The Triple Berry Frosty at Wendy’s

We got the Triple Berry Frosty at Wendy’s and we got a surprise answer at the order station when we asked what berries are in it:

“Uh, I don’t actually know.”

Fair enough. We tried to guess. Sena thought one of them was strawberry and another was blueberry (to account for the slightly bluish color). I couldn’t tell what was in it-but it was good.

I had to look on the web to find out the berries are strawberry, blackberry, and raspberry.

The Wendy’s Blog says that the Triple Berry Frosty is one way to take a break: “We all have moments when we could use a bit of an escape from our busy lives.”

That fits right now.

About That Artificial Intelligence…

I’ve got a couple of things to get off my chest about Artificial Intelligence (AI). By now, everyone knows about AI telling people to put hot glue on pizza and whatnot. Sena and I talked to a guy at an electronics store who had nothing but good things to say about AI. I mentioned the hot glue thing and pizza and it didn’t faze him.

I noticed the Psychiatric Times article, “AI in Psychiatry: Things Are Moving Fast.” They mention the tendency for AI to hallucinate and expressed appropriate reservations about its limitations.

And then I found something very interesting about AI and Cribbage. How much does AI know about the game? Turns out not much. Any questions? Don’t expect AI to answer them accurately.

FDA VRBPAC Meeting: Vaccine Targeting Lineage JN.1 for Fall 2024

I didn’t get a chance to watch the June 5th FDA advisory committee meeting on the new vaccine formulation for Covid-19 for this fall. There is a nice summary on the Minnesota CIDRAP (Center for Infectious Disease Research & Policy).

The committee unanimously upvoted the selection of the JN.1 lineage strain (which includes JN.1, KP.2 etc) for Covid vaccines this fall in the U.S.

As usual, Director Dr. Jerry Weir’s slides (summary slides 22-26) provide excellent background and clear discussion.

FDA VRBPAC Meeting on Covid Vaccine for Fall of 2024

The voting question for today’s FDA VRBPAC Meeting on the Covid Vaccine strain for this fall is:

“For the 2024-2025 Formula of COVID-19 vaccines in the U.S., does the
committee recommend a monovalent JN.1-lineage vaccine composition?
Please vote “Yes” or “No” or “Abstain.”

The FDA Selection of the 2024-2025 Formula for COVID-19 vaccines briefing document has a thorough review on the issue.

What Kind of Mailbox Does the USPS Really Want from Us?

I just saw the latest headline about the United States Postal Service (USPS) new recommendation that we all get a nice, big mailbox. Huh?

I gather one reason for the suggestion is to cut down on mail theft. I don’t think I’m allowed to put a lock on a mailbox, no matter how big it is.

In fact, the only way I’ve seen to reduce (notice I said reduce, not eliminate) mail theft are those big mailbox clusters you see everywhere in neighborhoods nowadays. Those are the neighborhoods with Homeowners Associations (HOAs), which require you to paint your window trim with beige (not taupe, read my lips!) or face lawsuits.

You know about those clusters, they’re a block away from your house. And you know how small your mailbox is there, yet the postal service is also big on recommending that you use them, probably because it makes their job easier. Which is it? Big mailbox with no lock or big locked mailbox cluster with small boxes?

Is the postal service in charge of maintenance on those mail cluster boxes? Of course not. We’re responsible for clearing away the ice and snow. And is theft not a problem with the cluster boxes? Scan the web for stories about armed bandits who hold up the letter carrier for the key. It happens.

Bigger mailboxes are not the answer to the postal service problems. They can attract the Halloween pranksters showing off their Hank Aaron batting skills (look him up!) and sadistic city snowplow drivers who like dragging your mailbox into the next county after plugging your driveway.

I can remember when the letter carrier walked the delivery route pushing a cart filled with mail. He stopped at every house in the neighborhood to put your mail in the mailbox, which was attached to the front of your house, or to drop it in the mail slot in your front door.

I’m not saying mail theft was not a problem in those days, but I don’t recall hearing about it on the news broadcasts or reading about it in the newspaper—which I hand delivered, sometimes risking injury from big dogs. The only theft I recall was by customers who avoided paying when I tried to collect:

“Do you have change for a hundred-dollar bill, sonny?”

“I’m a paperboy, not a banker!”

“Come back next week.”

Here’s an idea. What if some scientist invented a mailbox which contained a device which would trip only after your mail was delivered? This device would spray concentrated poison ivy resin all over the inside of the mailbox, teaching thieves a lesson. Of course you would have to wear gloves to collect your mail.

Another idea is to make your own mailbox, which would be big enough for a Ninja warrior to hide inside. That would surprise the crooks! I think you can get a Ninja for a fair price on eBay.

Memorial Day Events 2024 in Iowa City, Iowa

The Memorial Day ceremonies in Iowa City, Iowa this year will be on May 27, 2024. At 8:30 a.m. there will be a ceremony at Park Road Bridge. Then at 9:30 a.m., the second part will be at Oakland Cemetery. At 11:00 a.m. the third part will be at Memory Gardens.

DEA Announces Rescheduling Marijuana from Schedule I to Schedule III and Inviting Public Comments

The DEA is asking for public comments on the rescheduling of marijuana from Schedule I to III. There are many comments:

See the Federal Register notice about proposed rulemaking.

Also see the Regulations government website for further information.

Submitted My Two Cents on Centers for Medicare and Medicaid Services Proposal to Minimize the Importance of the Delirium Diagnosis Code

I found out that the Centers for Medicare and Medicaid Services (CMS) is planning to reclassify the diagnosis code for delirium, making it less serious than encephalopathy. Many clinicians are challenging it and organizations of consultation-liaison psychiatrists and the like, including me, don’t understand or agree with the plan.

Even though I’m a retired C-L psychiatrist, I put my two cents in as a comment. I told them what I used to tell others who were either my colleagues or my trainees—that delirium is a medical emergency. I support classifying delirium as a major complication or comorbidity (MCC).

Since CMS asked for supporting documents, I included a pdf of Oldham’s article:

Oldham MA, Flanagan NM, Khan A, Boukrina O, Marcantonio ER. Responding to Ten Common Delirium Misconceptions With Best Evidence: An Educational Review for Clinicians. J Neuropsychiatry Clin Neurosci. 2018 Winter;30(1):51-57. doi: 10.1176/appi.neuropsych.17030065. Epub 2017 Sep 6. PMID: 28876970.

As the authors say, “Delirium always has a physiological cause.”