Category: science

Maybe We Need a Dose of Humor

Sena and I were listening to the Mike Waters morning radio show (KOKZ 105.7) this morning and his invitation to listeners was to call in and quote their favorite dumb question. One of the callers recited something which was actually a George Carlin joke. Neither one of us thought we heard it right, but it’s the same framework as the joke I found on the web (only the numbers were changed):

“If you’ve got 24 odds and ends on the table and 23 of them fall off, what’ve you got? An odd or an end?”

This is an example of his wordplay humor.

Carlin’s humor was also marked by satire on American culture and politics, the latter of which has gotten pretty rough. You’ll also find references on the web to Carlin’s past history of substance use, which reportedly included psychedelics.

That reminds me of an opinion piece published in the September issue of Current Psychiatry, by the journal’s editor, Henry A. Nasrallah, MD (From neuroplasticity to psychoplasticity: Psilocybin may reverse personality disorders and political fanaticism. Current Psychiatry. 2022 September, 21(9): 4-6 | doi: 10.12788/cp.0283).

I was a little surprised at Dr. Nasrallah’s enthusiastic endorsement of psilocybin for treatment of personality disorders and political extremism. He acknowledges the lack of any studies on the issue. In the last paragraph of his essay is a sweeping endorsement:

In the current political zeitgeist, could psychedelics such as psilocybin reduce or even eliminate political extremism and visceral hatred on all sides? It would be remarkable research to carry out to heal a politically divided populace. The dogma of untreatable personality disorders or hopelessly entrenched political extremism is on the chopping block, and psychedelics offer hope to splinter those beliefs by concurrently remodeling brain tissue (neuroplasticity) and rectifying the mindset (psychoplasticity).

While I’m not so sure about how effective psilocybin would be for this, I’m all for trying something to reduce the “visceral hatred on all sides.”

Maybe humor could be part of the solution. It doesn’t have to be exactly like that of George Carlin. Both parody and satire have been used by many writers for this.

I like the distinction between parody and satire in one article I found on the web. One recent example of satire (or parody; the distinction is sometimes hard to make since the story was listed as “Iowa Parodies”) was in the news and it apparently fooled at least a few people. It was about the Iowa football coaching staff. The title was “Brian Ferentz Promoted to University President To Avoid Having to Fire Him (Satire): The move was deemed ‘a way easier conversation than having him fired’ by the athletic director. It was written by Creighton M, posted September 5, 2022.

I think the story was originally printed without the word “Satire” in the title. I can’t recall seeing the heading “Iowa Parodies” either. A later version of the story added the word “Satire.”

The story might have been about nepotism in the hiring of Brian Ferentz (he’s the son of head coach Kirk Ferentz) as offensive coach. On the other hand, under Iowa law, it was not illegal to hire Brian Ferentz, who in any case reports to athletic director Gary Barta, not Kirk Ferentz.

I suspect the joke had more to do with negative public attitudes about the performance of the Iowa football offense early in the season.

Is it funny? I guess it depends on your perspective. The Iowa football coaching staff probably didn’t chuckle over it. But it more or less fits the definition of satire. It uses humor to expose flaws in the way we behave. And it avoids direct and nasty confrontation, which usually triggers antagonism rather than collaboration. Will it change the Iowa football program? I doubt it. They’re actually doing pretty good so far.

But satire as a strategy to inform and maybe change the public opinion will endure. The Hitchhiker’s Guide to the Galaxy by Douglas Adams is one of my favorite books and it satirizes governments and the foolishness of people. I first learned about The Onion newspaper while we were in the process of relocating to Wisconsin (a short adventure). It satirizes the Associated Press news style.

One of the most uproarious examples of parody is a TV show which is no longer available on cable television but still offered on a streaming service (I think), Mountain Monsters. It’s a hilarious sendup of all the Bigfoot hunter shows.

The added benefit of parody and satire and other such forms of humor is that they are safer than psychedelics—unless your target was born without a funny bone.

Extraterrestrials Need Lentils Anonymous Program

Sena bought a bag of Spicy Sriracha Lentil Chips yesterday. They’re at the center of an extraterrestrial news flash on the web site of the company, The Daily Crave, which sells a lot of healthier snack food items. They’re mainly plant-based.

Apparently, extraterrestrials are known to have a tendency to get addicted to lentils. What proves this beyond a shadow of a doubt is that the website listing for The Daily Crave is directly below the website listing for the Reddit description of the Star Trek: Next Generation episode (S01E19) which details the sale of lentils to aliens. Lentils are a highly addictive drug to extraterrestrials, although they tend to bore me—and a lot of other snackers. Funny, I can’t find anything about it in the Wikipedia entry for that 1988 episode entitled “Coming of Age.” And I didn’t watch it.

Can you beat that? I love science!

The Daily Crave news item (“Crop Circles coincide with missing new snack displays”) on the website differs from what’s on our bag, which has the headline “Missing Snack Displays Blamed on Aliens.”

There’s also a Lentils meme for the Ancient Aliens hair guy, Giorgio Tsoukalos. It’s like almost all of the memes: a picture of him with his wild hair and a weird fake quote. This one has the word “Lentils” on it. What more proof do you need to support government funding of a Lentils Anonymous (LA) program for aliens?

On the other hand, you have to wonder whether dusting a little sriracha on lentil chips would make them taste zestier instead of just making me load them up with chip dip, a substance known to instantaneously transform humans into aliens.

There are also several flavors for Quinoa Chips (pronounced KEEN-wah). Quinoa is also very good for you. Contrary to popular belief, Himalayan Salt Quinoa Chips will not grow hair on your chest, according to many extraterrestrial scientists.

How to Get the Updated Covid-19 Vaccine Booster at University of Iowa Hospitals & Clinics

Here’s an updated link to how to get the updated Covid-19 vaccine booster (often called the Omicron bivalent booster). It’s sometimes faster to get this booster at local pharmacies, although there’s less urgency now.

Single Administration Therapeutic Interfering Particle (TIP) Reduces Covid-19 Viral Shedding & Pathogenesis in Hamsters

Proceedings of the National Academy of Sciences (PNAS) recently published a study showing:

Abstract

“The high transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a primary driver of the COVID-19 pandemic. While existing interventions prevent severe disease, they exhibit mixed efficacy in preventing transmission, presumably due to their limited antiviral effects in the respiratory mucosa, whereas interventions targeting the sites of viral replication might more effectively limit respiratory virus transmission. Recently, intranasally administered RNA-based therapeutic interfering particles (TIPs) were reported to suppress SARS-CoV-2 replication, exhibit a high barrier to resistance, and prevent serious disease in hamsters. Since TIPs intrinsically target the tissues with the highest viral replication burden (i.e., respiratory tissues for SARS-CoV-2), we tested the potential of TIP intervention to reduce SARS-CoV-2 shedding. Here, we report that a single, postexposure TIP dose lowers SARS-CoV-2 nasal shedding, and at 5 days postinfection, infectious virus shed is below detection limits in 4 out of 5 infected animals. Furthermore, TIPs reduce shedding of Delta variant or WA-1 from infected to uninfected hamsters. Cohoused “contact” animals exposed to infected, TIP-treated animals exhibited significantly lower viral loads, reduced inflammatory cytokines, no severe lung pathology, and shortened shedding duration compared to animals cohoused with untreated infected animals. TIPs may represent an effective countermeasure to limit SARS-CoV-2 transmission.”

I Say Omicron and You Say Ahmicron

Well, we tried the Miracle Whip salad dressing on egg salad sandwiches the other day. I thought they tasted better than the tuna fish sandwiches we had before.

But maybe it was the mustard in the egg salad. Anyway, Sena says we’ll be going back to Mayonnaise after the Miracle Whip is gone.

The difference between Mayo and Miracle Whip may be debatable. But the difference between the updated Covid-19 vaccine Omicron bivalent booster and the previous Covid-19 vaccines is more important than just the difference between the two pronunciations of Omicron. I say OH-muh-kraan, you say AH-muh-kraan. You say tuh-May-toh, I say to-MAH-toh, etc.

Some clinicians are worried about the risk for substituting the wrong vaccine for the new bivalent booster. That’s more than just fussiness; administration errors have already occurred with previous formulations of the vaccines and their boosters. These are nontrivial, reportable mistakes.

Some say the different colors of the vial caps should be enough to prevent mistakes. The CDC advisory committee members disagreed.

It doesn’t seem to be enough to simply read the vial labels. Busy workers in pharmacies and primary care clinics have grabbled the wrong ones and injected them.

One person at the CDC ACIP meeting on September 1, 2022 said, “Structural problems required structural solutions,” referring to the vials which have similar packaging, an opinion shared by others. The Interim Clinical Considerations for COVID-19 Vaccines: Bivalent Boosters slide set makes the distinctions pretty clear.

I hope the pharmacies and other clinics get the pictures. Just because we’re all a little nervous about making mistakes doesn’t mean we have to call the whole thing off.

Is Treatment with Antibodies a Substitute for Vaccination for Covid-19?

I read the news article about scientists publishing a study which shows it’s possible to make antibodies that may neutralize most of the Covid-19 variants. I read this after failing to find any local facility in my area that has the updated bivalent Covid-19 vaccine booster available yet. Sena and I plan to get the booster, which would be our 5th shot.

I don’t have a clue how to evaluate the study itself, which was published in an Open Access journal, Communications Biology. I didn’t understand the peer reviewers’ comments and suggestions because I lack the scientific background to make sense of them.

I was under the impression that using antibodies for Covid-19 has to be prompted by getting infected first. In fact, the lead author of the study actually points out in the news article in published in the Jerusalem Post,

“In our view, targeted treatment with antibodies and their delivery to the body in high concentrations can serve as an effective substitute for repeated boosters, especially for at-risk populations and those with weakened immune systems. COVID-19 infection can cause serious illness, and we know that providing antibodies in the first days following infection can stop the spread of the virus.

“It is, therefore, possible that by using effective antibody treatment, we will not have to provide booster doses to the entire population every time there is a new variant,” Freund concluded.

I understand that immunity wanes after vaccination and that’s frustrating because apparently you need another booster every few months.

But I’m not sure I see how the antibody treatment would be a replacement for vaccines, if that’s the implication.

The interventions sound complementary. Wouldn’t it be better to have vaccine-induced immunity and use the antibodies as a backup treatment when you get infected?

I got the impression from reading about monoclonal antibody treatments that they have to be administered by infusions in specialty clinics. And you have to catch it in the first few days. And the indication for it is getting infected with the virus—which I thought could be avoided in the first place by getting vaccinated.

The plan now seems to be to manufacture vaccines annually to target important variants of Covid-19, similar to what we’ve been doing for influenza. We’ve been getting flu shots every year for a long time. Maybe we won’t need to get boosters every few months.

It makes sense to use antibodies for immunocompromised persons, though, because they don’t respond as well to vaccines.

Why would we “substitute” monoclonal antibody infusions administered in clinics to treat infections for vaccines which can prevent severe disease and death?

I’m not knocking the study; I’m just a retired psychiatrist, not an infectious disease scientist. Am I missing something?

A Retired Consultation-Liaison Psychiatrist’s Perspective on Eating Disorders

This is just my presentation on eating disorders vs disordered eating for a Gastrointestinal Disease Department grand rounds several years ago. What’s also helpful is an eating disorder section on the National Neuroscience Curriculum Initiative (NNCI) web site. I left comments and questions there, which the presenter answered.

In addition, the Academy of Consultation-Liaison Psychiatry (ACLP) has an excellent web site and here is the link to a couple of fascinating presentations from the ACLP 2017 annual meeting on management of severe eating disorders, including a report on successful treatment using collaboration between internal medicine and psychiatry.

If you can’t find it from the link, navigate to the Live Learning Center from the ACLP home page and type “eating disorder” in the search field. One of the presentations is entitled “Has She Reached the End of Her Illness Process.” The other is entitled “Creating Inter-Institutional Collaborative Care Models.”

This is a very complex area of medicine and psychiatry. There are no simple solutions, although many experts across the country are hard at work on finding practical solutions.

The caveat is that the information here is not updated for recent changes in the literature.

EDO vs Disordered Eating GI grandroundsDownload

CDC Interim Clinical Considerations for Covid-19 Vaccine Bivalent Boosters

Taken from the CDC ACIP meeting on 9/01/2022, here is the link to the CDC Interim Clinical Considerations for the Covid-19 Vaccines: Bivalent Boosters.

University of Iowa Hospitals Information on Omicron-Specific Covid-19 Vaccine Booster

The University of Iowa Hospital & Clinics has information on the facts and expected availability of the new bivalent Omicron Covid-19 vaccine boosters.

CDC ACIP Meeting Today and Tomorrow: Covid-19 Vaccine Omicron Bivalent Booster Candidates

The CDC ACIP will meet today and tomorrow about the Covid-19 Vaccine Omicron Bivalent Booster candidates from Pfizer and Moderna. A vote is expected this afternoon.

Update: The committee voted by a majority to upvote the approval of the Pfizer and Moderna bivalent boosters this afternoon. There was one dissenting vote because there was no clinical data to present. There was a clinical study using the bivalent vaccine booster, but results would not have been available until November or December.

However, there was a complicated statistical predication model which showed that if the boosters were rolled out this month, many thousands of hospitalizations and deaths could be prevented as opposed to waiting a few more months. That got prioritized in order to approve the boosters now rather than wait for the clinical study results.

There was a lot of concern about the packaging of the boosters resembling other boosters which might lead to mistakes in administration. Pfizer has a booster vial that looks very similar to that of their bivalent Omicron booster, unless you closely read the tiny print on the vial which says it’s BA.4/BA.5.

The committee voted to cancel tomorrow’s meeting since they completed the goal today.