Thursday, November 28, 2024

This Is Not A Good News Story -- Despite The Headline -- November 28, 2024

Locator: 44446FETANYL.

This just showed up in my news feed today, November 28, 2024, but note that this story has a byline date of November 21, 2024. Strange.

Regardless, it's not a good news story. Almost every paragraph has an "are you kidding me moment?" 

Some of the relevant paragraphs that have that "are you kidding me moment"?

The fentanyl on the street is starting to become weaker. Anne Milgram, who heads the Drug Enforcement Administration, announced last week that for the first time since 2021, the agency was seeing a decline in fentanyl potency, a development she attributed to the government’s crackdown on Mexican cartels and international supply chains. Last year, seven out of 10 counterfeit pills tested in D.E.A. labs contained a life-threatening amount of fentanyl, she said, but that number has dropped to five out of 10.

From seven to five? Really? Is that good news?

Addiction experts say that other interventions contributed to the declining fatalities, including wider distribution of overdose reversal medications like Narcan; an uptick in some states in prescriptions for medication that suppresses opioid cravings; and campaigns warning the public about fentanyl-tainted counterfeit pills.

That's all great, but doesn't suggest Fentanyl use is declining all that much. Worse, the authors obfuscate Narcan with completely unrelated state policy changes.

Fentanyl is now often diluted with xylazine, an animal tranquilizer that can cause horrific skin ulcers, which have even led to limb amputations. But drug policy experts said that xylazine, in some cases, might also be having a lifesaving effect.

So, at least fentanyl pills are now being diluted with non-fentanyl drugs. Okay. 

Buy why the lifesaving effect?

People addicted to fentanyl often need the drug numerous times a day. But xylazine can sedate users for hours. If someone consumes fentanyl mixed with xylazine, “you might not shoot another bag of fentanyl, because you’re knocked out,” said Colin Miller, a researcher at the University of North Carolina, Chapel Hill, who has been interviewing drug users in Grand Rapids, Mich., and Pittsburgh about the effects of xylazine in the street supply.

Because when you're knocked out with a horse sedative, you can't shoot up with more fentanyl.  

And, then, of course, the numbers themselves, which don't give me much comfort but apparently many in the field are seeing progress.

According to the latest provisional data from the C.D.C., overdose deaths fell to 97,000, in the 12 months that ended in June, a welcome drop below the grim 100,000 threshold that was surpassed during the pandemic but still staggering.

There were 16,000 fewer drug-related fatalities during that time period than in the period a year earlier — a projected drop of 14.5 percent. Data suggests that in many states, nonfatal overdose rates are falling as well.

But the data also shows uneven progress among racial and ethnic groups and geographic regions. Fatal overdoses among Black Americans generally increased between 2022 and 2023, while they largely decreased among white Americans, according to a recent Georgetown University analysis of state data.

For me, the article results in one observation: it appears the headline writer was focusing on the wrong metric.  

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Meanwhile, Highway Fatalities


Chart of the day
: it doesn't take a rocket scientist to explain this chart:

Netflix -- Tim Burton -- Paint It Black -- Wednesday -- Rolling Stones -- Truly Amazing -- November 28, 2024

Locator: 44445NETFLIX.

Link here.

Wednesday is an American gothic coming-of-age supernatural mystery television series based on the character Wednesday Addams by Charles Addams

Created by Alfred Gough and Miles Millar, it stars Jenna Ortega as the titular character, with Gwendoline Christie, Riki Lindhome, Jamie McShane, Hunter Doohan, Percy Hynes White, Emma Myers, Joy Sunday, Georgie Farmer, Naomi J. Ogawa, Christina Ricci, and Moosa Mostafa appearing in supporting roles. 

Four out of the eight episodes of the first season were directed by Tim Burton, who also serves as executive producer

The first season revolves around Wednesday Addams, who attempts to solve a murder mystery at her new school.

Burton was previously approached to direct the 1991 film The Addams Family and was involved with a cancelled stop-motion animated The Addams Family film. 

In October 2020, he was reported to be helming a television series, which was later given a series order by Netflix

Ortega was cast in part to represent the character's Latina heritage. Ricci, who had played the titular character in the 1991 film and its 1993 sequel Addams Family Values, was asked by Burton to join the series in a supporting role. 

Filming took place in Romania between September 2021 and March 2022. 

Sophia brought this to my attention and now I see it featured on Macy's Thanksgiving Day Parade. Who would have thought?

That Tim Burton is a genius. I just watched Edward Scissorhands two nights ago, a movie now playing on Hulu. 

Link here.

"Paint It Black" is a song by the English rock band the Rolling Stones.
A product of the songwriting partnership of Mick Jagger and Keith Richards, it is a raga rock song with Indian, Middle Eastern and Eastern European influences and lyrics about grief and loss. London Records released the song as a single on 7 May 1966 in the United States, and Decca Records released it on 13 May in the United Kingdom.
Two months later, London Records included it as the opening track on the American version of the band's 1966 studio album Aftermath, though it is not on the original UK release.
Originating from a series of improvisational melodies played by Brian Jones on the sitar, the song features all five members of the band contributing to the final arrangement although only Jagger and Richards were credited as songwriters.
In contrast to previous Rolling Stones singles with straightforward rock arrangements, "Paint It Black" has unconventional instrumentation, including a prominent sitar, the Hammond organ and castanets. This instrumental experimentation matches other songs on Aftermath. The song was influential to the burgeoning psychedelic genre as the first chart-topping single to feature the sitar, and widened the instrument's audience. Reviews of the song at the time were mixed, and some music critics believed its use of the sitar was an attempt to copy the Beatles, while others criticised its experimental style and doubted its commercial potential.

Now 59 years later, it's featured in a Tim Burton production. Wow. Link here.

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NFL Today 

On Hulu and local networks.

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Tonight's Movie

Midnight in Paris.

The Day The Music Died -- I Was Completely Unaware Of This -- Nissan -- Dire -- November 28, 2024

Locator: 44444EVS.

Nissan: dire. Link here.

After posting net losses earlier this month, Nissan CEO Makoto Uchida said the "extremely tough situation" will force some bold restructuring moves.
In addition to downgrades to its full-year sales and operating outlooks, it set out to save $3 billion by drastically reducing its Mitsubishi share and cutting 9,000 from its global headcount of over 133,000 employees.
At its news conference, Nissan's Chief Monozukuri Officer (Head of Manufacturing) Hideyuki Sakamoto said that the controversial move will allow its factories to run more efficiently and save money.
“Globally, we currently have 25 vehicle production lines. Our current plan is to reduce the operational maximum capacity of these 25 lines by 20 percent,” Sakamoto said. “One specific method for this is to change the line speed and shift patterns, thereby increasing the efficiency of operational personnel.” 

But now, look at how how AI explains how this dire situation evolved -- basically it's Chinese EVs:

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Meanwhile, Stellantis

Link here

Short term vs long term dilemma?

Link here.

In the US? Think smack.

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Memories

About five years into my medical training, there was a transformation in the way we took notes. In hindsight, at the time, it was so incredibly obvious, it seemed to become a new way of taking / recording notes, essentially overnight. See wiki on SOAP notes. Remembering Dr Larry Weed.

An aside, some irony, fifty years later: the "clinical coder" won -- the physician (and perhaps the patient) lost. Link here

I learned all about "coding" and "medical records" between 1983 and 1986 while serving in the USAF as a pediatrician assigned to Bitburg Air Base hospital, Germany. At the time, I did not know, but a good "coder" could teach a physician the "right words" to use to maximize reimbursement from third party payers. LOL.

Since then, a new acronym has popped up, new to me. Probably developed by some smart Harvard intern. 

See "OPQRST."

"They" have since added AAA (OPQRST-AAA) and have expanded the "O."

My hunch: by the time Sophia begins her medical school training, we will have "ABCDEFGHIJK....XYZ." 

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Dire Straits

Link here.

Happy Thanksgiving - 2024

Locator: 44443ARCHIVES.

North Texas weather: after hitting a high of 83°F yesterday, it's going to be cold today, hitting a high of 53°F today and getting close to freezing overnight. 

No plans: for the blog today. Not sure what I'll do. But I am here. 

Note: the Dunkin' Donut parade did not replace Macy's Thanksgiving parade. The former is in Philadelphia televised on ABC; the latter is in NYC, televised on NBC. The former started about an hour earlier but by 8:30 a.m. local (?) time, both will be running simultaneously.

Term limits: speaking of term limits, network presenters need to have term limits. Assignments / appointments for life are simply a bit too much. Exhibit A: Al Roker. 

Memories: from inside my USAF flight jacket during the "Gulf War." It promised a monetary reward to anyone that assisted a downed aircrew member back to safety. Each "certificate" was numbered. Mine: 561 FS (flight surgeon).


Misplaced: somehow, in all our moves, the above got misplaced and "lost." I only recently found it when "de-cluttering" this past week.

Mr Lonely: this absolutely does not express my feelings today -- quite the opposite. But I happened to come across it last night -- perhaps one of the best videos ever. Interestingly, this has seen very, very few -- if any -- "professional” covers. A lot is packed into this song/video if one takes time to reflect this Thanksgiving season. " ... now, I'm a soldier, a lonely soldier, away from home, through no wish of my own."