u/vikramskumar
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The New Gatekeepers of Clinical Knowledge : Artificial Intelligence and the Financialization of Medical Knowledge
Health AI platforms are becoming important gateways to medical knowledge. By answering clinical questions and synthesizing published evidence, tools such as OpenEvidence could improve access to information—but they may also concentrate control in a small number of technology companies.
u/vikramskumar — 2 days ago
Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals
Adults who could successfully stand on one leg for 10 seconds had an 46% lower risk of dying from any cause compared with those who couldn’t complete the test.
I find this fascinating because it shows how much information can be captured by a very simple measure of physical function.
It’s another reminder that balance is probably a meaningful marker of overall health and resilience, especially as we get older.
u/vikramskumar — 2 days ago
Waist Size May Tell Us More About Heart Risk Than BMI. However, emerging evidence suggests that where body fat is stored may be just as important as how much a person weighs.
substack.comu/vikramskumar — 3 days ago
Why Humans and AI May Interpret Medical Narrative Data Differently
Why your chart notes and your AI model disagree with each other
A resident once handed me a chart that read "baby not himself today" — and three of us on the round read it three different ways, none of us wrong.
That sent me down a rabbit hole: when two clinicians, or a clinician and an AI model, read the same note and land differently, it's tempting to call it an error and go fix the reader. Usually it isn't one error — it's one of six different things, and each needs a completely different fix.
I've written up the six, with pediatric examples throughout — growth curves, NICU shorthand, proxy reporting through parents, and a safeguarding example that I think matters for anyone sitting on a chart review or ethics committee.
Would love your read on it, especially if you've felt the same disagreement in your own M&M or peer-review process.
u/vikramskumar — 2 days ago
Nearly Half of U.S. Internists Were Born Abroad — and India Is the Largest Contributor
This analysis highlights just how dependent U.S. internal medicine is on physicians born outside the country.
Nearly **half of the U.S. internal medicine workforce is non–U.S.-born**.
Some numbers that stood out:
* Non–U.S.-born IMGs make up **36.1%** of U.S. internists.
* **India alone contributes 10.8% of the entire internal medicine workforce**, the largest share from any foreign country.
* Non–U.S.-born IMGs constitute **more than half of geriatricians, nephrologists, and sleep medicine physicians**.
* In 2024, non–U.S.-born physicians cared for **22.5 million traditional Medicare beneficiaries**.
* Their patients were disproportionately **low-income, disabled, Black, Latino, and Medicare-Medicaid dual eligible**.
* They were also more likely to care for people living in **high-poverty, medically underserved, and physician-shortage areas**.
So this isn't simply a story about immigrant doctors filling vacancies.
**They are a fundamental part of the U.S. healthcare infrastructure—particularly for patients and communities that already struggle to access care.**
And India's contribution is remarkable: roughly **1 in every 9 U.S. internal medicine physicians is a non–U.S.-born IMG from India**.
u/vikramskumar — 6 days ago
The World's Vegetables Are Vanishing, And It's Quietly Wrecking Our Diets…! (A PNAS article) We often talk about food security as if the question is simply: Do people have enough to eat? But perhaps the more important question is becoming: Are we slowly losing the diversity …"
The World's Vegetables Are Vanishing, And It's Quietly Wrecking Our Diets…! (A PNAS article)
We often talk about food security as if the question is simply: Do people have enough to eat?
But perhaps the more important question is becoming: Are we slowly losing the diversity of what we eat?
A recent paper in PNAS draws attention to the decline of vegetable biodiversity. Across the world, hundreds of edible plant species and traditional varieties remain underused, poorly studied, or are gradually disappearing from our farms, markets and diets.
u/vikramskumar — 10 days ago
one of the several dark stories in the history of medicine
Of all the infamous research scandals that emerged in the 1960s and 1970s, however, none is more contested than the one over the Willowbrook hepatitis study. Between 1956 and 1972 a team of researchers from New York University led (beginning in 1958) by Saul Krugman deliberately infected institutionalized, mentally disabled children at the Willowbrook State School on Staten Island with the hepatitis virus.
u/vikramskumar — 12 days ago
Breastfeeding at the Crossroads: Are we Engineering the Collapse of Human Potential ?
Today opens the seven days the World Health Organization, UNICEF, and the World Alliance for Breastfeeding Action have set aside this year, under a theme that sounds almost bureaucratic until you sit with it: Breastfeeding for a Sustainable Start in Life — Strengthen What Works. Not stronger messaging. Stronger systems.
A joint WHO/UNICEF statement timed to this week puts a number on what's actually at stake: scaling up breastfeeding worldwide could save close to 540,000 lives a year — roughly 400,000 infants, 140,000 mothers — and return an estimated $59 for every $1 spent making it possible.
NFHS-6 (released in May): national exclusive breastfeeding fell 63.7% → 55.8% even as institutional births and private C-sections climbed toward/past half of all deliveries; Karnataka essentially held flat against the national drop.
So here's the question worth sitting with, this week specifically: when a mother's breastfeeding story fails near you, what did the system do — or fail to do — between delivery and the moment support actually mattered? Not what got posted. Not what got intended. What got delivered.
Strengthen what works is this year's phrase. But you can't strengthen a chain you never finished building. Seven days from now, the posters come down, the hashtag moves to something else, and the newborns discharged this week will already be three, four, five days into finding out whether anyone was actually there...!
The harder question is what we let stop working, and why. This is my 2025 blog.
u/vikramskumar — 16 days ago
Decision authority in health AI
u/vikramskumar — 21 days ago
Not a Mentor. Not a Master. What the guru–shishya bond actually asks of us on Guru Purnima
For Guru Purnima this year I write something a little more uncomfortable than the usual gratitude post — a look at the guru-shishya bond that holds old stories together instead of picking one
The core argument is that the closeness that makes real teaching possible is the same closeness that makes coercion invisible — and that no amount of AI-era optimism about the guru's renewed importance means anything if institutions won't fund the time it actually takes.
I Would genuinely value your read and pushback, especially from anyone who's sat on either side of this relationship...!
u/vikramskumar — 20 days ago
We don’t tell parents of a baby not to let him crawl because it’s a useless phase…!
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AI is a powerful tool — for adults who have already made the long, difficult journey of learning to read, think, analyse, and organise their own thoughts. For someone who has done that work, AI can be genuinely useful.
“But if you’re a child and you haven’t been through that lengthy, fibrous, but ultimately joyful journey of learning to do it yourself, then you’ve skipped a crucial part of cognitive development.”
And however many lectures you give teenagers on using AI responsibly as an intellectual sparring partner rather than a shortcut, the reality is predictable:
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This isn’t a moral failing. It’s a completely natural biological response to low-effort options. The question is why we keep building systems that set children up to take them.
u/Its_Stavro — 21 days ago
Retractions Are More Than Numbers—They’re a Wake-Up Call for Academia.
The latest data on research paper retractions in 2025 highlights an uncomfortable reality: research integrity is becoming one of the biggest challenges facing higher education worldwide.
A retracted paper doesn’t always indicate misconduct, but it often reflects issues such as plagiarism, data fabrication, duplicate publication, ethical violations, or major methodological errors. Each retraction affects not only individual researchers but also the credibility of institutions and the trust placed in scientific research.
The presence of several Indian universities in the list should not be viewed merely as a statistic to criticize. Instead, it should motivate us to strengthen our research ecosystem
u/vikramskumar — 25 days ago
ANRF Ramanujan Fellowship 2026 for outstanding Indian & Indian-origin researchers working abroad to build their research career in India.
A prestigious opportunity to lead independent research with generous funding while contributing to India's growing research ecosystem.
⏳ Applications are open until 31 December 2026.
🔬 Opportunity
• Fellowship by the Anusandhan National Research Foundation (ANRF)
• Open across all areas of Science & Engineering
• Choose any eligible host institution or university in India (other than your PhD institution)
• Tenure of up to 5 years
🎯 Eligibility
• Indian or Indian-origin scientists/engineers working abroad
• Below 40 years of age
• PhD (or equivalent higher qualification such as M.Tech./MD with relevant experience)
• Strong research publications and professional recognition
• Applicants must not hold a permanent, tenure-track, or contractual position in an Indian institution at the time of nomination.
💰 Support
• ₹1,35,000/month (including HRA)
• ₹7 lakh/year research grant
• ₹60,000/year institutional overheads
📅 Important Date
• Application Deadline: 31 December 2026
u/vikramskumar — 23 days ago
GitHub - vikramsakaleshpurkumar-byte/vikkypaedia-way-to-bookmarks: A private-first bookmark rescue tool that helps people find and use what they saved.
Most of us save hundreds of useful links—and rarely find them again.
I created Vikkypaedia Way to Bookmarks (Waymark), an open-source tool that helps people rediscover forgotten bookmarks, search using what they remember, and convert saved knowledge into action.
u/vikramskumar — 26 days ago
The Prevention Paradox A successful preventive programme is judged, unfairly, by how little it seems to do.
open.substack.comu/vikramskumar — 27 days ago
The Prevention Paradox.
It's about why a preventive measure that helps a population enormously can feel like it does almost nothing for any one person in it, and why that's not a flaw, it's the arithmetic of prevention working as designed. Grounded in Geoffrey Rose's 1985 paper and a statin NNT example, with a case from my own OPD.
Worth five minutes if you counsel patients on vaccines, statins, or anything preventive and struggle to explain the numbers honestly.
u/vikramskumar — 27 days ago
Caffeine and Cardiovascular Disease: A ScientificStatement From the American Heart Association 2026
Caffeine and Cardiovascular Disease: A Scientific Statement From the American Heart Association 2026
>The majority of human subject–based research is observational and has focused on beverages and foods that contain caffeine. The relationships between caffeine and cardiovascular risk factors and diseases are complex, exhibiting heterogeneity depending on the nature of the caffeine consumed and individual-level propensities.
Acute versus chronic caffeine-associated cardiovascular effects are often different. Most studies suggest an inverse J-shaped relationship between consumption of naturally occurring caffeinated products and blood pressure.
Data on relationships between caffeine and diabetes are not consistent, but habitual coffee consumption has been associated with a lower risk of incident type 2 diabetes. Whereas no clear relationship between caffeine and blood lipids is evident, unfiltered coffee raises low-density lipoprotein cholesterol. Caffeine, studied primarily in the context of coffee, has been shown either to have no relationship or to be associated with a lower risk of coronary artery disease and heart failure.
Randomized controlled trial data among regular caffeinated coffee drinkers showed that caffeinated coffee decreases the risk of atrial fibrillation occurrence but increases the frequency of premature ventricular contractions. Data are fairly consistent that moderate caffeine consumption, again studied primarily in the setting of coffee consumption, was associated with a lower risk of stroke.
Data on high doses of caffeine such as that found in energy drinks are limited and generally suggest cardiovascular harm.
Circulation. 2026;154:e00–e00.
DOI: 10.1161/CIR.0000000000001454
Checkout this interesting interactive website where you can learn and understand how much caffeine you are currently consuming or can consume with other important must know information about coffee, tea, energy drinks etc...
u/vikramskumar — 1 month ago
The initiative reduced diagnosis time from 15 days to just 5 days, while average patient costs fell from ₹9,451 to ₹91, making TB diagnosis faster, more affordable, and more accessible.
reddit.com
u/vikramskumar — 1 month ago
Silent Speech Breakthrough: Ultrasound-Powered AI Lets You "Talk" to Computers Without a Sound – A Game-Changer for Medicine and Healthcare
In a stunning leap forward at the intersection of AI, imaging, and human-computer interaction, developer Vadims (@vadi_ms) and the Aleph Neuro team have demonstrated a prototype system that decodes silent speech directly from tongue movements captured via ultrasound. After just one month and 50 hours of self-collected data, their model achieves an impressive 15.6% Word Error Rate (WER) on open-vocabulary tasks – rivaling early lip-reading systems trained on vastly more data – and generalizes to new speakers with American accents.
The setup is elegantly straightforward yet profoundly enabling: a submental ultrasound probe placed under the chin visualizes the tongue in real-time as the user silently articulates. A Video ResNet encoder processes the imagery, mapping it into embeddings that feed a Whisper decoder to output coherent text. Early training struggles gave way to breakthrough moments – like correctly inferring phonetic nuances ("a key stick" for "acoustic") rather than mere language modeling – proving the system reads genuine articulatory signals.
Why This Matters for Medicine and Healthcare
This isn't just a cool interface hack; it's poised to transform patient care, clinical workflows, and accessibility:
- Voice Restoration and Assistive Tech: For patients who have lost their voice due to ALS, stroke, laryngectomy, autoimmune conditions, or surgery, this offers a path to natural, silent communication.
- Private, Hands-Free Clinical Documentation: Doctors and nurses could dictate notes silently in busy wards, operating rooms, or during patient consultations without disrupting privacy or sterility. No more mumbled voice memos or typing interruptions – silent ultrasound input could integrate seamlessly with AI scribes.
- Accessibility in Noisy or Restricted Environments: ICU settings, libraries, public transport, or shared spaces become viable for communication. It enables discreet interaction for those with speech impairments, cultural/religious needs for quiet, or professionals requiring confidentiality (e.g., therapists, lawyers in healthcare).
- Scalability and Future Wearables: The team envisions shrinking the probe into a lightweight adhesive patch or wearable, replacing gel with hydrogel. With more data (they speculate on 1,000 hours), accuracy could soar, supporting accents and closed-mouth use. Safety data reassures: power levels are far below diagnostic ultrasound standards used in pregnancy imaging for decades.
Compared to alternatives like EMG, radar, or cameras (which capture far less information – ultrasound distinguishes ~34 phoneme classes vs. 10-14 for lip-reading), this approach is uniquely direct and invisible.
As a tech observer, it's exhilarating to witness a small, passionate team outpace expectations with minimal resources. This silent speech prototype echoes the trajectory of early speech recognition: crude at first, then ubiquitous. In healthcare, where every second counts and privacy is paramount, technologies like this could redefine how patients "speak," clinicians document, and humans interface with AI – quietly, efficiently, and universally.
The future of medicine just got a lot quieter – and infinitely more empowering. Watch this space.
u/vikramskumar — 1 month ago