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Thursday, May 17, 2018

Google Selfish Ledger: Unsettling Vision of Silicon Valley Social Engineering

Google has built a multibillion-dollar business out of knowing everything about its users. Now, a video produced within Google and obtained by The Verge offers a stunningly ambitious and unsettling look at how some at the company envision using that information in the future.
The video was made in late 2016 by Nick Foster, the head of design at X (formerly Google X), and a co-founder of the Near Future Laboratory. The video, shared internally within Google, imagines a future of total data collection, where Google helps nudge users into alignment with their goals, custom-prints personalized devices to collect more data, and even guides the behavior of entire populations to solve global problems like poverty and disease.
When reached for comment on the video, an X spokesperson provided the following statement to The Verge:
“We understand if this is disturbing — it is designed to be. This is a thought-experiment by the Design team from years ago that uses a technique known as ‘speculative design’ to explore uncomfortable ideas and concepts in order to provoke discussion and debate. It’s not related to any current or future products.”
google selfish ledger
All the data collected by your devices, the so-called ledger, is presented as a bundle of information that can be passed on to other users for the betterment of society.
Titled The Selfish Ledger, the 9-minute film starts off with a history of Lamarckian epigenetics, which are broadly concerned with the passing on of traits acquired during an organism’s lifetime. Narrating the video, Foster acknowledges that the theory may have been discredited when it comes to genetics but says it provides a useful metaphor for user data. (The title is an homage to Richard Dawkins’ 1976 book The Selfish Gene.) The way we use our phones creates “a constantly evolving representation of who we are,” which Foster terms a “ledger,” positing that these data profiles could be built up, used to modify behaviors, and transferred from one user to another:
“User-centered design principles have dominated the world of computing for many decades, but what if we looked at things a little differently? What if the ledger could be given a volition or purpose rather than simply acting as a historical reference? What if we focused on creating a richer ledger by introducing more sources of information? What if we thought of ourselves not as the owners of this information, but as custodians, transient carriers, or caretakers?”
The so-called ledger of our device use — the data on our “actions, decisions, preferences, movement, and relationships” — is something that could conceivably be passed on to other users much as genetic information is passed on through the generations, Foster says.
Resolutions by Google, the concept for a system-wide setting that lets users pick a broad goal and then directs their everyday actions toward it.
Building on the ledger idea, the middle section of the video presents a conceptual Resolutions by Google system, in which Google prompts users to select a life goal and then guides them toward it in every interaction they have with their phone. The examples, which would “reflect Google’s values as an organization,” include urging you to try a more environmentally friendly option when hailing an Uber or directing you to buy locally grown produce from Safeway.
An example of a Google Resolution superimposing itself atop a grocery store’s shopping app, suggesting a choice that aligns with the user’s expressed goal.
Of course, the concept is premised on Google having access to a huge amount of user data and decisions. Privacy concerns or potential negative externalities are never mentioned in the video. The ledger’s demand for ever more data might be the most unnerving aspect of the presentation.
Foster envisions a future where “the notion of a goal-driven ledger becomes more palatable” and “suggestions may be converted not by the user but by the ledger itself.” This is where the Black Mirror undertones come to the fore, with the ledger actively seeking to fill gaps in its knowledge and even selecting data-harvesting products to buy that it thinks may appeal to the user. The example given in the video is a bathroom scale because the ledger doesn’t yet know how much its user weighs. The video then takes a further turn toward anxiety-inducing sci-fi, imagining that the ledger may become so astute as to propose and 3D-print its own designs. Welcome home, Dave, I built you a scale.
A conceptual cloud processing node that is analyzing user information and determining the absence of a relevant data point; in this case, user weight.
Foster’s vision of the ledger goes beyond a tool for self-improvement. The system would be able to “plug gaps in its knowledge and refine its model of human behavior” — not just your particular behavior or mine, but that of the entire human species. “By thinking of user data as multigenerational,” explains Foster, “it becomes possible for emerging users to benefit from the preceding generation’s behaviors and decisions.” Foster imagines mining the database of human behavior for patterns, “sequencing” it like the human genome, and making “increasingly accurate predictions about decisions and future behaviours.”
“As cycles of collection and comparison extend,” concludes Foster, “it may be possible to develop a species-level understanding of complex issues such as depression, health, and poverty.”
A central tenet of the ledger is the accumulation of as much data as possible, with the hope that at some point, it will yield insights about major global problems.
Granted, Foster’s job is to lead design at X, Google’s “moonshot factory” with inherently futuristic goals, and the ledger concept borders on science fiction — but it aligns almost perfectly with attitudes expressed in Google’s existing products. Google Photos already presumes to know what you’ll consider life highlights, proposing entire albums on the basis of its AI interpretations. Google Maps and the Google Assistant both make suggestions based on information they have about your usual location and habits. The trend with all of these services has been toward greater inquisitiveness and assertiveness on Google’s part. Even email compositions are being automated in Gmail.
At a time when the ethics of new technology and AI are entering the broader public discourse, Google continues to be caught unawares by the potential ethical implications and downsides of its products, as seen most recently with its demonstration of the Duplex voice-calling AI at I/O. The outcry over Duplex’s potential to deceive prompted Google to add the promise that its AI will always self-identify as such when calling unsuspecting service workers.
The Selfish Ledger positions Google as the solver of the world’s most intractable problems, fueled by a distressingly intimate degree of personal information from every user and an ease with guiding the behavior of entire populations. There’s nothing to suggest that this is anything more than a thought exercise inside Google, initiated by an influential executive. But it does provide an illuminating insight into the types of conversations going on within the company that is already the world’s most prolific personal data collector.

Glaxo bets on lift from new lung drugs ahead of Advair’s last gasp

GlaxoSmithKline is putting more marketing muscle behind its new lung drugs and is looking for a sales boost as top respiratory experts gather to analyse clinical trials data at a meeting in San Diego this weekend.

The British drugmaker has dominated the lung drug market for decades, but its pre-eminence is no longer guaranteed, given declining sales of the ageing Advair inhaler, which could soon face generic competition in the United States.
The market is also seeing intensified pricing pressure, raising doubts over the long-term profitability of newer drugs.
That makes this year’s meeting of the American Thoracic Society (ATS) from May 18 to 23 a critical venue for GSK.
Luke Miels, GSK’s head of pharmaceuticals, told Reuters the good sales trajectory seen in the first quarter with its novel three-in-one inhaler Trelegy and the injectable Nucala had continued since March, with ATS offering further upside.
A recent expanded U.S. label for Trelegy, to include chronic obstructive pulmonary disease (COPD) patients who need long-term therapy, means GSK can aim its product at millions more patients. Doctors will be presented with clinical data from a pivotal study in this patient group at ATS.
The so-called IMPACT study showed GSK’s once-daily Trelegy was superior to other approaches at reducing severe attacks and improving lung function.
“I think the IMPACT data is going to generate lot of interest and out of that we will see a heightened interest in Trelegy,” Miels said.
Still, pricing pressure in respiratory medicine remains a black cloud, especially with U.S. generic Advair looming.
Although Advair copycats failed to launch in 2017 as U.S. regulators knocked back applications, they are very possible this year, with Mylan due to hear next month whether the U.S. Food and Drug Administration will approve its version.
TIME WILL TELL
The price squeeze in the U.S. inhaler market is proving more severe than GSK had anticipated at the start of the year, particularly in the ICS/LABA area, which includes Advair. Another class known as LAMA medicine is faring better.
Since Trelegy includes all three products in a single inhaler, it is potentially caught in the cross-fire.
GSK has priced Trelegy at a 20 percent discount to its components and the company has not reduced the price since its launch, but Miels acknowledged this might change once Advair generics arrive.
“We are not experiencing direct pressure on Trelegy at this point in time. I think it’s reasonable to think there will be some pressure with the introduction of Advair generics but we’re confident we can manage that,” he said.
Outside the United States, which is likely to account for around 60 percent of sales, Trelegy has already launched in Britain and is now being rolled out in Germany and Canada.
Consensus analyst forecasts compiled by Thomson Reuters don’t predict it becoming a $1 billion-a-year blockbuster before 2023 but Miels said such estimates looked conservative.
“We are more confident,” he said. “Time will tell but I hope that over time the analysts will move their numbers up.”
Miels, who was hired by new CEO Emma Walmsley last year from AstraZeneca, has redeployed resources to focus on such priority products and nearly all of GSK’s more than 2,000 respiratory reps in the United States are now selling Trelegy and Nucala, plus two other relatively new lung drugs Breo and Anoro.
That leaves only a small contract team working on Advair.
GSK will also present long-term data on Nucala – a new kind of biotech drug for severe asthma – at ATS. The medicine has enjoyed a head-start over rivals but now faces competition from AstraZeneca’s Fasenra.

Appaloosa gets permission for activist stance with Allergan stake

David Tepper’s Appaloosa Management and two of his funds received Federal Trade Commission clearance earlier this week that could clear the way for the billionaire to become an activist investor in drugmaker Allergan Plc.

Tepper received the Hart-Scott-Rodino anti-trust clearances on Wednesday, according to the FTC’s website.
Wells Fargo analyst David Maris said in a research note that Allergan “indicated this clearance provides flexibility to the filer as to whether they want take an activist approach to the investment or not.”
Tepper’s Appaloosa LP increased its stake in Allergan to 3.7 million shares from around 3.5 million shares over the last quarter, the firm said in a filing with the Securities and Exchange Commission on Tuesday.
“Allergan welcomes all investments in our company,” spokeswoman Amy Rose said, when asked about the clearances. Appaloosa was not immediately available for comment.
The company’s shares roe $5.70, or 3.7 percent, to $160.23 on Thursday.
Botox maker Allergan launched a strategic review of its business earlier this year. CEO Brent Saunders said in March the declining stock price required the company to look at all options “with a sense of urgency.”
Still, Saunders indicated on the company’s earnings conference call last month that he did not feel a fundamental change to the company’s strategy was necessary.

ED med, flu vax may help immune system fight cancer post surgery

A new study suggests that a common treatment for erectile dysfunction combined with the flu vaccine may be able to help the immune system mop up cancer cells left behind after surgery. The study, published in OncoImmunology, shows that this unconventional strategy can reduce the spread of cancer by more than 90 percent in a mouse model. It is now being evaluated in a world-first clinical trial.
“Surgery is very effective in removing solid tumours,” said senior author Dr. Rebecca Auer, surgical oncologist and head of  research at The Ottawa Hospital and associate professor at the University of Ottawa. “However, we’re now realizing that, tragically, surgery can also suppress the immune system in a way that makes it easier for any remaining  to persist and spread to other organs. Our research suggests that combining  drugs with the  may be able to block this phenomenon and help prevent cancer from coming back after surgery.”
The current study investigated sildenafil (Viagra), tadalafil (Cialis) and an inactivated influenza vaccine (Agriflu) in a mouse model that mimics the spread of cancer (metastasis) after surgery. The researchers evaluated these treatments by counting the number of metastases in mouse lungs. They found an average of:
  • 37 metastases with cancer  alone
  • 129 metastases with cancer cells and surgery
  • 24 metastases with cancer cells, surgery and one of the erectile dysfunction drugs
  • 11 metastases with cancer cells, surgery, one of the erectile dysfunction drugs and the flu vaccine
Sex, viruses and cancer
Surgery is very effective in removing solid tumors, but researchers now know that it also changes the immune system in a way that allows tiny cancers (metastases) to grow and spread. Credit: Rebecca Auer, Lisa MacKenzie
Dr. Auer is now leading the first clinical trial in the world of an erectile dysfunction  (tadalafil) and the flu vaccine in people with cancer. It will involve 24 patients at The Ottawa Hospital undergoing abdominal cancer surgery. This trial is designed to evaluate safety and look for changes in the immune system. If successful, larger trials could look at possible benefits to patients.
“We’re really excited about this research because it suggests that two safe and relatively inexpensive therapies may be able to solve a big problem in cancer,” said Dr. Auer. “If confirmed in clinical trials, this could become the first therapy to address the immune problems caused by cancer surgery.”
Using a variety of mouse and human models, Dr. Auer’s team has also made progress in understanding how erectile dysfunction drugs and the flu vaccine affect cancer after surgery. Normally, immune cells called natural killer (NK) cells play a major role in killing metastatic cancer cells. But surgery causes another kind of immune cell, called a myeloid derived suppressor cell (MDSC), to block the NK cells. Dr. Auer’s team has found that erectile dysfunction drugs block these MDSCs, which allows the NK cells to do their job fighting cancer. The flu vaccine further stimulates the NK cells.
“Cancer immunotherapy is a huge area of research right now, but we’re still learning how best to use it in the time around ,” said first author Dr. Lee-Hwa Tai, former postdoctoral fellow in Dr. Auer’s lab and now assistant professor at the Université de Sherbrooke. “This research is an important step forward that opens up many possibilities.”
Dr. Auer noted that although erectile dysfunction drugs and the flu  are widely available, people with cancer should not self-medicate. Any changes in medication should be discussed with an oncologist.
More information: Lee-Hwa Tai et al, Phosphodiesterase-5 inhibition reduces postoperative metastatic disease by targeting surgery-induced myeloid derived suppressor cell-dependent inhibition of Natural Killer cell cytotoxicity, OncoImmunology(2018). DOI: 10.1080/2162402X.2018.1431082

Antibacterial in your toothpaste may combat severe lung disease

A common antibacterial substance found in toothpaste may combat life-threatening diseases such as cystic fibrosis, or CF, when combined with an already FDA-approved drug.
Michigan State University researchers have found that when , a substance that reduces or prevents bacteria from growing, is combined with an antibiotic called tobramycin, it kills the cells that protect the CF bacteria, known as Pseudomonas aeruginosa, by up to 99.9 percent.
CF is a  with one in every 2,500 to 3,500 people diagnosed with it at an early age. It results in a thick mucus in the lungs, which becomes a magnet for bacteria.
These bacteria are notoriously difficult to kill because they are protected by a slimy barrier known as a biofilm, which allows the disease to thrive even when treated with antibiotics.
“The problem that we’re really tackling is finding ways to kill these biofilms,” said Chris Waters, lead author of the study and a microbiology professor.
According to Waters, there are many common biofilm-related infections that people get such as  and swollen, painful gums caused by gingivitis. But more serious, potentially fatal diseases join the ranks of CF including endocarditis, or inflammation of the heart, as well as infections from artificial hip and pacemaker implants.
The research is published in the journal Antimicrobial Agents and Chemotherapy.
Waters and his co-authors, Michael Maiden and Alessandra Hunt, grew 6,000 biofilms in petri dishes, added in tobramycin along with many different compounds, to see what worked better at killing the bacteria. Twenty-five potential compounds were effective, but one stood out.
“It’s well known that triclosan, when used by itself, isn’t effective at killing Pseudomonas aeruginosa,” Hunt said, a post-doctoral associate of microbiology and molecular genetics. “But when I saw it listed as a possible compound to use with tobramycin, I was intrigued. We found triclosan was the one that worked every time.”
Triclosan has been used for more than 40 years in soaps, makeup and other commercial products because of its antibacterial properties. Recently, the FDA ruled to limit its use in soaps and hand sanitizers due to insufficient data on its increased effectiveness and concern that it was being overused. Clear evidence has shown, though, that its use in toothpaste is safe and highly effective in fighting gingivitis, and it is still approved for use.
“Limiting its use is the right thing to do,” Maiden said, a graduate student in medicine. “The key is to avoid creating resistance to a substance so when it’s found in numerous products, the chances of that happening increase.”
Tobramycin is currently the most widely used treatment for CF, but it typically doesn’t clear the lungs of , Waters said. Patients typically inhale the drug, yet find themselves chronically infected their whole lives, eventually needing a lung transplant.
“Most transplants aren’t a viable option though for these patients and those who do have a transplant see a 50 percent failure rate within five years,” he said. “The other issue is that tobramycin can be toxic itself.”
Known side effects from the drug include kidney toxicity and hearing loss.
Antibacterial in your toothpaste may combat severe lung disease
Michigan State University microbiology professor Chris Waters (pictured left), with research associates Micheal Maiden and Alessandra Hunt, have found that a common antibacterial substance found in toothpaste may combat life-threatening …more
“Our triclosan finding gives doctors another potential option and allows them to use significantly less of the tobramycin in treatment, potentially reducing its use by 100 times,” Hunt said.
Within the next year, Waters and his colleagues will begin testing the effectiveness of the combination therapy on mice with hopes of it heading to a human trial soon after since both drugs are already FDA approved.
Just brushing your teeth with toothpaste that has triclosan won’t help to treat lung infections though, Maiden said.
“We’re working to get this potential therapy approved so we can provide a new treatment option for CF patients, as well as treat other biofilm infections that are now untreatable. We think this can save lives.”

How social isolation transforms the brain

Chronic social isolation has debilitating effects on mental health in mammals—for example, it is often associated with depression and post-traumatic stress disorder in humans. Now, a team of Caltech researchers has discovered that social isolation causes the build-up of a particular chemical in the brain, and that blocking this chemical eliminates the negative effects of isolation. The work has potential applications for treating mental health disorders in humans.
The work, led by postdoctoral scholar Moriel Zelikowsky, was done in the laboratory of David J. Anderson, Seymour Benzer Professor of Biology, Tianqiao and Chrissy Chen Leadership Chair, Howard Hughes Medical Institute Investigator, and director of the Tianqiao and Chrissy Chen Institute for Neuroscience. A paper describing the research appears in the May 17 issue of the journal Cell.
Confirming and extending previous observations, the researchers showed that prolonged social isolation leads to a broad array of behavioral changes in mice. These include increased aggressiveness towards unfamiliar mice, persistent fear, and hypersensitivity to threatening stimuli. For example, when encountering a threatening stimulus, mice that have been socially isolated remain frozen in place long after the threat has passed, whereas normal mice stop freezing soon after the threat is removed. These effects are seen when mice are subjected to two weeks of social isolation, but not to short-term social isolation—24 hours—suggesting that the observed changes in aggression and fear responses require chronic isolation.
In a previous study of the Drosophila fly, the Anderson laboratory had discovered that a particular neurochemical called tachykinin plays a role in promoting aggression in socially isolated flies. Tachykinin is a neuropeptide, a short protein molecule that is released from certain neurons when they are activated. Neuropeptides bind to specific receptors on other neurons, altering their physiological properties and thereby influencing neural circuit function.
To investigate whether the role of tachykinin in controlling social isolation-induced aggression might be evolutionarily conserved from insects to mammals, Anderson’s team turned to laboratory mice. In mice, the tachykinin gene Tac2 encodes a neuropeptide called neurokinin B (NkB). Tac2/NkB is produced by neurons in specific regions of the mouse  such as the amygdala and hypothalamus, which are involved in emotional and social behavior.
The researchers found that chronic isolation leads to an increase in Tac2 gene expression and the production of NkB throughout the brain. However, administration of a drug that chemically blocks NkB-specific receptors enabled the stressed mice to behave normally, eliminating the  of social isolation. Conversely, artificially increasing Tac2 levels and activating the corresponding neurons in normal, unstressed animals led them to behave like the stressed, isolated animals.
The researchers also inhibited the function of Tac2 and its receptors in multiple specific brain regions. They found that suppressing the Tac2 gene in the amygdala eliminated the increased fear behaviors, but not aggression, while conversely suppressing the gene in the hypothalamus eliminated increased aggression but not persistent fear. The results imply that Tac2 must increase in different brain regions to produce the various effects of social .
“The approach used here allowed us both to compare the effects of different manipulations of Tac2 signaling in the same brain region, as well as to compare the effects of the same manipulation across different brain regions,” says Anderson. “The rich data set generated by these experiments revealed how this neuropeptide acts globally across the brain to coordinate diverse behavioral responses to  stress.”
Though the work was done in , it has potential implications for understanding how chronic stress affects humans.
“Humans have an analogous Tac2 signaling system, implying possible clinical translations of this work,” says Zelikowsky. “When looking at the treatment of  disorders, we traditionally focus on targeting broad neurotransmitter systems like serotonin and dopamine that circulate widely throughout the brain. Manipulating these systems broadly can lead to unwanted side effects. So, being able to precisely and locally modify a neuropeptide like Tac2 is a promising approach to mental health treatments.”
More information: “The Neuropeptide Tac2 Controls a Distributed Brain State Induced by Chronic Social Isolation Stress”Cell (2018). DOI: 10.1016/j.cell.2018.03.037

FDA Approves Amgen’s Migraine Drug

The U.S. Food and Drug Administration has approvedAmgen AMGN +0.47%’s erenumab (which it’s calling Aimovig) to prevent migraines.
“We feel pretty strongly this is a huge opportunity to help patients with a targeted, migraine specific medication that’s broadly efficacious, and can be administered in a patient-friendly way,” said Rob Lenz, VP, development at Amgen who lead the development of Aimovig. The drug’s list price is $6,900 per year, or $575 per monthly injected dose, lower than many market-watchers expected. Amgen is commercializing Aimovig with Novartis in the U.S.
That Aimovig is the first drug approved in a new class of migraine drugs targeting a protein called CGRP class is “key,” Cowen analyst Steve Scala wrote in a note to clients earlier this week, “as there will likely be several competitors and differentiation does not appear substantial.”
The competition: Alder Biopharmaceuticals’ eptinezumab (an infusion patients get every three months), Lilly’s galcanezumab (a monthly injection) and Teva’s fremanezumab (a monthly or quarterly injection). Lenz emphasized Aimovig’s convenience for patients as a once-a-month injection, and that the drug proved effective in people who have migraines at least four days a month, people who have migraines at least half the days out of a month, and people who tried at least two migraine-prevention drugs before to no avail.
“Aimovig provides patients with a novel option for reducing the number of days with migraine,” said Eric Bastings, M.D., deputy director of the Division of Neurology Products in the FDA’s Center for Drug Evaluation and Research. “We need new treatments for this painful and often debilitating condition.”