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Robots and medicine: the future is now

I’m reading every now and then about the future of robot assisted medicine. Robots have long replaced humans in routine, repetitive tasks like auto assembly, but surgery seems like a bespoke activity beyond the reach of robots. Not so. A few years ago, I had mesh hernia repair surgery. The procedure was robotic-assisted laparoscopy. There were four small incisions in my abdomen, one at my navel. I was under general anesthesia during the operation, so I can’t say for sure what happened, but from what I’ve read, one incision is for a camera to guide the operation. One may have been for the insufflation, introducing carbon dioxide gas to create a working and viewing space by separating the abdominal wall from internal organs. Of course, a surgeon guided the procedure (or so I devoutly hope!), so the robot wasn’t on its own. So far, the results have been fine for me, and the sites of the incisions have healed indistinguishably from the surrounding skin. How many routine surgeries are amena
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E-Verify and undocumented workers in America

When alcoholic beverages were illegal in America, drinking didn’t stop. Alcohol smuggling just became lucrative for criminal gangs. Drugs like cocaine and heroin have been illegal for decades. Consumption of cocaine and heroin didn’t stop; smuggling of these drugs just became lucrative for criminal gangs. Making undocumented migration illegal and militarizing the Mexican border didn’t stop undocumented migration. Human trafficking just became lucrative for criminal gangs. The problem of alcohol smuggling during Prohibition was solved by repealing Prohibition. Narcotics and narco gangs continue to be a huge problem in America, since the market for drugs in America amply repays the efforts of the gangs. And the labor market for undocumented migrants? That also continues to be huge in America. All that could be addressed by enforcing the use of E-Verify. As Kevin Drum notes: “[E-Verify is] 98% accurate within 24 hours and 99.8% accurate overall. And it's easy to use. Despite this, few
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The politics of water fluoridation

When I was growing up, fluoridation of water was regarded as a commie plot by the John Birch Society wingnuts. Nevertheless, hundreds of millions of Americans (including my wife and I) have lived with fluoridated water without evidence of harm. I see where RFK, Jr is predicting that the second Trump Administration will recommend against water fluoridation. In a society where many city water supplies are fluoridated and fluoridated toothpaste is widely available, the benefits of putting fluoride in the water are less obvious than they were 70 years ago and are thus being forgotten. Yes, I understand that too much fluoride can kill you. So can too much water. As any pharmacologist will tell you, the dose makes the poison. Artificial fluoridation of water wasn’t some nefarious plot. In places where natural fluoride levels were high, the frequency of dental caries was lower. There’s plenty of epidemiological evidence that artificial fluoridation also results in fewer dental caries. Within
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Acetate and alternatives to the photosynthesis economy

  Agriculture requires photosynthesis to make food. However, the photosynthetic mechanism is slow,  inefficient and requires a lot of resources. A recent paper describes an electro-agriculture technology that combines carbon dioxide electrolysis with biological systems to boost the efficiency of food production. If implemented at scale, such a system could reduce agricultural land use in the United States by nearly 90% and allow food to be grown in urban areas and deserts without the need for light or pesticides. It would also allow more efficient fertilizer use. “The most readily consumable carbon sources produced via CO 2  electrolysis at relatively high efficiencies are ethanol and acetate. Metabolically, ethanol is converted to acetate with alcohol dehydrogenase and acetaldehyde dehydrogenase. Both ethanol and acetate can be used to cultivate common eukaryotic organisms such as yeast or mushroom-producing fungi, which are already consumed as food. Acetate can also serve as the sole
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The evolution of PhD research training

During my senior year in college, I did an independent research project in a lab that had several PhD students. This was my first personal immersion in graduate school culture. After that was five years of my own grad student career in a lab with several PhD students, four and a half years as a postdoc in a lab with several PhD students, and then a 37 year faculty career in which I mentored seven PhD theses, one masters, and served on committees of 38 PhD students. During this time, academic standards for training PhD students have evolved. In an email exchange with a colleague back in St. Louis, I wrote: "In our funding-driven culture, the luxury of having our students work out their own projects . . . is beyond the resources of most faculty. Faculty end up doing the concept and planning and use the students for execution. The result is that too many students are passive actors in their careers. A good fit for industry, but not for innovative start-ups or for academic PIs."
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No, overregulation isn’t crushing the American free market

Here’s House Speaker Mike Johnson: “We want to take a blowtorch to the regulatory state. These agencies have been weaponized against the people. It’s crushing the free market; it’s like a boot on the neck of job creators and entrepreneurs and risk takers. And so health care is one of the sectors, and we need this across the board.”  This is one of those geriatric hobby horses Republicans love to ride. Kevin Drum is having none of it, and he brings the receipts: “I'm hardly in favor of regulation willy nilly, but all the evidence suggests that it hasn't hurt much of anything. Business applications in the US continue to rise. Our economic growth is the best among advanced countries. Construction spending has skyrocketed. The finance industry continues to make mountains of money. Innovation is strong. Business profits as a share of the economy have nearly doubled over the past two decades. “At the same time, air and water quality has improved tremendously over the past 50 years. I
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The business of aging

My wife and I are recently retired. We moved to New England to be close to our grandson and his parents. We’re living independently in a three-bedroom detached house. My parents were able to live independently into their early 80s, when my dad began to dement. My mom was much smaller than him, and wasn’t able to manage him physically, so they moved into a retirement community. The entry fee back then was $300,000, which they couldn’t afford, so one of my brothers and I funded that, and their retirement income could handle the monthly fees. “Most communities charge an entry fee. The average initial payment is about $402,000, but the fees can range widely, from $40,000 to more than $2 million, according to NIC, which tracks costs at some 1,100 CCRCs in 99 major U.S. markets. “Once residents move in, they pay monthly maintenance or service fees. Other continuing care communities operate on a rental model with no up-front fee. The average monthly charge across both types of communities in
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