Monday, August 4, 2025

Brain drugs, a review (performance enhancement, side effects, and addiction)

 From the Free Press,  tasting notes on a variety of performance enhancing drugs for concentration, finally converging on what sounds like nicotine addiction.

I Tried Wall Street’s Famous Brain Drugs
My experimental high and crash through the not-quite-legal, sort of effective, occasionally heart-pounding medicine cabinet of Wall Street and Silicon Valley’s productivity optimizers.  by  Park MacDougald

"Vyvanse:
The brand name for lisdexamfetamine, a prodrug that, once ingested, slowly converts to dextroamphetamine, one of the 
active ingredients in Adderall. Originally developed as a longer acting and less easily abused alternative to dextroamphetamine, lisdexamfetamine is now the third most commonly prescribed stimulant in the United States, according to the Drug Enforcement Agency (DEA), with around 15 million prescriptions dispensed in 2023. With insurance, a 30-day supply of Vyvanse can run around $60.

...

" Strattera:  Generic name atomoxetine, Strattera is a selective norepinephrine reuptake inhibitor initially developed by Eli Lilly to treat depression, but later approved by the Food and Drug Administration (FDA) as an ADHD treatment when it was found to be ineffective for its intended use. Strattera is far less commonly prescribed than Adderall, Vyvanse, or Ritalin—4.3 million prescriptions were dispensed in 2023, per the DEA—but may be favored for patients with a history of addiction, due to its low potential for abuse. It’s also cheap; with my insurance, a month’s supply of Strattera cost less than $10.

...

"Dextroamphetamine: Basically like Adderall but without levoamphetamine, a less potent amphetamine isomer that helps to smooth the overall effects of the drug. Dextroamphetamine, or “dexy,” has been available since the 1930s, and was issued to U.S. bomber pilots in World War II to help keep them awake on nighttime missions. It’s still around today, but far less common than Adderall or Ritalin (methylphenidate). Around 915,000 dextroamphetamine prescriptions were dispensed in the United States in 2023, according to the DEA.

...

"Modafinil: Unlike the other drugs on this list, Modafinil is not primarily an ADHD treatment. It’s a non-amphetamine stimulant and “wakefulness-promoting agent” developed in France during the 1970s and 1980s as a treatment for narcolepsy, but its current claim to fame is for its use by the U.S. Air Force to manage pilot fatigue on long missions (it’s also frequently prescribed for night-shift workers). Prescription modafinil is generally cheap with insurance, but the variant I bought—a supplement containing adrafinil, a closely related substance—cost $40 for a jar of 30 pills.

...

 "Zyn: Zyn is the original brand of smokeless tobacco pouches, introduced by a Swedish company, Swedish Match, as a tobacco-free alternative to Snus in 2014 (its major competitor, Velo, is also Swedish, though both companies are now owned by international tobacco conglomerates). In the United States, Zyn is sold in tins of 3 mg or 6 mg pouches, though the European version of the product—which I purchase from my local Yemeni-owned bodega in New York City—also comes in 9 mg, 11 mg, and 13.5 mg varieties. Retail, in New York, a tin costs around $9—up from $5–$6 only a few years ago.

...

"For me, however, 6 mg of Zyn—rising to 9 mg in times of crisis—has become a necessity akin to drinking water. I no longer know what Zyn “feels like,” per se, since I only feel its absence, in the form of scattered attention, forgetfulness, and low-level irritability. When I am on deadline or otherwise swamped with work, I rarely go 10 minutes without a pouch in my mouth."

 

Sunday, August 3, 2025

Xenotransplantation in Humans: pig organs edge closer to being clinically kosher

  It has long been the conventional wisdom in transplantation that xenotransplants--transplanting a kidney from a genetically modified pig into a human--will be tomorrow's cure for kidney failure, and always will be.

But lately there are some causes for optimism that the timeline may be quicker than that.

Here's a recent review of the evidence:

Xenotransplantation in Humans: A Reality Check, by A. Joseph Tector, MD, PhD
Transplantation 109(2):p 231-234, February 2025. | DOI: 10.1097/TP.0000000000005223 

"Thirty years after the initial strategies to develop genetically engineered pigs for use as organ donors in xenotransplantation were described, evaluation of these pig organs in humans has begun.1 The initial experience includes decedent experiments in kidneys and hearts, as well as 5 clinical cases (2 hearts, 2 kidneys, and 1 auxiliary liver). The cardiac xenograft survival was 47 and 40 d, whereas patient survival was 60 and 40 d.2-4 In the initial kidney xenografts, patient survival was 52 d for the first kidney, and the second kidney was removed at 47 d with the patient still alive in the intensive care unit. The initial results in the decedent work as well as the clinical cases indicate that the initial barrier of hyperacute rejection (HAR) has been averted with genetic engineering, but that much work remains before we can begin to offer xenotransplantation as a routine therapy for the treatment of end-stage organ failure. Evaluation of the renal xenografts in decedents and the 2 cardiac xenografts make it clear that although HAR is no longer an issue the problem of antibody-mediated rejection (AMR) secondary to xenoantigens on the pig cell remains.5,6 Moving forward, 4 key areas that must be addressed to realize the goals of bringing xenotransplantation to clinical practice are (1) patient selection, (2) donor pig genetics, (3) immunosuppression issues, and (4) animal husbandry challenges."

 

 Here's the paper's final sentence:

"The human experience suggests that clinical xenotransplantation will work sooner rather than later, but there is still some heavy lifting in front of us that will require continued careful detailed laboratory investigation guided by the feedback from preclinical evaluation."

Saturday, August 2, 2025

Nicotine news--unintended consequences

 Nicotine remains a big source of addiction, and (especially in connection with cigarette smoking) a major cause of premature death.  Here's a brief report on the Whac-A-Mole nature of efforts to limit addiction, particularly by minors.

Vaping Declined in States With Flavor Bans -- But It's Not All Good News— Restrictions were also tied to increased cigarette use in youths and young adults
by Shannon Firth, MedPage Today  July 31, 2025

  • "To date, seven states and Washington, D.C. have enacted flavor restriction policies for e-cigarettes.
  • These state policies were associated with reduced e-cigarette use among adults in recent years.
  • However, relative to states without these policies, the restrictions were also tied to increased cigarette use among high school-age youths and young adults."

Friday, August 1, 2025

US Waitlist Registrants who Received Transplantation Abroad

 Here's a recent article about patients waiting for a deceased-donor organ transplant in the U.S. who (instead) received one overseas (and so removed themselves from the U.S. deceased-donor waiting list, from 2010 to 2023. In that period, the total number of deceased donor transplants in the US rose from about 20,000 per year to about 40,000 per year. Around 60 patients a year are removed from the waitlist for this reason, i.e. on the order of one tenth of one percent.

 The tone of the paper is captured by the statement that this is "not universally unethical".

 Landscape of US Waitlist Registrants who Received Transplantation Abroad
Terlizzi, Kelly MS1; Jaffe, Ian S. MD, MSc1; Bisen, Shivani S. MD1; Lonze, Bonnie E. MD, PhD1; Orandi, Babak J. MD, PhD1,2; Levan, Macey L. JD, PhD1; Segev, Dorry L. MD, PhD1; Massie, Allan B. PhD   Transplantation ():10.1097/TP.0000000000005467, July 14, 2025.  

Abstract:

"Background.
Transplant waitlist registrants in the United States may be delisted because of receipt of a transplant abroad. Although not universally unethical, “travel for transplantation” poses risks to posttransplant care. To better understand this phenomenon, this study identifies temporal trends, geographic patterns, and demographic factors associated with cross-border transplantation.

Methods.
Using Scientific Registry of Transplant Recipients data, we identified 818 US waitlist candidates who were removed because of transplantation abroad between 2010 and 2023. We described recipient characteristics overall, by organ, and by top transplant destinations. We used a Cox regression framework to identify characteristics associated with waitlist removal due to transplantation abroad.

Results.
Transplants abroad averaged 58.4 per year. Incidence peaked at 80 transplants in 2017, with an upward trend after 2021. Kidney transplants made up 92.1% of cases. The most common destinations were the Philippines (19.8%), India (16.5%), Mexico (9.4%), China (8.4%), and Iran (4.4%). India and Mexico experienced the smallest drop-off during the height of the COVID-19 pandemic 2020–2021. Most recipients were US citizens (65.0%) or residents (23.5%). Female (adjusted hazard ratio [aHR], 0.520.610.71; P < 0.001) and Black candidates (aHR, 0.120.180.26; P < 0.001) were less likely to travel abroad compared with Asian candidates (aHR, 5.927.108.52; P < 0.001). Nonresidents (aHR, 6.708.6911.26; P < 0.001) and, among registrations in 2012 or later, nonresidents who traveled to the United States for transplantation (aHR, 27.2738.9155.50; P < 0.001) had a greater chance of undergoing transplantation abroad.

Conclusions.
Understanding patterns of international travel for transplantation is key not only for preventing resource drains from destination countries but also for providing adequate posttransplant care for recipients."



Thursday, July 31, 2025

COMSOC 2025 workshop on Computational Social Choice, Vienna, Austria, 17-19 September 2025.

 COMSOC 2025 is the 10th workshop in the interdisciplinary workshop series on Computational Social Choice. It will take place at the TU Wien, Vienna, Austria, from 17-19 September 2025.

We welcome not only researchers and professionals but also students, newcomers, and individuals interested in the fields of Economics, Political & Social Sciences, and Computer Science. 

The poster for the conference (including the large program committee) is here.

Wednesday, July 30, 2025

Early hiring and late poaching

 Akhil Vohra's paper on unraveling is in the latest AEJ:Micro. It proposes a novel cause of unraveling of labor markets.  Unraveling--early hiring before competitors--can arise for multiple reasons...

Unraveling and Inefficient Matching

  • Akhil Vohra
American Economic Journal: Microeconomics
vol. 17, no. 3, August 2025
(pp. 415–53)
Download Full Text PDF

 

Tuesday, July 29, 2025

Tea and Hacking: Privacy and dating

 Here's a modern short story about privacy, and dating.  A dating app allowed women to widely share information about men.  The app asked women to reliably identify themselves.  It was hacked...

The NYT has the story

What to Know About the Hack at Tea, an App Where Women Share Red Flags About Men. A data breach exposed photos and ID cards of women who signed up for a fast-growing app for women to share details of men they might date.  By Isabella Kwai

 "A fast-growing app for women was hacked after it shot to the top of app download charts and kicked off heated debates about women’s safety and dating.

"The app, Tea Dating Advice, allowed women worried about their safety to share information about men they might date. Its premise was immediately polarizing: Some praised it as a useful way to warn women about dangerous men, while others called it divisive and a violation of men’s privacy.

"On Friday, Tea said that hackers had breached a data storage system, exposing about 72,000 images, including selfies and photo identifications of its users."

************ 

https://www.teaforwomen.com/

 "Share experiences and seek advice within a secure, anonymous platform. Tea is built on trust; screenshots are blocked and all members are verified as women"

Monday, July 28, 2025

WHO Resolution on Kidney Disease and Transplantation

The  78th World Health Assembly in May, 2025 recognized kidney failure as a global problem, with transplantation as the preferred treatment.

Here's a news story from the International Society of Nephrology (ISN):

Historic win for kidney health as WHO adopts global resolution

Here's the resolution:

WHO Resolution: Reducing the burden of noncommunicable diseases through promotion of kidney health and strengthening prevention and control of kidney disease

"The Seventy-eighth World Health Assembly

...

"(PP5) Recognizing that approximately 674 million people live with chronic kidney disease, comprising 9% of the global population2 and concerned that kidney disease is one of the fastest-growing causes of death globally and is projected to become the fifth leading cause of death by 2050, with a projected 33% increase in age-standardized death rate and a 28% increase in age-standardized disability-adjusted life years (DALYs) if no action is taken;

"(PP6) Recalling resolution WHA77.4 on increasing the availability, ethical access, and oversight of the transplantation of human cells, tissues, and organs, which urges countries to adopt preventive strategies and incorporate transplantation into the continuum of care of non-communicable and other diseases that may lead to the need for transplantation in accordance with their national contexts, and that requests the Director-General to support Member States in implementing the elements of the Resolution, particularly through the design of a Global Strategy on Donation and Transplantation.

...

" URGES Member States, in accordance with their national context and priorities, to: 

...

"(6) take measures to promote progressive access to kidney replacement therapy, of which kidney transplantation is preferred, enabling timely referral for transplantation, as well as by implementing interventions to maximize the availability of organs for clinical use aligned with the WHO Guiding Principles on human cell, tissue and organ transplantation"

 #########

 As I've noted elsewhere, the WHO has some counterproductive policies regarding transplantation (and blood and plasma donation, etc), but this particular resolution seems like a positive one.

Sunday, July 27, 2025

Medical aid in dying: the continuing debate in England

In June, the British Parliament passed a law to permit medical aid in dying, which still needs further action before going into effect.

  The Guardian looks at the harrowing situations facing some proponents of MAID:

‘Bad deaths scar families for ever’: what terminally ill people want you to know about assisted dying


Here's the backstory:

"MPs have voted to accept the assisted dying bill, with 314 votes in favour to 291 against, a majority of 23.

The bill will now go to the House of Lords for further scrutiny".

Saturday, July 26, 2025

Upcoming SITE summer seminars at Stanford

Program Overview

Upcoming Sessions

Date
Mon, Jul 28, 2025, 9:30am - Tue, Jul 29, 2025, 1:00pm PDT
Location:
Landau Economics Building, 579 Jane Stanford Way, Stanford, CA 94305

This is a segment exploring the latest papers in climate finance and banking.

Date
Wed, Jul 30, 2025, 8:45am - Thu, Jul 31, 2025, 2:10pm PDT
Location:
Landau Economics Building, 579 Jane Stanford Way, Stanford, CA 94305

In low-income countries, many markets, including credit, insurance, land and information, are frictional or missing altogether.

Date
Wed, Aug 6, 2025, 8:00am - Thu, Aug 7, 2025, 5:00pm PDT
Location:
Day 1 & Morning of Day 2, Aug. 6-7: Stanford Graduate School of Business, 655 Knight Way, Stanford, CA 94305

Afternoon of Day 2, Aug. 7: Landau Economics Building, 579 Jane Stanford Way, Stanford, CA 94305

Empirical Market Design is an emerging research field, blending the theoretical underpinnings of market design with novel empirical approaches that are sometimes related to those used applied…


Date
Thu, Aug 7, 2025, 8:00am - Fri, Aug 8, 2025, 1:30pm PDT
Location:
Landau Economics Building, 579 Jane Stanford Way, Stanford, CA 94305

Market failures are present in many markets, and governments throughout the world design interventions to address them.

Date
Mon, Aug 11, 2025, 8:30am - Wed, Aug 13, 2025, 5:15pm PDT
Location:
Stanford Graduate School of Business, M109, 655 Knight Way, Stanford, CA 94305

The idea of this session is to bring together microeconomic theorists working on dynamic games and contracts with more applied theorists working in macro, finance, organizational economics, and…

Date
Thu, Aug 14, 2025, 8:15am - Fri, Aug 15, 2025, 4:25pm PDT
Location:
Stanford Graduate School of Business, C102, 655 Knight Way, Stanford, CA 94305

This session will bring together researchers from political science and economics who apply economic theory to the study of politics.

Date
Thu, Aug 14, 2025, 8:30am - Fri, Aug 15, 2025, 5:30pm PDT
Location:
Landau Economics Building, 579 Jane Stanford Way, Stanford, CA 94305

This workshop will be dedicated to research that studies how gender influences economic outcomes and decision making.


Date
Mon, Aug 18, 2025, 9:30am - Tue, Aug 19, 2025, 7:00pm PDT
Location:
John A. and Cynthia Fry Gunn Building, 366 Galvez Street, Stanford, CA 94305

This session will bring together researchers working on issues at the intersection of psychology and economics.

Date
Wed, Aug 20, 2025, 9:30am - Thu, Aug 21, 2025, 6:30pm PDT
Location:
John A. and Cynthia Fry Gunn Building, 366 Galvez Street, Stanford, CA 94305

This workshop is dedicated to advances in experimental economics combining laboratory and field-experimental methodologies with theoretical and psychological insights on decision-making, strategic…

Date
Mon, Aug 25, 2025, 8:00am - Wed, Aug 27, 2025, 5:00pm PDT
Location:
Landau Economics Building, 579 Jane Stanford Way, Stanford, CA 94305

This session discusses the latest advances in theoretical and empirical issues related to financial regulation, defined broadly.

Date
Wed, Aug 27, 2025, 8:00am - Fri, Aug 29, 2025, 5:00pm PDT
Location:
Stanford Graduate School of Business, 655 Knight Way, Stanford, CA 94305

This session invites scholars and policymakers to explore the multifaceted dimensions of China's evolving economy and its global interconnections.

Date
Thu, Aug 28, 2025, 8:30am - Fri, Aug 29, 2025, 3:45pm PDT
Location:
Landau Economics Building, 579 Jane Stanford Way, Stanford, CA 94305

The idea of this session is to bring together labor economists and macroeconomists with interests in labor markets with two goals.

Date
Wed, Sep 3, 2025, 12:00pm - Fri, Sep 5, 2025, 12:00pm PDT
Location:
Landau Economics Building, 579 Jane Stanford Way, Stanford, CA 94305

The session will cover recent work on the causes and effects of changes in volatility and uncertainty in the aggregate economy, which is incredibly topical given the ongoing domestic and wider…


Date
Thu, Sep 4, 2025, 8:00am - Fri, Sep 5, 2025, 5:00pm PDT
Location:
John A. and Cynthia Fry Gunn Building, 366 Galvez Street, Stanford, CA 94305

This sessions aims to bring together scholars, both young and established, in as diverse fields as labor economics, public economics, industrial organization, and macroeconomics, who are…

Date
Mon, Sep 8, 2025, 12:30pm - Wed, Sep 10, 2025, 12:30pm PDT
Location:
Landau Economics Building, 579 Jane Stanford Way, Stanford, CA 94305

The past five years have seen an explosion of work in macroeconomics using the “sequence-space” approach to solving and analyzing models.

Date
Thu, Sep 11, 2025, 8:00am - Fri, Sep 12, 2025, 5:00pm PDT
Location:
Landau Economics Building, 579 Jane Stanford Way, Stanford, CA 94305

Several countries have now record high levels of public debt that are comparable to the ones inherited from WWII.

Friday, July 25, 2025

Tour de France competitions: conditioning, bikes, and drugs?

 Agence France Presse (AFP) reports on the bike race, and speculates on the historical competition between drug takers and drug testers.


Pogacar's Tour superiority stirs up old doping debate.  Tadej Pogacar's towering domination of this year's Tour de France is once again raising eyebrows in a sport long tainted by the spectre of doping.

"Pogacar himself brushes off the suggestions of skulduggery he has had to face ever since his first Tour win five years ago, always insisting that he should be "trusted".

"Last October he said to dope "is to ruin your life". "I don't want to take the risk of falling ill one day," he added, pointing out that cycling was "a victim of its past".
"
He continued, with an air of resignation: "There is no trust, and I don't know what can be done to restore it."

Dope-testing on the Tour

"Around 600 blood and urine samples will be collected from the peloton during this year's race, with 350 out-of-competition samples taken in the run-up to cycling's blue riband event. 

...

"A selection of the samples are held for 10 years to allow for retro-testing with the advance of new detection techniques.

The UCI also inspects bikes to prevent any technical cheating.

While ketones to help store energy are permitted and widely used, the UCI banned the inhalation of carbon monoxide earlier this year.

...

"Pogacar's ability to smash records set by infamous dopers like disgraced seven-time winner Lance Armstrong or Pantani is remarkable.

...

"And as in other sports, cycling has made enormous progress since the EPO years.

"Technology has led to faster bikes, with the Tour's technical director Thierry Gouvenou suggesting a there has been a 10% gain in performance just thanks to better two-wheeled machines. Nutrition and training have also evolved."


Thursday, July 24, 2025

INFORMS celebrates Yash Kanoria

Last month, INFORMS' Division of Manufacturing and Service Operations Management awarded Yash Kanoria  the 2025  MSOM Young Scholar Prize.

Here's a slide from the prize announcement (shared with me by Omar Besbes).

 

 

Here are two papers of his that I admire:

Ashlagi, Itai, Yashodhan Kanoria, and Jacob D. Leshno, (2017). “Unbalanced Random Matching Markets: The Stark Effect of Competition”,  Journal of Political Economy 125, 1: 69-98. https://www.journals.uchicago.edu/doi/full/10.1086/689869 

  Ashlagi, Itai, Mark Braverman, Yash Kanoria, and Peng Shi, (2020). Clearing matching markets efficiently: informative signals and match recommendations. Management Science66(5), 2163-2193 https://pubsonline.informs.org/doi/abs/10.1287/mnsc.2018.3265