While our genes can't be changed easily, you can avoid some dementia risk factors. Today we discuss dementia and five drugs that may increase risk.

Memory loss appears to come with age, but we're not talking about forgetfulness. Sometimes losing your car keys isn't an indication of dementia. Dementia impairs the capacity to think, remember, or make judgments. Dementia hinders daily tasks.

Alzheimers is the most common dementia. Dementia is not normal aging, unlike forgetfulness. Aging increases the risk of Alzheimer's and other dementias. A family history of the illness increases your risk, according to the Mayo Clinic (USA).

Given that our genes are difficult to change (I won't get into epigenetics), what are some avoidable dementia risk factors? Certain drugs may cause cognitive deterioration.

Today we look at four drugs that may cause cognitive decline.

Dementia and benzodiazepines

Benzodiazepine sedatives increase brain GABA levels. Example benzodiazepines:

• Diazepam (Valium) (Valium)

• Alprazolam (Xanax) (Xanax)

• Clonazepam (Klonopin) (Klonopin)

Addiction and overdose are benzodiazepine risks. Yes! These medications don't raise dementia risk.

USC study: Benzodiazepines don't increase dementia risk in older adults.

Benzodiazepines can produce short- and long-term amnesia. This memory loss hinders memory formation. Extreme cases can permanently impair learning and memory. Anterograde amnesia is uncommon.

2. Statins and dementia

Statins reduce cholesterol. They prevent a cholesterol-making chemical. Examples:

• Atorvastatin (Lipitor) (Lipitor)

• Fluvastatin (Lescol XL) (Lescol XL)

• Lovastatin (Altoprev) (Altoprev)

• Pitavastatin (Livalo, Zypitamag) (Livalo, Zypitamag)

• Pravastatin (Pravachol) (Pravachol)

• Rosuvastatin (Crestor, Ezallor) (Crestor, Ezallor)

• Simvastatin (Zocor) (Zocor)

This finding is contentious. Harvard's Brigham and Womens Hospital's Dr. Joann Manson says:

“I think that the relationship between statins and cognitive function remains controversial. There’s still not a clear conclusion whether they help to prevent dementia or Alzheimer’s disease, have neutral effects, or increase risk.”

This one's off the dementia list.

3. Dementia and anticholinergic drugs

Anticholinergic drugs treat many conditions, including urine incontinence. Drugs inhibit acetylcholine (a brain chemical that helps send messages between cells). Acetylcholine blockers cause drowsiness, disorientation, and memory loss.

First-generation antihistamines, tricyclic antidepressants, and overactive bladder antimuscarinics are common anticholinergics among the elderly.

Anticholinergic drugs may cause dementia. One study found that taking anticholinergics for three years or more increased the risk of dementia by 1.54 times compared to three months or less. After stopping the medicine, the danger may continue.

4. Drugs for Parkinson's disease and dementia

Cleveland Clinic (USA) on Parkinson's:

Parkinson's disease causes age-related brain degeneration. It causes delayed movements, tremors, and balance issues. Some are inherited, but most are unknown. There are various treatment options, but no cure.

Parkinson's medications can cause memory loss, confusion, delusions, and obsessive behaviors. The drug's effects on dopamine cause these issues.

A 2019 JAMA Internal Medicine study found powerful anticholinergic medications enhance dementia risk.

Those who took anticholinergics had a 1.5 times higher chance of dementia. Individuals taking antidepressants, antipsychotic drugs, anti-Parkinson’s drugs, overactive bladder drugs, and anti-epileptic drugs had the greatest risk of dementia.

Anticholinergic medicines can lessen Parkinson's-related tremors, but they slow cognitive ability. Anticholinergics can cause disorientation and hallucinations in those over 70.

5. Antiepileptic drugs and dementia

The risk of dementia from anti-seizure drugs varies with drugs. Levetiracetam (Keppra) improves Alzheimer's cognition.

One study linked different anti-seizure medications to dementia. Anti-epileptic medicines increased the risk of Alzheimer's disease by 1.15 times in the Finnish sample and 1.3 times in the German population. Depakote, Topamax are drugs.

Monkeypox was rare until recently. In 2005, a research called a cluster of six monkeypox cases in the Republic of Congo "the longest reported chain to date."

That's changed. This year, over 25,000 monkeypox cases have been reported in 83 countries, indicating widespread human-to-human transmission.

What spreads monkeypox? Monkeypox transmission research is ongoing; findings may change. But science says...

Most cases were formerly animal-related.

According to the WHO, monkeypox was first diagnosed in an infant in the DRC in 1970. After that, instances were infrequent and often tied to animals. In 2003, 47 Americans contracted rabies from pet prairie dogs.

In 2017, Nigeria saw a significant outbreak. NPR reported that doctors diagnosed young guys without animal exposure who had genital sores. Nigerian researchers highlighted the idea of sexual transmission in a 2019 study, but the theory didn't catch on. “People tend to cling on to tradition, and the idea is that monkeypox is transmitted from animals to humans,” explains research co-author Dr. Dimie Ogoina.

Most monkeypox cases are sex-related.

Human-to-human transmission of monkeypox occurs, and sexual activity plays a role.

Joseph Osmundson, a clinical assistant professor of biology at NYU, says most transmission occurs in queer and gay sexual networks through sexual or personal contact.

Monkeypox spreads by skin-to-skin contact, especially with its blister-like rash, explains Ogoina. Researchers are exploring whether people can be asymptomatically contagious, but they are infectious until their rash heals and fresh skin forms, according to the CDC.

A July research in the New England Journal of Medicine reported that of more than 500 monkeypox cases in 16 countries as of June, 95% were linked to sexual activity and 98% were among males who have sex with men. WHO Director-General Tedros Adhanom Ghebreyesus encouraged males to temporarily restrict their number of male partners in July.

Is monkeypox a sexually transmitted infection (STI)?

Skin-to-skin contact can spread monkeypox, not simply sexual activities. Dr. Roy Gulick, infectious disease chief at Weill Cornell Medicine and NewYork-Presbyterian, said monkeypox is not a "typical" STI. Monkeypox isn't a STI, claims the CDC.

Most cases in the current outbreak are tied to male sexual behavior, but Osmundson thinks the virus might also spread on sports teams, in spas, or in college dorms.

Can you get monkeypox from surfaces?

Monkeypox can be spread by touching infected clothing or bedding. According to a study, a U.K. health care worker caught monkeypox in 2018 after handling ill patient's bedding.

Angela Rasmussen, a virologist at the University of Saskatchewan in Canada, believes "incidental" contact seldom distributes the virus. “You need enough virus exposure to get infected,” she says. It's conceivable after sharing a bed or towel with an infectious person, but less likely after touching a doorknob, she says.

Dr. Müge evik, a clinical lecturer in infectious diseases at the University of St. Andrews in Scotland, says there is a "spectrum" of risk connected with monkeypox. "Every exposure isn't equal," she explains. "People must know where to be cautious. Reducing [sexual] partners may be more useful than cleaning coffee shop seats.

Is monkeypox airborne?

Exposure to an infectious person's respiratory fluids can cause monkeypox, but the WHO says it needs close, continuous face-to-face contact. CDC researchers are still examining how often this happens.

Under precise laboratory conditions, scientists have shown that monkeypox can spread via aerosols, or tiny airborne particles. But there's no clear evidence that this is happening in the real world, Rasmussen adds. “This is expanding predominantly in communities of males who have sex with men, which suggests skin-to-skin contact,” she explains. If airborne transmission were frequent, she argues, we'd find more occurrences in other demographics.

In the shadow of COVID-19, people are worried about aerosolized monkeypox. Rasmussen believes the epidemiology is different. Different viruses.

Can kids get monkeypox?

More than 80 youngsters have contracted the virus thus far, mainly through household transmission. CDC says pregnant women can spread the illness to their fetus.

Among the 1970s, monkeypox predominantly affected children, but by the 2010s, it was more common in adults, according to a February study. The study's authors say routine smallpox immunization (which protects against monkeypox) halted when smallpox was eradicated. Only toddlers were born after smallpox vaccination halted decades ago. More people are vulnerable now.

Schools and daycares could become monkeypox hotspots, according to pediatric instances. Ogoina adds this hasn't happened in Nigeria's outbreaks, which is encouraging. He says, "I'm not sure if we should worry." We must be careful and seek evidence.

The company seeking 24/7 ultra-powerful solar electricity.

We're rushing to adopt low-carbon energy to prevent a self-made doomsday. We're using solar, wind, and wave energy. These low-carbon sources aren't perfect. They consume large areas of land, causing habitat loss. They don't produce power reliably, necessitating large grid-level batteries, an environmental nightmare. We can and must do better than fossil fuels. Longi, one of the world's top solar panel producers, is creating a low-carbon energy source. Solar-powered spacecraft. But how does it work? Why is it so environmentally harmonious? And how can Longi unlock it?

Space-based solar makes sense. Satellites above Medium Earth Orbit (MEO) enjoy 24/7 daylight. Outer space has no atmosphere or ozone layer to block the Sun's high-energy UV radiation. Solar panels can create more energy in space than on Earth due to these two factors. Solar panels in orbit can create 40 times more power than those on Earth, according to estimates.

How can we utilize this immense power? Launch a geostationary satellite with solar panels, then beam power to Earth. Such a technology could be our most eco-friendly energy source. (Better than fusion power!) How?

Solar panels create more energy in space, as I've said. Solar panel manufacture and grid batteries emit the most carbon. This indicates that a space-solar farm's carbon footprint (which doesn't need a battery because it's a constant power source) might be over 40 times smaller than a terrestrial one. Combine that with carbon-neutral launch vehicles like Starship, and you have a low-carbon power source. Solar power has one of the lowest emissions per kWh at 6g/kWh, so space-based solar could approach net-zero emissions.

Space solar is versatile because it doesn't require enormous infrastructure. A space-solar farm could power New York and Dallas with the same efficiency, without cables. The satellite will transmit power to a nearby terminal. This allows an energy system to evolve and adapt as the society it powers changes. Building and maintaining infrastructure can be carbon-intensive, thus less infrastructure means less emissions.

Space-based solar doesn't destroy habitats, either. Solar and wind power can be engineered to reduce habitat loss, but they still harm ecosystems, which must be restored. Space solar requires almost no land, therefore it's easier on Mother Nature.

Space solar power could be the ultimate energy source. So why haven’t we done it yet?

Well, for two reasons: the cost of launch and the efficiency of wireless energy transmission.

Advances in rocket construction and reusable rocket technology have lowered orbital launch costs. In the early 2000s, the Space Shuttle cost $60,000 per kg launched into LEO, but a SpaceX Falcon 9 costs only $3,205. 95% drop! Even at these low prices, launching a space-based solar farm is commercially questionable.

Energy transmission efficiency is half of its commercial viability. Space-based solar farms must be in geostationary orbit to get 24/7 daylight, 22,300 miles above Earth's surface. It's a long way to wirelessly transmit energy. Most laser and microwave systems are below 20% efficient.

Space-based solar power is uneconomical due to low efficiency and high deployment costs.

Longi wants to create this ultimate power. But how?

They'll send solar panels into space to develop space-based solar power that can be beamed to Earth. This mission will help them design solar panels tough enough for space while remaining efficient.

Longi is a Chinese company, and China's space program and universities are developing space-based solar power and seeking commercial partners. Xidian University has built a 98%-efficient microwave-based wireless energy transmission system for space-based solar power. The Long March 5B is China's super-cheap (but not carbon-offset) launch vehicle.

Longi fills the gap. They have the commercial know-how and ability to build solar satellites and terrestrial terminals at scale. Universities and the Chinese government have transmission technology and low-cost launch vehicles to launch this technology.

It may take a decade to develop and refine this energy solution. This could spark a clean energy revolution. Once operational, Longi and the Chinese government could offer the world a flexible, environmentally friendly, rapidly deployable energy source.

Should the world adopt this technology and let China control its energy? I'm not very political, so you decide. This seems to be the beginning of tapping into this planet-saving energy source. Forget fusion reactors. Carbon-neutral energy is coming soon.

or, how I spread monkeypox and got it myself.

This story contains nsfw (not safe for wife) stuff and shouldn't be read if you're under 18 or think I'm a newborn angel. After the opening, it's broken into three sections: a chronological explanation of my disease course, my ideas, and what I plan to do next.

Your journey awaits.

As early as mid-may, I was waltzing around the lab talking about monkeypox, a rare tropical disease with an inaccurate name. Monkeys are not its primary animal reservoir. It caused an outbreak among men who have sex with men across Europe, with unprecedented levels of person-to-person transmission. European health authorities speculated that the virus spread at raves and parties and was easily transferred through intimate, mainly sexual, contact. I had already read the nejm article about the first confirmed monkeypox patient in the u.s. and shared the photos on social media so people knew what to look for. The cdc information page only included 4 photographs of monkeypox lesions that looked like they were captured on a motorola razr.

I warned my ex-boyfriend about monkeypox. Monkeypox? responded.

Mom, I'm afraid about monkeypox. What's monkeypox?

My therapist is scared about monkeypox. What's monkeypox?

Was I alone? A few science gays on Twitter didn't make me feel overreacting.

This information got my gay head turning. The incubation period for the sickness is weeks. Many of my social media contacts are traveling to Europe this summer. What is pride? Travel, parties, and sex. Many people may become infected before attending these activities. Monkeypox will affect the lgbtq+ community.

Being right always stinks. My young scientist brain was right, though. Someone who saw this coming is one of the early victims. I'll talk about my feelings publicly, and trust me, I have many concerning what's occurring.

Part 1 is the specifics.

Wednesday nights are never smart but always entertaining. I didn't wake up until noon on june 23 and saw gay twitter blazing. Without warning, the nyc department of health announced a pop-up monkeypox immunization station in chelsea. Some days would be 11am-7pm. Walk-ins were welcome, however appointments were preferred. I tried to arrange an appointment after rubbing my eyes, but they were all taken. I got out of bed, washed my face, brushed my teeth, and put on short shorts because I wanted to get a walk-in dose and show off my legs. I got a 20-oz. cold brew on the way to the train and texted a chelsea-based acquaintance for help.

Clinic closed at 2pm. No more doses. Hundreds queued up. The government initially gave them only 1,000 dosages. For a city with 500,000 LGBT people, c'mon. What more could I do? I was upset by how things were handled. The evidence speaks for itself.

I decided to seek an appointment when additional doses were available and continued my weekend. I was celebrating nyc pride with pals. Fun! sex! * ‍

On tuesday after that, I felt a little burn. This wasn't surprising because I'd been sexually active throughout the weekend, so I got a sti panel the next day. I expected to get results in a few days, take antibiotics, and move on.

Emerging germs had other intentions. Wednesday night, I felt sore, and thursday morning, I had a blazing temperature and had sweat through my bedding. I had fever, chills, and body-wide aches and pains for three days. I reached 102 degrees. I believed I had covid over pride weekend, but I tested negative for three days straight.

STDs don't induce fevers or other systemic symptoms. If lymphogranuloma venereum advances, it can cause flu-like symptoms and swollen lymph nodes. I was suspicious and desperate for answers, so I researched monkeypox on the cdc website (for healthcare professionals). Much of what I saw on screen about monkeypox prodrome matched my symptoms. Multiple-day fever, headache, muscle aches, chills, tiredness, enlarged lymph nodes. Pox were lacking.

I told my doctor my concerns pre-medically. I'm occasionally annoying.

On saturday night, my fever broke and I felt better. Still burning, I was optimistic till sunday, when I woke up with five red splotches on my arms and fingertips.

As spots formed, burning became pain. I observed as spots developed on my body throughout the day. I had more than a dozen by the end of the day, and the early spots were pustular. I had monkeypox, as feared.

Fourth of July weekend limited my options. I'm well-connected in my school's infectious disease academic community, so I texted a coworker for advice. He agreed it was likely monkeypox and scheduled me for testing on tuesday.

nyc health could only perform 10 monkeypox tests every day. Before doctors could take swabs and send them in, each test had to be approved by the department. Some commercial labs can now perform monkeypox testing, but the backlog is huge. I still don't have a positive orthopoxvirus test five days after my test. *My 12-day-old case may not be included in the official monkeypox tally. This outbreak is far wider than we first thought, therefore I'm attempting to spread the information and help contain it.

*Update, 7/11: I have orthopoxvirus.

I spent all day in the bathtub because of the agony. Warm lavender epsom salts helped me feel better. I can't stand lavender anymore. I brought my laptop into the bathroom and viewed everything everywhere at once (2022). If my ex and I hadn't recently broken up, I wouldn't have monkeypox. All of these things made me cry, and I sat in the bathtub on the 4th of July sobbing. I thought, Is this it? I felt like Bridesmaids' Kristen Wiig (2011). I'm a flop. From here, things can only improve.

Later that night, I wore a mask and went to my roof to see the fireworks. Even though I don't like fireworks, there was something wonderful about them this year: the colors, how they illuminated the black surfaces around me, and their transient beauty. Joyful moments rarely linger long in our life. We must enjoy them now.

Several roofs away, my neighbors gathered. Happy 4th! I heard a woman yell. Why is this godforsaken country so happy? Instead of being rude, I replied. I didn't tell them I had monkeypox. I thought that would kill the mood.

By the time I went to the hospital the next day to get my lesions swabbed, wearing long sleeves, pants, and a mask, they looked like this:

I had 30 lesions on my arms, hands, stomach, back, legs, buttcheeks, face, scalp, and right eyebrow. I had some in my mouth, gums, and throat. Current medical thought is that lesions on mucous membranes cause discomfort in sensitive places. Internal lesions are a new feature of this outbreak of monkeypox. Despite being unattractive, the other sores weren't unpleasant or bothersome.

I had a bacterial sti with the pox. Who knows if that would've created symptoms (often it doesn't), but different infections can happen at once. My care team remembered that having a sti doesn't exclude out monkeypox. doxycycline rocks!

The coworker who introduced me to testing also offered me his home. We share a restroom, and monkeypox can be spread through surfaces. (Being a dna virus gives it environmental hardiness that rna viruses like sars-cov-2 lack.) I disinfected our bathroom after every usage, but I was apprehensive. My friend's place has a guest room and second bathroom, so no cross-contamination. It was the ideal monkeypox isolation environment, so I accepted his offer and am writing this piece there. I don't know what I would have done without his hospitality and attention.

The next day, I started tecovirimat, or tpoxx, for 14 days. Smallpox has been eradicated worldwide since the 1980s but remains a bioterrorism concern. Tecovirimat has a unique, orthopoxvirus-specific method of action, which reduces side effects to headache and nausea. It hasn't been used in many people, therefore the cdc is encouraging patients who take it for monkeypox to track their disease and symptoms.

Tpoxx's oral absorption requires a fatty meal. The hospital ordered me to take the medication after a 600-calorie, 25-gram-fat meal every 12 hours. The coordinator joked, "Don't diet for the next two weeks." I wanted to get peanut butter delivered, but jif is recalling their supply due to salmonella. Please give pathogens a break. I got almond butter.

Tpoxx study enrollment was documented. After signing consent documents, my lesions were photographed and measured during a complete physical exam. I got bloodwork to assess my health. My medication delivery was precise; every step must be accounted for. I got a two-week supply and started taking it that night. I rewarded myself with McDonald's. I'd been hungry for a week. I was also prescribed ketorolac (aka toradol), a stronger ibuprofen, for my discomfort.

I thought tpoxx was a wonder medicine by day two of treatment. Early lesions looked like this.

however, They vanished. The three largest lesions on my back flattened and practically disappeared into my skin. Some pustular lesions were diminishing. Tpoxx+toradol has helped me sleep, focus, and feel human again. I'm down to twice-daily baths and feeling hungrier than ever in this illness. On day five of tpoxx, some of the lesions look like this:

I have a ways to go. We must believe I'll be contagious until the last of my patches scabs over, falls off, and sprouts new skin. There's no way to tell. After a week and a half of tremendous pain and psychological stress, any news is good news. I'm grateful for my slow but steady development.

Part 2 of the rant.

Being close to yet not in the medical world is interesting. It lets me know a lot about it without being persuaded by my involvement. Doctors identify and treat patients using a tool called differential diagnosis.

A doctor interviews a patient to learn about them and their symptoms. More is better. Doctors may ask, "Have you traveled recently?" sex life? Have pets? preferred streaming service? (No, really. (Hbomax is right.) After the inquisition, the doctor will complete a body exam ranging from looking in your eyes, ears, and throat to a thorough physical.

After collecting data, the doctor makes a mental (or physical) inventory of all the conceivable illnesses that could cause or explain the patient's symptoms. Differential diagnosis list. After establishing the differential, the clinician can eliminate options. The doctor will usually conduct nucleic acid tests on swab samples or bloodwork to learn more. This helps eliminate conditions from the differential or boosts a condition's likelihood. In an ideal circumstance, the doctor can eliminate all but one reason of your symptoms, leaving your formal diagnosis. Once diagnosed, treatment can begin. yay! Love medicine.

My symptoms two weeks ago did not suggest monkeypox. Fever, pains, weariness, and swollen lymph nodes are caused by several things. My scandalous symptoms weren't linked to common ones. My instance shows the importance of diversity and representation in healthcare. My doctor isn't gay, but he provides culturally sensitive care. I'd heard about monkeypox as a gay man in New York. I was hyper-aware of it and had heard of friends of friends who had contracted it the week before, even though the official case count in the US was 40. My physicians weren't concerned, but I was. How would it appear on his mental differential if it wasn't on his radar? Mental differential rhymes! I'll trademark it to prevent theft. differential!

I was in a rare position to recognize my condition and advocate for myself. I study infections. I'd spent months researching monkeypox. I work at a university where I rub shoulders with some of the country's greatest doctors. I'm a gay dude who follows nyc queer social networks online. All of these variables positioned me to think, "Maybe this is monkeypox," and to explain why.

This outbreak is another example of privilege at work. The brokenness of our healthcare system is once again exposed by the inequities produced by the vaccination rollout and the existence of people like myself who can pull strings owing to their line of work. I can't cure this situation on my own, but I can be a strong voice demanding the government do a better job addressing the outbreak and giving resources and advice to everyone I can.

lgbtqia+ community members' support has always impressed me in new york. The queer community has watched out for me and supported me in ways I never dreamed were possible.

Queer individuals are there for each other when societal structures fail. People went to the internet on the first day of the vaccine rollout to share appointment information and the vaccine clinic's message. Twitter timelines were more effective than marketing campaigns. Contrary to widespread anti-vaccine sentiment, the LGBT community was eager to protect themselves. Smallpox vaccination? sure. gimme. whether I'm safe. I credit the community's sex positivity. Many people are used to talking about STDs, so there's a reduced barrier to saying, "I think I have something, you should be on the watch too," and taking steps to protect our health.

Once I got monkeypox, I posted on Twitter and Instagram. Besides fueling my main character syndrome, I felt like I wasn't alone. My dc-based friend had monkeypox within hours. He told me about his experience and gave me ideas for managing the discomfort. I can't imagine life without him.

My buddy and colleague organized my medical care and let me remain in his home. His and his husband's friendliness and attention made a world of difference in my recovery. All of my friends and family who helped me, whether by venmo, doordash, or moral support, made me feel cared about. I don't deserve the amazing people in my life.

Finally, I think of everyone who commented on my social media posts regarding my trip. Friends from all sectors of my life and all sexualities have written me well wishes and complimented me for my vulnerability, but I feel the most gravitas from fellow lgbtq+ persons. They're learning to spot. They're learning where to go ill. They're learning self-advocacy. I'm another link in our network of caretaking. I've been cared for, therefore I want to do the same. Community and knowledge are powerful.

You're probably wondering where the diatribe is. You may believe he's gushing about his loved ones, and you'd be right. I say that just because the queer community can take care of itself doesn't mean we should.

Even when caused by the same pathogen, comparing health crises is risky. Aids is unlike covid-19 or monkeypox, yet all were caused by poorly understood viruses. The lgbtq+ community has a history of self-medicating. Queer people (and their supporters) have led the charge to protect themselves throughout history when the government refused. Surreal to experience this in real time.

First, vaccination access is a government failure. The strategic national stockpile contains tens of thousands of doses of jynneos, the newest fda-approved smallpox vaccine, and millions of doses of acam2000, an older vaccine for immunocompetent populations. Despite being a monkeypox hotspot and international crossroads, new york has only received 7,000 doses of the jynneos vaccine. Vaccine appointments are booked within minutes. It's showing Hunger Games, which bothers me.

Second, I think the government failed to recognize the severity of the european monkeypox outbreak. We saw abroad reports in may, but the first vaccines weren't available until june. Why was I a 26-year-old pharmacology grad student, able to see a monkeypox problem in europe but not the u.s. public health agency? Or was there too much bureaucracy and politicking, delaying action?

Lack of testing infrastructure for a known virus with vaccinations and therapies is appalling. More testing would have helped understand the problem's breadth. Many homosexual guys, including myself, didn't behave like monkeypox was a significant threat because there were only a dozen instances across the country. Our underestimating of the issue, spurred by a story of few infections, was huge.

Public health officials' response to infectious diseases frustrates me. A wait-and-see approach to infectious diseases is unsatisfactory. Before a sick person is recognized, they've exposed and maybe contaminated numerous others. Vaccinating susceptible populations before a disease becomes entrenched prevents disease. CDC might operate this way. When it was easier, they didn't control or prevent monkeypox. We'll learn when. Sometimes I fear never. Emerging viral infections are a menace in the era of climate change and globalization, and I fear our government will repeat the same mistakes. I don't work at the cdc, thus I have no idea what they do. As a scientist, a homosexual guy, and a citizen of this country, I feel confident declaring that the cdc has not done enough about monkeypox. Will they do enough about monkeypox? The strategic national stockpile can respond to a bioterrorism disaster in 12 hours. I'm skeptical following this outbreak.

It's simple to criticize the cdc, but they're not to blame. Underfunding public health services, especially the cdc, is another way our government fails to safeguard its citizens. I may gripe about the vaccination rollout all I want, but local health departments are doing their best with limited resources. They may not have enough workers to keep up with demand and run a contact-tracing program. Since my orthopoxvirus test is still negative, the doh hasn't asked about my close contacts. By then, my illness will be two weeks old, too long to do anything productive. Not their fault. They're functioning in a broken system that's underfunded for the work it does.

*Update, 7/11: I have orthopoxvirus.

Monkeypox is slow, so i've had time to contemplate. Now that I'm better, I'm angry. furious and sad I want to help. I wish to spare others my pain. This was preventable and solvable, I hope. HOW?

Third, the duty.

Family, especially selected family, helps each other. So many people have helped me throughout this difficult time. How can I give back? I have ideas.

1. Education. I've already started doing this by writing incredibly detailed posts on Instagram about my physical sickness and my thoughts on the entire scandal. via tweets. by producing this essay. I'll keep doing it even if people start to resent me! It's crucial! On my Instagram profile (@kyleplanckton), you may discover a story highlight with links to all of my bizarre yet educational posts.

2. Resources. I've forwarded the contact information for my institution's infectious diseases clinic to several folks who will hopefully be able to get tpoxx under the expanded use policy. Through my social networks, I've learned of similar institutions. I've also shared crowdsourced resources about symptom relief and vaccine appointment availability on social media. DM me or see my Instagram highlight for more.

3. Community action. During my illness, my friends' willingness to aid me has meant the most. It was nice to know I had folks on my side. One of my pals (thanks, kenny) snagged me a mcgriddle this morning when seamless canceled my order. This scenario has me thinking about methods to help people with monkeypox isolation. A two-week isolation period is financially damaging for many hourly workers. Certain governments required paid sick leave for covid-19 to allow employees to recover and prevent spread. No comparable program exists for monkeypox, and none seems to be planned shortly.

I want to aid monkeypox patients in severe financial conditions. I'm willing to pick up and bring groceries or fund meals/expenses for sick neighbors. I've seen several GoFundMe accounts, but I wish there was a centralized mechanism to link those in need with those who can help. Please contact me if you have expertise with mutual aid organizations. I hope we can start this shortly.

4. lobbying. Personal narratives are powerful. My narrative is only one, but I think it's compelling. Over the next day or so, i'll write to local, state, and federal officials about monkeypox. I wanted a vaccine but couldn't acquire one, and I feel tpoxx helped my disease. As a pharmacologist-in-training, I believe collecting data on a novel medicine is important, and there are ethical problems when making a drug with limited patient data broadly available. Many folks I know can't receive tpoxx due of red tape and a lack of contacts. People shouldn't have to go to an ivy league hospital to obtain the greatest care. Based on my experience and other people's tales, I believe tpoxx can drastically lessen monkeypox patients' pain and potentially curb transmission chains if administered early enough. This outbreak is manageable. It's not too late if we use all the instruments we have (diagnostic, vaccine, treatment).

*UPDATE 7/15: I submitted the following letter to Chuck Schumer and Kirsten Gillibrand. I've addressed identical letters to local, state, and federal officials, including the CDC and HHS.

I hope to join RESPND-MI, an LGBTQ+ community-led assessment of monkeypox symptoms and networks in NYC. Visit their website to learn more and give to this community-based charity.

How I got monkeypox is a mystery. I received it through a pride physical interaction, but i'm not sure which one. This outbreak will expand unless leaders act quickly. Until then, I'll keep educating and connecting people to care in my neighborhood.

Despite my misgivings, I see some optimism. Health department social media efforts are underway. During the outbreak, the CDC provided nonjudgmental suggestions for safer social and sexual activity. There's additional information regarding the disease course online, including how to request tpoxx for sufferers. These materials can help people advocate for themselves if they're sick. Importantly, homosexual guys are listening when they discuss about monkeypox online and irl. Learners They're serious.

The government has a terrible track record with lgtbq+ health issues, and they're not off to a good start this time. I hope this time will be better. If I can aid even one individual, I'll do so.

Thanks for reading, supporting me, and spreading awareness about the 2022 monkeypox outbreak. My dms are accessible if you want info, resources, queries, or to chat.

y'all well

kyle

Russia's nuclear threat may be nullified by physics.

Putin seems nostalgic and wants to relive the Cold War. He's started a deadly war to reclaim the old Soviet state of Ukraine and is threatening the West with nuclear war. NATO can't risk starting a global nuclear war that could wipe out humanity to support Ukraine's independence as much as they want to. Fortunately, nuclear physics may have rendered Putin's nuclear weapons useless. However? How will Ukraine and NATO react?

To understand why Russia's nuclear weapons may be ineffective, we must first know what kind they are.

Russia has the world's largest nuclear arsenal, with 4,447 strategic and 1,912 tactical weapons (all of which are ready to be rolled out quickly). The difference between these two weapons is small, but it affects their use and logistics. Strategic nuclear weapons are ICBMs designed to destroy a city across the globe. Russia's ICBMs have many designs and a yield of 300–800 kilotonnes. 300 kilotonnes can destroy Washington. Tactical nuclear weapons are smaller and can be fired from artillery guns or small truck-mounted missile launchers, giving them a 1,500 km range. Instead of destroying a distant city, they are designed to eliminate specific positions, bases, or military infrastructure. They produce 1–50 kilotonnes.

These two nuclear weapons use different nuclear reactions. Pure fission bombs are compact enough to fit in a shell or small missile. All early nuclear weapons used this design for their fission bombs. This technology is inefficient for bombs over 50 kilotonnes. Larger bombs are thermonuclear. Thermonuclear weapons use a small fission bomb to compress and heat a hydrogen capsule, which undergoes fusion and releases far more energy than ignition fission reactions, allowing for effective giant bombs. 

Here's Russia's issue.

A thermonuclear bomb needs deuterium (hydrogen with one neutron) and tritium (hydrogen with two neutrons). Because these two isotopes fuse at lower energies than others, the bomb works. One problem. Tritium is highly radioactive, with a half-life of only 12.5 years, and must be artificially made.

Tritium is made by irradiating lithium in nuclear reactors and extracting the gas. Tritium is one of the most expensive materials ever made, at $30,000 per gram.

Why does this affect Putin's nukes?

Thermonuclear weapons need tritium. Tritium decays quickly, so they must be regularly refilled at great cost, which Russia may struggle to do.

Russia has a smaller economy than New York, yet they are running an invasion, fending off international sanctions, and refining tritium for 4,447 thermonuclear weapons.

The Russian military is underfunded. Because the state can't afford it, Russian troops must buy their own body armor. Arguably, Putin cares more about the Ukraine conflict than maintaining his nuclear deterrent. Putin will likely lose power if he loses the Ukraine war.

It's possible that Putin halted tritium production and refueling to save money for Ukraine. His threats of nuclear attacks and escalating nuclear war may be a bluff.

This doesn't help Ukraine, sadly. Russia's tactical nuclear weapons don't need expensive refueling and will help with the invasion. So Ukraine still risks a nuclear attack. The bomb that destroyed Hiroshima was 15 kilotonnes, and Russia's tactical Iskander-K nuclear missile has a 50-kiloton yield. Even "little" bombs are deadly.

We can't guarantee it's happening in Russia. Putin may prioritize tritium. He knows the power of nuclear deterrence. Russia may have enough tritium for this conflict. Stockpiling a material with a short shelf life is unlikely, though.

This means that Russia's most powerful weapons may be nearly useless, but they may still be deadly. If true, this could allow NATO to offer full support to Ukraine and push the Russian tyrant back where he belongs. If Putin withholds funds from his crumbling military to maintain his nuclear deterrent, he may be willing to sink the ship with him. Let's hope the former.

Sundar Pichai unveiled Simplicity Sprint at Google's latest all-hands conference.

To boost employee efficiency.

Not surprising. Few envisioned Google declaring a productivity drive.

Sunder Pichai's speech:

“There are real concerns that our productivity as a whole is not where it needs to be for the head count we have. Help me create a culture that is more mission-focused, more focused on our products, more customer focused. We should think about how we can minimize distractions and really raise the bar on both product excellence and productivity.”

The primary driver driving Google's efficiency push is:

Google's efficiency push follows 13% quarterly revenue increase. Last year in the same quarter, it was 62%.

Market newcomers may argue that the previous year's figure was fuelled by post-Covid reopening and growing consumer spending. Investors aren't convinced. A promising company like Google can't afford to drop so quickly.

Google’s quarterly revenue growth stood at 13%, against 62% in last year same quarter.

Google isn't alone. In my recent essay regarding 2025 programmers, I warned about the economic downturn's effects on FAAMG's workforce. Facebook had suspended hiring, and Microsoft had promised hefty bonuses for loyal staff.

In the same article, I predicted Google's troubles. Online advertising, especially the way Google and Facebook sell it using user data, is over.

FAAMG and 2nd rung IT companies could be the first to fall without Post-COVID revival and uncertain global geopolitics.

Google has hardly ever discussed effectiveness:

Apparently openly.

Amazon treats its employees like robots, even in software positions. It has significant turnover and a terrible reputation as a result. Because of this, it rarely loses money due to staff productivity.

Amazon trumps Google. In reality, it treats its employees poorly.

Google was the founding father of the modern-day open culture.

Larry and Sergey Google founded the IT industry's Open Culture. Silicon Valley called Google's internal democracy and transparency near anarchy. Management rarely slammed decisions on employees. Surveys and internal polls ensured everyone knew the company's direction and had a vote.

20% project allotment (weekly free time to build own project) was Google's open-secret innovation component.

After Larry and Sergey's exit in 2019, this is Google's first profitability hurdle. Only Google insiders can answer these questions.

• Would Google's investors compel the company's management to adopt an Amazon-style culture where the developers are treated like circus performers?

• If so, would Google follow suit?

• If so, how does Google go about doing it?

Before discussing Google's likely plan, let's examine programming productivity.

What determines a programmer's productivity is simple:

How would we answer Google's questions?

As a programmer, I'm more concerned about Simplicity Sprint's aftermath than its economic catalysts.

Large organizations don't care much about quarterly and annual productivity metrics. They have 10-year product-launch plans. If something seems horrible today, it's likely due to someone's lousy judgment 5 years ago who is no longer in the blame game.

Deconstruct our main question.

• How exactly do you change the culture of the firm so that productivity increases?

• How can you accomplish that without affecting your capacity to profit? There are countless ways to increase output without decreasing profit.

• How can you accomplish this with little to no effect on employee motivation? (While not all employers care about it, in this case we are discussing the father of the open company culture.)

• How do you do it for a 10-developer IT firm that is losing money versus a 1,70,000-developer organization with a trillion-dollar valuation?

When implementing a large-scale organizational change, success must be carefully measured.

The fastest way to do something is to do it right, no matter how long it takes.

You require clearly-defined group/team/role segregation and solid pass/fail matrices to:

• You can give performers rewards.

• Ones that are average can be inspired to improve

• Underachievers may receive assistance or, in the worst-case scenario, rehabilitation

As a 20-year programmer, I associate productivity with greatness.

Doing something well, no matter how long it takes, is the fastest way to do it.

Let's discuss a programmer's productivity.

Why productivity is a strange term in programming:

Productivity is work per unit of time.

Money=time This is an economic proverb. More hours worked, more pay. Longer projects cost more.

As a buyer, you desire a quick supply. As a business owner, you want employees who perform at full capacity, creating more products to transport and boosting your profits.

All economic matrices encourage production because of our obsession with it. Productivity is the only organic way a nation may increase its GDP.

Time is money — is not just a proverb, but an economical fact.

Applying the same productivity theory to programming gets problematic. An automating computer. Its capacity depends on the software its master writes.

Today, a sophisticated program can process a billion records in a few hours. Creating one takes a competent coder and the necessary infrastructure. Learning, designing, coding, testing, and iterations take time.

Programming productivity isn't linear, unlike manufacturing and maintenance.

Average programmers produce code every day yet miss deadlines. Expert programmers go days without coding. End of sprint, they often surprise themselves by delivering fully working solutions.

Reversing the programming duties has no effect. Experts aren't needed for productivity.

These patterns remind me of an XKCD comic.

Programming productivity depends on two factors:

• The capacity of the programmer and his or her command of the principles of computer science

• His or her productive bursts, how often they occur, and how long they last as they engineer the answer

At some point, productivity measurement becomes Schrödinger’s cat.

Product companies measure productivity using use cases, classes, functions, or LOCs (lines of code). In days of data-rich source control systems, programmers' merge requests and/or commits are the most preferred yardstick. Companies assess productivity by tickets closed.

Every organization eventually has trouble measuring productivity. Finer measurements create more chaos. Every measure compares apples to oranges (or worse, apples with aircraft.) On top of the measuring overhead, the endeavor causes tremendous and unnecessary stress on teams, lowering their productivity and defeating its purpose.

Macro productivity measurements make sense. Amazon's factory-era management has done it, but at great cost.

Google can pull it off if it wants to.

What Google meant in reality when it said that employee productivity has decreased:

When Google considers its employees unproductive, it doesn't mean they don't complete enough work in the allotted period.

They can't multiply their work's influence over time.

• Programmers who produce excellent modules or products are unsure on how to use them.

• The best data scientists are unable to add the proper parameters in their models.

• Despite having a great product backlog, managers struggle to recruit resources with the necessary skills.

• Product designers who frequently develop and A/B test newer designs are unaware of why measures are inaccurate or whether they have already reached the saturation point.

• Most ignorant: All of the aforementioned positions are aware of what to do with their deliverables, but neither their supervisors nor Google itself have given them sufficient authority.

So, Google employees aren't productive.

How to fix it?

• Business analysis: White suits introducing novel items can interact with customers from all regions. Track analytics events proactively, especially the infrequent ones.

• SOLID, DRY, TEST, and AUTOMATION: Do less + reuse. Use boilerplate code creation. If something already exists, don't implement it yourself.

• Build features-building capabilities: N features are created by average programmers in N hours. An endless number of features can be built by average programmers thanks to the fact that expert programmers can produce 1 capability in N hours.

• Work on projects that will have a positive impact: Use the same algorithm to search for images on YouTube rather than the Mars surface.

• Avoid tasks that can only be measured in terms of time linearity at all costs (if a task can be completed in N minutes, then M copies of the same task would cost M*N minutes).

In conclusion:

Software development isn't linear. Why should the makers be measured?

Notation for The Big O

I'm discussing a new way to quantify programmer productivity. (It applies to other professions, but that's another subject)

The Big O notation expresses the paradigm (the algorithmic performance concept programmers rot to ace their Google interview)

Google (or any large corporation) can do this.

1. Sort organizational roles into categories and specify their impact vs. time objectives. A CXO role's time vs. effect function, for instance, has a complexity of O(log N), meaning that if a CEO raises his or her work time by 8x, the result only increases by 3x.

2. Plot the influence of each employee over time using the X and Y axes, respectively.

3. Add a multiplier for Y-axis values to the productivity equation to make business objectives matter. (Example values: Support = 5, Utility = 7, and Innovation = 10).

4. Compare employee scores in comparable categories (developers vs. devs, CXOs vs. CXOs, etc.) and reward or help employees based on whether they are ahead of or behind the pack.

After measuring every employee's inventiveness, it's straightforward to help underachievers and praise achievers.

Example of a Big(O) Category:

If I ran Google (God forbid, its worst days are far off), here's how I'd classify it. You can categorize Google employees whichever you choose.

The Google interview truth:

O(1) < O(log n) < O(n) < O(n log n) < O(n^x) where all logarithmic bases are < n.

O(1): Customer service workers' hours have no impact on firm profitability or customer pleasure.

CXOs Most of their time is spent on travel, strategic meetings, parties, and/or meetings with minimal floor-level influence. They're good at launching new products but bad at pivoting without disaster. Their directions are being followed.

Devops, UX designers, testers Agile projects revolve around deployment. DevOps controls the levers. Their automation secures results in subsequent cycles.

UX/UI Designers must still prototype UI elements despite improved design tools.

All test cases are proportional to use cases/functional units, hence testers' work is O(N).

Architects Their effort improves code quality. Their right/wrong interference affects product quality and rollout decisions even after the design is set.

Core Developers Only core developers can write code and own requirements. When people understand and own their labor, the output improves dramatically. A single character error can spread undetected throughout the SDLC and cost millions.

Core devs introduce/eliminate 1000x bugs, refactoring attempts, and regression. Following our earlier hypothesis.

The fastest way to do something is to do it right, no matter how long it takes.

Conclusion:

Google is at the liberal extreme of the employee-handling spectrum

Microsoft faced an existential crisis after 2000. It didn't choose Amazon's data-driven people management to revitalize itself.

Instead, it entrusted developers. It welcomed emerging technologies and opened up to open source, something it previously opposed.

Google is too lax in its employee-handling practices. With that foundation, it can only follow Amazon, no matter how carefully.

Any attempt to redefine people's measurements will affect the organization emotionally.

The more Google compares apples to apples, the higher its chances for future rebirth.