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Tag: breakthrough

  • The 3 Words That Capture Jeff Bezos’s Approach to Coming Up With Great Ideas

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    Jeff Bezos built his career and reputation on being a data-driven and execution focused leader. While Googlers dreamed of moonshots during their company sanctioned 20 percent time, Amazon employees worked from cheap door desks to get things done in a third of the time others thought was possible. 

    Amazon never seemed much like a company built by a daydreamer. The focus is on reality and execution. 

    Which is why, if you happened to be in the audience at Italian Tech Week in Turin recently, you might have been surprised to hear Bezos up on stage waxing poetic about the importance of wandering for success, and how exploring can open you up to make huge breakthroughs. 

    Bezos on the power of wandering

    “You have to wander,” Bezos, sporting some new post-wedding stubble, told the audience. Yes, he acknowledged, many people see wandering as inefficient. But he views it as essential.

     “Wandering is so important because wandering is a kind of humility,” he continued. (Bezos is a huge fan of humility.) “The only way to go straight to your destination is if you know where you’re going. And sometimes you know where you’re going, but sometimes you don’t.”

    “Wandering is that acknowledgement that in life and in business and in exploration and in invention, in building a company, a lot of the time you can see the mountaintop, but you can’t see the trail and you have to explore and you have to wander. It may feel very inefficient, but it’s actually very valuable,” Bezos concluded. 

    The exploration-execution machine 

    If this doesn’t sound much like the hard-charging Jeff Bezos you’ve heard about over the years, don’t be too alarmed. The Amazon founder went on to stress that while wandering has its place, nose-down execution is essential as well. 

    “Sometimes when you know where you’re going, yes, you should be very efficient,” he answered when the host pressed him on how much wandering is too much. 

    “I think for exploration, but also determined execution, you just need to do both. And they actually do feed each other. It’s the things that come out of the execution [that] gives you new data and new ideas about what the next step should be in your exploration. So the two things don’t work against each other, they work together,” he said. 

    In this view exploration and execution work together like two parts of a machine to churn out achievement. Without one of the other, the machine breaks down and progress stalls. It’s an intriguing image, but not one that’s unique to Jeff Bezos. 

    In fact, scientists have looked into how breakthrough ideas happen in the real world and found something very close to what Bezos described in Turin. 

    A 3-word mantra for success

    A few years ago Northwestern University economist Dashun Wang and his collaborators got curious about a phenomenon they observed in many fields. Whether you’re looking at the arts, science, or business, great minds often produce their best work in bursts of productivity. 

    Einstein, for instance, published his most influential papers over the course of his ‘annulis mirabilis’ or miracle year. Van Gogh’s best known works all come from a single two-year period.  

    What caused these fluorescences of brilliance, Wang wanted to know. To find out, his team pulled together data on the careers of more than 2,000 artists, 4,000 film directors, and 20,000 scientists using public data sources like IMDB and Google Scholar. Then they looked for patterns. 

    After crunching the data, the economists came up with a formula for how to get on a hot streak at work, whether you’re a business titan or a film director. Derek Thompson, writing for the Atlantic, crystallized it in three simple words: “Explore, then exploit.”

    Before the hot streak that makes their names, great minds almost always spend a period of time bumbling around in the intellectual wilderness. They explore blind alleys and endure a series of failed experiments. They appear to produce little during this time. Only afterwards does the value of this period of wandering become clear. 

    “Neither exploration nor exploitation alone in isolation is associated with a hot streak. It’s the sequence of them together,” Wang commented. Great success usually follows a pattern of unfocused wandering followed by relentless execution. 

    Impatient? Remember Jeff Bezos’ words 

    Sound familiar? If this strikes you as pretty much identical to the formula for coming up with great ideas that Jeff Bezos described is Turin, then I wholeheartedly agree. The economists just backed it up with data. And Thompson did the world the favor of packaging it memorably 

    His three word formula should make the takeaway here easy to remember the next time you’re worried that your wandering is costing your valuable execution time. If you know exactly what you’re doing then it probably is. Time to buckle down. 

    But wandering is an essential part of the process of accomplishing great things. If you’re too proud or impatient to explore and experiment, chances are poor that you’ll settle on the right idea to work on. So remember Jeff Bezos and this three-word formula next time you’re tempted to beat yourself up for not making speedy enough progress. 

    Wandering is an essential ingredient for eventual excellence.  

    The opinions expressed here by Inc.com columnists are their own, not those of Inc.com.

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    Jessica Stillman

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  • ‘Breakthrough’ Study: Diabetes Drug Helps Prevent Long COVID

    ‘Breakthrough’ Study: Diabetes Drug Helps Prevent Long COVID

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    March 9, 2023 – Metformin appears to play a role in preventing long COVID when taken early during a COVID-19 infection, according to a new preprint study from The Lancet. The preprint hasn’t yet been peer-reviewed or published in a journal.

    In particular, metformin led to a 42% drop in long COVID among people who had a mild to moderate COVID-19 infection. 

    “Long COVID affects millions of people, and preventing long COVID through a treatment like metformin could prevent significant disruptions in people’s lives,” says lead author Carolyn Bramante, MD, an assistant professor of internal medicine and pediatrics at the University of Minnesota.

    Between January 2021 and February 2022, Bramante and colleagues tested three oral medications – metformin (typically used to treat type 2 diabetes), ivermectin (an antiparasitic), and fluvoxamine (an antidepressant) – in a clinical trial across the U.S. called COVID-OUT. The people being studied, investigators, care providers, and others involved in the study were blinded to the randomized treatments. The trial was decentralized, with no in-person contact with participants.

    The researchers included patients who were ages 30-85 with overweight or obesity, had documentation of a confirmed COVID-19 infection, had fewer than 7 days of symptoms, had no known prior infection, and joined the study within 3 days of their positive test. The study included monthly follow-up for 300 days, and participants indicated whether they received a long COVID diagnosis from a medical doctor, which the researchers confirmed in medical records after participants gave consent.

    The medications were pre-packaged into pill boxes for fast delivery to participants and to ensure they took the correct number of each type of pill. The packages were sent via same-day courier or overnight shipping.

    The metformin doses were doled out over 14 days: with 500 milligrams on the first day, 500 milligrams twice a day for the next 4 days, and then 500 milligrams in the morning and 1,000 milligrams in the evening for the remaining 9 days.

    Among the 1,323 people studied, 1,125 agreed to do long-term follow-up for long COVID, including 564 in the metformin group and 561 in the blinded placebo group. The average age was 45, and 56% were women, including 7% who were pregnant. 

    The average time from the start of symptoms to starting medication was 5 days, and 47% began taking the drug within 4 days or less. About 55% had received the primary COVID-19 vaccination series, including 5.1% who received an initial booster, before enrolling in the study.

    Overall, 8.4% of participants reported that a medical provider diagnosed them with long COVID. Of those who took metformin, 6.3% developed long COVID, compared to 10.6% among those who took the identical-matched placebo.

    The risk reduction for metformin was 42% versus the placebo, which was consistent across subgroups, including vaccination status and different COVID-19 variants.

    When metformin was started less than 4 days after COVID-19 symptoms started, the effect was potentially even greater, with a 64% reduction, as compared with a 36% reduction among those who started metformin after 4 or more days after symptoms.

    Neither ivermectin nor fluvoxamine showed any benefits for preventing long COVID.

    At the same time, the study authors caution that more research is needed. 

    “The COVID-OUT trial does not indicate whether or not metformin would be effective at preventing long COVID if started at the time of emergency department visit or hospitalization for COVID-19, nor whether metformin would be effective as treatment in persons who already have long COVID,” they wrote. “With the burden of long COVID on society, confirmation is urgently needed in a trial that addresses our study’s limitations in order to translate these results into practice and policy.”

    Several risk factors for long COVID emerged in the analysis. About 11.1% of the women had a long COVID diagnosis, as compared with 4.9% of the men. Also, those who had received at least the primary vaccine series had a lower risk of developing long COVID, at 6.6%, as compared with 10.5% among the unvaccinated. Only one of the 57 people who received a booster shot developed long COVID.

    Notably, pregnant and lactating people were included in this study, which is important given that pregnant people face higher risks for poor COVID-19 outcomes and are excluded from most non-obstetric clinical trials, the study authors wrote. In this study, they were randomized to metformin or placebo but not ivermectin or fluvoxamine due to limited research about the safety of those drugs during pregnancy and lactation.

    The results are now under journal review but show consistent findings from other recent studies. Also, in August 2022, the authors published results from COVID-OUT that showed metformin led to a 42% reduction in hospital visits, emergency department visits, and deaths related to severe COVID-19.

    “Given the lack of side effects and cost for a 2-week course, I think these data support use of metformin now,” says Eric Topol, MD, founder and director of the Scripps Research Translational Institute and editor-in-chief of Medscape, WebMD’s sister site for health care professionals. 

    Topol, who wasn’t involved with this study, has been a leading voice on COVID-19 research throughout the pandemic. He noted the need for more studies, including a factorial design trial to test metformin and Paxlovid, which has shown promise in preventing long COVID. Topol also wrote about the preprint in Ground Truths, his online newsletter.

    “As I’ve written in the past, I don’t use the term ‘breakthrough’ lightly,” he wrote. “But to see such a pronounced benefit in the current randomized trial of metformin, in the context of it being so safe and low cost, I’d give it a breakthrough categorization.”

    Another way to put it, Topol wrote, is that based on this study, he himself would take metformin if he became infected with COVID-19. 

    Jeremy Faust, MD, an emergency medicine doctor at Brigham and Women’s Hospital in Boston, also wrote about the study in his newsletter, Inside Medicine. He noted that the 42% reduction in long COVID means that 23 COVID-19 patients need to be treated with metformin to prevent one long COVID diagnosis, which is an “important reduction.”

    “Bottom line: If a person who meets criteria for obesity or overweight status were to ask me if they should take metformin (for 2 weeks) starting as soon as they learn they have COVID-19, I would say yes in many if not most cases, based on this new data,” he wrote. “This is starting to look like a real win.”

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