evaluator-aware, patient-in-the-loop frameworks - ways of measuring not just whether the AI gets the right answer, but whether it helps real people make better choices. Because in healthcare, as in magic, the spell only works if it actually helps the patient in the real world.

REFERENCE

Irene S. Gabashvili Evaluating General-Purpose LLMs for Patient-Facing Use: Dermatology-Centered Systematic Review and Meta-Analysis medRxiv 2025.08.11.25333149; doi: https://doi.org/10.1101/2025.08.11.25333149

Catch-22 in Biomedicine: Where Innovation Goes to Die

2025-07-25T12:05:00.000-07:00

Welcome to the biomedical field, where the real disease is the system, and the only approved cure is being part of the club.

Let’s start with a fun little circle, a biomedical version of a hamster wheel — Catch-22 with a white coat and a PubMed badge. Here’s how it works:

To Be Read, You Must Be Indexed.
No matter how groundbreaking, disruptive, or life-saving your research is, it won’t exist in the eyes of the AI models and policymakers, unless it’s indexed in PubMed. That’s the velvet rope to the scientific VIP lounge.
To Be Indexed, You Must Be Published in a Journal That’s... You Know, PubMed-Worthy.
And to get into one of those? You need money. Either:
- Pay the journal a small fortune (ranging from $2,000 to “you’re gonna need a second mortgage”), or
- Be part of The Club™ - that elite group of insiders who don’t need to pay because they’ve been publishing in the same journals since Watson and Crick shared a sandwich.
Oh, You Did Something Novel? Sorry, That’s Not on the Approved Menu.
Maybe you developed a cost-saving, patient-driven clinical trial. Fantastic! But if it wasn’t:
- Funded by Big Pharma, or
- Backed by the NIH and conducted by a prestige university with ivy-covered walls,
  …then guess what? It doesn’t count. Reviewers will call it “methodologically unsound,” Editors will say "it's not interesting to our readers", which is code for “you didn’t buy the right ticket.”
Citations: The Scientific Echo Chamber
“You cite me, I cite you, we all cite the same five people we've known since grad school.”
If your work isn’t already blessed by the existing canon, if it dares to question current paradigms, or (God forbid) it talks about a topic not discussed by the establishment, it’s tossed into the "Thanks but no thanks" pile.

Citations are the currency of academia. But like real currency, they tend to trickle upward.

Exhibit A: The Case of PATM

Ever heard of People Are Allergic to Me (PATM)? No? Neither has most of PubMed, and certainly not your favorite dermatology AI (that will also tell you it's all in your head).

There was a peer-reviewed paper in JMIR Dermatology showing a microbial connection to PATM. It should’ve led to more interest in this condition.
But alas, JMIR Derm isn’t indexed in PubMed - a technicality that renders the findings invisible (unless the work was funded by NIH). Not because they’re invalid. Just… you know… they weren’t invited to the club gala.

Now you might think, “But what about establishment research?” Surely that gets through, right?

Monell Center — a well-regarded sensory science institute — published a genetic study on TMAU, another condition ignored for decades. Even they faced an uphill battle. The research showed genetic heterogeneity, meaning the story isn’t as simple as the textbooks would like. Ten years to publish (DNA of 130 subjects that contacted Monnell in 1999 to 2007; the paper was published in 2017). Ten. Because journals prefer tidy answers like “it’s just gene X” over complex truths like “it’s complicated and we don't fully understand it yet.”

Meanwhile, In the Land of AI

Your health chatbot? Your AI diagnostic assistant? It only reads what’s been indexed. It’s like a well-read librarian who refuses to touch any book without a barcode.

Which means all those brilliant papers:

From underfunded startups,
Crowdfunded patient trials,
Off-mainstream yet rigorous researchers...

Are off the radar. So AI, policy, and public knowledge stay blissfully ignorant — not due to a lack of evidence, but a lack of access.

So Why Does This Matter?

Because if you're a poor patient, or a researcher without connections, or someone who just wants to challenge bad assumptions, the system isn't just hard - it's set up to make you invisible.

Innovation doesn't fail here because it’s wrong.
It fails because it wasn’t published in the right place, by the right people, citing the right authorities.

The Streetlight Effect in Science

We’re all looking for the cure under the scientific streetlight - not because it’s there, but because that’s where the funding, indexing, and citations shine.

Meanwhile, in the dark, the real solutions — weird, messy, complex, human solutions - are waiting. But who’s going to look there?

Nobody. Unless someone with the right credentials takes a flashlight.

REFERENCES

Gabashvili IS. Cutaneous bacteria in the gut microbiome as biomarkers of systemic malodor and People Are Allergic to Me (PATM) conditions: insights from a virtually conducted clinical trial. JMIR Dermatology. 2020 Nov 4;3(1):e10508. doi: 10.2196/10508

Guo Y, Hwang LD, Li J, Eades J, Yu CW, Mansfield C, Burdick-Will A, Chang X, Chen Y, Duke FF, Zhang J, Fakharzadeh S, Fennessey P, Keating BJ, Jiang H, Hakonarson H, Reed DR, Preti G. Genetic analysis of impaired trimethylamine metabolism using whole exome sequencing. BMC Med Genet. 2017 Feb 15;18(1):11. doi: 10.1186/s12881-017-0369-8. PMID: 28196478; PMCID: PMC5310055.

April 1, 2025: The Fine Line Between Product and Punchline

2025-04-01T20:00:00.000-07:00

On this April Fools' Day in 2025 the line between absurdity and innovation has never been blurrier. From Anova's oven affirmations ("You're not overcooked, you're emotionally complex") to Razer’s Skibidi headset designed to decode Gen Z's in-game lingo, tech pranks continue to reflect our ever-evolving relationship with technology. Skibidit translates phrases thrown out by young gamers such as, "What the sigma? We're getting mobbed," which means, "Your team needs support." And "I think you're cute" becomes "ni hao fine shyt." New voice in ChatGPT also sounded like a teenager you just woke up from a nap. Lots of exaggerated sighs and sarcastic quips.

While we laugh, there's often a subtle truth behind even most absurd jokes – a nod to how technology can shape our lives, for better or worse. Perhaps in a world where we are trying to replace bike rides and walks (e.g., with KICKR EARTH, by Wahoo) and touch grass virtually via Dbrand’s latest skin (a remake of keyboards from 2022), the real punchline is that the future is here, and it's a little more ridiculous than we ever imagined.

We heard about gaming chairs, now meet Elgato’s Streaming Desks. It's actually a control panel with 1,262 customizable keys, for streamers and content creators who need every shortcut imaginable. Probably with plenty of "any keys", as well, The absurdity of turning an entire desk into a giant, impractical Stream Deck—complete with a premium walnut finish—hits the sweet spot of tech humor: it’s ridiculous yet just plausible enough to make you double-check the date. The over-the-top nature of it, paired with Elgato’s reputation for streaming gear, probably had people chuckling and wishing it were real (or not).

Artificial Peripheral intelligence (or API) by @deviparikh and @yutori_ai marks new era of agentic computer use. Your levitating mouse powered with AI will do all the work for you.

On the wearables front, UK's mattress company, the Odd Company has unveiled the “City Napper,” a £350 portable mattress designed for commuters who struggle to leave their beds in the morning. This “wearable mattress” comes with a wraparound headrest and quilted poncho, pitched as the ultimate commuting companion for napping on public transit. It provides neck support and warmth while keeping germs at bay – perfect for catching extra sleep on the go. It’s impractical in the best way—imagine someone waddling onto a subway wrapped in a mattress—and nails the wearable tech trend of solving first-world problems with over-engineered flair. Whether you're facing rain or shine, the Babybel Wax Sleeping Bagwill (from nostalgic snack cheese brand Babybel) will add more comfort and warmth, much like a cheese toastie - keeping you snug and toasty no matter the weather.

Another wearable-adjacent prank was Nothing’s “Ear (3.5mm),” a pair of wired earbuds with a comically long 50-meter cable, mocking the wireless trend while pretending to cater to audiophiles who miss the old days.

Protein Works has launched Doms Proteinon, an alcohol-free protein-packed version of Dom Pérignon champagne. Terry’s Chocolate is revolutionizing oral care with their “Chocolate Mint Toothpaste” combining dental hygiene with popular chocolate mint flavor. Aldi stores across Scotland have launched “Taps Aff,” a 100% natural alcohol alternative made from beloved Scottish tap water, one of the things Scots are so proud of! Sports drink company Bodyarmor launched a Sports Performance Shampoo packed with electrolytes and vitamins. Heck Food, renowned for its gluten-free sausages, burgers, and more, introduced Matcha Chipolatas. Gluten free, high protein lean chicken sausages spiced with Matcha Green tea. Wellness and sausages – a Match-a made in heaven?

April Fool's Day tech jokes have evolved significantly over the years. Initially, they often revolved around futuristic ideas that seemed absurd at the time but later inspired real innovations. Examples include Google's "MentalPlex" search by thought (2000), a predecessor of Google's Assistant and "Google Pigeon Internet" (2000), later launched as Google's Project Loon. Apple AirPods Pro with "EarFit"(2020) turned into AirPods Pro (2nd generation) released next year. These pranks hinted at creative concepts rooted in technology, reflecting optimism and imagination about technological possibilities. They were also used as a way to gauge people's enthusiasm about new ideas. Later, jokes started to focus on absurdity or satire rather than inspiring dreams of the future. For instance, Miz Mooz's Selfie Shoes with built-in cameras that automatically take selfies every time you take a step(2015) exaggerated society's obsession with selfies. Uber Kittens" (2017), a service where you could have kittens delivered to you by Uber for a few minutes of cuddling, was both heartwarming and completely absurd.

The rapid pace of technological advancements has made it harder to surprise audiences with futuristic concepts. People are now so accustomed to groundbreaking innovations that the impact of such jokes has diminished. Additionally, companies may steer clear of elaborate pranks due to concerns about misinformation or backlash. For instance, Google halted its April Fool's Day jokes in 2020, citing the global pandemic and a shift in focus toward more serious matters. As a result, humor has shifted increasingly toward absurdity and satire, reflecting current societal trends rather than aspirational visions of the future.

Yet, despite these shifts, there are still some genuinely creative ideas that come out of April Fools' Day pranks. At their best, these jokes remain not only enjoyable but also thought-provoking, offering a playful glimpse into what could be possible—or absurd—tomorrow. The tradition of humor through technology continues to evolve, keeping us laughing and questioning the world around us.

REFERENCES

John Kanellakos picks: https://www.pocket-lint.com/april-fools-day-2025-tech-roundup/

Andrew Liszewski's story://www.theverge.com/news/638284/dbrand-touch-grass-skin-tablet-smartphone-handheld-console

The Verge staff: https://www.theverge.com/news/639824/april-fools-day-2025-pranks-jokes-best-worst

Amaete Umanah: https://x.com/amaeteumanah/status/1907219854681342026

https://www.famouscampaigns.com/2025/04/april-fools-2025-round-up/

https://x.com/yutori_ai

The Post-COVID Tenure Shift

2025-02-25T18:51:00.000-08:00

Active lifestyle communities have long been a popular choice for older adults seeking wellness, social engagement, and a strong sense of community. Historically, residents in these communities have shown increasing tenure, with many staying well over a decade, drawn to the amenities and vibrant atmosphere. However, new research [1] reveals a striking shift: the median homeownership tenure has dropped post-COVID, reflecting a broader nationwide trend in homeownership duration.

COVID-19 has caused a devastating loss of life in the U.S. The surge in mortality had a noticeable impact on national longevity: life expectancy at birth dropped by about 2.7 years over 2020–2021, falling from 78.8 years in 2019 to 76.1 years in 2021. This marked the largest two-year decline in U.S. life expectancy in a century (since 1921–1923). Older adults experienced especially high COVID-19 death rates [2].

Beyond acute infections, many COVID-19 survivors have endured long-term health issues, known commonly as Long COVID or post-COVID conditions. The pandemic’s impact on mental health is another significant health consequence, sometimes termed a “mental health crisis". The prolonged stressors of the pandemic – including illness and grief, social isolation, job loss, and uncertainty – led to sharp increases in anxiety, depression, and substance abuse nationwide. By late 2020, public health experts were warning of a “second pandemic” of mental health issues.

The pandemic catalyzed major shifts in how and where people work in the United States. Perhaps the most visible change was the mass adoption of remote work. Given that remote work has allowed more people to move into scenic, retirement-friendly locations, one might expect tenure to increase rather than decrease. However, health consequences were likely outweighing this impact.

Utilizing longitudinal surveys (2018, 2021, 2023, 2024) and property transaction records, researchers examined why residents in retirement-style communities are moving out sooner. While national housing trends have been influenced by economic uncertainty, remote work, and shifting homeownership dynamics, these factors alone do not fully explain the accelerated turnover in active lifestyle communities.

One might assume that dissatisfaction is a leading factor in shorter tenure, but this study found that resident satisfaction remains consistently high at 93%, far exceeding the national average for similar communities (~73%).

Another emerging trend is that newer and younger residents—those who settled in active lifestyle communities post-pandemic—are significantly more sensitive to financial costs than their older, long-term counterparts. This financial sensitivity is expected to influence governance decisions, amenity funding strategies, and overall community stability.

This shift in tenure presents both a challenge and an opportunity. If residents are leaving due to health concerns rather than dissatisfaction, community leaders should focus on enhancing wellness support, improving access to preventive healthcare, and fostering even stronger social connections.

At the same time, addressing financial concerns—especially among newer residents—will be crucial in maintaining the long-term viability of these communities. Adjusting amenity funding strategies and providing cost-effective solutions may help mitigate financial pressures and sustain resident satisfaction.

More research is needed to fully understand the evolving needs of active lifestyle communities, particularly in light of demographic shifts and economic pressures. However, one thing is clear: these communities must continue to adapt—not just to attract new residents, but to support existing ones in staying healthier and happier for longer.

REFERENCES

Irene S. Gabashvili, Christopher K. Allsup. Resident Turnover and Community Satisfaction in Active Lifestyle Communities. February, 2025 arXiv:2502.15789 [stat.AP] https://doi.org/10.48550/arXiv.2502.15789

Gabashvili IS The Incidence and Effect of Adverse Events Due to COVID-19 Vaccines on Breakthrough Infections: Decentralized Observational Study With Underrepresented Groups JMIR Form Res 2022;6(11):e41914 doi: 10.2196/41914, PMID: 36309347, PMCID: 9640199

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Healthier Communities Through Inclusive Planning

2024-10-15T18:04:00.000-07:00

In today's fast-paced world, the design of our communities plays a pivotal role in our overall health and well-being. Imagine neighborhoods where walking trails weave through green spaces, parks beckon families outdoors, and pickleball courts foster friendly competition among neighbors of all ages. These aren't just amenities; they're vital components that reduce stress, promote physical activity, and enhance quality of life.

Traditionally, decisions about such community features have been made by a select few, often without direct input from those who will use them daily. But what if the residents themselves could steer these choices, ensuring that their community evolves in ways that truly support their health and happiness?

Our latest paper, "Democratizing Strategic Planning in Master-Planned Communities," introduces an innovative tool that puts community residents at the forefront of planning. By leveraging brief online surveys, we capture residents' preferences for amenities that enhance well-being. Whether it's serene walking trails that encourage daily exercise, vibrant parks for relaxation and social gatherings, or pickleball courts that offer fun, low-impact physical activity for all ages, our tool translates these insights into actionable strategies. This data-driven approach results in a ranked list of potential plans, taking into account how likely residents are to use them, their sensitivity to costs, and perceived risks.

This methodology is grounded in utility theory and utilizes exponential models to account for diminishing returns on investments in quality, cost, and risk mitigation. Essentially, it helps planners answer critical questions: What health-promoting amenities do residents value most? How can resources be allocated to maximize community well-being? Which amenities are residents willing to support financially?

By involving residents directly, we not only gather valuable insights but also foster a sense of ownership and commitment to community health initiatives. This participatory approach ensures that the amenities developed are those that residents genuinely desire and will actively use, leading to healthier lifestyles and stronger social connections.

Moreover, this method promotes transparency and inclusivity in the planning process. Planners and developers can make informed decisions that reflect the collective will, while residents see their preferences and needs acknowledged and addressed. It's a win-win scenario that builds trust and encourages ongoing community engagement.

By democratizing the planning process, we empower residents to actively shape their environment. Planners gain valuable, data-driven insights that lead to more inclusive and effective decision-making. The result is a community designed not just for its residents, but by its residents—a place where health and happiness are built into the very fabric of the neighborhood.

For a deeper exploration of how inclusive planning can revolutionize community health, we invite you to read our paper and listen to our podcast discussing this transformative tool.

The path to healthier communities begins with a simple step: listening to the people who call it home.

REFERENCE

Allsup CK, Gabashvili IS. Democratizing Strategic Planning in Master-Planned Communities. arXiv preprint arXiv:2410.04676 [econ.EM] https://doi.org/10.48550/arXiv.2410.04676

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April Fools' Day 2024: Reflecting Our Digital Psyche

2024-04-01T18:55:00.000-07:00

It's April Fools' Day, a time when tech companies, big and small, roll out their most outrageous, bizarre, and occasionally plausible inventions and announcements. It's another day of hoaxes in an internet landscape already teeming with misinformation and pranks. Yet, we find ourselves embracing this annual tradition, which never fails to elicit a mix of amusement, confusion, and sometimes, a hint of annoyance.

April 1st is not just about laughter; it's a day that offers a peek into our collective psyche. It's an opportunity to step beyond our everyday reality and imagine a world with a twist, sometimes bringing our most far-fetched tech fantasies closer to reality. This year, as artificial intelligence becomes increasingly integral to our lives, we find humor in its absurdities and potential—from gaming chairs with AI-powered tentacles to oversized repair tools that fix a device while a dozen more learn to self-repair, to the beyond-AI living pet rocks.

Reflecting on the past, we're reminded of Gmail's debut as an April Fools' joke exactly two decades ago—a service that has since become a staple in our digital lives. In 2009, Google introduced CADIE - AI assistant that can code. Fast forward to 2024, and we see Budsie's AI-enabled dolls enabled dolls "programmed to learn everything about you" and Razer's Cthulhu gaming chair offering AI-powered tentacles to cater to your every need, blurring the lines between fiction and the near-future possibilities of AI.

In 2022, Razer unveiled the Enki Pro HyperSense haptic chair at CES, offering vibrations and shakes synchronized with games, TV, and movies. Razer technology, introduced on April 1st, 2022, included a full-body gaming suit aimed at immersing users by simulating physical sensations and emotions through haptic feedback. In 2024, we witness a more refined iteration, reminiscent of the future depicted in WALL-E, where users find themselves deeply engaged without needing to leave their chairs.

Meanwhile, Waymo embraces its "Grandma of Robotaxis" title with a grandma-themed autonomous vehicle, and iFixit pokes fun at the absurdity of all-in-one oversized repair tools while tech retailer Currys lets customers exchange their old tech for delicious curry dishes. In the language learning world, Rosetta Stone and Fluent team up for "Rosetta Stoned," a fictional app that promises a laid-back approach to mastering vocabulary of seasoned stoners.

AI technology is revolutionizing health tracking with cutting-edge devices like the Withings Shaft smart cane and the Withings Puck truly smartwatch. At the heart of the Puck is "timeless tracking," offering a comprehensive suite of features including a built-in breathalyzer, glucose meter, heart rate sensor, DNA sampler, and more. This seamless integration ensures that users have access to a wealth of health insights right at their fingertips. And if you still need to connect with someone alive - try mental-health-boosting puppies from American Well. Seems to work even better than instant holographic physicians from 2022.

From the growing influence of AI to the quirks of autonomous vehicles, mental-health-boosting puppies and the ever-evolving language of cannabis culture, each prank holds a grain of truth about our world.

Smart Homes Redefined

2024-01-11T17:17:00.000-08:00

The concept of a smart home has evolved significantly, with technologies now focusing on health monitoring. The integration of advanced sensors and devices into our living spaces promises not only convenience but also proactive health management.

While sensors placed throughout the home can detect air and water contaminants, allergens, and pollutants, high-resolution cameras and microphones and other non-contact measurement devices could allow health monitoring and remote consultations with healthcare professionals.

Smart mirrors in bathrooms should transcend mere reflective surfaces. Enhanced with advanced computer vision capabilities, they could assess skin conditions, identify changes in appearance, and offer personalized health and beauty recommendations. They could also analyze the eyes for early signs of various health conditions, extending far beyond mere glaucoma and cataract detection. The eyes can unveil valuable information about cholesterol levels, liver conditions, and diabetes. Eye monitoring technology is a testament to the saying, "The eye is the window to the soul," extending its truth to health monitoring.

Ambient sensors equipped with radar technology in living rooms and bedrooms can continuously monitor vital signs like pulse rates. This non-intrusive monitoring could provide a seamless health tracking experience for residents.

Recent advancements include the use of mmWave radar sensors for continuous monitoring of human activity. Recently built system, utilizing an NVIDIA Jetson Nano board for real-time processing and a Texas Instruments Millimeter-Wave Radar Sensor, offers a non-intrusive and privacy-respecting way to monitor activities like sitting, walking, standing, and even detecting falls. This radar technology poses a challenge due to the high-dimensional point cloud data it generates. The PointNet neural network is developed to process this data efficiently, preserving spatial relationships and offering accurate activity classification.

The traditional method of measuring SpO2 involves contact sensors, which can be inconvenient for prolonged use. New techniques for contactless SpO2 measurement using different light wavelengths in video images are being developed. This approach promises a more comfortable and accessible way to monitor oxygen saturation levels, especially crucial in the wake of health crises like COVID-19.

The COVID-19 pandemic has underscored the importance of non-intrusive health monitoring, especially for elderly individuals. The development of a Multi-scaled Long Short Term Memory (Ms-LSTM) model, as part of a smart toilet system, represents a significant step in this direction. This model enables effective home-based health diagnostics through urine analysis, leveraging the IoT-Fog-Cloud paradigm. It's a particularly vital tool for early detection of potential viral infections, including COVID-19, in the elderly. The Ms-LSTM model integrates a four-layered architecture including data acquisition, fog layer (processing and analyzing the data locally) , cloud (for deeper analysis) and interface layer. The proposed system offers a non-invasive, efficient method for early disease detection and preventive health.

The integration of health monitoring technologies into smart homes is transforming how we approach personal health. From environmental sensors to advanced radar and neural networks, these innovations promise a future where health management is seamlessly woven into our daily lives. As technology continues to advance, we can expect even more sophisticated health monitoring solutions to emerge, making proactive health care a tangible reality in the comfort of our homes.

REFERENCES

Alhazmi AK, Alanazi MA, Alshehry AH, Alshahry SM, Jaszek J, Djukic C, Brown A, Jackson K, Chodavarapu VP. Intelligent Millimeter-Wave System for Human Activity Monitoring for Telemedicine. Sensors (Basel). 2024 Jan 2;24(1):268. doi: 10.3390/s24010268. PMID: 38203130.

Sasaki S, Sugita N, Terai T, Yoshizawa M. Non-Contact Measurement of Blood Oxygen Saturation Using Facial Video Without Reference Values. IEEE J Transl Eng Health Med. 2023 Sep 25;12:76-83. doi: 10.1109/JTEHM.2023.3318643. PMID: 38088997; PMCID: PMC10712673.

Kumar D, Sood SK, Rawat KS. Empowering elderly care with intelligent IoT-Driven smart toilets for home-based infectious health monitoring. Artif Intell Med. 2023 Oct;144:102666. doi: 10.1016/j.artmed.2023.102666. Epub 2023 Sep 20. PMID: 37783534.

Fatima H, Imran MA, Taha A, Mohjazi L. Internet of Mirrors for Connected Healthcare and Beauty: A Prospective Vision. arXiv preprint arXiv:2311.14734. 2023 Nov 21.

The Inverse Vaccine's Crusade Against Multiple Sclerosis and Other Autoimmune Diseases

2023-09-15T17:12:00.005-07:00

In the human body, there are many diverse communities working together to protect and nourish their beloved realm. The humblest among them are the Peasant Microbes from our microbiome, the first line of defense, always ready to shield their territory from the nefarious invaders keen on causing havoc.

And then there is the skin - the high stone walls of the castle, which act as a barrier to prevent the invaders from entering. These walls are fortified with various defensive structures like water barriers and parapets, representing the different layers of the immune system that use various methods to deter the assault of pathogens.

Then, we have the Jedi Masters of the immune system, the T cells. These are seasoned warriors, adept in distinguishing friend from foe. They patrol our body, teaching the younger warriors the art of recognizing and defeating the intruders. They hold the precious memories of past battles, ensuring that future attacks can be fended off swiftly and efficiently.

However, there came a time when these warriors could no longer tell friend from foe, leading them to attack the very thing they were sworn to protect - the Myelin, a protective sheath that covered the nerves of the kingdom, the pathways that communicated messages throughout the land. This tragedy unfolded as a vicious disease, making the residents suffer from weakness, numbness, and the loss of vital functionalities.

In the midst of this crisis, the magical "Inverse Vaccine" was proposed, which promised to restore peace and harmony in the land.

This Inverse Vaccine was a gentle teacher invoking mechanisms of immune tolerance. Through the utilization of a special sugar called N-acetylgalactosamine or pGal, it marked molecules with "do not attack" flags, mimicking the peaceful liver’s natural process of marking aged cells as friends, not foes. These molecules were sent to the great Liver School, where the T cell warriors were educated to differentiate between the true invaders and the kingdom's loyal citizens.

The T cells, now wise and compassionate, ceased their attack on the loyal myelin. This allowed the nerves to flourish once again, reviving the kingdom to its original glory, where each component worked in unison, guarding their territory while nurturing their community, promising a future of health and prosperity.

REFERENCE

Tremain, A.C., Wallace, R.P., Lorentz, K.M. et al. Synthetically glycosylated antigens for the antigen-specific suppression of established immune responses. Nat. Biomed. Eng 7, 1142–1155 (2023). https://doi.org/10.1038/s41551-023-01086-2

The Past, Present, and Future of AI-Powered Medicine

2023-07-24T12:56:00.008-07:00

In this era of rapidly advancing technology, Artificial Intelligence (AI) is spearheading transformative changes, particularly within the healthcare sector. A prime example is ChatGPT, a game-changer that is fast becoming an influential player in the biomedical field. Its potential to catalyze innovation and revolutionize medical research is profound.

A MedrXiv paper posted today is a systematic review of AI in biomedical literature. The scope of this review is broad, encompassing preprints, peer-reviewed articles, case reports, patents, clinical trials, and even FDA approvals. The paper talks about impact of AI, including ChatGPT, across all medical specialties and subsets of publications, finding overrepresented domains within each subset, highlighting potential research gaps, biases, or areas of excessive focus.

The pace at which the biomedical literature is growing is staggering, with two new papers being added every minute, around the clock. The MedrXiv paper also brings to light the limitations of current medical publishing models.

The human author collaborated with ChatGPT, Bing, Claude, and Bard, and used SciSpace Copilot to review hundreds of systematic reviews and thousands of unique records across various databases. It aimed to comprehensively map out past achievements, current developments, and potential future directions in AI-based medical research. The paper represents the latest brainchild of an open science collaboration project, which welcomes participation from others at https://osf.io/87u6q/.

The study reveals that as ChatGPT matures, it's finding applications across diverse medical specialties demanding cross-disciplinary collaboration. A fascinating trend shows a transition from theoretical to clinical applications in the AI literature, mirroring developments within the ChatGPT space.

Despite challenges such as ensuring the quality of training data and managing ethical concerns, ChatGPT is fostering the adoption of AI tools within medical areas that have been historically underrepresented in AI application.

If you have an interest in the future of medicine and the role AI technologies like ChatGPT play in shaping it, check out this project. It offers a compelling glimpse into what the future of healthcare might look like.

REFERENCES

Gabashvili I.S. Artificial Intelligence in Biomedicine: Systematic Review. medRxiv 2023.07.23.23292672; doi: https://doi.org/10.1101/2023.07.23.23292672

Gabashvili I.S. The impact and applications of ChatGPT: a systematic review of literature reviews. arXiv:2305.18086 [cs.CY] https://doi.org/10.48550/arXiv.2305.18086

Gabashvili IS. ChatGPT in Dermatology: A Comprehensive Systematic Review JMIR Preprints. 02/06/2023:48979. medRxiv 2023.06.11.23291252; https://doi.org/10.1101/2023.06.11.23291252

Transforming Dermatology

2023-06-13T08:15:00.009-07:00

Artificial intelligence has witnessed a rapid surge in the adoption of language models, with transformer-based pretrained language models (T-PLMs) playing a prominent role. These T-PLMs, such as BioBERT, MEP & Bioformer (BERT), Chatdoctor (LLaMA), OPAL & MedDialogue (BART), BioGPT and MedGPT (GPT 2), have revolutionized natural language processing in the biomedical research community, offering tailored performance for specific applications. Among these models, ChatGPT stands out due to its versatility, flexibility, and accessibility, making it widely applicable across various domains, including dermatology.

The fact that ChatGPT may be used by everyone, as opposed to models that can only be used by specialized developers and researchers, is one of its main advantages. This accessibility has paved the way for new possibilities in the field. By integrating clinical knowledge with interactive conversation, new generation of language models has the potential to transform all biomedical fields.

A recently posted preprint, open to peer review till July 8, focuses on the utilization of ChatGPT in dermatology. However, the study's conclusions have implications beyond dermatology and are relevant to other biomedical disciplines as well. Unlike previous reviews, this study goes further than performance evaluation by analyzing the actual utilization and real-world applications of ChatGPT in dermatology-related areas. By examining its practical use, the study offers valuable insights into the potential impact of ChatGPT in the broader biomedical research community.

REFERENCE:

Gabashvili IS. ChatGPT in Dermatology: A Comprehensive Systematic Review JMIR Preprints. 02/06/2023:48979. medRxiv 2023.06.11.23291252; https://doi.org/10.1101/2023.06.11.23291252

Accelerating Knowledge Innovation: Systematic Review of Reviews on ChatGPT

2023-05-30T10:01:00.014-07:00

In the beginning was the Word. It was used in the creation of all other things - from thoughts to stories and histories. However, as the amount of information available grew overwhelming, it became challenging to process and make sense of it all. Early academic reformers introduced the idea of reviews and digests to help navigate this sea of information. But it wasn't until the 1970s that systematic reviews gained popularity, starting in the field of medical research.

created by Author with ChatGPT, Bing Image Creator & Photoshop

Reviews play a crucial role in consolidating a vast array of studies and publications, allowing researchers to weave together the threads of evidence and create a cohesive and informative narrative. However, traditional review processes often require substantial time and the collaboration of multiple researchers to reach a consensus. With the rise of generative AI based on large language models, the power of words can be harnessed to streamline the systematic review process, unlocking new possibilities for learning and knowledge acquisition. By leveraging the capabilities of ChatGPT, researchers can potentially accelerate the production of high-quality reviews, facilitating the dissemination of insights and advancements in various fields of study.

The use of ChatGPT in conducting a systematic review of reviews on ChatGPT itself demonstrates the potential for accelerating the production of high-quality reviews in a timely manner.

While systematic reviews are considered to be the gold standard in knowledge synthesis, they usually require between 6 months and 2 years to complete and often have a narrow focus. While the methodological shortcuts allow rapid reviews (first mentioned in the literature in 1997) to be conducted in less time and with fewer resources, they also increase the likelihood of introducing bias into the review process and missing important information from grey literature (i.e., preprint servers).

In 2020, full systematic review was completed by a team of 6 in 2 weeks using automation tools. The most time-consuming tasks were data extraction, write-up, abstract screening, full-text screening, and risk of bias. 4 out of the 6 people on the team were experienced systematic reviewers with complementary skills (three experts in two domains required for the review and one information specialist).

In 2023, ChatGPT and I were able to complete the review of reviews in one week. We screened 7 large resources of papers, including grey literature and reviewed primary studies in Chinese, German, Indonesian, Norwegian, Portuguese, Russian, and Spanish, in addition to English.

ChatGPT helped me to filter relevant literature in all languages, extract key information, summarize findings, and even assisted with the synthesis of the overall review, enabling a more efficient and comprehensive analysis.

Our paper illustrates that ChatGPT is expanding into different domains and highlights the need to continually refine and expand the training datasets, ensuring that they are diverse and accurate. Another area of improvement involves developing customized integrations, designing specialized prompt instructions and involvement of domain-specific expert trainers, factual correctness evaluation, and investigation of societal impact.

Word by word, paper by paper, and review by review, ChatGPT is paving the way for a future where knowledge creation is accelerated, insights are amplified, and breakthroughs are within closer reach.

REFERENCE

Gabashvili I.S. The impact and applications of ChatGPT: a systematic review of literature reviews. Submitted on May 8, 2023. arXiv:2305.18086 [cs.CY]. https://doi.org/10.48550/arXiv.2305.18086

Depression AI

2023-05-09T14:57:00.006-07:00

Wearable AI is a promising tool for depression detection and prediction although it is in its infancy and not yet ready for use in clinical practice - as concluded in a recent review. AI can be also used therapeutically.

Research has shown that interacting with technology, such as chatbots, can lead to feelings of social connection and companionship, which can have both positive and negative effects on mental well-being. Chatbots have become increasingly popular in mental health domain because of their impact on social interactions and the ability to form and maintain meaningful relationships. They are effective in reducing symptoms of anxiety and depression, although there is always a risk that they may exacerbate mental health issues.

One of the main benefits of chatbots is their ability to provide low-cost and easily accessible mental health counseling. ChatGPT studies show that its potential for depression detection and treatment should be further explored, while addressing the challenges and ethical considerations. ChatGPT outperforms traditional neural network methods but still has a significant gap with advanced task-specific methods.

In the US, one in five individuals is affected by mental health issues each year, with recreational cannabis use increasing the risk. Intelligent wearables utilize over 30 types of data to predict depression, with physical activity, sleep, heart rate, and mental health measures being the most commonly used. The Depresjon dataset (motor activity recordings of 23 unipolar and bipolar depressed patients and 32 healthy controls) is most popular among researchers.

Previous systematic reviews have shown that AI has better performance in detecting patients without depression than those with depression, but the review published last week shows slightly higher sensitivity and specificity - based on data from wearable devices. It is recommended that tech companies develop wearable devices that can detect and predict depression in real-time. Neuroimaging data in addition to wearable devices would provide even higher diagnostic performance.

With the increasing popularity of IoT and AI, they will likely become an integral part of our lives. It may soon become a useful tool in clinical practice.

REFERENCES

Abd-Alrazaq A, AlSaad R, Shuweihdi F, Ahmed A, Aziz S, Sheikh J. Systematic review and meta-analysis of performance of wearable artificial intelligence in detecting and predicting depression. NPJ Digit Med. 2023 May 5;6(1):84. doi: 10.1038/s41746-023-00828-5. PMID: 37147384.

Garcia-Ceja E, Riegler M, Jakobsen P, Tørresen J, Nordgreen T, Oedegaard KJ, Fasmer OB. Depresjon: a motor activity database of depression episodes in unipolar and bipolar patients. In Proceedings of the 9th ACM multimedia systems conference 2018 Jun 12 (pp. 472-477).

Lamichhane B. Evaluation of ChatGPT for NLP-based Mental Health Applications. arXiv preprint arXiv:2303.15727. 2023 Mar 28.

Yang K, Ji S, Zhang T, Xie Q, Ananiadou S. On the Evaluations of ChatGPT and Emotion-enhanced Prompting for Mental Health Analysis. arXiv preprint arXiv:2304.03347. 2023 Apr 6.

Dana RA, Gavril RA. Exploring the psychological implications of ChatGPT: a qualitative study. Journal Plus Education. 2023 May 1;32(1):43-55.

From Laughs to Inspiration: April Fool's 2023

2023-04-01T14:04:00.009-07:00

April Fool's jokes provide us with a unique opportunity to exercise our imagination and step out of our everyday reality. Though some of these jokes may never come to fruition while others might, they allow us to envision a slightly different world and have a good laugh.

This year, we can even laugh together with AI. Let's start from ChatGPT's ideas for April Fool's products:

"Microsoft Office for Dogs" - a suite of productivity tools designed specifically for dogs, including "Excel for Fetching," "Word for Barking," and "PowerPoint for Begging."

"Jambé Pong" - A game that combines the musical elements of the Jambé with the classic game of beer pong. The Jambé Pong set comes with a special set of Jambé balls that you use to play the game, and every time you sink a ball, the Jambé plays a different sound effect.

Bing suggests more products:

Apple iFridge: A smart fridge that only stores items made by Apple.

Google Gulp: A drink that claims to optimize your use of the Google search engine by increasing your intelligence.

Here is another product described for google by you.com:

Google: GooGoo Glasses, smart glasses that automatically detect when you've had too much sugar and remind you to eat healthier snacks.

You.com also mentioned the following offerings from other tech companies:

Twitter: TwitHire, a service that helps you find the perfect candidate for your startup by analyzing their tweets for the right combination of wit, humor, and experience.

Netflix: NetFix, a feature that automatically skips to the happy ending of all sad movies, sparing you from the emotional trauma.

Dropbox: DropZone, a cloud storage service that uses drones to deliver your files directly to your desktop.

Perplexity.ai offered Facebook Friend Insurance: Worried about losing a friend on Facebook? With Facebook Friend Insurance, you can protect your friendships from unfriending, blocking, or even ghosting. Get peace of mind knowing your friendships are secure.

Google has had many great April Fool's announcements over the years. One of the best was in 2014 - a new service called "Google Nose" allowing users to smell things online. When asked about possible upgrades to this product, Bard mentioned the ability to create custom smells specific to users' interests and the ability to share them and use smells to communicate with each other.

Bard also described a new feature for Gmail that would allow users to send emails to people at any date in the past. The feature, called "Time Travel," was said to be powered by artificial intelligence.

Bard also announced a new vaccine that would protect people from getting sick from April Fools' Day jokes. It will be manufactured by Pfizer, Moderna and J&J.

While AI-suggested April Fool's products are creative and amusing, the real announcements made today by companies, though not involving cutting-edge technology, were just as funny and witty.

When they were released in the 1980s, Chicken McNuggets genuinely revolutionized the way all fast restaurant chicken was served, making them the industry's living legend. The Big McNugget Boot, a new seasonal must-have item from McDonald's, is based on one of their most well-liked products. The April 1 2023 tweet from the company said "Calling all fashionista. We’ve got the must have drop of the season. Unveiling the Big McNugget Boot, the most flavoursome shoe of SS23. Releasing exclusively through the McDonald’s App this Monday." Pizza Hut meanwhile was already selling their April 1st product - zero-harm pizza consisting only of a crust. Domino's Pizza announced that it was launching a new pizza that was made with real cheese from cows that had been fed pizza crust. The pizza, called the "Pizza Crust-Fed Cow Pizza," was said to be available for a limited time at select Domino's locations.

Telegraph reported that under radical climate plans secretly approved by the government, several of Britain's tallest structures, including the BT Tower, might be turned into wind turbines to assist Britain in reaching net zero. British Telecom agreed that their tower is a good place to start because it’s basically the same shape as a wind turbine, but without the propellers. So we just need to stick some on the side of it.

Torpedo7, the ultimate all-rounder for outdoor stores in New Zealand, introduced their latest product innovation: the Inflatable Rock.

Torpedo explained that it's perfect for hikers who want to take a break and sit on something that looks and feels just like a real rock. Instead of heavy camping chairs, you can now carry a lightweight and easy to inflate item along with a pump and instruction guide, to take your outdoor experience to the next level.

Meanwhile Amtrak introduced a loud car - where all your conversations will be heard by everyone else.

All phone calls must be on speaker, since all other passengers do want to hear the mixtape and that GRWM you're watching. Since everyone in the loud car wants to hear about other people's situationship, as a courtesy the train employees will come around for the disposing of headphones. It is not clear what will happen to those who are just quietly scrolling TikTok.

Duolingo and Peacock announced Love Language, a new reality dating show from Peacock and Duolingo where the hottest singles in the world will share a house in paradise in hopes of finding true love. The catch? None of them speak the same language.

Game developers often celebrate April Fool's Day by releasing special in-game events, updates, or content that are meant to be humorous or absurd.

A murder mystery visual novel game on Steam for PC and Mac is the point-and-click adventure that puts you amid the Sonic cast on a murder mystery party aboard the Mirage Express. Sonic as the victim. You, Tails, and Amy attempt to hunt down the killer among the other familiar guests.

Niantic celebrated "April Fowl’s day" with an announced epidemic of Pidgeys. Pokémon Center replaced Pokemons with Lechonks.

Mojang Studios, the developer of Minecraft, is debuting the Vote update, which gives all the power to the hands of the players. That is, players can vote for whatever features they want in the game, and it will come to life instantly.

While many of the products and designs introduced on this day may be jokes, they can still inspire us with their ingenuity and whimsy. So, keeping an eye on April Fool's jokes and pranks can be a fun way to stay up to date with the latest trends in tech, while also potentially discovering new ideas and concepts that could shape the future of innovation.

Check past year's jokes from our previous blog posts.

April 1, 2022: April Fools' 2022 April Fools' Technology jokes can be prophetic or ominous, wishful thinking or a reflection of real concerns.

April 1, 2021: Laughter as Medicine: The pandemics is not over, but should we pause the jokes?

April 1, 2019: Technologies we wish existed. Science fiction stories and April fool jokes often describe speculative technology we wish existed in our world.

April 1, 2018: Technology Funnies and Futures. Some April Fool's jokes come true, some have the potential to be prophetic or ominous, and some products we really wish existed.

April 1, 2016: Technology, Dreams and Jokes As Sigmund Freud suggested, jokes often expose unconscious desires. Perhaps the technologies listed below, too, have a grain of our desires wrapped in a smile? ...

April 1, 2016: IoT marches on: Key Fool's day Announcements Technology keeps marching ahead. And the future gets smarter with the Internet of Things. Here are a few announcements made on April 1 2016

Direct-To-Consumer Dentistry

2023-03-18T09:00:00.006-07:00

Direct-to-consumer (DTC) medical care is rapidly gaining momentum, appealing to everyone who values convenience, accessibility, and affordability when it comes to their health and wellness.

One area of DTC care is telemedicine - the use of technology to deliver medical care remotely. 5 years ago, radiology, psychiatry, cardiology, emergency medicine, and dermatology were among the top specialties of telemedicine. In recent years, teledentistry has experienced a surge in popularity as a new form of delivering dental care. According to the American Dental Association, 42% of people don't go to the dentist frequently enough. This could lead to poor oral health, more invasive and expensive emergency treatments, and wider health implications. Teledentistry could help to improve the general oral health of the public.

Another area of DTC healthcare is the direct sale of healthcare products to consumers without the involvement of healthcare providers. This can include the sale of over-the-counter medications, at-home testing kits, and other health-related products. While some dental products, such as toothbrushes, toothpaste, dental floss, and mouthwash, have always been easily accessible over the counter without a prescription, there have been other products that were exclusively available through licensed dental professionals and too expensive for most people to afford.

It wasn't until the mid-2010s that new DTC companies such as SmileDirectClub and Candid started offering teeth aligners directly to consumers online. These companies use a combination of telemedicine, at-home impression kits, and 3D printing technology to create customized clear aligners that are shipped directly to the patient's home. The list of DTC orthodontics companies keeps growing - including Byte, AlignerCo, NewSmile, SmileLove and SnapCorrect.

According to analysis of data collected in 2019, while many respondents would have preferred traditional treatment from a dentist or orthodontist, they chose direct-to-consumer aligners instead due to the lower cost and greater convenience. More than half did consult with a dentist before purchasing aligners and most respondents (87.5%) were satisfied with DTC treatment, although 6.6% had to visit their dentist due to the severity of adverse effects. Most recent analysis of 1,362 surveys identified a significant inverse association between the complexity of an orthodontic case and the likelihood of choosing DTC treatment over an orthodontist. Laypeople seemed to understand how complex their case was. Participants were 3.53 times more likely to choose DTC treatment for a mild case (DI score, 0-10) compared with a complex case (DI score, > 20), although the likelihood of choosing DTC treatment for a moderate case (DI score, 11-20) was only 1.79 times higher than for a complex case. (DI score, measured by professionals, evaluates severity of malocclusion, or misalignment of teeth, based on position of teeth in the jaws, the size and shape of teeth, the relationship between the upper and lower jaws, etc).

In recent years, more DTC companies have emerged offering dental laboratory services, where patients are instructed in how to independently take their own impressions and order products such as mouth guards, snoring appliances, teeth whitening trays and bleaching products, partial dentures, veneers, fake teeth and even temporary implants. Dentek store, for example, provides temporary filling kits (other options are zinc-oxide-based Safe-and-Sound kit, and Refilit material). DIYDenture offers supplies for those who need a quick solution for missing teeth. Temptooth and Brige sell tooth replacement kits on Amazon. Resetsmile offers an at-home tooth replacement option. New-York-based Dental Lab Direct is an online provider of custom-made dental products, including partial dentures, nightguards, retainers, and more. DentKits is a less known online provider of custom-made full dentures, partial dentures, and other dental appliances. TruSmile veneers offer Snap-On teeth veneers as a cheaper alternative to dentures.

The American Dental Association (ADA) and the American Association of Orthodontists (AAO) have raised concerns about this trend, referring to it as DIY dentistry. They are concerned that patients may be self-delivering unsupervised dental treatments, which can potentially cause damage and irreversible complications. However virtual dental care is much more than a cheap digital knockoff of in-person care. Besides, in-person care is not free of flaws, including a significant disparity among licensed dentists when it comes to evaluating radiographs, performing procedures, and making decisions that may be driven by profits rather than the patient's well-being. The human sensitivity can vary from 19% to 94%, and there is only a moderate level of agreement among clinicians, with less than 63% of the data considered reliable.

New computer-guided technologies allow the dentist to utilize AI and bioengineering to improve their interventions. 3D printing offers a faster, cheaper way to create dental products. New biotechnologies will allow to engineer tooth enamel that is harder and more durable than the real thing, including its elasticity and ability to absorb vibrations. Virtual/augmented reality headsets being developed could provide instructions or media for better patient-dentist interactions. These technologies can provide patients with more information about their dental health, guide their less-complicated DIY solutions, help them make more informed decisions about their treatment options and manage their wellbeing throughout the course of care.

Acknowledgements: Special thanks to the Stork app, OpenAI's Assistant, Perplexity (and other products based on the OpenAI API) for their help with illustrating this article and diligent research.

REFERENCES

Tabbaa S, Nguyen T, Toubouti Y, Saltaji H. Direct-to-consumer orthodontics: Exploring laypeople's perception of orthodontic treatment complexity. J Am Dent Assoc. 2023 Feb;154(2):130-140.e2. doi: 10.1016/j.adaj.2022.10.017. Epub 2022 Dec 31. Erratum in: J Am Dent Assoc. 2023 Feb 3;: PMID: 36593134.

Wexler A, Nagappan A, Beswerchij A, Choi R. Direct-to-consumer orthodontics: surveying the user experience. J Am Dent Assoc. 2020 Aug;151(8):625-636.e4. doi: 10.1016/j.adaj.2020.02.025. PMID: 32718492; PMCID: PMC7391059.

Bader JD, Shugars DA, Bonito AJ. Systematic reviews of selected dental caries diagnostic and management methods. J Dent Educ. 2001 Oct;65(10):960-8. PMID: 11699997.

Valachovic RW, Douglass CW, Berkey CS, McNeil BJ, Chauncey HH. Examiner reliability in dental radiography. Journal of Dental Research. 1986 Mar;65(3):432-6.

Alqutaibi, A.Y.; Aboalrejal, A.N. Artificial intelligence (AI) as an aid in restorative dentistry is promising, but still a work in progress. J Evid Based Dent Pract. 2023 Mar;23(1):101837. doi: 10.1016/j.jebdp.2023.101837. Epub 2023 Feb 8. PMID: 36914305.

Kane CK, Gillis K. The use of telemedicine by physicians: still the exception rather than the rule. Health Affairs. 2018 Dec 1;37(12):1923-30.

Quantified Self: From Sousveillance to Personal Science and Phenotyping

2023-01-02T20:25:00.010-08:00

The quantified-self movement which involves using technology to track various aspects of one's daily life and behaviors, could be traced back to the sousveillance-like monitoring described in 1970. One of the first platforms for these activities - Nike+ website publicly launched in 2006 - was helping runners to track and share their workouts.

The term "quantified self" was coined in 2007 by Wired magazine editors Gary Wolf and Kevin Kelly who co-founded the Quantified Self Institute and "Quantified Self Meetups." The movement experienced a period of rapid growth in popularity in the 2010s. Forbes has even called 2013 "The Year of the Quantified Self".

As the technology for self-tracking has become more advanced and widespread, it has attracted the attention of commercial hardware developers. Fitbit founded in 2007 as Healthy Metrics Research, released their first tracker in 2009. In the 2010s, a number of major tech companies, including Apple, Google, and Samsung, began to develop and market wearable devices and self-tracking apps.

Quantified Self movement has not become a mainstream trend due to a combination of cost, technical barriers, and privacy concerns. Many people resented self-tracking being pushed by their employers, health and life insurers in order to monitor them. And despite many attempts to develop analysis tools, most people are still lacking the skills to process their data in order to make better decisions in everyday life.

"Personal science" (the use of scientific methods and principles to analyze personal lifelogging) and N-of-1 studies (when individual is studied in isolation, rather than as part of a larger group in a clinical study) are related to the quantified-self movement in that they both involve the use of technology and data to track and understand one's own health and behavior. These approaches, however, are not yet widely used or understood by the general public.

The use of self-tracking data has the potential to inform the study of various medical conditions through the process of phenotyping, as several papers have demonstrated (eg, for vaccine-triggered anorexia and endometriosis). However, the understanding of how to effectively use this type of data for this purpose is still in the early stages, and it has not yet been widely adopted by traditional medical science. In contrast to what was expected 20 years ago, phenotyping has taken a back seat in human genetics research. It was thought that having a precise or well-measured phenotype was far less relevant than having a huge sample. However, now that the field of genetics has a working strategy for gene discovery, and AI is getting more sophisticated, the importance of phenotype is re-emerging, and this will likely lead to a renewed interest in the quantified self.

REFERENCES

McClusky M. The Nike experiment: how the shoe giant unleashed the power of personal metrics. Wired. 2009 Jun 22;17(07).

Gabashvili IS. Why Red Beans and Rice Are Good ... But Not with Coffee, Forbes 2012, April 30. DOI: 10.6084/m9.figshare.13600517

Osozawa S. Case report: anorexia as a new type of adverse reaction caused by the COVID-19 vaccination: a case report applying detailed personal care records. F1000Res 2022 Jan 4;11:4

Urteaga I, McKillop M, Elhadad N. Learning endometriosis phenotypes from patient-generated data. NPJ digital medicine. 2020 Jun 24;3(1):1-4.

Dick DM. The Promise and Peril of Genetics. Curr Dir Psychol Sci. 2022 Dec;31(6):480-485. doi: 10.1177/09637214221112041. Epub 2022 Sep 16. PMID: 36591341; PMCID: PMC9802013.

Special thanks to OpenAI's Assistant for their help with illustrating and writing this article.

COVID-19: vaccines and infections

2022-11-04T14:43:00.008-07:00

Personalized, precise and predictive vaccinology's holy grail is to anticipate immune response for every individual, depending on their genetic background and all other factors that may impact vaccine immunogenicity, efficacy, and safety.

The high expense of comprehensive genomic and immune-profiling tests, however, prohibits their routine use and this disproportionally affects underserved populations.

A new paper reports preliminary results of an ongoing study of COVID-19 vaccination in geographic neighborhoods and online health support groups. Due to innovative recruitment and monitoring strategies, the study has the largest representation of active "oldest old" - individuals aged 80 or older - than all other trials with diverse age groups.

Despite widespread belief of a biphasic pattern for the frequency of systemic adverse events post-vaccination (VAEs), the paper reports statistically significant differences in the incidence of VAEs for both younger and 80+ populations when compared to those in the 60-69 and 70-79 age brackets. The subtypes of adverse events in younger and older populations are different. This short paper groups post-vaccination events in three types: "No or minimal VAEs", and short- or long-term reactions that significantly impacted activities of daily living.

The paper suggests genetic origin for some adverse reactions. Scientists have only just begun to look into genetics of less common VAEs. HLA-A∗03:01 (contributing to low risk of severe COVID-19) was recently found to be associated with increased risk of stronger side effects (including fever and chills) from Pfizer-BioNTech COVID-19 vaccination. In another recent study, HLA-DQB1*06 alleles were found to protect from breakthrough infection during the ancestral SARS-CoV-2 virus and subsequent Alpha-variant waves compared with non-carriers. Hopefully, more studies will follow.

REFERENCE

Gabashvili IS. The Incidence and Effect of Adverse Events Due to COVID-19 Vaccines on Breakthrough Infections: Decentralized Observational Study With Underrepresented Groups. JMIR Form Res. 2022 Nov 4;6(11):e41914. doi: 10.2196/41914. PMID: 36309347.

Current Impact score of the journal is: 2.38 (Resurchify)

JMIR Formative Research has been accepted for the Web of Science: Emerging Sources Citation Index. The journal will receive a Journal Impact Factor in 2023.

The Rapid Expansion of DTC Healthcare

2022-09-17T18:31:00.004-07:00

Preventive care is recognized as the most effective strategy for health care cost reduction. Screening for early signs of heart disease, cancer, maintenance of diabetes and allergies and prevention of infectious diseases can be done without a supervising physician. Direct-to-consumer (DTC) laboratory testing allows individuals to order tests directly from a laboratory without going through their healthcare provider, and often at lower cost. The number of companies providing direct-to-consumer diagnostic testing is rapidly growing, along with the range of health information provided by these tests. Ancestry (genealogy) testing is an example. And so are new devices for cardiac monitoring.

Experts anticipate a near-term explosion in the DTC marketplace. DTC healthcare already was a US$700 billion industry in 2020, including over-the-counter drugs. The Mark Cuban Cost Plus Drug Company, PBC (MCCPDC) is nearing one million customers. An analysis of 2011-1019 records from Rock Health Digital Database, showed that 252 (21%) of 1214 digital health companies pursued a direct-to-consumer strategy. The pandemic has accelerated this growth. According to research by Deloitte, the number of people using virtual healthcare rose from 15% to 19% from 2019 to early 2020, then jumped to 28% in April 2020. On average, 80% were likely to have another virtual visit, even post COVID-19 and said they will use this type of care again. Latest data showed that consumers’ appetite for virtual health and digital health tools continued to steadily increased, although there was significant variation in physician adoption.

Human touch remains central to care delivery. In the 2022 Deloitte Survey of US Health Care Consumers, 70% of respondents who had a virtual visit in 2022 (vs. 67% in 2020) thought that the quality of virtual care was as good as in person, but only 73% (vs. 82% in 2020) thought they were able to connect with the clinician the same way they would in-person. Integration of data from patients' wearables and their self-reported outcomes into health records also experienced a setback.

The global market for Direct-to-Consumer (DTC) testing was predicted to grow from $1.4 billion in 2020 to $2.6 billion by 2025. There were cautionary cases of uBiome and Theranos, there are quackery labs, but as the industry matures and moves toward utilization of clear clinical metrics, and as the capabilities of technology advance, DTC testing will me more and more impactful. There are DTC companies that offer the tests and biometric screenings that a physician would typically order as part of a routine annual physical, such as a complete blood count, comprehensive metabolic panel, urinalysis, and cardiovascular and diabetes risk assessment. Ultalabs, JasonHealth, discounted labs, drsays and privatemdlabs all allow to self-order laboratory tests and Quest and Labcorps locations.

No more uncomfortable questions for a blood test prescription. No doctor visit needed to gettest results - they will be emailed instead. Consumers pay up front and know exactly what they are paying for. Unfortunately, the same cannot be said for many other healthcare services.

Genetic counseling for patients who are pursuing genetic testing in the absence of a medical indication, referred to as elective genomic testing (EGT), is becoming relatively common. More people are using technology to monitor their health, measure fitness, and order prescription refills. Before COVID-19, there was a slight decline in people who were willing to share their health data—but during the pandemic, new data showed that people are more comfortable sharing data during a crisis

REFERENCES

Cohen AB, Mathews SC, Dorsey ER, Bates DW, Safavi K. Direct-to-consumer digital health. The Lancet Digital Health. 2020 Apr 1;2(4):e163-5.

Stoffel M, Greene DN, Beal SG, Foley P, Killeen AA, Shafi H, Terrazas E. Direct-to-Consumer Testing for Routine Purposes. Clinical Chemistry. 2022 Sep;68(9):1121-7.

2022 Global health care sector outlook | Deloitte

deloitte-nl-healthcare-consumer-centered-future-of-health.pdf

https://www.beckershospitalreview.com/lab/lab-test-market-shifting-from-provider-driven-to-consumer-driven.html

Resolving the subtypes of COVID-19 in the elderly

2022-05-16T07:12:00.006-07:00

SARS-Cov-2 is one of the most complex viruses known to medical science. Patients with COVID-19 present a broad spectrum of clinical manifestations, ranging from asymptomatic infection to lethal outcome. Both the young and the old may have very different clusters of symptoms and responses to medications, including the COVID-19 vaccines. Each type is associated with how severe of an illness a patient might experience, ranging from asymptomatic to lethal.

Precision medicine approaches such as whole-exome sequencing can provide insight into the phenotypes, endotypes and underlying mechanisms of the disease. The high cost of cutting-edge approaches, however, keeps these tools out of reach for many research teams.

In this age of big data and large clinical studies, we should not forget about the value of individual cases. A good case report tells a detailed story. It describes a unique phenotype and offers unique clues to its resolution into an endotype.

A new systematic review of case reports aims to answer questions about COVID-19 subtypes in octogenarians, nonagenarians, and centenarians and offer possible solutions to organize the knowledge and identify the gaps.

REFERENCE

Irene S. Gabashvili. The outcomes of COVID-19 vaccination and SARS-CoV-2 infection in octogenarians, nonagenarians, and centenarians. PROSPERO 2022 CRD42022332621 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022332621

Irene S. Gabashvili (2022), “COVID-19 vaccine and SARS-CoV-2 in the oldest old: rapid literature review”, Mendeley Data, v1 http://dx.doi.org/10.17632/6sk33d9z7s.1 https://data.mendeley.com/datasets/6sk33d9z7s/1

Irene S. Gabashvili (2022), “The Outcomes of COVID-19 and Vaccination in the Oldest Old: a Longitudinal Observational Study and Literature Review”, April 2022, DOI: 10.13140/RG.2.2.15625.93285

Getting Out of Echo Chambers

2022-03-03T17:43:00.006-08:00

Web search is hyper personalized and social media creates echo chambers.

Nothing new, really. "The Facebook effect" was coined over 10 years ago, and the echo chamber effect of the Internet was known long before that. Echo chambers existed even in the early blogosphere. But the isolation from a diversity of views and opinions may be reaching the tipping point.

A study published last month in PLOS One, analyzed and visualized 60 billion tweets demonstrating how highly the vaccine debate is polarized.

Users with similar stances interacted preferentially with one another. Interactions between individuals with different views were rare and not productive. Extending this insight, the authors provide evidence of an epistemic echo chamber effect, where users are exposed to highly dissimilar sources of information, depending on the stance of their contacts.

But does it make sense to call an article or a blog post provaxx or antivaxx based on pro- or anti-vaccine sentiment?

Why can't we discuss pros and cons of vaccines objectively and admit that medicine should be personalized? Majority of population benefits from vaccines, but there are those that don't. Should not we try to understand why?

The only way to overcome hyperpolarization is to increase our collective cultural intelligence, improve critical thinking skills, counteract destructive polarization, recognize the legitimacy and ongoing necessity of opposing viewpoints.

The new.aurametrix.com site is a collection of scientific papers about the less discussed medical cases. We all know that vaccines work. We dare you to understand why there are cases when they don't.

REFERENCES

Less Discussed Medical Case Reports

Mønsted B, Lehmann S. Characterizing polarization in online vaccine discourse—A large-scale study. PloS one. 2022 Feb 9;17(2):e0263746.

Ries M. The COVID-19 Infodemic: Mechanism, Impact, and Counter-Measures—A Review of Reviews. Sustainability. 2022 Jan;14(5):2605.

Gorman, J. M., & Scales, D. A. (2022). Leveraging infodemiologists to counteract online misinformation: Experience with COVID-19 vaccines. Harvard Kennedy School (HKS) Misinformation Review. https://doi.org/10.37016/mr-2020-92

Myocarditis and COVID-19: for some people the risk may be higher following vaccination than infection

2021-12-25T08:26:00.005-08:00

COVID-19 is a known cause of cardiac complications such as myocarditis and systolic dysfunction. Vaccine associated myocarditis was described following smallpox vaccination, streptococcal pneumonia and influenza vaccine. In some cases, autoimmune/inflammatory syndrome induced by adjuvants used in the vaccine have been also implicated.

Associations of COVID-19 vaccination and myocarditis have been proposed in multiple publications, but the consensus was that the benefits of vaccine are worth the increased risk even though more personalized approach seems warranted by the evidence.

A new study presents data about the risk of myocarditis increasing with each subsequent dose of mRNA vaccines, especially mRNA-1273. Moreover, in younger males the risk of myocarditis was higher following vaccination than infection. Another study presents a case of fatal breakthrough infection in an older male who experienced myocarditis-like symptoms after his COVID-19 vaccine. Retrospective cohort study of 196,992 adults in Israel did not observe an increased incidence of neither pericarditis nor myocarditis in unvaccinated adult patients recovering from COVID-19 infection. See example case reports.

REFERENCES

Martina Patone, Winnie Xue Mei, Lahiru Handunnetthi, Sharon Dixon, Francesco Zaccardi, Manu Shankar-Hari, Peter Watkinson, Kamlesh Khunti, Anthony Harnden, Carol AC Coupland, Keith M. Channon, Nicholas L Mills, Aziz Sheikh, Julia Hippisley-Cox Risk of myocarditis following sequential COVID-19 vaccinations by age and sex medRxiv 2021.12.23.21268276; doi: https://doi.org/10.1101/2021.12.23.21268276

Kim HW, Jenista ER, Wendell DC, Azevedo CF, Campbell MJ, Darty SN, Parker MA, Kim RJ. Patients with acute myocarditis following mRNA COVID-19 vaccination. JAMA cardiology. 2021 Oct 1;6(10):1196-201.

Lazaros G, Anastassopoulou C, Hatziantoniou S, Kalos T, Soulaidopoulos S, Lazarou E, Vlachopoulos C, Vassilopoulos D, Tsakris A, Tsioufis C. A case series of acute pericarditis following COVID-19 vaccination in the context of recent reports from Europe and the United States. Vaccine. 2021 Oct 29;39(45):6585-90.

Hendren NS, Carter S, Grodin JL. Severe COVID-19 vaccine associated myocarditis: Zebra or unicorn?. International journal of cardiology. 2021 Nov 15;343:197-8.

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Cutaneous manifestations of SARS-CoV-2 and COVID-19 vaccines

2021-12-16T17:37:00.010-08:00

COVID-19 is associated with a wide range of skin signs.

The following six main clinical patterns have been proposed for such manifestations most recently: (i) urticarial rash, (ii) confluent erythematous/maculopapular/morbilliform rash, (iii) papulovesicular exanthem, (iv) chilblain-like acral pattern, (v) livedo reticularis/racemosa-like pattern, and (vi) purpuric "vasculitic" pattern. Livedo or necrosis - blotchy red or blue appearance with a net-like pattern - was associated with increased disease severity while measles-like (morbilliform) rash was generally seen in patients with moderate to severe infection (like in the patient shown on the left who died) and pseudo-chilblains, a late sign of COVID-19, was associated with decreased severity and more likely to happen for younger patients. The median duration of chiblain-like acral pattern, however, was significantly longer that all other patterns. One study of 200 patients found the following frequencies of these signs: 10.2% for Urticarial rash; 25.7% for confluent erythematous/maculo-papular/morbilliform rash; 15.5% for papulovesicular exanthem, 24.6% for a chilblain-like acral pattern; 2.1% for a livedo reticularis/racemosa-like pattern; and 6.9% for a purpuric vasculitic pattern. 15% of skin patterns were not clearly classified while 6.5% had more than one pattern present.

The prevalence of cutaneous involvement was 7.8% in a binational Chinese-Italian cohort of 678 hospitalized adults with laboratory-confirmed disease. Dermatologic reactions after COVID-19 vaccines have been also reported and can mimic SARS-CoV-2 infection itself (eg, pernio/chilblains). The prevalence was the highest after the 2nd dose of mRNA-1273 (over 12% in Moderna), although only 1-2% experienced it with ChAdOx1 nCov-19 vaccine (AstraZeneca).

Delayed large local reactions were most common among vaccinees, followed by local injection site reactions, urticarial eruptions, and morbilliform eruptions. In a study of 414 people, forty-three percent of patients with first-dose reactions experienced second-dose recurrence. Additional less-common reactions included pernio/chilblains, dyshidrotic eczema, psoriasiform dermatitis, cosmetic filler reactions, zoster, herpes simplex flares, and pityriasis rosea-like reactions.

Some of more serious reactions could be exacerbation of Erythema multiforme. It mostly happens in mild form of a sudden rash that goes away in a few weeks but could progress to larger raised patches that look like a target or "bulls-eye" and may have a blister or crust. Relapses of autoimmune bullous disease have been also reported as well as new onset Lichen planus, immune complex vasculitis or flares of subacute cutaneous lupus erythematosus, psoriasis and atopic dermatitis.

Morphologic misclassification is, however, possible.

REFERENCES

Tan SW, Tam YC, Oh CC. Skin manifestations of COVID-19: A worldwide review. JAAD international. 2021 Mar 1;2:119-33.

Slimani Y, Abbassi R, El Fatoiki FZ, Barrou L, Chiheb S. Systemic lupus erythematosus and varicella‐like rash following COVID‐19 in a previously healthy patient. Journal of Medical Virology. 2021 Feb;93(2):1184-7.

Genovese G, Moltrasio C, Berti E, Marzano AV. Skin manifestations associated with COVID-19: current knowledge and future perspectives. Dermatology. 2021 Jan 1:1-2.

Marzano AV, Genovese G, Moltrasio C, Gaspari V, Vezzoli P, Maione V, Misciali C, Sena P, Patrizi A, Offidani A, Quaglino P. The clinical spectrum of COVID-19–associated cutaneous manifestations: An Italian multicenter study of 200 adult patients. Journal of the American Academy of Dermatology. 2021 May 1;84(5):1356-63.

Bogdanov G, Bogdanov I, Kazandjieva J, Tsankov N. Cutaneous adverse effects of the available COVID-19 vaccines. Clinics in Dermatology. 2021 Apr 27.

Rice SM, Ferree SD, Mesinkovska NA, Kourosh AS. The art of prevention: COVID-19 vaccine preparedness for the dermatologist. International journal of women's dermatology. 2021 Jan 12.