Bringing down the cost of cancer treatment

Elie Doldin in Nature:

CancerThe year 2011 was a watershed for cancer medicines in the United States. In the space of five months, federal regulators approved the first checkpoint-inhibitor immunotherapy, the first treatment for an aggressive form of thyroid cancer, the first personalized drug for the skin cancer melanoma, the first in an innovative class of targeted agents for lung cancer, and a ‘weaponized’ antibody therapy that delivers a drug to tumour cells in people with lymphoma. The potency, complexity and innovative nature of these treatments were noteworthy. But so was the price. Each cost more than US$100,000 per person when taken for a year — a rarity at the time for oncology drugs.

The prices seemed staggering to doctors, patients and health-care providers alike. But quickly, they became normal. By 2014, the average cost of a new orally administered cancer medicine exceeded $135,000 a year — up to six times the cost of similar drugs approved in the early 2000s, after adjusting for inflation1. 2017 brought the most eye-popping price tag in oncology yet: a one-time cost of $475,000 per patient for a personalized cell-based therapy for childhood leukaemia. This generation of treatment promises to transform the field of cancer, yielding more cures and long-term remissions than ever before. But as medicine’s ability to tackle tumours races ahead, health-care systems worldwide are struggling to deliver the benefits. If the affordability of drugs is not addressed soon, many people with cancer might not be able to reap the rewards of cutting-edge therapies. “We’re on a trajectory that’s really unsustainable,” says Ameet Sarpatwari, an epidemiologist and legal scholar who studies drug pricing at Brigham and Women’s Hospital in Boston, Massachusetts. “It’s really a major issue,” says Sabine Vogler, a health economist at the Austrian Public Health Institute in Vienna. Drugs are unaffordable in many parts of the world2. “We have to ask ourselves,” she says, “how long can we continue paying these high prices?”

More here.



Monday, March 19, 2018

Monday Poem

I’m listening to something.
I don’t know what it’s called but it’s Chopin. Alexa 04
It’s something Alexa pulled
from the high capacity byte magazine
of her small black canister
which sits under a lamp upon a table
against the wall (where most of us have spent
at least a little time, sweating)
it’s power umbilical plugged to an outlet,
its invisible wireless thread stretched taut to a router
it’s bluesy halo perfectly apropos—
but whatever it is, it is necessarily of the moment
and I had asked for classical after all,
so I’m thinking Alexa must know more than I
of what this now must consist

Of what it partially consists are bell sounds
—not bells really but the closest thing
Chopin could come up with
to be played on an instrument
that sounds bell-like but which again
I admit: I haven’t a clue.
Despite having a poet’s surfeit of words
you’d think I’d not have come up short
before committing to a page, but it
is spontaneous magic as I sit here
among Chopin’s frequencies listening,
applying Chopin to the day’s doing,
wondering why, suddenly! Alexa has
shuffled Ahmad Jamal
into the mix
and left me mulling what Ahmad’s

poignant jazz has to do with
what
this now is
.

Jim Culleny
3/16/18

The pleasures of misrecognition

by Mathangi Krishnamurthy

Tumblr_inline_nj2tldu6Ok1qjuey1When I first moved into an apartment onto campus to take up my current job as faculty at one of the most prestigious institutes in India, I knocked at my neighbour's door to introduce myself, only to be asked, "What department is Sir in?" Highly amused, I responded, that actually only madam would take up residence and work here; madam, of course, being myself. What would otherwise have raised my feminist hackles, to this day amuses me, perhaps because I was able to take pleasure in overturning a kind of misrecognition, no matter to how small a degree. Gender, age and body are easy and frequent stages for misrecognition—one is seen, heard, and assumed to be of a certain age, gender, and life stage. "You don't look your age!" is a form of misrecognition that can offer pleasure or otherwise depending on whether such looking is over- or under-determined.

In the social sciences, such misrecognition informs identity. In other words, across literatures, it is only through agreeing, refusing, conforming, partly conforming, and co-opting available labels and modes of being does one gain identity. We all therefore, exist, by misrecognizing ourselves and others for there is either no core self, outside of such temporary and sometimes sedimented forms of knowing, or the possibility of gaining any authentic self is always already lost. In this short essay, this is what concerns my exploration of pleasure. For other theorists like Nancy Fraser, misrecognition refers to the denigration and refusal of common humanity in others; in other words, a literal refusal to recognize. While there are clearly pleasures to the latter, I do not take it up in this piece. However, where the first and the second come together is in reading Pierre Bourdieu, for who misrecognition resides in the everyday where things, people, and processes get attributed to available realms of meaning and thereby misrecognized as such, making no room available for the uncommon, the changing, and the different.

These days, I walk around utterly confused as to who to be. I am a thoroughly misrecognized entity; seen as woman even though I do not know how to behave in an adequately womanly fashion; considered responsible even though only I know how often I misplace my keys; accorded the privilege of teaching despite my own frequent misgivings and surrender to the "imposter" syndrome; and the most egregious burden of all, considered an adult, even though I, like most others, fake it.

Read more »

Conversational Contraception

by Max Sirak

(Look…er…Listen! It's a free audio version for all you on-the-go…)

Conversations are like sex. There's a safe and unsafe way to go about them. Today I'm going to share with you a way to protect yourself against unwanted communicational repercussions. But, before we get there, I'd like to take a moment to pay homage to the lineage of thought which led me to this prophylactic presentation. Ideas evolve. Not always, but sometimes. If a concept is sticky enough, it hangs around, lying in wait, and resurfaces. Each exposure granting more nuance to the original idea until eventually a fresh concept emerges, related and traceable to the first, but individual in its own right.

Which is how conversational contraception was born.

"Free Movies!" 640px-Sample_Gates _Indiana_University_Bloomington _2010

A college professor of mine would yell this, arms waving, at least once each class. Appealing to the broke nature of students, due to soaring expenses of tuition, Professor Terrill was very passionate (and demonstrative) in his attempts to steer us. Energy and enthusiasm aside, it never worked. At least not on my friends and me. We were too immersed in the other "recreational" options collegiate life had to offer. So it goes.

But that doesn't diminish the impact Prof. Terrill and his class had on me. Even now, 16 years after I was but one anonymous face in the tessellated sea of his lecture hall, I find myself thinking about ideas he taught. They were so foreign and new.

Read more »

Brooklyn Nights

by Christopher Bacas

On Flatbush Avenue,
the dollar vans squawk and beep,
threading through traffic. Image

City buses stream
rectangles of blue-white light
across the storefronts.

From dim upper floors,
blinds drawn, shadowed, comes music:
brass band with coro.

Tuba burps madly:
a bullfrog virtuoso
looking for lovers.

Beneath an awning,
they sit by a glowing grill,
rain sizzling its lid.

A thick woman prods
the charred corn, whole or sectioned,
smoke twists around her.

In the entrance way,
on a cart, plates, condiments:
mayonnaise and cheese.

Read more »

Poetry in Translation

One Evening in 1907 On The Banks Of The River Neckar, Heidelberg

by Mohammed Iqbal

The Silver moon is silent

Branches are silent as well

Valley birds that sell their songs are silent

Mountains cloaked in green are silent

Neckar flows regal under the spell of silence

Embraced by the night a world is silent

Be still, heart. Sing the blues.

Translated from the original Urdu by Rafiq Kathwari / @brownpundit

Sunday, March 18, 2018

Sean Carroll on Stephen Hawking’s Scientific Legacy

Sean Carroll in Preposterous Universe:

ScreenHunter_2998 Mar. 18 19.44Stephen Hawking is the rare scientist who is also a celebrity and cultural phenomenon. But he is also the rare cultural phenomenon whose celebrity is entirely deserved. His contributions can be characterized very simply: Hawking contributed more to our understanding of gravity than any physicist since Albert Einstein.

“Gravity” is an important word here. For much of Hawking’s career, theoretical physicists as a community were more interested in particle physics and the other forces of nature — electromagnetism and the strong and weak nuclear forces. “Classical” gravity (ignoring the complications of quantum mechanics) had been figured out by Einstein in his theory of general relativity, and “quantum” gravity (creating a quantum version of general relativity) seemed too hard. By applying his prodigious intellect to the most well-known force of nature, Hawking was able to come up with several results that took the wider community completely by surprise.

By acclimation, Hawking’s most important result is the realization that black holes are not completely black — they give off radiation, just like ordinary objects. Before that famous paper, he proved important theorems about black holes and singularities, and afterward studied the universe as a whole. In each phase of his career, his contributions were central.

More here.

A Twist in Our Sexual Encounters With Other Ancient Humans

Ed Yong in The Atlantic:

Lead_960 (1)Around 41,000 years ago, a young woman died in a cold cave, high up in Siberia’s Altai Mountains. Scientists uncovered one of her pinky bones in 2008. From it, they extracted her DNA. And from that, they deduced that she belonged to a previously unknown group of ancient hominin, whom they called the Denisovans after the cave where the finger was found.

To this date, we have no idea what a Denisovan looked like. You can still hold every known Denisovan fossil—that pinky, a toe, and two teeth—in your hand. But we know so much else about them. We know almost every letter of their genome. We know that they diverged from their close relatives, the Neanderthals, around 400,000 years ago, and that both groups diverged fromHomo sapiens around 600,000 years ago. We know that when our ancestors left Africa and spread into Asia, they encountered the Denisovans and had sex with them. We know that, as a result, Denisovan DNA lives on in people from Asia and Melanesia. One of these Denisovan genes provides modern Tibetans with a crucial adaptation that allows them to survive at high altitudes.

And now, thanks to work from Sharon Browning at the University of Washington, we know that Denisovan DNA entered the human gene pool on two occasions. Two separate groups of our horny, globe-trotting ancestors met with these mysterious hominins, and mated with them.

More here.

Why They Hate Margaret Atwood

Jonathan Kay in Quillette:

ScreenHunter_2997 Mar. 18 19.31On March 9, a University of Alberta English professor named Julie Rak headlined a speaking event that was billed as a showdown on the issue of “bad feminism.” A promotional poster done up in a boxing motif included a picture of Rak on one side, and legendary Canadian author Margaret Atwood on the other.

If you live outside Canada, and recognize Atwood as the author of such renowned feminist works as Cat’s Eye, you might assume that she’d be representing the side of sound feminist doctrine in this metaphorical bout. As literary critic Carmine Starnino once noted, Atwood is the “best-known English-language novelist of contemporary sexual politics.” She more or less invented the modern Anglo Canadian feminist fiction genre, specializing in what Starnino aptly describes as “salty post-Freudian satires on gender inequalities, the oppressiveness of marriage and the historical animosity of women.”

In the 1980s, when I studied North American Literature as a high school elective, Atwood was the only writer with two books on our reading list. She also was the youngest writer on that list by a significant margin. Decades later, when I acted as her editor for a 2016 book about the French presence in North America, she was just as sharp and witty as I’d hoped. (In response to her complaints that my edits were too severe, I feebly protested that I’d “left the bones where they were, and just moved around some of the skin and hair.” To which she replied that “all bones look much the same. The hair and skin are what make us recognizable.” It’s always a thrill when your heroes put you in your place.)

And yet, this being the bizarro world of 2018, Atwood’s role in Rak’s University of Alberta event wasn’t as a feminist heroine. In fact, Atwood wasn’t even in attendance. The above-described poster was just a gimmick to promote Rak’s caricature of Atwood as the Trotsky of Canadian feminism. And the fact that Rak feels comfortable signaling this posture on publicly displayed posters shows she isn’t some outlier loon. Just the opposite: In recent years, the ideological mobbing of Atwood and other well-established writers has become a mass-participation phenomenon among young Canadian literati who mobilize daily on social media.

More here.

The Silence of the Liberals

From the BBC:

Observer columnist and writer Nick Cohen thinks mainstream liberal culture and left-wing politicians are failing to help progressive Muslims who want to fight inequalities endorsed by culture and religion in their communities. He calls this the "racism of the anti-racist".

Forty years ago, Edward Said coined the term "Orientalism" to condemn the West's patronising representations of the "exotic" East, whose inhabitants were too irrational to handle the freedoms Americans and Europeans enjoyed.

In this programme, Nick Cohen examines evidence that this old colonial condescension is re-emerging in 2018, He interviews frustrated Muslims tackling discrimination – Muslims who feel betrayed by the Liberal left who, they say, should be their natural allies in their campaigning for women's rights and tackling discrimination such as homophobia in Muslim communities.

[Click photo below.]

ScreenHunter_2996 Mar. 18 19.21

The Kids Aren’t Alright

Natasha Lennard in Dissent:

KidsHarris’s new book, Kids These Days: Human Capital and the Making of Millennials, is a crucial work of generational analysis in part because it severs the connection between the idea of generations and the presupposition of progress. The book is not an explicit critique of this essentialist notion of generations, however, but something more practical: a corrective. Against a glut of reductive clickbait stories dedicated to asserting “Millennials be like [insert broad observation]” Harris (with whom I worked a number of years ago at the New Inquiry) takes up the task of asking why millennials are the way they are, and then providing an answer. As he states in his introduction: “if Millennials are different in one way or another, it’s not because we’re more (or less) evolved than our parents or grandparents; it’s because they’ve changed the world in ways that have produced people like us. And we didn’t happen by accident.” The pages that follow are a careful and convincing study of how specific material conditions account for the way millennials be like—and, crucially, “in whose interests it is that we exist this way.”

Kids These Days offers a historical materialist analysis, but Harris is too committed to accessibility to use that term or to mention Marx even once. In prose that is precise, readable, and witty, he explores the economic, social, and political conditions that shaped those of us—myself and Harris included—born between 1980 and 2000. Harris’s central contention is that millennials are what happens when contemporary capitalism converts young people into “human capital.” After reading his book, it seems ill-advised to understand millennials any other way.

More here.

Sunday Poem

The Cranes

Cranes lifting out of the marshland. . .
My brother brings his fingers to his temples
and then drops his hands.

Like that, he was dead.
The satin lining of autumn.
Oh my brother! I miss you now, and I'd like to have you back.

Hug you like a grown man
who knows the worth of things.
The mist of events drifts away.

Not in this life, I told you once.
I was given a different set of marching orders.
I planned to go mule-backing across the Isthmus.

Begone, though, if this is your idea of things!
But I'll think of you out there
when I look at those stars we saw as children.

The cranes wallop their wings.
In a moment, they'll fly true north.
Then turn in the opposite direction.
.

by Raymond Carver
from Where Water Comes Together With Water
Vintage Books, 1986
.

The crisis in modern masculinity

Pankaj Mishra in The Guardian:

ManOn the evening of 30 January 1948, five months after the independence and partition of India, Mohandas Karamchand Gandhi was walking to a prayer meeting at his temporary home in New Delhi when he was shot three times, at point-blank range. He collapsed and died instantly. His assassin, originally feared to be Muslim, turned out to be Nathuram Godse, a Hindu Brahmin from western India. Godse, who made no attempt to escape, said in court that he felt compelled to kill Gandhi since the leader with his womanly politics was emasculating the Hindu nation – in particular, with his generosity to Muslims. Godse is a hero today in an India utterly transformed by Hindu chauvinists – an India in which Mein Kampf is a bestseller, a political movement inspired by European fascists dominates politics and culture, and Narendra Modi, a Hindu supremacist accused of mass murder, is prime minister. For all his talk of Hindu genius, Godse flagrantly plagiarised the fictions of European ethnic-racial chauvinists and imperialists. For the first years of his life he was raised as a girl, with a nose ring, and later tried to gain a hard-edged masculine identity through Hindu supremacism. Yet for many struggling young Indians today Godse represents, along with Adolf Hitler, a triumphantly realised individual and national manhood.

The moral prestige of Gandhi’s murderer is only one sign among many of what seems to be a global crisis of masculinity. Luridly retro ideas of what it means to be a strong man have gone mainstream even in so-called advanced nations. In January Jordan B Peterson, a Canadian self-help writer who laments that “the west has lost faith in masculinity” and denounces the “murderous equity doctrine” espoused by women, was hailed in the New York Times as “the most influential public intellectual in the western world right now”.

More here.

Saturday, March 17, 2018

Humane prison to bring Greenland’s most dangerous criminals home

Sarah Lazarus at CNN:

180213101821-ny-anstalt-prison-1-super-169Nestled into the stunning Arctic landscape with panoramic views of sparkling fjords and snowy mountains, Ny Anstalt could easily be mistaken for a luxury ski lodge. But this stylish complex in Nuuk, the capital of Greenland, is actually a prison.

As any onlooker can deduce, when it opens in 2019 it will not be a normal penitentiary. It will be a "humane prison" — a correctional facility that emphasizes rehabilitating criminals through positive design, rather than punishment. Exponents of the "humane prison" philosophy believe that if prisons mimic the conditions of normal life, as far as is possible, offenders have a greater chance of successful reintegration into society, and less chance of re-offending. Ny Anstalt, however, is more than an architectural accomplishment for the country. It hopes to end a human rights issue that has haunted the island nation for decades.
More here.

The genius at Guinness and his statistical legacy

Karen Lamb and David Farmer in The Conversation:

Guinness-guinness-extra-stoutThis St Patrick’s Day, revellers around the world will crowd the streets seeking one of Ireland’s national drinks: a pint of Guinness. But besides this tasty stout, one of the most fundamental and commonly used tools of science also has its origins at the Guinness brewery.

Towards the end of the 19th century, Guinness was scaling up its operations, and was interested in applying a scientific approach to all aspects of Guinness production: from barley growth right through to the Guinness taste.

Before adopting a scientific approach, brewers at Guinness relied on subjective methods, such as the appearance and scent of hops, to assess produce quality.

Once scientific brewers were recruited, a more objective approach was taken. The first scientific brewer, Thomas Bennett Case, was hired in 1893 and he believed that the amount of soft resins in hops was related to the quality of Guinness. He was therefore keen to estimate the amount of soft resin in particular crops of hops.

The challenge facing Case was that he, like any scientist, could not measure everything at once. It was not possible for him to assess the amount of soft resin in every single one of the countless hop flowers (added by the thousands to enormous vats of soon-to-be Guinness) in his charge.

More here.

A Billionaire and a Nurse Shouldn’t Pay the Same Fine for Speeding

Alec Schierenbeck in the New York Times:

ScreenHunter_2995 Mar. 17 20.32If Mark Zuckerberg and a janitor who works at Facebook’s headquarters each received a speeding ticket while driving home from work, they’d each owe the government the same amount of money. Mr. Zuckerberg wouldn’t bat an eye.

The janitor is another story.

For people living on the economic margins, even minor offenses can impose crushing financial obligations, trapping them in a cycle of debt and incarceration for nonpayment. In Ferguson, Mo., for example, a single $151 parking violationsent a black woman struggling with homelessness into a seven-year odyssey of court appearances, arrest warrants and jail time connected to her inability to pay.

Across America, one-size-fits-all fines are the norm, which I demonstrate in an article for the University of Chicago Law Review. Where judges do have wiggle room to choose the size of a fine, mandatory minimums and maximums often tie their hands. Some states even prohibit consideration of a person’s income. And when courts are allowed to take finances into account, they frequently fail to do so.

Other places have saner methods. Finland and Argentina, for example, have tailored fines to income for almost 100 years. The most common model, the “day fine,” scales sanctions to a person’s daily wage. A small offense like littering might cost a fraction of a day’s pay. A serious crime might swallow a month’s paycheck. Everyone pays the same proportion of their income.

More here.

Virtuosos of Idleness

Charlie Tyson in THR:

I begin to doubt beautiful words. How one longs sometimes to have done something in the world.

—Virginia Woolf to Goldsworthy Lowes Dickinson, October 17, 19311

Bloomsbury_group_2Most artistic collectives flicker out after delivering, at best, a crackling manifesto. For a group of aspiring artists and intellectuals to vow to transfigure art, then the world, is no rare thing. Yet by any measure, the Bloomsbury Group—whose members included Virginia Woolf, John Maynard Keynes, Lytton Strachey, and, more peripherally, Bertrand Russell—made good on its ambitions. Of the countless novels, philosophical treatises, and economic theories that appeared in England in the early decades of the twentieth century, Bloomsbury claims credit for some of the most durable and dazzling.

The Bloomsbury Group, named for the London area where its members congregated, is known to us today for the work it left behind. Yet to their contemporary rivals, the “Bloomsberries” seemed contemptibly lazy. Caricatures pegged them as a band of snobbish rentiers who whiled away afternoons sprawled on couches murmuring about art and beauty. Even in their own work, they portrayed moneyed leisure with uneasy self-awareness. Standing on the soft carpet outside Clarissa Dalloway’s dressing room, the drab tutor Miss Kilman of Virginia Woolf’s Mrs. Dalloway seethes, “Instead of lying on a sofa—‘My mother is resting,’ Elizabeth had said—she should have been in a factory; behind a counter; Mrs. Dalloway and all the other fine ladies!”2 Miss Kilman’s rage blazes more furiously with each semicolon as she condemns not just Mrs. Dalloway but all her privileged class to the servile humiliations of wage labor. Clarissa Dalloway can lie on the couch for an hour after lunch. Her daughter’s tutor cannot. Miss Kilman correctly sees Clarissa’s leisure as the result of an economic position that excuses her from paid work.

To say that the Bloomsbury Group was lazy, that its members celebrated their own idleness, and that their leisure was enabled by unjust economic arrangements would seem to be damning pronouncements, if true. But in the writings of key Bloomsbury figures, these very ideas were disputed less defensively than we might imagine and judged more frankly than we might expect.

More here.