The Cough Doctor
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The Cough Doctor
This is Dr. Peter Small, who worked in epidemiology since the beginning of HIV epidemic. He became a pioneer in the field of molecular epidemiology. As such, his work was a guiding beacon for the public health response to the resurgence of tuberculosis. He’s travelled the world spending years in various institutions studying all manner of respiratory illnesses…. These have ranged from tuberculosis to pneumonia to lung cancer and (back to epidemiology) Covid-19.
He’s now the Chief Medical Officer at…
Hyfe
Hyfe, a medical AI company, was founded in 2020. Its objective: to build acoustic tools for respiratory diagnostics and monitoring.
In other words: it records coughs and collects data about coughing.
❝It’s ironic how much people focus on counting steps while ignoring cough, which is far more consequential. Hyfe is a science-driven company with the technology to make cough count. Particularly now, with increased awareness of cough and the rapid growth of digital health driven by Covid-19, this technology can improve the lives of patients, the care provided by doctors, and the efficiency of health systems.❞
~ Dr. Peter Small, CMO, Hyfe
How does it do it?
Hyfe’s AI monitors the number of times a person coughs and the sound of the cough through any smartphone or other smart device.
This data collected over time provides increasingly more reliable information than a single visit to the doctor! By constantly listening and analyzing, it can detect patterns that might otherwise go unnoticed.
How big is this “big data” effort?
Hyfe maintains the largest cough dataset in the world. This means it can compare the sound of a patient’s cough with more than 400 million cough-like sounds from 83 countries across all continents.
The human brain doesn’t handle big numbers well. So, just to illustrate: if the average cough is 1 second long, that means it’d take more than 12 years to listen to them all.
Hyfe, meanwhile, can:
- listen to many things simultaneously
- index them all against user and location,
- use its ever-growing neural net to detect and illustrate patterns.
It’s so attentive, that it can learn to distinguish between different people’s coughs in the same household.
❝Companies like Google Health see even basic information such as getting an accurate count of the number of times a person coughs a day as a useful resource, and part of a larger need to collect and chronicle more health information to refine the way doctors diagnose disease and manage treatments in the future.❞
What are the public health implications?
The most obvious application is to note when there’s a spike in coughing, and see how such spikes grow and spread (if they do), to inform of contagion risks.
Another is to cross-reference it with data about local environmental allergens. Knowing how things like pollution and even pollen affect individuals differently could be helpful in identifying (and managing) chronic conditions like asthma.
What are the private health implications?
❝It’s going to transform the whole clinical approach for this common and chronic symptom. Patients will come in, have the data on how much they are coughing, and the physician can suggest a treatment based on that information to see if it makes the coughs better❞
~ Dr. Peter Small
Dr. Small’s colleague Dr. Cai, speaking for Google Health on this project, sees even more utility for diagnostics:
❝When I was in medical school, never ever did they teach us that we could listen to somebody cough and identify whether that person has TB (tuberculosis), COPD, or a tumor. But I keep seeing more and more studies of people coughing into a microphone, and an algorithm can detect whether somebody has TB with 95% specificity and sensitivity, or if someone has pneumonia or an exacerbation of COPD❞
~ Dr. Lawrence Cai
And the privacy implications?
Perhaps you don’t quite fancy the idea of not being able to cough without Google knowing about it. Hyfe’s software is currently opt-in, but…
If you cough near someone else’s Hyfe app, their app will recognize you’re not the app’s user, and start building a profile for you. Of course, that won’t be linked to your name, email address, or other IDs, as it would if you were the app’s user.
Hyfe will ask to connect to your social media, to collect more information about you and your friends.
Whether you’d like to try this or perhaps you’re just curious to learn more about this fascinating project, you can check out:
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Gut-Healthy Sunset Soup
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So-called for its gut-healthy ingredients, and its flavor profile being from the Maghreb (“Sunset”) region, the western half of the N. African coast.
You will need
- 1 can chickpeas (do not drain)
- 1 cup low-sodium vegetable stock
- 1 small onion, finely chopped
- 1 carrot, finely chopped
- 2 tbsp sauerkraut, drained and chopped (yes, it is already chopped, but we want it chopped smaller so it can disperse evenly in the soup)
- 2 tbsp tomato paste
- 1 tbsp harissa paste (adjust per your heat preference)
- 1 tbsp ras el-hanout
- ¼ bulb garlic, crushed
- Juice of ½ lemon
- ¼ tsp MSG or ½ tsp low-sodium salt
- Extra virgin olive oil
- Optional: herb garnish; we recommend cilantro or flat-leaf parsley
Method
(we suggest you read everything at least once before doing anything)
1) Heat a little oil in a sauté pan or similar (something suitable for combination cooking, as we’ll be frying first and then adding liquids), and fry the onion and carrot until the onion is soft and translucent; about 5 minutes.
2) Stir in the garlic, tomato paste, harissa paste, and ras el-hanout, and fry for a further 1 minute.
3) Add the remaining ingredients* except the lemon juice. Bring to the boil and then simmer for 5 minutes.
*So yes, this includes adding the “chickpea water” also called “aquafaba”; it adds flavor and also gut-healthy fiber in the form of oligosaccharides and resistant starches, which your gut microbiota can use to make short-chain fatty acids, which improve immune function and benefit the health in more ways than we can reasonably mention as a by-the-way in a recipe.
4) Stir in the lemon juice, and serve, adding a herb garnish if you wish.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Our Top 5 Spices: How Much Is Enough For Benefits? ← today’s recipe scored 5/5 of these, plus quite a few more! Remember that ras el-hanout is a spice blend, so if you’re thinking “wait, where’s the…?” then it’s in the ras el-hanout 😉
- Making Friends With Your Gut (You Can Thank Us Later)
- Lycopene’s Benefits For The Gut, Heart, Brain, & More ← not to be underestimated!
Take care!
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Moore’s Clinically Oriented Anatomy – by Dr. Anne Argur & Dr. Arthur Dalley
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Imagine, if you will, Grey’s Anatomy but beautifully illustrated in color and formatted in a way that’s easy to read—both in terms of layout and searchability, and also in terms of how this book presents anatomy described in a practical, functional context, with summary boxes for each area, so that the primary concepts don’t get lost in the very many details.
(In contrast, if you have a copy of the famous Grey’s Anatomy, you’ll know it’s full of many pages of nothing but tiny dense text, a large amount of which is Latin, with occasional etchings by way of illustration)
Another way in which this does a lot better than the aforementioned seminal work is that it also describes and discusses very many common variations and abnormalities, both congenital and acquired, so that it’s not just a text of “what a theoretical person looks like inside”, but rather also reflects the diverse reality of the human form (we weren’t made identically in a production line, and so we can vary quite a bit).
The book is, of course, intended for students and practitioners of medicine and related fields, so what good is it to the lay person? Well, if you ask the average person where the gallbladder is and why we have one, they will gesture in the general direction of the abdomen, and sort of shrug sheepishly. You don’t have to be that person 🙂
Bottom line: if you’d like to know your acetabulum from your zygomatic arch, this is the best anatomy book this reviewer has yet seen.
Click here to check out Moore’s Clinically Oriented Anatomy, and prepare to be amazed!
PS: this one is expensive, but consider it a fair investment in your personal education, if you’re serious about it!
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Could not getting enough sleep increase your risk of type 2 diabetes?
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Not getting enough sleep is a common affliction in the modern age. If you don’t always get as many hours of shut-eye as you’d like, perhaps you were concerned by news of a recent study that found people who sleep less than six hours a night are at higher risk of type 2 diabetes.
So what can we make of these findings? It turns out the relationship between sleep and diabetes is complex.
The study
Researchers analysed data from the UK Biobank, a large biomedical database which serves as a global resource for health and medical research. They looked at information from 247,867 adults, following their health outcomes for more than a decade.
The researchers wanted to understand the associations between sleep duration and type 2 diabetes, and whether a healthy diet reduced the effects of short sleep on diabetes risk.
As part of their involvement in the UK Biobank, participants had been asked roughly how much sleep they get in 24 hours. Seven to eight hours was the average and considered normal sleep. Short sleep duration was broken up into three categories: mild (six hours), moderate (five hours) and extreme (three to four hours). The researchers analysed sleep data alongside information about people’s diets.
Some 3.2% of participants were diagnosed with type 2 diabetes during the follow-up period. Although healthy eating habits were associated with a lower overall risk of diabetes, when people ate healthily but slept less than six hours a day, their risk of type 2 diabetes increased compared to people in the normal sleep category.
The researchers found sleep duration of five hours was linked with a 16% higher risk of developing type 2 diabetes, while the risk for people who slept three to four hours was 41% higher, compared to people who slept seven to eight hours.
One limitation is the study defined a healthy diet based on the number of servings of fruit, vegetables, red meat and fish a person consumed over a day or a week. In doing so, it didn’t consider how dietary patterns such as time-restricted eating or the Mediterranean diet may modify the risk of diabetes among those who slept less.
Also, information on participants’ sleep quantity and diet was only captured at recruitment and may have changed over the course of the study. The authors acknowledge these limitations.
Why might short sleep increase diabetes risk?
In people with type 2 diabetes, the body becomes resistant to the effects of a hormone called insulin, and slowly loses the capacity to produce enough of it in the pancreas. Insulin is important because it regulates glucose (sugar) in our blood that comes from the food we eat by helping move it to cells throughout the body.
We don’t know the precise reasons why people who sleep less may be at higher risk of type 2 diabetes. But previous research has shown sleep-deprived people often have increased inflammatory markers and free fatty acids in their blood, which impair insulin sensitivity, leading to insulin resistance. This means the body struggles to use insulin properly to regulate blood glucose levels, and therefore increases the risk of type 2 diabetes.
Further, people who don’t sleep enough, as well as people who sleep in irregular patterns (such as shift workers), experience disruptions to their body’s natural rhythm, known as the circadian rhythm.
This can interfere with the release of hormones like cortisol, glucagon and growth hormones. These hormones are released through the day to meet the body’s changing energy needs, and normally keep blood glucose levels nicely balanced. If they’re compromised, this may reduce the body’s ability to handle glucose as the day progresses.
These factors, and others, may contribute to the increased risk of type 2 diabetes seen among people sleeping less than six hours.
Millions of people around the world have diabetes. WESTOCK PRODUCTIONS/Shutterstock While this study primarily focused on people who sleep eight hours or less, it’s possible longer sleepers may also face an increased risk of type 2 diabetes.
Research has previously shown a U-shaped correlation between sleep duration and type 2 diabetes risk. A review of multiple studies found getting between seven to eight hours of sleep daily was associated with the lowest risk. When people got less than seven hours sleep, or more than eight hours, the risk began to increase.
The reason sleeping longer is associated with increased risk of type 2 diabetes may be linked to weight gain, which is also correlated with longer sleep. Likewise, people who don’t sleep enough are more likely to be overweight or obese.
Good sleep, healthy diet
Getting enough sleep is an important part of a healthy lifestyle and may reduce the risk of type 2 diabetes.
Based on this study and other evidence, it seems that when it comes to diabetes risk, seven to eight hours of sleep may be the sweet spot. However, other factors could influence the relationship between sleep duration and diabetes risk, such as individual differences in sleep quality and lifestyle.
While this study’s findings question whether a healthy diet can mitigate the effects of a lack of sleep on diabetes risk, a wide range of evidence points to the benefits of healthy eating for overall health.
The authors of the study acknowledge it’s not always possible to get enough sleep, and suggest doing high-intensity interval exercise during the day may offset some of the potential effects of short sleep on diabetes risk.
In fact, exercise at any intensity can improve blood glucose levels.
Giuliana Murfet, Casual Academic, Faculty of Health, University of Technology Sydney and ShanShan Lin, Senior Lecturer, School of Public Health, University of Technology Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Finish What You Start – by Peter Hollins
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For some people, getting started is the problem. For others of us, getting started is the easy part! We just need a little help not dropping things we started.
There are summaries at the starts and ends of sections, and many “quick tips” to get you back on track.
As a taster: one of these is “temptation bundling“, combining unpleasant things with pleasant. A kind of “spoonful of sugar” approach.
Hollins also discusses hyperbolic discounting (the way we tend to value rewards according to how near they are, and procrastinate accordingly). He offers a tool to overcome this, too, the “10–10–10 rule“.
Also dealt with is “the preparation trap“, and how to know when you have enough information to press on.
For a lot of us, the places we’re most likely to drop a project is 20% in (initial enthusiasm wore off) or 80% in (“it’s nearly done; no need to worry about it”). Those are the times when the advices in this book can be particularly handy!
All in all, a great book for seeing a lot of things to completion.
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Measles cases are rising—here’s how to protect your family
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The U.S. is currently experiencing a spike in measles cases across several states. Measles a highly contagious and potentially life-threatening disease caused by a virus. The measles-mumps-rubella (MMR) vaccine prevents measles; unvaccinated people put themselves and everyone around them at risk, including babies who are too young to receive the vaccine.
Read on to learn more about measles: what it is, how to stay protected, and what to do if a measles outbreak happens near you.
What are the symptoms of measles?
Measles symptoms typically begin 10 to 14 days after exposure. The disease starts with a fever followed by a cough, runny nose, and red eyes and then produces a rash of tiny red spots on the face and body. Measles can affect anyone, but is most serious for children under 5, immunocompromised people, and pregnant people, who may give birth prematurely or whose babies may have low birth weight as a result of a measles infection.
Measles isn’t just a rash—the disease can cause serious health problems and even death. About one in five unvaccinated people in the U.S. who get measles will be hospitalized and could suffer from pneumonia, dehydration, or brain swelling.
If you get measles, it can also damage your immune system, making you more vulnerable to other diseases.
How do you catch measles?
Measles spreads through the air when an infected person coughs or sneezes. It’s so contagious that unvaccinated people have a 90 percent chance of becoming infected if exposed.
An infected person can spread measles to others before they have symptoms.
Why are measles outbreaks happening now?
The pandemic caused many children to miss out on routine vaccinations, including the MMR vaccine. Delayed vaccination schedules coincided with declining confidence in vaccine safety and growing resistance to vaccine requirements.
Skepticism about the safety and effectiveness of COVID-19 vaccines has resulted in some people questioning or opposing the MMR vaccine and other routine immunizations.
How do I protect myself and my family from measles?
Getting an MMR vaccine is the best way to prevent getting sick with measles or spreading it to others. The CDC recommends that children receive the MMR vaccine at 12 to 15 months and again at 4 to 6 years, before starting kindergarten.
One dose of the MMR vaccine provides 93 percent protection and two doses provide 97 percent protection against all strains of measles. Because some children are too young to be immunized, it’s important that those around them are vaccinated to protect them.
Is the MMR vaccine safe?
The MMR vaccine has been rigorously tested and monitored over 50 years and determined to be safe. Adverse reactions to the vaccine are extremely rare.
Receiving the MMR vaccine is much safer than contracting measles.
What do I do if there’s a measles outbreak in my community?
Anyone who is not fully vaccinated for measles should be immunized with a measles vaccine as soon as possible. Measles vaccines given within 72 hours after exposure may prevent or reduce the severity of disease.
Children as young as 6 months old can receive the MMR vaccine if they are at risk during an outbreak. If your child isn’t fully vaccinated with two doses of the MMR vaccine—or three doses, if your child received the first dose before their first birthday—talk to your pediatrician.
Unvaccinated people who have been exposed to the virus should stay home from work, school, day care, and other activities for 21 days to avoid spreading the disease.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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The Knowledge That Harvard Medical School’s Clinical Instructor Dr. Monique Tello Thinks Everyone SHOULD Have About Heart Health
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Anyone (who has not had a double mastectomy, anyway) can get breast cancer.
Breast cancer, if diagnosed early (before it spreads), has a 98% survival rate.
That survival rate drops to 31% if diagnosed after it has spread through the body.
(The US CDC’s breast cancer “stat bite” page has more stats and interactive graphs, so click here to see those charts and get the more detailed low-down on mortality/survival rates with various different situations)
We think that the difference between 98% and 31% survival rates is more than enough reason to give ourselves a monthly self-check at the very least! You’ve probably seen how-to diagrams before, but here are instructions for your convenience:
This graphic created by the Jordan Breast Cancer Program (check them out, as they have lots of resources)
If you don’t have the opportunity to take matters into your own hands right now, rather than just promise yourself “I’ll do that later”, take this free 4-minute Breast Health Assessment from Aurora Healthcare. Again, we think the difference early diagnosis can make to your survival chances make these tests well worth it.
Lest we forget, men can also get breast cancer (the CDC has a page for men too), especially if over 50. But how do you check for breast cancer, when you don’t have breasts in the commonly-understood sense of the word?
So take a moment to do this (yes, really actually do it!), and set a reminder in your calendar to repeat it monthly—there really is no reason not to! Take care of yourself; you’re important.
Pssst! Did you scroll past the diagrams, looking for the online 4-minute test promised by the subtitle? If so, scroll back up; the link is in the middle!
Harvard Medical School’s Clinical Instructor’s Five-Point Plan for Heart Health
Dr. Monique Tello, M.D., M.P.H., is a practicing physician at Massachusetts General Hospital, director of research and academic affairs for the MGH DGM Healthy Lifestyle Program, clinical instructor at Harvard Medical School, and author of the evidence-based lifestyle change guide Healthy Habits for Your Heart.
Here are what she says are the five most important factors to help keep your ticker ticking:
5. Have (at most) a moderate alcohol intake! While there are polyphenols such as resveratrol in red wine that could boost heart health, there’s so little per glass that you may need 100–1000 glasses to get the dosage that provides benefits in mouse studies. If you’re not a mouse, it may not be as beneficial, and Dr. Tello recommends drinking no more than one glass per day of any alcohol. What constitutes a glass? It varies from one kind of drink to another, so here’s a handy guide.
4. Don’t smoke. Best of all to never start. But if you did, quit. Simple as that. There is no healthy amount of smoking. While paradoxically, quitting smoking may of course be stressful to you, the long term gains are considered more than worth it. As with all advice, do consult your own physician for guidance, as individual circumstances may vary, and that may change the best approach for you.
3. Maintain a healthy body weight. While BMI (Body Mass Index) is not a perfect system, it’s a system in popular use, and Dr. Tello recommends keeping a BMI between 18.5 and 24.9.
What’s your BMI? It takes into account your height and weight; here’s a Quick BMI Calculator for your convenience.
2. Keep a healthy level of physical activity—which ideally means at least 30 minutes per day vigorous activity, but obviously if you’re not used to this, take it slowly and build up over time. Even just small lifestyle changes (walking where possible, taking the stairs instead of the elevator where possible, etc) can add up to a big difference.
1. Enjoy a healthy diet. This is the single most important thing, and the best modern scientific consensus holds that the best diet contains plenty of vegetables, fruits and nuts, whole grains, and omega-3 fatty acids, while it avoids processed meats, sugar-sweetened beverages, trans fats (what are trans fats?), and too much sodium.
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