26 de gener 2022

Reproductive genomics paradigm

The End of Genetics. Designing Humanity's DNA

Although human genetics has already advanced far enough to provide parents with information on which they may choose to act, key gaps in our knowledge make it very difficult to anticipate the consequences of the actions likely to become possible. These gaps mean that any reproductive engineering that is performed beyond the most straightforward elimination of strongly acting disease-causing mutations will be performed without a complete understanding of the likely consequences of those changes. This is a prospect that I find deeply troubling, and this book above all represents my best effort to empower non-specialists to develop their own opinions about this most central question for the future of humanity.

In response to this deep uncertainty, I have developed a thought experiment in reproductive genomics to help illustrate the kind of genome engineering that could be entertained in the not too distant future. Throughout the book I will refer back to this thought experiment to help make clear that we will have the technological ability of making some kinds of adjustments to the genomes of children, without having a matching ability to accurately predict the consequences of those adjustments. You will be in a position to understand this thought experiment more fully later in the book, but as a motivation in the reading that follows, consider the following possibility.

A very controversial book, glups!

This is the outline, 

Introduction

Chapter 1. The Future of Reproduction

Chapter 2. Learning to Read the Human Genome

Chapter 3. The Nature of Human Genetic Variation

Chapter 4. DNA and Human Disease

Chapter 5. Writing the Genomes of Our Children




25 de gener 2022

The financial crash of 2008 never really ended

 The Lords of Easy Money. How the Federal Reserve Broke the American Economy

Ten years on, the gap between the rich and poor has grown dramatically, stock prices are trading far above what’s justified by actual corporate profits, corporate debt in America is at an all-time high, and this debt is being traded by big banks on Wall Street, leaving them vulnerable—just as they were during the mortgage boom. Middle-class wages have barely budged in a decade, and consumers are buried under credit card debt, car loan debt, and student debt.




23 de gener 2022

Precision medicine (2)

Discovering Precision Health: Predict, Prevent, and Cure to Advance Health and Well-Being


Introduction The Power of Precision Health 1

Chapter 1 The State of U.S. Health and Health Care Delivery 15

Chapter 2 There’s More to “Health” Than Health Care 33

Chapter 3 The Innovation and Disruption Powering Progress in Health 43

Chapter 4 Fundamental, Discovery‐Focused Research: The Foundation of Biomedical Breakthroughs 111

Chapter 5 Peering into the Future: Leveraging The Powers of Prediction to Help Prevent Illness 147

Chapter 6 Prevention as a Pathway to Health and Wellness 177

Chapter 7 Curing Disease with More Precise Medical Therapies 207

Conclusion Achieving Precision Health: The Opportunities—and Challenges—Ahead 237




20 de gener 2022

Public health budget evolution

 Last September I posted the data on per capita health expenditure. In 2020 we spent 1786€ per capita. The total budget for 2021 was 13.162m€, 1700€ per capita. Now the budget for 2022 says that we are going to spend 1.446€. This is an absolute nonsense. The budget approval has no relationship with former incurred expenditures...

Somebody should explain it clearly to the population and take measures. Forget this figure, it has no relationship with reality.



19 de gener 2022

Bundled payments update (2)

 Year 1 of the Bundled Payments for Care Improvement–Advanced Model

A NEJM article shows a negligible effect of bundled payments. Unfortunately, I haven't seen any comment about the flaws in the design. A design mistake for not taking into account a holistic view.

If you reduce 78$ out of 27,315 $ per episode, this is an absolute FAILURE! (it is not a small reduction!!!)

However, the conclusion is:

In this study, we found that the BPCI-A program was associated with small reductions in Medicare payments among participating hospitals. Longer-term evaluation is needed to determine the full effect of the program.

Jean Pierre Capron

 

 

13 de gener 2022

The knowledge economy

 The Knowledge Economy

Adam Smith and Karl Marx recognized that the best way to understand the economy is to study the most advanced practice of production. Today that practice is no longer conventional manufacturing: it is the radically innovative vanguard known as the knowledge economy. In every part of the production system it remains a fringe excluding the vast majority of workers and businesses. This book explores the hidden nature of the knowledge economy and its possible futures.