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Tag: labor

  • The Billion-Dollar Adult Streaming Industry Is Fueled by Horrific Labor Abuses

    The Billion-Dollar Adult Streaming Industry Is Fueled by Horrific Labor Abuses

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    “When we were talking with workers, they just wanted to get back to the cockroaches, how the studio owner charges them for toilet paper or makes them work when they’re on their period. I couldn’t get people to talk to me about platforms, and that’s completely valid because of course you are mad at the guy you know,” Killbride tells WIRED. “But there’s a whole other layer that has been left completely invisible. This is a billion-dollar industry that has been able to excuse itself from rebuke.”

    WIRED attempted to contact BongaCams, Chaturbate, LiveJasmin, and Stripchat to request comment about the research findings. None responded.

    HRW’s report outlines crucial recommendations for improving conditions at both the studio and platform levels. This includes occupational safety standards for studios enforced with regular inspections. Models must be able to take breaks and receive a minimum wage for their work, studio management should not force models to perform specific sex acts or agree that they will perform any act on behalf of the models. Additionally, models should have access to a confidential reporting mechanism so they can notify law enforcement or other authorities about workplace violations.

    Developing recommendations for the platforms themselves is even more nuanced. Killbride says that most if not all of the popular adult streaming platforms have stringent authentication requirements for creating accounts and specifically prohibit studio owners or anyone from accepting terms of service on behalf of someone else. In practice, though, the companies are not doing enough, HRW researchers claim, to offer terms of service in a simple, understandable format in a variety of languages, including Spanish.

    Platforms also need to provide channels through which content creators can report violations and receive a timely response, the researchers say. And, crucially, platforms should establish policies that enable models to take ownership of and transfer their accounts from a studio. Researchers found that the current status quo on many platforms involves policy language that may confuse its users or technical complications that keep content creators say prevents them from being able to assert ownership of their accounts.

    On top of everything else, the stakes are particularly high for account ownership issues, because the researchers found that studios often use “recycled” accounts—those that were authenticated and established by one cammer and then retained by a studio—to circumvent minimum age requirements and stream child sexual abuse material.

    “We found that although the platforms are quite strict and have completely clear policies about not streaming kids, the studios do still manage to hire and stream children using fake IDs or, more commonly, recycled accounts,” Killbride says. “Our research was all with adults, but many people we talked to started streaming as kids when they were 13 to 17.”

    Killbride emphasizes that the situation reflects an important tenet of sex worker advocacy and labor reform in general: Listening to workers about their needs and the protections that would help them do their jobs most effectively and equitably also, simultaneously, protects other vulnerable populations. In this case, by allowing cammers to control and transfer their accounts and their followings, the adult streaming industry could also drastically reduce the prevalence of child sexual abuse material.

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  • How ‘World of Warcraft’ Devs Launched One of the Biggest Unions in Video Games

    How ‘World of Warcraft’ Devs Launched One of the Biggest Unions in Video Games

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    They started with fliers. The group of World of Warcraft developers at Activision Blizzard, determined to unionize, were testing the waters after Microsoft’s $69 billion acquisition. Microsoft had pledged to honor a labor neutrality agreement, active 60 days after the deal’s close, that would allow workers to explore collective bargaining without fear.

    Even with that agreement on their side, developers were still nervous about even showing interest in a union, says Paul Cox, a senior quest designer who served on the union’s organizing committee. “Prior to [the agreement], we had a lot of people who were like, ‘I’m interested, but I’m really worried about retaliation. I am terrified about getting my name put anywhere.’” he adds.

    That fear wasn’t unfounded. Prior to Microsoft’s acquisition, when they were still under Activision Blizzard’s leadership, unionized quality assurance workers at a studio in Albany, New York, accused management of engaging in union busting tactics. According to one QA tester WIRED spoke to at the time, management was hostile to their efforts, pulling employees into “spontaneous meetings” and “spread[ing] misleading or false information about unions and the unionization process” in a company Slack channel.

    On July 24, Microsoft voluntarily recognized the World of Warcraft developers’ union, a wall-to-wall unit of over 500 employees spanning multiple departments—an achievement that has long been unthinkable in the video game industry. Due to its size and breadth of departments involved, it’s the first of its kind at Activision Blizzard. Those QA testers in Albany eventually managed to establish their union, but they were just one relatively small group.

    The Warcraft developers follow in the footsteps of Bethesda Game Studios, another Microsoft-owned company, which created the first union at a major studio across its entire team with 241 members. Microsoft also voluntarily recognized that union.

    “It was really only after the Microsoft acquisition that the ball started racing down the hill,” Cox says of union efforts. “The lack of fear of retaliation really helped.”

    Also helpful: Reaching out to as many colleagues as possible. “When you’re trying to talk to people about a union, you can really only do it one-on-one,” Cox says. To do that organizers set up tents on the company campus for people to stop by and get information. Being able to openly exist in a space people might pass on the way to lunch, for example, made that process faster and easier.

    Activision Blizzard did not respond to a request for comment before publication.

    Cox says that because it was previously hard to communicate with other employees due to the discreet nature of organizing, he and his colleagues didn’t realize there was a World of Warcraft QA group already trying to unionize. Once they were aware of each other, they combined efforts. As for deciding who should be in the union, Cox says it boiled down to a very simple idea.

    “It was about game creators,” he says. “The people who you couldn’t make the game without.” Whether that’s writers, sound designers, or producers, it doesn’t matter. “We fought pretty hard to make sure that everybody was in the same group, as much as we could get.”

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  • Chatbots Are Entering the Stone Age

    Chatbots Are Entering the Stone Age

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    For all the bluster about generative artificial intelligence upending the world, the technology has yet to meaningfully transform white-collar work. Workers are dabbling with chatbots for tasks such as drafting emails, and companies are launching countless experiments, but office work hasn’t undergone a major AI reboot.

    Perhaps that’s only because we haven’t given chatbots like Google’s Gemini and OpenAI’s ChatGPT the right tools for the job yet; they’re generally restricted to taking in and spitting out text via a chat interface. Things might get more interesting in business settings as AI companies start deploying so-called “AI agents,” which can take action by operating other software on a computer or via the internet.

    Anthropic, a competitor to OpenAI, announced a major new product today that attempts to prove the thesis that tool use is needed for AI’s next leap in usefulness. The startup is allowing developers to direct its chatbot Claude to access outside services and software in order to perform more useful tasks. Claude can, for instance, use a calculator to solve the kinds of math problems that vex large language models; be required to access a database containing customer information; or be compelled to make use of other programs on a user’s computer when it would help.

    I’ve written before about how important AI agents that can take action may prove to be, both for the drive to make AI more useful and the quest to create more intelligent machines. Claude’s tool use is a small step toward the goal of developing these more useful AI helpers being launched into the world right now.

    Anthropic has been working with several companies to help them build Claude-based helpers for their workers. Online tutoring company Study Fetch, for instance, has developed a way for Claude to use different features of its platform to modify the user interface and syllabus content a student is shown.

    Other companies are also entering the AI Stone Age. Google demonstrated a handful of prototype AI agents at its I/O developer conference earlier this month, among many other new AI doodads. One of the agents was designed to handle online shopping returns, by hunting for the receipt in a person’s Gmail account, filling out the return form, and scheduling a package pickup.

    Google has yet to launch its return-bot for use by the masses, and other companies are also moving cautiously. This is probably in part because getting AI agents to behave is tricky. LLMs do not always correctly identify what they are being asked to achieve, and can make incorrect guesses that break the chain of steps needed to successfully complete a task.

    Restricting early AI agents to a particular task or role in a company’s workflow may prove a canny way to make the technology useful. Just as physical robots are typically deployed in carefully controlled environments that minimize the chances they will mess up, keeping AI agents on a tight leash could reduce the potential for mishaps.

    Even those early use cases could prove extremely lucrative. Some big companies already automate common office tasks through what’s known as robotic process automation, or RPA. It often involves recording human workers’ onscreen actions and breaking them into steps that can be repeated by software. AI agents built on the broad capabilities of LLMs could allow a lot more work to be automated. IDC, an analyst firm, says that the RPA market is already worth a tidy $29 billion, but expects an infusion of AI to more than double that to around $65 billion by 2027.

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  • The Low-Paid Humans Behind AI’s Smarts Ask Biden to Free Them From ‘Modern Day Slavery’

    The Low-Paid Humans Behind AI’s Smarts Ask Biden to Free Them From ‘Modern Day Slavery’

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    AI projects like OpenAI’s ChatGPT get part of their savvy from some of the lowest-paid workers in the tech industry—contractors often in poor countries paid small sums to correct chatbots and label images. On Wednesday, 97 African workers who do AI training work or online content moderation for companies like Meta and OpenAI published an open letter to President Biden, demanding that US tech companies stop “systemically abusing and exploiting African workers.”

    Most of the letter’s signatories are from Kenya, a hub for tech outsourcing, whose president, William Ruto, is visiting the US this week. The workers allege that the practices of companies like Meta, OpenAI, and data provider Scale AI “amount to modern day slavery.” The companies did not immediately respond to a request for comment.

    A typical workday for African tech contractors, the letter says, involves “watching murder and beheadings, child abuse and rape, pornography and bestiality, often for more than 8 hours a day.” Pay is often less than $2 per hour, it says, and workers frequently end up with post-traumatic stress disorder, a well-documented issue among content moderators around the world.

    The letter’s signatories say their work includes reviewing content on platforms like Facebook, TikTok, and Instagram, as well as labeling images and training chatbot responses for companies like OpenAI that are developing generative-AI technology. The workers are affiliated with the African Content Moderators Union, the first content moderators union on the continent, and a group founded by laid-off workers who previously trained AI technology for companies such as Scale AI, which sells datasets and data-labeling services to clients including OpenAI, Meta, and the US military. The letter was published on the site of the UK-based activist group Foxglove, which promotes tech-worker unions and equitable tech.

    In March, the letter and news reports say, Scale AI abruptly banned people based in Kenya, Nigeria, and Pakistan from working on Remotasks, Scale AI’s platform for contract work. The letter says that these workers were cut off without notice and are “owed significant sums of unpaid wages.”

    “When Remotasks shut down, it took our livelihoods out of our hands, the food out of our kitchens,” says Joan Kinyua, a member of the group of former Remotasks workers, in a statement to WIRED. “But Scale AI, the big company that ran the platform, gets away with it, because it’s based in San Francisco.”

    Though the Biden administration has frequently described its approach to labor policy as “worker-centered.” The African workers’ letter argues that this has not extended to them, saying “we are treated as disposable.”

    “You have the power to stop our exploitation by US companies, clean up this work and give us dignity and fair working conditions,” the letter says. “You can make sure there are good jobs for Kenyans too, not just Americans.”

    Tech contractors in Kenya have filed lawsuits in recent years alleging that tech-outsourcing companies and their US clients such as Meta have treated workers illegally. Wednesday’s letter demands that Biden make sure that US tech companies engage with overseas tech workers, comply with local laws, and stop union-busting practices. It also suggests that tech companies “be held accountable in the US courts for their unlawful operations aboard, in particular for their human rights and labor violations.”

    The letter comes just over a year after 150 workers formed the African Content Moderators Union. Meta promptly laid off all of its nearly 300 Kenya-based content moderators, workers say, effectively busting the fledgling union. The company is currently facing three lawsuits from more than 180 Kenyan workers, demanding more humane working conditions, freedom to organize, and payment of unpaid wages.

    “Everyone wants to see more jobs in Kenya,” Kauna Malgwi, a member of the African Content Moderators Union steering committee, says. “But not at any cost. All we are asking for is dignified, fairly paid work that is safe and secure.”

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  • Machine learning system offers new hope for diagnosis of rare genetic disorders

    Machine learning system offers new hope for diagnosis of rare genetic disorders

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    Diagnosing rare Mendelian disorders is a labor-intensive task, even for experienced geneticists. Investigators at Baylor College of Medicine are trying to make the process more efficient using artificial intelligence. The team developed a machine learning system called AI-MARRVEL (AIM) to help prioritize potentially causative variants for Mendelian disorders. The study is published today in NEJM AI. 

    Researchers from the Baylor Genetics clinical diagnostic laboratory noted that AIM’s module can contribute to predictions independent of clinical knowledge of the gene of interest, helping to advance the discovery of novel disease mechanisms. “The diagnostic rate for rare genetic disorders is only about 30%, and on average, it is six years from the time of symptom onset to diagnosis. There is an urgent need for new approaches to enhance the speed and accuracy of diagnosis,” said co-corresponding author Dr. Pengfei Liu, associate professor of molecular and human genetics and associate clinical director at Baylor Genetics.

    AIM is trained using a public database of known variants and genetic analysis called Model organism Aggregated Resources for Rare Variant ExpLoration (MARRVEL) previously developed by the Baylor team. The MARRVEL database includes more than 3.5 million variants from thousands of diagnosed cases. Researchers provide AIM with patients’ exome sequence data and symptoms, and AIM provides a ranking of the most likely gene candidates causing the rare disease. 

    Researchers compared AIM’s results to other algorithms used in recent benchmark papers. They tested the models using three data cohorts with established diagnoses from Baylor Genetics, the National Institutes of Health-funded Undiagnosed Diseases Network (UDN) and the Deciphering Developmental Disorders (DDD) project. AIM consistently ranked diagnosed genes as the No. 1 candidate in twice as many cases than all other benchmark methods using these real-world data sets. 

    We trained AIM to mimic the way humans make decisions, and the machine can do it much faster, more efficiently and at a lower cost. This method has effectively doubled the rate of accurate diagnosis.”


    Dr. Zhandong Liu, co-corresponding author, associate professor of pediatrics – neurology at Baylor and investigator at the Jan and Dan Duncan Neurological Research Institute (NRI) at Texas Children’s Hospital

    AIM also offers new hope for rare disease cases that have remained unsolved for years. Hundreds of novel disease-causing variants that may be key to solving these cold cases are reported every year; however, determining which cases warrant reanalysis is challenging because of the high volume of cases. The researchers tested AIM’s clinical exome reanalysis on a dataset of UDN and DDD cases and found that it was able to correctly identify 57% of diagnosable cases.

    “We can make the reanalysis process much more efficient by using AIM to identify a high-confidence set of potentially solvable cases and pushing those cases for manual review,” Zhandong Liu said. “We anticipate that this tool can recover an unprecedented number of cases that were not previously thought to be diagnosable.”

    Researchers also tested AIM’s potential for discovery of novel gene candidates that have not been linked to a disease. AIM correctly predicted two newly reported disease genes as top candidates in two UDN cases.

    “AIM is a major step forward in using AI to diagnose rare diseases. It narrows the differential genetic diagnoses down to a few genes and has the potential to guide the discovery of previously unknown disorders,” said co-corresponding author Dr. Hugo Bellen, Distinguished Service Professor in molecular and human genetics at Baylor and chair in neurogenetics at the Duncan NRI.

    “When combined with the deep expertise of our certified clinical lab directors, highly curated datasets and scalable automated technology, we are seeing the impact of augmented intelligence to provide comprehensive genetic insights at scale, even for the most vulnerable patient populations and complex conditions,” said senior author Dr. Fan Xia, associate professor of molecular and human genetics at Baylor and vice president of clinical genomics at Baylor Genetics. “By applying real-world training data from a Baylor Genetics cohort without any inclusion criteria, AIM has shown superior accuracy. Baylor Genetics is aiming to develop the next generation of diagnostic intelligence and bring this to clinical practice.”

    Other authors of this work include Dongxue Mao, Chaozhong Liu, Linhua Wang, Rami AI-Ouran, Cole Deisseroth, Sasidhar Pasupuleti, Seon Young Kim, Lucian Li, Jill A.Rosenfeld, Linyan Meng, Lindsay C. Burrage, Michael Wangler, Shinya Yamamoto, Michael Santana, Victor Perez, Priyank Shukla, Christine Eng, Brendan Lee and Bo Yuan. They are affiliated with one or more of the following institutions: Baylor College of Medicine, Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, Al Hussein Technical University, Baylor Genetics and the Human Genome Sequencing Center at Baylor.

    This work was supported by the Chang Zuckerberg Initiative and the National Institute of Neurological Disorders and Stroke (3U2CNS132415).

    Source:

    Baylor College of Medicine

    Journal reference:

    Mao, D., et al. (2024) AI-MARRVEL — A Knowledge-Driven AI System for Diagnosing Mendelian Disorders. NEJM AI. doi.org/10.1056/AIoa2300009.

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  • Google Fires Twenty-Eight Workers for Protesting Cloud Deal with Israel

    Google Fires Twenty-Eight Workers for Protesting Cloud Deal with Israel

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    Google fired twenty-eight employees Wednesday after they participated in protests against Project Nimbus, a $1.2 billion cloud contract with Israel’s government that also includes Amazon.

    Workers at both companies have claimed the deal makes advanced technology available to Israel’s security apparatus that could contribute to the killing or harm of Palestinians in Gaza and the West Bank. The Intercept and Time have reported that Project Nimbus provides services that can be tapped by the Israel Defence Forces.

    The twenty-eight firings, confirmed by Google, come hours after nine employees were detained by police late Tuesday for sit-in protests in the office of Google Cloud CEO Thomas Kurian in Sunnyvale, California, and a company office in New York. All nine of those workers were fired, in addition to nineteen other protest participants.

    Google spokesperson Anna Kowalczyk said in a statement that the employees were terminated after internal investigation” concluded they were guilty of “physically impeding other employees’ work and preventing them from accessing our facilities.” She added that “after refusing multiple requests to leave the premises, law enforcement was engaged to remove them to ensure office safety.” The Nimbus contract is “not directed” at classified or military work, she said.

    Tuesday’s action against Project Nimbus comes after the reported death toll from the IDF’s offensive on Hamas in Gaza climbed to more than 34,000 Palestinians. The military offensive began after Hamas killed about 1,100 Israelis on October 7.

    The sit-ins at Google were accompanied by protests of more than 100 people—including many Google workers—outside company offices in New York, Sunnyvale, and Seattle. Google’s Kowalczyk characterized the participation by employees as “a small number.”

    Google’s workforce comprises the vast majority of employees of parent Alphabet, which reported a headcount of more than 180,000 at the end of 2023. Several protesters at Google’s New York office told WIRED they have support within the company beyond those who directly participated in Tuesday’s protest.

    Jane Chung, a spokesperson for No Tech for Apartheid—the coalition of tech workers and Muslim- and Jewish-led activist groups MPower Change and Jewish Voice for Peace that organized the protests—says that some workers who were fired were involved in much less provocative action than those who occupied offices.

    Some, she said, had simply attended an outdoor protest and taken a t-shirt handed out by organizers. Others were “flyering outside, standing near the protesters for safety.”

    Zelda Montes, a now-former YouTube software engineer who says they were arrested after occupying Google’s New York office for more than ten hours, accuses the company of breaching US legal protections for workers.

    “It’s so clear that Google is engaging in illegal behavior to deter our labor organizing by retaliating against workers who weren’t arrested,” Montes says. “I’m disappointed at just how evil Google can be, but not surprised—they’re more outraged by employees peacefully sitting in, than at how their technology is murdering people.”

    Kowalczyk of Google said that the Nimbus contract is “not directed” at “workloads relevant to weapons or intelligence services.”

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  • Exploring the versatile roles of tissue macrophages beyond immune defense

    Exploring the versatile roles of tissue macrophages beyond immune defense

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    A recent study published in Science Immunology summarized the role of resident tissue macrophages (RTMs) in homeostasis and disease.

    Study: Resident tissue macrophages: Key coordinators of tissue homeostasis beyond immunity. Image Credit: ART-ur/Shutterstock.comStudy: Resident tissue macrophages: Key coordinators of tissue homeostasis beyond immunity. Image Credit: ART-ur/Shutterstock.com

    Background

    Macrophages are evolutionarily conserved phagocytes ubiquitously present in almost all organs and tissues. It is recognized that the umbrella term macrophage comprises highly heterogeneous cells with diverse functions and roles.

    RTMs are stable, long-lived subpopulations in different organs and tissues and have been linked to innate immunity and the pathogenesis of chronic inflammatory diseases. However, RTMs have broader functions beyond immunity.

    Recently, exploring RTM subsets to functional, developmental, and spatial levels has become feasible, helping identify mechanisms of tissue homeostasis.

    Notwithstanding these advances, substantial knowledge gaps remain. In the present review, researchers provided insights into conditions impacting RTM identity, division of labor among RTM subsets, and RTM dysfunction in disease.

    Tissue microenvironment impacts RTM development

    RTMs originate from embryonic progenitors or hematopoietic stem cell (HSC)-derived monocytes. The local microenvironment influences the trajectories of RTM differentiation upon seeding a tissue. In homeostasis, the local environmental cues shape RTM cell identity in a tissue-specific manner.

    Further, the phenotypic and functional convergence of HSC-derived monocytes towards a tissue-specific RTM program is driven by the local environment.

    However, inflammation or disease markedly impacts their differentiation. During such disturbance, the differentiation of HSC-derived monocytes skews toward pro-reparative, tumor-supportive, or pro-inflammatory phenotypes, differing from that of steady-state RTMs.

    These inflammation-associated macrophages (iMacs) are short-lived, and upon resolution (of the disturbance), the tissue transitions to a distinct state, i.e., inflammation aftermath.

    There may be permanent changes in the original homeostatic distribution and the composition of environmental factors. This was demonstrated in white adipose tissue, where HSC-derived RTMs acquired a more inflammatory phenotype following the resolution of chronic inflammation.

    This post-inflammation scar led to HSC-derived RTMs being unable to differentiate into their original cellular state.

    Coexistence of RTM subsets within tissues

    Historically, it has been believed that organs and tissues are populated by unique tissue-specific RTMs during homeostasis, such as Langerhans cells in the skin, alveolar macrophages (AMs) in the lungs, Kupffer cells in the liver, and microglia in the brain.

    However, a seminal work from 2010 showed that embryonic yolk sac progenitors, not monocytes, give rise to microglia.

    This was also instrumental in revealing the embryonic origin of other RTMs. Studies have demonstrated that two distinct conserved RTM subsets populate most tissues in the interstitial space.

    The authors term these RTM subsets as perivascular macrophages (PVMs). The PVMs precede with the name of the organ/tissue of residence.

    Of the conserved PVM subsets, T cell immunoglobulin and mucin domain containing 4 (TIM4+) PVMs emerge during embryogenesis in multiple organs and are characterized by low levels of major histocompatibility complex II (MHCII) and high levels of TIM4, folate receptor beta (FOLR2), lymphatic vessel endothelial hyaluronan receptor 1 (LYVE1), and cluster of differentiation 206 (CD206).

    By contrast, MHCII+ PVMs emerge from HSC-derived monocytes and are characterized by low/intermediate levels of FOLR2 and LYVE1 and high levels of CD206 and MHCII.

    While some studies have observed a C-C motif chemokine receptor 2 (CCR2+) PVM subset, they are likely to be recent organ immigrants. Although some organs have unique tissue-specific subsets of RTMs, almost all organs share these two conserved PVMs.

    Division of labor among RTMs

    Microglia are the only brain RTM subset in contact with neurons. Several fundamental microglial functions beyond immunity have been uncovered more recently. Animal studies have shown that microglia are essential in neuronal development and fitness.

    Microglia secrete growth factors critical for synapse formation. Additionally, they survey the brain microenvironment and modulate neuronal activity through synaptic engulfment and pruning.

    Recent studies have revealed the presence of PVMs in perivascular spaces of the central nervous system (CNS). Further, these PVMs regulate cerebrospinal fluid (CSF) dynamics, and TIM4+ PVMs in the brain facilitate proper extracellular matrix (ECM) dynamics.

    This idea was corroborated by the findings of abnormal ECM deposition and deterioration of CSF flow dynamics in aged mice, which are linked to a smaller ratio of brain TIM4+-to-MHCII+ PVMs.

    The distinct locations of lung PVMs indicate they have specialized roles. For instance, lung MHCII+ PVMs may regulate neuronal interaction with stromal cells, whereas lung TIM4+ PVMs contribute to lung homeostasis.

    Besides, lung TIM4+ PVMs may be involved in wound healing, while the MHCII+ counterparts may be involved in antigen presentation and immune activation.

    Heart MHCII+ and TIM4+ PVMs produce growth factors to support proper cellular functions and adjust to physiologic demands. Cardiac PVMs are in close contact with cardiomyocytes and participate in mutual electric conduction, supporting normal cardiac contractions.

    Gut muscularis MHCII+ and TIM4+ PVMs are close to blood vessels, myenteric plexus, and submucosal plexus. Gut MHCII+ PVMs are closely associated with neuronal bodies of the enteric nervous system.

    Mechanistically, gut muscularis PVMs secrete bone morphogenetic protein 2 (BMP2) to regulate enteric neurons expressing the BMP2 receptor. Besides, they regulate gastrointestinal motility independent of the enteric nervous system. Recent studies suggest that gut PVMs promote neuroprotection and limit neuronal cell death.

    RTM dysregulation and disease

    It is established that HSC-derived iMacs are linked to chronic inflammatory diseases. This chronicity is thought to be due to ongoing inflammation leading to tissue function loss.

    Nevertheless, how dysfunction or deviation of RTMs’ core homeostatic functions cause disease remains less studied. Usually, deviation is required for proper tissue repair.

    However, it is not clear how long-term and persistent deviation affects tissue physiology and disease severity. Pulmonary alveolar proteinosis is caused by AM dysfunction, characterized by protein and surfactant accumulation in the lung alveolar space, limiting proper gas exchange and increasing susceptibility to infections.

    This can occur due to mutations in the granulocyte-macrophage colony-stimulating factor (GM-CSF), autoantibodies against GM-CSF, or silica inhalation. Further, the absence or dysfunction of lung TIM4+ PVMs can result in increased fibrosis and loss of tissue function.

    Likewise, dysregulation of heart TIM4+ PVMs exacerbates fibrosis following cardiac infarction. Loss of RTM’s core homeostatic functions may impact cancer development.

    A recent study on breast cancer patients showed that those harboring tumors with increased breast TIM4+ PVMs had improved survival rates and T cell priming against the tumor.

    This suggested that enhancing the TIM4+ PVMs’ homeostatic functions while inhibiting the activity of HSC-derived tumor-related macrophages can be effective for treatment.

    Further, disruption of ECM remodeling in brain PVMs is associated with aging and Alzheimer’s disease (AD).

    Concluding remarks

    Taken together, ontogeny and local environmental cues shape the phenotype and heterogeneity of RTMs.

    There is a strong division of labor among RTM subpopulations. The study proposed a unifying nomenclature for the two conserved RTM subpopulations and explored the roles of several unique tissue-specific RTM subsets in homeostasis and disease.

    Nevertheless, further studies are required to delineate how RTM dysfunction leads to chronic inflammatory diseases fully.

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  • Google Workers Detained By Police for Protesting Cloud Contract with Israel

    Google Workers Detained By Police for Protesting Cloud Contract with Israel

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    Nine Google workers were removed by police from company offices in New York and Sunnyvale, California, late Tuesday after staging an hours-long sit-in protest against a cloud contract with Israel’s government.

    The Sunnyvale protest occupied the office of Thomas Kurian, CEO of Google’s cloud division, at a building close to Google’s main HQ in Silicon Valley for more than 8 hours. The New York protest occupied a common area on the tenth floor of Google’s Chelsea location.

    Videos seen by WIRED showed people who appeared to be Google security staff walking up to protesting workers in two different offices accompanied by local police. In the video from New York, a man who appears to be relaying a message from Google management informs the protesting workers that they have been placed on administrative leave and asks them to take the opportunity to depart peacefully.

    “We will not be leaving,” a protesting worker replies. A man in uniform then introduces the officers as NYPD and delivers a final ultimatum, saying the workers have a last chance to walk out freely. “If not, you can be arrested for trespass,” he says. When the protesters again decline to go, police officers put them in handcuffs.

    WIRED could not independently verify that the four workers in New York and five in Sunnyvale apparently detained by police had been arrested or charged. A person involved in coordinating the protests says the New York workers were arrested with desk appearance tickets, which specify when a person must appear in court. Google did not immediately respond to a request for comment.

    Tuesday night’s police action came after “dozens” of employees were placed on administrative leave after participating in the day’s sit-in protests but leaving peacefully, the person involved says. Protest rallies also took place outside Google offices in New York, Sunnyvale, and Seattle.

    The action called on Google to drop a $1.2 billion cloud computing contract with the Israeli government known as Project Nimbus that also involves Amazon. Last week Time reported that the contract involves providing direct services to the Israel Defense Forces.

    The detained workers in New York include software engineers Hasan Ibraheem and Zelda Montes. They also include two workers who identified themselves by their first names as Jesús and Mohammed on a speaker-phone call with protesters outside Google’s New York office Tuesday.

    Project Nimbus has been the target of protests by Google and Amazon workers for years. A campaign group called No Tech for Apartheid—which combines tech workers from the two the Muslim and Jewish-led activist groups MPower Change and Jewish Voice for Peace—formed in 2021 after details about the cloud contract became public.

    Google and Amazon workers protested outside company offices in 2022 after The Intercept published documents showing the contract includes AI technology such as video analysis. The protesting tech workers say such capabilities could be used by Israel’s security apparatus to harm Palestinians.

    Israel’s military assault on Gaza, which began after Hamas killed about 1,100 Israelis on October 7, has added new fuel to the internal opposition to Project Nimbus. The Israel Defence Forces have killed more than 34,000 Palestinians since bombing and moving into Gaza last fall.

    Last month, Google cloud software engineer Eddie Hatfield disrupted Google Israel’s managing director at Mind The Tech, a company-sponsored conference focused on the Israeli tech industry. More than 600 other Googlers signed a petition opposing the company’s sponsorship of the conference and after Hatfield was fired three days later Google trust and safety policy employee Vidana Abdel Khalek resigned in protest.

    Google is not the only Silicon Valley giant to see worker activism related to Israel’s war on Hamas. In late March, more than 300 Apple workers signed an open letter that alleged retaliation against workers who have expressed support for Palestinians, and urged company leadership to show public support for Palestinians.

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  • California health workers may face rude awakening with $25 minimum wage law

    California health workers may face rude awakening with $25 minimum wage law

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    Nearly a half-million health workers who stand to benefit from California’s nation-leading $25 minimum wage law could be in for a rude awakening if hospitals and other health care providers follow through on potential cuts to hours and benefits.

    A medical industry challenge to a new minimum wage ordinance in one Southern California city suggests layoffs and reductions in hours and benefits, including cuts to premium pay and vacation time, could be one result of a state law set to begin phasing in in June. However, some experts are skeptical of that possibility.

    The California Hospital Association brought a partly successful legal challenge to Inglewood’s $25 minimum wage ordinance, which barred employers from taking those sorts of steps to offset their higher costs.

    “Layoffs, reductions in premium pay rates, reductions in non-wage benefits, reductions in hours, and increased charges are consequences of an employer having less money to spend—which will necessarily be the case given the significant increase in spending on wages due to the minimum wage,” the association said in its lawsuit. Additional examples include reducing health coverage and charging for parking or work-related equipment.

    Inglewood voters approved the ordinance in November 2022, nearly a year before California legislators enacted a $25 minimum wage for health workers. Those statewide higher wages are to be phased in starting in June under California’s first-in-the-nation law, but Gov. Gavin Newsom has since said they are too expensive as the state faces a deficit estimated between $38 billion and $73 billion. It’s unclear if lawmakers will agree to a delay or take other steps to reduce the cost.

    U.S. District Judge Dale S. Fischer agreed with the hospital industry in a March 11 tentative ruling when he shot down the portion of Inglewood’s ordinance banning layoffs and clawbacks by employers, while allowing the rest of the ordinance to remain in effect. He gave the sides time to object to his preliminary decision, though none did.

    The California Hospital Association represents more than 400 hospitals and was a key backer of the state’s carefully crafted compromise law, which notably contains none of the employee safeguards included in the Inglewood ordinance.

    Spokesperson Jan Emerson-Shea said the association doesn’t know how providers will react once the state law takes effect. “We don’t have any insights,” she said.

    “The challenge for any health care organization is figuring out how to pay for the higher wages,” said Joanne Spetz, director of the Philip R. Lee Institute for Health Policy Studies at the University of California-San Francisco. “Since labor costs are the largest part of any health care organization’s costs, it’s hard to figure out how to reduce spending without looking at labor costs.”

    Providers can try to increase revenues by bargaining for higher reimbursements from commercial insurers, she said. Public hospitals, nursing homes, and community clinics get most of their money through Medi-Cal, the state’s Medicaid program.

    Providers could reduce the services they offer, pare back charity care, and cut or delay capital investments, Spetz said. In the long term, she expects some combination of spending cuts and revenue increases.

    Both the state law and local ordinance cover far more than doctors and nurses, with a definition of health worker that includes janitors, housekeepers, groundskeepers, security guards, food service workers, laundry workers, and clerical staff.

    The most recent estimate by the Health Care Program at the University of California-Berkeley Labor Center is that as many as 426,000 health workers would make an average of $6,400 extra in the law’s first year, a 19% average pay bump mainly benefiting lower-income workers of color and women. State finance officials project that well over 500,000 workers will benefit.

    Researchers didn’t include layoffs and other potential staffing and benefit reductions when they projected the state law’s costs and benefits, said Laurel Lucia, the program’s director. But she pointed to initial projections by hospitals, doctors, and business and taxpayer groups that the wage hike would cost $8 billion annually, thereby imperiling services and resulting in higher premiums and higher costs for state and local governments.

    “It seems like a contradiction to say this law’s going to cost billions of dollars while at the same time saying it’s going to reduce workers’ total compensation,” said Lucia, who projects a far lower price tag.

    She added that state finance officials had anticipated that Medi-Cal reimbursements would reflect the increased labor costs, while Medicare would eventually at least partially compensate for the higher labor costs.

    Michael Reich, chair of the Center on Wage and Employment Dynamics at UC Berkeley’s Institute for Research on Labor and Employment, and affiliated economist Justin Wiltshire recently argued that California’s new $20 minimum wage law for fast-food workers won’t result in mass layoffs and price increases, as some have predicted.

    Health care is much different than fast food, Reich acknowledged, but he argued for much the same positive result.

    “A higher minimum wage will make it easier and cheaper for hospitals to recruit and retain these workers. The cost savings, and the productivity benefits of more experienced workers, could offset much of the labor cost increase,” Reich said.

    The hospital association filed its lawsuit against Inglewood’s ordinance in July, while it was still opposing early versions of the statewide minimum wage legislation. Among many other provisions, the statewide law put on hold an initiative to cap hospital executives’ salaries in Los Angeles.

    The hospital association’s legal challenge referenced in part layoffs and reduced working hours imposed by Centinela Hospital Medical Center after Inglewood’s ordinance took effect.

    But Centinela said the reduction was entirely unrelated to the ordinance and that all staff were offered alternate positions, which many accepted.

    “Centinela Hospital also has since added many more jobs in new clinical positions above minimum wage scale,” the hospital said in a statement.

    Service Employees International Union-United Healthcare Workers West, the prime backer of both the local ordinance and the statewide law, sued the hospital in April 2023 alleging that it cut workers’ hours to offset the higher minimum wage. The case is still pending.

    The union did not respond to repeated requests for comment.

    In a court filing, however, the union and city of Inglewood said similar employer restrictions in previous minimum wage laws have survived.

    The ordinance “merely sets the backdrop for collective bargaining negotiations,” and does not bar employers from locking out employees or hiring replacement workers during a strike. Employers can still lay off workers or reduce their hours, they said, so long as they don’t do so to fund the higher minimum wage.

    But Fischer agreed with the hospital association that layoffs and reductions in employees’ total compensation packages are “obvious responses by an employer to rising compensation costs.”

    Restricting employers’ options would violate federal labor relations rules, he said.

    “The minimum wage an employer has to pay its employees will invariably affect the total amount of compensation it is able or willing to pay,” he wrote “This will then invariably affect the number of employees it can retain and the number of hours those employees will be scheduled to work.”

    This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 




    Kaiser Health NewsThis article was reprinted from khn.org, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF – the independent source for health policy research, polling, and journalism.

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  • Esketamine after childbirth cuts risk of postnatal depression by three-quarters

    Esketamine after childbirth cuts risk of postnatal depression by three-quarters

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    In a recent study published in the British Medical Journal, researchers investigated whether low-dose esketamine delivered after labor improves post-delivery depression in women with prenatal depression.

    Study: Efficacy of a single low dose of esketamine after childbirth for mothers with symptoms of prenatal depression: randomised clinical trial. Image Credit: christinarosepix / ShutterstockStudy: Efficacy of a single low dose of esketamine after childbirth for mothers with symptoms of prenatal depression: randomised clinical trial. Image Credit: christinarosepix / Shutterstock

    Background

    Perinatal depression is common among women, particularly in low-income nations, and has negative consequences for both the mother and her child. Mothers with depression frequently feel anxiety, weaker connections, and lower attachment. Their kids are more likely to experience behavioral and emotional issues, as well as long-term psychological and developmental disorders. Poor physical health, a lack of social support, a low socioeconomic level, insufficient education, and a history of violent exposure are all risk factors for prenatal depression.

    Prenatal depression is a primary predictor of postnatal depression, and pharmacological therapies are occasionally required. Esketamine, a rapid-onset antidepressant, offers potential advantages for treatment-resistant depression, but its effect on women with perinatal depression is unknown. Previous studies have mainly focused on cesarean births, omitting moms who are depressed or at high risk of developing depression after delivery.

    About the study

    In the present randomized, placebo-controlled, double-blinded, controlled trial, researchers evaluated whether low-dose esketamine administered immediately after birth lowers depression in moms suffering from prenatal depression for 42 days.

    The researchers conducted the trial at five hospitals across China between June 19, 2020, and August 3, 2022. They included pregnant women aged 18 years and above with mild, moderate, or severe prenatal depression [defined as Edinburgh postnatal depression scale (EPDS] scores equal to or above 10) hospitalized for delivery. They excluded women with pre-pregnancy mood disorders, severe pregnancy complications, physical status III or higher, or contraindications to ketamine or esketamine use, such as severe cardiovascular disease, refractory hypertension, or hyperthyroidism. Exclusion criteria included American Society of Anesthesiologists (ASA) physical status III or higher.

    The researchers randomized the individuals in a 1:1 ratio to the esketamine group (0.20 mg per kg body weight) or placebo group, with drugs administered intravenously during the initial 40 minutes post-delivery while clipping the birth cord. The primary research outcomes were major depressive events after 42 days of delivery, identified using mini-international neuropsychiatric interviews.

    Secondary study outcomes included EPDS scores on days one and 42 after childbirth and the Hamilton Depression Rating Scale (HDRS) score 42 days after delivery. The researchers monitored adverse occurrences until 24 hours after delivery. They used logistic regression to determine the relative risk (RR) values. They used imputed missing primary outcome data in post-hoc sensitivity analyses.

    The researchers measured anxiety using the Zung self-rating anxiety scale, social assistance using the social support rating scale, marital satisfaction using the ENRICH (evaluation and nurturing relationship issues, communication, and happiness) scale, and agitation-sedation using the Richmond agitation-sedation scale. Maternal data included epidural analgesia acceptance, delivery style, fluid infusion, and blood loss, as well as the use of additional analgesics and sedatives. Bodyweight, sex, Apgar scores at one and five minutes after delivery, and initial destination were all recorded.

    Results

    The researchers screened 14,243 women and randomly assigned 364 to the study groups. The average participation age was 32 years. After 42 days, 12 (6.7%) esketamine recipients and 46 (25%) placebo recipients experienced a severe depressive episode (RR 0.3). After accounting for missing data, 14 (7.7%) of esketamine recipients and 46 (25%) of placebo recipients experienced severe depressive episodes (RR 0.3). The protocol analysis yielded comparable results.

    Esketamine-treated women had lower EPDS scores on day 7 and day 42 (median difference, -3). Individuals receiving esketamine also had reduced HDRS scores 42 days after delivery (mean difference, -4). Neuropsychiatric adverse event occurrence (including dizziness, diplopia, and hallucinations) was higher among individuals receiving esketamine (45%, n=82) compared to those receiving placebo 22% (n=40); however, the symptoms lasted <24 hours, with none requiring pharmacological therapy.

    Esketamine-treated women had lower EPDS scores on day seven and 42 (median difference, -3). Individuals receiving esketamine also had reduced HDRS scores 42 days after delivery (mean difference, -4). Neuropsychiatric adverse event occurrence (including dizziness, diplopia, and hallucinations) was higher among individuals receiving esketamine (45%, n=82) compared to those receiving placebo 22% (n=40); however, the symptoms lasted <24 hours, with none requiring pharmacological therapy.

    Overall, the study found that a single modest dosage of 0.2 mg/kg of esketamine administered soon after childbirth reduces major depressive events among women with prenatal depressive symptoms by almost three-quarters at 42 days postpartum. Esketamine increased the frequency of neuropsychiatric symptoms, but they were brief and lasted <24 hours, requiring no medication. The antidepressant effect of low-dose esketamine appears to continue longer in women with prenatal depression than in the overall population with depression. Further analysis is required to establish whether the reaction continues after 42 days.

    Journal reference:

    • Shuo Wang et al., Efficacy of a single low dose of esketamine after childbirth for mothers with symptoms of prenatal depression: randomised clinical trial, BMJ 2024;385:e078218, DOI: 10.1136/bmj-2023-078218, https://www.bmj.com/content/385/bmj-2023-078218

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