As an investor in healthcare AI companies, I actually completely agree that there's a lot of bad implementations of AI in healthcare settings, and what practitioners call "alarm fatigue" as well as the feeling of loss of agency is a huge thing. I see a lot of healthcare orgs right now roll out some "AI" "solution" in isolation that raises one metric of interest, but fails to measure a bunch of other systemic measures.
Two thoughts:
1: I think the industry could take cues from aerospace and the human factors research that's drastically improved safety there -- autopilot and autoland systems in commercial airliners are treated as one part of a holistic system with the pilot and first officer and flight attendants in keeping the plane running smoothly. Too few healthcare AI systems are evaluated holistically.
2: Similarly, if you're going to roll out a system, either there's staff buy-in, or the equilibrium level of some kind of quality/outcomes/compliance measure should increase that justifies staff angst and loss of agency. Not all AI systems are bad. One "AI" company we invested in, Navina, is actually loved by physicians using them, but the team also spent a LOT of time doing UX research and feedback with actual users and the support team is always super responsive.
Pediatric allergy and atopic diseases in general is a mess an only slowly getting better. There's strong correlation between early eczema and food allergies, and now mild but convincing evidence it could even be causal. That eczema (and atopic disease in general) is strongly linked with microbiome and exposure to beneficial bacteria, especially in the first few days and weeks of life. This is also associated with malnutrition, diabetes, obesity, colic, and other symptoms we generally only treat symptomatically and in a silo. Yet for structural reasons, most pediatricians will at best tell you that early probiotics is a placebo. Top pediatricians in the know though will enthusiastically support targeted probiotics. Hell, the whole country of Bangledesh has a successful probiotic program -- https://www.science.org/doi/10.1126/scitranslmed.abk1107. It's amazing how much of common pediatric wisdom in the 80s/90s (clean newborn after birth, eat mushy prepared foods, enriched formula feeding, clean environments, avoid allergens, etc) are now seen as really harmful.
As a healthcare tech investor, I do see a lot of startups selling potentially dangerous AI systems into the healthcare system. That said, there are also a good number of companies that are implementing systems thoughtfully to address a number of issues that are very real in healthcare like staff burnout, continuing education, adherence to standard of care, managing complex value-based payment contracts and coordination of care, etc. The trouble I see is that clinician/hospital buyers of these systems can't always tell the difference. A basic initial filter that can be used is simply (a) does the team have an experienced medical professional with power on its executive team, and (b) does the team credibly know how to measure clinical quality impact of what they're building and do they have a plan to honestly measure it.
Metagenomic sequencing: The field exploded after technologies and techniques were developed for using next-gen sequencing to characterize entire populations/communities of living things, first with 16S rRNA sequences, then with full genomes. The cost to do this has also gone down many, many, many orders of magnitude in the last decade or two (just search "sequencing cost graph" on google).
Yep, you're right. Only meant to associate them in terms of why they're valued land, but yes, they're in separate riparian zones. Central valley is Sacramento/San Joaquin river delta.
The unfortunate thing is that large stretches of California desert (and much of the Central Valley to the north) used to be lake bottoms and have incredibly rich and fertile soils. Between that and a long growing season that's nearly cloudless, you get ideal growing conditions -- rich soil, lots of sun, low moisture (i.e. low disease load), and H2A labor -- provided you can control the irrigation. Ah the problems caused by mispriced externalities...
Had a similar experience with GCP -- wanted to run an experiment in AWS, Azure, and GCP side-by-side. AWS and Azure were set up within a day. GCP required hitting up support to "turn on the feature," then a salesperson called to tried to upsell over a few calls before they'd turn it on. There was then confusing payment UI flow that meant my payment wasn't set up correctly. Overall took 3 weeks of back and forth to even start. This was 4 years ago, so maybe it's changed a bit now, but it's hard imagining depending on them as a business unless you're the scale of Snap and have leverage.
I'm finding with the teams I'm working with that the junior employees are the ones most impacted by not working from an office, but they often don't realize what they're missing -- the less formal forms of mentorship, stronger community, interacting with more people that's not on their team and in their role, overhearing context, the ability to have a 3-min quick chat with a senior person without a scheduled meeting, and developing that stronger sense of "what good looks like." I'm really concerned that we're going to have a two-tiered system where a bunch of people early in their careers are going to feel stuck in a few years and not even realize why.
You should -- protease inhibitors inhibit replication, but existing viruses should be more than enough to generate a durable response in most individuals.
Yeah, as parent mentioned in another reply below, ritonavir is an antiviral, but has no effect on SARS-CoV-2 (https://pubmed.ncbi.nlm.nih.gov/34048671/). Ritonavir is just used to inhibit CYP and therefore reducing clearance of the drug.
Reminds me of when a honeybee swarm occupied the parking lot behind our building and eventually mostly settled on a bike rack (this also happens to be the building of the downtown Palo Alto Philz). As a beekeeper, I was so excited that I emailed our head of ops and physical security in all caps asking if I could have them. After he called me to confirm that I wasn't trolling, he graciously offered to stand guard to keep folks away while I grabbed my bee suit to safely remove the bees and put them in a new home.
^ Yeah that's directionally accurate. The AMA is one of the two funders of LCME, the accrediting agency of medical schools for MDs (outside of the med school trade association itself). While they do not run medical schools, they have enormous power over training standards, who should be a physician, how medicine should be practiced, and who shouldn't practice. As an example, they lobby pretty regularly against the expansion of the role of RNs/NPs (https://www.ama-assn.org/press-center/ama-statements/ama-sta...). Much of this derives originally from the Flexner Report which created the current system of US medical education, which is still based on old sensibilities that physicians should be professional gentlemen and "proper" (and perhaps fueled by cocaine -- no seriously, google "halstead cocaine").
I am not a physician, but I have been in the guts of healthcare for quite a while, and the AMA continues to pop up as the man behind the curtain surprisingly often.
The AMA chooses who can be a doctor, who can train doctors, who can practice any kind of medicine, has extremely strong pricing power over the entire healthcare system via the RUC (https://en.wikipedia.org/wiki/Specialty_Society_Relative_Val...), advocates on behalf of doctors whether or not you agree, and much more, all under a guise of "non-profit advocacy for public health." They are a racket -- we would do well to have a rogue upstart competing licensing body.
I was fascinated with the history of the Sami when I visited Karasjok in the dead of winter, and spoke to a few who still tried to keep a somewhat traditional lifestyle. It did feel like it was a fight against time to keep those nomadic herding ways alive, and a really interesting philosophical debate about what really defines the Sami other than blood and (partly forgotten or purged) shared history if most are living lives indistinguishable from Norwegians and Swedes in their community.
You can't go faster than the speed of light in a vacuum. But, you can definitely go faster than light in a medium. Speed of light in water, for example, is around 0.75c.
Two thoughts: 1: I think the industry could take cues from aerospace and the human factors research that's drastically improved safety there -- autopilot and autoland systems in commercial airliners are treated as one part of a holistic system with the pilot and first officer and flight attendants in keeping the plane running smoothly. Too few healthcare AI systems are evaluated holistically.
2: Similarly, if you're going to roll out a system, either there's staff buy-in, or the equilibrium level of some kind of quality/outcomes/compliance measure should increase that justifies staff angst and loss of agency. Not all AI systems are bad. One "AI" company we invested in, Navina, is actually loved by physicians using them, but the team also spent a LOT of time doing UX research and feedback with actual users and the support team is always super responsive.