bird flu, RFK Jr., inhalers and Monica from ‘Friends’

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I just got back from a wonderful two week work/vacation trip to Oregon and this meme is my mood today.

If you like a healthcare meme, check out the weekly Meme Ward in my colleague Bob Herman’s newsletter, Health Care, Inc. Normally it comes out on Monday, but it will come out next Tuesday because of Labor Day.

Speaking of Labor Day, don’t forget you can get it 25% discount on your first year of STAT+ with the code LABORDAY, valid until September 3. Now on to the news.

Three California dairy farms are being tested for H5N1

California, the nation’s largest milk producer, is investigating three herds for possible H5N1 outbreaks. If confirmed, these would be the first confirmed cases in the state.

Herds in California are at less risk of spreading the infection than in some other states, says STAT’s Megan Molteni, but many feared H5N1 would come to California sooner or later.

“It seemed like it was only a matter of time,” said Terry Lehenbauer, a bovine disease epidemiologist and director of the Veterinary Medicine Teaching and Research Center at the University of California, Davis.

What RFK would look like as Trump’s public health advisor

Former presidential candidate Robert F. Kennedy Jr. is angling for a place in a potential new Trump administration and profiles himself as a public health man.

Although he has linked an increase in chronic diseases, especially among children, to vaccines, he has recently tried to distance himself from those statements. He told House of Representatives MPs at a hearing last September that he has “never been anti-vax.”

RFK’s comments and campaign materials indicate he has plans for the FDA, including overhauling the user fee structure and requiring more safety studies on vaccines. He would shift the NIH’s focus from infectious diseases to the prevention of chronic diseases, including “toxic chemicals (PFAS, glyphosate, neonics, etc.), air and water pollution, microplastics, electromagnetic pollution, ultra-processed foods, and pharmaceuticals.” He would take legal action against scientific journals for ‘publishing bogus science to further the commercial ambitions’ of several industries, including the food and pharmaceutical sectors.

STAT’s Isabella Cueto and Sarah Owermohle have an analysis of RFK’s positions and a fact-check of health experts evaluating his claims. Read more.

Closing maternity wards does not only happen in rural areas

Many areas have turned into maternity care deserts as hospitals close expensive labor and delivery units. But while we popularly think that these closures are happening in rural areas and exacerbating urban-rural health disparities, STAT contributor Marissa Evans brings us news of the growing maternity desert in Los Angeles County.

As of 2021, 29 California hospitals have stopped delivering babies. Of the nearly fifty obstetric units that have closed in the past decade, seventeen were in Los Angeles County.

For pregnant people, it’s difficult to figure out where to go and how to get a new care team, especially if nearby hospitals aren’t equipped to handle a high-risk pregnancy. And as you might imagine, the hospitals that close labor and delivery units often serve Black and brown populations.

“We can’t be so dismissive [of maternity ward closures] if it wasn’t [happening in] a predominantly black and brown neighborhood,” said Raena Granberry, director of maternal and reproductive health for the California Black Women’s Health Project. Read more.

Obesity drug also reduced risk of dying from Covid

Last year, Novo Nordisk’s long-awaited Select study showed that the obesity drug Wegovy had cardiovascular benefits beyond just weight loss: it reduced the overall number of serious heart problems such as heart attacks, strokes or cardiovascular deaths by 20%.

The Select process took five years and the Covid-19 pandemic started halfway through. Knowing that the patients in the Select study – who were overweight, obese and had heart disease – were more vulnerable to severe Covid-19, researchers also began tracking Covid-related outcomes.

“We realized this was an unprecedented health event, and realized we had an opportunity to potentially contribute to science,” study author Benjamin Scirica told STAT.

At the annual meeting of the European Society of Cardiology in London, researchers unveiled an analysis showing that Wegovy reduced the risk of dying from Covid-19 by around a third. Although patients contracted Covid at the same rate as placebo participants, 65 patients given placebo died of Covid, compared to 43 of those taking the study drug.

Read more from STAT’s Andrew Joseph.

Carbon emissions per puff: a closer look at inhalers

While you might think of overly air-conditioned hospitals and waste from single-use medical devices as a bigger driver of healthcare carbon emissions, researchers are exploring how asthma and COPD inhalers could be greener.

The most common types of inhalers, the classic ‘metered dose’ inhalers, use propellants to aerosolize medications that patients inhale. But these gases – which switched from the ozone-depleting chlorofluorocarbons to today’s hydrofluorocarbons in the 2000s – are greenhouse gases that are more potent than carbon dioxide and a major contributor to climate change.

In a new JAMA research letter, Stanford allergist and immunologist Jyothi Tirumalasetty and colleagues looked at how much Medicare and Medicaid paid for inhalers in 2022 — and how many carbon equivalents they emitted.

Read my Q&A with Tirumalasetty on how Midwestern cities’ electricity use compares to inhaler emissions, and which pharmacy benefit formulas relate to carbon emissions.

What Monica from ‘Friends’ has to do with PubMed

When you search for “Marsha Reyngold” on PubMed, you won’t find the first author’s 2007 Memorial Sloan Kettering physician publication, when she used her married name Marsha Laufer. (She has since switched back to using her current name in publishing.)

Although she has registered both names under her ORCID author identification number, PubMed does not search for ORCID unless the searcher specifically enters it, and returns results based on name alone. This disadvantages many people, especially women, who are more likely to change their names after marriage, the National Civil Liberties Association argues in an article. new lawsuit.

The NCLA is suing the Department of Health and Human Services and the National Institutes of Health, which runs PubMed, over the issue, pointing out that the Internet Movie Database is able to pull up the filmography of ‘Friends’ actress Courteney Cox when you search for “Courtney Arquette,” and the same goes for judges in the Westlaw database.

“Because the search results in PubMed do not reflect the full scientific contribution of Dr. Reyngold, she will be disadvantaged in applying for various scientific grants, conferences, panel presentations and the like,” NCLA attorneys wrote.

Like a bad student, AlphaFold is still just memorizing

Even though ChatGPT has been around for almost two years, it and other artificial intelligence chatbots still struggle to get the word out how many ‘r’s are in the word ‘strawberry’. Why? These models don’t really use reasoning to answer your question.

Biological AI models face a similar problem, a recent one study nature communication say. One of the highlights of AI in the life sciences is AlphaFold, an AI platform developed by DeepMind that in 2020 essentially solved the problem of predicting the structure of a protein based on its amino acid sequence. Touted as a discovery that will accelerate drug development and improve rapidly, AlphaFold is an achievement… but it still defies rationalization.

When given a sequence for a protein that can fold into two different structures, the AI ​​failed to accurately predict either structure for 65% of the proteins for which it had training data. Of seven proteins it hadn’t seen before, it failed on six of them, leading researchers to conclude that AlphaFold, despite its good performance on most tasks, hasn’t learned the underlying physics of protein folding; it is merely memorized information and sometimes even favors memorization over information that suggests alternative answers.

What we read

• The case of the nearly 7,000 missing pancreases, Vox
• He got a new heart. Now this 34-year-old is fighting to fix the transplant system, Wall Street Journal
• Insects, mold and mildew found at Boar’s Head plant linked to deadly listeria outbreak CBS News
• Thoughts, decisions and burning biotech questions as the start of the year approaches, STAT
• Tribal food assistance program in shambles after USDA warehouse consolidation Buffalo fire
• ‘It was stolen from me’: Black doctors are forced out of training programs at much higher rates than white residents, STAT