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Manufacturing requirements are killing cell and gene therapy
Psychotherapybottleneckedrequirements
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19 September
18 September
17 September
15 September
14 September
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Recommendsrcmnd.app
Innovations in Psychotherapy ConferenceTheir words
Honored to be speaking at the 2026 Innovations in Psychotherapy Conference (Nov 10–13 in Anaheim & Online)! Join us for evidence-based education & practical strategies to enhance your practice. Use code SPEAK26 to save $50:
12 September
11 September
10 September
9 September
8 September
7 September
6 September
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korrents.com
Confidence in monitoring, not capability research, will become the binding constraint on AI progress.Their words
Still, I expect general AI progress to increasingly be bottlenecked by confidence in monitoring.
5 September
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Their words
For postmenopausal women—and women with premature estrogen deprivation for other reasons—vaginal estrogen is a safe and highly effective therapy to alleviate the genitourinary syndrome of menopause, prevent recurrent UTIs, and likely to save lives.
4 September
3 September
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Recommendstheir ownrcmnd.app
Therapeutic Yoga for Trauma Recovery: A Clinical Summit for Mind-Body HealingTheir words
There’s still time to join me for Therapeutic Yoga for Trauma Recovery: A Clinical Summit for Mind-Body Healing!
2 September
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Their words
If you suffer from amygdala hyperactivity that gives you one of the aforementioned psychiatric disorders, I think that not only should you be offered elective amygdalectomy, but your health insurance should be glad to pay for it (especially if done via ultramodern very safe radiosurgery) one time, rather than for a lifetime supply of more expensive, less effective talk therapies and medications.
Absurd Adventure And Amygdalectomy Advocacyastralcodexten.com
31 August
30 August
26 August
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Their words
The other thing I'd say is that most organizations don't know what they want. They don't know how to make it better. They're not bottlenecked on implementation. They're bottlenecked on ideas. They're bottlenecked on vision. They're bottlenecked on taste. And if you don't have those element in excess of your implementational capacity, it doesn't help. So you can make a lot of shitty ideas come true, then what?
25 August
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Their words
It may not be stored there, but what you're tapping into, it's not a repository of the memory, but it's part of this mind-body feedback loop where there's a sensation that your brain has an association to that might have a familiarity to a time in which you felt sad or scared.
If the Body Doesn't Keep the Score, What Does?drarielleschwartz.com
24 August
21 August
17 August
16 August
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Their words
This is a fascinating topic, and there’s a lot of BS floating around it. This book is one of the good ones.
14 August
11 August
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Recommendsrcmnd.app
Facts and Fallacies of Software EngineeringTheir words
Facts and Fallacies of Software Engineering by Robert L. Glass. In essence, this is a book about an industry that refuses to learn. That was true 25 years ago when this book was published, and it's probably twice as true today. (Just think about all the AI adoption metrics being rolled out — back to productivity mistaken for lines of code produced, only more elaborate. And expensive). What I like about this book is that Glass doesn't present anything new. Quite the opposite, actually. Rather, it's about research lessons that we all should know, but tend to forget. Ever had to do an estimate, or plan according to a requirements spec? Or maybe you thought that enough eyeballs make all bugs shallow? Then this book is for you. A great work by a fantastic author.
10 August
21 July
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Their words
I told him what I believe: that in the age of AI, medicine will be bottlenecked more than ever by regulation and the grind of clinical trials, and that billions poured into faster pre-clinical research won’t touch that problem, unsexy as it is.
Intelligence is not the main bottleneckwritingruxandrabio.com
20 July
11 July
5 July
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Their words
The emotional and relational dynamics are not an intrusion upon the work of prescribing. They are a part of the work itself.
1 July
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Their words
You look under the underneath though at the code and it was just a horrible unmaintainable mess. But the fact that people could program the programs that they wanted was a a significant step forward as opposed to I'm going to write a thousandpage requirements document and then wait 8 years and not get what I want which was the alternative that we were offering at the at the time.
26 June
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Their words
and I don't think we're headed to that world largely because of the fact that the models rely so much on large scale test time compute in order to achieve um their greatest intelligence. If you if it requires so much test time on compute to unlock the full capabilities of the model, then that means you're bottlenecked by time
22 June
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Their words
The phrase "your feelings are valid" does not invite curiosity or deeper self-understanding, which is the point of psychotherapy. It is the mirror image of "stop whining and get a grip." One sounds warm and one sounds harsh, but neither deepens self-awareness.
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Their words
There are many practices that promise to transform and improve us-therapy, meditation, psychedelics-, but that branding doesn't mean that they actually do much for us: it is common to see people use these techniques for years without any obvious progress on their problems.
10 June
From one piece Manufacturing requirements are killing cell and gene therapy 2 beliefs, in the piece's order there
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korrents.com
Manufacturing and batch-release requirements, not biology, are what kill most promising cell and gene therapies.Their words
Excessive manufacturing requirements are a pervasive problem, especially in the field of cell and gene therapy and they are killing countless of promising medicines before they ever reach patients.
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Their words
Until manufacturing and regulatory risks become easier to underwrite, capital will keep drifting away from one of the most promising technologies of the last century.
9 June
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Their words
I think the the whole industry bends towards youth for that reason and because it's a hustle business like there there's there's always a rock you haven't looked under and you know age brings children and homes and and and other requirements you get tied to and responsibilities and you're just not able to go spend 80 hours a week studying YouTube like you just can't.
3 June
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korrents.com
Having worked at a highly selective, demanding employer signals conscientiousness and reliability.Their words
Having worked there is a signal that you work hard, you complete your assignments, you adapt well to new tasks and requirements, and you're ready to take on new challenges.
30 May
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korrents.com
Being skilled at tracking project requirements doesn't make someone skilled at product management.Their words
But being good or even excellent at that does not automatically make you good at understanding user needs and making informed judgement calls about what features will meet those needs and how they should be designed.
3 May
7 April
From one piece Michael Nielsen – Why aliens will have a different tech stack than us 2 beliefs, in the piece's order there
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Their words
So certainly one thing that a lot of them seem to be bottlenecked on is now having interesting ideas and in particular having interesting design ideas.
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Their words
the point is that where we always get bottlenecked is where the the previous processes and and and heuristics don't apply. Right? Like that's almost sort of definitionally what causes the bottlenecks.
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Their words
This book is so full of wisdom and insight. I pulled down my copy just now and it's filled with underlines and margin notes.
2 March
28 February
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Their words
Lastly, the duration of a clinical trial does not merely determine how fast an individual therapy reaches patients. It also shapes which diseases attract serious investment and which do not.
25 January
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Recommendstheir ownrcmnd.app
Outcome Rating Scale (ORS)Their words
The ORS is a brief, 4-item measure designed to assess areas of life functioning known to change as a result of therapeutic intervention. It takes less than one minute to complete and score.
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Recommendstheir ownrcmnd.app
Session Rating Scale (SRS)Their words
The SRS is a brief, 4-item measure designed to assess the therapeutic alliance. It provides immediate feedback on the quality of the relationship and allows for course correction in real time.
18 January
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Recommendsrcmnd.app
The Balancing ActTheir words
The Balancing Act by therapist Nedra Tawwab (February)
24 December 2025
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Lovedrcmnd.app
Bad Therapy: Why the Kids Aren’t Growing UpTheir words
Best books I read in 2025: Just a note that these books weren’t all necessarily published this year (though some were). A Story is a Deal: How to use the science of story to motivate and persuade by Will Storr Bringing Up Baby: An Evolutionary View of Pediatrics by Paul Turke Bad Therapy: Why the Kids Aren’t Growing Up by Abigail Shrier
23 November 2025
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Their words
The benchmark is human performance, not perfection. We sometimes get requirements for 90%+ accuracy.
27 October 2025
9 October 2025
12 September 2025
From one piece Fully autonomous robots are much closer than you think – Sergey Levine 2 beliefs, in the piece's order there
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Their words
Like people are people and robots are robots. Like the the better analogy for the robot, it's it's like your car or a bulldozer. Uh like uh it has much lower maintenance requirements. You can put them into all sorts of weird places and they don't have to look like people at all.
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korrents.com
Better AI makes robots cheaper, because cheap visual feedback removes the need for expensive mechanical precision.Their words
So traditional robots and factories uh they need to make motions that are highly repeatable and therefore it requires a degree of precision and robustness that you don't need if you can use cheap visual feedback. So AI also makes robots more affordable uh and lowers the requirements on the hardware.
27 August 2025
22 August 2025
From one piece The Rumpelstiltskin effect: therapeutic repercussions of clinical diagnosis (with 1 co-authors) 3 beliefs, in the piece's order there
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Their words
Likewise, self-diagnosis should be understood as an attempt to secure the therapeutic effect of a medical intervention to which patients do not have official access.
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korrents.com
Diagnoses that have therapeutic effects are medical interventions and should be treated and researched as such.Their words
If a clinical diagnosis can have a therapeutic effect, then, at least in some instances, diagnoses are medical interventions in themselves and ought to be treated and researched as such, with an eye to both positive effects and potential iatrogenic harms.
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korrents.com
Clinical diagnosis can have a therapeutic effect independent of any other intervention.Their words
Their experiences highlight a striking, neglected and unchristened medical phenomenon: The therapeutic effect of a clinical diagnosis, independent of any other intervention, where clinical diagnosis refers to situating the person's experiences into a clinical category by a clinician or the patient.
14 April 2025
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korrents.com
The binding constraint on building anything in America is permitting and litigation, not money.Their words
Endless lawsuits, cost-exploding contracting requirements, decades to get permits, and more bedevil any attempt to invest here.
22 March 2025
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Their words
Most of the time I'm not thinking, I'm programming. I know what I want to do, I want to go as fast as possible because I've been just doing it for so long and I'm so familiar with the general space that it becomes a huge problem for me. I cannot tell you how many times that I've been purely bottlenecked by the fact that I just can't type fast enough and I just need to get it out of my head onto the text editor.
15 January 2025
17 September 2024
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Their words
Another challenge for Class II biotechs is that even if you have a nifty computational drug discovery platform, you are still often bottlenecked by the rest of the drug development process. It takes 1,000 (or more!) small steps to advance a drug through discovery, development, and past the regulators.
11 September 2024
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Their words
If one really wanted to know whether a treatment (e.g., CBT, IPT, ACT, EMDR) was more effective, it had to be directly compared to an approach intended to help - what Wampold and colleagues termed, a "bona fide" treatment. Doing otherwise, they argued, conflated artifacts of research design with actual research results.
21 August 2024
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korrents.com
Therapists overestimate their own effectiveness by about 65%, and it is not a Western cultural artifact.Their words
Since 2012 when the first study appeared in the literature, others have been published documenting the tendency of practitioners to overestimate their effectiveness - on average, by 65% (1, 2).
Alas, it seems everyone comes from Lake Wobegonwritings.scottdmiller.com
2 July 2024
From one piece How to (and not to) become a more effective therapist 2 beliefs · writings.scottdmiller.com
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korrents.com
What does make a therapist more effective is trainable interpersonal skill, not treatment technology.Their words
It turns out that therapists who perform well on the FIS establish stronger relationships and are more effective (2). More to the point, the evidence shows FIS-related skills are trainable and that such training leads to better results (3, 4, 5).
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Their words
Over the last 50 years, treatment methods have proliferated despite a lack of evidence of differential effectiveness between approaches. And even when a randomized controlled trial indicates a particular approach works, none show practitioners become more effective when they are trained in that modality.
21 May 2024
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Their words
Indeed, as I've reported in previous posts, research not only shows therapists do not improve with time and experience in the field, but on average become less effective (1, 2, 3, 4).
9 May 2024
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korrents.com
The human mind functions as an association-forming machine, linking past experiences to present beliefs.Their words
Exposure therapy works because the human mind is an association machine.
12 April 2024
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Their words
It has extra requirements on temporal consistency across frames in time, which naturally demands more world knowledge to be encoded into the model.
7 January 2024
19 December 2023
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Likedrcmnd.app
Cognitive Behavior TherapyTheir words
I recently reviewed Beck's book, which is written as a practical guide for therapists implementing CBT.
11 August 2023
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korrents.com
Character is not fixed: therapy works because habitual neural pathways can re-form, sometimes within minutes.Their words
In my practice, I have seen that opening neural pathways can lead to profound change, to brand-new traits and behavior, sometimes in a matter of minutes.
1 May 2023
13 January 2023
31 December 2022
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Their words
We are not suppliers. All the people writing and maintaining these projects, we are not suppliers. We do not have a business relationship with all these organisations.
7 September 2022
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What is a korrent?
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