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Dr. Ruxandra Teslo argues America's biotech problem isn't the science, it's how slowly we learn from humans: "This is going to be more and more of a bottleneck as science advances especially in oncology. It's not just that we don't have enough clinical trials and they are expensive. This...

16,475 görüntüleme • 11 gün önce •via X (Twitter)

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Physician Logic Squared8 gün önce

The key phrase is “relevant human data.” In medicine, AI is only as useful as the clinical context, evidence and expert feedback loop around it.

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NEW episode! Drug development has never been more expensive, in terms of output per dollar spent. This trend, called Eroom’s law, is surprising, considering the incredible technological advances in drug discovery, from genome sequencing to engineering to microscopy. On a new episode of the Works in Progress podcast, Ben Southwood and I talk to Ruxandra Teslo 🧬 about why this has happened and what can be done about it. We discuss how: • AI isn’t a magic bullet for drug discovery. Predictive models lack the physical human data, like individual variation and rare side effects, that can only be generated by actually running real-world clinical trials. • As scientists invent more effective drugs, it becomes harder to discover new treatments that can surpass past successes. This is known as the "Better than the Beatles" problem. • Biotech companies are increasingly moving their "first-in-human" trials to Australia because its simpler regulations allow researchers to test drug safety faster and cheaper than in the US. • Clinical trials can be made more efficient with various reforms including: embracing platform trials, allowing researchers to select from independent ethics boards, expanding the funding and validation of surrogate endpoints, increasing transparency by releasing regulatory correspondence from failed companies, and much more. Timestamps: 00:00:00 Eroom’s law and the paradox of drug development 00:08:03 How clinical trials actually work 00:10:23 The power and controversy of surrogate endpoints 00:14:01 How historical patent laws influenced trial timelines 00:22:46 The Australia advantage and regulatory drag 00:29:08 Institutional review boards (IRBs) and bureaucratic drag 00:32:21 Open science and successful reforms 00:41:49 Our wishlist for clinical trial reforms, and which reforms we *don’t* like 00:53:48 Why AI isn’t a magic bullet for drug discovery

Saloni

109,256 görüntüleme • 4 ay önce

The most interesting part for me is where Andrej Karpathy describes why LLMs aren't able to learn like humans. As you would expect, he comes up with a wonderfully evocative phrase to describe RL: “sucking supervision bits through a straw.” A single end reward gets broadcast across every token in a successful trajectory, upweighting even wrong or irrelevant turns that lead to the right answer. > “Humans don't use reinforcement learning, as I've said before. I think they do something different. Reinforcement learning is a lot worse than the average person thinks. Reinforcement learning is terrible. It just so happens that everything that we had before is much worse.” So what do humans do instead? > “The book I’m reading is a set of prompts for me to do synthetic data generation. It's by manipulating that information that you actually gain that knowledge. We have no equivalent of that with LLMs; they don't really do that.” > “I'd love to see during pretraining some kind of a stage where the model thinks through the material and tries to reconcile it with what it already knows. There's no equivalent of any of this. This is all research.” Why can’t we just add this training to LLMs today? > “There are very subtle, hard to understand reasons why it's not trivial. If I just give synthetic generation of the model thinking about a book, you look at it and you're like, 'This looks great. Why can't I train on it?' You could try, but the model will actually get much worse if you continue trying.” > “Say we have a chapter of a book and I ask an LLM to think about it. It will give you something that looks very reasonable. But if I ask it 10 times, you'll notice that all of them are the same.” > “You're not getting the richness and the diversity and the entropy from these models as you would get from humans. How do you get synthetic data generation to work despite the collapse and while maintaining the entropy? It is a research problem.” How do humans get around model collapse? > “These analogies are surprisingly good. Humans collapse during the course of their lives. Children haven't overfit yet. They will say stuff that will shock you. Because they're not yet collapsed. But we [adults] are collapsed. We end up revisiting the same thoughts, we end up saying more and more of the same stuff, the learning rates go down, the collapse continues to get worse, and then everything deteriorates.” In fact, there’s an interesting paper arguing that dreaming evolved to assist generalization, and resist overfitting to daily learning - look up The Overfitted Brain by Erik Hoel. I asked Karpathy: Isn’t it interesting that humans learn best at a part of their lives (childhood) whose actual details they completely forget, adults still learn really well but have terrible memory about the particulars of the things they read or watch, and LLMs can memorize arbitrary details about text that no human could but are currently pretty bad at generalization? > “[Fallible human memory] is a feature, not a bug, because it forces you to only learn the generalizable components. LLMs are distracted by all the memory that they have of the pre-trained documents. That's why when I talk about the cognitive core, I actually want to remove the memory. I'd love to have them have less memory so that they have to look things up and they only maintain the algorithms for thought, and the idea of an experiment, and all this cognitive glue for acting.”

Dwarkesh Patel

1,052,518 görüntüleme • 11 ay önce

.Naval: Epistemology, which is a fancy word for the theory of how knowledge grows or how knowledge growth occurs. And we've all been told since we're young that there's a scientific method and that scientists sort of do this stuff in white lab coats and we're supposed to accept it because of this thing called the scientific method. And then they give us true beliefs that we can then say, well the science is settled and we take that we move on. And we all only have a very, very vague understanding of how this works. And people say, well maybe you go out in the real world, you look at what's happening, you make all these observations, and then based on that you form a theory, you test the theory against more observations, and the more observations you get the closer you get to the truth. And once you have enough observation it's true and then you call it a scientific theory or a law and it's settled and you move on. And this is the popular conception of how science works. And as Popper pointed out and as you take even further, this is completely wrong. And so I'd love for you to get into that, which is what is knowledge? How does it grow? What is the real scientific method? And how do we figure things out? David Deutsch: I love the way you just stated the prevailing view there and laced every aspect of it with the contempt that it deserves. So you just went through touching every base. It's amazing that this series of misconceptions is still common sense. I mean, that it was common sense at a time when we didn't really have science or when science was just starting up, when the main issue in science was freeing itself from dogmatism, freeing itself from religion, freeing itself from authority, and so on. There it was understandable that people would look for an alternative source of authority and they would think, oh, it's sense impressions. We can see the world and you know, these religious people, they can't even see God and so on. And so we are confined to what we can see. That's where we get our ideas from. And as you say, that is completely false. Sense impressions, like all observation, even the most careful scientific observation is all theory laden. And theories are inherently fallible. I mean, we actually want to replace our best theories. Everybody who does a PhD is technically anyway, working to overturn something in the existing body of knowledge. You're not turned away at the door if you say, I don't believe this stuff, I'm going to produce something better. Whereas for most of human history, that was exactly what you were forbidden to do. The idea was that we already had all the important knowledge. If you want to discover something new, what you had to make sure of was that it didn't contradict the existing knowledge. Now, you have to make sure that it does contradict existing knowledge. So more or less. Naval: Yeah, it's this tradition of criticism that you've talked about in the West, that the Enlightenment really ushered in the Enlightenment era. David Deutsch: It has been institutionalized. So in many ways, our institutions are wiser than we are. So the institutions of science, for instance, have this built in, even if scientists actually don't always act that way. In fact, they often don't act that way, and act in a dogmatic way and try to preserve the status quo and are resistant to new ideas and so on. But the institutions, the way the procedures of science work, makes the right thing happen in the end anyway, regardless of what the people are trying to do. Naval: So you're saying the knowledge of the true scientific method is embedded in the institutions of science in the PhD process? David Deutsch: Well, the best scientific method that we know of, and one shouldn't really think of it as a method, you know, there's this wonderful lecture by Popper when he first was made a professor at the London School of Economics. He was made a professor of scientific method, and his first six lectures, I wish the rest of them were, the first six lectures are on the internet somewhere. And he starts the first one by saying, I am the first professor of scientific method in the British Empire. The British Empire still existed at the time, more or less. And so the first thing I want to say to you is that there is no such thing as the scientific method. And then he goes on from there. So this subject does not exist. So if any of you have come here to learn the handle that you have to turn in order to make scientific knowledge come out the other end, you're going to be disappointed.

Deutsch Explains

116,352 görüntüleme • 1 yıl önce

Steve Jobs on how he learned to run a company: Question: "You're 21. You're a big success. You know, you've just sort of done it by the seat of your pants. You don't have any particular training in this. How do you learn to run a company?" Steve Jobs: "You know, throughout the years in business, I found something, which was that I always ask why you do things. And the answers you invariably get are, oh, that's just the way it's done. Nobody knows why they do what they do. Nobody thinks about things very deeply in business. That's what I found. I'll give you an example. When we were building our Apple I's in the garage, we knew exactly what they cost. When we got into a factory in the Apple II days, the accounting had this notion of a standard cost, where you'd kind of set a standard cost and at the end of a quarter you'd adjust it with a variance. And I kept asking, well, why do we do this? And the answer was, well, that's just the way it's done. And after about six months of digging into this, what I realized was the reason you do it is because you don't really have good enough controls to know how much it costs. So you guess, and then you fix your guess at the end of the quarter. And the reason you don't know how much it costs is because your information systems aren't good enough. But nobody said it that way. And so later on, when we designed this automated factory for Macintosh, we were able to get rid of a lot of these antiquated concepts and know exactly what something cost to the second. So in business, a lot of things are, I call it folklore. They're done because they were done yesterday and the day before. And so what that means is if you're willing to sort of ask a lot of questions and think about things and work really hard, you can learn business pretty fast. It's not the hardest thing in the world. It's not rocket science. It's not rocket science."

Founder Mode

32,290 görüntüleme • 7 ay önce

Eric Weinstein: ROI Obsession and Consensus Are Killing American Science david friedberg: “Treat scientists like the rock stars that they should be. Otherwise, you're going to lose them?” Eric Weinstein: “When you have administrator types come in and say, ‘What we need is KPIs. I'm data-driven. I want to know what the translation is.’ Do you even know what ROI is, or is it just what you can measure? You want these people on retainer, so whenever you have a real problem, you call up the most terrifying intellects you can imagine, and we can get to work and we can solve your problems. If you tell me, ‘You should work on this because this thing is what drives the ROI,’ my feeling is, do you just not understand science? Do you imagine that your technology mindset is the same thing as my scientific mindset? You want to get paid. I’ve spent a lot of time in Silicon Valley. I'm not nearly as interested in having a new McLaren as whether my name is going to be discussed 10,000 years from now if humans are still around. We're in some sort of crazy world in which people who have radical ideas can't do the radical ideas inside of the institutions. When people say something different, do you force them back into this consensus? Well, that's what p*ssy nations do. And we have become a p*ssy nation when it comes to science.” ------------------------------ Thanks to our partners for making this possible! As wealth grows, complexity compounds. Between investments, tax strategy and estate planning, coordinating it all can feel like a full-time job. Creative Planning can help with the heavy lifting. Creative Planning With over nine million acres protected across all fifty states, The Conservation Fund secures the irreplaceable lands we love. Learn more at The Conservation Fund

The All-In Podcast

23,248 görüntüleme • 14 gün önce

NBC’s Gabe Gutierrez: “One on Iran and one on Cuba. Is Iran now bigger foreign policy priority for you than China and on Cuba — the Cuban government —” President Trump: “Iran is just a military operation. To me, Iran is something that was essentially largely over in two or three days because the Navy was wiped out almost immediately. The air force came next, the anti-aircraft came next. I mean, we're flying over Iran. We could take out their electric capacity in one hour. We have all the there's nothing they can do right now because everything is knocked out. They have no — again, no radar, no anti-aircraft. They have nothing, and we don't — and it was a decision I made. We discussed it. Pete, Marco, JD all of us, Chris. We discussed it. We can knock out their electricity in a matter of minutes if we wanted to. There's nothing they can do about it. We can knock out their oil in Kharg Island. The only thing we didn't take down was the oil. Because if we knock out, I call them the pipes. Very complex. But if you do that, it will take them forever to rebuild, meaning whoever — and hopefully it's a sane group of people, but whoever it is, it's going to be running that, and we're going to try to get people that are going to run it well. And you know, it's going to be a prosperous, wonderful place. It used to be, you know, if you go back, it used to be a very — the people are great. The people are smart and energetic and it used to be very successful. Now, it's a country run by fear. It's a country where they tell protesters, don't go outside, because if you do, we're going to kill you....Well, Cuba right now is in very bad shape. They're talking to Marco, and we'll be doing something with Cuba very soon. We're really focused on this, but we're dealing with Cuba. Marco, do you want to say a couple of words about it?” Secretary of State Rubio: “Yeah. I mean, Cuba has an economy that doesn't work and a political and governmental system. They can't fix it. It's not dramatic enough. It's not going to fix it, so they've got some big decisions to make over there.” Gutierrez: “But Secretary — Secretary Rubio, do you support and I know this is up to Congress, but do you support easing the Cuban trade embargo if you get more cooperation from Havana?” Rubio: “Well, I'm not going to discuss what we would talk about or not. Suffice it to say that the embargo is tied to political change on the island. The law has been the embargo is codified. And — but the bottom line is their economy doesn't work. It's a nonfunctional economy. It's an economy that has survived. It's for 40 — that revolution — it's not even a revolution, that thing they have — has survived on subsidies from the Soviet Union and now from Venezuela. They don't get subsidies anymore, so they're in a lot of trouble. And the people in charge are — they don't know how to fix it, so they have to get new people in charge. That's what happened.” Trump: “And the relationship we have with Venezuela has been, I think you could almost say, incredible. It's been really good. It's been good for Venezuela and it's been good for us. And I congratulate the Venezuelan baseball team because that was a big — that was a big win. And I guess they play another game tonight in the finals.” Rubio: “Against the U.S.” Trump: “And I said a lot of good things have happened to Venezuela lately. This is the first time they've ever been in the finals, and it was pretty exciting.

Curtis Houck

175,437 görüntüleme • 6 ay önce

Sam Altman says AI leaders have done a terrible job at communicating to the public: “The, ‘Dear peasants, we will bequeath upon you these gifts of a cure for cancer and material wealth and great entertainment, and you stop complaining, and we'll make all the decisions about the future and just trust us, we'll be benevolent dictators.’ That’s not good. Not good.” “A lot of the people building AI have been saying, ‘There's a 25% chance we're going to destroy the world, and yet we're going to race ahead to do it because otherwise those bad guys will do it first.’” “Or, ‘Man, this thing is going to be really terrible, and 50% of the jobs are going to go away in the next year, and we hope you all are okay, but it seems really scary.’” “We have not, as a field, done a very good job of explaining to people what the benefits are and how the downsides can be mitigated—and we certainly have not done a good job even if people have had answers like saying, ‘There's going to be UBI, or work will be optional.’” “There's been very little discussion from people about how and why it's important that people have more power and personal freedom in the world, not less. And that matters a lot to most people.” “The ability of people to influence their own future and collectively design where society is going to go, and the autonomy that comes with that, is very important. I don't think a lot of people in the AI field… they feel it for themselves, but they don't spend much time thinking about it, reflecting on or acknowledging how important that is to other people.”

David Senra

32,300 görüntüleme • 23 gün önce

Arteta on his role to re-energise the Arsenal team. 💪 “Certainly, when you lose a game, you have a lot of feelings because, especially, this group of players are so competitive and they seek for excellence and when you don't reach it, you ask yourself questions, and we did that. “But I think my role there as well is to bring optimism and reality about where we are, and yeah, our club has a long history. And to find a moment where, in February, we're in the position that we are, is very difficult to find. So guys, we are doing so many things so well, and let's focus mainly on that. And for sure, we want to improve, we want to be better in every area, but with that sense as well of self-confidence and conviction that we are in the right path. Anyone need to lift Arteta? “No, in these moments, no. Normally, I'm the opposite and when we are doing so well, I'm there with a stick to say, 'This is not good enough,' 'This is not good enough.' The other day, no, because I know how much they wanted the amount of games and the demands that we put on those players every day. “In those moments, they need to understand and feel that we are right behind them. I'm mainly responsible for that and they keep playing with that freedom, with that enjoyment, as I discussed the other day, and I make sure that that journey is beautiful because what is ahead is great and everybody has to be part of that but in a good sense and with good humor and with good optimism and looking forward to it.”

Connor Humm

17,767 görüntüleme • 7 ay önce