Brainstorm Health Daily: July 25, 2017

Composer John Williams once revealed how he pitched the iconic musical theme for Jaws to director Steven Spielberg, as Nigel Andrews relates in his aptly named movie guide, Nigel Andrews on Jaws: “Tapping out one-handed on a piano the creepy, chugging double-bass ostinato, Williams told the director, ‘Something stirs, an ominous growling, a rising semitone way down in the depths of the string basses…then the rhythm starts, slowly, slowly gathering momentum…then maybe, we add a tuba….’”

When the movie debuted in 1975, it was that riff—low, visceral, predatory—that terrified audiences as much as the huge mechanical great white shark. The two notes, E and F, sounded from a warren of bass strings and brass, like a reverberating heartbeat. Steady—then building hungrily into a sprint.

“‘You see, it was such a mindless thing, this idea,” Williams later told Andrews. ‘It had the effect of grinding away, coming at you, just as a shark would do, instinctual, relentless, unstoppable.’”

The notion that a musical score can make us feel something—in this case, raw, pulsing fear—is now well accepted. But understood or not, it creeps up in surprising ways. Take the conclusion of a study last summer by a team of researchers at the Scripps Institution of Oceanography. The report in PLOS One, by Andrew Nosal and colleagues, found that background music in shark documentaries, of all things, can be a subtle, “yet powerful source of fear that has been heretofore overlooked.”

In three experiments, the Scripps team presented more than 2,000 volunteers with either a 60-second video or an audio clip of swimming sharks—accompanied by uplifting music, ominous music, or silence—and then “asked a series of questions that measured their perceptions of sharks and willingness to conserve” them. In dramatic numbers, the people who watched the fish swimming to ominous music regarded them more negatively than those who saw the same footage with an upbeat score. Those who heard dark tones were more apt to apply adjectives like “scary,” “dangerous,” and “vicious” to the gliding vertebrates.” Those who heard the happier score were more likely to choose “peaceful,” “graceful,” and “beautiful” in their assessments.

Similar studies have arrived at parallel conclusions with regard to wine and even geometric shapes. Those who tasted wine while listening to background music that was “zingy and refreshing” tended to rate the wines in the same buoyant fashion; likewise, those who heard mellow music as they imbibed were more apt to describe the taste that way, too—and so on for music that was “powerful and heavy” or “subtle and refined.”

Why this matters in the case of sharks, say Nosal and his colleagues, is that documentaries meant to teach and inform may be sending the wrong message by way of musical undercurrent—teaching people to be more afraid of sharks than they should be, and harming conservation efforts in the process.

That’s not to say there isn’t a place for such ominous music. This afternoon, as the Senate takes up yet another iteration of its Obamacare-repeal bill, there will be mostly hushed and nervous tones in the Capitol building. I would suggest that someone pump in the Jaws theme to fill the void. The soundtrack, in this case, ought to match the stakes.

Sy has the news below.

DIGITAL HEALTH

Exclusive: Women's telemedicine health startup lands $11 million in early funding. My colleague Valentina Zarya has an exclusive on Maven, a telemedicine upstart that focuses on women's health. The firm has now secured more than $15 million in total funding. "Maven serves both individual women and employers, who use it as a health benefit for its female employees. As with any other telemedicine network, individual users can book a video appointment directly through the website or mobile app (a 10-minute doctor's appointment costs $35)," Valentina writes. "How Maven differentiates itself is through the experts it makes available, such as lactation specialists ($25 for 20 minutes) and midwives ($18 for 10 minutes)." (Fortune)

INDICATIONS

With cancer immunotherapy, you win some—and you lose some. Merck and rival Bristol-Myers Squibb, the first companies to win drug approvals for a new class of cancer immunotherapy drugs called "checkpoint inhibitors," have been trading milestone victories and setbacks. The latest reversal of fortunes came on Monday, when it was revealed that Merck's star drug Keytruda didn't improve overall survival rates in head and neck cancers (a cancer type where Bristol-Myers' Opdivo didshow a survival benefit). Merck shares fell modestly while BMS' stock gained modestly on the news. However, in other cancers—including the massive lung cancer market—Keytruda has produced far more impressive clinical results (and received more FDA approvals) than Opdivo has, highlighting the topsy-turvy nature of cancer immunotherapy.

AbbVie ordered to pay $150 million in AndroGel case. In a decision that could spell trouble for biotech giant AbbVie, a jury has ruled that the company should pay $150 million in punitive damages to a plaintiff for allegedly misrepresenting its AndroGel testosterone replacement therapy. This is just one of thousands of lawsuits against the firm, whose "low-T" therapy has come under scrutiny over claims that they've led to serious heart complications and been given to patients because of an aggressive marketing strategy. AbbVie says that the punitive damages are unlikely to stand and that it's comforted by the jury's assessment that the company wasn't responsible for the plaintiff's heart attack.

THE BIG PICTURE

The Senate's latest Obamacare strategy: Pass what's basically a blank piece of paper. Within the next hour or so, the Senate is expected to vote on a "motion to proceed" on its health care legislation. That procedural vote, if it passes (and while Sen. John McCain's surprise announcement that he's returning to Washington for several key votes makes that more likely, it's not necessarily assured), would then reportedly lead to a series of votes on "amendments" which would essentially supplant the existing legislative vehicle. Many of these—such as bills to "repeal-and-delay" Obamacare, or the Senate's existing Better Care Reconciliation Act—are widely expected to fail. But GOP leadership has a new idea: "skinny repeal." That would mean a repeal of Obamacare's most unpopular measures (the individual mandate to procure health insurance or pay a fine, the employer mandate to cover full time workers, and a tax on medical device makers). And while there's a chance such a bill could cobble together 50 necessary votes, especially since it doesn't contain deep cuts to Medicaid and other such measures, it would almost certainly be unrepresentative of a final Trumpcare bill. Rather, it would provide an avenue to proceed to a "conference committee" with the House of Representatives which would likely revive many of the controversial measures that's held up the Senate's Obamacare efforts so far. The voting is set to begin in the very near future.

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