Coronavirus Will Pave The Way To A New Healthcare Delivery Model (We Hope) – Forbes

LOS ANGELES, CA - MAY 13: Workers wearing personal protective equipment (PPE) perform drive-up ... [+] COVID-19 testing administered from a car at Mend Urgent Care testing site for the novel coronavirus at the Westfield Fashion Square on May 13, 2020 in the Sherman Oaks neighborhood of Los Angeles, California. A nasopharyngeal swab test kit is utilized at this COVID-19 testing center to determine the viral load and virus count of a patient. Los Angeles County 'safer at home' orders have been extended through August to stop the spread of coronavirus during the worldwide pandemic. (Photo by Kevin Winter/ Getty Images)

Pictures from Italy likely drove many decisions made in the US about how to handle the coronavirus outbreak. Particularly in Lombardy where the outbreak was heaviest initially, Italians descended on local hospitals, quickly overwhelming them, and concentrating the highly contagious virus in these facilities. Subsequent reports from officials in the Italian Health Ministry highlighted a problem in their healthcare system. Italy lacks a robust primary healthcare infrastructure, all but ensuring that a mass influx of acutely ill patients desperately seeking care will have few options but overcrowded and inundated hospitals.

While the US healthcare system has a stronger primary care focus than seen in Italy, the tendency to invest in specialty services with their higher associated costs has driven most of the investment in healthcare services over the last 15 years in this country. It is largely the reason that US healthcare costs are the highest in the world without the commensurate value in terms of key outcome measures like life expectancy. As a result, we have had increasing rates of diabetes, heart disease, obesity and respiratory illnesses, points covered in recent Forbes posts. While we have certainly underinvested in primary care in the US, we have had a primary care network and for many, the primary care physician has been the gatekeeper for access to specialty services. Trips to the emergency room for those of us with insurance are associated with high costs, and urgent care centers have sprung up throughout the country as a mechanism to shield the ER from inappropriate usage. A trip to the hospital as a first line of defense in the US is less likely than might have been true in years past, and certainly presents a picture different from the one seen in Italy.

But it was the frightening pictures of healthcare in Italy that seems to have shaped the US response to COVID-19. No city wanted to have its healthcare system overrun with patients lined up on gurneys in hallways while shell-shocked clinicians tried to navigate through the chaos. While the US couldnt get sufficient supplies to the front lines (e.g. personal protective equipment), the draconian measures taken to blunt the projected spread of the novel coronavirus were intended to protect the very same hospitals that a month later have been laying off staff. Mandatory stay at home and shelter in place orders were issued to stem the tide of the virus, but most importantly, to enable healthcare systems in hard hit areas like New York City to keep from becoming overwhelmed.

So far, most healthcare systems have not been overwhelmed; indeed, many are confronted with empty emergency rooms and empty beds. Some patients with serious, non-COVID-19 illness have apparently not sought medical care when they should have. The fact that the onslaught did not happen is touted by some as proof that the measures local governments have taken to protect their citizens worked. Yet as the nation watches, a decade of economic gains are evaporating, businesses large and small are being brought to their knees, and even healthcare delivery organizations are closing their doors. The despair that is griping the nation is palpable as people shelter in place from an unseen virus and see their ability to provide for themselves and their families evaporating in front of their eyes. Isnt it time to ask whether the success was worth the price?

In the natural world, weaker members of the species are ill-prepared to withstand the onslaught of disease, extreme weather, and other disasters. In the wild, the ill and the young fall victim to predators. It is the stronger members that survive. This dynamic plays out in business as well. Those businesses with weak balance sheets going into a crisis like we are experiencing are ill-prepared to withstand the challenges posed by a pandemic. Hospitals with limited days cash on hand before coronavirus hit are unlikely to survive. A town needs a bank and some healthcare services to survive. Part of that service needs to be geared toward supporting individual responsibility for well-being, and that must include the prevention, diagnosis, and management of chronic disease. Chronic disease increases the likelihood of more serious outcomes associated with COVID-19 in the event one is infected. But the incentives underpinning the current healthcare system are not aligned to systematically address chronic illness.

A fundamental tenet of human behavior is that people do what they are incented to do; they stop or avoid doing the things they are not incented to do. Understanding this tenet is the reason I predicted that DRGs would not bend the cost curve in the mid-1980s, despite CMSs good intentions. Until there is transparency in cost/quality, as well as payment tied to outcomes that matter, we are unlikely to see the fundamental changes we need better health outcomes and lower total cost of care.

Today, the path to a value-based healthcare delivery model is being challenged as unrealistic due to COVID-19. Many systems which have taken on some form of risk are attempting to renegotiate with payers to protect themselves against the impact of the pandemic. No one modeled COVID-19 into their forecasts. Healthcare systems that bet they could lower the cost of care and/or improve outcomes will have a hard time winning that bet in the face of the pandemic. But the problem is not taking on risk but a legacy of highly bureaucratic programs built on a traditional fee for service model. Ironically, those that have assumed more of a capitation model in which they receive a PMPM reimbursement are faring better than those who have dipped their toes in the risk pool as they hold onto the tried and true procedure based fee-for-service model. The experience of coronavirus should be a wake-up call that the future of healthcare and the well-being of the nation depend on our willingness to invest in a new model. What we need is a model that engages both the healthcare system and the patient/consumer in coordinated action over time to achieve better health outcomes at lower total cost of care.

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Coronavirus Will Pave The Way To A New Healthcare Delivery Model (We Hope) - Forbes

Study Finds Low Proportion of Individuals With Autism Receive Recommended Genetic Tests – Technology Networks

A study analyzing data from the Rhode Island Consortium for Autism Research and Treatment (RI-CART) found that only 3% of individuals diagnosed with autism spectrum disorder reported having fully received clinical genetic tests recommended by medical professional societies.

The results bring to light a dissonance between professional recommendations and clinical practice, the researchers behind the study say.

Autism spectrum disorder is one of the most strongly genetic neuropsychiatric conditions. Medical professional societies -- such as the American Academy of Pediatrics, the American College of Medical Genetics, and the American Academy of Child and Adolescent Psychiatry -- recommend offering chromosomal microarray testing and Fragile X testing for patients diagnosed with autism. The tests can identify or rule out genetic abnormalities that could have implications in a patient's diagnosis and clinical care.

The study, published in JAMA Psychiatry on May 13, analyzed 1,280 participants with autism spectrum disorder based on medical records and self-reported data from the time period of April 2013 to April 2019. The participants are enrolled with RI-CART, a public-private-academic collaborative focused on advancing research and building community among individuals with autism spectrum disorder in Rhode Island and their families. The study's goal was to determine the current state of clinical genetic testing for autism in this cohort, said authors Dr. Daniel Moreno De Luca and Dr. Eric Morrow.

Of the 1,280 participants, 16.5% reported having received some genetic testing, with 13.2% stating they received Fragile X testing, and 4.5% reporting that they received chromosomal microarray testing. However, only 3% of participants reported having received both recommended tests.

"I had the impression that the frequency of recommended genetic testing was not going to be very high based on the patients I encounter clinically, but 3% is actually lower than I thought it would be," said Moreno De Luca, an assistant professor of psychiatry and human behavior at Brown University, who is affiliated with the Carney Institute for Brain Science, and a psychiatrist at Bradley Hospital. "A higher proportion has had either test individually, and the proportion of people with chromosomal microarray is higher in recent calendar years, which is a hopeful glimpse for people who are being diagnosed recently and who may be younger. However, this underscores that there is still significant work to be done, especially for adults on the autism spectrum."

In the study, researchers examine possible reasons for the gap between clinical practice and the recommendations from medical professional societies. Age was among the most prominent, as people with autism in older age groups are less likely to be tested. According to the study, adults with autism were generally unlikely to have undergone the clinical genetic tests.

The researchers also found that patients diagnosed by subspecialist pediatricians were more likely to report genetic testing as compared to those diagnosed by psychiatrists and psychologists.

"This paper is really about how you implement clinical genetic tests in the clinical diagnostic setting," said Dr. Eric Morrow, an associate professor of biology at Brown and director of the Developmental Disorders Genetics Research Program at Bradley Hospital. "There is rapid progress from research, and then there's the doctor and health systems that need to translate that to clinical practice. The clinics need to set up more support to educate clinicians and families about genetics and autism. Generally, this is done by genetic counselors who may be rare in autism clinics."

Furthermore, the researchers found that nearly 10% of participants who received an autism spectrum disorder diagnosis between 2010 and 2014 reported receiving chromosomal microarray testing, one of the more modern genetic tests. Compared to those in the study who received a diagnosis in years before 2010, this showed an increase in self-reported testing.

"There is a more hopeful message that conveys that the success in implementing clinical genetic testing is increasing," said Morrow, who is affiliated with the Carney Institute, co-leads the Autism Initiative at the Hassenfeld Child Health Innovation Institute at Brown and directs the University's Center for Translational Neuroscience.

Based at Bradley Hospital in East Providence, the team behind RI-CART represents a partnership between researchers at Brown, Bradley Hospital and Women and Infants that also involves nearly every site of service for people on the autism spectrum and their families in Rhode Island.

As a next step, the researchers behind the JAMA Psychiatry study are conducting a separate study to understand in greater detail the factors that could be influencing the rate of genetic testing.

"Challenges can be found on the patient and families side, on the physician side, and on the systemic side with institutional requirements and many other potential barriers," said Moreno De Luca. "We want to address each of those factors independently."

Reference:Moreno-De-Luca, D., Kavanaugh, B. C., Best, C. R., Sheinkopf, S. J., Phornphutkul, C., & Morrow, E. M. (2020). Clinical Genetic Testing in Autism Spectrum Disorder in a Large Community-Based Population Sample. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2020.0950

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Study Finds Low Proportion of Individuals With Autism Receive Recommended Genetic Tests - Technology Networks

The Code and the Key – National Review

(Enisaksoy/Getty Images)Lessons from human nature about writing, politics, and Donald Trump

I worked one summer as a kitchen boy in a Wisconsin summer camp. It was one of those jobs from which you fall down at night near too tired to sleep. A previous occupant of my bunk had left behind a copy of Atlas Shrugged. So I spent the summer, between work and sleep, reading the perfect companion for my teenage summer.

I dont care for short stories. I prefer the heft of the doorstop book, reassuring me that I can immerse myself in the fantasy for a good long time. Yes, yes, I think. Thank you. Take me. Anywhere but here . . .

My companion for the lockdown is The Codebreakers: The Comprehensive History of Secret Communication from Ancient Times to the Internet, written by David Kahn in 1967 and updated by him in 1996. One thousand pages so interesting that my mind will not reject them even though they are informative.

My new novel, not yet released, is Forty Years at Anstett, a fictional account of one mans life at a New England prep school. In it, a young man returns from imprisonment in Japan during the RussoJapanese War. The fellow applies for the job of instructor of languages. He has no academic credentials, but a very practical one: He was forced, in prison, to learn Japanese, Russian, Chinese, and, more important, how to learn languages. He challenges the Head (my protagonist) to point out the dullest lad in the school, to name a language, to leave the applicant alone with the boy for an afternoon, and then to assess his progress in the new tongue.

Well, the Head says, Latin or Greek. Id say Latin; its simpler as it shares our alphabet. No, the applicant says, its simpler to teach Greek. A new alphabet is a code. What twelve-year-old boy has ever been able to resist a code?

Not I, certainly. It seems Ive spent my professional life fashioning them and solving them, and have found the process commutative, which is to say, the study of one is the study of the otherit works in both directions.

Heres what I mean. Raymond Chandler wrote, in his essay The Simple Art of Murder (1939), that it is near impossible to craft a good murder mystery, as it requires two otherwise unconnected skills: the ability to write beautifully and the ability to fashion a code.

He is near right in his observation. The two skillswhile not mutually exclusive per seare unlikely to be found fully developed in any practitioner, because to achieve excellence, he or she would have to devote all energy to one or the other. I know of no great contemporary instrumentalist who is also a great composer.

The intersection of cryptography and literary merit is discoverable, though, in one very particular craft, and it is my own: writing drama.

For the drama has much in common with the detective novel. The clues in each must, scene by scene, be displayed to the reader in such a way that their importance will become both clear and acceptable only when the protagonist (and, so, the reader) has finally arranged them, correctly, at the works conclusion. If a clue is omitted, the writer is cheating; if it is too apparent, he is a hack.

Oh, yes, it was there all the time is the revelation capping not only the story of Sam Spade and his Maltese falcon, but that of Oedipus.

Ive always understood my job as a playwright as crafting the code. I came to this understanding through watching the audience.

In the various storefront theaters of my youth, I was offered the opportunity to make a living superior to mine as a cabdriver, if and as I could please the audience: not the critics, not the universities, but the paying audience.

I could write sufficiently well to keep em in their seats, but I was not going to get out of the Yellow Cab Company, I saw, unless I could do something additionally, which was (and is) to lead the audience unconsciously, at the plays end, to a revelation, which is to say, to a thrill.

Most plays, and all dramas, conclude, Well, I suppose life is just like that. This is sufficient to get the audience back into their cars, but by half the drive home, the play is forgotten. It may have diverted, but it did not thrill. This is to say, it did not deliver anything that could not have been foreseen. One says of such plays, They came in humming the plot.

Well, I wanted to trade the delights of the Yellow Cab Company for those of Broadway. So I sat down to the study of a code, and the code was, and is, human behavior.

I now learn from David Kahn the same lesson I saw in the storefronts: The cipher cannot be resolved without possession of the key.

Human behavior is fairly clear. One did or did not do or say this or that; one keeps marrying the wrong guy, or forgetting ones car keys, Aunt Mae always arrives late, and so on.

The attempt to interpret these actions, to determine the underlying assumptions, and, so, possibly, arrange them for the understanding of the group, the family, or the individual, is a search for a unifying key.

Psychoanalysis is, essentially, cryptanalysis. It is the attempt to find the key that will render intelligible, that is, arranged into a cause-and-effect progression, a string of various otherwise puzzling actions. It is fairly useless as a clinical tool (for, finally, the solution is as moot as is, in most cases, the complaint). But it is a handy theoretical tool, for a dramatist/cryptanalyst. He may walk the cat both backward and forward, discovering, in his own, unconscious creative process, the hidden key, which resolves his disparate perceptions and creations (an event, a line, an interchange) into that whole that may at the plays end be revealed as a progressionthat is, as a surprise.

This key is called the plot.

The practical codebreaker differs from the psychoanalyst in this: It is not his job to evaluate and act on the decoded information, but only to strip away the code.

Applied to psychoanalysis: Rather than asking What was the repressed trauma to which cause I can assign these symptoms? we may ask What was the process that caused that particular trauma (plaintext) to be so encrypted; that is, what is the key?

For, even if the hidden trauma is correctly determined, this can mean nothing more than that it has been identified in a way sufficiently satisfying to doctor and patient as to be acceptable; and the very fact that the patient accepts a psychoanalytic solution (which, again, is merely suppositional) might argue for its falsity. Diagnostically, he leaves the analysis not having had his life changed by revelation but gratified in his assessment not only of his own reasoning but of his courage in being able to accept a (putatively) new idea.

Similarly, modern drama and entertainment, and the so-called news media that flog it, present as a cure for (inescapable) human anxiety various solutions that, in their inaccuracy and inconclusivity, induce the individual to commit to further, more-drastic (which is to say, more-macabre and more-bizarre) restatements of the original diagnosis: E.g., you are not anxious, you are legitimately appalled, and frightened, as who would not be, as the world is ending (burning up, poisoned, overpopulated, run by Monsters).

The committed liberal, leftist, or analysand is like the government establishments that have devoted so much time, energy, and treasure to the creation of a code that no evidence could convince them that it has been broken and so must be replaced.

Drama carries an acceptable, but not a transformative, solution. Only tragedy has the power to transform, its revelation shocking the hero/sufferer (who is only the representative of the audience) into an absolutely new life. This life, however different from or lesser than the previous one, has this great benefit: It can be led truthfully, without either shame or anxiety, as one no longer fears discovery. The neurotic individual or organization fears not that its code may be broken but the knowledge that it already has been.

A mass movement coalesces around previously unconnected forcesthose that, absent a catalyst, cannot combine to any effect. Its formation will be predated to account for a supernatural beginning, but this merely raises the question Why now?

Islam, Christianity, and, in the 20th century, Marxism and Fascism emerge and proliferate exponentially, creating a new polity, spreading first through the joy of novelty, then through the herd instinct, and, finally, through force directed at the unconvinced.

A doctrine that cannot be proved, and whose only benefit is membership in a herd of the similarly professing, must (like a neurosis) be vehemently defended, as its refutation would threaten the individual not only with expulsion but with shame at his complicity, which is to say, with self-knowledge. But this, again, just raises the question: Why does this or that belief or delusion emerge and metastasize at a particular time? What is the relationship between the individual and the mass movement?

Tolstoy asks the question in the epilogue to War and Peace. He observes that 5 million Frenchmen didnt march into Russia just because Napoleon told them to. There is some relationship between his and their folly, but the relationship is unclear. The question, he tells us, is What is power? For, if they did not march because of his orders (a proposition that is, on reflection, absurd), why did they march?

Why did the young of my post-war generation embrace the various doctrines of free love, anti-Americanism, dissent, and mass movement, which, here as everywhere in the West, have matured as leftism, its various doctrines as absurd and obviously destructive as Napoleons (or Hitlers) invasion of Russia: open borders, free health care and education, and a universal salary not only for our citizens but (given open borders) for the entire world.

Ive been puzzled for a while by the absence in this virulent movement not only of a handy name (for leftism defines the thing only in relation to its opposite) but of a leader.

In the upcoming election, the Left has proposed, and its adherents have accepted, no candidate onto whom can be grafted even the most basic and most provisional attributes of charisma, wisdom, or record (however factitious) of accomplishment.

Why has the Left, intent on destroying the West, put forth no leader, and why has no leader put himself forward to fill the vacuum of power? What does the Left have, in place of a Marx, a Hitler, a Lenin, or, indeed, a Roosevelt or a Churchill? One who could state and embody its principles and thereby unify a country or a party? Perhaps the Lefts inability to propose a leaderand, so, a coherent (even if loathsome) visionis not a problem but a solution.

The question, then, is: To what problem?

For four years Ive found the massteria (Professor Harold Hill, The Music Man, 1957) around Trump healthy, as energy directed thus was unavailable for the Lefts beatification of a new leader (a fhrer). How fortunate for the country, I thought.

The national emergency has given me some leisure to think and consider; it was awarded by a virus. My question of the Virus is Why now?

The virus could not have spread globally without universal air travel, the national wealth that created such travel, and the disposable incomes that allowed individuals to take trips.

The Black Death reached Europe through rats on merchant ships from the Orient, the Spanish flu was spread here largely by servicemen returning from Europe, and so on, and so on.

Each, perhaps, could be seen as occurring through, or spreading because of, some stage of progression or, say, maturity, in the economy, or, to flirt with eschatology, in the Progress of the World.

The individual lifespan lengthens, and now the elderly are faced with diseases unknown to or rare among grandparents who would have been dead at a similar age.

Traffic congestion, attendant pollution, anxiety, and so on are the result of urban success. The highways take the mass of the newly solvent to the suburbs, the commutes become intolerable, and the old cities die, or exist (all the old capitals of commerce) as tourist attractions, or amusement parks, with the super-wealthy maintaining their skyboxes above the entertainment, as in The Masque of the Red Death.

The liberal, elite cities and states raise taxes, because they must, as their tax base disappears. As the services disintegrate, the rich follow the middle class out and leave the cities to the homeless, their ranks engorged by the aliens attracted to the notion of something-for-nothing (as who is not?), which is to say the Garden of Eden before the Fall.

There it is, before our eyes, but those who call attention, like our friend Laocon, are swept back into the sea, and the wooden horse, inside which the voices of enemy soldiers are heard, is dragged inside the city.

The unabated loathing of Trump must be considered a delusion, for how could one man be responsible not only for treason, collusion, malversation, and other crimes that, though they might be practiced individually, would, in their conjoined execution, each cancel the efficacy of the other (e.g., armed robbery and embezzlement)? Consider that in addition to this endless litany of his human corruptions, he is, coincidentally, indicted as responsible for the weather and the spread (if not the inauguration) of a global pandemic.

A comparison of Trump Psychosis with adoration of Hitlerthough perhaps appropriate mechanically, that is, in terms of power exerted on the mobis inexact in terms of utility. For the apotheosis of Hitler united the Germans behind a shared vision; he personified, and gave voice to, a nationalist desire for revenge, pride, and power, in which vision, and through its supposed benefits, the individuals could participate.

But the revanchist Left is not opposed to Trump as the avatar of the Right, of capitalism, of Americanism (once called patriotism). They cannot object to his policies per se, because the policies, one by one, are demonstrably superior in practice to any the Left has employed and, in reason, to any they have suggested. Their objections are all ad hominem, alleging various isms, which epithet may be applied, given but little inventiveness, to any of his words or acts. (As they may to any of yours or mine.) To suggest it is his acts that enrage the Left would be as to understand the Islamist attacks of September 11 as architectural criticism.

The Trump resistance began in the first hours of his presidency and has continued unabated by either reason or fatigue. There are no dissentient voices on the left, for any suggesting consideration, let alone dissent, have been expelled, vilified, and canceledthey are thus no longer on the left. Perhaps in this the disease starts to proclaim itself.

Leo Marks was a British codebreaker at Bletchley Park, during the Second World War. In his book Between Silk and Cyanide (1998), he writes about the codebreakers disease: Engaged as they are in trying to break the code, it is their last thought at night, and their first on awakening. Many of them became illphysically or psychologicallyfrom the strain.

Marks was in charge of decrypting the messages sent by Allied agents parachuted into Nazi-controlled Holland. He was, he writes, driven mad by the suspicion that the Allied agents had been captured and turnedthat is, that they, and so their codes, were being manipulated by the Nazis. He could find no error in the transmissions, but his suspicions would not go away. One morning he awoke and realized that the problem (that he could find no errors) was, of course, the solution: It would have been impossible for an Allied spy in Nazi Holland to transmitin haste and in hiding, risking deathwithout errors in the transmission. The agents had been captured or turned, he concluded.

There are no errors in the unity of the Left, which may be a key to the solution of their irrational, implacable loathing. Trump is hated as the most prominent example of one whos not afraid to employ reason. He has been canceled but ridicules their verdict.

It is not his plans (the Left doesnt hear of them) or his accomplishments (they are discounted, attributed to others, glossed over, or dismissed as nefarious) that are loathed, but the man himself, as he had the temerity to hold himself superior to the zeitgeist.

The zeitgeist is the Decline of the West, which had been sweeping the world since the American apogee, victory in World War II, and the advent of the most prosperous economy in history.

Things age, mature, and die. Fascism was a 20-year-long dictatorship, expanded through murder and terror. American exceptionalism and prosperity are the overwhelming story of the 20th century; it was not spread by the sword, and it will not die by the sword. Lincoln said that all the massed armies of Europe, Asia, and Africa combined could not take a drink from the Ohio, but American culture has been decaying throughout my lifetime, as must any organism. Mr. Trumps presidency has lengthened the American experience by some number of years. That number will be debated by the civilizations that succeed us, who will wonder at our fall, as the educated once did at that of Nineveh and Tyre.

Tragedy, to be compelling, must address a prerational experience or unity. A Hokusai painting of a wave makes us nod in recognition, as we do at a resolution of a Bach fugue. We cannot explain or dissect our experience of understanding, but it is undeniable. True art creates in us the same feeling of fulfillment, its possible description just beyond the rational mind.

The technician might explain it technically, the musician employing the cycle of fifths, or the painter some theory of color or proportion, but this merely puts the problem at one remove. For, after the technical reduction, even the expert cannot quite answer the question of why: Why, for example, is the eye so pleased by the golden mean? Like any great truth, our understanding of art must devolve into metaphysics or an assertion merely leading to an infinite regression.

The human mind will and must assemble phenomena into cause and effect. We will intuit or ascribe a causal relationship to two events that, to another, have no possible connection: Aunt Edna did not call on my birthday because shes furious I didnt sufficiently praise her new frock; Germany is troubled because of the Jews; we are suffering a pandemic because Trump did or did not act quickly enough, and an economic disaster because he did.

Psychoanalysis (and politics) attempts to address or capitalize on our human suggestibility, particularly on our frenzied willingness to assign our disquiets to another. Solutions offered thus flatter our ability to identify a problem, suggest its cure, and remind us to come back tomorrow for another dose.

Drama acts similarly, engaging us in the assurance that the cause of all problems is evident, and that our reason will suffice to cure them. The Bad Butler did it; Deaf People are People, Too; Love Is All There Is; and so on. If we enjoy the mixture, it must (and will) be taken regularly.

Tragedy provides not reassurance but calm through the completion of a mechanical progression. Its end is probative, for it is the disposition of all the variables (the code) stipulated at its beginningmathematically, there is no remainder.

The journey of Oedipus begins because there is a plague on Thebes; it is the kings job to conquer it. Without the initiating impulse (the stated problem), the play becomes merely a drama, it cannot be a tragedy, and we take away from it not that peace from recognizing the human condition but the lesson Do not sleep with your mother.

Can our current national emergency be viewed as perhaps a classical tragedy rather than as sordid drama? We see that the various factions are fighting over a disordered kingdom; each employs (to its own degree) the universal tools of indictment, incitement, appeal, reason, conspiracy, deception, and so on (assignment of these to taste). Considering ourselves as the dramatist, we can prognosticate an end: civil war, dissolution and chaos, conquest by a foreign power, return to a new and healthier polity actually based on the Constitution . . .

But such an end, to satisfy as tragedy, must be understood as the resolution of that specific problem absent the appearance of which we would not have a play. (Hamlets father dies.)

But in our case, what brought about the plague of Thebes?

The builders of the Tower of Babel suffered from hubris. They thought that they could aspire to heaven and raise themselves above human concerns, and that the various conflicting impulses of humanity would go away if we all spoke with one tongue. This tongue, of course, would be that of the builders, and I will leave comparisons with globalism to the reader. But it is no sin to be prosperous, and even the most committed Marxist wishes only to regularize (that is, reduce) the wealth and consumption of his neighbor.

What is the precipitating event or situation whose resolution would be one of those mooted above? We know our current pandemic came from China, and from trade with China. And every schoolchild knows that April showers bring May flowers, Mayflowers bring Pilgrims, and Pilgrims bring typhus.

The demagogues of the Left have discovered anew the ancient secrets of corruption, collusion, and decay, and, like all their predecessors, delight in their discovery: indicting their opponents for their own crimes.

We had, on April Fools Day 2020, two events warring for pride of place in our reconstruction of the tragic cryptogram: the pandemic, and the election of Donald Trump. But tragedy cannot have two precipitating events. (See the childs excuse I didnt do my homework because the dog ate it, and my mother has the flu.) Two explanations are none.

We must choose one, determine how the two are, if not identical, then conjoined (My mother has the flu, she usually feeds the dog, she could not, the dog became hungry and ate my homework), or discard them both and begin our work again, remembering Tolstoys admonition that the first or most apparent manifestation of an event is not necessarily the cause: The savage seeing the puffs of smoke first might conclude that they caused the locomotive.

The Left insists that our national disruption is caused by the election of President Trump, which affront would be resolved by his removal from office.

But if the successful results of their machinations brought us to civil war or economic collapse, then the effect would be out of adjustment with the supposed cause. (See the all too common explanation of spousal murder: You would have shot her too if you saw the way she looked at me.)

That message was fictionalized in Atlas Shrugged. Ayn Rand lived through the Russian Revolution, in St. Petersburg, and spent her working life, in fiction and nonfiction, writing about the horror.

Here is another report, by Alexander, Grand Duke of Russia, first cousin to the czar, from Once a Grand Duke (1931):

What was to be done about those princes and countesses who spent their lives going from door to door and spreading monstrous lies about the Czar and Czarina? What was to be done with that scion of the ancient family of Princes Dolgoruky who sided with enemies of the Empire? What was to be done with the president of Moscow University, Prince Troubetskoi, who turned that famous institution of learning into a radical campus? What was to be done with that brilliant Professor Milukoff, who felt it his duty to denounce the regime in foreign lands, undermining our credit abroad and gladdening the hearts of our foes? . . . What was to be done with our press who met with rousing cheers every news of our defeat on the Japanese front?

The message on Nebuchadnezzars wall was You have been weighed in the balance and found wanting.

Trump Mania is not a message, but a key, serving to obscure an underlying message.

The key (the accusations of the Left) disguises an underlying terroroperating here just as the near-psychotic, immobilized by a terrifying, free-floating anxiety, extemporizes specific phobias in an effort to gain some control.

It is not that I am losing my mind in unnameable panic, he thinks, but that Martians, or mice, food additives, or Jews are trying to destroy me.

The Lefts loathing of Trump differs from their other attempts at constructive phobia in this: He is not an event, a phenomenon, an attitude, or a group, but an actual human being.

He has supplanted previous attempted solutions to panic, but universal and vicious loathing comes close, in its virulence, to revealing the key, and thus the presence of an underlying code.

He is a mere human being who has the temerity to disregard the taboo.

In the Salem Witch Trials of 1692, some brave soul might speak up for one accused of witchcraft; but no one would have dared to say, and few to think, There is no such thing as witchcraft.

The Lefts hatred of Trump reveals their code. They here are like the ghoul Rumpelstiltskin, whose power disappeared when the victim said his name.

Trump is loathed because he is feared, and he is feared because he named the monster.

The Monster is the zeitgeist, that is to say, the Left.

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The Code and the Key - National Review

This Philosopher Is Challenging All of Evolutionary Psychology – Gizmodo

Subrena SmithPhoto: University of New Hampshire

Its not often that a paperattempts to take down an entire field. Yet, this past January, thats precisely what University of New Hampshire assistant philosophy professorSubrena Smiths paper tried to do. Is Evolutionary Psychology Possible? describes a major issue with evolutionary psychology, called the matching problem.

The field of evolutionary psychology is no stranger to critiques, given its central idea: that human behaviors can be explained in evolutionary terms and that the core units governing our actions havent changed since the Stone Age. But Smiths paper garnered a particularly strong response after science journalist Adam Rutherford discussed it on Twitter and PZ Myers discussed it in his Pharyngula blog.

We at Gizmodo have long rolled our eyes at the often-nonsensical conclusions that some people come to when employing evolutionary psychology theory, so we were excited to chat with Smith about her work. This interview has been condensed and edited for clarity.

Gizmodo: Your papers main refutation of the field is something called the matching problem. Can you explain what that is?

Subrena Smith: Evolutionary psychologists thought is that, for at least some of our behaviors, they believe that we havedare I use this termhard-wired cognitive structures that are operating in all of us contemporary human beings the same way they did for our ancestors on the savannas. The idea is that, in the modern world, we have sort of modern skulls, but the wiringthe cognitive structure of the brain itselfis not being modified, because enough evolutionary time hasnt passed. This goes for evolutionary functions like mate selection, parental care, predator avoidancethat our brains were pretty much in the same state as our ancestors brains. The sameness in how our brains work is on account of genetic selection for particular modules that are still functional in our environment today. [Editors note: These modules refer to the idea that the brain can be divided up into discrete structures with specific functions.]

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The matching problem is really the core issue that evolutionary psychologists have to show that they can meet: that there is really a match between our modules and the modules of the prehistoric ancestors; that theyre working the same way then as now; and that these modules are working the same way because they are descended from the same functional lineage or causal lineage. But I dont see any way that these charges can be answered.

Gizmodo: What inspired you to write this paper?

Smith: I talked about some of these issues in my dissertation, but the ideas got mature and seasoned since graduate school. I suppose the question is, why evolutionary psychology? I was associated roughly with that scene some years ago. I found the evolutionary psychology explanations of human behavior in themselves evocative but also puzzling, given what I understood of the theory of evolution, particularly the importance of variation. People have been talking about it for so long, saying that its not workable, its problematic. Ive never taken that attitude. Ive seen evolutionary psychologists as scientists trying to figure things out. My approach has been to think carefully about what theyre doing. I didnt have an attitude of, this is just ridiculous. I wanted to carefully try to articulate what seems to be a fatal problem with the framework and to put it out there.

Gizmodo: Can you give some examples of scenarios of the matching problem in action?

Smith: Heres the problem. With respect to human beings, we dont have the relevant evidence about how our ancestors behaved to make any substantiative claims. We can only use evidence of our behavior and evidence of the likely kinds of behaviors that they would have exhibited in the past. We know that ancient humans avoided predation, for instance. What exactly they did is something evolutionary psychologists have to show. Did our ancestors avoid predation because they were good at hiding in bushes or because they were running? Evolutionary psychologists would say that the better explanation is that they were running. But the fact that they ran to avoid predation and the fact that we have the disposition to run when were endangered still does not establish that theres a singular module doing both of those jobs.

Gizmodo: You flesh out another example, from a paper by Aaron Goetz and Kayla Causey about cuckoldry. Can you explain this?

Smith: The hypothesis is that, in the environment of evolutionary adaptation, mate infidelity was costlier for males than it was for females. Presumably, its on accountof the fact that, if youre a man, you might end up taking care of someone elses child. So college students were asked how likely it is that theyd have sexual intercourse with someone other than their current partner. Now, one of my major charges with evolutionary psychologists is that they go to the ordinary folks, college students, and they ask them questions about such intimate things like their sexual behavior. We know that people are wanting to not be honest about such matters, and, of course, evolutionary psychologists are aware of this. The second issue is that the answers given to these sorts of questions are then generalized to humanity in general.

The thought is that we expect to find this particular behavior in the contemporary world, namely that respondents who answered these questions are apt to be vigilant around their mate; males in this context are inclined to be vigilant around their female partner. (The study authors didnt ask any questions about same-sex relationships, but lets set that aside). Evolutionary psychologists posit that, based on these questionnaire answers, mate guarding behavior is driven by a hard-wired, domain-specific cognitive module whose function is to procure and protect ones mate from extramarital relationships. But their evidence is nothing more than the responses given to these prying questions by contemporary college students. My worry is that it doesnt begin to be a scientific study. Theres no way to move from the contemporary case to the prehistoric case, which is a hypothesized case about how prehistoric males behaved with respect to their mates and cheating.

The hypothesis is: Were getting these reports from the U.S. context because theres a module they inherited from their ancestors. So were moving from a report of how people would behave in these situations to claims about how our ancestors did in fact behave. This is really deeply flawed. I dont think that this is good enough for the sorts of things that evolutionary psychologists want their theory to do. You need more than that.

Gizmodo: What are some of the potential harms of evolutionary psychology as a theory?

Smith: While I think that evolutionary theory is the only game in town to give us accounts of biological questions when were thinking about evolutionary history and claims about selection, I also think its grossly misappropriated. One of the things people tend to forget is that in On the Origin of Species, Darwin takes several chapters to talk about variations. And yet the impression one gets from evolutionary psychologists for uses of evolutionary theory is that, when were talking about human begins and our brains, evolution has given us this static system. That our brains are static. And in fact, nothing could be further from the truth. Our brains are dynamic, our behaviors are dynamic, were imaginative, we generate novel behaviors in contexts that never exhibited themselves. That variation is one of the things about evolution we should be including more in our theories.

The evolutionary psychologists I engage with are not silly people. They are thoughtful and philosophical about these matters. However, the attractiveness of evolutionary theory coupled with peoples ideological biases forces them to not be as careful as they might be otherwise. I think that the consequences for our world when we misappropriate evolutionary accounts are really serious. People are saying that people of color have smaller brains, which is not true, or that women arent as great as men, which is not true... I think we have a special responsibility, when we say evolution made us that way, to recognize that people will read innate or hardwired as synonymous with evolution. We should be especially careful to not be making claims like these, which can have consequences.

If you say evolution made us so, then governments can rightly say you dont have the capacity to do something, so we wont use our resources to make you do stuff you cant do. This is about the science and politicsmaking sure that were not misappropriating the science to underwrite our politics in a way to suit interests, be they my interests or their interests. If I have interests inconsistent with what the science says, I dont think I should be given a pass. But my view is that I dont see the framework of evolutionary psychology as-is providing us with an explanation of human behavior that we can get behind.

Gizmodo: I know the paper made a big splash. Can you tell me what the response has been like?

Smith: I did a [post] of sort for this evolution blog, and I understand that someone responded to me. Im happy to have the intellectual conversation. Im not a tweeter and I dont have a Twitter account. My spouse is, and he tells me that there have been some not-so-nice things, as well as people who are championing my cause. Adam Rutherford, who I really like, a British broadcaster who was a geneticist, was one of the first people to pick up the paper and say the arguments were compelling and that evolutionary psychologists should be answering these arguments. But otherwise, I told my husband I dont want to hear stuff from Twitter, particularly if its a teaching day. Its fair to say that its been not very nice, and also people who have been thoughtful in their responses, plus lots of people asking me if I want to write something for them. Thats a good thing, but I dont have time.

Gizmodo: Whats your end goal? What do you want from evolutionary psychologists?

Smith: My little paper isnt going to stop this discipline. Its not going to cease departments where evolutionary psychology is thriving from existing. I do hope it gets a conversation going. I actually think that it is a worthy project to ask ourselves questions about how are we related to our prehistoric ancestors in such things as behaviors.

My view is that while we might talk about similarity and ancestry with respect to normal physical phenotypes, I am reluctant to go there with behaviors. For me, its really because of the flexibility that is needed in order for any organism to thrive in the environments that they find themselves... Long story short, what I hope this paper does is gets us all thinking a little bit deeper about what is it to talk about evolution and psychology and human behavior.

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This Philosopher Is Challenging All of Evolutionary Psychology - Gizmodo

Daily COVID-19 reported cases dont say what we think they say – The Dallas Morning News

For many of us, the coronavirus has added something to the daily routine. We get up, make coffee, and then check how many new COVID-19 cases there are. Was yesterday better than the day before? This week better than last week? Are we flattening the curve? Is there a second surge?

But those daily counts may not mean what we think they mean, and the answers to the questions were all interested in are much more nuanced.

Last week, Dr. Daniel Podolsky, president of UT Southwestern Medical Center, told us there is wide variance in the amount of time between someone contracting COVID-19 and the case being reported. Sometimes the lag is a day or two. Sometimes its more than two weeks. Whats more, theres no way to tell how many of each days new cases were recently contracted and how many are weeks old. Because of that variance, day-to-day reports of new cases dont accurately reflect real-time public health dynamics.

Podolsky suggested another metric for measuring the viruss spread: ICU beds. On Monday, 25 Dallas hospitals reported 3,447 of 5,713 beds occupied. Thats just over 60%, which is down from a peak of nearly 70% last week but still higher than last month.

Still another metric, and one that would tell us exactly how successful weve been at flattening the curve, is something called an R0 score (pronounced R naught). The R0 is a measure of how many people are being infected by each infected person. If the R0 score is 1, then every infected person infects exactly one more, and the outbreak will plateau. If the R0 is greater than 1, then the outbreak is growing with each cycle, or what experts call serial interval. Thats the average time between each successive infection. Taken together, the R0 and the serial interval can predict how quickly an outbreak will grow or recede.

Without precautions like social distancing, doctors say, the coronavirus will have an R0 as high as 3 (thats very contagious; more contagious than flu or SARS1) and a serial interval of about four days. So based on those numbers, if there were one infected person in Dallas on March 1, then on March 5, there would have been four infected people (the original case plus the three he infected). On March 9, there would have been 13 infected, and on March 13, there would have been 40 infected. The number grows exponentially with each successive generation so that by the middle of April every person in North Texas would have been infected.

Of course, that is not what happened. The virus has not spread at that rate. And, whats more, Texas aggressive measures to slow the spread have spared us from the fate of hot spots like New York, according to Dr. James Cutrell, the director of the infectious disease fellowship program at UT Southwestern.

But as useful as R0 is in theory, it is frustratingly hard to determine. The actual R0 of the coronavirus in Dallas is affected by myriad unknown variables like weather, ZIP code (some neighborhoods are naturally more isolated than others), public policy and human behavior. The number is such a murky composite of medicine, mathematics and social science that Dallas County Health and Human Services doesnt report it.

But others are willing to guess. The founders of Instagram have coded a resource called rt.live that reports estimated R0 values for each state in the U.S., and though its not an academic or scientific resource, it is based on data from The Atlantics COVID Tracking Project and is used by institutions such as the White House and Johns Hopkins University. As of May 5, rt.live put Texas score at 0.85, down from a high of 1.2 in March, meaning that if it is right, the outbreak is receding.

All of this is fascinating guesswork but doesnt give us a lot of confidence in those daily reports of new cases. And that, said Cutrell, is the point. He compared day-to-day or even week-to-week case counts to stock market day trading: When you chase daily numbers you can miss the long-term trend. He said we should look at longer time horizons when judging our success at flattening the curve. Which means that our evaluations of public policy changes should also be tempered.

Last week, Dallas County reported more cases than any week since the outbreak began, and that on the heels of Gov. Greg Abbotts relaxing shelter-at-home rules. The temptation is to assume that the latter caused the former. And while more interpersonal interactions will certainly lead to more infection, Cutrell said its too simple to couple numbers from last week with policy from the week before.

There are two lessons to learn from all this. First, as World Health Organizations emergencies chief Dr. Michael Ryan said Monday, without adequate testing and contact tracing measures we are essentially shutting our eyes and trying to drive though this blind. But second, and more comforting, perhaps we can take a break from fretting over up-to-the-minute reports on this pandemic. As we said Monday, the psychological trauma of this time cannot be ignored. Theres no reason to feed that trauma with daily reports, so wed encourage putting the day-to-day numbers in context of the longer trend and reviewing other data points to see where we are headed.

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Daily COVID-19 reported cases dont say what we think they say - The Dallas Morning News

Worlds Shortest Population Reveal the Largest Genetic Contributor to Height – Technology Networks

At a glance:

A team of researchers from Harvard Medical School, Brigham and Womens Hospital, Socios En Salud, and the Broad Institute at Harvard and MIT report they have identified the single largest genetic contributor to height known to date.The findings, published in Nature,are based on an analysis of samples from ethnically diverse Peruvians, a population known to have the shortest stature in the world.

The team identified a previously unknown, population-specific variant of the FBN1 gene (E1297G). The variant, found exclusively in individuals of Native American ancestry, showed a striking association with lower height.

Each copy of the gene was associated with an average of 2.2 centimeters (around 0.8 of an inch) reduction in height. People who have two copies, or two alleles, of the gene variant were, on average 4.4 centimeters (1.7 inches) shorter in stature. The effect is an order of magnitude greater than the effects that previously identified gene variants have on human heightin the range of 1 millimeter (0.04 inches).

This study dramatically highlights the advantage of studying different populations and having a diverse, worldwide strategy to understanding the human genome, said study senior author Soumya Raychaudhuri, professor of medicine and of biomedical informatics at HMS, director for the Center for Data Sciences at Brigham and Womens Hospital, and an Institute member at the Broad Institute. We learned new things about how complex genetic traits work. Our findings have implications for important diseases linked to FBN1 that we could not have learned without looking at this population.

The multi-institutional international research project brought together computational biologists, epidemiologists, community health workers, dermatologists and experts on a variety of genetic and infectious diseases, using a variety of genomic, computational and imaging techniques. The results of their collaboration shed new light on the genetics of height, a key model system for studying complex, multigene systems that are crucial for understanding wellness and disease.

A wide range of mutations in the FBN1 gene have long been known to cause Marfan syndrome, an inherited connective tissue disorder marked by hypermobility of the joints, greater height compared to ones family members and, in some instances, by cardiovascular problems.

The newly identified variant, however, is not associated with disease.

One critical insight from this study is how genetic variants in the same gene can have very different effects, said lead author Samira Asgari, HMS research fellow in medicine at Brigham and Womens. Before now, if you asked a geneticist what a variant in this gene would do, they would probably say that they cause a disease. But that's not what we found.

On the contrary, based on the researchers analysis of the distribution of E1297G variant in the Peruvian population and throughout the wider Native American population, this variant may actually confer an evolutionary advantage, the researchers said, because it appears to have been selected for by evolution.

The study found that the new variant is notably more frequent in coastal Peruvian populations than in populations from the Andes or the Amazon, which suggests that short stature might be the result of adaptation to factors that are associated with the coastal environment in Peru, the researchers said.

These findings, based on one of the few studies of the genetics of Native American populations, highlight the importance of including diverse populations in biomedical research.

It's really important to include underrepresented populations, particularly in these kinds of studies that are models for the way other multigene, complex traits function, said Megan Murray, the Ronda Stryker and William Johnston Professor of Global Health at HMS and a senior author of the study. Leaving some people out means we might miss an important part of the picture were trying to see. And any people who are left out arent likely to reap the benefits of this kind of research.

Height is a complex genetic trait, and one that is easy to measure and provides an important model system for understanding how complex genetic systems work.

Meta analyses of genetic studies of height conducted on predominately European populations include more than 700,000 individuals, the researchers noted. This research has identified about 4,000 different genetic variations known to have an impact on an individuals height. Most such variants might make a persons stature less than one millimeter taller or shorter for each copy of the variant a person has.

In comparison, this variant that we found has a 2.2 cm effect per allele, Asgari said. Thats huge for a height variant.

The new variant was not present in any of the large genetic studies conducted with European majority populations.

The genomes the team analyzed in Peru are quite distinct from those analyzed in Europe or North America. About 80 percent of the genes of an average Peruvian come from their Native American ancestry, according to previous research.

Until now, Peruvians have not been included in any genomic studies of height. by studying a small, previously overlooked population, the researchers pinpointed an allele that showed a bigger effect on height than all the other variants.

Just amassing and amassing data isnt the answer, Raychaudhuri said. If youre not looking at different populations, you're going to miss really important stuff.

The E1297G variant appears in the genomes of 5 percent in the Peruvian population, but it occurs in the genomes of less than 1 percent of people of Native American descent from Mexico. The variant is completely absent from the genome of people of European descent.

We're doing studies in populations that are not normally on the map, Raychaudhuri said. This relatively small project is the largest genetic study thats been done in Peru at this point.

The new study grew out of a series of projects led by HMS researchers in Peru, including a long-term collaboration between Murray and colleagues with the health care delivery nongovernmental organization Socios En Salud, the Peruvian affiliate of Partners In Health.

Murrays work in Peru has centered around the epidemiology and genetics of tuberculosis. Her collaboration with Raychaudhuris team includes a previous study reported in Nature Communications last year that analyzed how a given individuals genetics impact their chances of becoming infected or ill with tuberculosis and identified a gene associated with TB progression.

After completing that project, Raychaudhuri and Asgari saw an opportunity to explore what the Peruvian genome might reveal about height. When their initial work revealed that there was a relationship to Marfan, other colleagues suggested they look for skin anomalies that are characteristic of variants in FBN1. The team grew, as they brought in Esther Freeman, HMS assistant professor of dermatology, a dermatologist and an epidemiologist at Massachusetts General Hospital. Working in Lima, the team tracked down homozygous individuals to analyze their skin, and found that it tracked with what would be expected with this genetic abnormality.

These diverse skills were all crucial to the process of discovery that allowed the researchers to produce this paper, the researchers said.

If you want to do really cool science you have to get out of your corner and collaborate, Asgari said.

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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Worlds Shortest Population Reveal the Largest Genetic Contributor to Height - Technology Networks

Seattle Genetics Highlights Data from Expanding Oncology Portfolio During Virtual Scientific Program of the 2020 ASCO Annual Meeting – BioSpace

Over the past six months, we have been able to deliver on our promise of bringing important new medicines to certain patients with HER2-positive metastatic breast cancer and metastatic urothelial cancer through two U.S. FDA approvals, said Clay Siegall, Ph.D., Chief Executive Officer at Seattle Genetics. We look forward to sharing data in the ASCO virtual scientific program that reinforce our ability to rapidly advance novel targeted agents across multiple tumor types.

An Expanding Portfolio of Marketed Therapies

Key data presentations will showcase progress for certain patients with HER2-positive metastatic breast cancer and metastatic urothelial cancer as well as for patients with classical Hodgkin lymphoma (HL). Highlights include:

TUKYSA Update in Patients with Brain Metastases

Results for TUKYSA in combination with trastuzumab and capecitabine in patients with brain metastases from the HER2CLIMB pivotal trial of previously treated patients with HER2-positive metastatic breast cancer will be featured in an oral session (Abstract #1005). Data will be presented from these exploratory analyses on findings from the TUKYSA arm of the study on reduction in the risk of death (OS), reduction in the risk of intracranial progression or death (CNS-PFS) and improvement of the intracranial confirmed objective response rate (ORR-IC) compared to trastuzumab and capecitabine. Data will be presented by Nancy U. Lin, Director of the Metastatic Breast Cancer Program in the Susan F. Smith Center for Womens Cancers at Dana-Farber in Boston, MA, during an oral presentation available on demand at 8:00 a.m. ET on May 29, 2020. A separate analysis of adverse events (AE) from the same trial will be presented (Abstract #1043; poster presentation).

PADCEV (enfortumab vedotin-ejfv) in Combination and in Other Solid Tumors

Additional results and durability data from the phase 1b EV-103 trial of PADCEV plus pembrolizumab in first-line metastatic urothelial cancer will be presented (Abstract #5044), and a separate Trials-in-Progress poster will provide details about a new randomized cohort added to the EV-103 study, Cohort K, which is evaluating PADCEV as monotherapy or in combination with pembrolizumab (#TPS5092). Both presentations will be featured in the Genitourinary CancerKidney and Bladder session. Data from the Cohort K, along with other data from the EV-103 trial evaluating PADCEV combined with pembrolizumab as first-line therapy for cisplatin-ineligible patients, could potentially support registration under accelerated approval regulations in the United States.

Additionally, information about the phase 2 EV-202 trial, which is studying PADCEV in six different types of locally advanced and metastatic solid tumors (HR-positive/HER2-negative and triple-negative breast cancers, squamous and non-squamous non-small cell lung cancers, head and neck cancer and gastroesophageal cancers), will be discussed in a Trials-in-Progress poster during the Developmental Therapeutics Molecularly Targeted Agents and Tumor Biology Poster Session (Abstracts #TPS3647).

ADCETRIS (brentuximab vedotin) Continues to Advance

Data to be presented on ADCETRIS will demonstrate the companys progress in efforts to continue expanding clinical research on combination regimens and monotherapy in a variety of HL and peripheral T-cell lymphoma (PTCL) patient populations, including in both older and younger disease settings. A poster presentation will highlight the potential of ADCETRIS in combination with nivolumab or dacarbazine and as a monotherapy for previously untreated older HL patients who typically have poorer outcomes than younger patients due to comorbidities and toxicities related to standard first-line chemotherapy (Abstract #8032). The primary analysis from an ongoing clinical trial evaluating ADCETRIS plus nivolumab in children, adolescents and young adults with standard-risk relapsed or refractory classical HL will also be presented (Abstract #8013; poster discussion). Lastly, two Trials-in-Progress poster presentations will highlight ongoing clinical trials evaluating ADCETRIS as a monotherapy in frontline older HL or CD30-expressing PTCL patients and in a combination regimen in frontline advanced-stage HL patients (Abstracts #TPS8069 and #TPS8068).

A Strong, Diverse Pipeline of Investigational Therapies

An additional four Trials-in-Progress posters for investigational therapies will showcase the companys continued clinical development of pipeline candidates in first-line cervical cancer (Abstract #TPS6095), metastatic breast cancer (Abstract #TPS1104), metastatic pancreatic ductal adenocarcinoma (PDAC) (Abstract #TPS4671) and other solid tumors (Abstract #TPS3652).

The abstracts published in advance of the ASCO meeting were made available today on the ASCO website. All data presentations will be available on-demand on May 29, 2020.

Details of Key Seattle Genetics Presentations at ASCO20 Virtual:

Abstract Title

Abstract #

Presentation Type

Presenter

ADCETRIS (brentuximab vedotin)

Nivolumab and brentuximab vedotin (BV)-based, responseadapted treatment in children, adolescents, and young adults (CAYA) with standard-risk relapsed/refractory classical Hodgkin lymphoma (R/R cHL): Primary analysis

8013

Poster discussion

P. Cole

Frontline Brentuximab Vedotin as Monotherapy or in Combination for Older Hodgkin Lymphoma Patients

8032

Poster presentation

C. Yasenchak

PADCEV (enfortumab vedotin-ejfv)

Study EV-103: Durability results of enfortumab vedotin plus pembrolizumab for locally advanced or metastatic urothelial carcinoma

5044

Poster presentation

J. Rosenberg

TUKYSA (tucatinib)

Tucatinib vs Placebo Added to Trastuzumab and Capecitabine for Patients with Previously Treated HER2+ Metastatic Breast Cancer with Brain Metastases (HER2CLIMB)

1005

Oral presentation

N. Lin

Management of adverse events in patients with HER2+ metastatic breast cancer treated with tucatinib, trastuzumab, and capecitabine (HER2CLIMB)

1043

Poster presentation

A. Okines

Trials-in-Progress

ADCETRIS (brentuximab vedotin)

Frontline brentuximab vedotin in Hodgkin lymphoma and CD30-expressing peripheral T-cell lymphoma for older patients and those with comorbidities

TPS8069

Poster presentation

C. Yasenchak

Brentuximab Vedotin in Combination with Nivolumab, Doxorubucin, and Dacarbazine in Newly Diagnosed Patients with Advanced Stage Hodgkin Lymphoma

TPS8068

Poster presentation

J. Friedman

PADCEV (enfortumab vedotin-ejfv)

Study EV-103: New randomized cohort testing enfortumab vedotin as monotherapy or in combination with pembrolizumab for locally advanced or metastatic urothelial carcinoma

TPS5092

Poster presentation

N. Mar

EV-202: A Phase 2 Study of Enfortumab Vedotin in Patients With Select Previously Treated Locally Advanced or Metastatic Solid Tumors

TPS3647

Poster presentation

J. Bruce

Investigational Therapies

Phase 1b/2 trial of tisotumab vedotin (TV) bevacizumab (BEV), pembrolizumab (PEM), or carboplatin (CBP) in recurrent or metastatic cervical cancer (innovaTV 205/ENGOT-cx8/GOG-3024)

TPS6095

Poster presentation

I. Vergote

SGNLVA-001: A phase 1 open-label dose escalation and expansion study of SGN-LIV1A administered weekly in breast cancer

TPS1104

Poster presentation

H. Beckwith

SGN228-001: A phase 1 open-label dose escalation and expansion study of SGN-CD228A in select advanced solid tumors

TPS3652

Poster presentation

A. Patnik

Phase 1 study of SEA-CD40, gemcitabine, nab-paclitaxel, and pembrolizumab in patients (pts) with metastatic pancreatic ductal adenocarcinoma (PDAC)

TPS4671

Poster presentation

A. Coveler

About ADCETRIS (brentuximab vedotin)

ADCETRIS is an antibody-drug conjugate (ADC) comprising an anti-CD30 monoclonal antibody attached by a protease-cleavable linker to a microtubule disrupting agent, monomethyl auristatin E (MMAE), utilizing Seattle Genetics proprietary technology. The ADC employs a linker system that is designed to be stable in the bloodstream but to release MMAE upon internalization into CD30-expressing tumor cells. Seattle Genetics and Takeda are jointly developing ADCETRIS.

About PADCEV (enfortumab vedotin-ejfv)

PADCEV is an antibody-drug conjugate (ADC) that is directed against Nectin-4, a protein located on the surface of cells and highly expressed in bladder cancer. Nonclinical data suggest the anticancer activity of PADCEV is due to its binding to Nectin-4 expressing cells followed by the internalization and release of the anti-tumor agent monomethyl auristatin E (MMAE) into the cell, which result in the cell not reproducing (cell cycle arrest) and in programmed cell death (apoptosis). PADCEV is co-developed by Seattle Genetics and Astellas.

About TUKYSA (tucatinib)

TUKYSA is an oral medicine that is a tyrosine kinase inhibitor of the HER2 protein. In vitro (in lab studies), TUKYSA inhibited phosphorylation of HER2 and HER3, resulting in inhibition of downstream MAPK and AKT signaling and cell growth (proliferation), and showed anti-tumor activity in HER2-expressing tumor cells. In vivo (in living organisms), TUKYSA inhibited the growth of HER2-expressing tumors. The combination of TUKYSA and the anti-HER2 antibody trastuzumab showed increased anti-tumor activity in vitro and in vivo compared to either medicine alone.

ADCETRIS (brentuximab vedotin) U.S. Important Safety Information

BOXED WARNING

PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY (PML): JC virus infection resulting in PML and death can occur in ADCETRIS-treated patients.

Contraindication

ADCETRIS concomitant with bleomycin due to pulmonary toxicity (e.g., interstitial infiltration and/or inflammation).

Warnings and Precautions

Administer G-CSF primary prophylaxis beginning with Cycle 1 for patients who receive ADCETRIS in combination with chemotherapy for previously untreated Stage III/IV cHL or previously untreated PTCL.

Monitor complete blood counts prior to each ADCETRIS dose. Monitor more frequently for patients with Grade 3 or 4 neutropenia. Monitor patients for fever. If Grade 3 or 4 neutropenia develops, consider dose delays, reductions, discontinuation, or G-CSF prophylaxis with subsequent doses.

Most Common (20% in any study) Adverse Reactions

Peripheral neuropathy, fatigue, nausea, diarrhea, neutropenia, upper respiratory tract infection, pyrexia, constipation, vomiting, alopecia, decreased weight, abdominal pain, anemia, stomatitis, lymphopenia, and mucositis.

Drug Interactions

Concomitant use of strong CYP3A4 inhibitors or inducers has the potential to affect the exposure to monomethyl auristatin E (MMAE).

Use in Specific Populations

Moderate or severe hepatic impairment or severe renal impairment: MMAE exposure and adverse reactions are increased. Avoid use.

Advise males with female sexual partners of reproductive potential to use effective contraception during ADCETRIS treatment and for at least 6 months after the final dose of ADCETRIS.

Advise patients to report pregnancy immediately and avoid breastfeeding while receiving ADCETRIS.

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Seattle Genetics Highlights Data from Expanding Oncology Portfolio During Virtual Scientific Program of the 2020 ASCO Annual Meeting - BioSpace

Animal Genetics Market Latest Trends and Future Growth of Industry Analysis Report to 2028 – BioSpace

The global animal genetics market is likely to rise at a healthy growth rate over the assessment timeframe. Augmented consumption of protein extracted from animals is prophesized to favor the growth of the global animal genetics market in the forthcoming years. In addition, increasing populations generates massive demand for animal-based protein, which further benefits the market.

The global animal genetics market has been segmented on the basis of region and product and services. The sole objective of providing such an all-inclusive report is to offer a deep insight into the market.

Global Animal Genetics Market: Notable Developments

The global animal genetics market has gone through a few developments in the last few years. These market developments make a manifestation of how and what is influencing the growth of the global animal genetics market. One such development is mentioned below:

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Some of the key market players of the global animal genetics market are

Global Animal Genetics Market: Growth Drivers

High Demand for Animal Protein Places the Market on a High Growth Trajectory

The global animal genetics market is estimated to experience considerable growth over the review period. Such stellar growth of the market is attributed to the augmented adoption of genetic technologies and strict implementation of animal welfare regulations.

Likewise, livestock population has witnessed a substantial rise together with awareness related to the existence of animal genetic disorders. Besides, the need to cater to the unmet demands of animal protein is likely to add fillip to the global animal genetics market over the forecast timeframe.

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With an objective to produce better milk and food products, there has been an escalation in the research and development activities by several scientists. Genetic modifications are likely to emerge as another factor supporting the expansion of the global animal genetics market in forthcoming years.

The market is also prophesized to be fuelled by rapid expansion of urbanization and rise in population, which place massive demand for animal protein. Increased adoption of various advanced genetic practices like embryo transfer, artificial insemination (AI) for production of modified breed on a large scale is estimated to favor the market in the years to come.

On the other hand, the dearth of properly skilled technicians and professional with expertise in genetic services is estimate to impede the growth of the global animal genetics market in years to come. Furthermore, strict regulations related to genetic engineering of animals together with high cost of animal testing is likely to obstruct the growth of the market.

Global Animal Genetics Market: Regional Outlook

Asia Pacific, the Middle East and Africa, South America, Europe, and North America comprise the major regions of the global animal genetics market.

Considering geographies, North America is likely to play a dominant role in the global animal genetics market over the assessment timeframe. Such regional supremacy is ascribed to the presence of a large number of well-known companies of the global animal genetics market. In addition, the presence of a well-established livestock industry is likely to propel the North America animal genetics market to prominence in the near future.

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The global animal genetics market is segmented as:

Products and Services

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Animal Genetics Market Latest Trends and Future Growth of Industry Analysis Report to 2028 - BioSpace

Predictive Genetic Testing and Consumer/Wellness Genomics Market Trends and Analysis Growth by 2025 – Cole of Duty

Predictive Genetic Testing and Consumer/Wellness Genomics Market: Snapshot

Genetic testing comprises examination of ones DNA. The term DNA refers to the chemical database that is responsible for conveying the instructions for functions that need to be performed by the body. Genetic testing is capable of revealing changes or mutations in the genes of living beings, which might result in any kind of disease or illness in the body.

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Predictive genetic testingrefers to the utilization of genetic testing methods in an asymptomatic individual to make a prediction about risk of contacting particular disease in future. These tests are regarded as representation of emerging class of medical tests, which differ in fundamental ways from the usual diagnostic tests.

The global predictive genetic testing and consumer/wellness genomics marketis likely to gather momentum owing to the benefits offered by predictive genetic testing.

The benefits of predictive genetic testing are

The global predictive genetic testing and consumer/wellness genomics marketis influenced by reducing cost of genetic sequencing and technological advancement in the field of genetics. North America is expected to emerge as a prominent region for the global predictive genetic testing and consumer/wellness genomics market in years to come due to high adoption rates of latest technologies in all fields.

Over centauries human DNA has undergone tremendous alteration due to evolutionary and lifestyle changes. They have led to both, advantages and disadvantages over the years. Some have given the mankind a deserving edge over other creatures while the others have led to disorders and diseases. Predictive genetic testing and consumer/wellness genomics market thrives on the growing demand for understanding the lineage of a certain gene pool to identify disorders that could manifest in the later or early stage of a human life. The surging demand for understanding the family history or studying the nature of certain diseases has given the global market for predictive genetic testing and consumer/wellness genomics market adequate fodder for growth in the past few years.

This new class of medical tests are aimed at reducing the risk of morbidity and mortality amongst consumers. The thorough surveillance and screening of a certain gene pool can allow an individual to avoid conditions that disrupt normal existence through preventive measures. The clinical utility of these tests remains unassessed. Therefore, increasing research and development by pharmaceutical companies to develop new drugs by understanding diseases and disorders is expected to favor market growth.

Unlike conventional diagnostic testing, predictive genetic testing identifies the risk associated with potential conditions. In certain cases it is also capable of stating when the disease may appear and the how severe will it be. Thus, this form of testing is expected to allow consumers to take up wellness measurements well in time to lead a life of normalcy, characterized by good health.

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Global Predictive Genetic Testing and Consumer/Wellness Genomics Market: Overview

Predictive genetic testing are used to identify gene mutations pertaining to the disorders that surface at a considerably later stage in life after birth. These tests are particularly beneficial for people from a family with a history of genetic disorder, although they themselves show no symptoms of the disorder at the time of testing. Genetic testing promises to revolutionize the healthcare sector, providing crucial diagnostic details related to diverse verticals such as heart disease, autism, and cancer. As the healthcare sector touches new peaks, the global predictive genetic testing and consumer/wellness genomics market is projected to expand at a healthy growth rate during the forecast period of 2017 to 2025.

This report on the global market for predictive genetic testing and consumer/wellness genomics analyzes all the important factors that may influence the demand in the near future and forecasts the condition of the market until 2025. It has been created using proven research methodologies such as SWOT analysis and Porters five forces. One of the key aspect of the report is the section on company profiles, wherein several leading players have been estimated for their market share and analyzed for their geographical presence, product portfolio, and recent strategic developments such as mergers, acquisitions, and collaborations.

The global predictive genetic testing and consumer/wellness genomics market, on the basis of test type, can be segmented into predictive testing, consumer genomics, and wellness genetics. The segment of predictive testing can be sub-segmented into genetic susceptibility test, predictive diagnostics, and population screening programs, whereas the segment of wellness genetics can be further divided into nutria genetics, skin and metabolism genetics, and others.

By application, the market can be segmented into breast and ovarian cancer screening, cardiovascular screening, diabetic screening and monitoring, colon cancer screening, Parkinsons or Alzheimers disease, urologic screening or prostate cancer screening, orthopedic and musculoskeletal screening, and other cancer screening. Geographically, the report studies the opportunities available in regions such as Asia Pacific, Europe, North America, and the Middle East and Africa.

Global Predictive Genetic Testing and Consumer/Wellness Genomics Market: Trends and Opportunities

Increasing number of novel partnership models, rapidly decreasing cost of genetic sequencing, and introduction of fragmented point-solutions across the genomics value chain as well as technological advancements in cloud computing and data integration are some of the key factors driving the market. On the other hand, the absence of well-defined regulatory framework, low adoption rate, and ethical concerns regarding the implementation, are expected to hinder the growth rate during the forecast period. Each of these factors have been analyzed in the report and their respective impacts have been anticipated.

Currently, the segment of predictive genetic cardiovascular screening accounts for the maximum demand, and increased investments in the field is expected to maintain it as most lucrative segment. On the other hand, more than 70 companies are currently engaged in nutrigenomics, which is expected to further expand the market.

Global Predictive Genetic Testing and Consumer/Wellness Genomics Market: Regional Outlook

Owing to robust healthcare infrastructure, prevalence of cardiovascular diseases, and high adoptability rate of new technology makes North America the most lucrative region, with most of the demand coming from the country of the U.S. and Canada. Several U.S. companies hold patents, which further extends the outreach of the market in the region of North America.

Companies mentioned in the research report

23andMe, Inc, BGI, Genesis Genetics, Illumina, Inc, Myriad Genetics, Inc, Pathway Genomics, Color Genomics Inc., and ARUP Laboratories are some of the key companies currently operating in global predictive genetic testing and consumer/wellness genomics market. Various forms of strategic partnerships with operating company and smaller vendors with novel ideas helps these leading players maintain their position in the market.

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About TMR Research

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Predictive Genetic Testing and Consumer/Wellness Genomics Market Trends and Analysis Growth by 2025 - Cole of Duty

Two new Corresponding Members admitted to the Academy – Australian Academy of Science

May 14, 2020

Professor Jane Langdale, of the Plant Sciences Department at the University of Oxford, and Professor Erwin Neher, of the Max Planck Institute for Biophysical Chemistry in Germany, have been admitted as Corresponding Members ofthe Australian Academy of Science for their outstanding contributions to science.

Corresponding Members of the Academy are eminent scientists not resident in Australia. They are elected based on scientific excellence, with consideration given to their connection to Australian science. The Academy will announce the election of 24 distinguished Australian scientists as New Fellows later this month.

Professor Jane Langdales research has transformed our understanding of how plants initiate leaves, how leaves adapted to major evolutionary transitions and how those changes affect photosynthesis in land plants.

She has explained various plant mechanisms, including organ inception and specification at the tip of shoots, patterning of distinct cell-typesand the development of chloroplasts.

Importantly, Professor Langdalehas carried outresearch in a comparative framework, advancing our understanding of leaf development not just in model flowering plant species but in species from all of the major land plant lineages.

What are you most proud of in your research?

The peopleI have worked with over the years. Any recognition of my research is recognition of the wonderful people who have contributed to the discoveries that we have madefrom the technicians who wash the lab glassware to the postdocs who challenge my ideas and prove me wrong.

What does your election to the Academy mean to you?

I have family, friends and many colleagues in Australia, and to be recognised by the national Academy is an incredible honour. I hope that I am able to contribute to the Academys mission in a meaningful way.

"Science should never be a single nation endeavour. Interactions and collaboration between people from different cultures, with a broad range of views and experiences, are essential for the synergy that fuels truly original and creative scientific advances.

Professor Erwin Neher is a world-renowned biophysicist specialising in the field of cell physiology. He is internationally known for his ground-breaking development of the patch clamp technique and further discoveries concerning the function of single ion channels in living cells, which allow cells to communicate with their surroundings.

Using this technique, Professor Neher was able to take ion channels from a physiological concept to the reality of biological macromolecules, revolutionising modern biology, facilitating research, and contributing to the understanding of the cellular mechanisms underlying several diseasesincluding diabetes and cystic fibrosis.

For his outstanding contributions, in 1991 he was awarded, along with Bert Sakmann, the Nobel Prize in Physiology or Medicine.

What are you most proud of in your research?

Following the development of the patch clamp, researchers worldwide adopted this technique for the study of diseases and drug action. Although I never did clinical work myself, this indirectly led to novel medications and improved therapies, which I am proud of.

What does your election to the Academy mean to you?

I first visited Australia in 1985 and since then kept contact with many of my colleagues. I consider election to the Academy as a major recognition of my work and as a unique chance to maintain contacts.

The laws of nature do not distinguish between countries and continents. The goal of science is to decipher these laws and scientists share their insights in this respect in a remarkable way. Most of us see our task as a joint effort, which is substantially enhanced by international cooperation.

Professor Langdale and Professor Neher join just 33 Corresponding Members of the Academy, including Nobel Laureates Professor Elizabeth Blackburn andProfessorRolf Zinkernageland Fields Medal recipient Professor Akshay Venkatesh.

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Two new Corresponding Members admitted to the Academy - Australian Academy of Science