Exercise: your organs are talking about you (nytimes)

How did I miss this the first time around? in a 2018 article, Gretchen Reynolds informs us that our organs are signaling each other with vesicles and communication molecules that change our physiology in response to exercise. This prompts more cooperation and health benefits and explains more of our internal workings.

We think we are one organism, walking and talking and stressing about our daily schedules. Instead, depending where you put your focus, you are: a human being OR a collection of organ systems (nervous system, respiratory system, cardiovascular, gastroenterological, etc) OR a bag of organs (heart, lungs, pancreas, liver, etc) OR a system of transport tubes (arteries, veins, lymphatics, nerves, or the most recently discovered: highways in the space outside of venules in the brain, activated during sleep!) OR a packed freeway of vehicles (red cells, white cells, platelets) OR a ghoulash of chemicals (thyroid hormone, insulin, interferon, cytokines that trigger fever or attract your immune defense, etc) OR a growing number of signaling vesicles (see the article above).

The rabbit hole goes very deep, my friends. And it is glorious.

“It’s like riding an escalator”: Burro racing isn’t likely to go mainstream, but it’s having a moment in Colorado (Colorado Sun)

I love living in Colorado. I’m not likely to do a burro race myself, but I totally enjoy the crazy friends and neighbors who do stuff like this. What are YOU doing this weekend for fun?

What is Paxlovid? (Wired). One of the better explanations of how this drug works against COVID

from npr.org

https://www.wired.com/story/what-is-paxlovid/

I found this to be timely and interesting.

As a physician, my advice (and what I continue to do now for myself, my patients, at this point in our Covid world):

  • Continue masking when indoors in public, mask off ok outdoors
  • I’m not eating at establishments indoors: I look for outdoor dining OR take out
  • Keep up with Covid vaccinations (I’m currently at 4 total, and likely will continue every 6-month boosters)
  • For patients with: diabetes, cancer, kidney disease, immune disorder, or over 65: Paxlovid within 5 days of onset of symptoms if test positive for Covid, with main purpose NOT to stop symptoms, but to avoid hospitalization and severe illness.

At UCHealth, we still have test positivity rates in the 20% and 30%, which is a major underestimate of the illness, since there is widespread availability of home Covid testing, none of which is reported publicly. We are still seeing a substantial number of hospitalizations with Covid illness. The pandemic is changing, but this thing isn’t over y’all.

Stay well out there.

Door-dash ride along, a parent’s and informaticist’s view

Ever wonder what the gig economy is all about? What is the experience of drivers, interacting with restaurants, with traffic, with the AI-in-the-cloud, with customers?

My son recently turned to this service to make some cash prior to his upcoming trip. Wonder of wonders, he offered to let me come ride-along for a few hours on one of his outings.

Finally! a chance to see behind the velvet curtain! Is there a Wizard in Oz controlling things?

We spent about 4 hours together, including the dinner rush.

What did I learn, as a parent and an informaticist?

Gas is expensive

at $5 and eats (pun intended) into any profit margin. Food delivery is particularly hard right now, but I can’t imagine it is much easier or more lucrative even with less expensive gas.

This is hard work.

Even four hours is a lot of work, I can’t imagine doing this for more, and day after day. Even my son, after a couple weeks of doing this, notes that “this could be an occasional supplement to someone with an existing job, but I can’t see doing this full time for the few dollars it brings in.”

It is good to go online

and learn tricks from others. I haven’t done the surfing, but it sounds like there are youtube videos for strategies on how Dashers can make money. For example, “don’t take every offer that comes to you over the phone.” Some deliveries only offer a couple dollars for 2-3 miles of driving, working out to about a dollar a mile. From what we believe of the algorithm, if a driver turns down a delivery, the next driver gets a slightly higher offer. IF that is the case, it is the responsibility of drivers to look out for each other and decline overly cheap delivery offers! (see: Fight the Man!).

The informaticist likes end-users who educate themselves to improve their own workflow and experience.

Traffic is terrible

and some drivers have lost sight of their humanity. I occasionally see bad behavior on the streets when I’m driving, but spending 4 hours driving around the city, gives you a concentrated view of your neighbors. The pandemic has done something to our vehicular civility. People honking at folks driving the speed limit, people swerving and gunning their engines to get 1 or 2 spaces ahead in traffic, emotions running high while operating multi-ton vehicles. A dangerous workplace.

The informaticist understands strong emotion and unhappy end-users who act out at times.

Sometimes little physical tweaks

help provide better service. Having a shopping bag that is insulated keeps the food hot a little longer on your drive from the source to the delivery. Wearing comfortable clothing, having a phone with charger (a task-horse! Receive delivery offers, map your drive, text your delivery recipient that you are on your way, take a photo to prove you left it in the right place), and even better if you get good gas mileage.

The informaticist enjoys seeing work-flow tweaks that improve outcomes.

The smells are free, but it costs you

One bad side effect of driving food around, is that the food smells eventually get to you. Maybe not when you start, but a few hours in and inevitably you’ll get hungry. Uh-oh. Those fries … fast food places sure have dialed in the sensory experience. Other times the food is NOT to your preference, and you can’t get there soon enough to let it go. On the other hand, you get to learn where people like to order from, and you’re likely to find some new places to eat (we found bb.q, a relatively new Korean barbecue chicken place in Denver: cool)!

Don’t forget the drink(s)

The algorithm is smart enough to remind you to pick up drinks; having several moving parts to the order (not just the food bag, but also drink(s) and secondary items complicates the process and increases risk of error, so some reminders are built in. Also, some restaurants are on the app and can also call you back if you miss something.

Error-anticipating and error-correcting. The informaticist smiles.

Don’t be greedy. Or, maybe be greedy.

Apparently some gig economy workers run Door Dash and also Uber Eats and sometimes also Uber and Lyft AT THE SAME TIME, just to increase their chance of picking up more offers and staying busy. I can’t imagine the cognitive load (and increased danger) that entails whether stationary or while moving.

Separately, the app will sometimes try to package deliveries together (hey! if you drive another block, you can deliver a second request from a nearby restaurant, want to?) I can see the algorithm trying to lower costs and combine trips within a restricted time-block and geography-block. Kind of like the ‘traveling salesman‘ math problem. Except different.

The informaticist likes the math, hates the multi-tasking.

The attention economy

This usually refers to advertising, social media, how they are all now optimized to capture your attention and keep it. See: Made to Stick, The Shallows, Reality is Broken. Also see: every social media app on your amazing phone.

In this case, how does the algorithm capture you? It tells you “hey, you’re not accepting enough of these offers”. The little joyful “ping” of a new offer keeps us on the edge of our seats waiting to see what pops up next. It is HARD to quit driving at the time you set yourself. “I’ll just do one more, maybe the next one will be the big score!” Like Pavlov’s dogs, we could literally salivate when awaiting the next reward.

The informaticist likes “sticky” design, but only when used for the greater good.

Sometimes the little social tweaks can improve tips

My son learned to use the optional “send a message” tool. He would use it to tell the recipient that he had picked up the food and was on his way, with an ETA. “Hi Betty, Joe here. I’m on my way! ETA 10m” He even worked out exactly how few letters it would take to send a friendly note, with his name included, hoping for a better tip. And it would work, most of the time!

Informaticists like social engineering nudges when used for good.

Fight the man

Not all algorithms are looking out for the front line worker. “Fight the man!” becomes “Fight the code!” It is disappointing that gig economy algorithms have no allegiance to their drivers. No “company loyalty” engendered here: it seems that the algorithm is testing “how low will you go?” Here’s an offer to pickup from McDonalds for $2 to drive 2 miles to deliver. Want it? (no). or, Pickup from Applebee’s for $3 to drive 4 miles? (no). How about pickup from Korean fried chicken for $6 to drive 3 miles? (YES).

Sometimes it is not busy and you have to decide whether to take the lower paying deliveries because THERE IS NOTHING ELSE. But then, is that better or worse than just parking and having your engine off, saving gas, waiting for the next one?

Sure the algorithm has to make money for its Master-in-the-sky, but surely we can take care of our front-line workers and set some sort of regional minimum wage? Deliveries at $2/mile are helpful, but when it is $1/mile, it works out to less than minimum wage, and recipients do not often tip.

Hmm. Can the informaticist learn from game theory to improve user engagement in our common purpose? And are there principles of respect for front line workers in the design of artificial intelligence algorithms that make life better for all, not just the corporation?

Be grateful

when a son or daughter volunteers to let you come along to do something crazy like this. I’m aware these opportunities will not always be there.

The informaticist yields to the parent: YES, the parent says. I’m grateful.

Cutlery Illustrates Good Informatics Design (thanks @DirkMD)

from dirkstanley.com

https://www.dirkstanley.com/2022/05/a-tale-of-applied-clinical-informatics.html

This is brilliant. That is all.

The rise of “BookTok”: 7 second emo sells books (nytimes)

Another sign of the times: older books getting a resurgence in sales from fans posting emotional reactions on TikTok.

Hmm. It seems that one can quickly change minds (and behavior!) on a population scale with super-short emotional appeal.

The good: Shows that Daniel Kahneman’s “Thinking, Fast and Slow” is an important pillar of modern online technology: emotions and story change more minds than just data. (link is to a blog post on The Undoing Project about Kahneman’s life and work).

The bad: Shows that Nicholas Carr’s book “The Shallows: what the internet is doing to our brains” is also right — we don’t have patience to read long-form fiction, except maybe when TikTok tells us to. (link to my mindfulness blog series, and a review of Carr’s book).

How ironic.

Things don’t make sense UNTIL THEY DO (mitochondria in the eye, from wired.com)

John Ball via wired.com

https://www.wired.com/story/mitochondria-double-as-tiny-lenses-in-the-eye/

In medical school, we all learned that the back of the eye, the retina that gathers and converts light from photons into electric signals in neurons, were cluttered with cell bodies and mitochondria that seemed to BLOCK light to the photo-receptors. We all sat around and puzzled “huh, why is that” and, in 1986, had no answer from the textbook.

Well, science progresses, and NOW there is an incredible answer, from the retinas of squirrels. Thanks to our brilliant basic science colleagues.

In a grand case of convergent evolution, birds circling high overhead, mosquitoes buzzing around their delicious human victims, and you reading this article have all independently evolved related optical functions—adaptations that bring a sharp and vibrant world to the eye of the beholder.

Yasemin Sapakoglu (wired.com)

Using CRISPR gene editing to affect epigenetics?

https://www.wired.com/story/a-new-kind-of-genome-editing-is-here-to-fine-tune-dna/

Here’s another editing function that we humans now have over our own genes. Cool advances by scientists to advance the frontier.

Epigenetics is the study of the chemical changes that happen to DNA throughout a lifetime, which in turn affect the expression of genes. These changes can occur as a result of a person’s behavior (such as through diet or smoking) or environmental exposures (such as to toxins or ultraviolet rays). Epigenetics is a kind of molecular memory that reflects the experiences that we’ve encountered over many years. It’s the reason why, among identical twins who share the same DNA code, one may develop cancer while the other remains healthy.

Emily Mullen, WIRED.com

Creativity DOES NOT come from our laptops

For all the great mind mapping tools out there, for all the shiny new apps that covet my attention, when it comes to creative thinking, designing things, or brainstorming a new talk, paper is it. #whyinformatics #hitsm #hcldr

Here are some examples:

Designing my Failure Resumé talk

Designing my AI talk

Designing my Sprint talk

Attending the Stanford Design Thinking for Social Systems

Of course, you should know that it is never this clean, never this simple. You don’t see the crumpled sheets, the trash can overflowing, the angry scribbles, the hair torn out and the yelling into the void. No, you don’t see it.

I’ll give John Cleese the last, inspiring words on this.

We don’t know where we get our ideas from. What we DO know is that we do not get them from our laptops.

John Cleese