The Black Death and Things

I was aware that the Black Death (Yeresina Pestis) has been around a long time, but I was unaware that it had left its homeland in Manchuria before the Plague of Justinian from 541 to 549 C.E.

Well, we now have evidence of a lethal plague outbreak around Lake Baikal circa 3500 BCE,

This is thousands of years before Y. pestis was thought to be virulent, and over 2000 km (1200 miles) from the primary reservior for this disease.

3500 BCE is largely before the advent or agriculture and long trade routes, so this is kind of weird.

Siberia 5,500 years ago, leaving dozens dead in its wake—with DNA from Yersinia pestis bacteria still trapped inside their teeth.

University of Oxford ancient DNA researcher Ruairidh Macleod and his colleagues recently sequenced the telltale bacterial DNA in teeth from plague victims at four ancient cemeteries in the area around Russia’s Lake Baikal. The tragedy that befell these communities is now the earliest known plague outbreak, courtesy of the oldest strain of Y. pestis ever sequenced.

Unearthing a new backstory for the plague

Until recently, scientists who study the evolution of diseases have held two fairly solid ideas about the origins of plague, the disease caused by Yersinia pestis bacteria. It’s a scourge so awful that it has gone down in history as not just a plague but the plague. The first idea is that the earliest strains didn’t have the right genetic traits to be really lethal. And the second is that the plague first began menacing humans when the first farmers settled in densely packed towns alongside rats and domestic animals.

But the dead of Ust’-Ida I cemetery, near Lake Baikal, tell a very different story.

“Our findings demonstrate that the earliest known outbreaks of plague occurred in prehistoric hunter-gatherers centuries before infections are observed in Neolithic farmers,” wrote Macleod and his colleagues in their recent paper.

That challenges our previous assumption that plague spillover was a side effect of people taking up farming and settling in permanent villages and towns, living closer to each other and to an assortment of animals (and their fleas).

“Much of the accepted theory around epidemiology of disease in the past is that this kind of thing shouldn’t occur in hunter-gatherers because hunter-gatherers are constantly moving around the landscape because they’re in such small groups all the time,” said Macleod in a press conference. “The theory, at least, is that infectious disease can’t really take hold and devastate entire communities in this way.” 

So much for that theory.

Fascinating.

Vaccines Work

In the UK, the widespread rollout of the HPV vaccine has cervical cancer deaths for young women falling to 0.

Imagine that.

The HPV vaccine, which protects against the Human Papillomavirus responsible for most cervical cancer cases, has been linked to a dramatic decline in cervical cancer deaths among young women in England, according to a new study published in The Lancet.

Researchers from Queen Mary University of London found that no cervical cancer deaths were recorded among women aged 20-24 years in England between 2020 and 2024, marking the first time such record in a five-year period. The study estimated that around 23 deaths would have been expected in this age group if the vaccination would not have been introduced.

The Human Papillomavirus (HPV) vaccine protects against several cancer-causing strains of the virus, particularly those responsible for cervical cancer. It works by prompting the body's immune system to produce antibodies that can neutralise the virus before infection occurs. Health authorities generally recommend routine vaccination for children aged 11 or 12, although it can be administered from the age of nine.

The study revealed that early vaccination at age 12 or 13 virtually eliminates the risk of cervical cancer deaths before age 30. Prior to the introduction of the vaccination programme in England in 2008, around 20 cervical cancer deaths were recorded annually among women under 30.

Get your vaccines. 

More Fruit of the Poisonous Antivaxx Tree

An increasing number of newborns are dying from intestinal and cranial bleeds because parents are refusing the once-routine vitamin K injection, because ……… anti-vaccine vibes.

They entered the world the way babies should, with piercing cries announcing their arrival. They passed their newborn screening tests. Some made it to their 2-week wellness visits without concern.

Then, without warning, their systems began to shut down. A 7-week-old boy in Maryland developed sudden seizures. An 11-pound girl in Alabama stopped breathing for 20 seconds at a time. A baby boy in Kentucky vomited before becoming lethargic. A brown-haired girl in Texas, not yet 2 weeks old, bled around her belly button.

Desperate to save them, records show, doctors inserted tubes into their airways and hooked them up to IVs. They ordered blood transfusions. They spent half an hour trying to resuscitate one boy until his parents told them they could stop. They shaved another boy’s soft locks to embed a needle directly into his skull to reduce the pressure in his brain.

None of it was enough.

At the morgue, the babies were brought in with their diapers and blankets and with their hospital ID bracelets still wrapped around their tiny ankles. The pathologists’ findings were like those you would typically see in ailing adults, not newborns — the kind of bleeding seen during strokes or brain tissue loss similar to what happens when radiation is administered to treat cancer.

Their autopsies, which took place over the last several years, all came to the same conclusion: The deaths were caused, in whole or in part, by a rare but potentially fatal condition known as vitamin K deficiency bleeding.

In almost every case, the babies’ deaths could have been prevented with a long-standard vitamin K shot. But across the country, families — first in smatterings, now in droves — are declining the single, inexpensive injection given at birth to newborns to help their blood clot.

RFK, Jr. and Andrew Wakefield should spend the rest of their lives behind bars. 

 

Ecch (Tweet) of the Day

I'm thinking I may have some orthopedic issues.

I'm going to cuddle the sh%$ out of my cats. 

Scientific research has confirmed that the vibrations produced by a cat’s purr, ranging between 25 and 150 Hertz, can accelerate bone healing and improve tissue repair.

Cats purr naturally during rest, stress, or pain, and these frequencies stimulate bone density and promote… pic.twitter.com/Ac6aQdmxV3

— Massimo (@Rainmaker1973) December 3, 2025

Best Healthcare in the World

A man committed suicide after he was unable to get mental health care, and his mother is suing the insurance company because their directory of providers was completely inaccurate.

She are claiming that the company was falsely claiming that there were in-network mental health professionals when there were none.

This is a very common thing for insurance companies to do:

The mother of an Arizona man who died after being unable to find mental health treatment is suing his health insurer, saying it broke the law by publishing false information that misled its customers.

Ravi Coutinho, a 36-year-old entrepreneur, bought insurance from Ambetter, the most popular plan on HealthCare.gov, because it seemed to offer plenty of mental health and addiction treatment options near his home in Phoenix. But after struggling for months in early 2023 to find in-network care covered by his plan, he wasn’t able to find a therapist. In May 2023, after 21 calls with the insurer without getting the treatment he sought, he was found dead in his apartment. His death was ruled an accident, likely due to complications from excessive drinking.

Coutinho was the subject of a September 2024 investigation by ProPublica that showed how he was trapped in what’s commonly known as a “ghost network.” Many of the mental health providers that Ambetter listed as accepting its insurance were not actually able to see him. ProPublica’s investigation also revealed how customer service representatives and care managers repeatedly failed to connect Coutinho to the care he needed after he and his mother asked for help. The story was part of a yearlong series, “America’s Mental Barrier,” that investigated the ways insurers employed practices that interfered with their customers’ ability to access mental health care.

The lawsuit, filed on May 23 in Maricopa County by Coutinho’s mother, Barbara Webber, accused the insurer Centene, along with the subsidiary that oversaw her son’s plan, Health Net of Arizona, of publishing an “inaccurate and misleading” provider directory. The suit also accused the companies of breaking state and federal laws, including ones that require directories to be kept accurate.

In case you are unaware, it works like this:  The insurance company lists hundreds of mental health professionals in their directory, but most (all?) of them are either not taking new patients, or they have left the network.

……… 

The lawsuit also describes how Arizona insurance regulators had previously informed Health Net of Arizona that it had failed to maintain accurate provider directories. Health Net of Arizona promised to correct the errors. Regulators did not fine the insurer and declined to answer ProPublica’s questions about whether the Centene subsidiary addressed their concerns. 

………

One of the 25 largest companies in America, Centene and its subsidiaries have been accused in past lawsuits of purposefully misrepresenting the number of in-network providers by publishing inaccurate directories. Centene lawyers have previously denied such claims in two of the bigger cases, in Illinois and California. Both cases are ongoing. 

The top trade group for the industry, AHIP, has told lawmakers that companies contact in-network providers to ensure the listings are accurate. AHIP also stated that the companies could correct inaccuracies faster if providers did a better job updating their listings. Providers have told ProPublica, however, that insurers don’t always remove their names from insurer lists when they officially request to leave their networks. 

The insurers have no incentive to keep their directories accurate.  If they had to list the practices that had closed to new patients and remove the listings for companies that have told them to pound sand, it would be clear to people shopping for insurance that their coverage sucks, and people would not buy their insurance and pay their premiums.

Their solution, rather unsurprisingly, is to defraud their customers.

We need to start prosecuting this sort of bullsh%$. 

Living the Meme

So, I was driving to the gym with Sharon,* and she discussed her appointment with her new rheumatologist today.

She is dealing with fibromyalgia.

She mentioned that the doctor did a Lupus test, which she has been tested for before, and as on previous occasions, she tested negative this time.

So, I said, "It's not Lupus, it's never Lupus."

She gave me a profoundly confused look, and replied that she had already said that. 

I asked if she understood the meme, and she shook her head, and I said, "House," and suddenly there was memetic recognition in her eyes.

It made my day.

^*Love of my life, light of the cosmos, she who must be obeyed, my wife.

Our Corrupt Markets

Terumo Cardiovascular, makes a perfusion system used in open heart surgery has changed its terms of service, so now hospitals will be forbidden from doing any maintenance on these machines.

So, they are going to f%$# hospitals just like John Deere f%$#s farmers.

The manufacturer of a machine that costs six figures used during heart surgery has told hospitals that it will no longer allow hospitals’ repair technicians to maintain or fix the devices and that all repairs must now be done by the manufacturer itself, according to a letter obtained by 404 Media. The change will require hospitals to enter into repair contracts with the manufacturer, which will ultimately drive up medical costs, a person familiar with the devices said.

The company, Terumo Cardiovascular, makes a device called the Advanced Perfusion System 1 Heart Lung Machine, which is used to reroute blood during open-heart surgeries and essentially keeps a patient alive during the surgery. Last month, the company sent hospitals a letter alerting them to the “discontinuation of certification classes,” meaning it “will no longer offer certification classes for the repair and/or preventative maintenance of the System 1 and its components.”

This means it will no longer teach hospital repair techs how to maintain and fix the devices, and will no longer certify in-house hospital repair technicians. Instead, the company “will continue to provide direct servicing for the System 1 and its components.”

………

Hospitals are increasingly being pushed into signing maintenance contracts directly with the manufacturers of medical equipment, which means that repair technicians employed by hospitals can no longer work on many devices and hospitals end up having to employ both their own repair techs and keep up maintenance contracts with device manufacturers. 

“One of my fears is that if a device goes down, we’re going to be subject to their field engineers’ availability,” a source who works in hospital medical device repair told 404 Media. 404 Media agreed to keep the source anonymous because they were not authorized by their hospital to speak to the media. “They may not be able to get here that same day or the next day, and if you’ve got people waiting to get an open-heart surgery, you have to tell them ‘Oh, the machine’s down, we’re going to have to postpone this.’ That’s detrimental to a patient who has a life-altering, very serious thing that they’re having to cancel and reschedule.” 

………

This specific ventilator repair crisis during COVID led experts at Harvard Medical School to write that “For years, manufacturers have curtailed the ability of hospitals to independently repair and maintain medical equipment by preventing access to the necessary knowledge, software, tools, and parts” in a piece calling for right-to-repair legislation. The FTC, meanwhile, suggested in a report that medical device manufacturers sometimes charge two-to-three times what an independent repair tech would charge for the same repair. 

………

Medical equipment manufacturers have strongly lobbied against right to repair legislation all over the country, and have been successful in getting medical devices exempted from right to repair legislation by claiming that the machines are too sensitive and complex to be repaired by anyone besides the manufacturer. The medical device giant AdvaMed, for example, says “the risk to patient safety is too high.”

What AdvaMed is really saying is that, "The risk to senior executive stock options are too high."

We no longer have a free market in America, we have lobbyist driven looting.

This ain't gonna end until we start arresting and imprisoning senior executives who do this.

About F%$#ing Time

The American Board of Internal Medicine (ABIM), has revoked their certifications of two doctors who have continued to push Ivermectin as a Covid treatment.

It has been known for about 4 years that this was bullsh%$, and that continuing to use the medication was dangerous, though not quite as dangerous as drinking bleach, and it is only in the past 10 days that these guys got their tickets pulled:

The American Board of Internal Medicine (ABIM) has revoked the board certification of two physicians involved in the Front Line COVID-19 Critical Care Alliance (FLCCC).

An ABIM spokesperson confirmed to MedPage Today that Paul Marik, MD, and Pierre Kory, MD, had their certifications revoked as of August 8.

Marik and Kory previously had certifications in internal medicine and critical care medicine, and Kory additionally held a certification in pulmonary disease.

The ABIM spokesperson said the organization "does not comment publicly on the reasons for the revocation of certification," but the FLCCC had previously statedopens in a new tab or window that the action was taken because of the doctors' "public endorsements of early treatment methods for COVID-19, their discussions on repurposed medications, and their critique of vaccine risks and harms."

Initial notification to Marik and Kory about losing ABIM certification came about 2 years ago, in May 2022, according to the FLCCC. Last year, ABIM's Credentials and Certification Committee reportedly recommendedopens in a new tab or window -- after a "year-long back-and-forth" -- that Marik and Kory have their certifications revoked for spreading "false or inaccurate medical information."

Now, how about going after Joseph Mercola, who not only has been stridently antivax, but has caused thousands of deaths with his Jihad against Soy,  resulting in an increased incidence of breast cancer among women with BRCA mutations.

Actually, good luck with that one, he's an osteopath, and their professional standards regarding cranks are somewhat lax.

Unfortunately, there is no such certification for economists, so Emily Oster will continue to spread dangerous misinformation regarding the effects of Covid in schools without any repercussions. (She actually wrote an article in The Atlantic calling for. "Covid Amnesty," for folks who screwed the pooch like her.)

Yeah, Just Like the Flu

It turns out that the Covid pandemic has corresponded with an explosion of atypical cancers, either rare cancers becoming more prevalent, or less rare cancers occurring at freakishly young ages.

I know, correlation is not causation, but we know that Covid messes with the circulatory system, which plays an integral role in cancer development, and that it can cause immune dysregulation, which also plays an integral role in cancer development.

Under any other circumstance, this would be the subject of extensive research and analysis by doctors and entities like the CDC, but because aggressively enforced omerta in the interest of a return to, "Normalcy," we hear crickets:

Kashyap Patel looked forward to his team’s Friday lunches. All the doctors from his oncology practice would gather in the open-air courtyard under the shadow of a tall magnolia tree and catch up. The atmosphere tended to the lighthearted and optimistic. But that week, he was distressed.

It was 2021, a year into the coronavirus pandemic, and as he slid into a chair, Patel shared that he’d just seen a patient in his 40s with cholangiocarcinoma, a rare and lethal cancer of the bile ducts that typically strikes people in their 70s and 80s. Initially, there was silence, and then one colleague after another said they’d recently treated patients who had similar diagnoses. Within a year of that meeting, the office had recorded seven such cases.

“I’ve been in practice 23 years and have never seen anything like this,” Patel, CEO of Carolina Blood and Cancer Care Associates, later recalled. Asutosh Gor, another oncologist, agreed: “We were all shaken.”

There was other weirdness, too: multiple patients contending with multiple types of cancer arising almost simultaneously, and more than a dozen new cases of other rare cancers.

Increasingly, Patel was left with an unsettling thought: Could the coronavirus be inflaming the embers of cancer?

The uptick in aggressive, late-stage cancers since the dawn of the pandemic is confirmed by some early national data and a number of large cancer institutions. Many experts have mostly dismissed the trend as an expected consequence of disruptions to health care that began in 2020.

An uptick in mortality as a result of disruptions to the healthcare system might explain some things, but these sort of cancer outbreaks don't just happen because you could not get an appointment to see your doctor.

Virally induced cancers are a proven phenomenon.  It's why you see the push for HPV vaccines, for example.

………

[Director of the Cancer Center at Cold Spring Harbor Laboratory David] Tuveson said a number of small and early studies — many of which have been published within the past nine months — suggests that coronavirus infection can induce an inflammatory cascade and other responses that, in theory, could exacerbate the growth of cancer cells.

Tuveson said a number of small and early studies — many of which have been published within the past nine months — suggests that coronavirus infection can induce an inflammatory cascade and other responses that, in theory, could exacerbate the growth of cancer cells.

He has wondered whether it could be more akin to an environmental stressor — like tobacco, alcohol, asbestos or microplastics.

“Covid wrecks the body, and that’s where cancers can start,” Tuveson said, explaining how autopsy studies of people who died of covid-19 showed prematurely aged tissue.

Yea, it's just the flu.

Bullsh%$.

I Can't Imagine Why This is Happening

So, I came across this thread on Ecch (Twitter) and it's mind blowing.

Short version, the UK is facing a major spike in Whooping Cough (Pertussis) that appears to be unprecedented in this century.

So this raises the obvious question, why are we seeing such horrific numbers?

The poster does not try to explain this, which is kind of refreshing.

He sees something odd, and does not have a clue as to why, so he doesn't engage in wild speculation.

It's the smart thing to do, which is why I ain't doing that.

I'm calling out Covid immune dysregulation.

I am, as always, coming from a position of profound ignorance, I'm an engineer, not an epidemiologist, dammit,* but we know that immune issues related to Covid-19 are real, (in addition to things like heart disease, strokes, etc.) and that it has been associated with things like RSV outbreaks, etc.

This was all foreseeable, but the public health authorities as well as the polity across the world, were too eager to return to normalcy, which has resulted in a continuation of what remains an emergency.

The "Tinker Bell" theory of public health, where everything can be solved by clapping harder is a stupidity.

^*I love it when I get to go all Dr. McCoy!

Things I Don't Expect from the Wall Street Journal

An article (accurately) blaming private equity for increasing medical costs.

I've been talking about the pernicious impact of PE, but I don't expect this from the WSJ.

Consolidation is as American as apple pie.

When a business gets bigger, it forces mom-and-pop players out of the market, but it can boost profits and bring down costs, too. Think about the pros and cons of Walmart and “Every Day Low Prices.” In a complex, multitrillion-dollar system like America’s healthcare market, though, that principle has turned into a harmful arms race that has helped drive prices increasingly higher without improving care.

Years of dealmaking has led to sprawling hospital systems, vertically integrated health insurance companies, and highly concentrated private equity-owned practices resulting in diminished competition and even the closure of vital health facilities. As this three-part Heard on the Street series will show, the rich rewards and lax oversight ultimately create pain for both patients and the doctors who treat them. Belatedly, state and federal regulators and lawmakers are zeroing in on consolidation, creating uncertainty for the investors who have long profited from the healthcare merger boom.

Consider the impact of massive private-equity investment in medical practices. When a patient with employer-based insurance goes under for surgery, the anesthesiologist’s fee is supposed to be determined by market forces. But what happens if one firm quietly buys out several anesthesiologists in the same city and then hikes the price of the procedure?

Such a scheme was allegedly implemented by the private-equity firm Welsh, Carson, Anderson & Stowe and the company it created in 2012, U.S. Anesthesia Partners, according to a Federal Trade Commission lawsuit filed last year. It started by buying the largest practice in Houston and then making three further acquisitions, eventually expanding into other cities throughout the state of Texas. In each location, the lawsuit alleges, USAP pursued an aggressive strategy of eliminating competitors by either acquiring them or conspiring with them to weaken competition.

………

Over the past decade, private equity has spent hundreds of billions of dollars acquiring healthcare businesses from emergency care to anesthesiology to nursing homes. Where private equity has gone, studies show, prices have tended to increase.

Such so-called rent-seeking behavior is a unique feature of the American healthcare system. Nowhere else in the world do so many healthcare dollars encounter so few mechanisms to limit profiteering. The U.S. commercial market relies on negotiations between insurers and medical providers to deliver the best possible quality and price for patients. Increasingly, though, it is becoming less competitive by design.

………

One particularly troublesome aspect of the private-equity marriage with healthcare is that it can put businesses that are essential to society at risk. An example is the crisis engulfing Steward Health Care System. The hospital chain was formed by the private-equity firm Cerberus Capital Management when it first bought six struggling Massachusetts hospitals in 2010. A 2016 sale-leaseback agreement with the hospital landlord Medical Properties Trust allowed Cerberus to receive hundreds of millions of dollars in dividends and helped Steward expand through acquisitions.

………

Alongside major hospitals and health insurers, private-equity firms have gone on a healthcare buying binge in recent decades, claiming that their acquisitions will ultimately make healthcare more affordable. All the while, Americans’ medical bills have gone nowhere but up.

A condemnation (albeit a mild one) of monopolistic behavior, merger and acquisition activity, the PE looting, false claims, and rent seeking in the Wall Street Journal? 

I did not see that coming.

Not a Good Look

Medcape, a medical website, set up an anti-smoking education program sponsored in part by Philip Morris.

If this sounds mind-mindbogglingly stupid and a bit hypocritical, you get this:

One of the largest medical education providers in the United States has terminated its multimillion-dollar deal with Philip Morris International following public outcry over the tobacco giant’s sponsorship of its smoking cessation courses.

The move comes after The BMJ revealed Medscape’s partnership with the world’s second biggest tobacco company earlier this month. An internal document shared with The Examination and The BMJ now reveals the scale of the deal: Philip Morris International was due to pay $2.9 million in order to deliver a year-long “PMI curriculum” to be sent to the provider’s vast network of healthcare professionals.

The Medscape deal appears to be part of a strategy by Philip Morris International to sponsor continuous professional development courses for medical professionals around the world. The Examination has discovered that the tobacco company has also sponsored webinars on “harm reduction” across the the Middle East and in South Africa.

For some reason, this level of rat-f%$#ery reminds me of 2 or 3 classic Warner Brothers cartoons.

This is Not News

So, we are seeing increasingly large numbers of antifungal resistant infections as a result of overuse.

This is not a surprise.

7 years ago, there were a number of articles finding a surprising number of people entering hospital in Holland with resistant fungal infections, which is odd, because normally you get resistant infections in hospital, you don't come in that way.

It turned out that huge amounts of antifungal medications were used in the cultivation of Tulips, leading to hotspots of resistance outside of hospital wards.

Now, we are seeing resistant fungi popping out all around the world:

Clinicians in the US may be overprescribing topical antifungal treatments for skin infections, potentially exacerbating a growing problem of drug resistance, according to a new study.

Drug-resistant ringworm reported in US for first time; community spread likelyLast year, a dermatologist in New York reported the country's first cases of a newly emerging skin fungus that is highly contagious and resistant to common antifungal treatments. Silent community spread appeared to be behind the unconnected cases. Overall, drug-resistant fungal skin infection cases (aka ringworm) have been identified in at least 11 US states to date.

With resistance on the rise, researchers at the Centers for Disease Control and Prevention took a closer look at how US clinicians prescribe topical antifungals. As is the case of antibiotics and bacterial infections, overuse of antifungals can drive the development of resistance. And properly diagnosing skin infections can be extremely difficult without diagnostics. A 2016 survey study found that even board-certified dermatologists were frequently wrong when trying to identify skin infections just by sight.

Over-prescription may be a problem, but if this is anything like agricultural antibiotic use, where 80% of the antibiotics in the US are used on farm animals, it is a drop in the proverbial bucket.

It's Not Lupus

Some doctors tried to see how ChatGPT would diagnosing sick kids.

What they got was an 83% error rate.

Tell me how this is not all snake oil again?

ChatGPT is still no House, MD.

While the chatty AI bot has previously underwhelmed with its attempts to diagnose challenging medical cases—with an accuracy rate of 39 percent in an analysis last year—a study out this week in JAMA Pediatrics suggests the fourth version of the large language model is especially bad with kids. It had an accuracy rate of just 17 percent when diagnosing pediatric medical cases.

The low success rate suggests human pediatricians won't be out of jobs any time soon, in case that was a concern. As the authors put it: "[T]his study underscores the invaluable role that clinical experience holds." But it also identifies the critical weaknesses that led to ChatGPT's high error rate and ways to transform it into a useful tool in clinical care. With so much interest and experimentation with AI chatbots, many pediatricians and other doctors see their integration into clinical care as inevitable.

The medical field has generally been an early adopter of AI-powered technologies, resulting in some notable failures, such as creating algorithmic racial bias, as well as successes, such as automating administrative tasks and helping to interpret chest scans and retinal images. There's also lot in between. But AI's potential for problem-solving has raised considerable interest in developing it into a helpful tool for complex diagnostics—no eccentric, prickly, pill-popping medical genius required.

In the new study conducted by researchers at Cohen Children’s Medical Center in New York, ChatGPT-4 showed it isn't ready for pediatric diagnoses yet. Compared to general cases, pediatric ones require more consideration of the patient's age, the researchers note. And as any parent knows, diagnosing conditions in infants and small children is especially hard when they can't pinpoint or articulate all the symptoms they're experiencing.

For the study, the researchers put the chatbot up against 100 pediatric case challenges published in JAMA Pediatrics and NEJM between 2013 and 2023. These are medical cases published as challenges or quizzes. Physicians reading along are invited to try to come up with the correct diagnosis of a complex or unusual case based on the information that attending doctors had at the time. Sometimes, the publications also explain how attending doctors got to the correct diagnosis.

I've said it before, and I will say it again, the current LLM AIs are little more than an overhyped ELIZA program.

Well, I'm calling this as the next bubble, or, more accurately, the next fraud out of Silicon Valley.

Live in Obedient Fear, Citizen

Did you know that your pharmacy is giving law enforcement warantless access to your medical records?

So, if your Cop ex-spouse wants a copy of your prescription records in order to contest custody arrangements, for example, all they have to do is ask.

I do not find this reassuring:

All of the big pharmacy chains in the US hand over sensitive medical records to law enforcement without a warrant—and some will do so without even running the requests by a legal professional, according to a congressional investigation.

The revelation raises grave medical privacy concerns, particularly in a post-Dobbs era in which many states are working to criminalize reproductive health care. Even if people in states with restrictive laws cross state lines for care, pharmacists in massive chains, such as CVS, can access records across borders.

Lawmakers noted the pharmacies' policies for releasing medical records in a letter dated Tuesday to the Department of Health and Human Services (HHS) Secretary Xavier Becerra. The letter—signed by Sen. Ron Wyden (D-Ore.), Rep. Pramila Jayapal (D-Wash.), and Rep. Sara Jacobs (D-Calif.)—said their investigation pulled information from briefings with eight big prescription drug suppliers.

They include the seven largest pharmacy chains in the country: CVS Health, Walgreens Boots Alliance, Cigna, Optum Rx, Walmart Stores, Inc., The Kroger Company, and Rite Aid Corporation. The lawmakers also spoke with Amazon Pharmacy.

All eight of the pharmacies said they do not require law enforcement to have a warrant prior to sharing private and sensitive medical records, which can include the prescription drugs a person used or uses and their medical conditions. Instead, all the pharmacies hand over such information with nothing more than a subpoena, which can be issued by government agencies and does not require review or approval by a judge.

Some members of Congress are concerned by this and are asking the Department of Health and Human Services to declare that such data is private.

I would not hold my breath on this one.  HHS Secretary Xavier Becerra has a long history of opposition to meaningful regulation of law enforcement.

………

The “required by law” phrase is important here. Law enforcement agencies have their own legal interpretations of the Third Party Doctrine, but none of that matters much in the case of HIPAA. All it would take to prevent pharmacy chains from handing out this data without a warrant would be the federal Department of Health and Human Services (HHS) taking this out of the Third Party Doctrine’s hands and placing a presumption of privacy on it.

That’s the gist of the letter [PDF] recently sent to HHS Secretary Xavier Becerra by Senator Ron Wyden, Rep. Pramila Jaypal, and Rep. Sara Jacobs. It cites a bit of courtroom and private company precedent to urge this situation along.

We urge HHS to consider further strengthening its HIPAA regulations to more closely align them with Americans’ reasonable expectations of privacy and Constitutional principles. Pharmacies can and should insist on a warrant, and invite law enforcement agencies that insist on demanding patient medical records with solely a subpoena to go to court to enforce that demand. The requirement for a warrant is exactly the approach taken by tech companies to protect customer privacy. In 2010, after just one Federal Court of Appeals held that Americans have a reasonable expectation of privacy in their emails and that the 1986 Congressionally enacted law permitting disclosures of email pursuant to a subpoena was unconstitutional, all of the major free email providers — Google, Yahoo, and Microsoft — started insisting on a warrant before disclosing such data.

Looks pretty simple. All that’s needed is a change of policy, even if there’s no change in law. The problem with this, though, is that the head of the HHS has had plenty of time to change this policy to erect a higher standard for demands for customers’ information. The letter notes the legislators first informed Becerra of this potential issue in July, following the Dobbs decision in June, hoping the HHS would erect more protections to prevent people from being prosecuted for obtaining birth control products.

Unfortunately, unless and until a Republican lawmaker's drug habit becomes public as a result of this loophole, Congress will not pass any legislation preventing this abuse of process.

Another Nail in the Amyloid Plaque Theory

When the brains of Alzheimer's patients are examined post mortem, there are large amounts of deposits on the nerves in the central nervous system known as amyloid plaques.

It has been dogma in the field for almost 50 years that this is the cause of this form of dementia, but it increasingly looks like these structures are not the cause of the condition, but rather a symptom, which has the effect of invalidating 50 years of basic and pharmaceutical research into the disease:

At the start of the 20th century, psychiatrist Alois Alzheimer became the first person to notice the strange clumps and tangles in the brain of a person who had died with dementia.

These bundles of amyloid beta proteins have since become the dominant hypothesis for what causes Alzheimer's disease. And, despite decades of failed studies, finding ways to clear them away has remained an obsession.

Now, in two trials, a drug designed to eradicate these sticky plaques has failed to preserve the cognitive abilities of people with early Alzheimer's disease compared to people given a placebo.

The monoclonal antibody gantenerumab did significantly reduce the amount of amyloid beta in the brain as intended, but this did not translate into improvements in cognitive function.

"Among persons with early Alzheimer's disease, the use of gantenerumab led to a lower amyloid plaque burden than placebo at 116 weeks but was not associated with slower clinical decline," the researchers reported in their paper covering the two drug trials.

These results arrive as the amyloid hypothesis reaches a critical juncture in its history – with pharmaceutical companies controversially winning anti-amyloid drug approvals based on thin evidence.

So, it is very likely we've been wrong for the past 50+ years. 

It's time to go to work and get a better understanding of the mechanisms involved.

It's time, to quote the movie The Martian, to, "Science the sh%$ out of this."

 

Nope.

Definitely not!While I appreciate the selfless effort made by big pharma to develop treatments for erectile dysfunction, but using a spider venom that can make one's penis fall off seems to be to be a bridge too far.

Call me old school about this, but I am extremely skeptical of such a treatment:

The venom of the Brazilian wandering spider (Phoneutria nigriventer) can cause necrosis of the penis – essentially, the death of penis tissue – which can sometimes require amputation.

It's a terrifying poison best avoided, yet research suggests that in smaller amounts, the venom could hold clues to the next Viagra.

The large dose of venom dished out by the spider in nature triggers erections in mammals that are very painful and that last much too long for their primary purpose. These abnormally extended boners are technically known as priapisms, and the venom adds nausea and abdominal cramps for good measure.

P. nigriventer is also known as the banana spider because it is commonly found on banana leaves. The arachnid's body can grow up to five centimeters in length, and its leg span sometimes stretches three times further than that. It's one of the most toxic spiders there is.

Nevertheless, scientists from the Universidade Federal de Minas Gerais in Brazil have been able to develop a synthetic version of the molecule in the venom that causes the erection. It's called BZ371A, and has now been tested with some success on mice and rats: when put into a gel and spread on the groins of the animals, erections were triggered.

I'm surprised that this is being developed in Brazil.  Marketing a product as, "Giving you an erection, but your dick might fall off," seems to me to be an archetypal American marketing scheme.

Nope! Nope! Nope! Nope! Nope! Nope! Nope! Nope!

So, doctors in Australia, operating on a patient to investigate an anomaly spotted on a brain scan, found a live worm, still wriggling.

Just no.  F$#@ no!

From the Department of About F%$#ing Time

The Federal Trade Commission is rescinding its previous statements supporting Pharmacy Benefit Managers. (PBM)

This has the effect of ending implied regulatory threats against state legislation trying to regulate these parasites.

Given that PBMs have proven to be rent seeking gate keepers accumulating vast quantities of money through opaque decision, the only question is, "What took them so long?"

The FTC on Thursday plans to walk back years of advocacy in support of the entities that manage prescription drug coverage—support that analysts say has helped fuel the growth and market integration the agency is now investigating.

The agenda for the Democratic-controlled Federal Trade Commission’s open meeting includes voting on a statement that would withdraw prior advocacy statements against state legislation aimed at boosting transparency, as well as studies related to pharmacy benefit managers that the FTC said “no longer reflect current market realities.”

The agency declined to provide specifics on the statement ahead of the meeting but said the vote is a direct response “to PBMs’ continued reliance on older FTC advocacy materials that opposed mandatory PBM transparency and disclosure requirements.”

………

“The fundamental effect of these comments” against state PBM bills “was basically to put the PBMs in a regulatory free zone, fundamentally like giving Tony Soprano a ‘Get Out of Jail Free’ card,” said David Balto, an antitrust attorney who served as assistant director of policy and evaluation at the FTC from 1997 to 2001.

“Now that it’s becoming crystal clear that federal regulation is essential, it is necessary to abandon past advocacy,” added Balto, who will be testifying at the FTC open meeting.

Independent pharmacies and pharmaceutical manufacturers blame PBMs for high prescription drug costs in the US because of the rebates and fees they collect. But PBMs argue that they work to deliver discounts to patients, and that manufacturer list prices and use of patents that limit competition are responsible for driving up prices.

Clearly this is not an either/or thing.

Evergreening, which is a misuse of IP protections, along with a staunch refusal to use Dole-Bayh march in rules both need to be addressed as well.

Just because there is more than one source for the problem is not a reason to try to address other sources individually.

Here is the official FTC statement.

The Headline is Very Revealing

There are now reports that Elon Musk's company Neuralink has been granted approval for clinical studies of its brain implants in human beings.

The interesting thing is that when I searched the news about this, all the headlines were the same.

Not one said that the FDA granted approval, they all said something like, "Neuralink claims," or "Neuralink says," that it has FDA approval for human trials.

This is an odd, and rather contrived, way of stating this.

It's almost as if no one believes a word that the Apartheid Era Emerald Heir Pedo Guy™ says.

It's not like he did any of the following:

• Falsified self driving demonstrations.
• Falsified solar shingles.
• Misstated sales and production number of Tesla cars.
• Resold returned lemons.
• Lied about recalls to customers.
• Lied about a battery swap program.
• Required customers with defective cars to sign non-disclosure agreements in order to get service.
• Lied about accident rates at the factories.
• Overstated Starlink speed and latency.
• Overstated Starlink coverage.
• Claimed regulatory approval for an east coast hyperlink loop.
• Lied about his dad having an ownership interest in an emerald mine, after telling the truth about it 5 years earlier.

Oh, wait, he DID do all of those things.

Maybe Elon is just a lying sack of sh%$.