Paper Makers Lobby to Retain Mandate for Costly and Useless Long Pamphlets with Prescription Drugs

(p. B5) Doctors and pharmacists receive lengthy pamphlets for all prescription drugs that can stretch as long as a dining-room table. Efforts to go digital in this heavily regulated industry are finally making headway, offering drugmakers the chance to provide up-to-date information while also saving money, trees and greenhouse-gas emissions.

. . .

Advocates arguing such prescription information should go fully digital say the instructions are only for medical professionals, who often already consult up-to-date electronic versions and leave the papers unread and discarded. Proponents of keeping paper say the printed instructions are consulted frequently enough to help ensure medicine is used safely.

. . .

“It’s like a dream come true looking in the facility and seeing the packs coming off the manufacturing lines without these paper leaflets,” said Pam Cheng, operations and sustainability chief at pharmaceutical company AstraZeneca. “This is like win, win, win.”

AstraZeneca spends $30 million a year on the papers globally and is pushing to digitize prescribing information as part of its goal to cut 50% of emissions across its value chain by 2030, Cheng said. The company aims to have a plan by 2025 for all its medical information to go electronic by the end of the decade. Many other pharma companies also want to go digital.

. . .

The U.S. Food and Drug Administration in 2014 proposed to replace the paper information with a digital source, saying it would ensure information is up-to-date and bring environmental and cost benefits. However, an obscure clause in the FDA’s Congressional spending bill has blocked the move, with intense lobbying from two dedicated groups: the Alliance to Modernize Prescribing Information, representing drugmakers such as AstraZeneca, Eli Lilly and Pfizer, and the Pharmaceutical Printed Literature Association, backed by paper producers such as Avery Dennison, JP Gould and WestRock.

. . .

Other countries have digitized drug information, with Japan leading the way. In 2021, the country required drug inserts to go digital by August 2023, both those for patients and medical professionals.

For the full story, see:

Dieter Holger. “Bill Would Let Drugmakers Stop Printing Long Pamphlets.” The Wall Street Journal (Friday, June 16, 2023): B5.

(Note: ellipses added.)

(Note: the online version of the story has the date June 15, 2023, and has the title “One Change Could Help U.S. Drugmakers Save 11 Million Trees a Year.”)

Michael Milken Applies “Entrepreneurial Zeal” to Quest to Live Forever

(p. B3) Michael Milken wants to live forever.

. . .

Milken in April [2023] published “Faster Cures,” a book that is part memoir, part a recounting of his efforts to bring the results of medical research to patients more quickly.

. . .

Shortly after his release from prison in 1993, he received a diagnosis of terminal prostate cancer and was told he had 12 to 18 months to live. He survived thanks to a relentless pursuit of the latest treatments and a dramatic change in diet. Longevity is one focus of the Milken Institute.

. . .

While at Berkeley, Milken read a book called “Corporate Bond Quality and Investor Experience” that examined, among other things, yield charts and default rates for bonds issued by railroads, utilities and industrial companies between 1900 and 1943.

The data revealed something surprising, he recounted in “Faster Cures:” While risk and return had always been presumed to be directly correlated, the reality was that the market had historically overestimated the risk of higher-yielding investments. Investors actually got lower returns on a portfolio of high-grade bonds than they did on a portfolio of low-grade ones over time because the higher yields more than made up for the higher level of defaults.

Milken continued his work on high-yield bonds while pursuing an M.B.A. from the University of Pennsylvania’s Wharton School. When he graduated in 1970, he joined the staff of Drexel, where he had previously worked as a consultant.

Bonds issued by Drexel were the primary source of financing for the likes of cable-industry titan Ted Turner, cellular pioneer Craig McCaw, fiber-optic entrepreneur William McGowan and casino magnate Steve Wynn.

“There was an entrepreneurial zeal in that firm that I haven’t seen since,” said Ted Virtue, a Drexel alumnus who now runs private-equity firm MidOcean Partners.

. . .

Milken’s work on prostate cancer has also made him an influential figure in medical research, where he has developed a reputation for being data-driven and impatient with bureaucracy. Every year he hosts a summit for scientists working on prostate cancer.

“Mike looked at the problem of cancer like a business problem to be solved,” said Dr. Karen Knudsen, CEO of the American Cancer Society. “He wasn’t focused on the flashy. He really focused on what is going to make a difference.”

When the Prostate Cancer Foundation lacked the resources to fund a major study Knudsen needed to conduct to advance her research, she said, Milken introduced her to executives from a pharmaceutical company who he thought would be interested in the science. The company ended up funding the study.

For the full story, see:

Miriam Gottfried. “Bond King, Felon, Billionaire Philanthropist.” The Wall Street Journal (Saturday, July 15, 2023): B3.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story was updated July 14, 2023, and has the title “Bond King, Felon, Billionaire Philanthropist: The Nine Lives of Michael Milken.”)

Milken’s book on how to cure more diseases faster is:

Milken, Michael. Faster Cures: Accelerating the Future of Health. New York: William Morrow, 2023.

Wind and Solar Power Prices Have Doubled Since Pandemic, Due Partly to Regulatory and Policy Challenges

(p. B1) After more than a decade of declining prices for wind and solar power, the cost of renewables has been ticking up, pushed by everything from macroeconomic forces to countries’ attempts to take control of their energy-supply chains.

The cost of large-scale solar and wind power rose as much as 20% last year versus the year before in most of the world, the International Energy Agency said in a June report. In the U.S., financial-services company Lazard’s widely watched report on the cost of power generation logged its first increase for renewables this year since it started (p. B4) tracking it nearly 15 years ago.

The whiplash has been particularly bad among renewables developers in the U.S., many of whom have rewritten contracts to stay afloat. The price they are charging long-term buyers for their electricity has doubled since the pandemic and risen nearly 30% in the past year alone, according to clean-energy marketplace LevelTen Energy.

. . .

The U.S. has . . . challenges, including policies that make it harder and more costly to import solar panels and other clean-energy components. Rising labor costs and delays in permitting or getting projects hooked up to the power grid have made building solar and wind projects more expensive.

For the full story, see:

Phred Dvorak. “Price of Green Power Is on the Rise.” The Wall Street Journal (Monday, Aug. 14, 2023): B1 & B4.

(Note: ellipses added.)

(Note: the online version of the story has the date August 13, 2023, and has the title “Green Power Gets Pricier After Years of Declines.”)

“Unexpected” New Evidence of the Ubiquity and Resilience of Life on Earth

(p. D3) Off the western shores of Central and South America, there is a Lovecraftian, lava-licked realm thousands of feet beneath the ocean. There, on the seafloor, volcanically powered exhaust ports known as hydrothermal vents fire off jets of water that reach temperatures of up to 700 degrees Fahrenheit. While the surfaces and peripheries of these vents have long been known to host a diverse mosaic of life, scientists had never known animals to find a home beneath these hellish geysers.

But that changed in July [2023] when a diving robot overturned volcanic bedrock pockmarked with hydrothermal vents and revealed an explosion of animal life — including an abundance of tubeworms, bizarre creatures that resemble sentient spaghetti.

“This is the first time that animal life was found below the surface” of hydrothermal vents, said Monika Bright, an ecologist at the University of Vienna and lead scientist on the expedition.

. . .

Much about these unusual habitats is a mystery. But, like many revelations found at the bottom of the sea, this discovery once again pushes the boundaries of what scientists consider possible — perhaps even normal — for life on Earth.

Hydrothermal vents, first discovered off the Galápagos Islands, are Dalí-esque chimneys and chasms that often grow atop or close to midoceanic ridges — vast volcanic fissures in the seafloor made by the divergence of two tectonic plates. Deep below, the magmatic heat roasts percolating seawater, which jets back out into the water column as superheated, mineral-rich soups.

Despite their extreme natures, these vents are metropolises of strange critters. Common among them are tubeworms, which start life as free-swimming larvae before becoming immobile adults that grow to several feet in length and that are fed by sulfur-eating bacteria living in their guts.

Dr. Bright suspected that these wiggly weirdos could also be found beneath the vents. “It’s kind of a really crazy idea I had,” she said.

. . .

. . . for Dr. Bright, Earth is all that matters. “I’m not thinking of other planets and moons — I’m thinking that there’s so much mystery to be discovered in our Earth,” she said. “I feel like I know this place. I’ve studied this place for 30 years. And still, you can find something unexpected.”

For the full story, see:

Robin George Andrews. “Odd Creatures Found Under Oceanic Vents.” The New York Times (Tuesday, August 15, 2023): D3.

(Note: ellipses, and bracketed years, added.)

(Note: the online version of the story has the date Aug. 8, 2023, and has the title “Under a Hellish Ocean Habitat, Bizarre Animals Are Lurking.”)

Long Waits for Italian Cabs Due to Regulations Limiting More Cabs and Ride-Sharing

(p. A4) Returning to Rome from Naples one Monday afternoon in June [2023], a train trip that takes just over an hour, Daniele Renzoni said that he and his wife waited for more than an hour and a half at Termini station for a cab under a blazing sun.

“Just image a long line of grumbling, frustrated people, complaining, cursing. Hot day, angry tourists, there’s not much else to say,” said Mr. Renzoni, who is retired. “Taxi drivers will tell you there’s too much traffic, too many requests, too much everything, but the fact is, the customer pays.”

The situation is “a disgrace to Italy,” said Furio Truzzi, president of the consumer rights group Assoutenti, one of several associations that protested the shortage.

. . .

Thanks to the taxi lobby, ride-sharing services are almost nonexistent in Italy, where Uber is the only platform in use, with many restrictions.

The government lost an opportunity for real change, said Andrea Giuricin, a transportation economist at a research center at the University of Milan Bicocca. He said the best way to meet consumer needs would be to increase the number of licenses for Italy’s chauffeur services, known as N.C.C., which work with Uber.

“It’s very difficult in Italy” because “there isn’t a culture of liberalization in general,” creating little opportunity for competition, said Professor Giuricin. Taxis “are a small but powerful lobby” that easily influences politics, “which is very weak” in Italy, he said.

Angela Stefania Bergantino, a professor of transportation economics at the University of Bari, pointed out that previous governments had tried to open up the taxi market. But they failed.

“The problem is that taxis are regulated by municipal governments, which can find themselves captive in the sense that it is difficult for City Hall to implement policies that the cab lobby doesn’t like,” she said. “These are lobbies that have effective strike tools,” like wildcat strikes or traffic blockages that can paralyze entire cities, she said.

. . .

Above all, though licenses are issued by the city, they can then be sold by the drivers, for sums that can reach 250,000 euros, or about $276,000, depending on the city — a retirement nest egg for many. With an influx of new licenses, the value of an existing license would depreciate.

City administrators fear cabbies could revolt and strike if the status quo changes. “If I decide to issue new licenses,” said Eugenio Patanè, Rome’s city councilor in charge of transportation, “I’m going to find 1,000 taxis blocking traffic in Piazza Venezia,” the downtown Rome square that taxi drivers habitually clog while protesting.

For the full story, see:

Elisabetta Povoledo. “Getting a Cab in Italy Is Hard. But Remedying That Isn’t Easy.” The New York Times (Friday, August 11, 2023): A4.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date Aug. 10, 2023, and has the title “Getting a Taxi in Italy Is Too Hard. Fixing That Is Not Easy.”)

“Persistent Plucky Outsiders” Innovate a Better Way to Stop Bleeding

(p. 20) Charles Barber’s “In the Blood” treats a consequential topic, and contains moments of real insight, drama and humor.

. . .

Though hemorrhage is a leading cause of death in both war and peacetime, we learn, the techniques for stopping it haven’t improved significantly for millenniums. Barber explores the mysteries of the “coagulation cascade” — during which diverse proteins activate in intricately choreographed sequence to facilitate clotting — as well as the “lethal triad” of hypothermia, acidosis and coagulopathy (impaired clotting) that can send the body into shock.

We watch a surgeon at a Navy hospital in Bethesda slit the femoral arteries of a herd of 700-pound pigs, then apply different hemostatic agents to the spurting wounds, to see which substance stops the bleeding best. Most products, backed by biotech and medical companies, fail: The poor beasts bleed out. But zeolite, a simple mineral with hitherto unknown hemostatic properties, saves their bacon every time.

Barber’s earlier books feature persistent, plucky outsiders who strive to change the world, and he finds two more likely subjects in the men who brought zeolite’s lifesaving properties to light. Frank Hursey is the brilliant, nerdy engineer who discovers that this cheap, highly porous mineral, used by industry to absorb radiation, chemicals and bad odors, also happens to accelerate clotting, by mopping up water in the blood and thereby concentrating its coagulation agents. (Later Hursey finds that another inexpensive mineral, kaolin, works even better.)

Barely anyone pays attention to Hursey’s discovery until he partners with Bart Gullong, a down-on-his-luck salesman who rebrands Hursey’s invention “QuikClot” and persuades a military scientist to try it out on people. Hursey and Gullong are soon befriended by iconoclasts within the armed forces medical establishment, more of Barber’s appealing, quirky, determined Davids, who together take on two of the biggest Goliaths around: the military-industrial complex and Big Pharma.

For the full review, see:

Tom Mueller. “The Home Front.” The New York Times (Sunday, Aug. 20, 2023): 20.

(Note: ellipsis added.)

(Note: the online version of the review has the date July 26, 2023, and has the title “A Fight to Save Soldiers, From the Lab to the Battlefield.”)

The book under review is:

Barber, Charles. In the Blood: How Two Outsiders Solved a Centuries-Old Medical Mystery and Took on the Us Army. New York: Grand Central Publishing, 2023.

Threatened Red Knot Shorebirds Numbers Rebound Due to “Warm Ocean Waters” Increasing Food Source From Horseshoe Crab Eggs

(p. A13) The number of rufa red knot shore birds migrating via Delaware Bay beaches to Arctic breeding sites this spring rose to the highest level in four years, according to an independent annual survey.

The count, by land and boat, tallied about 22,000 of the robin-sized birds, an encouraging sign for a shorebird that is listed as federally threatened. The survey’s figures were the highest since 2019, and a sharp increase from a record low of 6,880 in 2021, according to Larry Niles, an independent biologist. He has been monitoring the migration of the rufa red knot, an Atlantic coast subspecies, on the Delaware Bay for the last quarter century.

Dr. Niles attributed the healthier number to the relatively warm ocean waters that aided in the spawning of horseshoe crabs, whose eggs are a crucial food source for the birds. A week or two of gorging on the crab eggs each May allows the birds to regain weight after long-distance flights from as far away as Tierra del Fuego, Argentina, and to complete their migration, one of the longest in the avian world.

. . .

“I was elated to see 22,000 birds this year,” he said.

For the full story, see:

Jon Hurdle. “More Threatened Red Knot Shorebirds Are Seen on Jersey Shore Beaches.” The New York Times (Thursday, June 15, 2023): A13.

(Note: ellipsis added.)

(Note: the online version of the story also has the date June 15, 2023, and has the title “Uptick Seen in Red Knots on Jersey Shore.”)

Conservationists Criticize the Woke Who Raise Bees as a Virtue Signal

(p. 1) When the B&B Hotel in Ljubljana, Slovenia, decided to reinvent itself as an eco-friendly destination in 2015, it had to meet more than 150 criteria to earn a coveted Travelife certificate of sustainability. But then it went step further: It hired a beekeeper to install four honey bee hives on the roof.

. . .

The hives are managed by Gorazd Trusnovec, a 50-year-old with a graying goatee who is the founder and sole employee of an enterprise called Najemi Panj, which translates to “rent-a-hive.” For a yearly fee, he will install a honey bee colony on the roof of an office, or in a backyard, and ensure that its bees are healthy and productive. Customers get the honey and the pleasure of doing something that benefits bees and nourishes the environment.

That, at any rate, was Mr. Trusnovec’s original sales pitch. In recent years, he and other beekeepers, as well as a broad variety of leading conservationists, have come to a very different conclusion: The craze for honey bees now presents a genuine ecological challenge. Not just in Slovenia, but around the world.

“If you overcrowd any space with honey bees, there is a competition for natural resources, and since bees have the largest numbers, they push out other pollinators, which actually harms biodiversity,” he said, (p. 4) after a recent visit to the B&B bees. “I would say that the best thing you could do for honey bees right now is not take up beekeeping.”

. . .

Honey bees, it turns out, are a commercially managed animal — essentially livestock, like cows — and large beekeeping operations are remarkably adept at replacing colonies that die. In the United States, about one million hives are trucked each year to places like California, where honey bees pollinate almonds and other crops, Mr. Black said. It’s a major industry. Revenue from beekeeping will reach $624 billion this year in the United States alone, reports IBISWorld, a market research firm.

While techniques for nurturing hives have improved, honey bees remain vulnerable animals. As of a few years ago, nearly 30 percent of commercial honey bees still did not survive the winter months, says the Environmental Protection Agency. That’s a large number and one that puts a financial strain on commercial beekeepers.

“But that’s an agriculture story, not a conservation story,” Mr. Black said. “There are now more honey bees on the planet than there have ever been in human history.”

Figures from the Food and Agriculture Organization of the United Nations underscore the point. The number of beehives around the world has risen by nearly 26 percent in the last decade, to 102 million from 81 million.

. . .

Recently, the Museum of Modern Art posted an image of four hives on its Instagram account, along with text that read, “We recognize the essential part bees play in our ecosystem and that’s why we are proud to provide a home to all these bees here at the Museum.” In London, the sheer quantity of hives poses a threat to other species of bees, says a report issued in 2020 by the Royal Botanical Gardens, Kew. The city’s financial district is now overrun with what Richard Glassborow, the chair of the London Beekeepers’ Association, calls “trophy bees.”

“We’ve had companies from outside London come with plans to put 20 hives a year on roofs,” he said, “and persuade businesses that this will tick some kind of corporate responsibility box.”

New York City has a similar problem, says Andrew Coté, president of the New York City Beekeepers Association. In February [2023], MoMA asked him to install the hives it recently showed off. He declined.

“The population is already overwhelming the finite floral resources,” he said. “We don’t need more honey bees here.”

. . .

With the number of hives rising, pressure is mounting on less charismatic insects, like moths, wasps and wild bees, which are essential to pollinating wild plants and many crops, and which academic studies have found are in decline. Apparently nobody wants 25,000 moths parked near the C-suites.

Today, hives are so ubiquitous in some places, especially urban areas, that the amount of honey each yields is dropping. Slovenia now produces less honey than it did 15 years ago, (p. 5) according to government figures, even though it has more than doubled the number of hives in the country. That’s because there is not enough nectar to go around, said Matjaz Levicar, a Slovenian beekeeping instructor, and honey bees are consuming it to survive rather than turning it into honey.

“It’s a tragedy,” he said. “In Slovenia, we need to feed honey bee colonies with sugar most of the year.”

For the full story, see:

David Segal and Ciril Jazbec. “Mind Your Own Bees, but Don’t Buy More.” The New York Times, SundayBusiness Section (Sunday, August 20, 2023): 1 & 4-5.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story was updated Aug. 21, 2023, and has the title “The Beekeepers Who Don’t Want You to Buy More Bees.” The sentence about the $624 billion in U.S. revenue from beekeeping appears in the print, but not in the online, version of the article.)

Heat Wave in India Causes Rise in Mortality

(p. A11) An unusually intense heat wave has swept across northern India in the last four days, with some hospitals in the state of Uttar Pradesh recording a higher-than-usual number of deaths. Doctors there are convinced there’s a link between the punishing temperatures and the deaths of their patients, but officials are investigating what role the dangerous combination of heat and humidity played in the rise in mortality.

For the full story, see:

Alex Travelli and Hari Kumar. “Northern India Endures a Heat Wave, and a Wave of Deaths, as a Possible Link Is Pondered.” The New York Times (Monday, June 19, 2023): A11.

(Note: the online version of the story has the date June 18, 2023, and has the title “Northern India Endures a Heat Wave, and a Wave of Deaths.”)

Phage Therapy Renaissance-“Once Derided as an Idea for Cranks and Commies”

(p. C7) As engaging as it is expansive, “The Good Virus” describes the distinctive biology and murky history of bacteriophage (generally shortened to “phage”), a form of life that is remarkably abundant yet obscure enough to have been termed the “dark matter of biology.”

. . .

In a South London research institute in the early 1910s, the meticulous English bacteriologist Frederick Twort set out to grow the smallpox virus in petri dishes, hoping it could be “observed and studied like bacteria.” He succeeded in growing only contaminating bacteria, but within these colonies he noticed the occasional small clearing, as if something invisible was killing the bacteria. With the outbreak of World War I, Twort lost funding, closed his lab and published his results in 1915, cautiously suggesting that a virus could be the cause of the observed phenomenon. Few took notice.

Twort’s unlikely competitor would be Felix d’Herelle, a free-spirited Frenchman . . .

. . .

He found the same glassy spots that Twort had observed and (with noticeably less restraint) announced in 1917 that he had discovered a new form of life, which he called “bacteriophage.” D’Herelle went on to use phage to treat five sick boys successfully. But his “wild and abrasive style” (in Mr. Ireland’s words) antagonized his peers, who conspired to undermine him.

D’Herelle’s discoveries inspired many, including George Eliava, a microbiologist from the Soviet Union’s republic of Georgia. In 1936, he would establish the first institute (and still one of the few) devoted to bacteriophage research. Unfortunately for Eliava, he soon ran afoul of the Soviet secret police, who disappeared him in 1937. The institute continued to pursue the development of phage therapy and scored many victories—phage helped treat soldiers suffering from gangrene, for example. But there were also frustrating failures, in part because the phage weren’t adequately purified and often because they weren’t appropriately matched to the specific strain of infecting bacteria.

. . .

. . ., the “dubious and unreliable nature of commercial American phage products” in the 1930s, we learn, meant that “whether they worked for a particular patient was a complete lottery.”

During World War II, the West turned decisively to newly discovered penicillin, sharing the formula for it with the Soviets but not the methods of mass production. Thus the Soviets continued to rely on phage as the therapy of choice for bacterial infections. When a Soviet researcher tried to obtain production rights to penicillin in 1949, he was arrested by government authorities and died under interrogation, all for the crime of nizkopoklonstvo—adulation of the West.

. . .

Once “derided as an idea for cranks and commies,” Mr. Ireland writes, phage therapy seems to be enjoying a renaissance. Having been sustained for years by an idiosyncratic global community of true believers, phage-based medicines have now attracted the attention of high-powered biotechnologists and investors.

For the full review, see:

David A. Shaywitz. “The Enemy of My Enemy.” The Wall Street Journal (Saturday, Aug. 5, 2023): C7.

(Note: ellipses added. In the original, the Russian word nizkopoklonstvo is in italics.)

(Note: the online version of the review has the date August 4, 2023, and has the title “‘The Good Virus’ Review: An Unlikely Healer.”)

The book under review is:

Ireland, Tom. The Good Virus: The Amazing Story and Forgotten Promise of the Phage. New York: W. W. Norton & Company, 2023.

Fish Would Remember More if Hot Water Could Be Air Conditioned

(p. A4) . . ., a new study suggests for the first time that high water temperatures can cause memory loss in reef fish, and even render them unable to learn at all.

. . .

The researchers designed a maze with a reward in one hallway. For about two weeks before maze training began, three groups of fish were gradually exposed to different temperatures: 28to 28.5 degrees Celsius for the control group, 30to 30.5 Celsius for the second, and 31.5 to32 Celsius for the third.

. . .

The researchers spent five days training the fish to navigate the maze and to associate a blue tag with their reward. Five days after training ended, they tested the fish to see which groups could remember how to find the tag, and their reward, in the maze.

The control group did well, quickly remembering how to reach the reward in the maze. But fish in even the moderately hot group didn’t fare as well. Although they learned to navigate the maze quickly during training, five days later, all evidence of their experience had vanished. In earlier experiments, Dr. Luchiari found that damselfish could remember experiences for at least 15 days, so an inability to remember the maze after only five was striking.

Fish in the hottest group failed to learn the maze at all, taking roughly the same amount of time to navigate it throughout the whole experiment.

For the full story, see:

Rebecca Dzombak. “Fish Get More Forgetful In Higher Temperatures.” The New York Times (Thursday, Aug. 24, 2023): A4.

(Note: ellipses added.)

(Note: the online version of the story has the date Aug. 23, 2023, and has the title “Damselfish in Distress: Warmer Seas Might Be Clouding Their Brains.”)