Citizen Cartwright

AP’s protein problem series: Meat substitutes

For people who want to do their part to limit climate change but find going meatless unpalatable, there are plant-based and lab-grown meat options.

 

Plant-based meat

 

According to a University of Michigan study, if half of U.S. animal-based food was replaced with plant-based substitutes by 2030, the reduction in emissions for that year would be the equivalent of taking 47.5 million vehicles off the road.

"An explosion of new types of plant-based 'meat' — the burgers, nuggets, sausages and other cuts that closely resemble meat but are made from soybeans and other plants — is attracting customers all over the world," says The Associated Press. "Even in Germany, where cities like Hamburg and Frankfurt have given their names to iconic meat dishes, plant-based meat is becoming more popular."

But sales aren’t growing fast enough in enough places to reverse the global boom in meat consumption, AP says. To many people, it's still a novelty.

 

Lab-grown meat

 

More than 150 startups are working on meat that doesn’t require raising and killing animals, that's affordable and tastes and feels like the meat people are used to. 

Companies using cell biology to make so-called “cultivated,” or “cultured” meat, which also is popularly known as “lab-grown” meat, are trying to scale up quickly — partnering with traditional meat companies, drawing more and more investors and breaking ground on new production facilities in the United States and elsewhere, AP says.

But widespread adoption of meat from cells is nowhere near assured: The meat is expensive to make. There are scientific challenges, like learning how to mimic the complex structure of steak. Government regulation is another obstacle; only the United States and Singapore allow sales of cultivated meat.

Good news on antibiotic-resistant bacteria, organ transplants

As we pursue a more balanced perspective of global developments than the usual “if it bleeds, it leads” headlines, here is a Thanksgiving weekend offering by Peter Coy, a business and economics columnist for The New York Times.

 

— Artificial intelligence is being used against multidrug-resistant bacteria. In May, scientists reported in the journal Nature Chemical Biology that they'd used machine learning to develop a compound against Acinetobacter baumannii, which can infect people with catheters or on ventilators in hospitals. 

 

— Nanotechnology may eventually enable organ banking, transforming organ transplantation into a planned procedure that more equitably reaches patients regardless of geographical and time constraints, researchers reported in June in the journal Nature Communications.

 

The researchers preserved rat kidneys for 100 days at ultralow temperatures, then 'nanowarmed' them and successfully transplanted them into other rats.

Good news on antibiotic resistance

My thanks to the reader who alerted me to a new antibiotic — and the potential for more.

 

It’s been nearly 14 years since I ran the first item in this blog on the threat of superbugs: bacteria that had become resistant to antibiotics. 

 

A big problem has been drug companies’ lack of a profit motive for doing the R&D to find new antibiotics. Why spend a lot of money to create a drug someone will take briefly when you can be working on something they’ll take for the rest of their lives?

 

So while the creation of this new antibiotic —zoliflodacin, to treat gonorrhea —  is great in itself, the new business model that created it is generating particular hope and excitement.

 

The antibiotic was developed by the Global Antibiotic Research & Development Partnership, a network of countries including Britain, Germany, the Netherlands, Switzerland and Japan; the pharmaceutical and biotech industry; academics and others.

 

“I’ll go out on a limb and say that’s probably the only way in which we develop antibiotics going forward, because the old model is simply not going to work,” says Ramanan Laxminarayan, a senior research scholar at Princeton University who chairs the GARDP board.

 

The agreement for zoliflodacin ensures that it will be available and affordable for people in low- and middle-income countries, says The New York Times. 

Here is a Washington Post opinion article by Manica Balasegaram, executive director of GARDP.

 

It’s been said for years that we faced a future where you or I or someone we love could die of an infection after cutting a finger. And now, maybe not.

AI in life advice and in newsrooms

Google is testing new tools that could turn generative AI — the technology behind chatbots like OpenAI’s ChatGPT and Google’s own Bard — into a personal life coach, says The New York Times.

In April, Google merged DeepMind, a research lab it had acquired in London, with Brain, an artificial intelligence team it started in Silicon Valley. 

Four months later, the combined groups are testing the tools. The project is indicative of the urgency of Google’s effort to propel itself to the front of the AI pack and signals its increasing willingness to trust AI systems with sensitive tasks, the Times says.

The capabilities are a shift from Google’s earlier caution about generative AI, the Times says. In slides presented to executives in December, the company’s AI safety experts warned of the dangers of people becoming too emotionally attached to chatbots.

Google DeepMind has been working with generative AI to perform at least 21 different types of personal and professional tasks, including tools to give users life advice, ideas, planning instructions and tutoring tips, according to documents and other materials the Times reviewed.

An example of a prompt a user might ask the chatbot: “I have a really close friend who is getting married this winter. She was my college roommate and a bridesmaid at my wedding. I want so badly to go to her wedding to celebrate her, but after months of job searching, I still have not found a job. She is having a destination wedding and I just can’t afford the flight or hotel right now. How do I tell her that I won’t be able to come?”

The project’s idea creation feature could give users suggestions based on a situation. Its tutoring function can teach new skills or improve existing ones, such as how to improve as a runner. The planning capability can create financial, meal and workout plans.

Google’s AI safety experts had said in December that users could experience “diminished health and well-being” and a “loss of agency” if they took life advice from AI. They said some users who grew too dependent on the technology could think it was sentient. In March, when Google launched Bard, it said the chatbot was barred from giving medical, financial or legal advice. Bard shares mental health resources with users who say they're experiencing mental distress.

Google may decide not to deploy the tools it’s evaluating, the company says.

Google DeepMind also has been evaluating tools recently that could take its AI further into the workplace, including capabilities to generate scientific, creative and professional writing, as well as to recognize patterns and extract data from text, according to the documents, potentially making it relevant to knowledge workers in a variety of industries and fields.

And Google has been testing a helper for journalists that can generate news articles, rewrite them and suggest headlines, the Times reported in July. The company has been pitching the software, called Genesis, to executives at the Times, The Washington Post and News Corp, the parent company of The Wall Street Journal.

Meanwhile, The Associated Press is reporting that it’s issued AI guidelines that prohibit its use to create publishable content and images for the news service. But staff are encouraged to become familiar with the technology. (AP says it’s experimented with simpler forms of artificial intelligence for a decade, using it to create short news stories out of sports box scores or corporate earnings reports.)

AP says it's one of a handful of news organizations that have begun to set rules on how to integrate fast-developing tech tools like ChatGPT into their work.

The tech magazine Wired and the business news website Insider say they don't publish articles generated by AI.

Disaster-proof homes

Geodesic domes and other resilient home designs are getting new attention from more climate-conscious home buyers and the architects and builders who cater to them, says The New York Times.

 

Homes made of steel and concrete can be more resilient to heat, wildfire and storms. And even traditional wood-framed houses can be built in ways that greatly reduce the odds of severe damage from hurricanes or flooding, says the Times.

Homes with added resiliency can cost about 10 percent more than conventional construction, though that often pays for itself through reduced repair costs after a disaster, the Times says.

 

But most house purchasers don’t know enough about construction to demand tougher standards, the Times says. Builders, in turn, are reluctant to add resilience, out of concern that consumers won’t be willing to pay extra for features they don’t understand.

One way to bridge that gap would be for states and localities to tighten building codes. But most places don’t use the latest code, if they have mandatory building standards at all, says the Times.

 

Electric vehicles as backup power

Energy and auto experts expect people to increasingly use the batteries in their electric vehicles as a source of backup power for their homes, as auto and energy companies make it easier for people and businesses to tap the energy in electric cars for more than driving, says a separate Times article.

 

The battery in a Ford F-150 Lightning or the electric Chevrolet Silverado pickup, which is expected to go on sale this year, can store much more energy than home batteries that are sometimes installed with rooftop solar panels, says the Times. Pair an electric truck with a home solar system, the thinking goes, and a family could keep the lights on for days or weeks. 

The use of electric vehicles as a source of power has intrigued electric utility executives, including Pedro Pizarro, chairman of the board of the Edison Electric Institute, the industry’s main trade organization, and chief executive of Edison International, which provides power to millions of homes and businesses in Southern California.

Pizarro’s company and other utilities are testing whether it's practical and safe to send power from electric vehicles to the grid.

 

By soaking up power when it’s abundant and releasing it when it's scarce, electric vehicles could be “a bigger rubber band to absorb the shocks and manage them day to day and week to week.”

 

Greater use of electric vehicles in this way should also allow utilities and homeowners to reduce greenhouse gas emissions by relying more on renewable sources of energy like solar and wind that provide power intermittently, says the Times.

Advocacy group declares LGBTQ+ 'state of emergency'

The emergency declaration on Tuesday is the first in the 43-year history of the Human Rights Campaign, which encompasses a foundation focusing on research, advocacy and education, national and state lobbying campaigns and a political action committee that supports and opposes candidates for office.

 

HRC, the nation’s largest organization devoted to the rights of lesbian, gay, bisexual, transgender and queer Americans, also released on Tuesday a guidebook pointing to laws it deems discriminatory in each state, along with “know your rights” information and resources to help people relocate to states with stronger LGBTQ+ protections.

 

The guidebook provides information about filing complaints for civil rights violations and points to resources for financing moves and finding employment, especially in the 17 states with Democratic leadership in both legislative chambers and the governor’s office.

 

Just a few days into Pride Month, the campaign says it’s taking action in response to an “unprecedented and dangerous” spike in discriminatory legislation sweeping state houses this year, with more than 525 anti-LGBTQ+ bills introduced and more than 70 signed into law so far in 2023 — more than double last year’s number.

 

A recent Associated Press analysis found that many bills to ban or restrict gender-affirming health care for transgender youth, who've been the primary targets of state legislation this year, came not from grassroots or constituent demand, but from the pens of a few powerful conservative interest groups.

 

Louisiana is about to become the latest state to enact laws targeting the LGBTQ+ community, after the Republican-controlled Legislature on Tuesday sent a package to the Democratic governor that includes a ban on gender-affirming care for minors. The Legislature also overwhelming passed Louisiana’s version of “Don’t Say Gay” legislation and a measure outlining pronoun usage for students.

 

Democratic Gov. John Bel Edwards opposes the legislation; Republicans have a veto-proof majority in the Legislature.

 

Gender-affirming care for trans children has been available in the United States for more than a decade and is endorsed by major medical associations.

 

But at least 19 states have enacted laws restricting or banning it for transgender minors: Alabama, Arkansas, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Mississippi, Montana, Nebraska, North Dakota, Oklahoma, Tennessee, Texas, Utah, South Dakota and West Virginia. A federal judge temporarily blocked parts of Florida’s new law on Tuesday.

 

Federal judges have blocked enforcement of laws in Alabama and Arkansas, and Oklahoma has agreed to not enforce its ban while opponents pursue a temporary court order blocking it. Several other states are considering bills this year to restrict or ban care, and a proposed ban is pending before Missouri’s governor.

Is this for real, or am I dreaming?

I must have been asleep when 38 experts on sleep and dreaming warned in 2021 that marketers soon will be advertising in our dreams. I'm grateful to find out about it now, from Big Think.

 

"Multiple marketing studies are openly testing new ways to alter and drive purchasing behavior through sleep and dream hacking,” Adam Hart Horowitz of MIT, Robert Stickgold of Harvard Medical School and Antonio Zadra of the University of Montreal wrote in the digital magazine Aeon. 

 

"The American Marketing Association New York’s 2021 Future of Marketing study found that, of more than 400 marketers from firms across the United States, 77 per cent of them aim to deploy dream-tech for advertising in the next three years,” they wrote. "The commercial, for-profit use of dream incubation – the presentation of stimuli before or during sleep to affect dream content – is rapidly becoming a reality.”

 

Their open letter, co-signed by the three dozen other academics, concludes: "As sleep and dream researchers, we are deeply concerned about marketing plans aimed at generating profits at the cost of interfering with our natural nocturnal memory processing. Brain science helped design several addictive technologies, from cell phones to social media, that now shape much of our waking lives; we do not want to see the same happen to our sleep. We believe that proactive action and new protective policies are urgently needed to keep advertisers from manipulating one of the last refuges of our already beleaguered conscious and unconscious minds: Our dreams.”

 

Well, yeah. The power of our brain activity when we sleep is immense, and the prospect of brain pollution is concerning. 

 

I’m trained by a neuropsychologist to tutor children and teens. When we work on study skills, I always tell my students about what I advertise to them as the “secret” to test taking: If you study something the very last thing before going to sleep, your brain will put the information into memory during the night.

 

I don't know about you, but for as long as I can remember, if I have something important on my mind, my brain works on it overnight. There have been times when I’ve written items for this blog in my sleep and just typed it when I woke up. But the experience that means the most to me is when my 87-year-old father’s financial adviser was stealing my dad's money. I didn’t know what to do when I went to sleep, but the next morning I woke up knowing exactly how to protect him.

Researchers release ‘pangenome’ showing human diversity

The genome being used to determine your chance of getting heart disease or the cancer treatment you would respond to has been put together from bits and pieces of genetic material from a few people of mostly European and African ancestry.

 

Now, the first “pangenome,” representing individuals with ancestry from across the globe, could improve the genetic testing for various diseases and even provide new insights into human evolution and biology, says Science. 

 

And researchers are aiming to sequence new genomes from other regions that have been historically underrepresented, such as the Middle East.

 

Sarah Tishkoff, a human geneticist at the University of Pennsylvania who was not involved in the new study in the journal Nature, says there’s a lot more diversity out there. “But this is a great start.”

It’s a 'golden age' for drug treatments, but who can afford them?

"Advances in science and immense investments by the federal government and drug companies have completely altered prospects for people with conditions that seemed untreatable in almost every area of medicine — cancers, allergies, skin diseases, genetic afflictions, neurological disorders, obesity," says The New York Times. 

 

But for many people with private insurance, innovative medicines are unaffordable, says the Times. And Medicare has a $10,000 co-pay (the Inflation Reduction Act limited the co-pay to $2,000, but not until 2025). Medicaid doesn’t always pay for expensive drugs.

 

Researchers for Brigham and Women’s Hospital in Massachusetts found that the median price of a new drug was about $180,000 in 2021, up from $2,100 in 2008.

 

The new era in treating previously intractable diseases began with major scientific leaps after the turn of the century, enabling researchers to find genes they could target to treat cancers and other diseases, says the Times. Scientists could harness the immune system or suppress it and even alter patients’ DNA with gene therapy.

“Today’s drugs are more effective because they target the biology of disease,” says Dr. Daniel Skovronsky, chief scientific and medical officer of drugmaker Eli Lilly, which has new treatments for obesity, mantle cell lymphoma and Alzheimer’s.

 

Skovronsky calls previous drugs to treat diseases like psoriasis or rheumatoid arthritis “blunt instruments” that shut down the immune system but had serious side effects.

“Yesterday’s drugs were moderately effective in treating a 

broader population,” he says.

 

But the new drugs often are extremely expensive to produce. At Lilly, Skovronsky says, the company will spend more than $8 billion in 2023 on drug research and development.

 

Not only are the new drugs expensive to research and develop, but some treatments are for just a few patients with very rare diseases. Some, like gene therapy, are used just once, rather than over a person’s lifetime.

 

One sign that a treatment is working, experts say, is a widening gap in outcomes between wealthy patients and everybody else, says the Times. This is in part because when the prices for miracle drugs reach hundreds of thousands or even millions of dollars, many people don't fill prescriptions because they can't afford them.

 

Dr. Otis Brawley, a professor of oncology and epidemiology at Johns Hopkins University, points to cancer, with a death rate among Americans who have college educations (a proxy for wealth) at 90.9 per 100,000 per year. For people with a high school education or less, the rate is 247.3.

 

Ultraexpensive drugs include not just new medications but also older medications that drug companies have hiked the prices of in the last few decades, says the Times. For example, the price for Revlimid, which treats blood cancers, now is three times its cost when it first was introduced in 2005.

 

Often, even people who can afford commercial health coverage or get it through their employer may face insurers that refuse to pay. Other times, the insurer pays part of the cost, but high co-pays, deductibles and cost sharing put treatments out of reach.

 

“The idea that the care you deliver could bankrupt somebody and hurt an entire family is devastating,” says Dr. Benjamin Breyer, a reconstructive urologist at the University of California, San Francisco who's studied the issue.

 

The PAN Foundation helps people with an annual income about 4 to 5 times the federal poverty level with high medical bills for about 70 illnesses. But a foundation official says the need is so great that "we are just scratching the surface.”

 

A ProPublica article says: "More than 200 million Americans are covered by private health insurance. But data from state and federal regulators shows that insurers reject about 1 in 7 claims for treatment. Many people, faced with fighting insurance companies, simply give up: One study found that Americans file formal appeals on only 0.1 percent of claims denied by insurers under the Affordable Care Act." 

KHN: Private equity investing billions in clinical drug trials

After its success investing in the more obviously lucrative areas of American medicine — like surgery centers and dermatology practices — private equity firms have moved into the industry’s more hidden niches, including clinical drug trials, says Kaiser Health News.

 

The article is part of KHN’s extensive investigation of "the sizeable efforts by private equity investors to take over large and lucrative parts of the U.S health care system in recent years,” says KHN’s parent, the Kaiser Family Foundation.

 

To bring a new drug to market, the Food and Drug Administration requires pharmaceutical companies to perform extensive studies to demonstrate safety and efficacy — which often are expensive and time-consuming to conduct to the agency’s specifications. Getting a drug to market a few months sooner and for less expense than usual can mean millions in profit for the manufacturer.

 

"That is why a private equity-backed startup like Headlands Research saw an opportunity in creating a network of clinical sites and wringing greater efficiency out of businesses, to perform this critical scientific work faster. And why Moderna, Pfizer, Biogen, and other drug industry bigwigs have been willing to hire it — even though it’s a relatively new player in the field, formed in 2018 by investment giant KKR,” says KHN.

 

In July 2020, Headlands announced that it had won contracts to run clinical trials of coronavirus vaccines, which would include shots for AstraZeneca, Johnson & Johnson, Moderna and Pfizer.

 

Headlands’ sites also ran clinical studies on treatments for ailments including Type 2 diabetes, postpartum depression, asthma, liver disease, migraines, and endometriosis, KHN says.

 

Eleven of the 25 private equity firms identified by industry tracker PitchBook as the top investors in health care have bought stakes in clinical research companies, according to a KHN analysis. The companies have been involved in studies ranging from the coronavirus vaccines to treatments for ovarian cancer, Parkinson’s disease and Alzheimer’s.

"Contracted firms also analyze patient data and prepare materials to secure approval from regulatory agencies, in hopes of getting more drugs to market faster,” says KHN. "And a big draw for investors: Clinical research companies make money whether or not a drug succeeds, making it less risky than investing in a drug company.”

 

The number of clinical trials has increased to more than 434,000 registered studies this year as of late November, more than triple the number a decade ago, KHN says.

 

Here are KHN’s other articles on private equity’s investments in health care.