Brainstorm Health Daily: June 2, 2017

But the original research paper—and my follow-up conversation with the lead author, Laëtitia Maréchal​—turned out to be more fascinating than even the phrase “wild monkey” might suggest.

The gist is that we humans are not so good at reading the facial expressions of Barbary macaques—and hint: this is important—even though we think we are.

In the study, Marechal, a behavioral ecologist/primatologist/conservation biologist at the UK’s University of Lincoln (it’s hard to know what to call a scientist with two Master’s degrees and a Ph.D.), and her colleagues showed volunteers photos of Barbary macaques displaying various “facial expressions related to aggressive, distressed, friendly or neutral states” and then tested their ability to identify them.

The humans really missed the mark when it came to matching a particularly toothy macaque expression—one in which “the corners of the lips are fully retracted and the upper and lower teeth are shown”—with the correct emotion. What looked to many like a smile was, in fact, a reflection of “a distressed emotional state…usually displayed as a submissive behavior during aggressive or dominant interactions.” Similarly, an expression that looked like “blowing kisses” was actually a sign of aggression. Oh well.

Marechal and her teammates conclude that this instinctive misreading may be getting both tourists and monkeys injured in places like South Africa’s Cape peninsula, Gibraltar, and various temples in Southeast Asia, where macaques and Ray-Ban-toting bipeds often get too close to one another.

But what makes the study truly compelling is that the research flies in the face of a very old theory, proposed by none other than Charles Darwin—that human beings and their close evolutionary cousins (in the words of Rachael E. Jack and colleagues) “communicate six basic internal emotional states (happy, surprise, fear, disgust, anger, and sad) using the same facial movements.” Indeed, that theory, called the universality hypothesis, has been getting beaten up over the last decade or so, with one research study after another taking an evidentiary swipe.

You say, “Okay, fine—I may not know my macaques, but I sure know what my beloved Labrador is thinking.” (Ahem.) You don’t. Or at least not as definitively as you think you do. (One of Marechal’s university colleagues, Kerstin Meints, has helped to develop an interactive CD, called “the Blue Dog,” to teach children how to interact with puppies and not get bit.)

Tellingly, a bevy of experimental evidence now demonstrates that even among humans, the meanings of facial expressions are often not intuitive across cultures, national origins, ethnicities, or the ages of individuals.

Which brings me to the question of whether mortals with wholly different political orientations can readily understand one other—not just one another’s words, but also their facial expressions, physical behavior, inflections of voice, and so on.

Yesterday, for instance, Jennifer Jacobs, a White House reporter for Bloomberg News tweeted an analysis of President Trump’s own interpersonal relations by one of his former aides, Corey Lewandowski. Trump is “so good at communicating,” Lewandowski reportedly said, that it takes staff with a “preexisting relationship to understand how the president functions.”

Earlier in the week, Mr. Trump himself tweeted out a “Thank you for your support” message, highlighting a Rasmussen opinion poll that concluded that 52% of voters disapproved of his performance as president.

While that tweet and others have raised eyebrows, they may be telling us something important about human perception and how sharply partisan orientations can shape it.

The President, in recent days and weeks, has withdrawn from the Paris Agreement on climate, lobbied hard for a bill that slashes funding for Medicaid by more than $830 billion even as it puts coverage of pre-existing conditions in the cross-hairs, and released a budget that eliminates or sharply cuts funding for health programs, research, and environmental protections—in each case, taking a position that is opposite to what large majorities of Americans, rich and poor, red state and blue, say they support. And, for that matter, opposite to what business leaders say they want, too.

The policies, on their face, as I’ve written in this space, don’t make sense. When examined through the lens of electoral politics, they make even less sense.

But maybe the issue isn’t policy or politics at all. Maybe it’s a question of perception. It may be that when the President is confronted with a nation in distress, he simply sees a smile.

More news below.

DIGITAL HEALTH

Net neutrality retreat could have health IT and public health consequences. The Trump administration's moves to reverse former FCC Commissioner Tom Wheeler's net neutrality rules (and make such regulations optional for companies to follow) could harm public health, particularly in rural and isolated American towns, writes a group of health care experts in the Health Affairs  blog. "Reverting back to a voluntary approach to [net neutrality] potentially threatens the well-being of many people, particularly those at risk for health disparities due to low income or rural residency," the wrote. "Not only does this voluntary approach shift winners and losers to favor large telecommunication giants, we are specifically concerned with several areas of health care being negatively impacted, including innovative solutions for telemedicine, health enhancement, and cost effective scalable sharing of health care data." They go on to ask several provocative questions: "What happens to telehealth if Netflix traffic is preferred above medical applications? Could Internet Service Providers (ISPs) offer better services for one hospital system than another, helping them take over telehealth in a region?" (Health Affairs)

Digital insurance startup Bright Health raises $160 million to branch into Medicare Advantage. Bright Health, one of the digital health upstarts that's been trying to take capitalize on the new individual insurance markets created under the Affordable Care Act, has raised $160 million in a funding round led by Greenspring Associates. The firm will now be concentrating on expanding its particular brand of insurance and associated mobile apps which seek to make the insurance experience more simple to other markets as uncertainty continues to swirl around Obamacare. Specifically, the company wants to get into the Medicare Advantage sector. Bright Health was co-founded by former UnitedHealthcare CEO Bob Sheehy. (Minneapolis/St. Paul Business Journal)

INDICATIONS

The world's biggest cancer conference begins today.  The American Society of Clinical Oncology's (ASCO) annual meeting officially kicked off on Friday in Chicago. The cancer confab draws tens of thousands of investors, scientists, doctors, biopharma executives, and others each year and is a central hub for drug makers who want to unveil new clinical trial data about the treatments. There are already several notable trends in cancer medicine R&D going into the event. For instance, several new analyses have shown that a pricey new form of cancer immunotherapy treatments called checkpoint inhibitors (which includes new flagship drugs like Merck's Keytruda and Bristol-Myers Squibb's Opdivo) are being tested in combinations with each other. And in another trend that has some researchers worried, the number of cancer-related studies presented at ASCO that were fully funded by the National Institutes of Health (NIH) has dropped by a precipitous 75% in the last decade, raising concerns about the agency's funding levels as President Donald Trump calls for steep cuts to its budget. We'll have more coverage on the most important news out of the conference, which ends next Tuesday.

Pfizer defeats appeals on Zoloft birth defect claims. Pharma giant Pfizer has smacked down an appeal that was seeking to resurrect a class action lawsuit claiming that the company's popular antidepressant Zoloft is linked with heart birth defects in the children of women taking the drug during pregnancy. Another court had previously ruled that the plaintiffs didn't provide compelling evidence establishing a link between Zoloft and the birth defects, leading to the dismissal of more than 300 lawsuits. (Coins2Day)

Another day, another biotech lines up an IPO. Add one more biotech firm to the recent onslaught of drug companies going public: Mersana Therapeutics, which is seeking a tentative $75 million stock offering to fund clinical trials for the firm's experimental breast cancer treatment. Mersana is in the very early stages of its clinical studies but has already attracted interest from giants like Takeda Pharmaceuticals, Japan's largest drug maker (which is also allied with the biotech in R&D). The specific kind of cancer drug that Mersana is developing is called an "antibody drug conjugate," which aims to combat cancerous tumors while sparing healthy cells. Major companies like Bristol-Myers Squibb and Pfizer are also testing out treatments in this space. (Xconomy)

THE BIG PICTURE

GOP Senator Burr doesn't think Obamacare repeal will pass. Richard Burr, a Republican and the senior U.S. Senator from North Carolina who sits on a number of committees directly related to health care legislation, has joined a growing list of lawmakers who are skeptical that a comprehensive plan to replace Obamacare will actually make its way through Congress. Burr told a local North Carolina outlet that a deal on health care is "unlikely" and that the House-passed American Health Care Act (AHCA) is "dead on arrival" in the Senate. The senator says he'd rather focus on fixing Obamacare markets that health insurers have fled and left few options for consumers. (Coins2Day)

Aetna Foundation president on the link between geography and your health. Aetna Foundation president Dr. Garth Graham has a commentary piece up on Coins2Day  about the striking link between where people live and their health. "Our entire nation is facing a Flint-like crisis when it comes to our life expectancy because of financial instability and crumbling infrastructure around us causing a ripple effect that makes it harder for people to eat healthfully, get more exercise, and spend time outside in a clean, healthy, and safe environment," he writes. Graham goes on to argue that turning the tide will require widespread recognition of the social determinants of health and active efforts to improve people's living conditions to boost life expectancy and wellness. (Coins2Day)

Did you indulge in National Doughnut Day? Here's how much sugar you consumed. Not to be a Friday buzzkill or anything, but my colleague Laura Entis has a depressing-but-informative post about the health consequences of National Doughnut Day (aka, today). Doughnut makers like Dunkin' Donuts and Krispy Kreme are doling out deals and discounts for the occasion. But how much added sugar will you be pumping into your system by taking advantage of the offers? Read Laura's post if you dare. (Coins2Day)

REQUIRED READING

Why Business Opposes Trump's Retreat from Paris Climate Pact, by Alan Murray

Why Apple Co-Founder Steve Wozniak Is the Original Geek, by Jennifer Reingold

Alcohol Consumption Dropped in 2016, by John Kell

Elon Musk Leaves Trump Advisory Council After Paris Agreement Exit, by Lucinda Shen