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A 58-year-old Texan bet $430,000 of retirement funds on a golf franchise — and the business was profitable in one month
From boredom in retirement to the pursuit of higher investment returns, older Americans are launching businesses instead of settling into traditional retirement.
Globavend Expands Entertainment Business Through Strategic Investment in MAMAMOO 2026 WORLD TOUR <4WARD> Hong Kong, Securing Participation in Concert Economics
Investment strengthens company's live entertainment presence and advances its AI-powered digital entertainment strategy...
MLS’ Newest Billionaire Owner Thinks Investors Can Do Better Than Buying A Sports Team
Months after spending hundreds of millions of his own cash to buy Sporting Kansas City, wealth advisor Peter Mallouk says he still prefers stocks as an investment.
SKF eyes role in humanoid robotics business
SKF is looking to work its way into the expanding Chinese robotics market with a recently announced agreement with Leaderdrive (LD), a global manufacturer specializing in precision robotic components. The companies are working together on a venture in China focused on high-precision transmission components for robot joints. SKF officials said the investment is a step […]
NAVER D2SF Invests in 23i, a Virtual Entertainment Startup
NAVER D2SF, the corporate venture capital arm of NAVER, has made a new investment in 23i (CEO, Hyungmin Kim), a virtual entertainment startup. As the global virtual entertainment market continues to grow rapidly, particularly in Korea and Japan, NAVER D2SF decided to invest in the team based on its ability to create expanded entertainment IP through strong content production capabilities and an in-house technology pipeline designed to maximize the strengths of virtual artists.
State officials highlight housing investments following deadly Knights Inn fire
State Sen. Lea Webb and Assemblywoman Donna Lupardo on Wednesday discussed concerns with the housing issues in Broome County.
Holland packaging company buys former Howard Miller Clock facility for $15.9M
Coastal Container plans to use the facility to meet ongoing growth as it makes other investments.
Justin Ishbia’s Shore Capital buys employee benefits firm in healthcare push
Chicago-based Shore Capital has raised more than $2 billion for healthcare investments since 2024.
Illinois Surpasses 1,000 Certified Peer Professionals, Marking Major Milestone in Behavioral Health Workforce Growth
State’s peer workforce growth was supported by investments in peer recovery support services and the CRSS Success Program
HSBC opens review of Turkish retail and business banking operations
The assessment does not cover wholesale banking operations, including investment banking.
Apple to invest $30 billion in US chip manufacturing
Apple announced it is investing more than $30 billion in chip manufacturing in the U.S. that will produce a whopping 15 billion chips as part of its $600 billion long-term investment within America.
Ascension to buy Tennessee hospital as part of a $1B investment deal
One of the largest nonprofit health systems in the country is set to buy Williamson Health, a Tennessee-based regional hospital and provider network. If approved by regulators, the transaction could be finalized sometime next year.
Martin County and ECU Health celebrate progress toward re-establishing essential health care services in Martin County
Martin County and ECU Health are celebrating investments included in the State Budget to support access to essential health services in eastern North Carolina.
Explaining The Comcast and NBCUniversal Divorce
(Welcome to the “Most Important Story of the Week”, my bi-weekly strategy column analyzing the most important (but often not buzziest) news story of the last two weeks. I’m the Entertainment Strategy Guy, a former streaming executive who now analyzes business strategy in the entertainment industry. Please subscribe.) I hope everyone had a happy Fourth of July in America, celebrating the country’s 250th birthday. Frankly, I am bummed the 250th wasn’t a bigger celebration, but that’s a different topic for a different Substack. While it was generally a quiet week on the entertainment/streaming/media business fronts, we still had some interesting news stories. Actually, that kinda undersells one of the stories, a huge, huge, huge divestment that could upend the entertainment landscape... So let’s get right to it. In today’s column, I’ll cover Comcast spinning off the rest of NBCUniversal, an entertainment company investing in an LLM company and an LLM-owner investing in a movie studio, the latest round of threats of digital tariffs, and more. Let’s dive in. Subscribe Most Important Story of the Week - Most: Comcast/NBCU Breakup!!!! If I had to describe my reaction to Comcast spinning out NBCUniversal, it feels like a relationship ending, either breaking up or divorcing. Comcast’s decision to spin off the rest of NBCUniversal, after spinning off some of its cable assets into Versant last year, really does feel like a family breaking up under “irreconcilable differences”. Of my stereotypes of the entertainment moguls, my go-to for Comcast CEO Brian Roberts—heir to the Comcast fortune, but a man who’s been at the helm for 24 years now, and president for twelve years before that—is that he likes building empires. He cut his teeth acquiring cable rivals in the 1990s and tried to buy Disney repeatedly, then settled for NBCUniversal after a long court battle. (Contrast this with Rupert Murdoch, a man who also loved to buy, but would also sell when the price is right. Murdoch made Fox out of nothing, but then sold 20th Century Fox to Disney, arguably at the top of the market. So I understood why he sold.) But I don’t understand Roberts’ motivation to sell now. I have some explanations but no single, super-satisfying explanation. Strategically, it would just make more sense to have kept NBCUniversal in-house, especially for a one-time empire builder like Comcast. Yet one powerful force—arguably the decider in modern capitalism—likely overwhelmed all other considerations. At first, I thought I’d arrange my thoughts as a “Five Why” analysis, digging through each layer of the puzzle. But instead, I found myself asking, “But…why?” (And I only ended up with four sections.) So let’s look at Comcast from that angle. Then, at the end, I’ll give my biggest strategic recommendation for every company in Hollywood. It’s obvious, but sometimes, the obvious strategy is the most ignored. But…Why? The Stock Market, Conglomerations, and Sum of the Parts Analysis We’re just getting started with this issue, but the rest is for paid subscribers of the Entertainment Strategy Guy, so if you’d like to find out… Why Comcast could never get a “tech company” valuation The not-so-secret motivation for Comcast What Versant has to do with all of this The key strategic advice I think every entertainment exec should follow (though it’s really obvious) Some big AI investment news… Whether we’ll see digital tariffs… And more… ...please subscribe! We can only keep doing this great work with your support.
Ask an Antelope: Sara Bruner helps students discover healthcare careers
"Investing in health science education is an investment in the future health and well-being of our state."
Rahm Emanuel to denounce Netanyahu during Tel Aviv speech as American politics shift against Israel
According to remarks obtained by The Associated Press, Emanuel on Wednesday will criticize Israeli Prime Minister Benjamin Netanyahu for leading Israel to a "dead end" and say unconditional U.S. support has been a mistake.
Make the Business Case for Your Sustainability Initiative
Sustainability proposals often stall not because they lack merit, but because they are framed in a language that does not match how senior leaders allocate capital. While CSOs tend to emphasize impact, materiality, and disclosure, CFOs and CEOs need to understand cash flow, risk, and return. External reporting frameworks are useful for accountability, but they are poorly suited to internal investment decisions, which require project-level comparisons rather than aggregated enterprise metrics. Sustainability investments should therefore be evaluated like any other investment: by showing how they reduce current costs, avoid future costs, generate new revenue, or protect existing revenue. Strong cases begin with a clear business story that links the proposed action to a specific business impact and cash-flow outcome, then quantify what can credibly be quantified while treating harder-to-measure benefits as either upside or an explicit strategic bet.
News | Live Nation buys land in Dublin Docklands for live entertainment venue
The near three-hectare site was purchased with Oak View Group and Gaiety Investments
Thousands of acres, billions in investment: What's next for RiverPlex MegaPark?
The RiverPlex MegaPark is still years away from reaching its full potential, but the foundation is being laid for what could become one of the Gulf Coast’s largest industrial hubs, according to Ascension Economic Development Corporation President and CEO Kate MacArthur. With roughly $10 billion in announced investment already committed and thousands of acres still […]
CaroMont Health Opens CaroMont Hematology & Oncology in Belmont
CaroMont Health has opened CaroMont Hematology & Oncology in Belmont, expanding access to cancer and blood disorder care across the region. Located in the CaroMont Health Medical Pavilion on the campus of CaroMont Regional Medical Center in Belmont, the practice offers physician visits, infusion therapy and laboratory services in one convenient location, along with comprehensive hematology and medical oncology care including chemotherapy, immunotherapy, targeted therapy, hormone therapy and survivorship support. The opening is part of CaroMont Health's $200 million investment in cancer care, the second largest investment in the health system's history, which will double its oncology capacity across the region.
Meet Naomi Osaka’s Business Partners Behind Her Wimbledon Comeback
Naomi Osaka has returned to IMG while continuing to build Hana Kuma, KINLÒ and an investment portfolio spanning sports and startups.
Safety Is Everybody's Business
Safe communities don't happen by chance. From business investment to neighborhood design, every sector has a role to play in creating places where people and economies thrive.
Molasky Family Gift Names Lee Business School's Department of Economics and Real Estate
UNLV’s first named academic department honors the Molasky family’s decades-long connection to the university; reflects investment in students, faculty, and region's future.
New disease threats follow Trump administration's health program cuts
The Trump administration has cut investments in programs and agencies that prevent, track, and respond to health hazards.
Opinion | Trade Uncertainty Is Bad for Business
The Trump administration’s failure to renew the U.S.-Mexico-Canada pact in its current form is a gift to lobbyists and will discourage investment.
How New York’s ‘summer camp kings’ left Israeli investors burned
Simad Holdings Simad leapfrogged over a long series of watchdogs without difficulty and won the confidence of some of Israel's biggest investment managers.
Ukraine recovery: International Coalition for Science, Research and Innovation signs Gdansk Declaration
On 26 June, the first-ever High-level Steering Committee of the International Coalition for Science, Research and Innovation in Ukraine signed the Gdansk Declaration during the Ukraine Recovery Conference in Poland. The Declaration outlines a shared ambition to support Ukraine in increasing its research and development investment to 3% of the GDP following the end of Russia’s full-scale war of aggression. This is in line with the European Research Area target. It also outlines various activities that Coalition members can implement to achieve this objective. The Declaration further provides a strategic framework for the Coalition’s work to support Ukraine’s modern and
Mubadala Opens $25 Billion Credit Business to Outside Investors
Abu Dhabi’s Mubadala Investment Co. is opening up one of its largest investment businesses to outside investors for the first time, betting on its ability to attract institutional capital as demand for alternative lending rises.
Free ‘Finding Financing for Your Small Business’ workshop coming to Carbondale July 16
Champion Community Investments will host a free workshop in Carbondale for entrepreneurs and small business owners on July 16.
Jaguars’ QB Lawrence Outperformed His Salary Last Season
An MVP finalist campaign and elite efficiency metrics prove Jacksonville’s $275 million investment is paying off as the star signal-caller climbs into the league’s upper echelon of quarterbacks.
EasyJet agrees to £5bn takeover by US investment firm
Agreement in principle with Castlelake follows several rejected offers and means UK’s biggest low-cost carrier will be taken private
Connections: Steve Toth appointed Thrilled Land company president
Cave Springs-based Thrilled Land Investments LLC, parent company of Leadership Properties and Thrilled Home Builders, recently named Fayetteville business leader Steve Toth as the company’s first president. Toth has more...
SoFi (SOFI) Launches AI Investing And Small Business Loans In Product Push
SoFi Technologies (NasdaqGS:SOFI) has launched Composer by SoFi, an AI-powered investing platform designed to help members build and automate customized investment strategies. The company has also introduced SoFi Small Business Loans, a digital-first lending product aimed at giving entrepreneurs faster access to capital with no fees. These product rollouts expand SoFi's presence in AI-driven investing tools and small business lending within its broader financial services platform. SoFi...
Booz Allen Hamilton (BAH) to Buy Ultra I&C Mission Solutions Business for $720 Million
Booz Allen Hamilton Holding Corp. (NYSE:BAH) is one of the 12 best industrial stocks with more than 50% upside. The company’s acquisitive growth strategy is making it a compelling investment case. On June 22, Booz Allen Hamilton Holding Corp. (NYSE:BAH) signed a definitive agreement with an Advent portfolio company, Cobham Ultra Group, to purchase its […]
89 Percent — And a Reminder of What Science Can Do When We Pay For It
A century of work, and finally a shot that protects against one of the world's great killers of children. That is not luck. That is investment. Every once
Watch Ebola Crisis Exposes Congo's Fragile Health System
Daniele Nyirandutiye, Senior Fellow at the Center for American Progress, discusses how the Ebola outbreak in Congo exposed critical weaknesses in healthcare and why long-term investment is essential.
Knicks Success Assert Madison Square Garden Sports Corp. (MSGS) as a Top Stock to Buy According to Ariel Investments
Madison Square Garden Sports Corp. (NYSE:MSGS) is one of the top stocks to buy according to Ariel Investments. On June 23, Susquehanna reiterated a Positive rating on Madison Square Garden Sports Corp. (NYSE:MSGS) and raised the price target to $430. The new price target represents significant upside as the stock is trading at about $403 […]
Solid Growth Prospects Assert Sphere Entertainment Co. (SPHR) as a Top Stock to Buy According to Ariel Investments
Sphere Entertainment Co. (NYSE:SPHR) is one of the top stocks to buy according to Ariel Investments. On June 18, Benchmark reiterated a Buy rating on Sphere Entertainment (NYSE:SPHR) and raised the price target to $175 from $155. The price target hike comes amid expectations that the company is well positioned to deliver a solid second […]
Madison Square Garden Entertainment Corp. (MSGE) To Remain Fully Operational Amid New York Penn Station Redevelopment
Madison Square Garden Entertainment Corp. (NYSE:MSGE) is one of the top stocks to buy according to Ariel Investments. On June 9, Madison Square Garden Entertainment Corp. (NYSE:MSGE) entered into a non-binding agreement with Penn Transformation Partners for the development of the New York Penn Station. Under the terms of the agreement, Madison Square Garden will […]
Securing a high-character goldmine preserves Cowboys draft investment
It is still unbelievable that Caleb Downs fell to the Cowboys.
Final State Budget Brings $5M for New Behavioral Health Pilot to Central Coast
The State budget includes a one-time $5 million investment for CenCal Health and the behavioral health departments of both Santa Barbara and San Luis
Microsoft launches AI-focused professional services business with $2.5B investment
Microsoft launches AI-focused professional services business with $2.5B investment - SiliconANGLE
What Makes Live Nation Entertainment (LYV) a Good Investment Bet?
TimesSquare Capital Management, an equity investment management company, released its “U.S. Mid Cap Growth Strategy” first-quarter 2026 investor letter. A copy of the letter can be downloaded here. The Strategy fell 7.72% (net) in the quarter compared to -6.35% for the Russell Midcap Growth Index. In the first quarter, markets navigated geopolitical tensions and economic resilience alongside […]
Microsoft Frontier Company: AI engineering that amplifies and protects your intelligence
The pace of AI adoption is moving incredibly fast. Customers have moved well beyond experimentation and understand the importance of adopting AI to transform their business. They are now concentrating on delivering measurable business outcomes and demonstrating a return on their AI investments, while ensuring their intelligence is amplified and their IP is protected. Today...
U.S. Healthcare Spending’s Meager Return On Investment
The U.S. spends a lot on healthcare — in terms of total and per capita expenditures and patient out-of-pocket costs — but gets a relatively poor return on its investment.
Why Norma Kamali Swapped Fashion Shows for Team Fitness
The New York-based designer says free exercise classes are an investment in her team’s mental health and her brand’s resilience.
4 tech stocks that can weather an upheaval in the AI trade
Ben McMillan, IDX Advisor's chief investment officer, said of his clients are growing wary of a sea change in the AI trade.
How Investors May Respond To PENN Entertainment (PENN) Aurora Casino Opening And Russell 2000 Shift
PENN Entertainment recently celebrated the grand opening of its new US$360 million Hollywood Casino and Hotel Aurora in Illinois, while also being moved from the Russell 1000 family of indices into the Russell 2000, Russell 2000 Value, and Russell 2000 Dynamic indices as part of the latest rebalancing. This combination of a large-scale brick-and-mortar investment and a shift toward small-cap and value-oriented index inclusion reshapes how both fundamental and index-tracking investors may...
BlueCrest warns UK is bad for business after losing £200mn tax battle
Investment firm says country ‘no longer a serious contender’
Halogen Ventures founder Jesse Draper shares her daily routine
Jesse Draper, founder of Halogen Ventures, shares her Santa Monica routine, managing investments and family while advocating for female entrepreneurs.
Xbox ends deal to fund and publish IO Interactive's Project Fantasy; redundancies expected
Developer says it must "adapt to new reality" as Xbox reshapes investment priorities
Trump made hundreds of millions from cryptocurrency ventures in first year back in office
President Donald Trump collected billions of dollars through an array of cryptocurrency holdings, royalty payments and property investments last year, according to his latest annual financial disclosure released on Tuesday.
South Fulton leaders hopeful new investment will address crucial healthcare gap on Atlanta's south side
For decades, residents and officials alike have raised the issue regarding limited access to hospitals and specialty care in South Fulton. Now, county leaders and health officials are earmarking funds to address the situation.
Private equity in youth sports draws bipartisan scrutiny in Congress
Democratic and Republican Congress members expressed alarm at the trend of private equity investment in youth sports.
FMOL Health pegs Cancer Institute investment at $70M, shares timeline
FMOL Health expects to invest roughly $70 million to transform the former Bone & Joint Clinic of Baton Rouge building into a new home for the Our Lady of the Lake Cancer Institute, according to E.… Already an INSIDER? Sign in. Already an INSIDER? Sign in
Jon and Mindy Gray Bet on AI Science Research to Prevent Cancer
Blackstone Inc. President Jon Gray has steered his firm to more artificial-intelligence investments, and the same is true with his science philanthropy.
Meitav Investment House Announces Immediate Report Concerning Selected Business Data for May 2026
/PRNewswire/ -- Meitav Investment House (TASE: MTAV) announced today that further to the Company's immediate report dated March 2, 2026 (Reference No....
RWJBarnabas Health Invests $1.7 Million to Support Community Health Initiatives in Hudson County
On June 16, 2026, RWJBarnabas Health announced a combined $1.7 million investment to support local organizations working to address barriers to care, food insecurity, and economic stability among underserved communities in Jersey City and Hudson County.
Gov. Laura Kelly surveys landscape as she exits government service, points to unfinished business
Term-limited Gov. Laura Kelly celebrates work on priorities of economic development, fiscal stewardship and investment in early-childhood development.
Talawar Therapeutics and JATT II Acquisition Corp. Announce Definitive Business Combination Agreement to Create Publicly Listed Biotechnology Company Developing Potentially Best-in-Class Bispecifics for I&I Diseases
Oversubscribed $225 million concurrent private investment in public equity ("PIPE") with available cash to the combined company at closing anticipated to fund...
Investor Clive Meanwell on designing biotechs for population health, and AI's role as a catalyst
Clive Meanwell, chairman of investment firm Population Health Partners, was an AI skeptic until recently. Now, he thinks it's a catalyst.
AI scientist company Edison Scientific tapped by team behind Metsera to create new biotechs
Edison Scientific and investment firm Population Health Partners are teaming up to leverage AI agents in drug discovery and development.
India’s Yash Raj Films Backs Rusk Media in Vertical Entertainment Push (EXCLUSIVE)
Yash Raj Films has made a strategic investment in Rusk Media, the digital-first entertainment company behind the Alright! TV platform that specializes in original content for Gen Z and Gen Alpha audie...
Meaningful Outcomes Determine the Winners of the Health AI Race
Global investment in healthcare AI exceeded $18 billion in 2025, yet health systems still lack a shared understanding of the outcomes that investment should deliver. This paper argues that success in the health AI race will be determined not by technological sophistication but by which systems first identify and pursue the outcomes that matter most to patients, professionals and health systems. Without a shared language for defining and measuring what healthcare AI should deliver, systems risk optimizing for what is easiest to count rather than what matters most. This paper provides a framework for ensuring AI investment translates into real value for healthcare systems and the populations they serve.
“Toy Story 5 ”soars past “Supergirl”'s bumpy $38 million takeoff at the box office
D.C. and Warner Bros. were hoping for a $50–55 million return on their $170 million investment into the standalone supheroine flick.
I Put Apple CarPlay In My Wife's 2006 Toyota 4Runner And I'm Never Looking Back
Despite its 300,000 miles we're not getting rid of the 4Runner anytime soon, so it was worth making a small investment to bring its infotainment into the 2020s.
Investment in Israeli health tech startups dove 40% in 2025
Data shows that while the global industry saw a resurgence in private funding, investments in Israeli startups hit a five-year low amid geopolitical uncertainty
Best investments over the past 100 years? Almost all are tech companies
Most of the top performers are tech companies, headed by Apple, Nvidia and Microsoft.
How PENN’s US$360 Million Aurora Resort Shift At PENN Entertainment (PENN) Has Changed Its Investment Story
PENN Entertainment has opened the US$360 million Hollywood Casino and Hotel Aurora, replacing its former Fox River riverboat with a 388,500-square-foot, 24/7 land-based resort featuring over 1,000 slots, 50 table games, a sportsbook, 226-room hotel, spa, event center, and extensive dining options. The Aurora project, which created around 700 permanent roles and mirrors PENN’s broader shift into higher-amenity land-based properties, highlights how the company is reinvesting heavily to refresh...
Sweden and WHO launch new long-term initiative to transform Ukraine’s health system
WHO and the Swedish International Development Cooperation Agency (Sida) have launched a new multi-year cooperation project to support the long-term recovery and transformation of Ukraine’s health system. The new project, “Ukraine’s Health System Transformation Initiative: Strengthening Health Governance, Health Financing and Service Delivery for Long-Term Recovery”, was launched at the Ukraine Recovery Conference 2026 in Gdansk, Poland on 26 June, and will run from June 2026 to 2029. Sweden will contribute approximately US$ 26 million (240 million Swedish krona) to support this project. This contribution forms part of Sweden’s broader support to Ukraine through the Team Europe approach, which brings together the European Union, its Member States, and key partners such as the European Commission’s Directorate-General for Enlargement and Eastern Neighbourhood and Enabel, and WHO as lead health agency, to support Ukraine’s recovery, reform agenda and European integration.“Ukraine’s health recovery cannot be measured only by what is rebuilt, but by whether people can count on the health system when they need it most. The scale of the task is immense, with health reconstruction and modernization needs estimated at US$ 19.4 billion over the next decade. Sweden’s US$ 26 million contribution to Ukraine’s Health System Transformation Initiative is a timely investment in the institutions, financing and services that will support Ukraine’s long-term recovery and European integration. WHO remains a trusted partner of the Government of Ukraine in advancing this process. I am deeply grateful to Sweden for its consistent support and partnership,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. More than 4 years of war have placed unprecedented pressure on Ukraine’s health system, creating 3 interconnected challenges. The first is responding to the immediate consequences of the war and the urgent health needs of the population. The second is recovering and modernizing health services today. The third is continuing reforms and aligning the health system with European standards in the context of Ukraine’s future accession to the European Union. The war has led to large-scale population displacement, an increasing need for trauma care and rehabilitation, and shortages of health workers. High out-of-pocket payments in Ukraine make access to health services more difficult. Around 46% of total health expenditure is paid directly by individuals, placing a significant financial burden on many households and underscoring the need for reforms in health financing. Older people, persons with disabilities, women, children and veterans continue to face the greatest difficulties in accessing health services. “Ukraine is demonstrating that health system transformation can continue even during war. Ukraine is also continuing to align its health system with European norms and standards. WHO is committed to supporting Ukraine on this journey. We provide technical support, help coordinate partners’ efforts and support the institutional changes needed to strengthen the system. We are grateful to Sweden for its support. Through this partnership, we can help Ukraine build a more resilient, accessible and people-centred health system,” said Dr Jarno Habicht, WHO Representative in Ukraine. About the Health System Transformation InitiativeThe new initiative will support Ukraine through 3 interconnected areas: strengthening governance and coordination of health sector reforms through more inclusive coordination platforms and structured policy dialogue; transforming service delivery by reinforcing a primary health care-centred model that integrates family medicine, nursing and midwifery; and improving financial sustainability by supporting reforms that ensure the long-term viability of the national health system and reduce out-of-pocket payments for households. Overall, these reforms are expected to make the health system more coherent and easier to navigate, improve the quality and continuity of care, and ensure more equitable access to services, particularly for those who need them most. They will also support Ukraine’s progress towards a more modern health system aligned with European standards. “We are convinced that long-term recovery is not possible without strong, high-quality, person-centred health services that are accessible to everyone. Our partnership with WHO is designed to support deep and lasting systemic changes. Investments in human capital especially autonomous midwives, whose role for maternal, newborn and adolescent sexual and reproductive health cannot be understated, stronger governance, digital transformation and the financial sustainability of the health system are investments in Ukraine’s future. We are proud to support this process,” said Malin Perhult, the Head of the Ukraine Unit at Sida. Focus throughout implementation will be given to the most vulnerable population groups, including older people, women and children, and persons with disabilities, who have been affected by the war and face greater health-care needs. The initiative will be implemented in close cooperation with the Ministry of Health of Ukraine, the National Health Service of Ukraine, the Public Health Centre of Ukraine, regional authorities and international partners. This project will help Ukraine move towards a system where everyone can access the health care they need. It will strengthen primary care, make the health finance system more stable and predictable, and reduce the out-of-pocket costs that Ukrainians face when using health services. As a result, the Ukrainian health system will become more aligned with European standards and more sustainable in the long run.
How to manage public investment in science with balance
Public debt is higher today and growing at a faster rate than before the pandemic in 80% of the world's economies. According to the latest fiscal report from the International Monetary Fund, global public ...
Making Our Own Luck
We are cross-posting a piece that former NIH official Kris Willis wrote for Macroscience. Kris is now the President and Founder of the Woodley Park Institute, for which I’m a board member. Picking winners or hedging bets? Federal science agencies have long wrestled with the question of how to ensure their billions of dollars of grants and contracts result in maximum benefits for Americans. On the surface, it might seem that a goal-oriented, interventionist style of management would be the best policy: prioritize our most pressing problems and distribute funding accordingly.This top-down strategy creates a unique hazard, though: bad choices can send resources in the wrong direction, resulting in slow progress that impedes the delivery of tangible benefits to citizens. Moreover, if decision makers pursue an applied advance when the underlying scientific principles remain poorly understood, they risk costly failures and a loss of support for the research enterprise at large. Examples include Nixon’s 1971 War on Cancer, undertaken on the premise that a cure could be achieved in less than a decade, the drive to build an operational commercial fusion plant by the mid-1990s, and the National Plan to Address Alzheimer’s Disease, which failed to produce the effective treatments and prevention strategies promised by 2025. The contrasting laissez-faire approach is to hedge your bets. If the path to an advance is impossible to predict, then the wisest choice might be to distribute funding to as widely as possible. The main risk of this strategy is that spreading funding thinly may limit the resources available to the most promising research, resulting in the same negative outcomes as the interventionist approach: limited support for the most promising topics, slow progress, and delayed returns. In reality, at science agencies like the National Science Foundation and National Institutes of Health, program managers navigate between these two extremes, setting some funds aside to target high-priority areas and using the rest to cover the widest possible range of meritorious proposals. This middle path seems like the most rational way to proceed, but it still requires making choices. How much should be set aside for high priority topics? What should those topics be? How should we define merit? Expert opinion can provide a helpful guide, but leading experts can have remarkably different opinions about what matters and what should be prioritized. Moreover, experts and administrators alike can be risk averse, giving an edge to high-profile, well-established concepts. What’s really needed is a data-driven framework to help guide decision-making, one that doesn’t simply repackage prestige or incumbency. Recognizing breakthroughs years in advance Many breakthroughs fail to attract funding or recognition at the earliest stages of development. Katalin Karikó, for example, spent years struggling to win grants for work on mRNA that would eventually win her and Drew Weissman a Nobel Prize. Similar stories can be told about Jim Allison’s groundbreaking studies leading to the development of cancer immunotherapy, Stan Pruisner’s demonstration that prions can self-replicate without DNA, or Robin Warren and Barry Marshall’s proof that Helicobacter pylori, not stress, causes ulcers. Yet at some point, the scientific community recognizes and responds to transformative breakthroughs like these. How does that change happen? And what if science funders could identify the areas that are on the cusp of a breakthrough? Those questions led my collaborators and me to study how scientists responded to past breakthroughs. Based on patterns in that data, we developed a means of predicting future breakthroughs, using biomedicine as a proof of concept. It’s worth taking a moment to describe how our approach works. Briefly, our prediction process begins by grouping the 18 million or so peer-reviewed papers in PubMed, the authoritative database of biomedical research, into roughly 50,000 unique topics. A small subset of these topics are so widely acclaimed as breakthroughs that they have been recognized with a major prize like a Nobel or a Lasker Award. We theorized that studying the development of these outliers over time, especially before they gained acclaim, was the key to identifying future instances of them. After defining topics, we chose 21 representative breakthroughs and asked what they looked like before they won prestigious prizes. To answer that question, we re-ran our topic-mapping algorithm repeatedly, winding back the clock one year each time, stringing together the years to follow the progress of each field as it grew and advanced. We found that in each case, the years leading up to a discovery followed a pattern: a burst of papers on a new, rapidly evolving topic, many of which quickly became influential. These characteristics—the percent of papers that are new, the percentage of papers that are brought in from other topics, and the influence of each individual paper—can all be measured separately for any given topic. Together, they act as a predictive signal that is detectable an average of five years before a transformative discovery is made, and up to thirty years before the discovery receives a major prize. Scanning the current research landscape for topics that display this signal allows us to predict what work will likely produce a future breakthrough. Each year we analyzed includes four or five signals, a number that appears to have remained constant across a twenty year time frame. In their classic work on the sociology of science, Bruno Latour and Steve Woolgar established that the desire to participate in a major discovery is an important motivator for scientists as they consider whether they should take up (or abandon) a research problem. Although further work is needed, the simplest explanation for our results is that this behavior is widespread enough to detect at scale. A foundational advance, or something like it, draws the attention of scientists and causes them to change the direction of their research. They vote with their feet, staking their own reputation and careers by publishing on and citing the new idea. That upswell of interest is the foundation of our breakthrough signal. What kind of research does our model identify as a breakthrough? After building a model based on the patterns in our 21 preselected breakthroughs, we tested it by identifying all early signals of discovery from 1994 through 1997. Of the 18 signals we found in that time period, 17 can be traced forward in time to a breakthrough. Examples include super-resolution fluorescence microscopy (see the image above), the directed evolution of proteins and enzymes (Chemistry Nobel, 2018), and sequencing the human genome (National Medal of Science, 2008). The discovery of the role of leptin signaling in obesity is a particularly interesting case study. Around 1950, scientists noticed the existence of a type of lab mouse that suffered from a unique inherited form of obesity. When given the freedom to choose their own diet, these mice ate more than normal and preferred food that was high in fat. Researchers had few clues as to why the animals overate; early experiments pointed to the existence of a soluble ob factor found circulating in the bloodstream that regulated appetite, but its identity was unknown. In 1994, Jeffrey Friedman and colleagues identified and sequenced the ob gene, noting that the protein it encoded appeared to fit the profile of a circulating factor. A year later, a trio of high-profile publications demonstrated that ob was a hormone that regulated body weight and fat deposition by regulating appetite. One of these was co-authored by Friedman, who christened it leptin from the ancient Greek word for thin. Using our model, the data from 1996 make it clear this advance would become a breakthrough. Scientists had flocked to study the biology of the new hormone, generating the flurry of new papers and citations required to produce a signal. One of these demonstrated that serum leptin concentrations reflected the amount of adipose tissue in the human body, providing clinical validation of the earlier mouse studies. Before the identification of leptin, scientists were unable to point to a specific molecule that controlled appetite and adiposity, so that it was impossible to rule out non-physiological causes of obesity; its characterization fundamentally changed our concept of weight gain. In 2010, Friedman and fellow pioneer Douglas Coleman were awarded a Lasker for the discovery. Our work also identifies breakthroughs in clinical practice and behavioral and social sciences, even though these areas are less likely to draw the attention of major prize committees. One example that falls into this category is the introduction of endovascular aneurysm repair, a minimally invasive surgical procedure for the treatment of abdominal aortic aneurysm, a leading cause of death among Americans over the age of 65. Relative to the previous standard of care, it reduces in-hospital mortality by almost four-fold. In 2017, Timothy Chuter received the American College of Surgeons’ prestigious Jacobsen Innovation award for his multiple refinements to the technique. Another under-recognized breakthrough identified by our model is the development of standardized survey instruments to assess the quality of life for HIV+ patients. The antiretroviral cocktails introduced in the mid-1990s reduced AIDS mortality, but treatment came with serious side effects. The new evaluations showed that patients whose disease progressed had worse physical functioning than Americans with other chronic diseases, while those who were asymptomatic maintained a health-related quality of life on par with the overall US population. This evidence made it possible for patients and activists to argue that even in the absence of a total cure, and in spite of the side effects, alleviation of symptoms was a worthwhile priority for clinicians. My colleagues and I have failed to identify any significant recognition for the physicians and health policy experts who pioneered this advance, although in 2016, researchers called for the World Health Organization to set targets for good health-related quality of life as part of its framework to end the AIDS pandemic. From forecasting to funding How should science funders use our predictions? Any serious discussion of what we should do with this new capability needs to begin with an understanding of its limitations. We can’t (and shouldn’t) invest all of our resources in the small number of topics predicted to produce breakthroughs. Innovative new fields are born from existing ones; they rarely arise de novo. If funders don’t maintain a diverse portfolio, the breakthroughs of tomorrow will have no antecedents. Think of this as eating the seed corn, or killing the goose that lays the golden egg. There are also multiple goals of funding beyond basic scientific discovery, including translating discoveries into clinical practice, developing new technologies, supporting economic development, and training new scientists. The investments needed to accomplish these goals are likely different from those required to support emerging breakthroughs. Finally, we must be aware that we may not capture every instance of a breakthrough. The concept is fuzzy, and not every significant discovery is recognized with a major award. Further, breakthroughs are rare, meaning that our dataset is, by necessity, small. This makes formal estimates of accuracy challenging. Although our overall success rate appears to be high, any one signal may turn out to be a false positive. We found one apparent example: the development of the third generation COX-2 inhibitors, Vioxx and Celebrex, which were much celebrated in the early 2000s as effective but non-addictive pain relievers, meets all the algorithmic criteria of a breakthrough. Five years after it received FDA approval, researchers demonstrated that Vioxx was associated with serious cardiovascular complications, and the manufacturer voluntarily pulled the drug from the market. Celebrex remains available, although like other NSAIDs, it carries an FDA warning for increased cardiovascular risk. Decision makers who were overly focused on the breakthrough potential of this research might have wasted substantial resources nurturing an area that ultimately proved to be a failure—but so would those who relied on expert opinion at the time. That said, the potential benefits of funding the next mRNA vaccine or cancer immunotherapy years earlier than we might have are large. When we can’t assume the outcome of an action, it’s worth conducting an experiment. Can targeted support for areas that are poised to produce a breakthrough increase the return on scientific investment without cannibalizing future advances? With the necessary administrative infrastructure in place, conducting this experiment would be straightforward. First, identify all the breakthrough signals between 2018 and 2023, select half at random, and commit to a decade of investment. For biomedicine, a six year window should yield about 30 topics with the potential to produce a breakthrough. Providing strong support to half of these might be accomplished for $300 million a year. That’s roughly half of the recent annual budget of the NIH Common Fund or around 20% of the fiscal year 2025 budget for ARPA-H. After five years, then again at ten, compare to see which group — the one that was actively managed, or the control — produced more breakthroughs, and on what timescale. Although we used biomedicine as an example, the same experiment could just as well be run for physics, materials science, or any other discipline. Any attempt to undertake such an experiment should keep three points top of mind. First, we can predict the topic of future breakthroughs, but the people and vision for how to move the work forward are still important. In practice, this means success requires active program managers with the expertise to develop the science and the authority to do so, including by recruiting investigators. Second, we would be wise to learn from the failures of past attempts to fund transformative research. High among these are funding modestly repackaged work, confusing the genuinely novel with the merely unfamiliar, and relying too much on incumbent investigators. All of these risks can be mitigated by thoroughly and intelligently integrating high quality data into portfolio management. Finally, we need to have patience. Even with strong funding support, producing a breakthrough takes time. If supporting breakthroughs is the best way to nurture the birth of new fields, we also need to accurately describe and properly manage the other two stages, so that we invest wisely throughout the productive lifetime of ideas and divest once they reach the point of diminishing returns. We would benefit from more study of all of these phases, especially the transition from one to another. More research could answer questions like: When does a breakthrough become an established field? How do the availability of funding, the size and characteristics of the available workforce, and the accumulation of evidence that disagrees with prevailing models affect a field’s decline? Exactly how do old ideas give birth to new ones, and can we speed up the process? The more we understand about the dynamics of scientific progress, the better we can maximize the odds that our curiosity leads to results. I’d call that finding a way to make our own luck.
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