Category Archives: Web Article Review

where gene therapy is heading

The “J.P. Morgan Healthcare Conference” provided some clues on where biotechnology may be going next.

After decades of setbacks, gene therapy—a loosely defined umbrella term for any technique that uses genes to treat or prevent disease—is finally here. In December, the field got its very first FDA approval with Luxturna, which corrects a defective gene in a rare, inherited retinal disease. With a half dozen more treatments in late-stage trials and an unusually open-minded FDA commissioner in Washington, the industry is expecting a flurry of new approvals this year…

Lambert’s lobbying roadmap for 2018 includes helping insurance companies understand what to do with a new gene therapy like Luxturna, which cures blindness with a single, $850,000 injection into the eye. Ranked by sticker price, it’s the most expensive medicine in America. Spark Therapeutics, the company that makes Luxturna, argues that the six-figure price tag isn’t actually that unreasonable, if you factor in all the costs that patients with the inherited retinal disease would have racked up in a lifetime of seeking better care.

But because their clinical trial patients haven’t been followed long enough to determine if the treatment benefits are actually durable for a whole lifetime, Spark has received significant pushback from insurers. As a result, the company is already exploring a some creative new pricing models. It announced last week that it’s offering a rebate program based on the treatment’s effectiveness at 30 to 90 days and again at 30 months with one East Coast provider, and is in talks about expanding it to other insurers, Spark CEO Jeffrey Marrazzo said at JPM. He said Spark is also in discussions with the Centers for Medicare and Medicaid Services on a multi-year installment plan option. Either of these could soon serve as a model for how gene therapies might be made available to patients without cutting the legs out from under the healthcare system.

The article also mentions one study that has some potentially bad news about the effectiveness of CRISPR in humans, but it sounds like the jury is still out on that.

7 wars

The Week counts and lists the number of wars the United States is currently involved in.

we’re currently at war in (at least) seven countries across the Greater Middle East: Afghanistan, Iraq, Syria, Yemen, Libya, Somalia, and Pakistan…

It would be shockingly easy for the White House and Department of Defense to do whatever they wanted with no meaningful democratic oversight at all. Our wars are fought thousands of miles from American shores with an all-volunteer force drawn from a tiny percentage of the population. Meanwhile, the country has spent the astonishing sum of $250 million a day on war-making for each of the nearly 6,000 days since the 9/11 attacks 16 years ago. Instead of raising taxes to pay for it, Congress has cut taxes, insulating the American people entirely from the cost and handing the bill to future generations of Americans in the form of debt.

Other people fight, other people suffer, other people pay — it’s a recipe for political ignorance and indifference. All the American people know is that there hasn’t been another 9/11. And that one must always, no matter what, “support the troops.” Together these sentiments translate into: “We dare not say anything critical about whatever the military is doing.” That holds for members of Congress no less than for average Americans. Rather than raise questions or concerns, we’re expected to defer. And for the most part we’re all too happy to comply with this debased and degraded form of civic duty.

I have a proposal – fund these wars through a sales tax levied very clearly on everything we buy. Every time you buy a bag of groceries, your receipt would tell you how much you contributed to the war effort. This way, those of us not fighting or sending other people to fight would at least think about it every day, and maybe be willing to speak out against it or at least make the politicians clearly explain to us why it has to be this way.

Gene Editing 2.0

Before CRISPR even becomes a household word (er, acronym?), it is already being replaced by newer and more precise methods, according to Wired.

Usually, when we’ve referred to Crispr, we’ve really meant Crispr/Cas9—a riboprotein complex composed of a short strand of RNA and an efficient DNA-cutting enzyme. It did for biology and medicine what the Model T did for manufacturing and transportation; democratizing access to a revolutionary technology and disrupting the status quo in the process. Crispr has already been used to treat cancer in humans, and it could be in clinical trials to cure genetic diseases like sickle cell anemia and beta thalassemia as soon as next year...

But this year, newer, flashier gene editing tools began rolling off the production line, promising to outshine their first-generation cousin. So if you were just getting your head around Crispr, buckle up. Because gene-editing 2.0 is here.

 

2018 transportation trends

U.S. News has predictions for transportation technology in 2018. In a nutshell, sales of electric vehicles will take off, but people will also keep buying inefficient gas vehicles because is relatively cheap right now.

According to this article, the commercial rollout of autonomous vehicles has suffered some setbacks, and 2018 might not be the big widespread adoption year.

Automated vehicle developers will push back their timelines for deployment, for good reason. Automated vehicles are coming, but the real question is when. Just over a year ago, tech magnate Elon Musk said he “felt pretty good” about a Tesla driving completely autonomously from Los Angeles to New York without any human interaction by the end of 2017. But at a recent conference, he pushed that date back another two years. Chevy delayed the debut of Super Cruise, and driverless shuttles have yet to move beyond pilot phases.

Society will greatly benefit from automated vehicle safety improvements. However, it’s a good thing that automated technologies are delayed. Automakers are finding it more difficult to design the system than they originally expected. Instead of putting a product on the road that is unsafe, they are responsibly taking the time they need to make sure the system is ready for the public. Patience will pay off in the long run.

I wonder if it is really a setback in technology, or a matter of a few high profile accidents getting a lot of media attention. Markets and regulatory agencies are going to respond to perception, no matter how clearly the statistics show that imperfect computer-controlled vehicles are a huge advance over human controlled vehicles. Insurance companies are somewhat immune to emotion and responsive to hard numbers though, so at some point when there are safer options available they may just jack rates up on people who don’t take those options. It probably won’t pay to be a late adopter.

Summers: “better than even” chance of recession in next 3 years

Larry Summers is concerned about the stability of the international economic, financial, and political systems.

While high equity prices and low volatility may seem surprising, they likely reflect the limited extent to which stock-market outcomes and geopolitical events are correlated. For example, Japan’s attack on Pearl Harbor, the assassination of President John F. Kennedy, and the 9/11 terrorist attacks had no sustained impact on the economy. The largest stock-market movements, such as the 1987 crash, have typically occurred on days when there was no major external news…

Financial markets are widely cited, including by US President Donald Trump, as providing comfort in the current moment. But a relapse into financial crisis would likely have catastrophic political consequences, sweeping into power even more toxic populist nationalists. In such a scenario, the center will not hold…

But recessions are never predicted successfully, even six months in advance. The current expansion in the US has gone on for a long time, and the risk of policy mistakes there is very real, owing to highly problematic economic leadership in the Trump administration. I would put the annual probability of recession in the coming years at 20-25%. So the odds are better than even that the US economy will fall into recession in the next three years.

He goes on to say that recession is not even what he is most worried about, but a downward spiral where people lose faith in their governments and elect people who will actually act to destroy the effectiveness of governments. In this environment, autocrats can seize control by rallying the population against internal and external enemies, whether real but exaggerated, or completely fictional.

The Best of the Best of 2017

Here’s a little feature I call the Best of the Best of. Basically I’ll link and comment on a few “2017 in review” articles I happen to come across. I’ll let all this rattle around in my brain and do a “best of” my own blog in January.

  • Worst cyberattacks of 2017 (Axios): Cyberattacks are bad, of course. This is an article about the most successfully bad ones, including hospitals, pacemakers, and Equifax. The article suggests, without providing any evidence at least in this short article, that some of these might be government hackers in North Korea, Russia, or China gathering information and probing U.S. vulnerabilities prior to a larger attack in the future.
  • The year in architecture (curbed.com). Not that I particularly care about architectural style, but the architectural press covers some planning and sustainability topics that I find interesting, A few highlights for me include Hurricane Harvey coverage, what Google Citylabs is up to in Toronto, Blade Runner 2049, a new energy-efficient Cornell campus on Roosevelt Island in New York City, timber-framed skyscrapers, and a Philadelphia rowhouse because Philadelphia rowhouses are where all the cool kids live and you don’t know what you’re missing until you buy one.
  • And for completeness, the year in landscape architecture (Huffington Post). A highlight for me was the reopening of the big fountain garden at Longwood Gardens outside Philadelphia. I have fond memories of visiting that garden as a kid and got a chance to see it again with my own children shortly after it reopened this year. The rest of the article is a bunch of park designs and book reviews including some touching on urban ecology.
  • Planetizen urban planning blog’s most popular posts of 2017: a few that caught my eye are a Microsoft smart city development in Arizona, Seattle discontinuing its bikeshare program, “bikelash” from angry drivers, skepticism about self-driving cars, and the never-ending debates about density, gentrification, and New Urbanism. They also have Top 10 lists of planning-related books, websites, and apps. One new website that caught my attention is called “Treepedia”.
  • 2017 MacArthur Fellows: I hadn’t heard of any individuals, but it can be interesting to see the professions and trending specialties. I count 10 artists/writers, 7 social scientists/activists (sorry to lump you guys together), 4 computer/physical scientists/mathematicians, 1 journalist, and 2 landscape architects/planners
  • Stuff that happened in the Middle East in 2017 (Lawfare): Saudi Arabia initiated some social and economic reforms, but also an internal crackdown on political rivals, aggressive diplomatic attacks on some of its neighbors and a vicious, ongoing military attack on Yemen which the U.S. is participating in. The war in Syria is apparently winding down with its government hanging on. ISIS was decisively defeated by the Iraqi and U.S. armies and no longer controls territory politically, but has “gone underground” to plot and inspire terrorist attacks around the world. The U.S. is trying to back out of the Iran nuclear deal. Kurdistan tried to declare independence and the rest of the world basically ignored it. The U.S. has also torpedoed the Israeli-Palestinian peace process and gotten itself condemned by the great bulk of the United Nations. But good news: the U.S. still leads a “coalition of the willing” including “Israel, Guatemala, Honduras, the Marshall Islands, Micronesia, Nauru, Palau and Togo”, at least until several of those blink out of existence from sea level rise (a slight irony there?).
  • The year in hate crimes (ProPublica): Somewhat unsurprisingly, Islamophobic and anti-Semitic incidents were both up in the U.S.
  • Best political long-form articles of 2017 (Longreads.com): This is a seriously deep dive into resurgent white nationalism in Europe and the U.S. If you take the plunge be sure to come back up for air.
  • Best science and technology long-form articles of 2017 (Longreads.com): The most interesting one here is on artificial intelligence augmenting human intelligence.
  • Jealousy List 2017 (Bloomberg): This is a list of articles Bloomberg writers liked in other publications. There is way too much to read here. A few interesting ones are the decline of public research universities, James Burnham’s “managerial elite”, what is going on at Snopes.com, even more white nationalism, the risk of nuclear war, Elizabeth Warren, chemical industry foxes guarding the toxic hen house at the EPA, the complete dysfunction and failure that is the U.S. health care system, the Bin Laden raid, and octopuses.
  • The Most-Read Business Stories of 2017 (Wired): A lot of these have to do with the effect of automation on jobs. Also, Amazon’s “nomadic retiree army”, guaranteed basic income, and China’s social scoring plan.
  • Best of Wired Science (Wired): Wired Science is awesome. I could spend 2018 just reading these articles from 2017. The most popular commercial species of banana is so inbred it is in serious trouble. (But, one thing I learned when I lived, worked, and traveled in Asia for awhile is that there is a whole universe of delicious bananas out there most of us have never tried. Some have seeds, don’t ship well or don’t keep well, and therefore are not commercially ideal, but are actually quite delicious.) Meat allergies might be caused by a tick. Life-extension pills, fake meat, and robot friends might all become real things.
  • 2017’s Biggest Conspiracy Theories (Snopes.com): Maybe these really were big, but I hadn’t heard of most of them. A few things I didn’t know is that this year’s killer hurricanes either were real and created by the government, or else they were fictitious and created by the government. The survivors of the Las Vegas shooting are being hunted down and murdered. Bitcoin is a creation of an evil artificial intelligence. And Obama is running a shadow government. Now, I don’t automatically discount all conspiracy theories. I figure that for every 100 conspiracy theories, one or two are probably true, so it’s good to keep an open mind, review the facts, and then reject about 99% of them.
  • Wired most-read opinion pieces (Wired): A few interesting ones are about “permanent” drought in California, the idea that a state government could just pull the plug on a private corporation like Equifax, playing the odds in sports, and criminal sentencing using algorithms.
  • Top economics commentary from Project Syndicate: Some top economists wrote about everything from why the U.S. economy, stock market, and/or dollar could be headed for a fall, to the collapses of Puerto Rico and Venezuela, to recognizing the need to compensate globalization’s losers.

Big-C and Little-C Consciousness

This article in KurzweilAI explains the competing “Big C” and “Little C” theories of consciousness.

Another viewpoint on consciousness comes from quantum theory, which is the deepest theory of physics. According to the orthodox Copenhagen Interpretation, consciousness and the physical world are complementary aspects of the same reality. When a person observes, or experiments on, some aspect of the physical world, that person’s conscious interaction causes discernible change. Since it takes consciousness as a given and no attempt is made to derive it from physics, the Copenhagen Interpretation may be called the “big-C” view of consciousness, where it is a thing that exists by itself – although it requires brains to become real. This view was popular with the pioneers of quantum theory such as Niels Bohr, Werner Heisenberg and Erwin Schrödinger.

The interaction between consciousness and matter leads to paradoxes that remain unresolved after 80 years of debate. A well-known example of this is the paradox of Schrödinger’s cat, in which a cat is placed in a situation that results in it being equally likely to survive or die – and the act of observation itself is what makes the outcome certain.

The opposing view is that consciousness emerges from biology, just as biology itself emerges from chemistry which, in turn, emerges from physics. We call this less expansive concept of consciousness “little-C.” It agrees with the neuroscientists’ view that the processes of the mind are identical to states and processes of the brain. It also agrees with a more recent interpretation of quantum theory motivated by an attempt to rid it of paradoxes, the Many Worlds Interpretation, in which observers are a part of the mathematics of physics.