The biggest news today should probably be about one of the Executive Orders from yesterday evening.
Trust me, it's big.
The President just authorized DOGE to start cutting regulations🧵
This order starts off huge.
Remember those recently-created DOGE Team Leads going into every agency? They're going to work with agency heads and the OMB to review all of the regulations across a number of huge categories.
The first category is those rules and regulations which violate the law of the land: unlawful and unconstitutional regulations, things that agencies enacted but which they shouldn't have been able to.
Now you might ask: Who decides what's lawful or unlawful, constitutional or unconstitutional, a good or a bad interpretation of statutes, prohibitions, and the law writ large?
Try to keep up, because the administration outlined this a few days ago:
The next category of regulations that DOGE will be purging is sizable.
DOGE was tasked with purging the federal government of socially significant regulations that Congress didn't roll out, and regulations that are costly for private entities without benefitting the public more.
This next category of regulations is where things get huge.
DOGE will be purging all regulations that impede innovation and infrastructure, make it harder to response to natural and manmade disasters, and just generally anything unnecessarily standing in the way of business.
Now obviously this is a major task, but don't worry: the next section says which regulations to focus on first.
It says to focus on regulations that are particularly important. This is totally logical: get rid of the big barriers to growth first, and then move down the list.
The next section might be my favorite part of this whole Order.
This section calls for an end to bureaucratic overreach.
It says that if a bureaucrat is doing more than they're required to, they need to stop it. This means fewer bureaucrats abusing their 'authority'.
Additionally, if agencies are currently engaged in overreach in the enforcement of rules and regulations, they're going to stop.
This can also apply to rules and regulations that the President does not want enforced in a given way based on his valid interpretation of said rule.
And finally, the Order says what to do with new regulations:
Run them by DOGE, and if they're a barrier to business or a burden on the public, they won't go into effect.
Every new regulation will be reviewed and every existing regulation will be reviewed too, and all barriers to growth that can be extirpated from the Federal Register will be extirpated from it.
This authority is expansive and unprecedented, and the admin was building to this.
And just to be sure, there's still more to come.
DOGE is enabling the digitization of records, the installation of modern systems and tools that will enable the U.S. to be governed in a modern, rapid, and flexible way.
That's its purpose, is making a 21st-century government.
And why?
Well obviously because regulations are burdensome, the spending has been too high, and so on, but this Order contains another clue.
One of Trump's goals is ending the secret fourth branch of government that persists between Presidencies and ensures Democrats are always in power.
It is an explicit goal of this Administration to end the "Administrative State."
In their Fact Sheet on this Executive Order, the Presidency stated that it is their goal to end the extreme burdens on the American people from this unconstitutional fourth branch of government, and to stop them from prying into American lives forevermore.
It is hard to overstate how huge this Order is.
There are hundreds of thousands of federal regulations, and a very large portion of them can be stripped back with executive authority alone.
And now, DOGE has been enabled to start that process, with all that entails.
That entails a lot, but I'll cut myself off here. And keep in mind, this is just the first month of this administration.
The beta blocker propranolol reliably impairs memory consolidation.
The above result is for healthy volunteer samples. This is the result for clinical samples.
It's effectively the same picture.
This result holds up to corrections for publication bias. In fact, there's barely any evidence for publication bias, and trim-and-fill does nothing here.
So I'm reasonably confident in the memory formation impairment effects of propranolol based on this evidence.
Today the New England Journal of Medicine published the second big win for lifesaving N-of-1 gene therapies.
They might have just saved a baby's life from being snuffed out by a fatal, ultrarare metabolic condition.
This is good for the baby, but maybe for many others too 🧵
The deficiency the baby was born with is carbamoyl-phosphate synthetase 1 or CPS1 deficiency.
CPS1 is a mitochondrial enzyme that is involved in detoxification during the urea cycle. If you lack it like this baby, you tend to see hyperammonemia (ammonia buildup) right away.
This buildup is typically but not always deadly.
Roughly half of those who develop the condition in early infancy end up dying from it.
And for those who don't, the result is usually not a good life: dialysis, mental retardation, liver transplantation, restrictive dieting, etc.
People might be able to limit the side-effects of GLP-1 drugs by avoiding Ozempic/Wegovy and instead using Mounjaro/Zepbound.
The reason has to do with Zepbound's other ingredient besides GLP-1: GIP🧵
GIP is short for either gastric inhibitory peptide or glucose-dependent insulinotropic polypeptide.
It was originally called gastric inhibitory peptide, but people now prefer the 'insulinotropic' name because the gastric stuff rarely happens in normal circumstances.
Basically, it's an inhibiting secretin hormone that holds back gastric acid secretion somewhat and stimulates insulin secretion a lot.
The timeline of key discoveries undergirding GIP's therapeutic potential is quite long and leads all the way back to the 1970s.
If you've been following along, you already knew this.
Tirzepatide (Zepbound) and Retatrutide (no name yet) add GIP and GIP + Glucagon, respectively, making them more effective products. Not only that, but they might even have milder side effects.
Pharmaceutical R&D is on death's doorstep and its current rebound is fragile and temporary.
Returns are already below the cost of capital, and any additional harms to profitability will drain the life-blood of the future, instantly snuffing out biomedical progress.
I am talking about the engine of survival, the thing that explains so much of why so many of us are alive today, and the thing that will keep you alive in the future.
This is also the thing that might eventually bring you immortality.
Destroy it, and we all lose.
Attacking pharmaceutical returns right now is also a form of redistribution of future returns to a state enemy, China.