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Suspending the Laws of Biology, and Common Sense, For Health
One of the eminently amusing and frustrating things in life is how people suspend common sense when thinking about anything related to their bodies or their health. Most people understand that there are repercussions, or side effects, to interventions of all kinds in all areas of life. But, when the intervention in question is a new diet, exercise regime, or medication, this thinking goes right out the window. It’s likely because of the emotionally charged nature of the subject, which makes it hard for people to engage their logical faculties with the vigor required to think about the full mid-term and long-term consequences of their actions. In addition, because the body is so complex, people seem to look for, and respect, the word of authorities more robustly than in other domains.
This, however, is a problem. While we know a great deal about human biology, our understanding is still at the elementary level — and we have absolutely no clue about how to manipulate in an effective manner with few unwanted, and unforeseen, effects. Thus, medications and medical treatments often have side effects that are worse than the ailments they’re designed to treat. For example, Finasteride (also known as Propecia), which aims to reduce hair loss, causes “increased risk of high-grade prostate cancer.” In addition, there have been reports of decreased libido and erectile dysfunction with patients on the drug. While we would all like to have a head of hair to die for, I think that few would be willing to take that phrase literally.
Side effects are not just found in the realm of pharmaceuticals. They also haunt behavioral interventions and remedies. For example, most people I know think that exercise is an effective way to lose weight. Each year, right around the holidays, I hear many of my friends and family members talk about “starting to run again” or “going to the gym more often.” They’re in pursuit of a slimmer and healthier physique and see exercise as a valid way of pursuing these goals. The problem, as many studies have shown, is that exercise doesn’t really help one lose weight. People assume that they’ll exercise, and thus burn calories, but that everything else in their lives will stay the same. If that were the case, exercise would surely work. Unfortunately, we’re not simple automatons that can simply modulate one variable at a time. If we change one input, we’ll get a range of different outputs.
Exercise increases one’s energetic expenditure and is quite stressful (in the classic sense of the word). It thus makes us hungry. We’ve all had the experience of pigging out after an intense soccer game, run, or weight session. To recover our glycogen stores and come back to homeostasis, we need calories and nutrients. Thus, the very activity that we perform in order to lose weight causes us to eat more. It’s no surprise that a meta-analysis by Franz et al., which looked at a number of weight-loss interventions, found almost no change in weight after 12 months of exercise.
In the jargon-heavy and over-scientized world of modern health advice, common sense takes a back seat, and the unintended consequences of silly plans run amok. It's obvious to anyone willing to take a moment to think about the side effects of running or exercise that appetite would offset the energy expenditure, but in the health world, the laws of practical reasoning are placed on hold in favor of magical, mystical pseudoscientific tropes. For every problem, there’s a shiny, new solution — whether it’s a new treatment, medicine, or diet. The wheels of the marketing machine will keep rolling as long as we keep forgetting to ask the most important question of all: “And then what?”
Image: Leonardo da Vinci
Northwell Health is using insights from website traffic to forecast COVID-19 hospitalizations two weeks in the future.
- The machine-learning algorithm works by analyzing the online behavior of visitors to the Northwell Health website and comparing that data to future COVID-19 hospitalizations.
- The tool, which uses anonymized data, has so far predicted hospitalizations with an accuracy rate of 80 percent.
- Machine-learning tools are helping health-care professionals worldwide better constrain and treat COVID-19.
The value of forecasting<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTA0Njk2OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyMzM2NDQzOH0.rid9regiDaKczCCKBsu7wrHkNQ64Vz_XcOEZIzAhzgM/img.jpg?width=980" id="2bb93" class="rm-shortcode" data-rm-shortcode-id="31345afbdf2bd408fd3e9f31520c445a" data-rm-shortcode-name="rebelmouse-image" data-width="1546" data-height="1056" />
Northwell emergency departments use the dashboard to monitor in real time.
Credit: Northwell Health<p>One unique benefit of forecasting COVID-19 hospitalizations is that it allows health systems to better prepare, manage and allocate resources. For example, if the tool forecasted a surge in COVID-19 hospitalizations in two weeks, Northwell Health could begin:</p><ul><li>Making space for an influx of patients</li><li>Moving personal protective equipment to where it's most needed</li><li>Strategically allocating staff during the predicted surge</li><li>Increasing the number of tests offered to asymptomatic patients</li></ul><p>The health-care field is increasingly using machine learning. It's already helping doctors develop <a href="https://care.diabetesjournals.org/content/early/2020/06/09/dc19-1870" target="_blank">personalized care plans for diabetes patients</a>, improving cancer screening techniques, and enabling mental health professionals to better predict which patients are at <a href="https://healthitanalytics.com/news/ehr-data-fuels-accurate-predictive-analytics-for-suicide-risk" target="_blank" rel="noopener noreferrer">elevated risk of suicide</a>, to name a few applications.</p><p>Health systems around the world have already begun exploring how <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315944/" target="_blank" rel="noopener noreferrer">machine learning can help battle the pandemic</a>, including better COVID-19 screening, diagnosis, contact tracing, and drug and vaccine development.</p><p>Cruzen said these kinds of tools represent a shift in how health systems can tackle a wide variety of problems.</p><p>"Health care has always used the past to predict the future, but not in this mathematical way," Cruzen said. "I think [Northwell Health's new predictive tool] really is a great first example of how we should be attacking a lot of things as we go forward."</p>
Making machine-learning tools openly accessible<p>Northwell Health has made its predictive tool <a href="https://github.com/northwell-health/covid-web-data-predictor" target="_blank">available for free</a> to any health system that wishes to utilize it.</p><p>"COVID is everybody's problem, and I think developing tools that can be used to help others is sort of why people go into health care," Dr. Cruzen said. "It was really consistent with our mission."</p><p>Open collaboration is something the world's governments and health systems should be striving for during the pandemic, said Michael Dowling, Northwell Health's president and CEO.</p><p>"Whenever you develop anything and somebody else gets it, they improve it and they continue to make it better," Dowling said. "As a country, we lack data. I believe very, very strongly that we should have been and should be now working with other countries, including China, including the European Union, including England and others to figure out how to develop a health surveillance system so you can anticipate way in advance when these things are going to occur."</p><p>In all, Northwell Health has treated more than 112,000 COVID patients. During the pandemic, Dowling said he's seen an outpouring of goodwill, collaboration, and sacrifice from the community and the tens of thousands of staff who work across Northwell.</p><p>"COVID has changed our perspective on everything—and not just those of us in health care, because it has disrupted everybody's life," Dowling said. "It has demonstrated the value of community, how we help one another."</p>
"You dream about these kinds of moments when you're a kid," said lead paleontologist David Schmidt.
- The triceratops skull was first discovered in 2019, but was excavated over the summer of 2020.
- It was discovered in the South Dakota Badlands, an area where the Triceratops roamed some 66 million years ago.
- Studying dinosaurs helps scientists better understand the evolution of all life on Earth.
Credit: David Schmidt / Westminster College<p style="margin-left: 20px;">"We had to be really careful," Schmidt told St. Louis Public Radio. "We couldn't disturb anything at all, because at that point, it was under law enforcement investigation. They were telling us, 'Don't even make footprints,' and I was thinking, 'How are we supposed to do that?'"</p><p>Another difficulty was the mammoth size of the skull: about 7 feet long and more than 3,000 pounds. (For context, the largest triceratops skull ever unearthed was about <a href="https://www.tandfonline.com/doi/abs/10.1080/02724634.2010.483632" target="_blank">8.2 feet long</a>.) The skull of Schmidt's dinosaur was likely a <em>Triceratops prorsus, </em>one of two species of triceratops that roamed what's now North America about 66 million years ago.</p>
Credit: David Schmidt / Westminster College<p>The triceratops was an herbivore, but it was also a favorite meal of the T<em>yrannosaurus rex</em>. That probably explains why the Dakotas contain many scattered triceratops bone fragments, and, less commonly, complete bones and skulls. In summer 2019, for example, a separate team on a dig in North Dakota made <a href="https://www.nytimes.com/2019/07/26/science/triceratops-skull-65-million-years-old.html" target="_blank">headlines</a> after unearthing a complete triceratops skull that measured five feet in length.</p><p>Michael Kjelland, a biology professor who participated in that excavation, said digging up the dinosaur was like completing a "multi-piece, 3-D jigsaw puzzle" that required "engineering that rivaled SpaceX," he jokingly told the <a href="https://www.nytimes.com/2019/07/26/science/triceratops-skull-65-million-years-old.html" target="_blank">New York Times</a>.</p>
Morrison Formation in Colorado
James St. John via Flickr
|Credit: Nobu Tamura/Wikimedia Commons|
The Persian polymath and philosopher of the Islamic Golden Age teaches us about self-awareness.
Can computers do calculations in multiple universes? Scientists are working on it. Step into the world of quantum computing.
- While today's computers—referred to as classical computers—continue to become more and more powerful, there is a ceiling to their advancement due to the physical limits of the materials used to make them. Quantum computing allows physicists and researchers to exponentially increase computation power, harnessing potential parallel realities to do so.
- Quantum computer chips are astoundingly small, about the size of a fingernail. Scientists have to not only build the computer itself but also the ultra-protected environment in which they operate. Total isolation is required to eliminate vibrations and other external influences on synchronized atoms; if the atoms become 'decoherent' the quantum computer cannot function.
- "You need to create a very quiet, clean, cold environment for these chips to work in," says quantum computing expert Vern Brownell. The coldest temperature possible in physics is -273.15 degrees C. The rooms required for quantum computing are -273.14 degrees C, which is 150 times colder than outer space. It is complex and mind-boggling work, but the potential for computation that harnesses the power of parallel universes is worth the chase.