JAMA Network Open

• The research focuses on discharge notes written by doctors to capture patient's health status in the medical record as they are discharged from the hospital.
• Specifically, running discharge notes through generative AI dropped the reports from an eleventh-grade reading level on average to a sixth grade level, the gold standard for patient education materials.
• They also found that just 56% of notes created by AI were entirely complete.
• Feldman notes that generative AI tools are sensitive, and asking a question of the tool in two subtly different ways may yield divergent answers.

• A new Netflix documentary, You Are What You Eat, showcases sets of identical twins as they adopt different diets.
• For eight weeks one twin follows a vegan diet while the other one follows an omnivorous diet.
• The experiment is compelling because, being genetically identical, the health of each twin is very similar before the trial.

Twins as comparisons for each other

• The Netflix documentary highlights one important feature of twins – they are good for making comparisons.
• Identical twins share nearly all of their genes, and usually grow up in the same household, meaning they experience the same parenting, schooling and so on.
• By focusing on differences between twins, we eliminate genetic and common family factors, and can be more confident about causality.
• Using twins doesn’t fully solve the problem of omitted factors, but it helps to reduce it.

Twins and heritability

• Galton’s fascination with twins stemmed from wanting to know why we are the way we are.
• The main approach is essentially to see whether identical twins, who are genetically the same, are more similar than fraternal twins, who on average share only 50% of the gene variants that make us unique.
• If the identical twins are more similar, that indicates genes matter.

Limitations and misuse of twin research

• One drawback to twin studies is that twins are a select group, and findings may not always generalise to the broader population.
• Twin heritability studies also rely on strong assumptions, like that the common family environment matters to the same extent for identical and fraternal twins.
• There has also been some misunderstanding and misuse of findings from twin studies.

The future of twin research

• Twin studies have been conducted for decades, with more than 60 twin registries operating around the world.
• In Australia, the largest registry is Twins Research Australia, who have around 75,000 members.

Nathan Kettlewell does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

• According to the World Health Organization , COPD is the third deadliest disease in the world.
• Today, there are an estimated 480 million people who suffer from COPD.
• This study in JAMA Network Open projects the increased regional and global burden of COPD by 2050 through an analysis of historical COPD prevalence and data on COPD risk factors such as tobacco smoking, outdoor air pollution, and household air pollution.
• “The disproportionate growth of COPD among women is a critical finding as COPD has not always been as prevalent in women.

• Mass shootings tend to dominate the debate over gun violence – but they accounted for just 3% of all firearm homicides in the United States in 2021.
• The vast majority of gun homicides are murders that happen in an extremely concentrated number of neighborhoods – places where the rate of gun deaths rivals war zones.

Concentrated disadvantage

• These same neighborhoods tend to suffer from what criminologists call concentrated disadvantage – an unsavory mix of high crime rates, illegal drug markets, poverty, limited educational and economic opportunities, and residential instability.
• Cumulatively, these factors decrease the residents’ ability to maintain public order and safety in the ways that safer neighborhoods do informally by confronting violent behavior or supervising teenagers.
• The demographics of these neighborhoods means that both victims and perpetrators of shootings are disproportionately young Black men.
• Young Black men represented 93.9% of firearm-related homicide victims in Chicago and 79.3% of gun homicides in Philadelphia – where young Hispanic men make up another 12.9%.

How we did this work

• Our paper is published in JAMA Network Open, an open-source medical journal, and is freely available to read.
• We first collected all publicly available city-level data on shooting deaths, including the time, exact place and information about the victim.
• Our study focused on Philadelphia, New York, Los Angeles and Chicago because they were the largest American cities with public data available.

In military zones

For the military casualties, we relied on the estimates from studies of the mortality of U.S. soldiers at war in Afghanistan and Iraq. The Afghan War was deadlier, with 395 deaths of U.S. combatants per 100,000 people per year, compared with 330 in Iraq. We used the higher rate from the Afghan War as our reference, setting its value as 1 and expressing the homicide rate in other places in relationship to this benchmark.

How places compare

• The violence of these city streets was captured by sociologist Elijah Anderson in his ethnographic study “Code of the Street,” published in 2000.
• During 2020 and 2021, this ZIP code was home to about 2,500 young men.
• Young men living there were 3.23 times more likely to die from a bullet than U.S. service members deployed to Afghanistan.
• Moreover, survivors of this violence bear the burden of it for the whole time they live in these neighborhoods.

Complicating the narrative

• Answering them can better help us understand the limitations of our study.
• For example, many service members do not engage in active combat.
• The brigade had a casualty rate 1.71 times higher than our benchmark.
• It is also worth noting that we studied two particularly violent years in U.S. cities.

Faster care could help

Our research also showed that soldiers who are injured on the battlefield are less likely to die from their wounds than people shot in the American cities we studied. Surviving a wound is more likely if medical help is immediate. This suggests two ideas to decrease shooting deaths: train more police officers to provide urgent basic medical treatment to the victims of gun violence and add capacity to trauma centers near violent neighborhoods.
Alex Knorre does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.