Economics of Technology – Page 7

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.

Caution in Interpreting Alternative Explanations of Ancient Artifacts

A few weeks ago, an article highlighted the finding of female bones in a burial along with a sword. It was interpreted that the sword belonged to a distinguished female warrior and was interpreted as evidence against patriarchal assumptions.

(p. D1) The epitaph on more than one Roman tombstone read: “A gang of doctors killed me.”

Medical remedies have improved since those times — no more smashed snails, salt-cured weasel flesh or ashes of cremated dogs’ heads — but surgical instruments have changed surprisingly little. Scalpels, needles, tweezers, probes, hooks, chisels and drills are as much part of today’s standard medical tool kit as they were during Rome’s imperial era.

Archaeologists in Hungary recently unearthed a rare and perplexing set of such appliances. The items were found in a necropolis near Jászberény, some 35 miles from Budapest, in two wooden chests and included a forceps, for pulling teeth; a curet, for mixing, measuring and applying medicaments, and three copper-alloy scalpels fitted with detachable steel blades and inlaid with silver in a Roman style. Alongside were the remains of a man presumed to have been a Roman citizen.

The site, seemingly undisturbed for 2,000 years, also yielded a pestle that, judging by the abrasion marks and drug residue, was probably used to grind medicinal herbs. Most unusual were a bone lever, for putting fractures back in place, and the handle of what appears to have been a drill, for trepanning the skull and extracting impacted weaponry from bone.

The instrumentarium, suitable for performing complex operations, provides a glimpse into the advanced medical prac-(p. D4)tices of first-century Romans and how far afield doctors may have journeyed to offer care. “In ancient times, these were comparatively sophisticated tools made of the finest materials,” said Tivadar Vida, director of the Institute of Archaeology at Eötvös Loránd University, or ELTE, in Budapest and leader of the excavation.

Two millenniums ago Jászberény and the county around it were part of the Barbaricum, a vast region that lay beyond the frontiers of the Empire and served as a buffer against possible outside threats. “How could such a well-equipped individual die so far from Rome, in the middle of the Barbaricum,” mused Leventu Samu, a research fellow at ELTE and a member of the team on the dig. “Was he there to heal a prestigious local figure, or was he perhaps accompanying a military movement of the Roman legions?”

. . .

The tool-laden grave was discovered last year at a site where relics from the Copper Age (4500 B.C. to 3500 B.C.) and the Avar period (560 to 790 A.D.) had been found on the surface. A subsequent survey with a magnetometer identified a necropolis of the Avars, a nomadic peoples who succeeded Attila’s Huns. Among the rows of tombs, the researchers uncovered the man’s grave, revealing a skull, leg bones and, at the foot of the body, the chests of metal instruments. “The fact that the deceased was buried with his equipment is perhaps a sign of respect,” Dr. Samu said.

That is not the only possibility. Dr. Baker said that she often cautioned her students about interpreting ancient artifacts, and asked them to consider alternative explanations. What if, she proposed, the medical tools were interred with the so-called physician because he was so bad at his practice that his family and friends wanted to get rid of everything associated with his poor medical skills? “This was a joke,” Dr. Baker said. “But it was intended to make students think about how we jump to quick conclusions about objects we find in burials.”

For the full story, see:

Franz Lidz. “Old Roman Medicine Wasn’t So Pleasant.” The New York Times (Tuesday, June 13, 2023): D1 & D4.

(Note: ellipsis added.)

(Note: the online version of the story also has the date June 13, 2023, and has the title “Scalpel, Forceps, Bone Drill: Modern Medicine in Ancient Rome.”)

To Charge EV on Road Required Downloading an App, Which Required Non-Dodgy Cell Service

(p. B5) The adoption of electric vehicles represents the biggest shift in our energy and transportation systems in more than a century—but it’s also the biggest shift in consumer electronics since the debut of the iPhone. On both counts, progress is accelerating in the U.S. And on both counts, we are far from where we need to be.

A recent 1,000 mile road-trip in the longest-range electric vehicle you can buy brought this home for me. That journey was as worrisome as it was thrilling, and it clarified how much more needs to be done for drivers to have a consistent and satisfying experience on par with buying a gasoline vehicle.

. . .

On my trip, there was one moment in particular when the future felt like a big step backward.

It happened when I arrived at a street charging station in Montreal, and discovered that I’d have to download an app and prepay for the electricity I wanted to use. Cell service was dodgy, and I had to find a better signal to download the app. Had I been unable to find a decent signal, I would have been out of luck. (Even once I downloaded the app, the first station I connected to didn’t work—another issue that sometimes comes up at charging stations.)

Unfortunately, having to download an app is common practice for proprietary networks.

For the full commentary, see:

Christopher Mims. “Why America Isn’t Ready for the EV Takeover.” The Wall Street Journal (Saturday, June 10, 2023): B5.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date June 9, 2023, and has the same title as the print version.)

Crisis in Wind Industry Due to Inflation, Regulatory, and Grid Connection Hurdles

(p. B5) The wind business, viewed by governments as key to meeting climate targets and boosting electricity supplies, is facing a dangerous market squall.

After months of warnings about rising prices and logistical hiccups, developers and would-be buyers of wind power are scrapping contracts, putting off projects and postponing investment decisions. The setbacks are piling up for both onshore and offshore projects, but the latter’s problems are more acute.

In recent weeks, at least 10 offshore projects totaling around $33 billion in planned spending have been delayed or otherwise hit the doldrums across the U.S. and Europe.

“At the moment, we are seeing the industry’s first crisis,” said Anders Opedal, chief executive of Equinor, in an interview.

. . .

The holdup of projects that could generate 11.7 gigawatts—enough to power roughly all Texas households and then some—likely pushes 2030 offshore wind targets out of reach for the Biden administration and European governments.

. . .

(p. B11) The list of woes is long: inflation, supply-chain backlogs, rising interest rates, long permit and grid connection timelines. The increasing pace of the energy transition has created a loop of escalating costs.

For the full story, see:

Mari Novik and Jennifer Hiller. “Wind Power Stumbles as Problems Mount.” The Wall Street Journal (Tuesday, Aug. 8, 2023): B5 & B11.

(Note: ellipses added.)

(Note: the online version of the story was updated Aug. 7, 2023, and has the title “Wind Industry in Crisis as Problems Mount. The online version says that the title of the print version is “Wind Power Stumbles as Cost, Logistical Problems Mount.” But my print version of the national edition had the shorter title “Wind Power Stumbles as Problems Mount.”)

Improved AI Models Do Worse at Identifying Prime Numbers

(p. A2) . . . new research released this week reveals a fundamental challenge of developing artificial intelligence: ChatGPT has become worse at performing certain basic math operations.

The researchers at Stanford University and the University of California, Berkeley said the deterioration is an example of a phenomenon known to AI developers as drift, where attempts to improve one part of the enormously complex AI models make other parts of the models perform worse.

“Changing it in one direction can worsen it in other directions,” said James Zou, a Stanford professor who is affiliated with the school’s AI lab and is one of the authors of the new research. “It makes it very challenging to consistently improve.”

. . .

The goal of the team of researchers, consisting of Lingjiao Chen, a computer-science Ph.D. student at Stanford, along with Zou and Berkeley’s Matei Zaharia, is to systematically and repeatedly see how the models perform over time at a range of tasks.

Thus far, they have tested two versions of ChatGPT: version 3.5, available free online to anyone, and version 4.0, available via a premium subscription.

The results aren’t entirely promising. They gave the chatbot a basic task: identify whether a particular number is a prime number. This is the sort of math problem that is complicated for people but simple for computers.

Is 17,077 prime? Is 17,947 prime? Unless you are a savant you can’t work this out in your head, but it is easy for computers to evaluate. A computer can just brute force the problem—try dividing by two, three, five, etc., and see if anything works.

To track performance, the researchers fed ChatGPT 1,000 different numbers. In March, the premium GPT-4, correctly identified whether 84% of the numbers were prime or not. (Pretty mediocre performance for a computer, frankly.) By June its success rate had dropped to 51%.

. . .

The phenomenon of unpredictable drift is known to researchers who study machine learning and AI, Zou said. “We had the suspicion it could happen here, but we were very surprised at how fast the drift is happening.”

For the full commentary, see:

Josh Zumbrun. “THE NUMBERS; AI Surprise: It’s Unlearning Basic Math.” The Wall Street Journal (Saturday, Aug. 5, 2023): A2.

(Note: ellipses added.)

(Note: the online version of the commentary has the date August 4, 2023, and has the title “THE NUMBERS; Why ChatGPT Is Getting Dumber at Basic Math.”)

“An Inalienable Right to Sit In AC”

(p. C4) “Let’s sit in AC.” An American friend of mine, recently living in Mumbai, was wildly amused to hear this said in that steamy megalopolis, as if retreating to the tantalizing cool of an air-conditioned room were an activity in itself.

It took me a moment to see what he found so funny. I had grown up with the deprivations of socialist India in the 1980s. I was hardwired to fetishize air-conditioning. It was not an adjunct to life, sewn seamlessly into our daily routines, as it is in the U.S., where 82.7 million homes have central AC. It was, as the philosopher Immanuel Kant would say, the “thing-in-itself,” and to sit “in” AC was something of a national pastime.

. . .

Our first AC was an unbranded gimcrack contraption, jerry-built by a local electrician, but—my god!—how we loved it.

. . .

India loves to assert the demands of belonging through pacts of mutual suffering, and to be in AC was almost to be a little less Indian, as if you had decamped for the West. Even now that the country is the world’s fastest growing market for air-conditioners—projected by the International Energy Agency to be the biggest by 2050—the first line of attack from your average troll is: “What do you know of the realities of India, sitting in AC?”

. . .

. . . this summer, as newspapers report the hottest temperatures ever recorded on Earth and Amazon blasts me with discounts on their best-selling ACs, I cannot help feeling that our turn has come at a bad time. If nothing is done to make air-conditioning more energy-efficient, India alone is projected to use 30 times more electricity in 2030 than it did in 2010. Globally, air conditioning is projected to account for 40% of the growth in energy consumption in buildings by 2050—the equivalent of all the electricity used today in the U.S. and Germany combined. It’s enough to send a chill down the spine of the most ardent of AC evangelists.

The irony of a world made hotter by our need to be cool strikes some as proof of our rapacity. To me, having grown up in the place where so much of the new demand is coming from, I see it as part of a necessary realignment. As the global south gets richer, it will act as a frontier and laboratory. My hope is that it will achieve a miraculous breakthrough in energy efficiency, even as it asserts an inalienable right to sit in AC.

For the full commentary, see:

Aatish Taseer. “My Love Affair With Air- Conditioning.” The Wall Street Journal (Saturday, July 15, 2023): C4.

(Note: ellipses added.)

(Note: the online version of the commentary has the date July 14, 2023, and has the same title as the print version.)

Blue Cross of California Seeks to End Drug Rebates and Hidden Fees

(p. A3) A major health insurer says it will jettison the complicated system that Americans use to pay for drugs, and create something that aims to be better, with partners including Amazon.com and the entrepreneur Mark Cuban.

Blue Shield of California said it is dropping CVS Health’s Caremark, the pharmacy-benefit manager it currently uses, which negotiates drug prices and wraps in other services such as a mail-order pharmacy.

. . .

Blue Shield said that, working with its partners, it aims to negotiate prices with pharmaceutical makers in a way that is different from the typical approach—with a simple net price structure that is supposed to eliminate rebates and hidden fees.

Blue Shield executives said that with one company handling many aspects of how drugs are procured through the system, it is often hard to track the flow of payments accurately.

“The current pharmacy supply chain is a forest of opacity and profit,” said Paul Markovich, Blue Shield’s chief executive officer, in an interview with The Wall Street Journal. “It is overwhelmingly complex, it is designed to maximize the earnings of the participants.” His company’s new setup, he said, will be “flipping that on its head.”

For the full story, see:

Anna Wilde Mathews. “Health Insurer Revamps Drug Pricing Model.” The Wall Street Journal (Friday, Aug. 18, 2023): A3.

(Note: ellipsis added.)

(Note: the online version of the story was updated Aug. 17, 2023, and has the title “A Big Health Insurer Is Ripping Up the Playbook on Drug Pricing.”)

Nimbly Use What Is Available Now Rather Than Wait for Adoption of Perfect Global Standards

(p. A9) For more than five decades, Don Bateman led teams of engineers at what is now Honeywell International in creating and enhancing technology that warns pilots of impending disasters.

The result is an array of software and equipment, much of it mandatory, that squawks warnings and flashes digital admonitions if a plane is heading into a mountain, a ridge, a radio tower or some other obstacle.

. . .

Rather than waiting years for global industry standards to be adopted, he always wanted to use whatever technology was available immediately. Ratan Khatwa, a former Honeywell colleague of Bateman, recalled his advice: “You’ve got to work like farmers,” using whatever is available now rather than waiting for perfection.

For the full obituary, see:

James R. Hagerty. “Safety Engineer Helped Pilots Avoid Crashes.” The Wall Street Journal (Saturday, June 3, 2023): A9.

(Note: ellipsis added.)

(Note: the online version of the obituary has the date May 30, 2023, and has the title “Don Bateman, Champion of Airline Safety, Dies at 91.”)

With Repetitions Surgeons Gain Informal Knowledge, Such as “Muscle Memory”

(p. C6) Imagine you’ve been admitted to the hospital and you’re meeting the physician taking care of you for the first time. Who are you hoping walks through that door? Would you rather they be in their 50s with a good amount of gray hair, or in their 30s, just a few years out of residency?

In a study published in 2017, one of us (Dr. Jena) and colleagues set out to shed some light on the role of age when it came to internists who treat patients in hospitals. These physicians, called hospitalists, provide the majority of care for elderly patients hospitalized in the U.S. with some of the most common acute illnesses, such as serious infections, organ failure and cardiac problems.

. . .

. . ., the results suggested if the over-60 doctors took care of 1,000 patients, 13 patients who died in their care would have survived had they been cared for by the under-40 doctors. We repeated the analysis using 60- and 90-day mortality rates, in case longer term outcomes might have been different, but again, the pattern persisted: Younger doctors had better outcomes than their more experienced peers.

. . .

Younger doctors possess clinical knowledge that is more current. If older doctors haven’t kept up with the latest advances in research and technology, or if they aren’t following the latest guidelines, their care may not be as good as that of their younger peers.

. . .

. . ., a separate study by Dr. Jena and colleagues looked at about 900,000 Medicare patients who underwent common non-elective major surgeries (for example, emergency hip fracture repair or gall bladder surgery) performed by about 46,000 surgeons of varying age.

. . .

The results showed that unlike hospitalists, surgeons got better with age. Their patient mortality rates had modest but significant declines as they got older: mortality was 6.6% for surgeons under 40, 6.5% for surgeons age 40-49, 6.4% for surgeons age 50-59, and 6.3% for surgeons over age 60.

Clearly something different was happening here. It may be that for hospitalists, the benefit of steadily increasing experience starts to be outweighed by their waning knowledge of the most up-to-date care. It’s different for surgeons, though, who hone many of their skills in the OR. Surgeons build muscle memory through repetition, working in confined spaces with complex anatomy. They learn to anticipate technical problems before they happen and plan around them based on prior experience. Over time, they build greater technical skills across a wider variety of scenarios, learn how to best avoid complications, and choose better surgical strategies.

What does this mean for all of us as patients when we meet a new doctor? Taking studies of hospitalists and surgeons together, it’s clear that a doctor’s age isn’t something that can be dismissed out of hand—age does matter—but nor can it be considered in isolation. If we’re concerned about the quality of care we’re receiving, the questions worth asking aren’t “How old are you?” or even “How many years of experience do you have?” but rather “Do you have a lot of experience caring for patients in my situation?” or “What do you do to stay current with the research?”

For the full essay, see:

Anupam B. Jena and Christopher Worsham. “Do Younger or Older Doctors Get Better Results?” The Wall Street Journal (Saturday, July 8, 2023): C6.

(Note: ellipses added.)

(Note: the online version of the essay was updated July 8, 2023, and has the same title as the print version.)

The essay quoted above is adapted from the book:

Jena, Anupam B., and Christopher M. Worsham. Random Acts of Medicine: The Hidden Forces That Sway Doctors, Impact Patients, and Shape Our Health. New York: Doubleday, 2023.

Hybrids Appeal to Consumers with Short-Term E.V. “Range Anxiety”

(p. A19) . . . there’s a good argument to be made that the government, and automakers, are leaning too hard into all-electric and neglecting the virtues of hybrid technology. When I first heard this counterintuitive argument from Toyota, I dismissed it as heel-dragging by a company that lags in electrics, but I’ve come around to the idea that hybrids — at least for now — do have a lot of advantages over all-electric vehicles.

. . .

(p. A6) “Toyota’s claim is accurate. We’ve crunched the numbers on this,” Ashley Nunes told me. He is a senior research associate at Harvard Law School and the director for federal policy, climate and energy at the Breakthrough Institute, a think tank. He testified on the topic in April [2023] before the House Subcommittee on Environment, Manufacturing and Critical Materials.

. . . electric vehicles consume huge quantities of lithium and other materials because they have huge batteries. And they have huge batteries because customers suffer from “range anxiety” and won’t buy an E.V. unless it can go for hundreds of miles without charging — even though the vast majority of trips are short.

. . .

Some people will keep driving old ICE-mobiles (cars with internal combustion engines) because they can’t afford an E.V. And those ICE-mobiles will continue to be major emitters of greenhouse gases.

The production of electric vehicles produces more greenhouse gases than the production of cars with combustion engines. So E.V.s have to travel between 28,000 and 68,000 miles before they have an emissions advantage over similarly sized and equipped ICE-mobiles, according to Nunes. That may take 10 years or more if the E.V. isn’t driven much.

For the full commentary, see:

Peter Coy. “We May Not Be Ready for an All-E.V. World.” The New York Times (Monday, July 17, 2023): A19.

(Note: ellipses added.)

(Note: the online version of the commentary has the date July 14, 2023, and has the title “A Climate Hawk’s Issues With Electric Vehicles.”)

“Engineering Is Achieving Function While Avoiding Failure”

(p. A21) Dr. Petroski, a longtime professor of civil and environmental engineering at Duke University, adapted the architectural axiom “form follows function” into one of his own — “form follows failure” — and addressed the subject extensively in books, lectures, scholarly journals, The New York Times and magazines like Forbes and American Scientist.

“Failure is central to engineering,” he said when The Times profiled him in 2006. “Every single calculation that an engineer makes is a failure calculation. Successful engineering is all about understanding how things break or fail.”

. . .

“Even though I had three degrees in engineering, and had been teaching engineering and was registered as a professional engineer,” he told The Times in 2014, “if some neighbor asked me, ‘What is engineering?,’ I said, ‘Duh.’ I couldn’t put together a coherent definition of it.” His best effort, he said, was, that “engineering is achieving function while avoiding failure.”

Pencils proved a prosaic object for Dr. Petroski’s failure analysis.

. . .

“By asking why and how a pencil point breaks in the way it does,” he concluded, “we are not only led to a better understanding of the tools of stress analysis and their limitations, but we are also led to a fuller appreciation of the wonders of technology when we analyze the aptness of such a manufactured product as the common pencil.”

Two years later, he expanded on the journal article with “The Pencil: A History of Design and Circumstance,” a 448-page tour through its invention and evolution — with brands like Faber-Castell, Dixon Ticonderoga and Koh-I-Noor among them — that included a chapter about the pencil-making business of Henry David Thoreau’s family in Concord, Mass.

Thoreau, best known for writing about his experience living simply in the woods in “Walden,” was a self-taught pencil engineer who learned about the graphite and clay mixture that made European pencils superior, and who helped adapt them to his family’s pencil manufacturing.

For the full obituary, see:

Richard Sandomir. “Henry Petroski, Whose Books Decoded Engineering, Is Dead at 81.” The New York Times (Friday, June 23, 2023): A21.

(Note: ellipses added.)

(Note: the online version of the obituary has the date June 22, 2023, and has the title “Henry Petroski, Whose Books Decoded Engineering, Dies at 81.”)

Petroski’s best-known book is:

Petroski, Henry. The Pencil: A History of Design and Circumstance. New York: Knopf, 1989.