This week on The Intersect, we delve into groundbreaking cellular research that's challenging our understanding of memory and intelligence.

Scientists at NYU's Center for Neural Science have discovered that memory isn't exclusive to brain cells; it's a fundamental feature of cellular biology.

Their study, published in Nature Communications, reveals that non-neural cells, like kidney cells, can exhibit "memory-like" responses.

Here's what we'll explore:

●The Massed-Spaced Effect in Cells: Just like when you study for an exam, cells respond better to spaced-out stimuli than cramming. The researchers found that when non-neural cells are exposed to repeated chemical signals, they show enhanced responses to spaced stimuli, similar to how neurons behave during learning.

●Cellular "Training": Lead researcher Nikolay Kukushkin suggests that we might one day be able to "train" cells to perform beneficial behaviors. This could include teaching muscle cells to produce healthy hormones or programming cancer cells to stop dividing.

●Molecular Mechanisms: The study shows that the memory-like responses in cells are linked to the activation of molecules like CREB and ERK, which are also essential for memory formation in neurons. Spaced stimulation leads to a stronger and more sustained activation of these molecules.

●Challenging Neurocentrism: This research, along with the work of Dr. Michael Levin on bioelectricity, challenges the traditional neurocentric view that information processing is unique to the brain. Both studies demonstrate that non-neural cells can process and store information, suggesting "intelligence-like" behaviors exist at the cellular level.

●Therapeutic Applications: Manipulating cellular behavior could have potential therapeutic applications. Instead of just blocking processes with drugs, we might be able to modify cells themselves to treat diseases.

●The Broader Implications: The researchers are also investigating what kinds of time patterns cells respond to and how these patterns change the cell. They hope to be able to predict cellular behavior in response to time patterns.

●What is "memory" at the cellular level?: The researchers emphasize that the memory processes they are observing in cells are not metaphorical but are the same processes with the same evolutionary roots and functional use as memory in the brain . This episode will explore the implications of this research, which demonstrates that the capacity for memory extends far beyond the brain and opens new possibilities for medicine and our understanding of life itself.

We're diving into the fascinating world of cognitive science, exploring the ideas from Chapter 6 of Kevin Simler and Robin Hanson's book, "The Elephant in the Brain."

Prepare to question your understanding of your own motives and actions. Are we truly the rational decision-makers we believe ourselves to be? Or are we more like a press secretary, spinning narratives to justify decisions made by a hidden "king" within our brains?

Key topics in this episode include:

●Counterfeit Reasons: We often make up reasons for our behavior, not consciously lying, but creating stories to explain our actions. These "reasons" are not necessarily the real "motives". This is something J.P. Morgan pointed out, saying "A man always has two reasons for doing anything: a good reason and the real reason".

●The Press Secretary: The brain contains a module, called the "interpreter module" or the "Press Secretary", that explains our actions to ourselves and others6. This module often operates by creating narratives that may not accurately reflect our true motives.

●Rationalization: We will look at how easily we rationalize our behavior by creating fabricated stories without the intention to deceive. Neuroscientists call this confabulation.

●Split-Brain Studies: We'll examine groundbreaking experiments by Roger Sperry and Michael Gazzaniga with "split-brain" patients that revealed how the left hemisphere of the brain can create explanations for actions that it had no part in making, demonstrating how easily we can rationalize our behavior. One example is how patients made up reasons for pointing to a shovel when shown a snowy field. Another example is how a patient said they stood up to get a coke, even though they were asked by researchers.

●Strategic Ignorance: This episode will explore how our brains, like a press secretary, can strategically remain ignorant of our darker motives in order to avoid acknowledging our selfish behaviors.

●Real-World Examples: We will discuss how rationalization appears in everyday life, from toddlers stalling bedtime to adults using half-truths. We'll examine common examples like parents enforcing bedtimes "for their own good" or people making excuses for not going to work or declining meetings.

Get ready to delve into the surprising ways our brains work and how we often deceive even ourselves about the true reasons behind our actions. You might find that you are, in fact, a stranger to yourself!

Source: The Elephant in the Brain: Hidden Motives in Everyday Life by Kevin Simler and Robin Hanson

This episode explores the long history of energy use as told by Vaclav Smil in Energy and Civilization: A History⁠, starting with the basic power of human and animal muscles and moving toward the harnessing of wind and water.

We will look at how these traditional power sources were essential for early agriculture, transportation, and manufacturing.

The episode also examines the transition to the use of fossil fuels like coal, which greatly expanded the availability of energy and enabled the Industrial Revolution.

We will see how innovations like the steam engine and the development of electricity transformed societies, and also look at the human cost of these developments, for example in coal mining.

Finally, we will consider how the concentration of power in modern technologies requires new safety precautions and how energy use continues to evolve and impact our civilization.

Source: Energy and Civilization: A History by Vaclav Smil

This Week in Healthcare, Jan 10, 2024

In this week’s episode of The Intersect, we dive into the latest headlines reshaping the healthcare industry.

From CVS’s bold move to "cost plus" pharmacy pricing to Transcarent’s $621 million acquisition of Accolade, strategic shifts in healthcare delivery and benefits are taking center stage.

We also explore the FDA’s efforts to tackle bias in AI-powered medical devices, a new rule wiping medical debt from credit reports, and updates on UnitedHealth’s delayed $3.3 billion merger.

Plus, we break down the VA’s timeline to resume its electronic health record rollout and what’s next in the ongoing reassessment of state Certificate of Need laws.

Tune in for insightful analysis and discussions on the stories that matter most in This Week in Healthcare!

This episode is adapted from a transcript of The Storytelling Expert: Hidden Triggers That Make People Act | Matthew Dicks on September 4, 2024 by The Knowledge Project Podcast from Farnam Street.

Master storyteller Matthew Dicks reveals the hidden blueprint behind stories that win million-dollar deals, transform resistant teams, and turn skeptical investors into champions.

Learn why most leaders tell stories that fail, and discover the counterintuitive techniques that make audiences lean in, remember, and act. From high-stakes boardrooms to viral TED talks, Dicks unveils the psychological triggers that turn everyday moments into weapons of mass persuasion.

Dicks emphasizes that a story is about change, usually a shift in mindset or transformation. He highlights that the fundamental rule for great storytelling is understanding that no one is obligated to listen unless given a reason. Skilled storytellers acknowledge that they must “entertain relentlessly” regardless of the format.

Dicks discusses how much preparation goes into making a story appear spontaneous. The best storytellers find a middle ground, where they "remember" stories rather than memorize them verbatim, allowing for flexibility in delivery based on the audience's engagement.

He describes carrying “five anecdotes in his pocket” to re-engage an audience if needed. The art is in knowing the beats, the key moments, without locking into precise phrasing.

He also notes that a story should stay with you for days, weeks, or even a lifetime, unlike anecdotes which are easily forgotten. A well-told story creates a connection with the listener’s life experiences, eliciting shared emotions and reflections.

Dicks uses "The Spoon of Power" story to illustrate his points. He explains that he organizes his stories around scenes, each tied to a location: the playground, the classroom, the math test, the bus ride, the principal’s office, the hallway, the last day of school, and the pandemic year.

Dicks outlines the "Mount Rushmore" of storytelling elements: stakes, suspense, surprise, and humor and introduces six key storytelling techniques.

Did you know that your doctor might be encouraged to diagnose you with conditions you don't actually have?

This episode dives deep into the practices of UnitedHealth Group, the nation's largest health insurer, and their impact on Medicare Advantage payments.

We explore how UnitedHealth's system of employing doctors and providing them with checklists of potential diagnoses has led to significant increases in patient sickness scores and, consequently, billions in extra government payments.

● We’ll discuss how doctors working for UnitedHealth were sometimes presented with lists of diagnoses before they even saw the patient, and how the company’s software required them to weigh in on each one before moving on to the next patient.

●We'll delve into the details of how these diagnoses affected patients' sickness scores. For example, analysis showed that sickness scores for UnitedHealth patients increased 55% on average in their first year in the plans.

●We'll hear from doctors who worked for UnitedHealth, like Nicholas Jones, who described how the diagnoses suggested were often "irrelevant or wrong", and who sometimes had to look up obscure conditions suggested by the company’s software.

●We will also examine specific conditions, such as senile purpura, a benign bruising condition, that were diagnosed much more frequently in UnitedHealth Medicare Advantage patients than in traditional Medicare patients.

●The episode will also investigate how financial incentives such as bonus payments were offered to doctors who confirmed or ruled out a high percentage of the suggested diagnoses.

●We’ll also explore how some patients began to suspect that their doctors had a financial incentive to portray them as higher risk1011, for example, a patient who was diagnosed as morbidly obese despite being an athletic weightlifter.

●We will also examine how the design of the diagnostic system could lead to errors that ultimately resulted in more money from taxpayers.

●The podcast will also discuss the company's response and the government's reaction to the findings.

This episode raises crucial questions about the integrity of the Medicare Advantage system, the pressure doctors face to prioritize payments over patient care, and the potential consequences for patients and taxpayers. Join us as we uncover the truth behind UnitedHealth’s diagnosis dilemma.

Source: UnitedHealth’s Army of Doctors Helped It Collect Billions More From Medicare

This podcast discussion explores the hidden motivations behind patients' healthcare choices. It argues that people seek medical care not primarily for medical outcomes, but for social validation and reassurance.

The discussion uses examples like the popularity of likeable but potentially ineffective doctors and patients' low interest in objective medical data to support this claim.

Experts highlight the significant role of patient experience and service quality in overall satisfaction, even at the cost of medical efficacy.

The conversation also touches upon the NHS and its efforts to balance patient experience with clinical standards, and the inherent inefficiencies driven by patients' desire for the best care.

Book Source

Hacking the Unconscious (Rory Sutherland)

This episode explores the concept of "nudging," using insights from behavioral science to influence decision-making for the better.

We delve into how individuals and organizations can design choices that promote positive outcomes, from health and finance to environmental sustainability.

We examine real-world examples of effective nudges, as well as potential pitfalls, including the misuse of nudges for self-serving purposes and the dangers of “sludge,” which makes it harder for people to make good decisions.

We discuss the ethics of nudging and the importance of transparency and respect for individual choice, and consider how the principles of libertarian paternalism can be applied to improve society while preserving individual freedoms.

Learn how seemingly small changes in our environment can lead to big differences in behavior and how to harness the power of nudges for good.

Key points covered:

● The definition of nudges and their roots in behavioral science.

● The concept of choice architecture and how it can be used to improve decision-making.

● Examples of successful nudges in various fields, including health, finance, and the environment.

● The potential for misuse of nudges, and the concept of "sludge".

● The importance of transparency and the "publicity principle" in nudging.

● The idea of libertarian paternalism and its implications for policy.

● Real-world cases of nudging, such as organ donation policies, and the ways in which language can impact these policies.

● The need to apply rigorous tests to determine the effectiveness of nudges.

Book Links

Nudge: Improving Decisions About Health, Wealth and Happiness

Misbehaving: The Making of Behavioral Economics