Cardiologists share historic research that led to FDA’s long-awaited approval of coronary DCB – Cardiovascular Business

Overall, clinical procedural success rates (92.1% for DCB patients vs. 88.7% for uncoated balloon patients) and technical success rates (93.4% for DCB patients vs. 89.7% for uncoated balloon patients) were similar. Bailout stents, meanwhile, were required for three patients treated with a paclitaxel-coated balloon and one patient treated with an uncoated balloon.

Target lesion failure after 12 months was seen in 17.9% of DCB patients and 28.6% of uncoated balloon patients. This difference was primarily attributed to lower rates of ischemia-driven revascularization and target vessel myocardial infarction among patients in the DCB group.

Drug-coated balloons have emerged internationally as an alternative treatment option, but despite promising international data, they have not been previously evaluated or approved for use in the United States, lead investigator Robert W. Yeh, MD, MSc, MBA, director of the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology and section chief of interventional cardiology at Beth Israel Deaconess Medical Center, said in a statement. Even with advances in stent technology, patients with coronary in-stent restenosis continue to comprise approximately 10% of individuals undergoing angioplasty interventions each year. In particular, patients with multiple prior stents have very poor long-term outcomes. There's growing sentiment that drug-coated balloons could address an unmet clinical need among patients with coronary artery disease in the United States.

Click here to read the full analysis in JAMA, a journal from the American Medical Association.

When the initial positive results from AGENT IDE were presented at TCT 2023, cardiologists were thrilled that a coronary DCB could finally be on its way toward FDA approval.

Our European colleagues have had these devices for a decade, Ajay J. Kirtane, MD, an interventional cardiologist with the Columbia University Department of Medicine, said during a TCT press conference in October 2023. In the United States, we basically tell patients routinely that we can use a peripheral balloon that is too big for your coronary and try to put it in your coronary to prevent the restenosis from happening, or you can buy a ticket to London and go over there to get this treated. Its embarrassing.

American College of Cardiology President B. Hadley Wilson, MD, meanwhile, described the new analysis as a game changer.

For 25 years, weve been trying to peel back this restenosis problem, he said during the same press conference. Now we can see light at the end of the tunnel.

Boston Scientific said the Agent DCB should be available on the U.S. market in the coming months.

In addition, AGENT IDEs researchers will be tracking patient data for up to five years, so expect updates on their findings as time goes on.

Follow this link:

Cardiologists share historic research that led to FDA's long-awaited approval of coronary DCB - Cardiovascular Business

SS Innovations’ SSi Mantra Surgical Robotic System used to perform Mitral Valve Replacement – Diagnostic and Interventional Cardiology

March 18, 2024 SS Innovations International, Inc., a developer of innovative surgical robotic technologies dedicated to making world class robotic surgery affordable and accessible to a global population, today announced that surgeons have successfully performed the worlds first mitral valve replacement using the Made in India, SSi Mantra Surgical Robotic System. This procedure was carried out at the Narayana Hrudayalaya Institute of Cardiac Sciences in Bengaluru, India, and represents a milestone in the treatment of heart disease using the SSi Mantra Surgical Robotic System.

The mitral valve surgery was performed by Dr. Nitin Kumar Rajput from the Narayana Institute of Cardiac Sciences in Bengaluru, Karnataka, and guided by SS Innovations Founder and Chairman, Dr. Sudhir Srivastava, one of the early pioneers of robotic cardiac bypass surgery.

Considering this accomplishment, Dr. Srivastava commented, We are very proud of our team for pushing the envelope to be able to add the field of full spectrum robotic cardiac surgery to all other surgical subspecialties. 90-95% of all cardiac surgeries are still done today using large sternum splitting incisions. Since the inception of the Company, it was always our goal to address the need of offering a highly minimally invasive solution for cardiac patients.

During my practice in the US, I found that patients benefited immensely from surgical approaches which spared splitting of the sternum. Many patients would be discharged the following day and in full functional recovery in just a week to ten days later. The results were inspiring. This led me to develop more complex robotic bypass procedures that were adopted by other surgeons and would ultimately benefit more and more patients who underwent heart surgery.

We are very proud that using our Made in India, SSi Mantra Surgical Robotic System, we have performed a variety of robotic heart surgeries including, Bilateral Internal Mammary Takedowns, Totally Endoscopic Coronary Artery Bypass on a beating heart, Atrial Septal Defect Repair and now a completely robotic Mitral Valve Replacement. I am very pleased that our original goal is now being met in conjunction with the highly talented surgeons at the Narayana Institute of Cardiac Sciences.

Dr. Nitin Kumar Rajput, Consultant Cardiac Surgeon from Narayana Health, the primary surgeon on the Mitral Valve Replacement, commented following the successful completion of the procedure, We have performed more than 60 CABGs (Heart Bypass Procedures) with the SSi Mantra Surgical Robotic System and we just did our first Robotic Mitral Valve Repair a few days back. The surgery went flawlessly, and it was wonderful operating with the Mantra System. Four ports were made for the robotic arm and a tiny 2.5 cm working port for the table side assistant. The surgery was completed quickly; the patient did well in the postoperative period and was discharged with good exercise tolerance three days post-surgery.

Dr. Srivastava said: SS Innovations is dedicated to improving patient access and optimizing surgical outcomes with our accessible and cost-effective surgical robotic system. We recognize the immense opportunity to address the significant unmet need for safe, timely, and affordable cardiac surgical care in India and around the world.

This milestone procedure is a testament to our commitment to advancing cardiac care. The successful operation opens new avenues for treating cardiac conditions, offering patients less invasive options, reduced recovery times, and better results.

The SSi Mantra embodies innovation and excellence and provides unmatched precision and control in robotic-assisted surgeries. Today's success is a proud moment for everyone at SS Innovations and our partners at Narayana Hrudayalaya, concluded Dr. Srivastava.

The mitral valve disease market size was valued at $2.5 billion in 2021 and is estimated to reach $5.7 billion by 2031, growing at a CAGR of 8.8% from 2022 to 2031.

The SSi Mantra Surgical Robotic System, the first surgical robotic system to be made in India, and one of the few cost-effective global options with a wide range of surgical applications, has received regulatory approval in India, Indonesia and Guatemala, and is clinically validated for over 50 different types of surgical procedures. To date, more than 800 surgical procedures have been conducted using the system. SS Innovations has initiated the regulatory approval process in the United States and the EU, with approvals anticipated in the latter half of 2024 or 2025.

For more information: http://www.ssinnovations.com

View original post here:

SS Innovations' SSi Mantra Surgical Robotic System used to perform Mitral Valve Replacement - Diagnostic and Interventional Cardiology

Gilbert H. L. Tang Appointed Editor-in-Chief of JACC: Case Reports – Diagnostic and Interventional Cardiology

March 15, 2024 Renowned cardiovascular surgeon Gilbert H. L. Tang, MD, has been named Editor-in-Chief ofJACC: Case Reports, bringing a wealth of experience and expertise to the helm of one of the top cardiovascular journals published by the American College of Cardiology.

I am both honored and humbled to be a cardiac surgeon among the Editor-in-Chiefs in theJACCfamily of journals, Tang said. It is going to be an exciting time forJACC: Case Reportsto build on a team of multidisciplinary cardiovascular practitioners with diverse backgrounds and experiences, and at different stages of their professional careers, to enhance the journals academic and educational impact globally.

Tang is currently serving as a professor in the Department of Cardiovascular Surgery at the Icahn School of Medicine at Mount Sinai, the surgical director of the Structural Heart Program at the Mount Sinai Health System, and the director of Structural Heart Education at the Mount Sinai Fuster Heart Hospital in New York.

JACC: Case Reportsis one of 10 journalsin the ACCsJACCplatform of journals. It publishes high-quality, educationally valuable case reports, case series, images, and quality improvement projects covering all aspects of cardiology. It serves as a publication vehicle for early career cardiologists and members of the cardiovascular care team, providing a forum for mentorship on the review and publication process.

Widely recognized for pioneering innovative concepts and techniques in TAVR, Tang has set contemporary standards in the field. His impressive international academic collaborations include the establishment of multiple global registries and the training of heart teams in structural heart imaging and procedures worldwide. His research centers on the comprehensive management of patients post-TAVR, transcatheter mitral and tricuspid valve interventions, and advanced imaging techniques in structural heart disease.

In addition to serving on committees in the Heart Valve Collaboratory, and several clinical trials in structural heart, he has served as a member of the ACC Scientific Publications Committee. He is also a member of the ACC/STS TVT Research and Publications Committee, a four-time recipient of theJACCSimon Dack Award for Outstanding Scholarship and has served as an associate editor forCirculation: Cardiovascular Interventions.

Tang is a Diplomat and Fellow of the Royal College of Physicians and Surgeons of Canada (FRCSC), Fellow of the American College of Cardiology (FACC), and the first surgeon fellow of the Society for Cardiovascular Angiography and Interventions (SCAI). He has published over 250 peer-reviewed articles and lectures extensively worldwide.

Together with members of our editorial board and through closer collaborations with international communities and theJACCfamily of journals, we will strive to makeJACC: Case Reportsthe go-to digital resource to improve cardiovascular care and training worldwide, Tang said.

As the new Editor-in-Chief, Tang will officially assume the role of Editor in Chief on August 1, 2024,with his first issue slated for August 7, 2024.

For more information:www.jacc.org

Continued here:

Gilbert H. L. Tang Appointed Editor-in-Chief of JACC: Case Reports - Diagnostic and Interventional Cardiology

Meth-Related Cardiomyopathy: Where the Biggest Clusters Are – Medpage Today

The American West has seen the biggest surge of cardiomyopathy-associated hospital admissions among methamphetamine users, based on 13 years of the latest available hospital admission data.

The National Inpatient Sample (NIS) showed that methamphetamine-related cardiomyopathy admissions spiked by 231% from 2008 to 2020 nationwide -- whereas overall admissions for heart failure increased just 12% during this period, according to Mohammad Bhuiyan, PhD, of Louisiana State University Health Sciences Center at Shreveport, and colleagues.

They reported various geographical and social disparities evident across methamphetamine-related cardiomyopathy admissions:

"Demographically, cardiomyopathy among methamphetamine users occurs predominantly in middle-aged patients and men and tends to be concentrated more in the western region of the United States," Bhuiyan's team reported in JACC: Advances.

Methamphetamine (popularly known as "meth") is a highly addictive psychostimulant drug. It is available as a prescription drug for obesity and attention deficit-hyperactivity disorder, while illegal versions are derived from over-the-counter drugs. An estimated 1.6 million U.S. adults reported past-year methamphetamine use in 2015-2018, the CDC estimates.

Methamphetamine has known links to cardiovascular disease (CVD), including cardiomyopathy, heart failure, pulmonary hypertension, and coronary artery disease.

"Given the rapidly increasing global burden of methamphetamine-associated cardiomyopathy, this work ... should be a call to action for researchers, healthcare providers, and policymakers to fight this growing epidemic. Importantly, the healthcare system must also acknowledge and address its bias towards patients with substance use disorders," urged cardiologist Nisha Parikh, MD, MPH, of University of California San Francisco Health, and two colleagues.

In an accompanying editorial, the trio said the present NIS study extends prior work showing that meth-associated heart failure (MethHF) hospitalizations increased at an exponential rate between 2002 and 2014, particularly on the West Coast and among men, younger patients, and lower socioeconomic groups. Also disproportionately affected were people of Hispanic, Native American, and Asian/Pacific Islander descent.

"This work should lead us to interrogate why certain geographic areas and populations suffer a disproportionate burden of MethHF and the ways in which local public policies, differential availability of psychostimulant drugs, and socioeconomic disparities have shaped the epidemic," Parikh and colleagues wrote.

They stressed the importance of targeted interventions -- development of a pharmacotherapy for methamphetamine use disorder (MAUD), for example -- and recognition of the "competing health and life priorities relevant for this vulnerable patient population."

"We should also consider employing innovative, multidisciplinary approaches to co-manage heart failure and MAUD. For example, the development of specialty heart failure clinics that also offer contingency management -- a highly effective, evidence-based behavioral treatment for MAUD -- deserves further study and potential scale up," the editorialists wrote.

The NIS study relied on hospital records from all 50 states and captured over 12.8 million cardiomyopathy-associated hospital admissions (59.3% men, over 57% were older than 65) during the study period.

Of these admissions, 222,727 were related to methamphetamine users based on medical records (58.5% men, over 55% were ages 41-64 years). Notably, people who used methamphetamine together with other drugs were excluded from the study.

Bhuiyan's group acknowledged that the study lacked individual-level data and any postdischarge information. The authors were also uncertain how people came to be diagnosed as methamphetamine users.

"Further research is warranted to identify high-risk populations and develop strategies to prevent and mitigate CVD among methamphetamine users," they urged.

Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures

The study was supported by grants or awards from the National Institutes of Health and Louisiana State University.

Bhuiyan and Parikh had no disclosures.

Co-editorialists reported support from the NIDA and Chan Zuckerberg BioHub San Francisco.

Primary Source

JACC: Advances

Source Reference: Al-Yafeai Z, et al "Cardiomyopathy-associated hospital admissions among methamphetamine users: geographical and social disparities" JACC Adv 2024; DOI: 10.1016/j.jacadv.2024.100840.

Secondary Source

JACC: Advances

Source Reference: Walker SL, et al "Facing a tsunami: methamphetamine heart failure demands novel approaches" JACC Adv 2024; DOI: 10.1016/j.jacadv.2024.100838.

Read the original here:

Meth-Related Cardiomyopathy: Where the Biggest Clusters Are - Medpage Today

Most physicians think private equity is bad for healthcare – Cardiovascular Business

Overall, 60.8% of physicians said they view the involvement of PE in healthcare in a negative light. Just 10.5% of physicians said they have a positive opinion about PE, and the remaining 28.8% said they were neutral. In addition, 52% of respondents said they think PE ownership is worse than being owned by a not-for-profit hospital or health system.

What is it about PE involvement that worries physicians the most? Its potential impact on physician well-being, healthcare prices/spending and health equity were the three most common concerns.

The authors also noted that the small subset of physicians who are owned by a PE-backed group were less likely to report high professional satisfaction and autonomy than physicians not owned by a PE-backed group. They were also less likely to say they would likely remain with their employer.

While this survey had a limited sample size and is not generalizable to non-ACP members, our findings add to the dearth of evidence on PEs perceived effects on physicians, the authors wrote. Our estimates of PE-involved physicians mirror those in the literature and suggest new areas for inquiry around clinical practice and workplace experience.

Read the full research letter in JAMA Internal Medicine here.

The rise of PE continues to be one of the biggest trends in all of healthcare, and its presence in cardiologyseems to be growing by the day. Cardiovascular Associates of America, Cardiovascular Logistics and other PE-backed cardiology management groups are acquiring more and more practices, and the trend has shown no signs of slowing down.

Click here and here for additional insights into PE's impact on cardiovascular care in the United States.

Originally posted here:

Most physicians think private equity is bad for healthcare - Cardiovascular Business

Intravascular imaging during PCI in heart disease patients improves survival, reduces adverse outcomes – News-Medical.Net

Using intravascular imaging to guide stent implantation during percutaneous coronary intervention (PCI) in heart disease patients significantly improves survival and reduces adverse cardiovascular events compared to angiography-guided PCI alone, the most commonly used method.

These are the results from the largest and most comprehensive clinical study of its kind comparing two types of intravascular imaging methods (intravascular ultrasound, or IVUS, and optical coherence tomography, or OCT) with angiography-guided PCI. The study, published Wednesday, February 21, in The Lancet, is the first to show that these two methods of high-resolution imaging can reduce all-cause death, heart attacks, stent thrombosis, and the need for revascularization.

Our study, representing a synthesis of all early and recent clinical studies, has shown for the first time that the routine use of intravascular imaging guidance improves survival and enhances all aspects of the safety and effectiveness of coronary stenting, even with excellent contemporary drug-eluting stents."

Gregg W. Stone, MD.,first author

Dr. Stone is Director of Academic Affairs for the Mount Sinai Health System, and Professor of Medicine (Cardiology), and Population Health Science and Policy, at the Icahn School of Medicine at Mount Sinai.

"Prior studies had shown benefits of intravascular imaging, but never to this extent," Dr. Stone adds. "The addition of four recent trials in which 7,224 patients were enrolled now shows that intravascular imaging reduces all-cause death and all heart attacks across the wide range of patients who undergo stent treatment. As such, the routine use of intravascular imaging to guide stent implantation is one of the most effective therapies we have to improve the prognosis of patients with coronary artery disease."

Patients with coronary artery disease-;plaque buildup inside the arteries that leads to chest pain, shortness of breath, and heart attack-;often undergo PCI, a non-surgical procedure in which interventional cardiologists use a catheter to place stents in the blocked coronary arteries to restore blood flow. Interventional cardiologists most commonly use angiography to guide PCI, which involves a special dye (contrast material) and X-rays to see how blood flows through the heart arteries to highlight any blockages.

Angiography has limitations, however, making it difficult to determine the true artery size and the makeup of the plaque, and is suboptimal in identifying whether the stent is fully expanded post-PCI and in detecting other conditions that affect the early and late outcomes of the procedure. Intravascular ultrasound was introduced more than 30 years ago to provide a more accurate and specific picture of the coronary arteries. Even though studies have shown that IVUS-guided PCI is superior to angiography-guided PCI and reduces cardiovascular events, it is only used in roughly 15 to 20 percent of PCI cases in the United States, since the images may be difficult to interpret and the procedure is not fully reimbursed.

Optical coherence tomography uses light instead of sound to create images of the blockages. OCT images are much higher in resolution, more accurate, and more detailed compared to IVUS, and easier to interpret. However, as a newer technique, OCT is used in only 3 percent of PCI cases, partly because of a lack of study data-;a limitation this new study has addressed.

In their study, the researchers analyzed data from 15,964 patients undergoing PCI from 22 trials in hundreds of centers from the United States, Europe, Asia, and elsewhere between March 2010 and August 2023. Patients underwent either angiography-guided PCI or intravascular imaging-guided PCI using either IVUS or OCT. During follow-up ranging from 6-60 months with a mean of two years, patients who received intravascular imaging guidance experienced a 25 percent reduction in all-cause death, 45 percent reduction in cardiac death, 17 percent reduction in all myocardial infarctions, and 48 percent reduction in stent thrombosis compared with angiography guidance. The study also found that intravascular imaging reduced target vessel myocardial infarction by 18 percent and target lesion revascularization by 28 percent. The outcomes were similar for OCT-guided and IVUS-guided PCI.

"With these results, we now need to shift from performing more studies to determine whether intravascular imaging is beneficial, to increasing efforts to overcome the remaining impediments to the routine use of OCT and IVUS, including better training of physicians and staff and increasing reimbursement," Dr. Stone said. "In this regard, we now have better 'hard evidence' that intravascular imaging guidance of PCI procedures makes a greater impact to improving our patients' lives than other routine therapies which are more widely used and reimbursed."

Read more from the original source:

Intravascular imaging during PCI in heart disease patients improves survival, reduces adverse outcomes - News-Medical.Net

The Road to Biology 2.0 Will Pass Through Black-Box Data – Towards Data Science

AI-first Biotech This year marks perhaps the zenith of expectations for AI-based breakthroughs in biology, transforming it into an engineering discipline that is programmable, predictable, and replicable. Drawing insights from AI breakthroughs in perception, natural language, and protein structure prediction, we endeavour to pinpoint the characteristics of biological problems that are most conducive to being solved by AI techniques. Subsequently, we delineate three conceptual generations of bio AI approaches in the biotech industry and contend that the most significant future breakthrough will arise from the transition away from traditional white-box data, understandable by humans, to novel high-throughput, low-cost AI-specific black-box data modalities developed in tandem with appropriate computational methods. 46 min read

This post was co-authored with Luca Naef.

The release of ChatGPT by OpenAI in November 2022 has thrust Artificial Intelligence into the global public spotlight [1]. It likely marked the first instance where even people far from the field realised that AI is imminently and rapidly altering the very foundations of how humans will work in the near future [2]. A year down the road, once the limitations of ChatGPT and similar systems have become better understood [3], the initial doom predictions ranging from the more habitual panic about future massive job replacement by AI to declaring OpenAI as the bane of Google, have given place to impatience why is it so slow?, in the words of Sam Altman, the CEO of OpenAI [4]. Familiarity breeds contempt, as the saying goes.

We are now seeing the same frenetic optimism around AI in the biological sciences, with hopes that are probably best summarised by DeepMind

Continued here:

The Road to Biology 2.0 Will Pass Through Black-Box Data - Towards Data Science

How to better research the possible threats posed by AI-driven misuse of biology – Bulletin of the Atomic Scientists

Over the last few months, experts and lawmakers have become increasingly concerned that advances in artificial intelligence could help bad actors develop biological threats. But so far there have been no reported biological misuse examples involving AI or the AI-driven chatbots that have recently filled news headlines. This lack of real-world wrongdoing prevents direct evaluation of the changing threat landscape at the intersection of AI and biology.

Nonetheless, researchers have conducted experiments that aim to evaluate sub-components of biological threatssuch as the ability to develop a plan for or obtain information that could enable misuse. Two recent effortsby RAND Corporation and OpenAIto understand how artificial intelligence could lower barriers to the development of biological weapons concluded that access to a large language model chatbot did not give users an edge in developing plans to misuse biology. But those findings are just one part of the story and should not be considered conclusive.

In any experimental research, study design influences results. Even if technically executed to perfection, all studies have limitations, and both reports dutifully acknowledge theirs. But given the extent of the limitations in the two recent experiments, the reports on them should be seen less as definitive insights and more as opportunities to shape future research, so policymakers and regulators can apply it to help identify and reduce potential risks of AI-driven misuse of biology.

The limitations of recent studies. In the RAND Corporation report, researchers detailed the use of red teaming to understand the impact of chatbots on the ability to develop a plan of biological misuse. The RAND researchers recruited 15 groups of three people to act as red team bad guys. Each of these groups was asked to come up with a plan to achieve one of four nefarious outcomes (vignettes) using biology. All groups were allowed to access the internet. For each of the four vignettes, one red team was given access to an unspecified chatbot and another red team was given access to a different, also unspecified chatbot. When the authors published their final report and accompanying press release in January, they concluded that large language models do not increase the risk of a biological weapons attack by a non-state actor.

This conclusion may be an overstatement of their results, as their focus was specifically on the ability to generate a plan for biological misuse.

The other report was posted by the developers of ChatGPT, OpenAI. Instead of using small groups, OpenAI researchers had participants work individually to identify key pieces of information needed to carry out a specific defined scenario of biological misuse. The OpenAI team reached a conclusion similar to the RAND teams: GPT-4 provides at most a mild uplift in biological threat creation accuracy. Like RAND, this also may be an overstatement of results as the experiment evaluated the ability to access information, not actually create a biological threat.

The OpenAI report was met with mixed reactions, including skepticism and public critique regarding the statistical analysis performed. The core objection was the appropriateness of the use of a correction during analysis that re-defined what constituted a statistically significant result. Without the correction, the results would have been statistically significantthats to say, the use of the chatbot would have been judged to be a potential aid to those interested in creating biological threats.

Regardless of their limitations, the OpenAI and RAND experiments highlight larger questions which, if addressed head-on, would enable future experiments to provide more valuable and actionable results about AI-related biological threats.

Is there more than statistical significance? In both experiments, third-party evaluators assigned numeric scores to the text-based participant responses. The researchers then evaluated if there was a statistically significant difference between those who had access to chatbots and those who did not. Neither research team found one. But typically, the ability to determine if a statistically significant difference exists largely depends on the number of data points; more data points allow for a smaller difference to be considered statistically significant. Therefore, if the researchers had many more participants, the same differences in score could have been statistically significant.

Reducing text to numbers can bring other challenges as well. In the RAND study, the teams, regardless of access to chatbots, did not generate any plans that were deemed likely to succeed. However, there may have been meaningful differences in why the plans were not likely to succeed, and systematically comparing the content of the responses could prove valuable in identifying mitigation measures.

In the OpenAI work, the goal of the participants was to identify a specific series of steps in a plan. However, if a participant were to miss an early step in the plan, all the remaining steps, even if correct, would not count towards their score. This meant that if someone made an error early on, but identified all the remaining information correctly, they would score similarly to someone who did not identify any correct information. Again, researchers may gain insight from identifying patterns in which steps and why participants failed.

Are the results generalizable? To inform an understanding of the threat landscape, conclusions must be generalizable across scenarios and chatbots. Future evaluators should be clear on which large language models are used (the RAND researchers were not). It would be helpful to understand if researchers achieve a similar answer with different models or different answers with the same model. Knowing the specifics would also enable comparisons of results based on the characteristics of the chatbot used, enabling policymakers to understand if models with certain characteristics have unqiue capabilities and impact.

The OpenAI experiment used just one threat scenario. There is not much reason to believe that this one scenario is representative of all threat scenarios; the results may or may not generalize. There is a tradeoff in using one specific scenario; it becomes tenable for one or two people to evaluate 100 responses. On the other hand, the RAND work was much more open-ended as participant teams were given flexibility in how they decided to achieve their intended goal. This makes the results more generalizable, but required a more extensive evaluation procedure that involved many experts to sufficiently examine 15 diverse scenarios.

Are the results impacted by something else? Part way through their experiment, the RAND researchers enrolled a black cell, a group with significant experience with large language models. The RAND researchers made this decision because they noticed that some of their studys red teams were struggling to bypass safety features of the chatbots. In the end, the black cell received an average score almost double that of the corresponding red teams. The black cell participants didnt need to rely only on their expertise with large language models; they were also adept at interpreting the academic literature about those models. This provided a valuable insight to the RAND researchers, which is [t]herelative outperformance of the black cell illustrates that a greater source of variability appears to be red team composition, as opposed to LLM access. Simply put, it probably matters more who is on the team than if the team has access to a large language model or not.

Moving forward. Despite their limitations, red teaming and benchmarking efforts remain valuable tools for understanding the impact of artificial intelligence on the deliberate biological threat landscape. Indeed, the National Institute of Standards and Technologys Artificial Intelligence Safety Institute Consortiuma part of the US Department of Commercecurrently has working groups focused on developing standards and guidelines for this type of research.

Outside of technical design and execution of the experiments, challenges remain. The work comes with meaningful financial costs including the compensation of participants for their time (OpenAI pays $100 per hour to experts); for indviduals to recruit participants, design experiments, administer the experiments, and analyze data; and of biosecurity experts to evaluate the responses. Therefore, it is important to consider who will fund this type of work in the future. Should artificial intelligence companies fund their own studies, a perceived conflict of interest will linger if the results are intended to be used to inform governance or public perception of their models risks. But at the same time, funding that is directed to nonprofits like RAND Corporation or to academia does not inherently enable researchers access to unreleased or modified models, like the version used in the OpenAI experiment. Future work should learn from these two reports, and could benefit from considering the following:

The path toward more useful research on AI and biological threats is hardly free of obstacles. Employees at the National Institute of Standards and Technology have reportedly expressed outrage regarding the recent appointment of Paul Christianoa former OpenAI researcher who has expressed concerns that AI could pose an existential threat to humanityto a leadership role at the Artificial Intelligence Safety Institute. Employees are concerned that Christianos personal beliefs about catastrophic and extistential risk posed by AI broadly will affect his ability to maintain the National Institute of Standards and Technologys commitment to objectivity.

This internal unrest comes on the heels of reporting that the physical buildings that house the institute are falling apart. As Christiano looks to expand his staff, he will also need to compete against the salaries paid by tech companies. OpenAI, for example, is hiring for safety-related roles with the low end of the base salary exceeding the high end of the general service payscale (federal salaries). It is unlikely that any relief will come from the 2024 federal budget, as lawmakers are expected to decrease the institutes budget from 2023 levels. But if the United States wants to remain a global leader in the development of artificial intelligence, it will need to make financial commitments to ensure that the work required to evaluate artificial intelligence is done right.

See the rest here:

How to better research the possible threats posed by AI-driven misuse of biology - Bulletin of the Atomic Scientists

Nobel-winning biologist on the most promising ways to stop ageing – New Scientist

ANTI-AGEING is big business. From books encouraging diets such as intermittent fasting to cosmetic creams to combat wrinkles, a multibillion-dollar industry has been built on promises to make us live longer and look younger. But how close are we really to extending our lifespan in a way that gives us extra years of healthy life?

Nobel prizewinner Venki Ramakrishnan, a molecular biologist and former president of the UKs Royal Society, is the latest to tackle this question. He has spent 25 years studying the ribosome, which is where our cells make proteins using the information encoded in our genes, at the MRC Laboratory of Molecular Biology in Cambridge, UK.

In his latest book, Why We Die: The new science of ageing and the quest for immortality, he goes on a journey around the cutting-edge biology of human ageing and asks whether it will be possible to extend our lifespan in the near future.

He talks to New Scientist about the recent breakthroughs in our knowledge of what causes ageing, how close we are to creating therapeutics to combat it, and the potential consequences if we succeed.

Graham Lawton: What inspired you to take a break from a hugely successful career researching how cells make proteins to write a book about ageing?

Venki Ramakrishnan: Two things. One is that the translation of genetic code into proteins affects almost every biological process, and it turns out to be central to many aspects of ageing.

The other reason is that we have worried about ageing and death ever since we

See original here:

Nobel-winning biologist on the most promising ways to stop ageing - New Scientist

Understanding Reductionism and ID – Discovery Institute

Photo: Monarch butterfly, by liz west from Boxborough, MA [CC BY 2.0 ], via Wikimedia Commons.

The burgeoning field of systems biology, as defined by the National Institutes of Health (NIH),

is an approach in biomedical research to understanding the larger picture be it at the level of the organism, tissue, or cell by putting its pieces together. Its in stark contrast to decades of reductionist biology, which involves taking the pieces apart.

Im sure that statement is designed to make systems biology sound radical and exciting, and it succeeds. Its especially exciting for proponents of intelligent design, because ID theorists have been arguing against reductionism in biology for a long time.

But we need to be careful. We dont want to make an argument based on an equivocation. The word reductionism is thrown around a lot, but it can mean several different things. Its not as simple as saying, Biologists are learning that reductionism is bad!

As it turns out, the move away from reductionism in systems biologyissignificant for the ID debate, but not simply by word-association. So I want to take some time to suss out the different meanings of the word reductionism and what they have to do with intelligent design.

There are two kinds of reductionism that are relevant to this discussion:methodological reductionismandontological reductionism. (For a third kind,epistemological reductionism,see this cartoon.) The opposing philosophies are, respectively, methodologicalantireductionism and ontologicalantireductionism. The terms are a bit eye-splitting, but they arent difficult to understand.

Methodological reductionism is the idea that a thing can best be understood by breaking it down into its parts. The contrary philosophy, methodological antireductionism, says that a thing can be best understood by looking at it as a whole.

The opposing views are summed up nicely in a conversation between the wizards Saruman and Gandalf inThe Lord of the Rings. Saruman shows Gandalf his new rainbow-colored outfit and tells him that he has decided to stop going by Saruman the White and go by Saruman of Many Colours instead.

I liked white better, says Gandalf.

White! Saruman sneers. It serves as a beginning. White cloth may be dyed. The white page can be overwritten; and the white light can be broken.

In which case it is no longer white, says Gandalf. And he that breaks a thing to find out what it is has left the path of wisdom.

Saruman is a methodological reductionist and Gandalf is a methodological antireductionist.

Methodological reductionism:The white light can be broken.

Methodological antireductionism:He that breaks a thing to find out what it is has left the path of wisdom.

Ontological reductionism, on the other hand, is not about the best way to study something, but rather about what that thing really is at the deepest level. Ontological reductionism says that a thing can be reduced to its most basic parts, and thats what it is nothing more. According to this theory, a tree is a collection of cells, which in turn are collections of molecules, which are collections of atoms, which are collections of subatomic particles. So in the final analysis, a tree is a collection of subatomic particles.

This view, and its antithesis, is expressed in C. S. LewissVoyage of the Dawn Treader. On an island near the edge of the world, the characters meet a being named Ramandu who claims to be a star.

In our world, Eustace Scrubb objects, a star is a huge ball of flaming gas.

Even in your world, my son, replies Ramandu, that is not what a star is but only what it is made of.

Eustace is an ontological reductionist and Ramandu is an ontological antireductionist. (And if Ramandus statement seems mind-bending or baffling, thats because most of us were educated into ontological reductionism.)

Ontological reductionism:A star is a huge ball of flaming gas.

Ontological antireductionism: That is not what a star is but only what it is made of.

The field of systems biology ismethodologicallyantireductionist. It does not have to be ontologically antireductionist. So, systems biologists do not necessarily reject materialism or physicalism. They do not have to believe in minds, or be willing to posit neo-Platonic souls of cabbages, or think the true meaning of a mushroom can only be found in its wholeness.

They have simply found it to be the case that looking at living organisms as complete systems yields better results than only taking them apart to focus on their bare components. Researchers are coming to realize that it is more productive to think about the plan of an organism than simply about its physical structure or components.

But this is important, because whether systems biologists always admit it or not, methodological antireductionismimpliesontological antireductionism. Gandalf agrees with Ramandu, not Eustace.

Thats not to say that ontological antireductionism logically follows from methodological antireductionism, or vice versa. In theory, you could have one without the other. But the success of methodological antireductionism fulfills a prediction of the hypothesis of ontological antireductionism.

That is: if there really is a plan, then you would naturally suppose that looking for a plan would turn out to be a great strategy, and that proceeding as if there were no plan would not be a great strategy. And that is the reality. It turns out that when you take a creature apart to see what its parts are, you see a bunch of parts; but when you take a step back and look for a plan, you find a plan.

Intelligent design is a sub-type of ontological antireductionism. To be exact, it is one way of answering the question if a thing isnt just the sum of its parts, then whatisit? ID proposes that (at least some) natural entities are more than the sum of their parts because they are ultimately an expression of an idea in a conscious mind. If this is true, then you would predict those entities to be best understood by grasping the idea behind them; you would try to see the scheme, the purpose, the outline, the plan.

The neo-Darwinian model, in contrast, does not inherently lead to this prediction, because the mechanism of natural selection and random variation is, by definition, anuncoordinatedpiling-up of useful features, whereas a plan is thecoordinationof useful features. (Michael Behes three books andMarcos EberlinsForesightexplore this idea in depth.)

This is not proof of the design hypothesis, but itisevidence for it. In fact, this sort of evidence is one of the pillars of the scientific method: the strength of a scientific hypothesis depends on its ability to make predictions that are borne out by investigation. Based on that criterion, the hypothesis of intelligent design is doing very well. The hypothesis of mindless evolution is not doing so well, because although mindless processes might generate great complexity, they do not make plans.

Some systems biologists may want to reject Saruman but stay with Eustace; to reap the practical benefits of methodological antireductionism while avoiding the philosophical costs. But they may find that stance difficult to maintain. An unwary systems biologist could easily drift over to Ramandus Island, where the ID theorists are waiting.

View post:

Understanding Reductionism and ID - Discovery Institute