skybrian's recent activity

  1. Comment on Lyme disease vaccine shows 70 percent efficacy, Pfizer says in ~health

    skybrian
    Link
    From the article: [...] [...]

    From the article:

    Four doses of an experimental vaccine to protect against Lyme disease reduced the number of tick-borne infections by more than 70 percent, according to Pfizer and Valneva, the pharmaceutical companies developing the shot.

    [...]

    Pfizer said in a statement the companies are “confident in the vaccine’s potential” and plan to submit the data to regulatory authorities seeking approval. If successful, it could become the only Lyme disease vaccine available for people — although it would not be the first.

    A previous Lyme disease vaccine, called LYMErix, was approved in 1998. But it became controversial because of reports of adverse events following vaccination, and it was pulled from the market four years later due to poor sales.

    [...]

    The results of the trial, which tested the vaccine against a placebo in 9,400 people ages 5 and up, have not yet been published or peer reviewed. Pfizer said in its statement that its late-stage clinical trial just missed a statistical cutoff for success, because there were fewer than expected cases of Lyme disease in the trial.

    2 votes

  3. Comment on Android to debut "advanced flow" for sideloading unverified applications in ~tech

    skybrian
    Link Parent
    They could do that already if they wanted to using the built-in malware protection: The new system is a countermeasure against malware that’s actively evading that protection, but the...

    They could do that already if they wanted to using the built-in malware protection:

    Every day, Google Play Protect automatically scans all of the apps on Android phones

    The new system is a countermeasure against malware that’s actively evading that protection, but the cat-and-mouse game is already happening.

    1 vote

  4. Comment on The miracle cure for sickle cell is now two years old. Most are still waiting. in ~health

    skybrian
    Link
    From the article: [...] [...] [...] [...] [...]

    From the article:

    The Trump administration is aiming to change that with a new program within Medicaid, the federal-state insurer for low-income people that covers about half of the 100,000 people in the U.S. with sickle cell disease. The program, launched this year, helps states negotiate payments for the treatments based on patient outcomes and whether the therapies deliver the promised cure. If the treatments fail, the 33 states that have signed up will receive discounts and rebates from the drug manufacturers.

    The first-of-its-kind model — “a historic step in the fight against sickle cell disease,” in the words of Centers for Medicare and Medicaid Services Administrator Mehmet Oz — was first spearheaded by the Biden administration and launched through CMS’s Innovation Center this year.

    Doctors and policy experts say it’s a promising attempt at making it easier for state Medicaid programs to pay for costly sickle cell treatments. But they also worry the model’s potential is limited given existing barriers to delivering these types of new-age, innovative treatments to the people who need them the most — namely a lack of health care facilities across the U.S. that have the financial, administrative and structural capacity to provide such complex care.

    The therapies must be provided at authorized treatment centers — specialized and highly regulated facilities that are specifically chosen and trained by the drugmakers to ensure they can administer the treatments safely. People living in metropolitan areas, like Boston and Los Angeles, might have multiple treatment centers to choose from; but in rural areas, access to the facilities is sparse.

    [...]

    About a quarter of people living in rural areas are enrolled in Medicaid. For Medicaid programs, approving care for a patient in another state can be a long and complex process that can lead to lengthy delays, doctors said.

    [...]

    The treatments, Casgevy, from Boston’s Vertex Pharmaceuticals and Switzerland’s CRISPR Therapeutics, and Lyfgenia, from Boston’s Genetix Biotherapeutics of Boston, cost $2.2 million and $3.1 million, respectively, and have not been routinely covered in Medicaid since their approval two years ago.

    [...]

    State Medicaid officials say they want to make the lifesaving treatments more accessible, but cost is a major barrier, even with the promising new federal payment model.

    Many states have faced massive budget deficits this year, and pharmacy spend has been a key year-over-year driver of Medicaid costs. Looking at the pipeline of hundreds of cell and gene therapies being developed — which treat a range of diseases beyond sickle cell, including rare cancers and blood disorders — state officials and economists say that new, innovative approaches to paying for the treatments will be necessary to manage the cost burden.

    [...]

    The rapid development and approval of the treatments for a range of diseases threatens to cripple state budgets at a time when federal funding for the health insurance program is in flux — Trump signed off on a megabill over the summer that will result in nearly $1 trillion in health care cuts, most of which will come from Medicaid.

    [...]

    The new payment model offers help from the federal government to negotiate contracts for sickle cell treatment with drugmakers, which could ease some of the burden on participating states.

    “The fact that 35 states decided to join the model after reviewing the agreements CMS negotiated with each of the drug manufacturers indicates that these agreements, in their totality, were preferable to states than what they were able to negotiate on their own,” said a CMS spokesperson in a statement. Thirty-three states have signed up for the model, in addition to Washington, D.C., and Puerto Rico. More than 80 percent of Medicaid enrollees with sickle cell disease live in the participating states, according to CMS.

    Still, such outcomes-based models are new, and it’s not clear whether they actually save payers money in the long run, even if they ease the burden on states in negotiating individual payment agreements, said David Ridley, a health economist at Duke University’s Fuqua School of Business.

    “I can see [the model] being appealing to the public. From an economic perspective, it doesn’t make that much difference,” said Ridley, who suspects the model will lead to states paying the same amount for the treatments in the long-term.

    3 votes

  6. Comment on How Invisalign became the world’s biggest user of 3d printers in ~tech

    skybrian
    Link
    From the article: [...] [...] [...]

    From the article:

    Align is embarking on its biggest manufacturing overhaul since it was founded by two Stanford Graduate School of Business classmates 29 years ago. The company is preparing to begin directly 3D printing the aligners at the core of its business, ditching what Hogan describes as a longer, more wasteful process that involves making molds. A successful transition could lower costs and make treatment more affordable in the long run, bringing Invisalign to more customers and boosting Align’s profits.

    It also, according to Hogan, would entrench Align as the world’s biggest user of 3D printers. Hogan isn’t a founder or a scientist, though he has raised honeybees for over 25 years. He also doesn’t have a Wikipedia page, despite having run three multibillion-dollar international companies. But he’s a manufacturing veteran who knows about plastics and 3D printing, especially after over a decade at Align.

    [...]

    Joe Hogan: We were the first ones to what I call mass customization, to be able to 3D print a million different aligners a day. It took us years to figure out how to do that. When these guys started, if they did five cases a day, they were excited. We had to take 3D printing equipment and modify it massively, because most 3D printing was a prototype business at that point in time.

    [...]

    One of our biggest costs is just shipping. We're probably one of the largest small volume shippers in the world, and it's getting to a point as we've reduced our internal costs that a lot of what we do is transportation costs. If you look at our margins, you'd say they’re margins of a good company. It does well, but not extravagant margins.

    [...]

    Going back to 3D printing, you've said you’re trying to directly print the aligners. But it sounds like you still need to have a breakthrough in terms of a material that'll go into these machines and be able to do that.

    We feel we have that material. We do. That's why we bought Cubicure in Austria. It bothered me to death that we couldn't 3D print an aligner. We tried to work with chemical companies, everyone, to make this, and we couldn't find anyone that could do this. We hired our own polymer chemist, and then over time, we figured out how to make a resin that would have the properties of our current material that we vacuum form but be able to 3D print.

    Once we had that material science done, we knew it was going to have to be high viscosity. Watery resins cannot deliver the combination of complex material properties and performance characteristics required for our applications. And that's why we bought Cubicure, because they have machines that know how to process high viscosity, performance resins. We have a resin we want, and that resin is as good or better than SmartTrack [Align’s current material]. And then we have a process to make aligners. Remember, we have to make a million of these a day. That kind of scale is monstrous, and we have a brand-new process. That's what we're going through now.

    But what is the scaling challenge here? Is it just making enough of the machines? Is it getting quality control?

    First of all, how do you print these things to limit the amount of resin that's used on them? Do you print them vertically? Do you print them horizontally? Do you print them sideways? Where do you put the runners, where the material actually goes into? Do you put it on the outside? Do you put it on the inside? Do you put it on the label side? Do you cut it with lasers?

    When we vacuum formed, all you had to do was laser the gingival area, and you were done. In this case, it's a completely different story. It's a really dynamic and incredible engineering problem. We certainly have to be efficient enough to make sure that when we go into the marketplace, that it's a profitable equation. At scale, we should get to a point where the resin is less expensive, and that will help. But that takes years.

    5 votes

  8. Comment on At twenty airports in the United States, security screening is handled not by the Transportation Security Administration, but by private companies — and their checkpoints aren’t seeing long lines in ~transport

    skybrian
    Link
    From the article: [...] [...] [...] [...]

    From the article:

    Airports like San Francisco International, Kansas City International, Orlando Sanford, and 17 smaller facilities participate in TSA’s Screening Partnership Program which uses contractors at the checkpoints.

    The private companies have avoided the large-scale absences some airports that use TSA staff are struggling with right now during the partial government shutdown.

    [...]

    “All operations at the privatized airports are normal because we continue paying our employees during the shutdown,” said Nat Carmack of BOS Security, which screens passengers at Tupelo Regional Airport in Mississippi. “Our employees have never missed a paycheck during any of the government shutdowns.”

    Carmack said while employees are getting paid, the company will have to cover the expense while it waits for the government to reopen and pay its bills.

    [...]

    All private airport security operations remain under federal oversight and must comply with the same rules TSA agents follow. The companies do get to decide how many people to hire and what to pay them.

    [...]

    Airports experiencing problems with TSA staff not showing up during this current shutdown can’t simply call a contractor and bring in private employees within a few days.

    For an airport to implement private screening, it must first get permission from TSA. If approved, a contract could be issued within a year. TSA would select the company that could take over within six months, according to BOS Security.

    [...]

    AFGE, the union which represents TSA screeners, says contracts, usually awarded to the lowest bidder, compromise the safety of the traveling public, incentivize companies to prioritize profit over passengers or employees, and actually cause staff shortages.

    They also note that prior to the September 11, 2001, terror attack all airport security in the United States was operated by private companies.

    Jacobson, the professor who studies aviation security systems, thinks of privatizing more of like a “partnership.” He points to NAV CANADA, which has operated Canada’s air traffic control system since it privatized in 1996.

    5 votes

  10. Comment on Android to debut "advanced flow" for sideloading unverified applications in ~tech

    skybrian
    Link Parent
    We actually do need to drive the scammers who take people’s life savings out of business. The elderly are often victims. It’s more important than your “freedom” from a bit of inconvenience. It’s a...

    We actually do need to drive the scammers who take people’s life savings out of business. The elderly are often victims. It’s more important than your “freedom” from a bit of inconvenience.

    It’s a good sign that Google is taking the victims’ side when designing their systems.

    4 votes

  11. Comment on Android to debut "advanced flow" for sideloading unverified applications in ~tech

    skybrian
    Link Parent
    It doesn’t actually block that, but it might take a day.

    It doesn’t actually block that, but it might take a day.

    3 votes

  12. Comment on US tariffs refunds: pick your poison in ~society

    skybrian
    Link
    From the article: [...] [...] (Omitted: Unikowsky speculates about a legal system where AI is used instead.)

    From the article:

    On February 20, 2026, the Supreme Court ruled, correctly in my view, that the International Emergency Economic Powers Act (IEEPA) does not authorize tariffs.

    While the case was pending, the government collected billions of dollars in IEEPA tariffs. Because the government lost, it must now refund all that money, with interest.

    [...]

    The jury is still out on how eagerly the government will cooperate with the refund process. Early signs, however, are not promising. Among other things, after the Court of International Trade issued an order directing the government to immediately stop liquidating entries subject to the illegal tariffs, the government asserted it couldn’t comply with the order.

    [...]

    It would have been nice if the government had been open about these challenges before the Supreme Court’s decision. The government successfully persuaded the Federal Circuit to stay its mandate on the theory that if the government lost, the importers would get refunds. The government did not mention that (1) it would push for a 90-day stay even after the Supreme Court’s decision; (2) even after that stay was denied, it would be forced to keep liquidating entries with IEEPA tariffs because its possibly FORTRAN-driven computer system made it impossible to stop the tariff snowball from rolling downhill; and (3) technology for processing refunds doesn’t currently exist.

    There is nothing we can do about this now. I agree with Elsa that the past is in the past. But the government has announced a new set of so-called Section 122 tariffs. In my opinion, these tariffs are also illegal and the government will have to refund them too. The government will no doubt argue that any injunction against Illegal Tariffs II should be stayed pending Federal Circuit and Supreme Court review, as with Illegal Tariffs I. The stay should be denied. The government might say that a stay is unnecessary because the importers are guaranteed to get refunds, but fool me twice, shame on me. And you know what will happen: if the government ultimately loses on Illegal Tariffs II, it is going to say that it is too hard to issue refunds because it is too busy dealing with refunds for Illegal Tariffs I.

    (Omitted: Unikowsky speculates about a legal system where AI is used instead.)

    So if everyone fulfills their role—if the lawyers try their best to be both persuasive and credible and the judge tries to resolve the dispute as accurately as possible—then we’ll have AI deciding between two AI-written submissions, with the human lawyers claiming that their submissions are credible precisely because humans were not involved. So much for our legal system.

    On the other hand, the current situation is not much better. The government claims it has no choice but to keep billions of dollars in illegally-exacted tariffs, and there’s nothing anyone can do about it.

    4 votes

  14. Comment on Ozempic is about to go generic in India, China and Canada in ~health

    skybrian
    Link
    From the article: [...] [...] [...] [...] [...] [...]

    From the article:

    The blockbuster weight loss drug sold as Ozempic and Wegovy will soon go generic in countries that are home to 40 percent of the world’s population, significantly lowering the price of a costly medicine that had been largely unaffordable to nearly all but the wealthiest people.

    On Saturday, Novo Nordisk, the company that until now has had a monopoly on selling the drug, will lose patent protection in several of the world’s most populous countries. The first generic versions are expected to arrive in India as soon as this weekend. In the coming months, the generics are also expected to become available in China, Canada, Brazil, Turkey and South Africa.

    [...]

    In the United States and Europe, the drug is not expected to go generic until the early 2030s. That delay is due to special regulatory protections that are intended to encourage innovation by extending a brand-name drugmaker’s monopoly.

    Dozens of generic manufacturers have been racing to produce supplies and win regulatory approvals in countries where they can soon compete. Huge demand is expected from patients who could not afford Novo Nordisk’s offering but can budget for cheaper generics. Novo Nordisk sells the drug, semaglutide, as Ozempic for diabetes and as Wegovy for obesity.

    [...]

    The expiration of the patents presents more trouble for Novo Nordisk, whose stock has plummeted as global competition has eroded its market share. At its peak in mid-2024, the Danish drugmaker was the most valuable public company in Europe.

    Eli Lilly, an American company that sells its weight loss drug as Mounjaro for diabetes and as Zepbound for obesity, poses the biggest competitive threat. Eli Lilly is expected to retain patent protection for another decade in most major markets.

    [...]

    Seeking to preserve its monopoly, Novo Nordisk has fought in courts in India, China and Brazil to try to block the generics. The company has also cut prices in China and India in anticipation of competition.

    [...]

    Once the generics arrive in Canada, where Novo Nordisk’s patent protection expired in January, some U.S. patients might seek to import the drug from Canadian pharmacies.

    [...]

    By early March, 10 generic competitors were in the final stage of being evaluated by Chinese regulators to sell their semaglutide products, and at least a dozen more firms had completed clinical trials.

    The United Laboratories, which has its headquarters in the southeastern province of Guangdong and in Hong Kong, expects approval to sell its generic for diabetes before July, said Cao Chunlai, an executive at the company’s research and development subsidiary.

    China’s national health insurance system covers Novo Nordisk’s drug for diabetes, while people taking it for obesity must pay out of pocket.

    [...]

    Patents are good for 20 years after an application is filed. But because Novo Nordisk spent years developing its drug and waiting for regulatory review, the company has been selling it for only about eight years.

    For situations like this, the United States and Europe grant brand-name drugmakers like Novo Nordisk special protections, called patent term extensions, giving them a monopoly for a few more years.

    8 votes

  16. Comment on Android to debut "advanced flow" for sideloading unverified applications in ~tech

    skybrian
    Link Parent
    Not sure what legal frameworks (in which countries?) you have in mind that are going to help against North Korea or organized crime running pig butchering schemes in Myanmar. How would it help...

    Not sure what legal frameworks (in which countries?) you have in mind that are going to help against North Korea or organized crime running pig butchering schemes in Myanmar. How would it help victims?

    Technical fixes seem more direct.

    2 votes

  17. Comment on Android to debut "advanced flow" for sideloading unverified applications in ~tech

    skybrian
    Link Parent
    I don't see how you could possibly know that? There's nobody reporting on who inside Google is advocating for what. There's no way to know, that I can see. All we can do is speculate.

    I don't see how you could possibly know that? There's nobody reporting on who inside Google is advocating for what. There's no way to know, that I can see. All we can do is speculate.

    2 votes

  18. Comment on Android to debut "advanced flow" for sideloading unverified applications in ~tech

    skybrian
    Link Parent
    Yes, they are going through a fair bit of trouble to preserve side-loading, which I think suggests that there are some people at Google in favor of keeping it.

    Yes, they are going through a fair bit of trouble to preserve side-loading, which I think suggests that there are some people at Google in favor of keeping it.

    4 votes

  19. Comment on Iran hits Gulf energy sites, escalating war, as US mulls sanctions rollback in ~society

    skybrian
    Link Parent
    I think it’s rather unlikely that the Trump administration expected the war to turn out the way it did.

    I think it’s rather unlikely that the Trump administration expected the war to turn out the way it did.

    8 votes

  20. Comment on Asia turns back to coal as war chokes off natural gas in ~enviro

    skybrian
    Link
    From the article: [...]

    From the article:

    Many nations in Southeast Asia began significantly ramping up import volumes in the early 2010s as domestic gas reserves dwindled. Thailand led the push. The country built two major import terminals and took steps to liberalize its domestic gas market. By 2022, natural gas generated more than half its electricity, with L.N.G. accounting for nearly a quarter of that supply — up from just 2 percent in 2011, according to data from the Asia Pacific Energy Research Center, a research organization in Tokyo.

    The Russia-Ukraine war dented confidence in L.N.G. When Moscow cut pipeline supplies to Europe in 2022, wealthy European nations pivoted to the global L.N.G. market, often outbidding developing Asian economies. The resulting shortages forced countries to curb imports and endure rolling blackouts. In Thailand, electricity rates rose to record highs, prompting the government to postpone the retirement of coal-fired units at the Mae Moh power plant.

    [...]

    Four years later, the pattern is repeating. This month, the Thai government ordered coal-fired power plants to operate at full capacity and began tapping heavily into a state energy-subsidy fund to help absorb price shocks.

    With ships being rerouted, “it’s once again widening economic disparities between the richer countries and the emerging economies,” said Dinita Setyawati, an Indonesian-based senior energy analyst at Ember, a think tank.

    In Bangladesh, utilities have begun significantly increasing their use of coal to create electricity since the start of the war in Iran, data from Bangladesh’s state-owned company responsible for electricity transmission show.

    Supply disruptions are causing problems in Asia’s most developed economies as well. Taiwan’s economy ministry said this month that it would be prepared to buy more L.N.G. from the United States and restart its retired Hsinta coal-fired power plant if supply disruptions persisted through April. South Korea is also preparing to boost nuclear and coal-fired power generation to offset volatility in oil and L.N.G. supply, its industry minister said last week.

    6 votes