Catch-22 in Biomedicine: Where Innovation Goes to Die

Welcome to the biomedical field, where the real disease is the system, and the only approved cure is being part of the club.

Let’s start with a fun little circle, a biomedical version of a hamster wheel — Catch-22 with a white coat and a PubMed badge. Here’s how it works:  

1. To Be Read, You Must Be Indexed.
   No matter how groundbreaking, disruptive, or life-saving your research is, it won’t exist in the eyes of the AI models and policymakers, unless it’s indexed in PubMed. That’s the velvet rope to the scientific VIP lounge.

2. To Be Indexed, You Must Be Published in a Journal That’s... You Know, PubMed-Worthy.
   And to get into one of those? You need money. Either:

   • Pay the journal a small fortune (ranging from $2,000 to “you’re gonna need a second mortgage”), or

   • Be part of The Club™ - that elite group of insiders who don’t need to pay because they’ve been publishing in the same journals since Watson and Crick shared a sandwich.

3. Oh, You Did Something Novel? Sorry, That’s Not on the Approved Menu.
   Maybe you developed a cost-saving, patient-driven clinical trial. Fantastic! But if it wasn’t:

   • Funded by Big Pharma, or

   • Backed by the NIH and conducted by a prestige university with ivy-covered walls,
     …then guess what? It doesn’t count. Reviewers will call it “methodologically unsound,” Editors will say "it's not interesting to our readers", which is code for “you didn’t buy the right ticket.”

4. Citations: The Scientific Echo Chamber
   “You cite me, I cite you, we all cite the same five people we've known since grad school.”
   If your work isn’t already blessed by the existing canon, if it dares to question current paradigms, or (God forbid) it talks about a topic not discussed by the establishment, it’s tossed into the "Thanks but no thanks" pile.

   Citations are the currency of academia. But like real currency, they tend to trickle upward.

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Exhibit A: The Case of PATM

Ever heard of People Are Allergic to Me (PATM)? No? Neither has most of PubMed, and certainly not your favorite dermatology AI (that will also tell you it's all in your head).

There was a peer-reviewed paper in JMIR Dermatology showing a microbial connection to PATM. It should’ve led to more interest in this condition. 
But alas, JMIR Derm isn’t indexed in PubMed - a technicality that renders the findings invisible (unless the work was funded by NIH). Not because they’re invalid. Just… you know… they weren’t invited to the club gala.

Now you might think, “But what about establishment research?” Surely that gets through, right?

Monell Center — a well-regarded sensory science institute — published a genetic study on TMAU, another condition ignored for decades. Even they faced an uphill battle. The research showed genetic heterogeneity, meaning the story isn’t as simple as the textbooks would like. Ten years to publish (DNA of 130 subjects that contacted Monnell in 1999 to 2007; the paper was published in 2017). Ten. Because journals prefer tidy answers like “it’s just gene X” over complex truths like “it’s complicated and we don't fully understand it yet.”

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Meanwhile, In the Land of AI

Your health chatbot? Your AI diagnostic assistant? It only reads what’s been indexed. It’s like a well-read librarian who refuses to touch any book without a barcode.

Which means all those brilliant papers:

• From underfunded startups,

• Crowdfunded patient trials,

• Off-mainstream yet rigorous researchers...

Are off the radar. So AI, policy, and public knowledge stay blissfully ignorant — not due to a lack of evidence, but a lack of access.

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So Why Does This Matter?

Because if you're a poor patient, or a researcher without connections, or someone who just wants to challenge bad assumptions, the system isn't just hard - it's set up to make you invisible.

Innovation doesn't fail here because it’s wrong.
It fails because it wasn’t published in the right place, by the right people, citing the right authorities.

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The Streetlight Effect in Science

We’re all looking for the cure under the scientific streetlight - not because it’s there, but because that’s where the funding, indexing, and citations shine.

Meanwhile, in the dark, the real solutions — weird, messy, complex, human solutions - are waiting. But who’s going to look there?

Nobody. Unless someone with the right credentials takes a flashlight.

REFERENCES

Gabashvili IS. Cutaneous bacteria in the gut microbiome as biomarkers of systemic malodor and People Are Allergic to Me (PATM) conditions: insights from a virtually conducted clinical trial. JMIR Dermatology. 2020 Nov 4;3(1):e10508. doi: 10.2196/10508

Guo Y, Hwang LD, Li J, Eades J, Yu CW, Mansfield C, Burdick-Will A, Chang X, Chen Y, Duke FF, Zhang J, Fakharzadeh S, Fennessey P, Keating BJ, Jiang H, Hakonarson H, Reed DR, Preti G. Genetic analysis of impaired trimethylamine metabolism using whole exome sequencing. BMC Med Genet. 2017 Feb 15;18(1):11. doi: 10.1186/s12881-017-0369-8. PMID: 28196478; PMCID: PMC5310055.

April 1, 2025: The Fine Line Between Product and Punchline

On this April Fools' Day in 2025 the line between absurdity and innovation has never been blurrier. From Anova's oven affirmations ("You're not overcooked, you're emotionally complex") to Razer’s Skibidi headset designed to decode Gen Z's in-game lingo, tech pranks continue to reflect our ever-evolving relationship with technology.  Skibidit translates phrases thrown out by young gamers such as, "What the sigma? We're getting mobbed," which means, "Your team needs support." And "I think you're cute" becomes "ni hao fine shyt." New voice in ChatGPT also sounded like a teenager you just woke up from a nap. Lots of exaggerated sighs and sarcastic quips.

While we laugh, there's often a subtle truth behind even most absurd jokes – a nod to how technology can shape our lives, for better or worse. Perhaps in a world where we are trying to replace bike rides and walks (e.g., with KICKR EARTH,  by Wahoo) and touch grass virtually via Dbrand’s latest skin (a remake of keyboards from 2022), the real punchline is that the future is here, and it's a little more ridiculous than we ever imagined. 

We heard about gaming chairs, now meet Elgato’s Streaming Desks. It's actually a control panel with 1,262 customizable keys, for streamers and content creators who need every shortcut imaginable. Probably with plenty of "any keys", as well, The absurdity of turning an entire desk into a giant, impractical Stream Deck—complete with a premium walnut finish—hits the sweet spot of tech humor: it’s ridiculous yet just plausible enough to make you double-check the date. The over-the-top nature of it, paired with Elgato’s reputation for streaming gear, probably had people chuckling and wishing it were real (or not).

Artificial Peripheral intelligence (or API) by  @deviparikh and @yutori_ai marks new era of agentic computer use. Your levitating mouse powered with AI will do all the work for you. 

On the wearables front, UK's mattress company, the Odd Company has unveiled the “City Napper,” a £350 portable mattress designed for commuters who struggle to leave their beds in the morning. This “wearable mattress” comes with a wraparound headrest and quilted poncho, pitched as the ultimate commuting companion for napping on public transit. It provides neck support and warmth while keeping germs at bay – perfect for catching extra sleep on the go. It’s impractical in the best way—imagine someone waddling onto a subway wrapped in a mattress—and nails the wearable tech trend of solving first-world problems with over-engineered flair. Whether you're facing rain or shine, the Babybel Wax Sleeping Bagwill (from nostalgic snack cheese brand Babybel) will add more comfort and warmth, much like a cheese toastie - keeping you snug and toasty no matter the weather.

Another wearable-adjacent prank was Nothing’s “Ear (3.5mm),” a pair of wired earbuds with a comically long 50-meter cable, mocking the wireless trend while pretending to cater to audiophiles who miss the old days.

Protein Works has launched Doms Proteinon, an alcohol-free protein-packed version of Dom Pérignon champagne. Terry’s Chocolate is revolutionizing oral care with their “Chocolate Mint Toothpaste” combining dental hygiene with popular chocolate mint flavor. Aldi stores across Scotland have launched “Taps Aff,” a 100% natural alcohol alternative made from beloved Scottish tap water, one of the things Scots are so proud of! Sports drink company Bodyarmor launched a Sports Performance Shampoo packed with electrolytes and vitamins. Heck Food, renowned for its gluten-free sausages, burgers, and more, introduced Matcha Chipolatas. Gluten free, high protein lean chicken sausages spiced with Matcha Green tea. Wellness and sausages – a Match-a made in heaven?

 April Fool's Day tech jokes have evolved significantly over the years. Initially, they often revolved around futuristic ideas that seemed absurd at the time but later inspired real innovations. Examples include Google's "MentalPlex" search by thought (2000), a predecessor of Google's Assistant and "Google Pigeon Internet" (2000), later launched as Google's Project Loon. Apple AirPods Pro with "EarFit"(2020) turned into AirPods Pro (2nd generation) released next year. These pranks hinted at creative concepts rooted in technology, reflecting optimism and imagination about technological possibilities. They were also used as a way to gauge people's enthusiasm about new ideas. Later,  jokes started to focus on absurdity or satire rather than inspiring dreams of the future. For instance, Miz Mooz's Selfie Shoes with built-in cameras that automatically take selfies every time you take a step(2015) exaggerated society's obsession with selfies. Uber Kittens" (2017), a service where you could have kittens delivered to you by Uber for a few minutes of cuddling, was both heartwarming and completely absurd. 

The rapid pace of technological advancements has made it harder to surprise audiences with futuristic concepts. People are now so accustomed to groundbreaking innovations that the impact of such jokes has diminished. Additionally, companies may steer clear of elaborate pranks due to concerns about misinformation or backlash. For instance, Google halted its April Fool's Day jokes in 2020, citing the global pandemic and a shift in focus toward more serious matters. As a result, humor has shifted increasingly toward absurdity and satire, reflecting current societal trends rather than aspirational visions of the future. 

Yet, despite these shifts, there are still some genuinely creative ideas that come out of April Fools' Day pranks. At their best, these jokes remain not only enjoyable but also thought-provoking, offering a playful glimpse into what could be possible—or absurd—tomorrow. The tradition of humor through technology continues to evolve, keeping us laughing and questioning the world around us.

REFERENCES

John Kanellakos picks: https://www.pocket-lint.com/april-fools-day-2025-tech-roundup/

Andrew Liszewski's story://www.theverge.com/news/638284/dbrand-touch-grass-skin-tablet-smartphone-handheld-console

The Verge staff: https://www.theverge.com/news/639824/april-fools-day-2025-pranks-jokes-best-worst

Amaete Umanah: https://x.com/amaeteumanah/status/1907219854681342026

https://www.famouscampaigns.com/2025/04/april-fools-2025-round-up/

https://x.com/yutori_ai

The Post-COVID Tenure Shift

Active lifestyle communities have long been a popular choice for older adults seeking wellness, social engagement, and a strong sense of community. Historically, residents in these communities have shown increasing tenure, with many staying well over a decade, drawn to the amenities and vibrant atmosphere. However, new research [1] reveals a striking shift: the median homeownership tenure has dropped post-COVID, reflecting a broader nationwide trend in homeownership duration. 

COVID-19 has caused a devastating loss of life in the U.S. The surge in mortality had a noticeable impact on national longevity: life expectancy at birth dropped by about 2.7 years over 2020–2021, falling from 78.8 years in 2019 to 76.1 years in 2021​. This marked the largest two-year decline in U.S. life expectancy in a century (since 1921–1923)​. Older adults experienced especially high COVID-19 death rates [2]​. 

Beyond acute infections, many COVID-19 survivors have endured long-term health issues, known commonly as Long COVID or post-COVID conditions. The pandemic’s impact on mental health is another significant health consequence, sometimes termed a “mental health crisis". The prolonged stressors of the pandemic – including illness and grief, social isolation, job loss, and uncertainty – led to sharp increases in anxiety, depression, and substance abuse nationwide. By late 2020, public health experts were warning of a “second pandemic” of mental health issues. 

The pandemic catalyzed major shifts in how and where people work in the United States. Perhaps the most visible change was the mass adoption of remote work. Given that remote work has allowed more people to move into scenic, retirement-friendly locations, one might expect tenure to increase rather than decrease. However, health consequences were likely outweighing this impact. 

Utilizing longitudinal surveys (2018, 2021, 2023, 2024) and property transaction records, researchers examined why residents in retirement-style communities are moving out sooner. While national housing trends have been influenced by economic uncertainty, remote work, and shifting homeownership dynamics, these factors alone do not fully explain the accelerated turnover in active lifestyle communities.

One might assume that dissatisfaction is a leading factor in shorter tenure, but this study found that resident satisfaction remains consistently high at 93%, far exceeding the national average for similar communities (~73%).

Another emerging trend is that newer and younger residents—those who settled in active lifestyle communities post-pandemic—are significantly more sensitive to financial costs than their older, long-term counterparts. This financial sensitivity is expected to influence governance decisions, amenity funding strategies, and overall community stability.

This shift in tenure presents both a challenge and an opportunity. If residents are leaving due to health concerns rather than dissatisfaction, community leaders should focus on enhancing wellness support, improving access to preventive healthcare, and fostering even stronger social connections.

At the same time, addressing financial concerns—especially among newer residents—will be crucial in maintaining the long-term viability of these communities. Adjusting amenity funding strategies and providing cost-effective solutions may help mitigate financial pressures and sustain resident satisfaction.

More research is needed to fully understand the evolving needs of active lifestyle communities, particularly in light of demographic shifts and economic pressures. However, one thing is clear: these communities must continue to adapt—not just to attract new residents, but to support existing ones in staying healthier and happier for longer.

REFERENCES

Irene S. Gabashvili, Christopher K. Allsup.  Resident Turnover and Community Satisfaction in Active Lifestyle Communities. February, 2025 arXiv:2502.15789 [stat.AP]  https://doi.org/10.48550/arXiv.2502.15789   

Gabashvili IS The Incidence and Effect of Adverse Events Due to COVID-19 Vaccines on Breakthrough Infections: Decentralized Observational Study With Underrepresented Groups JMIR Form Res 2022;6(11):e41914 doi: 10.2196/41914, PMID: 36309347, PMCID: 9640199

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