Tuesday, September 26, 2023

The EU considers tightening bans on compensating donors of Substances of Human Origin (SoHO)

 Peter Jaworski considers an  EU proposal this month to harmonize across the EU bans on paying donors for Substances of Human Origin (SoHO).  Presently Germany, Austria and Chechia allow payment to plasma donors.

The E.U. Doesn't Want People To Sell Their Plasma, and It Doesn't Care How Many Patients That Hurts. The United States currently supplies about 70 percent of the plasma used to manufacture therapies for the entire world.  by PETER JAWORSKI 

"The European Union looks like it might take the foolish step of banning financial incentives for a variety of substances of human origin, including blood, blood plasma, sperm, and breast milk. The legislation on the safety and quality of Substances of Human Origin includes an approved amendment that says donors can only be compensated for "quantifiable losses" and that such donations are to be "financially neutral." This legislation is supposed to harmonize the rules across the 27 member countries, promote safety, with the ban on financial incentives intended to avoid commodification and the exploitation of the poor. 


"Already the E.U. is dependent on plasma collected in the United States for around 40 percent of the needs of its 300,000 rare disease patients. They're not as dependent as Canada because Germany, Austria, Hungary, and the Czech Republic allow a flat-fee donor compensation model and so are able to have surplus collections that contribute 56 percent of the E.U. total. The remaining 23 countries, each of which runs a plasma collection deficit, manage just 44 percent. 

"So what is likely to happen if the new rules make this flat-fee donor compensation model illegal? Will safety improve and commodification and exploitation be avoided? No, the E.U. will just become even more dependent on the United States."

Monday, September 25, 2023

Smart toilets and data privacy

 Something to sit and think about:

Smart toilets could leak your medical data, warn security experts. by Matthew Sparkes New Scientist, Volume 259, Issue 3456, 2023, Page 14, ISSN 0262-4079, https://doi.org/10.1016/S0262-4079(23)01720-7. 

"A range of start-ups and research projects have developed smart toilets to monitor everything from heart rate to the consistency of stools and the presence of certain proteins in urine that indicate disease. One device even features an “anus camera” that takes a photo from below for identification, something that has been described as the “polar opposite of facial recognition”.*


"One concern was the privacy of people other than the owner: are visitors consenting to have photographs or measurements taken? There were also worries about the risk of losing sensitive data to hackers, as well as the possibility of companies selling the data on. And if smart toilets were installed in public areas or workplaces, there would be questions about who has access to that data, it was argued.The group of experts concluded that smart toilets shouldn't be sold as consumer devices, but instead as medical devices that have to meet high regulatory standards for privacy and safety (arXiv, doi.org/ksx5).

"Chase Moyle at smart toilet start-up Coprata says he set out to build a consumer device because creating a medical device under US Food and Drug Administration regulations would raise the price by a factor of 10. It would also mean that, in the US, insurance companies would only offer it to people with diagnosed conditions.


"Alan Woodward at the University of Surrey, UK, says so-called internet of things (IoT) devices, such as heart rate monitors and CCTV cameras, have often been found to have security flaws, including a smart toilet with a computer-controlled bidet. He fears the same could be true for medical-focused smart toilets. “With a lot of IoT devices, security has never been uppermost in the mind and yet something like a smart toilet is collecting some very personal data,” he says. “They're making these weird devices because they can, but nobody's thought through ‘should we?’”


See also (for the first instance of that quote I can find):

‘Smart toilet’ monitors for signs of disease. A disease-detecting “precision health” toilet can sense multiple signs of illness through automated urine and stool analysis, a new Stanford study reports.  April 6, 2020 - By Hanae Armitage, Stanford Medicine News

"One of the most important aspects of the smart toilet may well be one of the most surprising — and perhaps unnerving: It has a built-in identification system. “The whole point is to provide precise, individualized health feedback, so we needed to make sure the toilet could discern between users,” Gambhir said. “To do so, we made a flush lever that reads fingerprints.” The team realized, however, that fingerprints aren’t quite foolproof. What if one person uses the toilet, but someone else flushes it? Or what if the toilet is of the auto-flush variety?

"They added a small scanner that images a rather camera-shy part of the body. You might call it the polar opposite of facial recognition. In other words, to fully reap the benefits of the smart toilet, users must make their peace with a camera that scans their anus.

“We know it seems weird, but as it turns out, your anal print is unique,” Gambhir said. The scans — both finger and nonfinger — are used purely as a recognition system to match users to their specific data. No one, not you or your doctor, will see the scans."


Also, Meet the winners of the 2023 Ig Nobel Prizes 

"Public Health Prize

Citation: "Seung-min Park, for inventing the Stanford Toilet, a device that uses a variety of technologies—including a urinalysis dipstick test strip, a computer vision system for defecation analysis, an anal-print sensor paired with an identification camera, and a telecommunications link—to monitor and quickly analyze the substances that humans excrete."

Sunday, September 24, 2023

Nobel Symposium on Social Networks Lund, Sweden, August, 2023

A Nobel Symposium on Social Networks was held in Lund last month.The papers don't appear to be online, but it ended with a round table discussion:
"You can join in online when the symposium ends with an open “round table discussion” with a panel of leading scientists on August 24 at 14:00. The discussion will be introduced by Tommy Andersson, Professor in Economics at LUSEM and Member of the Committee for the Prize in Economic Sciences in Memory of Alfred Nobel.

The panelists are Prof. Matthew Jackson, Prof. Albert-Laszlo Barbasi, Prof. Kathleen M. Carley, Prof. Damon Centola, Prof. Vittoria Colizza, and Prof. David Lazer."

Stanford was well represented. Aside from my colleague Matt Jackson, Mark Granovetter joined the symposium itself by Zoom (which I guess is a weak link).

Round table discussion: Nobel Symposium on the Future of Network Analysis

Nobel watchers, take note.

Saturday, September 23, 2023

Big ideas at Stanford; interviews by Ran Abramitzky


Big Ideas

Stanford’s Nobel Laureates and MacArthur “Genius” Fellows talk with H&S Senior Associate Dean Ran Abramitzky about their award-winning research and their personal and professional paths.

Open to the Stanford community.

Autumn quarter (Thursdays, 3 – 4:20 pm, at CEMEX. The talk series is open to the Stanford community, and is also offered to undergrads as a 1-unit course (syllabus attached).

9/28: Market Design with Alvin Roth

10/12: Causal Inference with Guido Imbens

10/19: Energy with Steven Chu

10/26: Pediatric Neuro-oncology with Michelle Monje

11/2: Auctions with Paul Milgrom and Robert Wilson

11/9: Experimental Physics with Monika Schleier-Smith

11/16: Bioorthogonal Chemistry with Carolyn Bertozzi

11/30: Natural Language Processing with Dan Jurafsky

12/7: Innovation with Heidi Williams

Friday, September 22, 2023

Support for hepatitis C human challenge studies, in The Lancet Gastroenterology & Hepatology

 Here's a call for action, in The Lancet Gastroenterology & Hepatology:

Joint statement in support of hepatitis C human challenge studies by Harvey J Alter, Eleanor Barnes, Mia J Biondi, Andrea L Cox, Jake D Eberts, Jordan J Feld, T Jake Liang, Josh Morrison, Charles M Rice, Naglaa H Shoukry, David L Thomas, Jennifer Van Gennip, Charles Weijer, on behalf of other signatories †, Published:September 20, 2023 DOI:https://doi.org/10.1016/S2468-1253(23)00314-X

"We, the 121 undersigned, believe that human challenge studies among adult volunteers will be critical in the development of hepatitis C vaccines.


"Despite the advent of safe and highly effective direct-acting antiviral (DAA) treatments, the ongoing toll of hepatitis C remains high among low-income and middle-income countries and vulnerable populations such as people who inject drugs. Millions of new infections occur annually, outpacing cures in some regions,1 with progress further disrupted by the COVID-19 pandemic. Without a change in strategy and the development of new tools, we will not reach the ambitious goal set out by WHO of elimination of viral hepatitis as a public health threat by 2030. This will require an effective hepatitis C vaccine—“the best insurance for the future”, as highlighted by a recent announcement of the White House national hepatitis C elimination programme.2


"Human challenge studies for a hepatitis C vaccine could accelerate vaccine development dramatically. The effort to establish the model and test an initial vaccine candidate could take as little as 3 years. If that candidate fails, subsequent studies to test others could provide evidence of efficacy as quickly as 1 year.

"It is only because of the remarkably effective treatments that we can now consider human challenge studies for hepatitis C. With DAAs, cure rates of people without cirrhosis are reliably over 98%, with highly effective salvage regimens for the few who do not respond to a first course of therapy.5,  6 We are confident that in the era of DAAs, human challenge studies can be done in accordance with the highest ethical and safety standards. Healthy volunteers providing fully informed consent would be infected for at most 6 months before treatment and would be free to go about their lives with the right to request treatment and withdrawal from a study at any time. Acute infection causes no or few symptoms in most, and unlike in most challenge studies, where the risk of transmission necessitates quarantine of participants, the risk of passing hepatitis C to others is very low in day-to-day life.

"The impact of a vaccine would be enormous: reducing transmission, preventing cirrhosis, and most importantly, markedly reducing the rate of liver cancer, the world's second-most deadly cancer in terms of total fatalities.7 The global success of hepatitis B vaccine in achieving these goals exemplifies the importance of an effective hepatitis C vaccine. With the prospect of such a significant advance, we have confidence that people will volunteer to participate in hepatitis C challenge studies, and with such a strong team of experts worldwide, we are confident this approach will lead to the development of a successful hepatitis C vaccine."


Here's the full list of 121 signers of the letter


1Day Sooner has a related web page with some background: https://www.1daysooner.org/hepatitis-c-open-letter


Earlier related posts:

Monday, May 15, 2023

Thursday, September 21, 2023

Drugs, drug economics, and violence in Colombia and Ecuador, as Colombia withdraws from the war on drugs

 Fighting a war on drugs hasn't yielded clear successes (at any point in the supply chain), but surrendering is no picnic either. The WSJ has the story from Colombia, and the Guardian reports on the situation in Ecuador.

Here's the WSJ story:

Colombian Cocaine Production Sees Record Surge. The country’s output of the drug, which reaches far corners of the world, rises 24%, U.N. says. By Juan Forero

"Colombia has set a record in the estimated production of cocaine, the United Nations said Monday, as President Gustavo Petro’s government tries a less punitive approach to fighting drugs.

"The amount of cocaine manufactured in Colombia, the world’s largest producer, rose to 1,738 tons in 2022, compared with 1,400 tons the year before, a 24% increase, with the cocaine shipped not only to the U.S. but increasingly to Europe and other continents, said officials presenting the U.N. Office on Drugs and Crime’s annual report on Colombia’s cocaine trade. Some 22 million people worldwide consume the drug.


"The size of Colombia’s coca fields and the production of cocaine has been rising fast since 2013, when the government of then-President Juan Manuel Santos began a process that by 2015 phased out a U.S.-sponsored program to spray coca fields from crop dusters with the herbicide glyphosate. 


"The leftist government of Petro, who took office 13 months ago, has characterized the war on drugs as a failure and veered away from a hard-line approach to dealing with coca farmers. For Colombia to reduce cocaine production to 900 tons by 2026, Justice Minister Néstor Iván Osuna, said Bogotá would hold negotiations with armed groups, build roads and provide social services. The state also offered assistance for the so-called cocaleros, or farmers, to produce legal crops.


"There is additional cause for concern, he said, because of the increasing importance to traffickers of 15 so-called “productive enclaves,” which make up only 14% of all the land dedicated to coca but produce 44% of all the coca in Colombia. In those regions, powerful gangs are intensely focused on the production of high-quality cocaine and the entire economy is linked with the cocaine trade. Those regions are particularly lawless as well as close to transnational drug routes.


"About 65% of all the coca in Colombia is now in the provinces of Nariño and Putumayo, which border Ecuador, and Norte de Santander in the northeast bordering Venezuela. All three provinces are hard-hit by violence and lack schools, paved roads, hospitals and other state institutions—as is Ecuador, where the homicide rate has skyrocketed as Colombian cocaine has flowed in."


Here's the Guardian report on Ecuador:

‘We should treat it as a war’: Ecuador’s descent into drug gang violence. Successive governments have been unable to rein in violence as South American country became cocaine superhighway.  by Dan Collyns 

"In recent years, the South American nation has experienced a nightmarish descent into violence, with successive governments proving unable to rein in organized crime factions. Last month, the cartels showed their power with a mass hostage-taking in six prisons, in an apparent response to the prison transfer of a senior gang leader.

"Before that, presidential candidate Fernando Villavicencio was shot dead in broad daylight less than two weeks before the election’s first round.


"But the country’s armed forces and police appear to be losing the battle against the narcos who have turned the country into a cocaine superhighway as gangs – both inside and outside the weak and overcrowded prison system – vie for drug trafficking routes, with backing from powerful Mexican cartels.

"Drug trafficking is not new in Ecuador, thanks to its location – sandwiched between the world’s main cocaine producers Colombia and Peru – its porous borders and major Pacific Ocean ports. The amount of cocaine seized at the country’s ports has tripled since 2020 to 77.4 tonnes last year.

"But in recent years, the scale of the accompanying violence has rocketed. Ecuador saw 4,600 violent deaths in 2022, double the previous year, and the country is set to break the record again with 3,568 violent deaths in the first half of 2023. Of those, nearly half were in Guayas, the province that includes Guayaquil, where nearly 1,700 people have been murdered so far this year.


Earlier posts on further down the supply chain:

Tuesday, August 8, 2023

Wednesday, September 20, 2023

Mathematics and Computer Science of Market and Mechanism Design: SLMath introductory workshop (videos)

Last week I gave the opening talk of the week long  Introductory Workshop at SLMath, on Mathematics and Computer Science of Market and Mechanism Design.  Some of the video lectures are now online here (consisting mostly of slides and voice).

My talk introduces the general themes of market design by recounting the history and challenges facing the market for new doctors from 1900 through this year.

Berkeley's Simons Laufer Mathematical Sciences Institute (SLMath), formerly known as the Mathematical Sciences Research Institute (MSRI) has a commanding view of the SF Bay.