DOCSLIB.ORG

Sickle Cell Disease: the Challenge of Healthcare Disparity April 2018

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Sickle Cell Disease: the Challenge of Healthcare Disparity April 2018 Sickle Cell Disease: The Challenge of Healthcare Disparity April 2018 Global Blood Therapeutics, Inc. SICKLE CELL DISEASE (SCD): DISABLING INHERITED BLOOD DISORDER • SCD is an uncommon (or orphan) disease in the U.S., affecting approximately 100,000 people.1 • It disproportionately impacts African American and Hispanic Americans, occurring in 1 out of every 365 African American births and 1 out of every 16,300 Hispanic American births. • Every system in the body is impacted due to a lack of oxygen • Symptoms vary from childhood (e.g., stroke, acute chest syndrome) to adulthood (e.g., osteonecrosis of bone) • Clinical manifestations get worse over time in terms both of the severity of particular episodes (e.g., pain) and the presence or absence of a particular problem (e.g., leg ulcers) Sickle cell disease decreases median lifespan by decades Sources: Piel FB et al. N Engl J Med 2017;376:1561-1573 1. Centers f or Disease Control and Prevention. Sickle Cell Disease (SCD) Data & Statistics. https://www.cdc.gov/ncbddd/sicklecell/data.html ©Global Blood Therapeutics 2 SCD SPURRED ADVANCES IN MOLECULAR BIOLOGY AND GENETICS FOR A CENTURY James Herrick and Ernest E. Irons at Harvey Itano and Linus Pauling used Vernon Ingram at MRC in London Cook County Hospital in Chicago first the newly invented technique of used protein sequencing to described sickle cell disease in a protein electrophoresis to demonstrate demonstrate that HbS derived from a student from Grenada, Walter Clement that sickle hemoglobin (HbS) differed glutamic acid to valine amino acid Noël. He had an anemia marked by from normal hemoglobin (HbA). change at position β-6. The recently red cells that looked like “crescents or elucidated genetic code allowed sickles”. Noël returned to Grenada deduction of the nucleotide change after training in dentistry. (GAG → GTG). 1949 1956 1910 First demonstration of disease due to First demonstration of disease due to an abnormal protein a specific DNA mutation 3 CLINICAL CARE CONTINUES TO LAG SCIENCE 50 90% of Children reach Hydroxyurea 45 18 years of age Preventive 40 penicillin Median life expectancy: ) 35 Males- 42 years yr Females- 48 years 30 Transfusion for stroke prevention 25 National Sickle Cell Control Act 20 Life Expectancy ( Expectancy Life 15 10 5 0 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 Increases in Life Expectancy in Persons w ith Sickle Cell Disease, 1910–2000. 4 CONCENTRATED POPULATION, MOSTLY INSURED BY MEDICAID & MEDICARE Age Distribution Geographical Distribution West >30, 10% 40% Older Adults ~100K Americans are SCD is fairly concentrated in the US. living with SCD Northeast + 80% of the population resides in 17 states 18 to 20% + ~90% of SCD are African South 30, Transitioning Adults 55% + Most of the rural population lives in the American 27% Midwest south <18, + ~10% are Hispanic American 15% Pediatric Patients 33% % of patients % of patients Payer Mix Medicaid: ~50% of the population Medicaid dominates payer mix These individuals tend to be younger due to Medicaid eligibility criteria A significant share of Medicare Medicare: 30% of the population are dual eligible ~15% of the population Commercial: ~ Uninsured: More likely to be adult patients <10% of the Most of the southern states did not participate in Medicaid expansion population Sources: Piel et al NEJM 2017. November 2017 Analysis of Administrative Claims Data For 72,573 patients sourced from Symphony Healthcare Solutions. On File at GBT ©Global Blood Therapeutics 5 CURRENT THERAPIES FOR SCD ARE SUBOPTIMAL… Consensus Evidence Treatment Use Duration Recommendation Quality Daily until at least 5 years of Penicillin V • Prevention of Infections • Strong • Moderate age Pneumococcal • Prevention of Infections Every 5 years for life • Strong • Moderate vaccination Acute Blood • Treatment of Anemia • Strong • Low Limited Transfusion • Pre-operative transfusion • Strong • Moderate Analgesics (Opioid • Treatment of Acute Pain • Strong • High Limited and Nonopioid) • Treatment of Chronic Pain • Moderate • Low • Primary Stroke Prevention • Strong • High Chronic Blood • Secondary Stroke Prevention • Moderate • Low Every 3-6 weeks indefinitely Transfusion • Prevention of additional Silent Cerebral • Moderate • Moderate Infarctions • Universal Use • Moderate • Moderate Hydroxyurea • Prevention of Acute Complications Daily indefinitely • Strong • High • Primary Stroke Prevention • Strong • Moderate • Not yet Endari • Prevention of Acute Complications Daily indefinitely • Not yet assessed assessed Sources: Piel FB et al. N Engl J Med 2017;376:1561-1573 Evidence-Based Management of Sickle Cell Disease, Expert Panel Report. National Heart, Lung & Blood Institute. 2014 © Global Blood Therapeutics 6 … LEADING TO SIGNIFICANT NUMBERS OF EMERGENCY DEPARTMENT VISITS… Average Number of Emergency Department Visits Per Year1 7 6.1 6 5.5 5 • In 2014, SCD was responsible for ~250,000 Commercial Medicaid Emergency Department U.S. visits2 4 3 2.2 2 • About 20% of sickle cell disease patients 1.5 1.4 1.1 receive most of their care in the emergency 1 department setting3 0 < 18 18-30 > 30 Studies in the US indicate that about a third of patients are rehospitalized within 30 days of initial discharge due to SCD-related complications. 3,4 Sources: 1. Dampier et al. Access To Care For Medicaid And Commercially-Insured United States Patients With Sickle Cell Disease. GBT Sponsored ASH 2017 poster 2. Quality A f HRa. HCUPnet Healthcare Cost and Utilization Project. 2017; https://hcupnet.ahrq.gov/#setup. Accessed 02/14/2018 3. November 2017 Analysis of Administrative Claims Data For 63,256 patients sourced from Symphony Healthcare Solutions ©Global Blood Therapeutics 7 … AND INPATIENT HOSPITAL STAYS, PARTICULARLY FOR ADULTS LIVING WITH SCD Average Number of Inpatient Stays Per Year1 7 • In 2014, SCD was responsible for ~90,000 6 Inpatient stays in the United States2 5 • Average length of stay was 4-7 days3,4,5 4 Commercial Medicaid 3 2.4 2.3 2 1.2 1 0.7 0.8 0.7 0 < 18 18-30 > 30 Studies in the US indicate that about a third of patients are rehospitalized within 30 days of initial discharge due to SCD-related complications. 3,4 Sources: 1. Dampier et al. Access To Care For Medicaid And Commercially-Insured United States Patients With Sickle Cell Disease. GBT Sponsored ASH 2017 poster 2. Quality A f HRa. HCUPnet Healthcare Cost and Utilization Project. 2017; https://hcupnet.ahrq.gov/#setup. Accessed 02/14/2018 3. Rajpura, J. and J. Thomas Iii, All-cause health care resource utilization in individuals w ith sickle cell disease. Blood, 2015. 126(23): p. 5582 4. Raphael, J.L., et al., Shorter hospitalization trends among children w ith sickle cell disease. Pediatr Blood Cancer., 2012. 59(4): p. 679-84. doi: 10.1002/pbc.24065. Epub 2012 Jan 4 5. Jordan, L., et al., Sickle cell day hospital: A four year review of SCD patient tailored pain management and disease specific comprehensive care in an outpatient setting. American Journal of Hematology, 2012. 87(7): p. E11-E12 ©Global Blood Therapeutics 8 SCD DRIVES HIGHEST ALL-CAUSE 30-DAY READMISSION RATES • Studies in the US indicate that about a third of patients are rehospitalized within 30 days of initial discharge due to SCD-related complications. 2,3 Sources: 1. Elixhauser A and Steiner C, HCUP Strategical Briefs, 201 2. Brousseau, D.C. JAMA., 2010. 303(13): 1288-94 3. Nouraie, M. and V.R. Gordeuk, Transfusion., 2015. 55(10): 2331-8 11 ©Global Blood Therapeutics SCD RESULTS IN ~$10 MM IN LIFETIME HEALTHCARE EXPENSES & LOST PRODUCTIVITY PER INDIVIDUAL ED Visits, 5% Expected Lifetime Outpatient Cohort Income Per Visits, 1% Individual Lab Services, 6% SCD (all genotypes) $1.2M Hospital Admissions, 84% Transfusions & Non-SCD (Matched Medications, 5% $1.9M Controls) General US Population $2.1M + SCD significantly also limits quality adjusted life % of fees expectancy & costs the US economy over $800M in lifetime productivity • Average annual fee for the care of an adult This estimate does not include lost with SCD (SS genotype) is $231,000* educational potential, caregiver productivity or patient time spent in the hospital. • Lifetime healthcare fees are ~$9 MILLION per individual* Sources: 1. Ballas, American Jour of Hematology, 2009. Assumptions based on HbSS patients 2. SCD Societal Cost Model In Development by GBT for Journal Submission. All SCD Patients * in 2009 dollars, cost does not include future inflation rates; fee is defined as the price charged by providers; cost is usually about 60-65% of fee ©Global Blood Therapeutics 10 CURRENT ECONOMICS ARE CHALLENGING FOR SCD CLINICS TO PROVIDE INTEGRATED CARE Medicaid payments can be significantly lower than …Making it challenging to maintain an other payers… integrated care model $300 Charges vs Payment Analysis for Commonly Needed Resources Routine Outpatient Visit (Established Adult Patient) for SCD Quality Care Delivery $250 Benioff Children’s Hospital Oakland (BCHO) • SCD specialist (e.g. Hematologist) • Nurse Practitioners / Physician Assistants $200 • Primary Care Physician $148 $150 • Community Health Workers (CHW) • Nurse Educators $100 $92 $89 • Social Workers $50 62% 60% $28 • Patient Navigators 19% (payment to charges ratio) • Mental Health Professional $0 Charge Commercial Medicare Medicaid Source: BCHO 2017 Practice Analysis for CPT Code 99214 - 25 minute office visit (most commonly billed code) ©Global Blood Therapeutics 11 LESS THAN 10% OF CMS PATIENTS SEE A SPECIALIST ANNUALLY Proportion of SCD Population with at Least 1 Hematologist* Visit Per Year 60%
Load more

Recommended publications
  • The Gene in the Twenty-First Century
    CGA_C01.qxd 4/24/07 10:16 Page 1 1 CHAPTER 1 The gene in the twenty-first century Choong-Chin Liew, PhD, & Victor J. Dzau, MD Vries named the transmitted substances “pangens”; Introduction he later coined the term “mutation” to signify the When the word was first used in 1909, “gene” was a appearance of a new pangen [5]. hypothesis necessary to explain puzzling observa- Cambridge evolutionist William Bateson (1861– tions about heredity. As the century progressed, the 1926) translated Mendel into English and worked hypothesis began to acquire reality as the structure vigourously to promote Mendel’s ideas in the and functions of the gene were gradually elucidated. English-speaking scientific world. Bateson himself Earlier and simpler concepts became superseded as coined the term “genetics” in 1906 [6]. The word evidence led to better understanding of the gene. “gene” was not introduced until 1909, when Wilhelm Today the gene is recognized to be a highly complex Johannsen (1857–1927), a Danish botanist, offered entity. The genomics revolution is well underway this term in preference to earlier terms [7]. but there is much that remains for twenty-first cen- A next major step towards an elucidation of tury science to learn before the potential of molec- the gene came with the discovery that genes have ular biology and technology can be fully realized. physical locations on chromosomes in studies on Drosophila carried out by Thomas Hunt Morgan (1866–1945) and his colleagues at the zoology de- The search for the gene partment of Columbia University [8,9]. Morgan’s Much of the science that laid the foundation for the student, Alfred Sturtevant (1891–1970) was able to genetics and genomics revolution took place in the show that the gene for a trait was localized in a fixed very near past; 1900 is the date often considered to location or locus arranged “like beads on a string” be the beginning of modern genetics.
    [Show full text]
  • Hemolytic Anemias
    Hemolytic Anemias May 16, 2012 Anand S. Lagoo, MD, PhD Department of Pathology Anand Lagoo/Hereditary Anemias RS/5-12 Anemia Reduced red cell mass below the normal limit for age and sex of patient In practice, a hemoglobin level below the normal limit for age and sex of patient Anand Lagoo/Hereditary Anemias RS/5-12 Classifications of Anemias Morphological classification- Based on size of RBCs and their hemoglobin content Normocytic vs Microcytic vs Macrocytic Normochromic vs Hypochromic NOTE: The morphological classification suggests an etiologic differential which is confirmed by additional tests Etiological Classification 12 - Decreased Hgb and/or RBC production Defects of red cell survival (Hemolytic Anemias) Anand Lagoo/Hereditary AnemiasRS/5 Automated Blood Count Mean cell Hb Mean cell Hb concentration Red cell distribution width Mean cell volume Anand Lagoo/Hereditary Anemias RS/5-12 Platelet Central pallor Normal Decreased below Increased above Range lower limit = upper limit = Hgb g/dL M 14 - 18 Anemia Polycythemia F 12 - 16 MCV in fL 80 - 98 Microcytic Macrocytic MCH in pg 27 - 34 Hypochromic Hyperchromic (usually seen in Reticulocyte: % 0.5 – 1.5 (usually seen in aplastic anemia or hemolytic anemia) Abs /c mm 20k –100k myeoldysplasia) Anand Lagoo/Hereditary Anemias RS/5-12 Use of reticulocyte count in the evaluation of anemias HIGH Retic Index >2% or Low Retic Index <2% or Absolute count >100,000/ul Absolute count <100,000/ul HIGH Production LOW Production Anemias Anemias RESPONSE TO BLOOD HYPOPROLIFERATIVE LOSS MATURATION
    [Show full text]
  • S. Jonathan Singer: a Man Who Loved Ideas and Detested Walls Russell F
    RETROSPECTIVE RETROSPECTIVE S. Jonathan Singer: A man who loved ideas and detested walls Russell F. Doolittlea,b,1 S. Jonathan Singer, “Jon” to one and all, died Febru- porous. At UCSD, the departments of Chemistry and ary 2, 2017, at the age of 92. Educated as a physical Biology would not only be housed in the same chemist, he transitioned gracefully by way of protein building, they would have their laboratories alternately and immunochemistry to become a cell and molecular placed and would share general equipment as well as biologist of huge renown. His initial bout with fame cold and warm rooms. Moreover, the undergraduate came in 1949 when Jon was a postdoctoral fellow with curriculum would be particularly fashioned to in- Linus Pauling at the California Institute of Technology tegrate principal fields of knowledge, and a planned and, together with Harvey Itano, showed that sickle school of medicine would have its first-year curriculum cell hemoglobin differed from normal hemoglobin seamlessly rooted in the Biology and Chemistry by Tiselius electrophoresis (1). The years at the Cali- departments. fornia Institute of Technology also led Jon into the I first met Jon in July 1964, when I arrived to take a antibody field by way of a collaboration with the im- research position in his laboratory at UCSD after munologist Dan Campbell, something that would stand 2 years of postdoctoral work in Sweden. The timing him in good stead later. After his postdoctoral stint, Jon was inauspicious. The fledgling Biology Department was appointed to the faculty at Yale in the Department of was still located in temporary space at the Scripps Chemistry, where he remained until 1961.
    [Show full text]
  • And Cooley's Trait*
    VOL. 38, 1952 BIOCHEMISTRY: A. RICH1 187 at low temperature may mean that the DNA particles are enabled to sus- tain one ionization within their structures, but no more. Increasing the ion density by a factor of two could then give the observed increase in cross-section. Another possible extension of the work would be the bom- bardment of active DNA before the separation from protein. Summary.-Pneumococcus transforming principle DNA has been bombarded with 2-m. e. v. electrons and 3.8-m. e. v. deuterons with indica- tion by assay of activity remaining of a molecular weight of about 6,000,000. Acknowledgments.-We were assisted in the cyclotron work by Mr John Preiss. We are indebted to Dr. A. 0. Allen and to Dr. J. Saltick of Brookhaven for the use of the Van de Graaff machine and for assistance in those runs, and to Mr. Marvin Slater for the run with the linear acceler- ator. * Assisted by the U. S. Atomic Energy Commission. 1 Griffith, F., J. Hyg., Camb., 27, 113 (1928). 2 Dawson, M. H., and Sia, R. H. P., J. Exp. Med., 54, 681 (1931). 3 Avery, 0. T., MacLeod, C. M., and McCarty, M., Ibid., 79, 137 (1944). 4 Svedberg, T., and Brohult, S., Nature, 143, 938 (1939). 5 Lea, D., Smith, K. M., Holmes, B., and Markham, R., Parasitology, 36, 110 (1944). 6 Pollard, E., and Forro, F., Arch. Biochem. Biophys., 32, 256 (1951). 7 Pollard, E., Buzzell, A., Jeffreys, C., and Forro, F., Ibid., 33, 9 (1951). 8 McCarty, M., and Avery, 0.
    [Show full text]
  • Linus Pauling and the Belated Nobel Peace Prize,” Science & Diplomacy, Vol
    Peter C. Agre, “Fifty Years Ago: Linus Pauling and the Belated Nobel Peace Prize,” Science & Diplomacy, Vol. 2, No. 4 (December 2013*). http://www.sciencediplomacy.org/letter- field/2013/fifty-years-ago-linus-pauling-and-belated-nobel-peace-prize. This copy is for non-commercial use only. More articles, perspectives, editorials, and letters can be found at www.sciencediplomacy.org. Science & Diplomacy is published by the Center for Science Diplomacy of the American Association for the Advancement of Science (AAAS), the world’s largest general scientific society. *The complete issue will be posted in December 2013. Fifty Years Ago: Linus Pauling and the Belated Nobel Peace Prize Peter C. Agre RADUATE students have approached me on multiple occasions to inquire Gabout pursuing a career in science diplomacy. My first reaction is to fire back, “And so how is it going in the lab?” This often provokes embarrassment and an occasional confession about the frustrations of being a graduate student. On other occasions I think their questions were primed by the idealism of doing something with importance far beyond the laboratory. Is it possible that extracurricular activities efforts outside of the laboratory might have special value? And to what extent is the credibility in the lab essential for extracurricular attention? It seemed likely that the international network of scientists who know other scientists represents unique opportunities to use science to foster friendships worldwide. This has caused me to reflect on the many interesting people I have encountered during my career in science. A few were particularly inspirational, and of these, Linus Pauling, the fascinating and colorful American scientist, stands out for opening doors both worldwide and here in the United States.
    [Show full text]
  • The Man Who Thought of Everything Algis Valiunas
    Algis Valiunas DAVE CHENG • [email protected] DAVE 60 ~ The New Atlantis Copyright 2015. All rights reserved. See www.TheNewAtlantis.com for more information. The Man Who Thought of Everything Algis Valiunas There are no scientists any more. Of course there are more persons than ever before who practice one scientific discipline or another, but they do not call themselves scientists plain and simple. To do so would offend against the clannish pride in expertise that is so often a hallmark of mod- ern intellectual endeavor in just about any field you can name. Specialties and sub-specialties are abundant and scrupulously differentiated. One does not expect a cosmologist to have as much as a passing acquaintance with paleobotany. For that matter, a particle physicist adept in string theory might have difficulty making conversation with an acolyte of eter- nal recurrence; after their common undergraduate immersion in intro- ductory physics, these experts pursued divergent professional paths and now speed ever faster and farther away from each other, as the universe of knowledge, and especially of the most abstruse theories, expands at an ever increasing rate. For Plato the most sublime form of eros was philosophical friends’ sharing the same exquisite thought at the same moment; for today’s sci- entist, the most glorious proof of his wizardry is that when he is at the top of his game almost no one else in the world has any idea of what he is talking about. This rarefied collegiality might be considered the modern incarnation of Platonic friendship; it is in fact something very different.
    [Show full text]
  • Sickle Cell Anemia: Current Treatments and Potential Advancements Vanessa Martinez Southeastern University - Lakeland
    Southeastern University FireScholars Selected Honors Theses Spring 4-28-2017 Sickle Cell Anemia: Current Treatments and Potential Advancements Vanessa Martinez Southeastern University - Lakeland Follow this and additional works at: http://firescholars.seu.edu/honors Part of the Biochemistry, Biophysics, and Structural Biology Commons, Immunoprophylaxis and Therapy Commons, and the Molecular Genetics Commons Recommended Citation Martinez, Vanessa, "Sickle Cell Anemia: Current Treatments and Potential Advancements" (2017). Selected Honors Theses. 68. http://firescholars.seu.edu/honors/68 This Thesis is brought to you for free and open access by FireScholars. It has been accepted for inclusion in Selected Honors Theses by an authorized administrator of FireScholars. For more information, please contact [email protected]. SICKLE CELL ANEMIA: CURRENT TREATMENTS AND POTENTIAL ADVANCEMENTS by Vanessa Martinez Submitted to the Honors Program Committee in partial fulfillment of the requirements for University Honors Scholars Southeastern University 2017 2 ©Copyright, Vanessa Martinez 2017 3 Table of Contents ABSTRACT .............................................................................................................................................................. 4 CHAPTER ONE: SICKLE CELL ANEMIA ........................................................................................................... 5 Introduction & Background ............................................................................................................................................
    [Show full text]
  • S. Jonathan Singer Elected to Newton-Abraham Visiting Professorship in Medical, Biological and Chemical Sciences at the University of Oxford
    S. Jonathan Singer elected to Newton-Abraham Visiting Professorship in Medical, Biological and Chemical Sciences at the University of Oxford April 23, 1984 FOR RELEASE APRIL 26, 1984 Dr. S. Jonathan Singer, professor of biology and American Cancer Society Research Professor of Biology at the University of California, San Diego, has been elected to the Newton-Abraham Visiting Professorship in Medical, Biological and Chemical Sciences at the University of Oxford, England, for 1984-85. Singer, one of the nation's leading molecular and cell biologists, will travel to Oxford with his wife, Ruth, in October to be in residence during the 1984-85 academic year. While there he will serve in the Department of Biochemistry and, in addition, will be granted the Oxford degree of Master of Arts, thus making him a member of the university faculty for all purposes. During his tenure he will be actively involved in the stimulation of research and will deliver a number of classroom lectures and the public Newton-Abraham Lecture in his field of study. The Singers will reside in a house provided by the University of Oxford on the campus during their academic year. Their daughter, Julianne, is currently enrolled at Oxford as a student in literature. Singer received an A.B. degree in chemistry from Columbia College in 1943 and a Ph.D. in chemistry from Brooklyn Polytechnic Institute in 1947. He began his career as a physical chemist, largely concerned with synthetic polymers but soon developed an interest in problems interlacing both chemistry and biology. He early gained an international reputation through his work as a postdoctoral fellow with Dr.
    [Show full text]
  • Harvey Itano Personal Correspondence and Memorabilia
    http://oac.cdlib.org/findaid/ark:/13030/c8tm7gmp No online items Harvey Itano Personal Correspondence and Memorabilia Finding aid prepared by Special Collections & Archives Special Collections & Archives, UC San Diego 9500 Gilman Drive La Jolla, California, 92093-0175 858-534-2533 [email protected] Copyright 2013 Harvey Itano Personal MSS 0755 1 Correspondence and Memorabilia Descriptive Summary Title: Harvey Itano Personal Correspondence and Memorabilia Identifier/Call Number: MSS 0755 Contributing Institution: Special Collections & Archives, UC San Diego 9500 Gilman Drive La Jolla, California, 92093-0175 Languages: English Physical Description: 2.8 Linear feet (3 archives boxes, 1 records carton, 1 card file, 3 oversize folders and 1 art bin item) Date (inclusive): 1937 - 2010 (bulk 1941-1945) Abstract: Personal papers and memorabilia of Harvey Itano, American biochemist and pioneer in the study of sickle cell anemia hematology. During World War II, Itano, along with his parents and siblings were sent to an internment camp; of particular interest in the collection are letters written to and from Itano during his internment. Creator: Itano, Harvey A. Publication Rights Publication rights are held by the creator of the collection. Preferred Citation Harvey Itano Personal Correspondence and Memorabilia, MSS 755. Special Collections & Archives, UC San Diego. Acquisition Information Acquired 2013. Biography Harvey Akio Itano was born on November 3, 1920, in Sacramento, California, the eldest son of Masao and Sumako (Nakahara) Itano. Itano attended University of California, Berkeley, and graduated in 1942 with highest honors in chemistry. Due to President Roosevelt's anti-Japanese campaign following Pearl Harbor, Itano with his family was sent to the desolate Tule Lake camp.
    [Show full text]
  • What Mad Pursuit BOOKS in the ALFRED P
    What Mad Pursuit BOOKS IN THE ALFRED P. SLOAN FOUNDATION SERIES Disturbing the Universe by Freeman Dyson Advice to a Young Scientist by Peter Medawar The Youngest Science by Lewis Thomas Haphazard Reality by Hendrik B. G. Casimir In Search of Mind by Jerome Bruner A Slot Machine, a Broken Test Tube by S. E. Luria Enigmas of Chance by Mark Kac Rabi: Scientist and Citizen by John Rigden Alvarez: Adventures of a Physicist by Luis W. Alvarez Making Weapons, Talking Peace by Herbert F. York The Statue Within by François Jacob In Praise of Imperfection by Rita Levi-Montalcini Memoirs of an Unregulated Economist by George J. Stigler Astronomer by Chance by Bernard Lovell THIS BOOK IS PUBLISHED AS PART OF AN ALFRED P. SLOAN FOUNDATION PROGRAM What Mad Pursuit A Personal View of Scientific Discovery FRANCIS CRICK Library of Congress Cataloging-in-Publication Data Crick, Francis, 1916– What mad pursuit. (Alfred P. Sloan Foundation series) Includes index. 1. Crick, Francis, 1916– 2. Biologists—England—Biography. 3. Physicists—England—Biography. I. Title. II. Series. QH31.C85A3 1988 574.19’1’0924 [B] 88–47693 ISBN 0–465–09137–7 (cloth) ISBN-10: 0-465-09138-5 ISBN-13: 978-0-465-09138-6 (paper) eBook ISBN: 9780786725847 Published by BasicBooks, A Member of the Perseus Books Group Copyright © 1988 by Francis Crick Printed in the United States of America Designed by Vincent Torre Experience is the name everyone gives to their mistakes. —OSCAR WILDE Preface to the Series THE ALFRED P. SLOAN FOUNDATION has for many years had an interest in encouraging public understanding of science.
    [Show full text]
  • January 2011
    January 2011 American Society for Biochemistry and Molecular Biology MMoreore LLipidsipids withwith thethe eexcitingxciting nnewew FFLuorophoreLuorophore TopFluor™ LPA It’s New, It’s Effective*, Avanti Number 810280 It’s Available AND It’s made with Avanti’s Legendary Purity *Similar Spectral characteristics as BODIPY® TopFluor™ PI(4,5)P2 Avanti Number 810184 TopFluor™ Cholesterol Also in stock: Avanti Number 810255 C11 TopFluor PC C11 TopFluor PS C11 TopFluor PE C11 TopFluor Ceramide C11 TopFluor Dihydro-Ceramide C11 TopFluor Phytosphingosine C11 TopFluor Sphingomyelin C11 TopFluor GluCer C11 TopFluor GalCer Visit our new E-commerce enabled web site for more details www.avantilipids.com or Email us at [email protected] FroM research to cgMp production - avanti’s here For you contents JANUARY 2011 On the cover: “Birth of an Idea” by Julian Voss- society news Andreae, based 2 President’s message on a potassium Impact factors— what the H? channel structure. 5 News from the hill 18 New year, new Congress, same concerns PHOTO BY DAN KVITKA 6 Meet the new JBC editor, Marty Fedor 8 George Stark to give 2011 annual meeting opening lecture 9 ASBMB education award An interview goes to Cheryl A. Kerfeld with new JBC Editor-in-chief 10 Retrospectives Martha Fedor. 10 Britton Chance (1913 – 2010) 6 11 Harvey Itano (1920 – 2010) 12 Member update feature stories 14 Science focus: Potent science A look at venom protein research 18 Science in art and art in science: an interview with Julian Voss-Andreae 20 Giving students endurance in the graduate-school marathon in every issue 21 Minority affairs An interview with Heather Pinkett 22 Meetings Submitting a special symposium proposal? Get the inside scoop 23 World science UNESCO releases 2010 science report 24 Education 24 Effective letters of evaluation 27 Undergraduates receive ASBMB A look inside the UNESCO 2010 science report.
    [Show full text]
  • Narratives and Comparisons
    Martin Carrier, Rebecca Mertens, Carsten Reinhardt (eds.) Narratives and Comparisons BiUP General Martin Carrier, born in 1955, teaches philosophy of science at Bielefeld University. His research is directed at methodological characteristics of science in the context of practice, that is, research targeted at economically or politically relevant fields. Rebecca Mertens (PhD), born in 1984, is a postdoctoral researcher in the history and philosophy of science at Bielefeld University. She works on the role of analo- gies, models and forms of comparison in the history of molecular genetics and is a member of the collaborative research program »Practices of Comparison: Orde- ring and Changing the World«. Carsten Reinhardt, born in 1966, teaches history of science at Bielefeld University. His research fields are the history of twentieth-century physical sciences, met- hods development, and expertise. Martin Carrier, Rebecca Mertens, Carsten Reinhardt (eds.) Narratives and Comparisons Adversaries or Allies in Understanding Science? The volume has grown out of the workshop »Practices of Comparing and Narra- ting in the Sciences« within the collaborative research center on Practices of Com- parison (SFB 1288, Praktiken des Vergleichens). The workshop took place at Bielefeld University in April 2018 and was organized by Veronika Hofer. Bibliographic information published by the Deutsche Nationalbibliothek The Deutsche Nationalbibliothek lists this publication in the Deutsche National- bibliografie; detailed bibliographic data are available in the Internet at http:// dnb.d-nb.de This work is licensed under the Creative Commons Attribution-NonCommercial-NoDeri- vatives 4.0 (BY-NC-ND) which means that the text may be used for non-commercial pur- poses, provided credit is given to the author.
    [Show full text]