What Adam Is Reading
What Adam Is Reading

What Adam is Reading - Week of 07-20-26

Medicine & Clinical CareNephrologyHealth Policy & EconomicsAI & Machine LearningAging & LongevityThings I LearnedAI Art of the WeekKidney Facts (JERKFoW)Anti-Anti-ScienceAI Impact / Living with AIScience & Technology Trends

Thanks to the North Brunswick, New Jersey Holiday Inn Express on US Route 1, I learned that the Sierra Leone People's Party and Fatima Maada Bio, the First Lady of Sierra Leone, rely on a good night's sleep, hotel coffee, and the make-your-own-waffle buffet to bolster their educational and economic development platforms. Our overlapping stay with the Sierra Leoneans was just the first of several Wes Anderson-esque moments from last weekend's visit to our older son, who is doing summer research on Long Island.

At Sagamore Hill, Teddy Roosevelt's house in Oyster Bay, I learned that the National Park Service does not offer gift shop deals to nephrologists; the military and "service workers" discount does not extend to kidney specialists. In fact, I received a negative discount, doling out free medical advice to the cashier while I paid full price for the latest of my presidential mugs. Low back pain is rarely the kidneys' fault.

Thanks to the Vanderbilt Museum and Planetarium's laser light and music show, I learned that there is a robust cohort of aging Depeche Mode fans still willing to put on black eyeliner, spike their hair, and squeeze into 1980s swag.

And at the farmhouse where Walt Whitman was born, our tour guide delivered a memorized talk track, pausing once to confide, "I'm a half page ahead in the script." It was a rigid, fact-dense forty-five minutes about America's great free-verse poet, a man who refused to write the same line twice.

It is easy to be grumpy about weekend travel between two busy work weeks. But places contain multitudes, people are people, and a budget hotel waffle maker is shaping the future of Sierra Leone.

I've moved the AI-summarized artifacts, the podcast, and images out of the Claude domain and away from my Google Drive, since some organizations now block them. The hosted data below should open from most networks.

The Google NotebookLM AI-generated podcast version of this week's newsletter.
https://wair.ajwein.com/podcast-2026-07-20-v2

Science and Technology Trends

I am usually skeptical of anti-aging therapies and supplements that claim to slow or repair aging. At the heart of my skepticism are two questions. Can aging actually be measured, and can the process itself be slowed or reversed? We have known for years that telomeres, the ends of chromosomes, serve as a surrogate for how many times a cell can divide before errors accumulate. What we never established is that lengthening them changes senescence in any way that matters.

Over the past few weeks, several articles have discussed new data on this topic, including an excellent Ground Truths post from Eric Topol and a Nature Medicine review he coauthored. Using high-throughput proteomics, investigators can now assign a biological age not just to an organ but to individual cell types by looking at roughly 11,000 proteins from a single tube of blood. The proteins are not measured inside the cells. They are cell-derived proteins circulating in plasma, so a blood draw is sufficient. And, amongst a British cohort in which every participant was born in the same week of 1946, organ ages spanned a 10-year range at the same chronological age. A 63-year-old could carry organ-specific signals matching those of people a half-decade younger or older.

The testing Topol describes is not commercially available. What is on the market is poorly regulated, varies widely across vendors, and can yield highly variable answers for the same person. There are also no validated geroprotective therapies. Exercise, omega-3, multivitamins, the shingles vaccine, and GLP-1s all shift clock readings, but the effects are small, several are based on post hoc analyses, and few have been shown to change meaningful health outcomes. It is also important to keep in mind that diseases may alter the plasma proteins years before formal diagnosis. More data will be needed to demonstrate that the proteins and protein patterns used to measure organ-specific cellular age are not related to underlying diseases.

While aging measurement now appears credible, slowing or reversing aging remains a hypothesis. That gap is going to be an enticing space for supplements and snake-oil salesmen. Infused glutathione and peptides, anyone?

Blog Post
https://erictopol.substack.com/p/medicine-is-moving-from-calendars

Nature Article:
https://www.nature.com/articles/s41591-026-04495-3

AI-Assisted Review:
https://wair.ajwein.com/aging-clocks-nature-medicine

Of course, slowing aging may have second-order consequences. Vonnegut wrote my favorite dystopian short story on this topic:
https://en.wikipedia.org/wiki/2_B_R_0_2_B

In June, aboard the International Space Station, Auxilium Biotechnologies used its AMP-1 orbital bioprinter (built on cell and tissue designs from the Wake Forest Institute for Regenerative Medicine) to produce kidney, liver, cartilage, and nerve repair implants. It's the first time that kidney and other cells have been bioprinted in microgravity. Cells printed in space settle into a more uniform distribution, solving a problem for Earth-based bioprinting, where gravity causes uneven settling.
https://www.space.com/technology/space-medicine-breakthrough-kidney-and-liver-tissue-bioprinted-off-earth-for-1st-time-ever
and
https://auxiliumbio.com/

In the same week, I found this NY Times article on the discovery of sugar molecules in interstellar space. Scientists identified erythrulose, a sugar also found in raspberries, in a gas cloud near the Milky Way's center, using two radio telescopes. Astronomers are calling this the first confirmed true sugar in interstellar space. The finding suggests life's chemical building blocks can assemble before stars or planets even exist and, via erythrulose's link to a related sugar called threose, points to how precursors of DNA and RNA can arise.
https://www.nytimes.com/2026/07/13/science/space/sugar-milky-way.html

AI-assisted review
http://wair.ajwein.com/space-kidneys-and-sugar

So, now we have kidney (cells) in space and sugar in space, the precursors to diabetes in space and ultimately dialysis in space, which in turn will yield the need for galactic health insurance. I've been ready since 2019 when I presented a healthcare plan to Emperor Palpatine while wearing my Renal Physicians Association jacket:
https://nigelworks.smugmug.com/2019/April/i-Zs25wBG/A

Anti-Anti-Science

Jess Steier has a new post on the re-emergence of journal articles and papers exploring whether mRNA vaccines cause "turbo cancer." Here is the fallacy checklist I compiled as I went through her writing about the new, flawed research. The hyperbolic phrase "turbo cancer" would be funny if it were not legitimately offered as a reason to avoid vaccines.

  1. Post hoc ergo propter hoc — Cancer appeared after vaccination; therefore, vaccination caused it. Temporal sequence as a surrogate for causation.
  2. Missing comparator — A single clinician's patient panel has no control group. Anecdotal observation across non-randomized groups can show that two events are temporally related, never that one caused the other.
  3. Selection bias by clinical setting — An oncology practice concentrates patients with a high likelihood of recurrence, delayed diagnosis, and intensive surveillance. It is the worst possible vantage point from which to find a new pattern.
  4. Anecdote elevated to evidence — A stack of case reports is still a stack of case reports, no matter how many case reports.
  5. Reverse causation / latency mismatch — Solid tumors do not arise within twelve months. A cancer found in that window was already growing before the exposure. Known carcinogens run on decades: colorectal cancer develops over 10 or more years, and asbestos and arsenic show similar timelines. None of the six cancers flagged in the Korean study is known to have a rapid onset.
  6. Surveillance and detection bias — Vaccinated people are more engaged with the health system and thus are likely to receive all sorts of health care, including cancer screenings, which will turn up cancers that were already there.
  7. Overdiagnosis — The flagged cancers are the most commonly screened-for cancers. You find things you are searching for more often than the things you are not searching for.
  8. Multiple comparisons — Test dozens of cancer types and a few will appear significant by chance alone. The fix is pre-specified endpoints and correction for multiplicity, not a larger sample or randomization.
  9. Suppression as vindication — Criticism is recast as censorship. Once the act of disagreeing counts as evidence for a claim, the argument can no longer be tested. And once the critic's character or past conduct is offered in place of a response to the actual criticism, the original error goes unaddressed, while attention shifts to the person who raised it.
  10. Confounding by the more plausible exposure — By late 2022, nearly everyone had been infected. The unvaccinated comparison group carries more spike and inflammation, not less. It is very challenging to find a control group that had neither COVID nor the vaccine.
  11. Cherry-picking against the source's own data — The Korean study directly tested the dose-response claim by comparing people with more doses to those with fewer. The overall cancer risk was flat, with a hazard ratio of 1.01. There was no meaningful difference in cancer rates between those who received multiple vaccine doses and those who received only one. Those who use the paper to bolster their turbo-cancer hypothesis pass over this inconvenient data.

Interestingly, there is a comment under the blog from someone who writes about their recent lung cancer diagnosis and how they were vaccinated but never had COVID. The comment appears to be implying the vaccines induced their cancer, an example of Post hoc ergo propter hoc (fallacy #1 above). It is sadly ironic that someone can read this blog post and conclude the exact opposite of Jess Steier's point is, but it also shows how strong belief is, irrespective of logic or data.

The blog post:
https://theunbiasedscipod.substack.com/p/no-covid-vaccines-still-arent-giving

AI-supported analysis:
http://wair.ajwein.com/turbo-cancer-debunk-2026-07-19-v1

AI Impact

I often run across lists of ways AI is impacting various fields. This week I found a roundup that made six specific claims about how AI is impacting archaeology - items like identifying Nazca lines, better understanding Babylonian hymns, gaining a deeper understanding of the dates surrounding the writing of the Dead Sea Scrolls, and updating AI's ability to read the carbonized papyri from Herculaneum. Rather than share six different articles, I decided to create a single review that looks at the quality of the headline and, of course, the bibliography, in case you want to read more. Long story short, AI is making an amazing impact on how archaeologists process obscure, difficult, and often disconnected data, but some of the claims that make it through on social media are often a little overblown. Nevertheless, especially with artifacts like the Herculaneum Scrolls, valuable new insights are being gained from very old artifacts.
https://wair.ajwein.com/ai-archaeology-2026-07-19-v1

NEW The J&E Random Kidney Facts of the Week

Two loyal readers recently suggested I salt the newsletter with random kidney facts for the nephrologic edification of the readers. Be edified, friends!

Patients (and National Park Service employees?) often believe their low back pain is their kidneys "talking." The irony is kidneys (mostly) don't hurt. Kidney disease is almost entirely silent, which is exactly what makes it dangerous, and it usually surfaces not as pain but as abnormalities on blood tests. The exceptions are few: a kidney stone (flank-to-groin pain, typically with blood in the urine, not a dull backache), acute trauma with kidney injury, and (under rare circumstances) a clot in one of the kidney's blood vessels. Almost all other kidney diseases are painless. Since back pain is common and kidney disease is silent, the odds that your low back ache is from your kidneys are really, really small.

Things I learned this week

One of my favorite parts of visiting museums, like the Walt Whitman birthplace, is the random facts you can pick up along the way. On one of the displays highlighting the evolution of Walt Whitman as "America's Poet" from the 1840s through the 1890s, I learned that he spent a significant amount of time among the first generation of self-proclaimed bohemians in a Greenwich Village beer hall called Pfaff's. The hall was a meeting point for an amazing array of intellectuals and artists in New York from the 1850s to the 1860s. I did not realize there was such a bohemian social network, let alone that many of them hung out together. These were the intellectual forbearers of so much of our modern-day culture:

Wikipedia has an easy-to-read selection about Pfaff's:
https://en.wikipedia.org/wiki/Pfaff%27s

A professor at Lehigh University has an entire website dedicated to the cultural impact of the Pfaff's regulars:
https://pfaffs.web.lehigh.edu/

One of my hobbies is tracing back the intellectual lineage of ideas and events through history. Given the number of people involved with Pfaff's, I had Claude put together an interactive people and idea map, along with how Walt Whitman was related to more modern-day political figures through a "six degrees of separation" style exercise.
http://wair.ajwein.com/pfaffs-lineage-map-2026-07-19-v1

If there is a higher power, it is animals like the leaf sheep sea slug that make it seem as if said higher power has a sense of humor or is up for a good marketing stunt. The Leaf Sheep Sea Slug is motile, eats algae, photosynthesizes, is cute, and makes a great plush toy. WWF (the World Wildlife Fund, not the World Wrestling Federation) offers it as a gift for donations.

Meet the Leaf Sheep Sea Slug!
https://www.worldwildlife.org/resources/facts/what-is-a-leaf-sheep/

Learn more!
https://en.wikipedia.org/wiki/Costasiella_kuroshimae

Get a plush sea slug!
https://gifts.worldwildlife.org/gift-center/gifts/species-adoptions/Leaf-sheep

And, all of this reminds me of the 1986 Robin Williams' bit on the platypus (NSFW):
https://youtu.be/_YVJvPif5v0

Finally, someone addressed the ethical ambiguity of leaning your airplane seat back. Like all of us, I want to be a recliner, not the recipient of reclining.
https://www.newyorker.com/culture/open-questions/should-you-recline-your-airplane-seat

AI art of the week

A visual mashup of topics from the newsletter and an exercise to see how various LLMs interpret the prompt. I use an LLM to summarize the newsletter, suggest prompts, and generate images with different LLMs.

New Art Display - Gallery with all images:
https://wair.ajwein.com/art-celestial-atlas-2026-07-20-v2

Prompt: A hand-colored copperplate celestial atlas plate in the exact style of Andreas Cellarius's Harmonia Macrocosmica (1660), engraved and illuminated by a Dutch Golden Age master cartographer. A deep Prussian-blue night-sky ground crowded with fine gold stars; concentric ecliptic and equatorial rings ruled in sepia; a zodiac band; delicate copperplate hatching throughout. Aged, faintly foxed paper with off-register hand coloring in antique gold, oxblood red, verdigris green, and lapis blue. Ornate Baroque cartouches in the corners with cherubs, robed astronomers, and allegorical figures holding astrolabes, compasses, and armillary spheres. A grand engraved Latin banner title across the top. The plate must look utterly authoritative and scholarly, a genuine 17th-century scientific artifact, while every constellation it charts is gently absurd.

Full prompt here: https://wair.ajwein.com/art-celestial-atlas-2026-07-20-v1

Clean hands and sharp minds,
Adam