Summary Immediate skin-to-skin contact (SSC) between mothers and newborns and early initiation of breastfeeding (EIBF) may play a significant and underappreciated role in reducing neonatal mortality. These practices are distinct in important ways from more broadly recognized (and clearly impactful) interventions like kangaroo care and exclusive breastfeeding, and they are recommended for both preterm and full-term infants. A large evidence base indicates that immediate SSC and EIBF substantially reduce neonatal mortality. Many randomized trials show that immediate SSC promotes EIBF, reduces episodes of low blood sugar, improves temperature regulation, and promotes cardiac and respiratory stability. All of these effects are linked to lower mortality, and the biological pathways between immediate SSC, EIBF, and reduced mortality are compelling. A meta-analysis of large observational studies found a 25% lower risk of mortality in infants who began breastfeeding within one hour of birth compared to initiation after one hour. These practices are attractive targets for intervention, and promoting them is effective. Immediate SSC and EIBF require no commodities, are under the direct influence of birth attendants, are time-bound to the first hour after birth, are consistent with international guidelines, and are appropriate for universal promotion. Their adoption is often low, but ceilings are demonstrably high: many low-and middle-income countries (LMICs) have rates of EIBF less than 30%, yet several have rates over 70%. Multiple studies find that health worker training and quality improvement activities dramatically increase rates of immediate SSC and EIBF. There do not appear to be any major actors focused specifically on promotion of universal immediate SSC and EIBF. By contrast, general breastfeeding promotion and essential newborn care training programs are relatively common. More research on cost-effectiveness is needed, but it appears promising. Limited existing

Summary: The NAO will increase our sequencing significantly over the next few months, funded by a $3M grant from Open Philanthropy. This will allow us to scale our pilot early-warning system to where we could flag many engineered pathogens early enough to mitigate their worst impacts, and also generate large amounts of data to develop, tune, and evaluate our detection systems. One of the biological threats the NAO is most concerned with is a 'stealth' pathogen, such as a virus with the profile of a faster-spreading HIV. This could cause a devastating pandemic, and early detection would be critical to mitigate the worst impacts. If such a pathogen were to spread, however, we wouldn't be able to monitor it with traditional approaches because we wouldn't know what to look for. Instead, we have invested in metagenomic sequencing for pathogen-agnostic detection. This doesn't require deciding what sequences to look for up front: you sequence the nucleic acids (RNA and DNA) and analyze them computationally for signs of novel pathogens. We've primarily focused on wastewater because it has such broad population coverage: a city in a cup of sewage. On the other hand, wastewater is difficult because the fraction of nucleic acids that come from any given virus is very low,[1] and so you need quite deep sequencing to find something. Fortunately, sequencing has continued to come down in price, to under $1k per billion read pairs. This is an impressive reduction, 1/8 of what we estimated two years ago when we first attempted to model the cost-effectiveness of detection, and it makes methods that rely on very deep sequencing practical. Over the past year, in collaboration with our partners at the University of Missouri (MU) and the University of California, Irvine (UCI), we started to sequence in earnest: We believe this represents the majority of metagenomic wastewater sequencing produced in the world to date, and it's an incredibly rich dataset. It has allowed us to develop

Remember: There is no such thing as a pink elephant. Recently, I was made aware that my “infohazards small working group” Signal chat, an informal coordination venue where we have frank discussions about infohazards and why it will be bad if specific hazards were leaked to the press or public, accidentally was shared with a deceitful and discredited so-called “journalist,” Kelsey Piper. She is not the first person to have been accidentally sent sensitive material from our group chat, however she is the first to have threatened to go public about the leak. Needless to say, mistakes were made. We’re still trying to figure out the source of this compromise to our secure chat group, however we thought we should give the public a live update to get ahead of the story.  For some context the “infohazards small working group” is a casual discussion venue for the most important, sensitive, and confidential infohazards myself and other philanthropists, researchers, engineers, penetration testers, government employees, and bloggers have discovered over the course of our careers. It is inspired by taxonomies such as professor B******’s typology, and provides an applied lens that has proven helpful for researchers and practitioners the world over.  I am proud of my work in initiating the chat. However, we cannot deny that minor mistakes and setbacks may have been made over the course of attempting to make the infohazards widely accessible and useful to a broad community of people. In particular, the deceitful and discredited journalist may have encountered several new infohazards previously confidential and unleaked: * Mirror nematodes as a solution to mirror bacteria. "Mirror bacteria," synthetic organisms with mirror-image molecules, could pose a significant risk to human health and ecosystems by potentially evading immune defenses and causing untreatable infections. Our scientists have explored engineering mirror nematodes, a natural predator for mirror bacteria, to