What I'm Reading (June 6)

By Chuck Dinerstein, MD, MBA — Jun 06, 2024
The guidelines on what we should eat - science speaks but politics reign, Procedural tricks, the lobbyist's way. New York's subways crime, AI scan not so intelligent A Roman pandemic teaches in hindsight.
What I Am Reading June 6th

“In 1995, when Marion Nestle was on the committee drafting the Dietary Guidelines for Americans, things were run differently. She and other experts handled it all: deciding on nutrition-related research questions, collecting the evidence, issuing a scientific report, and then writing guidance for how Americans should eat.

When it came time for that last part — the writing — Nestle and two co-authors got together at a bar, ordered glasses of wine, and got to work. “I’m not kidding,” she said. At the time, the research suggested small amounts of alcohol reduced the risk of heart disease. The guidelines reflected that. “Alcoholic beverages have been used to enhance the enjoyment of meals by many societies throughout human history,” read a part of the 1995 document (a note Nestle says was added last-minute by a federal official who believed in wine’s benefits). …

“It’s not a question of what the science says. It’s a question of what is politically acceptable science,” said Nestle.

From Stat, No, alcohol isn’t good for you. Will new dietary guidelines be shaped more by health or industry interests?

 

“What comes next is usually where such rules come to die. Corporate lobbyists have a number of tricks to thwart popular ideas. They typically don’t confront it directly, since it’s popular and politicians don’t like to openly thwart the will of voters, if they can help it. Instead, lobbyists go after these kinds of rules procedurally. Instead of straight repeal, they often try to cut funding to enforce a rule. Or they can make it procedurally difficult to take advantage of a consumer or worker right, in the name of ‘due process’ for a dominant corporation. Sometimes, they can sue in the courts. Or they can put forward a similar proposal that looks similar to the popular provision, but is different in point of fact. And that’s what they did here.”

Sound familiar? It should. It is the updated playbook, especially regarding suing over procedural rules. We might argue about some regulations, but I think we might all agree that requiring a refund for services not performed is a good thing. From Big, How Airline Lobbyists Just Got Humiliated

 

New York has its share of crime problems, especially in the subways where pushing people into the oncoming path of trains seems to be a “thing.” Of course, one answer has been more police down in the tubes, and the Governor reinforced that with State troopers carrying “long” guns – as if firing a rifle by anyone in this closed space would be a net benefit. A more straightforward answer would be a return to stop and frisk or even simply stopping fare beaters from entering the system. However, those enforcements have a perception of discrimination. Enter our new favorite tool, AI, and an AI system to detect guns.

“Evolv’s technology was used to screen visitors in a city-run Bronx hospital, where a man had been shot inside the emergency room in January 2022. This wasn’t very successful—the scanners produced false positives 85 percent of the time during the seven-month pilot.

If Evolv’s accuracy in a hospital was low, its accuracy in NYC subway stations may be worse. In an investor call on March 15, 2024, Peter George, the company’s CEO, admitted that the technology was not geared toward subway stations. “Subways, in particular, are not a place that we think is a good use case for us,” George said, due to the “interference with the railways.”

Despite this, following the death of a man who was pushed onto the subway tracks in late March, Adams announced that Evolv’s gun-detection scanners would be tested in the city’s train stations. “This is a Sputnik moment,” Adams said on March 28. “When President Kennedy said we were going to put a man on the moon.”

 

From Wired, Internal Emails Reveal How a Controversial Gun-Detection AI System Found Its Way to NYC, And you thought Tammany Hall was dead.

 

The problem with the American view of history is that we are such a young country; we are no longer toddlers but far from being even close to a tween. That means that our understanding of history is skewed.

“In the year 166 AD, however, seemingly eternal Rome was caught completely off-guard as a deadly novel disease swept across the Eurasian landmass. It ransacked Rome’s cities for at least a decade and preceded centuries of decline. This major biological event—now known as the Antonine plague—appears to have been the world’s first pandemic.

Historians hotly debate its death toll—with estimates ranging from 2 percent to 35 percent mortality—and its broader social and economic effects. The disease itself remains undiagnosed. The great Greek physician Galen described its main symptoms as fever, throat ulcers, and a pustular rash. …

Although the plague did not on its own cut short Rome’s dominance, it struck an empire that was confronting multiple challenges beneath a veneer of prosperity and growth—factors that modern-day infectious disease experts might recognize as creating the ideal conditions for pandemics.”

I’ll spare you the Santayana quote on remembering. From the Bulletin of the Atomic Scientists, A ‘plague’ comes before the fall: lessons from Roman history

Chuck Dinerstein, MD, MBA

Director of Medicine

Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.

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