It’s Wednesday! Postcall here, bringing you enough tasty, nutritious stories to make a quokka smile!

We’ve got an action-packed issue for you — no time to waste!

• The Skyfall of Bonds🤵

• Things your attending might pimp you on

  • Which GLP-1 agonist is best?

  • An update on measles

  • E-cigs for smoking cessation?

• Samsung Is Watching You Sleep

• Having money ain't everything but not having it is

• 🍔 Quick Bites

• Postcall Picks ✅

• 🕹️ Game ⛳️

What happened in the markets this week:

The 2024 rally hit a pause last week, ending relatively flat amidst a mix of emotions. On one hand, robust corporate earnings reports from heavy hitters like Coke, Cisco, and Manulife brought a wave of optimism about the economy's strength. And Stats Can told us yesterday that inflation hit 2.9% (below the 3% goal)! BUT inflation in the US still high, and that might mean that anticipated rate cut might need to wait.

If you like buying individual stocks: Nvidia’s earning come out today after markets close, which will give us a measure of how the AI hype is going.

The Skyfall of Bonds🤵

What happened: A 2023 study simulating a US household's 40-year earnings and investing habits (across several asset classes) challenged the status quo: an all-stock portfolio outperformed a traditional mix of stock/bonds.

Why it’s interesting: Bonds are supposed to stabilize a portfolio, cushioning losses in stock market downturns by virtue of low correlation with stocks. But Benjamin Felix, Head of Research at PWL Capital, says bonds might be riskier than we thought.

The study reveals that the stock-bond correlation increases dramatically over time (one-month: 0.18 to 30-year: 0.46), offering less diversification benefit for long-horizon investors. In 2022, we saw this in practice — interest rates spiked, triggering one of the worst bond market crashes that coincided with a stock market pullback. The simultaneous drop of bonds and stocks in 2022 made many rethink their bond allocations.

But before you reshuffle your portfolio…

• Wall Street is divided: BlackRock suggests a fresh approach. Vanguard believes the traditional mix will remain strong for the next decade. And Redditors point out this study’s lack of peer review, aligning with the 2023 trend of 10k+ research paper retractions. 

• Many investors also don’t want to live with the psychological cost of an all-equity portfolio.

• The historical data in the study doesn’t predict future returns.

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

1. Which GLP-1 agonist is best?

A network meta-analysis including 39,000 adults with type 2 diabetes has shown that Tirzepatide, a GLP-1/GIP receptor agonist, was the most effective for weight loss and glycemic control with mean differences of −2.1% in HbA1c, −56 mg/dL in FBG, and −8.5 kg in body weight compared with placebo. Semaglutide followed closely behind in effectiveness for both indications. For context, Eli Lilly’s Mounjaro, which contains tirzepatide, was approved in Canada in 2022 and has been prescribed off-label for obesity at the hefty price of $100/week.

2. An update on measles

Remember our story on measles back in February? Toronto has a confirmed case of measles in an infant who has since been hospitalized. As a refresher, symptoms include maculopapular rash, fever, cough, runny nose, red eyes, and fatigue. Meanwhile, the CDC has updated their immunization schedule in the US. A key change is the inclusion of RSV vaccines for infants and young children as well as pregnant people. 

3. E-cigs for smoking cessation?

In an RCT from Switzerland, 1,246 adult smokers received free e-cigarettes plus smoking-cessation counselling vs. counselling alone. The bottom line is that e-cigarette use facilitated smoking cessation (NNT ≈8), with the caveat that the provision of e-cigarettes and supplies for free may have contributed to the intervention's success. Nevertheless, experts are wondering: is it time to include e-cigs in the smoking cessation toolkit?

Samsung Is Watching You Sleep

What happened? The FDA approved Samsung Galaxy Watch’s new feature that helps detect warning signs of sleep apnea (in the US — it’s not approved in Canada… yet).

Why it’s interesting: According to the National Sleep Foundation, 25% of men and 10% of women in the US experience sleep apnea. Samsung’s new technology aims to understand sleep patterns and build healthier sleeping behaviours. 

The watch works by monitoring blood oxygen levels throughout the night to see if they drop — a common sign of sleep apnea. The device must be worn twice for at least 4 hours of sleep within a 10-day period to produce results. Designed for users over the age of 22 with a compatible Samsung phone and watch, this update to the Health Monitor app will be available this Sept.

Samsung is the first US company to get FDA approval for this tech, but they won’t be the last — it’s rumoured that Apple and FitBit are designing a sleep tracking feature as well. 

Bottom line: Despite FDA approval, some doctors don’t believe the device is a reliable tool for sleep apnea detection. Samsung has said that the new feature is a “pre-diagnosis tool” and shouldn’t be used to replace qualified healthcare professionals. 

Having Money Ain't Everything but Not Having It Is

In the bustling corridors of St. Michael's Hospital, Dr. Gary Bloch stands as a beacon of change, merging frontline health care with a passionate fight against social inequality.

What makes him a Baller? He developed a “Clinical Tool on Poverty” to address socio-economic factors in patient care:

He gives a great example of this – of, basically, prescribing money – in his Vox interview:

To use this tool in your practice, filter for your province here and download the PDF or EMR form.

He has also noticed powerful grassroot changes, “huge shifts in the way that issues are being talked about, more nuanced and complex discussions around the impact of social issues on health. That was kicked forward by the George Floyd murder, the Truth and Reconciliation Commission, the opioid crisis, etc. So at a frontline community level, I think there really have been significant steps forward.”

How should other physicians (who are inclined) try to help?

• Look for community groups organizing around a specific issue (e.g. improving low-income housing, supporting people who use opioids, starting shelters, etc.)

• Reach out and offer help. Could they use the voice, power, or privilege of a physician to boost their advocacy?

“The medical world is starting to get really serious about listening,” he said. 

Doing cleft palate surgeries abroad? Baller. Know somebody who started a sick side hustle? Baller. If you know of any ballers in your life you want to nominate, let us know at [email protected].

🍔 Quick Bites

1: 💊 According to a new survey, nearly 1 in 4 Canadians split pills or skip doses because their prescription medications cost too much. According to Heart & Stroke, it would be in the government’s best interests to pony up: universal coverage of essential drugs would save the system about $1,488/patient by preventing unexpected hospital trips.

2: 🤖 A new AI system specifically for heart health has been unveiled: SEATTLE HF, from the Peter Munk Cardiac Centre in Toronto, which has demonstrated a high degree of precision in predicting heart failure. However, it has not yet been tested in clinical practice, and open questions remain around legal accountability.

3: 🩺 Quebec’s College of Physicians is about to scrutinize doctors for overprescribing benzodiazepines, reaching out to doctors who are the highest prescribers and make sure they are aware of the dangers. Unlike Alberta and Nova Scotia, Quebec poses no limits on benzodiazepine prescriptions.

4: 👾 Google’s Gemini chatbot (its competitor to ChatGPT) has finally arrived in Canada. Extra useful (or creepy) as it can use your Gmail and Drive results to personalize your responses. Try it out here.

5: 🧑‍✈️ Not so fast though — companies are legally responsible for their chatbots?! “What!” said nobody but Air Canada, who was ordered to pay compensation to a customer after their chatbot led to an ill-advised purchase. So don’t go replacing your MOA just yet…

6: 📊 A new poll shows that less than half of Canadians feel MAiD should be available to those whose sole underlying condition is mental illness.

Postcall Picks ✅ 

👀 Watch: It’s incredible (and scary) how realistic generative AI is getting. Below is a X user’s prompt, and the video is OpenAI’s CEO Sam Altman’s output from the new Sora text-to-video model.

At the same time, lots of folks are critical of how these images and videos are made — off the back of (usually unpaid) training data. What if that training data was your diagnoses? And don’t get us started on the inevitable disinformation.

🥧 File: your taxes. NETFILE (from the CRA) opened on Monday this week, if you like doing it yourself. Otherwise, let your accountant know to get on it. Here’s four things that’s changing for 2023:

1. This is the first year that FHSA can be claimed.

2. Disability tax credit can be claimed online.

3. Properties flipped in under a year will now be subject to business taxes.

4. No more flat $2/day simplified WFH tax deduction; we’re back to the detailed method only.

💳️ Buy: FIFA World Cup 2026 tickets (once they’re out). For now, the “interest list” is open and we’re hoping they’ll be just slightly cheaper than Taylor Swift tickets.

🧠 Learn: how cardiology and urology can work together 😉 

@norton_fam

Urology 🤝 Cardiology (don’t do this) #medstudent #medschool #medicalhumor #medicaltiktok #doctorsoftiktok #nursesoftiktok #fyp

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