Oh, hey there! Postcall here, popping into your inbox like a Valentine’s Day card! 💕

Here’s some trivia to take to heart:

❓Trivia Question❓: In what century was circulation of blood demonstrated?

Now, time for this week’s stories!

• Is Elon Musk’s New Tech A No-Brainer? 

  • Neuralink has been implanted

• Things your attending might pimp you on 🙋🏽‍♀️👨‍ …

  • Is opiate agonist therapy (OAT) safe in pregnancy?

  • Guideline watch 👀

  • Radon is not so rad 

• Belleville in OD Emergency Mode🚨

• 🍔 Quick Bites

• Postcall Picks ✅

• The Crossword

• ❓Trivia Answer❓

Based on popular demand (over 60% of you want economy/market updates), we’re bringing back our financial summary — in a short, but sweet format called the Postcall’s one-sip markets update:

The S&P’s 1% gain for the week meant it had its 14th gaining week out of the last 15 (and pushed the index above the 5,000-point threshold for the first time). Despite the market gains, inflation expectations remain low (which means inflation should remain low). In Canada, Shopify showed off its Q4 earnings beat but takes a hit on share price (the street was expecting it to spend less).

Is Elon Musk’s New Tech A No-Brainer? 🧠

What happened? Neuralink, a neurotech company founded by billionaire Elon Musk, has implanted its first “brain-reading” device into a human.

Why it’s interesting: The FDA gave the green light for Musk and his team to start implanting the chips into humans last Sept. The chip is meant to “record and decode” brain activity and allow people with sleep paralysis, spinal cord injuries, or missing limbs to control devices with only their thoughts. 

Despite Musk claiming that the patient is “showing promising neurospike detection,” Neuralink hasn’t said anything about the product's long-term effects. Neuralink’s study brochure says patients will be monitored for 5 years after the procedure. In other brain computer interface products, the quality of the detected neuronal signals degrades over time. No information on what happens to patients beyond the 5 years has been given. 

The device was first tested on monkeys and, although their motor skills improved, some of them experienced seizures, brain swelling, and paralysis. 

Neuralink isn’t registered at ClinicalTrials.gov, despite it being a requirement for medical journals and universities to protect volunteers. Some researchers find the lack of protocol “uncomfortable,” and say that transparency from Neuralink is important because many people would be relying on the product to improve their lives.

Bottom line: Elon Musk may try to be a jack of all trades, but until he or his company coughs up more information about their “life-saving product,” his plans for world domination will just have to wait. 

Things your attending might pimp you on 🙋🏽‍♀️👨‍⚕️ 

Women to the front, in honour of International Day of Women and Girls in Science (Feb. 11). 🤸🏽‍♀️

1. Is opiate agonist therapy (OAT) safe in pregnancy?

A population-based cohort study of >9,000 pregnant individuals has shown that the risk of major congenital malformations with first-trimester OAT was 51/1000 and 61/1000 with buprenorphine and methadone, respectively. Buprenorphine-exposed infants had lower rates of cardiac malformations, oral clefts, and clubfoot, but had a higher rate of gastrointestinal malformations (mainly pyloric stenosis). Despite a small excess risk for major congenital malformations, OAT remains crucial for optimizing outcomes in pregnancies affected by OUD.

2. Guideline watch 👀

New US guidelines on HIV management in pregnancy highlight that Bictegravir/FTC/TAF (aka Biktarvy) can now be used as an alternative initial therapy based on small studies that suggest bictegravir is safe and effective in pregnancy. Protease inhibitors are no longer preferred for most pregnant people over concerns about integrase inhibitor resistance. Infants with perinatal exposure to HIV should be screened for congenital cytomegalovirus.

3. Radon not so rad 

A prospective cohort study of >150,000 postmenopausal women aged 50–79 found that radon exposure was associated with moderately increased stroke risk. Compared with women living at concentrations of radon of <2 pCi/L, those at 2–4 and >4 pCi/L had higher covariate-adjusted risks of incident stroke: hazard ratio (95% CI) 1.06 (0.99–1.13) and 1.14 (1.05–1.22). Associations were slightly stronger for ischemic than hemorrhagic stroke.

Belleville in OD Emergency Mode🚨

What happened: Last week, Belleville, ON declared a state of emergency after 23 suspected ODs in under 48 hours. Fortunately, no deaths occurred, but the strain on emergency services led to road closures and ambulances being pulled from rural areas. 

Why it’s interesting: This concentrated surge in ODs that Belleville is grappling with is a trend across Canada. 

• Since 2016, nearly 40,000 Canadians have OD'd.

• The street drug supply is increasingly contaminated, as sedatives like Xylazine (an elephant tranquilizer) are mixed in.

• Hydromorphone prices have fallen by 70-95% in cities with safer supply programs.

• Canada's crisis is rooted in inequity, from extreme poverty to lack of housing.

How are we solving this? There isn’t a silver bullet, but various levels of government have been funding safe supply solutions. (Since the 2010s, Health Canada has chipped in $77.8 million for 28 nationwide safer supply programs.)

• Substituting pharmaceutical-grade medications (e.g. hydromorphone) for highly toxic street drugs could save lives and improve health outcomes.

• Ontario’s take-home prescription model addresses fentanyl withdrawal, stabilizes patients, and maintains connections with service providers.

• Proponents point to reduced healthcare interactions overall.

Yes, but: There are ongoing risks to safe supply.

• Some doctors worry that, without oversight, safer-supply drugs might “destabilize people who have been on the road to recovery.”

• PO meds can be crushed and injected, resulting in possible increased risk of infections.

• Federal funding is set to run out in March this year, leading to a dilemma: keep prescribing or wean off of safe supply?

🍔 Quick Bites

1: 🦇 Save the bats! BC residents are encouraged to report any winter bat activity and sick or dead bats to prevent the spread of white-nose syndrome — a devastating infection that has killed millions of hibernating bats. No cases yet — but the fungus that causes the infection was discovered in Grand Forks last year.

2: 🏥 The Ontario Union of Family Physicians met last week to discuss alternative career paths, saying that FM practice is no longer sustainable in Ontario. The week prior, the Ontario health ministry announced adding new doctors and expanding interdisciplinary care teams – but not financial support for FMs.

3: 🤑 The rich are getting richer… in obnoxiousness? There’s been a rise in businesses that let people pay to cut in line — like airports, theme parks, and ski resorts, according to CNN. The article points out this is nothing new — like when wealthy people tried to pay to cut in line for COVID-19 vaccines.

4: 🏡 Have you been claiming home office expenses on your personal tax returns? That’s about to change, starting with 2023’s tax year filing — the CRA has removed the “simplified method.” Now you’ll need to do some math on the square footage of your workspace, but it’s a small price to pay being able to work in your sweatpants. 🤷‍♀️

5: 🪧 Police are investigating the protest on Monday at Toronto's Mount Sinai Hospital by Pro-Palestinian protesters. CTV reports that an internal email notes that police will be increasing their presence in the area and the hospital’s University Avenue entrance will be closed after 6 p.m. on weekdays, and closed entirely on weekends.

Postcall Picks ✅ 

🛫 Buy and Travel: Today’s the last day to get 20% (and free shipping) from one of our favourite luggage companies, Monos, using code “FORTHEM“

🥧 Learn: what happens to the economy when we eat less pork. “The American pork industry has become so efficient that demand can’t keep up with supply.“ - WSJ.

👂️ Listen: Send this to your loved one(s) — the Glaucomfleckens talk with The Flipside Life, an organization that supports partners that support physicians (through all stages of a medical career).

The Crossword

Secure your stethoscopes and fasten your lab coats — it’s time for our weekly puzzle. It’s the Valentine’s Day edition, where all clues are related to LOVE or the HEART 💘 .

First question: What is a rare but surgical correctable congenital heart defect involving numerous structures / Olympic snowboarder Shaun White?

Average time last week: 4:36

Forgot to send someone a Valentine’s Day card? No worries! Just send them this puzzle instead! 🥰

❓Trivia Answer❓

In the 1600s, William Harvey discovered the circulation of blood. This was before anybody knew about capillaries and how blood got from arteries to veins. Prior to this, people “believed the blood to be continually formed anew from the digested food, to be dissipated and used up in the tissues, and considered that the primary function of the heart was the production of heat.”

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