vendredi 20 novembre 2020

A lot of genomic tools evolved already in the past evolution: CRISPR and now Retrons, mRNA for vaccines and cancer

 10.1126/science.370.6519.898


Retrons seem to be a powerful tool to defend bacteria when invaded by a phage virus.



https://advances.sciencemag.org/content/6/47/eabc9450

Targeting cancer cells with a protein produced on site in the cell by a coding mRNA




jeudi 19 novembre 2020

Hospital: the new feature is a patient-centred hub

https://inge.ch/evenements/imaginer-lhopital-de-demain/ 


The next move of medicine will be very disruptive and first about the fusion of workflows. It is the end of three concrete silos. It is the beginning of a new patient experience.


The first step is the fusion of department silos.

This will need breaking walls. Medicine is no longer a matter of anatomy or symptoms. Medicine is about a person and its aim is preventing humans from diseases and caring efficiently them when ill. It is a practice patient-centred. It is mainly a matter of disease or risk of disease in an individual person. Diseases are singularized by their mechanism, cancers, atheroma, metabolism (T2D, obesity, metabolic syndrome), autoimmunity and chronic inflammation, neurodegeneration, heredity and congeniality for the main ones. Anatomic department of medicine is an old residue of the medicine of symptoms. They will disappear. The architecture of hospitals will take into account this change and fuse the beds and ambulatory places as a proxy of consultation hubs without any reference to symptoms. Some specificities could persist however as pediatry and neonatology or specific ICU departments.


The second step is the fusion of disease approaches. 

This will need a high level of collaboration between institutions. Clinic, intervention and research will fuse geographically in order to operate together at the patient level. Clinical hubs will change the patient experience is scheduled or emergency consultations. These hubs will, contrary to the present way, allow a global insight into the dysfunctional body. A very comprehensive and massive collection of information will be retrieved from the EMR, home monitoring, wearable devices and actual parameters recorded at entry.  The patient will discuss with the team virtually or physically and propositions of diagnosis and treatment will shape his or her fate in the new hospital. A lot of data will be collected by an unmanned robot which will come to the patient instead of the reverse. The research lab will be connected to the usual lab and other techs in order to work instantaneously on data even if a research team is remote.


The third step is the fusion of data in AI systems. 

This will need first to break walls of exchange protocols. All the data from a patient will be organised and stored, then continuously analyzed by AI. Decisive algorithms of diagnosis and treatments will be presented very fast to the patient and the medical team in the consultation hub. The patient choice will be recorded and figured with risks, probability of healing, side effects and post-interventional prognosis. These predictions will be based on the continuous flow of patients locally but also on a larger basis or even on the whole number of patients with the same characteristics presently treated in a continent. The patient experience will be totally different in terms of informed consent and rational confidence.

Les masques et l'incroyable système étatique français

Ce n'est pas à l'état de faire un stock de masques pour 67 millions de français. 

D'ailleurs la preuve cela n'a pas du tout fonctionné! Laissez les Français s'organiser et tout se passera mieux.



Ce n'est pas à l'état de fournir les hôpitaux en masques.


Les hôpitaux seraient donc seulement administrés et n'auraient pas de masques pour les situations d'urgence alors que les entreprises en ont? Il faut donc gérer les hôpitaux et les transformer le plus tôt possible en entreprises publiques avec un PDG responsable, un conseil d'administration responsable, bref des personnes qui prennent des décisions au lieu de "community managers" qui arbitrent sans sifflet le ballet des revendications syndicales de fonctionnaires.

Biases: the misleading picture of impacts on war planes

Impacts on planes during WWII. How can they draw this picture? By analyzing the planes which came back after a mission. Any idea of the bias?

mardi 17 novembre 2020

Are we too wealthy?

1956, NYC simplicity, essential breakfast
Robert Frank et son épouse Mary, née Lockspeiser, avec leur fille Andrea photographiés par Hermann Landshoff, New York 1956

Abundance even in food banks, the colour of future obesity, calories are too available