Waiting for HRSA's request for bids to reorganize deceased organ recovery and allocation

Frank McCormick's invaluable email newsletter includes this Bloomberg article on potential bidders who may emerge when HRSA puts out bids to break up the functions that UNOS presently aggregates for managing the deceased donor organ system.  I'm still not at all sure what bids will be forthcoming, especially since the planned request for bids is still quite opaque.

Big Tech, Startups Look to Revamp Troubled Organ Donation System  by Tony Pugh

"Later this fall, the Health Resources and Services Administration plans to solicit bids for the first round of contracts on the OPTN modernization project. The competition will usher in a years-long effort to both stand up new digital technology that better serves the 100,000-plus people on the organ waiting list, while increasing accountability, equity, and efficiency in the way organs are recovered, matched, and transplanted."

Often when I see a short quote broken up into even smaller pieces I worry that it might not accurately represent what was actually said, but this quote is spot on:

“When I look at” the current software used to match organs with possible recipients and to send accept-or-refuse offers to transplant surgeons, “it reminds me of the 1980s,” said Nobel Prize-winning Stanford University economist Alvin E. Roth, who studies how kidneys are matched with suitable candidates.

The market for battlefield intelligence

Here's a column from the Washington Post, which (although it reads partly like an ad from Palantir) emphasizes that real time battlefield data can be acquired from a variety of commercial sources:

How the algorithm tipped the balance in Ukraine, By David Ignatius

"The “kill chain” that I saw demonstrated in Kyiv is replicated on a vast scale by Ukraine’s NATO partners from a command post outside the country. The system is built around the same software platform developed by Palantir that I saw in Kyiv, which can allow the United States and its allies to share information from diverse sources — ranging from commercial satellite imagery to the West’s most secret intelligence tools.

...

"What makes this system truly revolutionary is that it aggregates data from commercial vendors. Using a Palantir tool called MetaConstellation, Ukraine and its allies can see what commercial data is currently available about a given battle space. The available data includes a surprisingly wide array, from traditional optical pictures to synthetic aperture radar that can see through clouds, to thermal images that can detect artillery or missile fire.

"To check out the range of available data, just visit the internet. Companies selling optical and synthetic aperture radar imagery include Maxar, Airbus, ICEYE and Capella. The National Oceanic and Atmospheric Administration sells simple thermal imaging meant to detect fires but that can also register artillery explosions.

"In our Kherson example, Palantir assesses that roughly 40 commercial satellites will pass over the area in a 24-hour period. Palantir normally uses fewer than a dozen commercial satellite vendors, but it can expand that range to draw imagery from a total of 306 commercial satellites that can focus to 3.3 meters. Soldiers in battle can use handheld tablets to request more coverage if they need it. According to a British official, Western military and intelligence services work closely with Ukrainians on the ground to facilitate this sharing of information.

"A final essential link in this system is the mesh of broadband connectivity provided from overhead by Starlink’s array of roughly 2,500 satellites in low-earth orbit. The system, owned by Elon Musk’s SpaceX company, allows Ukrainian soldiers who want to upload intelligence or download targeting information to do so quickly."

UNOS and organ transplant technology

 Organ transplant  communications and logistics are difficult, and current procedures are clunky. But never attribute to malevolence what can be accounted for by incompetence (and difficulty).

The Washington Post has the story:

Thousands of lives depend on a transplant network in need of ‘vast restructuring’. White House Digital Service found that the technology that matches donated organs to patients has failed repeatedly  By Joseph Menn and Lenny Bernstein

"The system for getting donated kidneys, livers and hearts to desperately ill patients relies on out-of-date technology that has crashed for hours at a time and has never been audited by federal officials for security weaknesses or other serious flaws, according to a confidential government review obtained by The Washington Post.

"The mechanics of the entire transplant system must be overhauled, the review concluded, citing aged software, periodic system failures, mistakes in programming and over-reliance on manual input of data.

"In its review, completed 18 months ago, the White House’s U.S. Digital Service recommended that the government “break up the current monopoly” that the United Network for Organ Sharing, the non-profit agency that operates the transplant system, has held for 36 years. It pushed for separating the contract for technology that powers the network from UNOS’s policy responsibilities, such as deciding how to weigh considerations for transplant eligibility.

...

"UNOS is overseen by the Health Resources and Services Administration (HRSA), but that agency has little authority to regulate transplant activity. Its attempts to reform the transplant system have been rejected by UNOS, the report found. Yet HRSA continues to pay UNOS about $6.5 million annually toward its annual operating costs of about $64 million, most of which comes from patient fees.

...

"UNOS considers its millions of lines of code to be a trade secret and has said the government would have to buy it outright for $55 million if it ever gave the contract to someone else, according to the report.

...

"UNOS oversees what is formally known as the Organ Procurement and Transplant Network, a complex collection of about 250 transplant-performing hospitals; 57 government-chartered non-profits that collect organs in their regions; labs that test organs for compatibility and disease; and other auxiliary services.

"Located in Richmond, UNOS sits at the center of the system. It is the only organization to ever hold the 36-year-old contract to run the operation, currently a multi-year pact worth more than $200 million, funded mainly by fees patients pay to be listed for transplants."

HT: Martha Gershun

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My understanding is that the contract is occasionally put out to bid, but that any successful bidder would have to be prepared to operate the whole national deceased organ transplant system immediately from a cold start, which is why the issue of who owns the existing software, data, etc. is important.

The international market for fonts

 There was a time when printing was a local business, and so fonts had local markets. And the buyers were printers, so even if the ultimate customers had artistic preferences (e.g. newspapers liked to look different from books), the names of the fonts were not a big issue.

But Microsoft's announcements of new fonts for Word has opened up a window (so to speak) on some considerations that I hadn't thought about.

CNBC has the story, including an interview with Lucas de Groot, the designer of the previous default font, Calibri:

Microsoft is rolling out a new default font to 1.2 billion Office users after 14 years — and the designer of the old one is surprised  by Jordan Novet

"Coming up with the name was not easy. For both of his fonts, Microsoft wanted names that started with the letter C.

"As de Groot put it in an email, “I had proposed Clas, a Scandinavian first name and associated with ‘class,’ but then the Greek advisor said it meant ‘to fart’ in Greek. Then I proposed Curva or Curvae, which I still like, but then the Cyrillic advisor said it meant ‘prostitute’ in Russian, it is indeed used as a very common curse word.” Microsoft legal workers also checked each possible name to see if it had already been trademarked.

"The company came up with the name “Calibri,” and when de Groot first heard it, he found it odd. It was similar to Colibri, a genus of hummingbirds. But then Microsoft employees said that it related to calibrating the rasterizer in the company’s ClearType font rendering system."

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I realize that I like fonts with serifs, which for example distinguish my name from the acronym for Artificial Intelligence: Al and AI.

In a sans-serif font, those are Al and AI.

Apparently sans-serif fonts were easier to read on low resolution computer screens.

Kidney exchange in Israel using Itai Ashlagi's software

My colleague Itai Ashlagi has been inventing, building, distributing and updating state of the art kidney exchange software ever since he came to Harvard, some years ago. Since then he's been at MIT, and now Stanford, but this recent article from the Jewish Telegraphic Agency about how his software is propagating in Israel still thinks he's at Harvard:

New program finds donors for complicated kidney transplant patients

"JERUSALEM (JTA) — Kidney transplant patients who have had a hard time finding a match will have another opportunity through a new unit at an Israeli hospital.

"Kidney transplant patients who suffer from high levels of antibodies due to previous transplants or blood donations can go for many years without finding a suitable donor. A new and advanced software program can be used to cross-check through advanced information systems from hospitals in Israel and around the world.

"The program, developed by Professor Itai Ashlagi of Harvard University, was donated to the Matnat Chaim organization and will be operated out of Beilinson Hospital’s Department of Transplantation in Petach Tikvah, in central Israel."

College admissions "customer relations management" software, and the marketing of Slate

The Chronicle of Higher Ed has a story about customer-relations management systems (CRMs) used by colleges to organize their marketing and admissions, focusing on one called Slate and how it sells itself to admissions officers:

A Tech Whiz Is Conquering College Admissions. It Takes Charm, Innovation, and Dancing Sharks.

"What is Slate? Technically, it’s a customer-relations management system, or CRM, which many colleges use to track data about prospective students and serve them customized information. Imagine a big virtual file cabinet full of such data, with a built-in brain that tells you how to act on it, responding to students’ interests and behaviors.

"Many admissions offices of all stripes rely on Slate for just about everything they do. Enrolling a freshman class requires relentless grunt work, and the system automates a great deal of it. An admissions officer who’s about to visit a high school can use Slate to send a text message to the cellphones of 20 prospective applicants there all at once.

The market for "zero day" software vulnerabilities

What can you do if you discover a brand new, never exploited ("zero day") vulnerability in a ubiquitous piece of software? Forbes is on the case: Shopping For Zero-Days: A Price List For Hackers' Secret Software Exploits

"A clever hacker today has to make tough choices. Find a previously unknown method for dismantling the defenses of a device like an iPhone or iPad, for instance, and you can report it to Apple and present it at a security conference to win fame and lucrative consulting gigs. Share it with HP’s Zero Day Initiative instead and earn as much as $10,000 for helping the firm shore up its security gear. Both options also allow Apple to fix its bugs and make the hundreds of millions of iPhone and iPad users more secure.

"But any hacker who happens to know one Bangkok-based security researcher who goes by the handle “the Grugq”–or someone like him–has a third option: arrange a deal through the pseudonymous exploit broker to hand the exploit information over to a government agency, don’t ask too many questions, and get paid a quarter of a million dollars–minus the Grugq’s 15% commission."
...
"The Grugq is hardly alone in his industry. Small firms like Vupen, Endgame and Netragard buy and sell exploits, as do major defense contractors like Northrop Grumman and Raytheon.

"Netragard’s founder Adriel Desautels says he’s been in the exploit-selling game for a decade, and describes how the market has “exploded” in just the last year.  He says there are now “more buyers, deeper pockets,” that the time for a purchase has accelerated from months to weeks, and he’s being approached by sellers with around 12 to 14 zero-day exploits every month compared to just four to six a few years ago."
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And here's a related article about a French firm, Vupen (which describes itself as follows: "As the leading source of advanced vulnerability research, VUPEN provides government-grade exploits specifically designed for the Intelligence community and national security agencies to help them achieve their offensive cyber security and lawful intercept missions using extremely sophisticated codes created in-house by VUPEN.).")

HT: Duncan Gilchrist

Kidney exchange software

Itai Ashlagi has made available some of the  kidney exchange software (for both cycles and chains) that we used in two recent papers.

He writes: "To use
(i) one should have cplex and
(ii) please cite

• Ashlagi, Itai, Duncan S. Gilchrist, Alvin E. Roth, and Michael A. Rees, ; ''Nonsimultaneous Chains and Dominos in Kidney Paired Donation -- Revisited,'' American Journal of Transplantation, forthcoming, 2011.
• Ashlagi, Itai and Alvin E. Roth, "Individual rationality and participation in large scale, multi-hospital kidney exchange," working paper, January 2011.

The software either generates simulated patient/donor pairs as well as a compatibility matrix, or alternatively gets as an input such data. It finds an allocation that maximizes the number of transplants using cycles and chains each of a different bounded length. (Chains begin with non-directed donors.)"

Itai has also created a video abstract of the second paper above, about incentives for participation in large scale kidney exchange: