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Given the poor results of UniQuire, why are investors so willing to invest more in gene therapy?

The MIT Technology Review article cited in the question gets the current data about UniQure and its Gene Therapy (GT) product, Glybera, right. However, lacking historical context, its analysis is short-sighted and fails to hold the spotlight on the main culprit, namely a doddering healthcare financing system firmly stuck in the past and highly resistant to innovation.1999-2004: Excess Hype Followed Closely By Tragedy Made Gene Therapy (GT) A Scientific Outcast For Several YearsEliciting stratospheric levels of interest and enthusiasm, GT was an undoubted star of the 1990s biotech firmament. Early results heralded a new era of potential cures for hitherto incurable diseases like hemophilia. However, its promise came to an abrupt, screeching halt. Reason? Two sequential human GT tragedies, Jesse Gelsinger 's death in 1999 during a GT trial in Philadelphia, USA (1, 2), and in 2004, leukemia in 3 of 11 GT-treated severe combined immunodeficiency (SCID-XI) children in France directly as a result of the gene transfer (3) (see figure below from 4). Seemingly in an instant, GT became a scientific outcast. Its funding dried up. Following capital's flight, scientists quit the field in droves. Making GT palatable again entailed two dauntingly uphill challenges for its remaining die-hard enthusiasts, to prove it was safe enough for a 2nd chance and carefully plot a path to regulatory approval now rendered even more onerous.2000s till date: Now the Underdog, GT Makes A Quiet, Steady But Undeniably Noticeable ComebackSlowly over the course of the 2000s, these die-hard GT specialists built up an impressive portfolio of promising clinical trial results for a variety of chronic diseases such as Leber congenital amaurosis (LCA), an inherited recessive blindness (5, 6, 7, 8), Lipoprotein lipase deficiency (LPLD), a rare autosomal recessive disorder Uniqure's Glybera promises to treat better than current options, if not cure (9, 10, 11), and more prevalent diseases such as Hemophilia (12, 13, 14, 15), Parkinson's (16, 17, 18).Into this mix came small intrepid biotechs like UniQure. Knowing the path to regulatory approval for GT was now steeper, they cannily focused on an inherited metabolic disorder that affects a relatively tiny proportion of the population. Let's consider such diseases for a bit. Relatively small population bases make them unattractive research topics in both pharma and academia. In essence, people with such diseases are captive patients. Lacking strength in numbers, they can't dictate terms. No option but to submit to the sparse disease management options available. Classic scarcity of Rx. Along comes a company with a potential cure and what else could it be but manna from heaven? Similar calculation at play for the regulators. Potential cure for a small group of patients whose current disease management options are far from optimal implies benefits easily outweigh the risks. Hence lower bar for approval. This is likely how UniQure estimated Glybera's cost-benefit and how it seems to have indeed panned out. Seen from this perspective, Glybera is anything but a failure and its company, UniQure, anything but short-sighted for focusing on LPLD as a path to pioneer regulatory approval for GT.The spotlight then turns logically to how to pay for such Rx. Crux of the problem is current healthcare financing models. Too single-mindedly focused on short-term bottom-lines, they remain almost completely unprepared to meaningfully incorporate payment plans for potential cures for chronic conditions (19). Meantime, technology is accelerating the potential for future spectacular Rx successes but alas, healthcare systems prevailing today lag far behind in appreciating and accommodating this new normal, namely, cure when the only previous options were incremental improvements or lifelong management. This applies not just to GT but also novel immunotherapies like those for cancer, and newer drugs that could potentially cure other previously chronic conditions. Such a status quo leaves in the lurch millions of patients whose conditions are now potentially curable. Left stranded like thirsty desert wanderers of yore who mistook distant shimmering sand particles for oases. Only in this case, their visions are no mirages, making their predicament all the more palpably egregious and acute because this is an eminently solvable problem but for pricing and accounting systems stuck in old ways.Currently a lifelong chronic condition, GT could cure hemophilia in the near future for example. Cure! An entirely different ball game to what current healthcare financing models accommodate. Strictly short-term in vision and approach, healthcare financing typically factors costs of chronic conditions piece-meal. Estimated to cost US $300,000 per year per patient (19), weekly prophylactic clotting factor Rx is only one cost for managing hemophilia. Such prohibitive costs render hemophilia prophylaxis out of reach even in wealthy countries. The norm is instead on-demand (episodic) Rx (20), classic rationing of care. Such sub-optimal management only increases hemophilia's other lifelong risks. Hospitalizations, joint damage, viral infections from transfusions (screenings minimize but don't completely eliminate) to name just a few. What about their lifelong economic costs? Estimated separately of course. No surprise then that such a system would balk at a one-time bolus cost for potential cures of such chronic conditions. It's simply not set up to consider, let alone estimate, cumulative costs. Just consider for a minute all the lifetime healthcare resources, personnel and time it takes to manage a single hemophiliac in an advanced economy today. With GT, all those cumulative burdens could potentially be eliminated in one fell swoop.Nor does the prevailing healthcare pricing system seem capable of parsing accounting for diseases with smaller (LPLD) versus larger (hemophilia) population bases (see figures below from 21). Given stark differences in population size, associated complications and risks, healthcare pricing plans even for simple genetic diseases simply cannot be one size fits all.Thus major structural problems in current healthcare financing are serious obstacles in funding Rx like GT that could potentially cure diseases that until now were managed as lifelong conditions. How then to pay for such potential cures? Unfortunately, solution is obviously not in the hands of hapless patients but in those of lawmakers, regulators, insurers, Rx developers and their funders who need to evolve healthcare pricing structures fundamentally different from those that existed before (22, 23). Hence it's unfair to pin the blame solely on UniQure for how Glybera panned out. As far as the GT field is concerned, UniQure has done the necessary needful. Given the debacles of the 1990s, regulatory approval of its Glybera sets a precedent that can only be beneficial for GT's future. Ultimately, GT's promise lies in potential cures for single gene defects. At >2000 diseases and counting, GT's potential to cure human genetic disease is by no means a humble goal. If it fulfills this goal even partially, imagine the release from pain and suffering for the millions directly and indirectly affected. Incalculable.Bibliography1. Lehrman, Sally. "Virus treatment questioned after gene therapy death." Nature 401.6753 (1999): 517-518.2. Marshall, Eliot. "Gene therapy death prompts review of adenovirus vector." Science 286.5448 (1999): 2244-2245.3. Fischer, Alain, et al. "LMO2 and gene therapy for severe combined immunodeficiency." N Engl J Med 350.24 (2004): 2526-7. http://www.nejm.org/doi/pdf/10.1056/NEJM2004061035024224. How Gene Therapy Is Changing Society. John Allen, 2015. http://www.referencepointpress.com/pdfs/samples/stas.pdf5. Bainbridge, James WB, et al. "Effect of gene therapy on visual function in Leber's congenital amaurosis." New England Journal of Medicine 358.21 (2008): 2231-2239. https://www.researchgate.net/profile/Gary_Rubin/publication/5411767_Effect_of_gene_therapy_on_visual_function_in_Leber's_congenital_amaurosis/links/0912f5064811a1e907000000.pdf6. Hauswirth, William W., et al. "Treatment of leber congenital amaurosis due to RPE65 mutations by ocular subretinal injection of adeno-associated virus gene vector: short-term results of a phase I trial." Human gene therapy 19.10 (2008): 979-990. http://www.afanporsaber.es/wp-content/uploads/2012/05/Treatment-of-LCA-due-to-RPE65-mutations-by-ocular-subretinal-injection.pdf7. Maguire, Albert M., et al. "Safety and efficacy of gene transfer for Leber's congenital amaurosis." New England Journal of Medicine 358.21 (2008): 2240-2248. https://www.researchgate.net/profile/Thomas_Redmond/publication/38033948_Age-dependent_effects_of_RPE65_gene_therapy_for_Leber's_congenital_amaurosis_a_phase_1_dose-escalation_trial/links/0046353bc5755be1c3000000.pdf8. Maguire, Albert M., et al. "Age-dependent effects of RPE65 gene therapy for Leber's congenital amaurosis: a phase 1 dose-escalation trial." The Lancet 374.9701 (2009): 1597-1605. https://www.researchgate.net/profile/Francesco_Testa/publication/38033948_Maguire_AM_High_KA_Auricchio_A_Wright_JF_Pierce_EA_Testa_F_et_al.._Age-dependent_effects_of_RPE65_gene_therapy_for_Leber's_congenital_amaurosis_a_phase_1_dose-escalation_trial._Lancet_374_1597-1605/links/09e415087fb893183c000000.pdf9. Salmon, Florence, Konstantina Grosios, and Harald Petry. "Safety profile of recombinant adeno-associated viral vectors: focus on alipogene tiparvovec (Glybera®)." Expert review of clinical pharmacology 7.1 (2014): 53-65. https://www.researchgate.net/profile/Florence_Salmon/publication/259204624_Salmon_F_Grosios_K_and_Petry_H._Safety_profile_of_recombinant_adeno-associated_viral_vectors_focus_on_alipogene_tiparvovec_%28Glybera%29._Expert_Rev_Clin_Pharmacol_7_53-65/links/0c96052dfe36c4ff7b000000.pdf10. Bryant, Laura M., et al. "Lessons learned from the clinical development and market authorization of Glybera." Human gene therapy Clinical development 24.2 (2013): 55-64. http://umh3625.edu.umh.es/wp-content/uploads/sites/882/2015/03/4.-Lessons-learned-from-the-clinical-development-and-market-authorization-of-Glybera.pdf11. Melchiorri, Daniela, et al. "Regulatory evaluation of Glybera in Europe [mdash] two committees, one mission." Nature reviews Drug discovery 12.9 (2013): 719-719. https://www.researchgate.net/profile/Janis_Ancans/publication/255975202_Regulatory_evaluation_of_Glybera_in_Europe-Two_committees_one_mission/links/00b7d52b41646d46c4000000.pdf12. Manno, Catherine S., et al. "AAV-mediated factor IX gene transfer to skeletal muscle in patients with severe hemophilia B." Blood 101.8 (2003): 2963-2972. https://www.researchgate.net/profile/Mark_Kay/publication/10960759_AAV-mediated_factor_IX_gene_transfer_to_skeletal_muscle_in_patients_with_severe_hemophilia_B/links/09e41512b93302118a000000.pdf13. Manno, Catherine S., et al. "Successful transduction of liver in hemophilia by AAV-Factor IX and limitations imposed by the host immune response." Nature medicine 12.3 (2006): 342-347. https://www.researchgate.net/profile/Margareth_Ozelo/publication/7303044_Successful_transduction_of_liver_in_hemophilia_by_AAV-Factor_IX_and_limitations_imposed_by_the_host_immune_response/links/54fa2d3e0cf2040df21b1d14.pdf;14. Nathwani, Amit C., et al. "Adenovirus-associated virus vector–mediated gene transfer in hemophilia B." New England Journal of Medicine 365.25 (2011): 2357-2365. http://www.nejm.org/doi/pdf/10.1056/NEJMoa110804615. Nathwani, Amit C., et al. "Long-term safety and efficacy of factor IX gene therapy in hemophilia B." New England Journal of Medicine 371.21 (2014): 1994-2004. http://www.nejm.org/doi/pdf/10.1056/NEJMoa140730916. Kaplitt, Michael G., et al. "Safety and tolerability of gene therapy with an adeno-associated virus (AAV) borne GAD gene for Parkinson's disease: an open label, phase I trial." The Lancet 369.9579 (2007): 2097-2105. https://www.researchgate.net/profile/Helen_Fitzsimons/publication/6251704_Kaplitt_MG_Feigin_A_Tang_C_Fitzsimons_HL_Mattis_P_Lawlor_PA_et_al.._Safety_and_tolerability_of_gene_therapy_with_an_adeno-associated_virus_%28AAV%29_borne_GAD_gene_for_Parkinsons_disease_an_open_label_phase_I_trial._Lancet_369_2097-2105/links/00b7d52449ae7e2854000000.pdf17. Eberling, J. L., et al. "Results from a phase I safety trial of hAADC gene therapy for Parkinson disease." Neurology 70.21 (2008): 1980-1983.18. Christine, C. W., et al. "Safety and tolerability of putaminal AADC gene therapy for Parkinson disease." Neurology 73.20 (2009): 1662-1669. https://www.researchgate.net/profile/Henry_Vanbrocklin/publication/38011330_Safety_and_tolerability_of_putaminal_AADC_gene_therapy_for_Parkinson_disease/links/53dfa2e90cf27a7b8306923b.pdf19. Skinner, Mark W. "Gene therapy for hemophilia: addressing the coming challenges of affordability and accessibility." Molecular Therapy 21.1 (2013): 1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538323/pdf/mt2012272a.pdf20. MANCO‐JOHNSON, M. "Comparing prophylaxis with episodic treatment in haemophilia A: implications for clinical practice." Haemophilia 13.s2 (2007): 10-15.21. State of the Development and Viability of Gene Therapy Ventures. Gary, E., Ahmed, S. A., Khan, S. Bioengineering and Bioscience, 2015; 3 (1): 6-12. http://www.hrpub.org/download/20150201/BB2-10103293.pdf22. How will we pay for the cost of cures? American Enterprise Institute, July 11, 2014. https://www.aei.org/wp-content/uploads/2014/07/-cost-of-cures_154738513625.pdf23. Establishing new payment provisions for the high cost of curing disease. American Enterprise Institute, Scott Gottlieb, Tanisha Carino, July 2014. https://www.aei.org/wp-content/uploads/2014/07/-establishing-new-payment-provisions-for-the-high-cost-of-curing-disease_154058134931.pdfThanks for the R2A, Jonathan Brill.

How is life at IIM Amritsar?

IIM Amritsar is currently running from the transit campus located inside the Punjab Institute of Technology, Government Polytechnic Compound. The institute offers its students a holistic place to learn and grow. The lush green, 60 acres permanent campus for IIM Amritsar will come up at Manavala on Amritsar-Jalandhar GT Road.The Indian Institute of Management Amritsar is furnished with state of art infrastructure & modern technologies. The campus of the Indian Institute of Management Amritsar is located 14 km from the airport and 05 km away from the railway station, located in the city of Amritsar. All classrooms and seminar rooms available at the campus are air-conditioned & spacious equipped with facilities like LCD projector, internet access, speakers, etc. to make the learning experience a joyful ride for the students.Daily RoutineTypically, Everyday classroom activities begin at 9:15 am and end at 4 pm which include 4 interaction each of 1 hour 15 min. There is an hour long break in between which is require to cool down your brain. Its almost 5:30 pm when every one is in their respective rooms, The real work of the day begin from here. You have to work around 2 hours per subject which include tedious note making, followed by assignment and preparation for surprise quizzes.ClassroomsAll classrooms are equipped with high tech and state of the art infrastructure such as digital podiums, ultra-shot through projectors with screens / interactive displays sound system that enhances the overall learning process of pupils. High speed internet connectivity, power sources for connecting laptops is provided in all the classrooms.Connectivity and networkingIIM Amritsar is a fully Wi-Fi enabled campus where the student, faculty members & other staff members can seamlessly use the internet facility without any restrictions. The computer lab at the Indian Institute of Management Amritsar has a large number of PCs with multi-terminal facilities. It offers a 24-hours internet facility to the students. The computer lab at IIM Amritsar offers students practical sessions Management Application. Intensive practical training on computers is compulsory for all students of the IIM Amritsar.Clubs and CommitteesSeveral Clubs like ABC, FEC, Markophilic, Opera zeal, Stratagem, and Committees like Media and Public Relations Cell, Placement Committee, Industry Interaction Cell, Hostel and Mess Committee represent and promote the interests of the students of IIM Amritsar.EventsAnnual Strategy and Operations Conclave, 'Sankshetra' . Sankshetra was aimed at canvassing this new tsunami of revolution, with the experts of industry and the students of IIM Amritsar.Pariprekshya, a dais where the industry and academia will unite with the future managers to reflect on the recent developments in the fields of finance and marketing with the surge of such disruptions.Yukti HR Conclave aims to provide a dais where the veterans from industry interact and reflect with the budding managers on the recent trends and developments in the domain of human resource management.HostelsIIM Amritsar's hostel is presently located approx. two kilometres from the Airport in Blessing City. The Society accommodate students and faculties. Students are provided with 2/3 BHK flats on a twin sharing basis. Students are also provided with various facilities like Bed, Study Table, Chair, Cupboard, etc. In addition to this, facilities like Wi-Fi, Geyser, etc. are also provided. The hostel houses a Gym, Recreation room, TV room and facilities to play various sports.MessThe mess serves breakfast, lunch, evening snacks and dinner. The Hostel and Mess Committee decides the menu for the week/month. Owing to a wide range of people, the menu is prepared such that the cuisine preference of all students are satisfied. The mess serves all types of food including North Indian, South Indian, Chinese and Non-Veg. One might miss mom's food but will never remain hungry as a decent mess fills one's tummies with food and one's hearts with warmth.The Hostel and Mess Committee also holds the responsibility of keeping a check on the hostel infrastructure, housekeeping issues, etc.LibraryIndian Institute of Management Amritsar library is a repository of textbooks, e-journals, magazines, CDs, case studies, project reports on a wide range of subjects. The library of IIM Amritsar is an open-access library and it also has the facility of e-Journals. IIM Amritsar library is fully automated with 24 hours internet availability. In addition to print materials, the library offers thousands of books, journals, magazines, videos, cases and newspapers in the electronic format.Hope it will help, thanks.

What are some tips on making it through the job interview process at KLA-Tencor?

To highlight this I will quote first the detailed description of the recruitment process.There are multiple rounds.Resume Screening - 75% overall (10th, 12th, BE, ME) - Is negotiable and might change based on the placement committee efforts.Written - Since they shortlist people from multiple domains so it does not typically have any technical questions as such. It will be having 25 question (60 Minutes) which will be distributed in 2 sections and both are non technical. Aptitude, reasoning, english mostly. Level of questions are good. Almost 50–60% screened out.GD - This will have any topic. Not be any topic which is completely out of box. general neutral GD topic atleast in my group. 50% will be screened out.GT (Group Task): All the shortlisted candidate will be assigned to one group in my case as there were only 15–16 candidates left and then they will basically describe a problem. Yeah that will be completely and well explained by the concerned persons. In my case problem was related to the image processing and defect inspection but this could be anything. and this is the major elimination round. Only one left and all other got rejected so be careful in this round. follow all the instructions carefully and try to write algo rather than just end results.Puzzle Round: They will mainly ask you 3 puzzles and then you need to answer them. Again focus on algorithm.Guesstimate Round: In this you need to randomly make guesses and then come to conclusion. Again focus on algorithm.Behavior Round: This will mostly sort of HR Interview.HR Round: This will be the last round and this will mainly consist of normal HR conversation.This organization is more focused towards the problem solving skill rather than just making some end conclusion so my suggestion is, focus more on the algorithm part rather than just jumping to the end conclusion.There are multiple rounds and all the rounds except HR and GD have no time limit. In my case most of the interviews were having timings near about 1 hour each. But believe me I have appeared in various interviews, This is the best experience so far. The interview is less of an interview but more of an interaction and they will even help you at all the steps.Just be humble and true to yourself!!All the best!! Upvote if this help you.

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