Children adopted from China can now find birth-family connections via DNA sites

 Like children conceived with the help of anonymous sperm donors, adopted children can use DNA websites to search for family members.  For children adopted from China during the one-child policy period, that can mean finding siblings and even parents who may have put them up for adoption under duress.

The New Yorker has the story:

The Chinese Adoptees Who Were Stolen. As thousands of Chinese families take DNA tests, the results are upending what adoptees abroad thought they knew about their origins.
By Barbara Demick   May 23, 2025

"Back when China started allowing foreign adoptions, in the early nineties, there was no expectation that adoptees would ever connect with their birth families. The babies, mostly girls, were said to have been picked up at train stations, markets, and roadsides, where they had been abandoned by families fearful of the ruthlessly enforced one-child policy. They had no identification. Even the orphanages didn’t know who they were. And China, with its staggeringly large population—more than one billion—was so far away from the adoptive parents. An adoptee finding her birth family seemed no more likely than locating a particular grain of sand.

"Those assumptions have been upended in recent years. Like it or not, and many do not, technology has compressed this vast world into an interconnected village. Adoptees who could only fantasize about their birth families are now identifying them through DNA testing and chatting with them online. Even more unexpected, Chinese birth parents and, sometimes, adult siblings are seeking out and finding their lost kin who were adopted abroad."

American doctors moving to Canada

 Many Canadian doctors practice in the U.S., where pay is generally higher and they may have more access to high tech imaging and other medical equipment.  But there's a stream of docs moving in the other direction now.

KFF Health news has the story:

American Doctors Are Moving to Canada To Escape the Trump Administration
By Brett Kelman 

"The Medical Council of Canada said in an email statement that the number of American doctors creating accounts on physiciansapply.ca, which is “typically the first step” to being licensed in Canada, has increased more than 750% over the past seven months compared with the same time period last year — from 71 applicants to 615. Separately, medical licensing organizations in Canada’s most populous provinces reported a rise in Americans either applying for or receiving Canadian licenses, with at least some doctors disclosing they were moving specifically because of Trump.

...

"Doctors Manitoba, which represents physicians in the rural province that struggles with one of Canada’s worst doctor shortages, launched a recruiting campaign after the election to capitalize on Trump and the rise of far-right politics in the U.S.

"The campaign focuses on Florida and North and South Dakota and advertises “zero political interference in physician patient relationship” as a selling point."

Tinder has plans to become less focused on hookups

 The WSJ has the story:

Tinder’s New Chief Is Out to Change Its Hookup-App Reputation. Spencer Rascoff is rethinking Match Group’s biggest app as younger online daters grow tired of swiping  By  Chip Cutter 

"Tinder’s new chief, Match Group CEO Spencer Rascoff, aims to revamp the app’s image away from hookups to attract Gen Z.

"Rascoff plans to introduce new features, leverage AI, and enhance user safety to improve user experience.

"Tinder is testing a “double dating” feature and will roll it out globally this summer to create low-pressure ways for people to meet.

...

“This generation of Gen Z, 18 to 28—it’s not a hookup generation. They don’t drink as much alcohol, they don’t have as much sex,” he told investors this month. “We need to adapt our products to accept that reality.”

Medical aid in dying advances in France

 The proposed French law has some familiar and some novel features.

Reuters has the story:

French lawmakers approve assisted dying bill, paving the way for approval
By Elizabeth Pineau May 27, 2025

"- French lower house lawmakers approved a bill on Tuesday to legalise assisted dying, paving the way for France to become the latest European nation to allow terminally ill people to end their lives.
 

"The final passage of the bill remains some way off, with the text now heading to the Senate. However, the legislation is expected to pass, with polls showing more than 90% of French people in favour of laws that give people with terminal diseases or interminable suffering the right to die.

...

"The bill, which was approved in parliament by 305 votes to 199, provides the right to assisted dying to any French person over the age of 18 suffering from a serious or incurable condition that is life-threatening, advanced or terminal.
 

"The person, who must freely make their decision, must also have constant physical or psychological suffering that cannot be alleviated. Lawmakers stipulated that psychological suffering alone would not be enough to end one's life.
 

"The patient can administer the lethal dose themselves or by an accredited medical professional if they are physically unable. Healthcare workers who object to doing so are free to opt out. Anyone found to have obstructed someone's right to die can face a two-year prison sentence and a 30,000 euro fine.

"Laws to enable assisted dying are gathering steam across Europe. In November, British lawmakers voted in favour of allowing assisted dying, paving the way for Britain to follow countries such as Australia, Canada and some U.S. states in what would be the biggest social reform in a generation.
 

"In March, the Isle of Man, a self-governing British Crown Dependency off northwest England, approved an assisted dying bill, potentially making the island the first place in the British Isles where terminally ill people could end their lives.
 

"France is one of the last countries in Western Europe to legislate on this issue," leftist lawmaker Olivier Falorni told Reuters. "We are in a global process ... France is behind, and I hope we will do it with our own model."

 

 

HT: Alex Chan

Kidney and liver exchange in India

 Here's an update from Dr. Vivek Kute and his colleagues on kidney and liver exchange in India.

Kute, V. B., Patel, H. V., Banerjee, S., Aziz, F., Godara, S. M., Bansal, S. B., ... & Srivastava, A. (2025). Analysis of kidney and liver exchange transplantation in India (2000–2025): a multicentre, retrospective cohort study. The Lancet Regional Health-Southeast Asia, Volume 37, June 2025, 100597. 

Ethical compensation for research participants: an open letter

 Institutional review boards (IRBs) are often faced with the question of whether research participants should or must be compensated, and how much.  In the medical ethics community there is often a presumption that there are ethical reasons not to offer participants too much compensation. This is a very different intuition from the more general notion (embodied e.g. in minimum wage laws) that there are ethical reasons not to offer too little compensation.

I'm one of 64 signers of an open letter about this...

Abadie, R. et al. (2025) ‘Pursuing Fair and Just Compensation for Research Participants: An Open Letter to the Research Ethics Community’, The American Journal of Bioethics, pp. 1–5. doi: 10.1080/15265161.2025.2506328.
 

"We, the 64 undersigned, from fields including philosophy, law, medicine, policy, public health, patient advocacy, and research ethics, offer this open letter to highlight the growing recognition of the pitfalls of excessive concern over payment to research participants. Experts in the field of research oversight, including institutional review boards/research ethics committees (IRB/RECs), now recognize that for adult participants capable of providing their own informed consent, instances of monetary undue influence are generally quite rare, underpayment is far more common and ethically concerning than overpayment, and that lowering payments threatens justice and fairness without providing substantive protection for participants.

...

"Absent strong evidence that monetary payment will lead to undue influence, it is likely that more harm than good is done by lowering compensation levels for a given study. Research participation generates immense social value, and generous compensation can reflect this value and serve as an important sign of respect and appreciation for participants (Fernandez Lynch et al. Citation2021).

...

"Concern over undue influence through monetary compensation, while well intended, receives outsized attention, even at the expense of other ethical issues. Ultimately, there must be very strong rationale when suggesting such limits for an otherwise approved study, and attempts to limit payment based on the potential for undue influence should be scrutinized especially closely. IRBs/RECs should still keep in mind the amount of time required and burden on participants to ensure at least a minimum standard of compensation is met. At times, they should even require sponsors or investigators to increase compensation amounts when what they are proposing is insufficient. It is high time that the default question shift from “is this payment too much?” to “is this enough?” in clinical trials."

 

Signed by:

Roberto Abadie    Assistant Professor, University of Wisconsin-Madison Department of Kinesiology
Adam L. Anderson    Associate Professor of Medicine, Washington University in St. Louis
Emily E. Anderson    Professor of Bioethics, Loyola University Stritch School of Medicine
Andrew Berman    Professor of Medicine, Rutgers New Jersey Medical School
Barbara Bierer    Professor of Medicine, Harvard Medical School, and Faculty Director, MRCT Center
François Bompart    Member, INSERM Ethics Committee (France)
Brandon Brown    Professor of Medicine, University of California, Riverside, School of Medicine
Arthur Caplan    Head, Division of Medical Ethics, NYU Grossman School of Medicine
Carolyn Riley Chapman    Lead Investigator/Faculty, Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard
Coalition for Clinical Trial Equity
Alexandra Collins    Assistant Professor of Community Health, Tufts University
Marci Cottingham    Associate Professor of Sociology, Kenyon College
Stephanie Solomon Cargill    Associate Professor of Research Ethics, Albany Medical College
Arlene M. Davis    Professor of Social Medicine, UNC School of Medicine
David DeGrazia    Elton Professor of Philosophy, George Washington University
David Diemert    Professor of Medicine, George Washington University
Anna Durbin    Professor, Johns Hopkins Bloomberg School of Public Health
Jake Earl    Adjunct Lecturer in Philosophy, Georgetown University
Jake D. Eberts    Member of the Board of Directors, 1Day Sooner
Gunnar Esiason    Head of Patient Engagement & Patient-Centered Innovation, RA Ventures
James A. Feldman    Professor of Emergency Medicine, Boston University School of Medicine
Holly Fernandez Lynch    Associate Professor of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine
Susan S. Fish    Professor, Boston University Chobanian & Avedisian School of Medicine
Celia B. Fisher    Marie Ward Doty Endowed University Chair in Ethics and Professor of Psychology
Jill A. Fisher    Professor of Social Medicine, UNC Center for Bioethics
Allison Foss    Executive Director, Myasthenia Gravis Association
Foundation for Sarcoidosis Research
Luke Gelinas    Senior IRB Chair Director, Advarra
Kevin Griffith    Assistant Professor of Health Policy, Vanderbilt University
Marielle Gross    Founder/ceo, de-bi, co; Faculty, Johns Hopkins Berman Institute of Bioethics
Scott D. Halpern    John M. Eisenberg Professor in Medicine, University of Pennsylvania
Logan Harper    ILD & Sarcoidosis Center, Cleveland Clinic, Assistant Professor of Medicine, CCLCM/CWRU School of Medicine
David A. Heagerty    Associate Director, University of Pennsylvania IRB
Kristin Hermann    Executive Vice President, Strategic Accounts, Scout
W. Ennis James    Associate Professor of Medicine and Sarcoidosis Program Director, Medical University of South Carolina
Steven Joffe    Art and Ilene Penn Professor and Chair of Medical Ethics & Health Policy, University of Pennsylvania Perelman School of Medicine
Nancy M. P. King    Emeritus Professor, Wake Forest University School of Medicine
Stephanie A. Kraft    Assistant Professor, Geisinger College of Health Sciences
Walter K. Kraft    Professor, Thomas Jefferson University
Benjamin Krohmal    Assistant Professor, Georgetown University School of Medicine
Emily A. Largent    Associate Professor of Medical Ethics, University of Pennsylvania Perelman School of Medicine
Anne Drapkin Lyerly    Professor of Social Medicine, University of North Carolina at Chapel Hill
Lazarex Cancer Foundation
Dylan Matthews    Senior Correspondent, Vox
Lindsay McNair    Principal Consultant, Equipoise Consulting
Josh Morrison    President, 1Day Sooner
Joseph Millum    Senior Lecturer, University of St Andrews
Torin Monahan    Professor, University of North Carolina at Chapel Hill
Axel Ockenfels    Professor of Economics at the University of Cologne and Director at the Max Planck Institute for Research on Collective Goods in Bonn
Joshua Osowicki    Infectious diseases physician and Team Leader, Murdoch Children’s Research Institute, Melbourne, Australia
Leah Pierson    MD/PhD candidate, Harvard Medical School; Cohost of the Bio(un)ethical podcast
Jessica Propps    Caregiver Advocate, Foundation for Sarcoidosis Research
Jeanne M. Regnante    Principal, Patient 3i, LLC
David B. Resnik    Bioethicist
Donald Richardson    Cardiovascular Disease Fellow, Cedars-Sinai Medical Center
Alvin Roth    Craig and Susan McCaw Professor of Economics, Stanford University
Julian Savulescu    Professor of Medical Ethics, National University of Singapore
Scout Clinical    
Peter H. S. Sporn    Professor of Medicine, Northwestern University Feinberg School of Medicine
Kawsar Talaat    Associate Professor, Johns Hopkins Bloomberg School of Public Health
Rebecca L. Walker    Professor of Philosophy and of Social Medicine, University of North Carolina at Chapel Hill
Margaret Waltz    Research Associate, University of North Carolina at Chapel Hill
Kathryn Washington    Sarcoidosis patient advocate
Sarah A. White    Executive Director, The Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard
Megan M. Wood    Assistant Professor of Communication and Media, Ohio Northern University

 

Thinking about the ethical, legal and political relationships between IVF and abortion (in JAMA)

Some people support both IVF and abortion (women's right to choose) and some people oppose both (embryos are people), but many oppose abortion but support IVF.  Here's an article that focuses on some ethical distinctions (is the intention to have a child or not), and also on some political ones (IVF patients are on average more affluent than abortion patients).

Watson K. Rethinking the Ethical and Legal Relationship Between IVF and Abortion. JAMA. Published online May 22, 2025. doi:10.1001/jama.2025.6733 

"US voters have elected a president who promised he would make the government or private insurance cover in vitro fertilization (IVF), yet takes credit for reversing Roe v Wade. These positions highlight a question that has lingered since US IVF practice began in 1981: are hospital and governmental policies that support IVF but do not support abortion ethically consistent? And if not, why is this division so common?

"Those who see IVF and abortion as ethically distinct often focus on differences in intention and outcome—having a baby vs avoiding having a baby. Others see them as comparable practices because both destroy embryos. I offer a third perspective, which is that abortion and IVF are comparable practices because both are family-building medical interventions; therefore, support for IVF access ought to lead to support for abortion access.

"Abortion was a federal constitutional right until 2022, and IVF was subject to state regulation like the rest of medicine. Yet constitutional protection did not stop many states from heavily regulating abortion, and IVF rarely faced governmental limits. A stark example of their disparate treatment occurred shortly after Roe v Wade was reversed when the traditionally antiabortion state of Indiana began its statute criminalizing abortion provision by clarifying “This article does not apply to in vitro fertilization” (IN Code §16-34-1-0.5 [2024]).

"Yet like abortion, IVF also involves embryo death. 

...

" differences in patient income, race, age, and education also suggest a stark difference in political power between the constituencies invested in IVF and abortion. Eighty-one percent of fertility patients have household incomes of more than $100 000 and 75% are White6; 72% of abortion patients have incomes less than 200% of the federal poverty line and 59% are Black or Latinx.3 Sixty-four percent of IVF patients are 35 years or older,7 while 70% of abortion patients are in their teens or 20s.3 Fourteen percent of births to women with a college or graduate degree were conceived with the use of assisted reproductive technology, but only 1.5% of births to women with some college or less were conceived with assisted reproductive technology in 2023.8 In contrast, 77% of abortion patients have some college or less.9 (There are no data documenting how many IVF patients deferred their childbearing by having an abortion when they were younger, or how many IVF patients later abort to decrease a multiple pregnancy or avoid unexpected medical problems.)

"Entities involved in providing IVF also have financial interests in preserving the legality of a practice with a median cost of $19 200 per cycle.6 Infertility care generates approximately $8 billion per year in gross revenues in the US.10 High operating margins have drawn private equity investors to many private fertility practices, and IVF is lucrative for hospitals and physicians."

A controversial artificial intelligence experiment in Hungary

 Peter Biro alerts me to this artificial intelligence experiment  that caused a backlash when it was conducted in Hungary.

Here's the story from Telex.hu, via Google Translate:

"Some of the students can use AI in the exam, the other part cannot, and they were outraged  by
Halász Nikolett,Interior May 21, 2025  

"This semester, the teachers of the subject of operations research have started a special experiment at the Corvinus University of Budapest, where one half of the students can use artificial intelligence (such as ChatGPT) in exams, while the other half cannot. More than ten students contacted our newspaper because they consider the system unfair, but according to the lecturers of the subject, the experiment was preceded by very careful professional consultation.

...

"In order not to be disadvantaged by either group, the instructors introduced point compensation, which brings the average of the two groups to the same level, i.e. the worse performers receive the difference calculated from the average of the other group. To illustrate with an example: Marcsi belongs to experimental group B. The participants of group A scored an average of 67 points during the year, and the participants of group B scored an average of 62 points. Marcsi scored 46 points on the exam. This score is compensated by the 5 points resulting from the group differences, so she scored a total of 51 points on the exam. 

...

"According to several students, the main problem is that there are students who can complete the subject with zero work invested with the help of AI. While others prepare for several days, even a week, and achieve a similar result, but they have actually acquired the knowledge."

############

Somewhat related earlier post:

Saturday, June 8, 2024

The ethics of field experiments in Economics, in the Financial Times

Deceased organ allocation: deciding early when to move fast

The deceased donor waiting list for kidneys to transplant is congested: offers, which take time to evaluate, are often rejected, while cold ischemia time accumulates.

 Here's a paper just published in Transplantation, in which we suggest new ways to detect organs that will be hard to match, and which might therefore be expedited through the allocation process (to get more quickly to patients who will accept them).

Insights From Refusal Patterns for Deceased Donor Kidney Offers, by Guan, Grace MS1; Neelam, Sanjit MS2; Studnia, Joachim MS2; Cheng, Xingxing S. MD, MS3; Melcher, Marc L. MD, PhD4; Rees, Michael A. MD, PhD5,6; Roth, Alvin E. PhD7; Somaini, Paulo PhD8; Ashlagi, Itai PhD1
Author Information
Transplantation ():10.1097/TP.0000000000005434, May 21, 2025 

"Background.
The likelihood that a deceased donor kidney will be used evolves during the allocation process. Transplant centers can either decline an organ offer for a single patient or for multiple patients at the same time. We hypothesize that refusals for a single patient indicate issues with individual patients, whereas simultaneous refusals for multiple patients indicate issues with organ quality.

Methods.
We investigate offer refusal patterns between January 1, 2022, and December 31, 2023, using Organ Procurement and Transplantation Network data. We aggregate refusals at the same timestamp by a center and define a multiple patient refusal as >1 or >5 patients simultaneously refused. We report the refusal codes associated with single and multiple patient refusals and the nonutilization rate after receiving single and multiple patient refusals by cross-clamp.

Results.
Patient-related refusal reasons are more commonly single patient refusals, whereas organ-related refusal reasons are more commonly multiple patient refusals. Multiple patient refusals before cross-clamp are associated with nonutilization, but single patient refusals are positively correlated with utilization. The nonutilization rate was 28% for organs without pre-clamp refusals, 35% with a single center sending a multiple patient refusal, but only 12% with a single center sending a single patient refusal.

Conclusions.
The risk of nonutilization can be assessed early in the offering process based on the number of single and multiple patient refusals received by a specific time (e.g., cross-clamp). Understanding refusal patterns can guide the development of transparent protocols for accelerated placement."

 

Susan Athey on biggish data and machine learning

 Susan Athey is interviewd in JAMA:

How an Economist’s Application of Machine Learning to Target Nudges Applies to Precision Medicine   by Roy Perlis and Virginia Hunt  JAMA. Published online May 16, 2025. doi:10.1001/jama.2025.4497 

"A recent study by economist Susan Athey, PhD, and her colleagues may shed light on how best to target treatments using machine learning. The investigation, published in the Journal of Econometrics, focused on the effectiveness of text and email reminders, or nudges, sent to students about renewing their federal financial aid. The researchers compared causal targeting, which was based on estimates of which treatments would produce the highest effects, and predictive targeting, which was based on both low and high predicted probability of financial aid renewal.

"In the end, the study found hybrid models of the 2 methods proved most effective. However, the result that may be most surprising to Athey was that targeting students at the highest risk of nonrenewal was actually less effective.

...

"Dr Athey:When I first started working on this, I was like, “Oh, there’s going to be a gold mine. I’m going to go back and reanalyze all of these experiments that have already been run, and we’re going to be doing new scientific discoveries every day.” It didn’t quite work out that way. We had some big successes, but there has been a lot of lack of success.

What are the cases where this doesn’t work? Machine learning is using the data to learn about these treatment effects. You have to do a lot of sample splitting. There’s always a cost to using the data to discover the model. You can do it without sample splitting, but then you have to adjust your P values. There’s no free lunch. If you have a very small dataset, you probably know what the most important factors are. You might be better off prespecifying those and just doing your subgroup analysis. If [there are] hundreds of observations, it’s just unlikely. These techniques are too data hungry to work.

Generally, you need thousands of people in the experiment. Then more than that, the statistical power needed to get treatment effect heterogeneity is large. And even treatment effect heterogeneity is easier—trying to get differential targeting is another thing. Imagine you have 3 drugs. It’s hard enough to say that something works relative to nothing. If you’re trying to say that one drug works better than another drug where both work, that’s hard. Usually you need really large, expensive trials to do that.

Then you add on top of that that I want to say, “This drug is better for these people, and this other drug is better for these other people.” You need 10 times as much data as you would for the basic “is there a treatment effect at all?” Now, of course, sometimes there’s a genetic thing: this drug literally doesn’t work or it has this terrible side effect for some people. That will pop out of the data.

For more subtle effects, you do need larger studies. That’s really been the main impediment. And as an economist, it’s like, why are all these things just barely powered? Why are there so many clinical studies with a t-statistic of 2? Of course, people did the power calculations, and they had some data already when they planned the experiments. If you have more data, maybe you add another treatment arm or something else. You don’t actually overpower an experiment. In my own research, I’ve ended up running my own experiments that are designed to get heterogeneity. I’ve also had a lot of luck when there’s very big administrative datasets, and there’s a really good natural experiment. Then you have lots of data. But former clinical trials are selected to not be good because the researcher themself didn’t overpower their own experiment. That’s why this isn’t so useful.

But nonetheless, that’s not to say it’s not out there. Like in any discovery, if it’s going to save lives and money, it’s worth doing. It’s just that there’s not a whole bunch of low-hanging fruit. There’s no dollars lying on the sidewalk."

There's a gray market for diabetes supplies

 High prices and inadequate medical insurance force some patients to get their diabetes monitoring supplies second hand. Here's a suggestion for some redesign...

Medpage has the story:

The Diabetic Supplies Gray Market Is Ripe for Disruption by Jacob Murphy 

""CA$H 4 SEALED & UNEXPIRED DIABETIC TEST STRIPS -- CALL NOW."

This message, printed in black on a neon yellow poster board, hangs just outside the $1.1 billion Charlotte R. Bloomberg Children's Center at Johns Hopkins Hospital. The sign represents a peculiar offshoot of American healthcare: the diabetic supplies gray market. Here, blood glucose test strips are exchanged within an informal network.

This market operates through handwritten signs and websites like QuickCash4TestStrips.com, often flourishing in areas with high rates of poverty and uninsured patients. How does it work? Insured patients obtain excess test strips at little personal cost through insurance, then sell them to reseller companies. These companies profit by selling the strips below original retail prices, which far exceed manufacturing costs, to uninsured individuals. And, surprisingly, this is all legal.

...

"Diabetes costs have steadily risen to thousands of dollars annuallyopens in a new tab or window for individuals. These expenses can be even higher for the 1.5 million diabetic Americans without health insurance, especially if they experience diabetes-related complications. Without proper monitoring, these individuals face life-threatening risks of ketoacidosis, hypoglycemia, and long-term complications including vision loss, kidney failure, and amputations. In the end, they're left with a tough choice: turn to an unregulated "gray" market or potentially face major health complications and financial consequences. 

...

"[ academic medical centers] should establish formal redistribution programs that incentivize donations of excess diabetic supplies. These programs would provide safer alternatives to unregulated gray market exchanges, leveraging institutional scale to deliver essential supplies at minimal or no cost to those most in need.

"Incentives to donors could include copay waivers for downstream care, free diabetes check-ups such as eye and foot exams, or connections to food assistance programs. Conditional cash transfers could also serve as effective motivators, particularly for the lowest-income donors. Additionally, centers could help patients transition from test strips to continuous glucose monitors "

"Pocket listings" in residential real estate

 After recent antitrust rulings regarding residential real estate sales, big brokers are regrouping:

Yahoo finance has the story

The real estate world is fighting over secret listings and the future of how homes are sold

"Barely a year after the National Association of Realtors settled a lawsuit and rewrote the rules for how agents get paid, the powerful trade group is examining the fate of another policy that could change how homes are bought and sold across the country.

"The policy, known as Clear Cooperation, requires agents to list homes on shared databases known as multiple listing services (MLS) within one business day of beginning to market the properties. The rule is designed to cut down on what are known as “off-market” or “pocket” listings, where a home for sale is marketed semi-privately to small pools of potential buyers without being advertised widely on the MLS. 

"The NAR is currently reviewing whether the rule should be repealed, remain in place, or be changed.

...

"Where most real estate companies fall on the issue tends to align with whether or not they benefit from the rule. Executives at Zillow and Redfin, which aggregate home listings from the MLS, are for it. Compass, a luxury-focused brokerage that touts its access to “Private Exclusives,” is against it. Anywhere Real Estate, the parent company of franchises including Century 21, Coldwell Baker, and Sotheby's International Realty, has said it would like to see the rule remain but with changes.

Pocket listings are a relatively niche way to sell a home in most parts of the country. Data is scarce, but estimates generally put the deals at 5% or less of sales nationwide. Using deals that were listed as “sold” the same day they first appeared on the MLS as a proxy, Redfin estimates that they made up 1.8% of deals in mid-2024."

Notes from Messina (kidney exchange and the Accademia Peloritana dei Pericolanti)

 We traveled last week from Prague to Sicily, for the Matching in Practice workshop in  Messina, which was rich in kidney exchange. I was glad to reconnect with the Director of the National Transplant organization, Dr. Giuseppe Feltrin, and with Professors Antonio Nicolò and Antonio Miralles.

But a funny thing happened first, at the University of Messina. I was inducted into the university's Accademia Peloritana dei Pericolanti, founded in the early 1700's, at a time when autocrats didn't look fondly on universities (imagine that!). The symbol of the Academy is a ship sailing in the Strait of Messina (between Scylla and Charybdis) with the motto "Inter utramque viam periclitantes," "Taking risks between both paths," reflecting (I was told) the perils of navigating the strait between scholarship and politics.  It seemed very appropriate for the times.

Here's the story in the local news: with a picture:

 

Notes from Prague (kidney exchange, market design, and progress on a new book)

I flew back to California yesterday, after spending some time in Czechia and Italy talking about kidney exchange.  Here is a video of the public talk I gave at Prague Castle.  Among other things it highlights the Czech kidney exchanges with Israel. (I had the pleasure of meeting  Prof. Jiri Fronek, the distinguished surgical pioneer who led the Czech side of that effort.)

https://youtu.be/jrrlNWMkQyE?feature=shared

I also had the privilege of visiting CERGE-EI  (Center for Economic Research and Graduate Education - Economics Institute) where my host was Prof  Štěpán Jurajda.  He and I first met when we were both at the University of Pittsburgh in the 1990s.

And here's an interview with the Economic newspaper  Hospodářské noviny  that starts off with the optimistic notion that I may have just (largely) completed the draft of a new book:)

Zkoumá trhy, kde peníze nevládnou. Ledvinu ani lásku si za ně většinou nekoupíte, říká nobelista Alvin Roth [ He explores markets where money doesn't rule. You can't usually buy a kidney or love with it, says Nobel laureate Alvin Roth]

“Before flying from the USA to Prague, economist and Nobel laureate Alvin Roth managed to send the publisher a draft of his new book, which he is currently finishing. He calls it Controversial Markets. Between an afternoon lecture for students at the CERGE-EI Institute in Prague and an evening lecture at Prague Castle, he also found time for an interview with Hospodářské noviny, in which he outlines what his new book will be about. One of the controversial markets he deals with, for example, is the organ transplant market."

Wine barrels, barrel brokers, and tariffs

 Wine barrels are traded and reused internationally.

The Guardian has the story:

Stained, warped and terroir rich: the global and shockingly sustainable lives of wine barrels
Wood barrels circle the world and can be used for more than a century. They tell a story, but they’re imperiled by tariffs  by Kiki Aranita

"In the alcohol industry, when ageing liquor can easily take decades, the vessels that house them can also become more covetable over the years. In an age of disposable materials and dire news of plastics polluting our environment, reused wooden barrels exist in stark contrast. The lives of barrels are long, shockingly sustainable and currently imperiled by trade war.

"Many circumnavigate the globe and end their days in distilleries in remote corners of the world, originating in the forests of Hungary and moving from mountain towns in Canada to distilleries in the Caribbean and Mexico. At Hamilton, new American oak barrels hold fresh distillate, alongside the dinosaurs: French cognac barrels that show their age

...

“We think of barrels as teabags. It gets used first for bourbon, like the first steep of a teabag. You get a lot of color and flavor from the barrel quickly. If you use the barrel again, it’ll take longer to impart, so maybe it’s used for scotch, which sits and ages longer. You mute the barrel’s flavors along the way.”

...

"The international use of barrels is part and parcel of the global liquor industry. Large conglomerates like LVMH, Brown-Forman and Suntory have multiple spirits brands in their portfolios, and barrels make their rounds internally. A Kentucky-made barrel might end up in Scotland to age scotch because Brown-Forman owns both the Jack Daniel’s and Glendronach brands.

...

"Distilleries that aren’t owned by large conglomerates enlist the help of a barrel broker who can source unique barrels. Mara Smith sources old pinot noir barrels from France through a broker, as they give her Inspiro tequila a rosy hue and flavors like “berries, some nuttiness, a floral [aroma] on the nose”.

...

"Rizzo outlines a Laws Whiskey barrel’s typical lifespan. “We age our Four Grain Bourbon and send those used bourbon barrels [after four to 10 years] to a local apiary, Bee Squared, in Berthoud, Colorado. They age their honey in those used barrels for 90 days to produce a glorious local barrel-aged honey. We then get those barrels back and put more bourbon into them to make a natural honey-aged bourbon [which takes a year and a half of ageing]. One went to our friends at Lady Justice Brewing, who aged a honey bock beer in the honey barrel. Once that was finished in six months to two years, they put malted barley grain inside the barrel for another six months to two years to flavor the grain to produce another beer. And then the barrel is made into furniture.” These barrels had seven lives.

"Recent tariffs are making the very aspect of manufacturing barrels, distilling alcohol and selling its finished product more expensive. In American winemaking, particularly in California, French oak barrels will be affected by the EU’s retaliatory tariffs. Since barrels are essentially an ingredient in any given type of alcohol’s recipe, a winemaker would not be able to easily switch out a type of wood they have used previously for something available domestically."

Chronic diseases in the U.S.

 The top three chronic diseases--Hypertension, Obesity, and Diabetes--all contribute to the fourth, Kidney Disease.

How Chronic Disease Became the Biggest Scourge in American Health
Americans live shorter and sicker lives than people in other high-income countries   By  Brianna Abbott  | Graphics by  Josh Ulick