Quebecs Couillard Plans Health-Care Cuts to Trim Deficit

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Quebec expects to save C$220 million ($199 million) by eliminating hundreds of administrative jobs in health care to help balance the budget next year, Premier Philippe Couillard said.

We have a very complex health-care system, Couillard, 57, said yesterday in an interview at Bloomberg headquarters in New York. Theres a vast reform thats going to be announced this week of doing away with most of the bureaucracy in the system, freeing money to be dedicated to the patients.

Couillard, a neurosurgeon and former health minister, was elected in April as leader of Canadas second most-populous province after promising to shrink the bureaucracy. He has vowed to plug a C$2.35 billion budget gap in 2015-16 with the help of measures such as spending cuts and a hiring freeze.

Health care is Quebecs largest expenditure, accounting for about C$37.3 billion, or 43 percent, of the governments program spending of C$86.6 billion this fiscal year.

Quebecs health-care spending climbed by an average of 5.6 percent a year in the decade ended in March, budget figures show. With demographic projections showing that the provinces working-age population will start declining in 2017, investors such as Hosen Marjaee of Manulife Asset Management warn that costs could climb even faster.

Since his election, Couillard created two committees to overhaul government programs and the provinces taxation system. He gave the program review committee a mandate to find more than C$3 billion in savings.

Quebec has long-term demographic issues, Marjaee, who manages about C$19 billion and owns Quebec bonds, said in a telephone interview from Toronto. So far, it appears that the government of Mr. Couillard will take the necessary steps to curb the deficit.

The health-care reform will likely entail the elimination of regional bodies that oversee hospitals, the premier said.

Were removing a layer of administration, Couillard said. We have a ministerial layer, a regional layer and a local layer. Were essentially going to do away with the regional layer.

Cutting costs is difficult, Douglas Offerman, a senior director at Fitch Ratings in New York, said in a telephone interview. There are services that people depend on, and its always challenging. Its the turn of the expense side of the budget to provide some savings now.

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These 3 hot health-care stocks look strong: Pro

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"So, large-cap biotechs have done well this year," he said. "We went back and actually analyzed what's driven that outperformance. Interestingly, the majority of the outperformance has been driven by new-product introductions and earnings upside because of leverage down to P&L.

"The multiple has actually contracted, which I think is kind of counterintuitive to what the public believes."

Read More3 top biotech stocks with big upside: Pro

Over the next year or two, the large-cap biotech sector is likely to see "robust data flow, new clinical data announcements, continued momentum in terms of the blockbuster product launches and the P&L leverage to drive earnings," Chai added.

"And in a way, we can envision a scenario where now sentiment, which we define as sort of the multiple, can catch up to fundamentals."

Chai said that his top three health-care stock picks are: Medtronic, which should do well regardless of how its proposed tax-inversion deal with Covidien turns out; pharmaceutical company Sanofi, and Tornier, a medical-device manufacturer that should benefit from a variety of factors, including recent restructuring and potential consolidation.

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These 3 hot health-care stocks look strong: Pro

TOO HOT? Feverish Health Care Investment By REITs Poses Risks for Investors

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Analysts Worry 'Frothy' Market for Health Care Real Estate May Erode Yields, Leave Some Buyers With Bad Case of Debt

Some analysts, however, are concerned that certain investors may end up in traction. While the most recent acquisitions highlight the segment's continued rapid growth, Fitch Ratings recently issued a report raising questions about the risk that a growing pool of buyers from all end of the investment spectrum may end up overpaying for properties, pursue higher-yield, higher-risk assets, or go into debt to maintain the frenzied growth pace that investors have come to expect from the sector.

To date, publicly traded health care REITs, the largest suppliers of investment capital, have funded their growth conservatively and without significant leverage, benefiting from opportunistic equity raises at substantial premiums to net asset value (NAV), Fitch said. But the rating agency warned that growth expectations for this sector may be difficult to maintain.

"We believe the premiums reflect shareholders' expectations of continued growth, and continuing to satisfy these expectations may prove challenging," according to research headed by Fitch Director Britton O. Costa.

While publicly traded REITs remain the largest suppliers of health-care property capital, private buyers such as non-traded REITs are also jumping into the game, aggressively buying properties and keeping capitalization rates low and prices high, said PJ Camp, principal with Hammond Hanlon Camp LLC, a health care-focused independent investment banking and advisory firm.

"Clearly there are more players in the market than ever before. It's hard to find anyone who doesn't want to be in the space," Camp said during a presentation on MOB mergers and acquisition activity this week by Levin & Associates.

Medical office buildings, assisted-living facilities and other health care real estate were ranked as the most attractive property investment this year and over the next 12 months, for the first time surpassing multifamily and industrial assets, according to DLA Piper's 2014 State of the Market Survey released earlier this month.

However, despite their favored status, health-care properties are still not producing yields as high as some other asset classes, DLA Piper noted. The firm cited research from Green Street Advisors that the average cap rate on health care properties was about 6.8% in July -- down from about 7.2% a year earlier but still nearly two percentage points higher than average yields on office or apartment buildings.

Meanwhile, investors continue to raise cash and pour money into the health-care space, with the REIT sector being particularly active, including property acquisitions, M&A deals and initial public offerings.

Health Care REIT, Inc. (NYSE:HCN) announced recently that it anticipates acquiring about $1.7 billion of properties in the second half of 2014, including the previously announced deals to acquire HealthLease Properties REIT for $950 million, the $257 million transaction with Sunrise Senior Living to buy Gracewell Healthcare. HCN expects to invest $535 million in new deals expected to consummate before the end of the year.

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TOO HOT? Feverish Health Care Investment By REITs Poses Risks for Investors

Study Explores Drug Users' Opinions on Genetic Testing

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Newswise Genomic medicine is rapidly developing, bringing with its advances promises of individualized genetic information to tailor and optimize prevention and treatment interventions. Genetic tests are already guiding treatments of the human immunodeficiency virus (HIV) and hepatitis c virus (HPC), and emerging research is showing genetic variants may be used to screen for an individuals susceptibility to addiction to a substance, and even inform treatments for addiction.

While there appear to be many benefits inherent in the development of this field and related research, there is a lack of data on the attitudes of marginalized populations towards genetic testing. A new study by researchers affiliated with New York University's Center for Drug Use and HIV Research (CDUHR) is the first to present the perceptions of genetic testing among drug users.

Published in the International Journal of Drug Policy, the study, Perceptions of genetic testing and genomic medicine among drug users, gauged drug users attitudes and understandings of genetics and genetic testing through six focus groups. The focus groups were segregated by race and ethnicity to increase participants comfort in talking about racial and ethnic issues. Over half of the participants (53%) reported having either HIV/AIDs or HCV, or a co-infection, and understood the potential value of genetic testing.

The researchers found that the participants had concerns regarding breaches in confidentiality and discrimination which might have reduced their inclination to undergo testing. Participants mistrust stemmed from concerns of lack of full disclosure of the tests purpose, or that once submitting to the test, their samples may be used for unspecified purposes. Participants were also uncomfortable with race/ethnicity-based genetic testing, and had concerns that a genetic test may adversely affect a drug user by aiding law enforcement.

Most participants were uncomfortable with engaging in genetic testing for either addiction-related care or for research to understand addiction, because most did not consider addiction to be a genetic disorder, said David Perlman, M.D., Professor of Medicine at Mount Sinai Beth Israels Icahn School of Medicine and director of Infectious Diseases and Biomedical Core at CDUHR. All participants were more comfortable understanding genetics as explaining physical traits rather than behavior. They viewed addiction as a behavior resulting from environment and experiences rather than genetic inheritance.

However, despite these concerns, many participants indicated they would feel more positive towards genetic testing were they to believe it could improve their medical care. Additionally, participants indicated they would be more trusting of the test were it to be administered by their primary physicians, rather than drug treatment programs. The results of this study may inform further research and how programs and providers might best approach drug users, and potentially other marginalized populations, for genetic testing when appropriate.

Study Authors: David C. Perlman, Camila Gelp-Acosta, Samuel R. Friedman, Ashly E. Jordan, Holly Hagan. Correspondence: David C. Perlman, Mount Sinai Beth Israel Health System, New York, NY, USA. (E-mail: dperlman@chpnet.org)

Acknowledgements: This work was supported by the National Institutes of Health grant P30 DA 011041. We gratefully acknowledge the assistance of the participating recruitment sites and all of the participants. Note: The findings and conclusions in the article are those of the authors and do not necessarily represent the views of the National Institute on Drug Abuse or the National Institute of Health.

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Study Explores Drug Users' Opinions on Genetic Testing

NYU-Mount Sinai Beth Israel study explores drug users' opinions on genetic testing

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PUBLIC RELEASE DATE:

23-Sep-2014

Contact: Christopher James christopher.james@nyu.edu 212-998-6876 New York University @nyuniversity

Genomic medicine is rapidly developing, bringing with its advances promises of individualized genetic information to tailor and optimize prevention and treatment interventions. Genetic tests are already guiding treatments of the human immunodeficiency virus (HIV) and hepatitis c virus (HPC), and emerging research is showing genetic variants may be used to screen for an individual's susceptibility to addiction to a substance, and even inform treatments for addiction.

While there appear to be many benefits inherent in the development of this field and related research, there is a lack of data on the attitudes of marginalized populations towards genetic testing. A new study by researchers affiliated with New York University's Center for Drug Use and HIV Research (CDUHR) is the first to present the perceptions of genetic testing among drug users.

Published in the International Journal of Drug Policy, the study, "Perceptions of genetic testing and genomic medicine among drug users," gauged drug users' attitudes and understandings of genetics and genetic testing through six focus groups. The focus groups were segregated by race and ethnicity to increase participants' comfort in talking about racial and ethnic issues. Over half of the participants (53%) reported having either HIV/AIDs or HCV, or a co-infection, and understood the potential value of genetic testing.

The researchers found that the participants had concerns regarding breaches in confidentiality and discrimination which might have reduced their inclination to undergo testing. Participants' mistrust stemmed from concerns of lack of full disclosure of the test's purpose, or that once submitting to the test, their samples may be used for unspecified purposes. Participants were also uncomfortable with race/ethnicity-based genetic testing, and had concerns that a genetic test may adversely affect a drug user by aiding law enforcement.

"Most participants were uncomfortable with engaging in genetic testing for either addiction-related care or for research to understand addiction, because most did not consider addiction to be a genetic disorder," said David Perlman, M.D., Professor of Medicine at Mount Sinai Beth Israel's Icahn School of Medicine and director of Infectious Diseases and Biomedical Core at CDUHR. "All participants were more comfortable understanding genetics as explaining physical traits rather than behavior. They viewed addiction as a behavior resulting from environment and experiences rather than genetic inheritance."

However, despite these concerns, many participants indicated they would feel more positive towards genetic testing were they to believe it could improve their medical care. Additionally, participants indicated they would be more trusting of the test were it to be administered by their primary physicians, rather than drug treatment programs. The results of this study may inform further research and how programs and providers might best approach drug users, and potentially other marginalized populations, for genetic testing when appropriate.

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NYU-Mount Sinai Beth Israel study explores drug users' opinions on genetic testing

Dr. David Goldstein to Direct Columbia's Institute for Genomic Medicine as Key Part of University-Wide Initiative

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Newswise NEW YORK (September 23, 2014) David Goldstein, PhD, will join Columbia University as professor of genetics and development in the College of Physicians and Surgeons and director of a new Institute for Genomic Medicine in partnership with NewYork-Presbyterian, effective January 1, 2015. Dr. Goldstein will be responsible for building a program that comprehensively integrates genetics and genomics into research, patient care, and education at Columbia University Medical Center (CUMC) and NewYork-Presbyterian and that develops programs to prepare students for careers in the expanding field of genomic and personalized medicine.

Dr. Goldsteins role includes serving as an adviser to Columbia University President Lee C. Bollinger and Executive Vice President for Health and Biomedical Sciences Lee Goldman, MD, on the genetic and genomic components of Columbias university-wide initiative in precision or personalized medicine, which was announced in February.

Having a pioneering researcher like David Goldstein join us marks a crucial next step in our initiative to be at the forefront of genomics, data science, and the core science and engineering disciplines essential to this emerging field of truly humanistic medicine, said President Bollinger. The potential for progress in this broad subject encompasses not only new cures for disease, but also virtually every part of the University, including areas that explore fundamental issues of human self-understanding, as well as the legal, policy, and economic implications of revolutionary changes in knowledge and practice.

Dr. Goldsteins research has focused on identifying the relationship between human genetic variations and diseases such as epilepsy, hepatitis C, and schizophrenia, as well as the response of these diseases to pharmacologic treatments. In addition to his leadership of the Institute for Genomic Medicine at CUMC, he will have a faculty appointment at the New York Genome Center, as well as one in neurology at Columbias College of Physicians and Surgeons.

David Goldstein has shown himself to be both an innovative scientist and a visionary leader in genetic, genomic, and personalized medicine, said Dr. Goldman, who is also the Harold and Margaret Hatch Professor of the University and dean of the Faculties of Health Sciences and Medicine at CUMC. Working with our partners across Columbia and at New York-Presbyterian, Dr. Goldstein will help us establish a fully integrated genetics and genomics research environment to maximize the scientific possibilities and apply them to the frontiers of patient care and public health.

Personalized medicine and targeted therapies represent the future of patient-centered health care, said Steven J. Corwin, MD, CEO, NewYork-Presbyterian. Dr. Goldsteins expertise in genetics will help us not only to tailor individualized treatments for patients, but also to identify diseases before they develop. His work will have a transformative impact on patient care at NewYork-Presbyterian.

Dr. Goldstein comes to Columbia from Duke University, where he has been director of the Center for Human Genome Variation and the Richard and Pat Johnson Distinguished University Professor, with appointments in the departments of molecular genetics & microbiology and biology. He joined Duke in 2005 after six years at University College London, which named him Honorary Professor in 2007. He received his PhD in biological sciences from Stanford University in 1994.

The vision of Columbia University and NYP to create a truly integrated environment for research, clinical application, and student instruction is exactly the right vision, said Dr. Goldstein. Human genomics is creating breathtaking new opportunities to better understand the biology of disease and to provide more effective and more accurately targeted therapies. Capitalizing on these opportunities and ensuring that clinical applications adhere to the highest possible scientific standards requires close collaborations among researchers, the clinical community, and patients and their families. I am thrilled to be joining Columbia University at this pivotal time in my field, and I am honored to participate in Columbias university-wide initiative in precision medicine.

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Dr. David Goldstein to Direct Columbia's Institute for Genomic Medicine as Key Part of University-Wide Initiative

Stanford scientists use stem cells to learn how common mutation in Asians affects heart health

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PUBLIC RELEASE DATE:

24-Sep-2014

Contact: Krista Conger kristac@stanford.edu 650-725-5371 Stanford University Medical Center @sumedicine

Over 500 million people worldwide carry a genetic mutation that disables a common metabolic protein called ALDH2. The mutation, which predominantly occurs in people of East Asian descent, leads to an increased risk of heart disease and poorer outcomes after a heart attack. It also causes facial flushing when carriers drink alcohol.

Now researchers at the Stanford University School of Medicine have learned for the first time specifically how the mutation affects heart health. They did so by comparing heart muscle cells made from induced pluripotent stem cells, or iPS cells, from people with the mutation versus those without the mutation. IPS cells are created in the laboratory from specialized adult cells like skin. They are "pluripotent," meaning they can be coaxed to become any cell in the body.

"This study is one of the first to show that we can use iPS cells to study ethnic-specific differences among populations," said Joseph Wu, MD, PhD, director of the Stanford Cardiovascular Institute and professor of cardiovascular medicine and of radiology.

"These findings may help us discover new therapeutic paths for heart disease for carriers of this mutation," said Wu. "In the future, I believe we will have banks of iPS cells generated from many different ethnic groups. Drug companies or clinicians can then compare how members of different ethnic groups respond to drugs or diseases, or study how one group might differ from another, or tailor specific drugs to fit particular groups."

The findings are described in a paper that will be published Sept. 24 in Science Translational Medicine. Wu and Daria Mochly-Rosen, PhD, professor of chemical and systems biology, are co-senior authors of the paper, and postdoctoral scholar Antje Ebert, PhD, is the lead author.

ALDH2 and cell death

The study showed that the ALDH2 mutation affects heart health by controlling the survival decisions cells make during times of stress. It is the first time ALDH2, which is involved in many common metabolic processes in cells of all types, has been shown to play a role in cell survival. In particular, ALDH2 activity, or the lack of it, influences whether a cell enters a state of programmed cell death called apoptosis in response to stressful growing conditions.

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Stanford scientists use stem cells to learn how common mutation in Asians affects heart health

If Synthetic Biology Lets Us Play God, We Need Rules

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TIME Ideas Science If Synthetic Biology Lets Us Play God, We Need Rules MOLEKUULBrand X/Getty Images

Zocalo Public Square is a not-for-profit Ideas Exchange that blends live events and humanities journalism.

Synthetic biology has been called genetic engineering on steroids. Its also been described as so difficult to pin down that five scientists would give you six different definitions. No matter how this emerging field is characterized, one thing is clear: the ability to synthesize and sequence DNA is driving scientific research in brand-new and exciting directions.

In California, scientists have created a breakthrough antimalarial drugbakers yeast made in a lab that contains the genetic material of the opium poppy. The drug has the potential to save millions of livesand to ensure drug production that independent of poppy flowers. At MIT, researchers are working on a way for plants to fix their own nitrogen, so farmers will no longer need to use artificial fertilizers. And, in the far future, scientists and NASA researchers are looking to create a digital biological teleporter to bring to Earth life forms detected on Mars via a sort of biological fax.

What should we worrying about in this moment of tremendous, and potentially cataclysmic, scientific discovery? In advance of the Zcalo/Arizona State University event How Will Synthetic Biology Change the Way We Live?, we asked experts the following question: Soon well be able to program DNA with the same ease we program computers. What new responsibilities will be imposed on us?

1) Stepping ahead of technology to imagine the world we want to live in

Synthetic biology sees life as an engineering project a repertoire of processes that can be reprogrammed to produce technologies and products. It envisions powerful new tools for constructing biological parts. Many in synthetic biology celebrate technologies like automated DNA synthesis as agents of democratization, potentially allowing easy and widespread access to custom-made DNA. According to their vision, these technologies will enable bioengineers to freely experiment with living systems, accelerating progress in innovation and producing enormous benefits for society.

But there are risks. The question is often raised: How can we prevent these technologies from falling into the wrong hands? DNA synthesis machines cannot distinguish between tinkerers and terrorists. Though this question is crucially important, it is revealing for what it leaves unasked. Why are synthetic biologys tinkerers presumed to be the safe hands for shaping the technological future? Why do we defer to their visions and judgments over those that we collectively develop?

We tend to focus governance not on projects of innovation, but on how resulting technologies might be used in society. By attending primarily to technologys misuses, impacts, and consequences, we confine ourselves to waiting until new problemsand responsibilitiesare imposed upon us. Science is empowered to act, but society only to react. This leaves unexamined the question of who gets to imagine the future and, therefore, who has the authority to declare what benefits lie ahead, what risks are realistic, and what worries are reasonable and warrant public deliberation?

Our imaginations of the future shape our priorities in the present. It is a task of democracy, not science, to imagine the world we want to live in. Genuine democratization demands that we embrace this difficult task as our own, rather than wait to react to the responsibilities that emerging technologies impose upon us.

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If Synthetic Biology Lets Us Play God, We Need Rules

Opportunities to reduce patient burden associated with breast cancer screening

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PUBLIC RELEASE DATE:

23-Sep-2014

Contact: Kathryn Ryan kryan@liebertpub.com 914-740-2100 Mary Ann Liebert, Inc./Genetic Engineering News @LiebertOnline

New Rochelle, NY, September 23, 2014New technology and better screening strategies can lower the rate of false-positive results, which impose a substantial financial and psychological burden on women. The many misperceptions about breast cancer screening options and risks, the benefits and costs of screening, and the need for new approaches and better education are discussed in a series of articles in a supplement to Journal of Women's Health, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The supplement is available free on the Journal of Women's Health website at http://online.liebertpub.com/toc/jwh/23/S1.

In the article "The Patient Burden of Screening Mammography Recall," the authors report that among more than 1.7 million women aged 40-75 years who underwent screening mammography and were not diagnosed with breast cancer, 15% were recalled for further testing. The cumulative risk of a false-positive result after 10 years of annual screening mammograms is an estimated 61%. Coauthors Matthew Alcusky, PharmD, MS, Janice Clarke, RN, BBA, and Alexandria Skoufalos, EdD, Jefferson School of Population Health; Liane Philpotts, MD, FSBI, Yale University School of Medicine; and Machaon Bonafede, PhD, MPH, Truven Health Analytics, evaluate the direct cost burden of recall, the indirect costs associated with missed work time, travel, and substitute caregivers, for example, and the physical or psychological effects of a false-positive result, which may include unnecessary anxiety and reduced quality of life.

In an accompanying review article on "Understanding Patient Options, Utilization Patterns and Burdens Associated with Breast Cancer Screening," authors Susan C. Harvey, MD, Johns Hopkins Medical Institutions; Sharon Mass, MD, FACOG, Morristown Obstetrics and Gynecology Associates; and Ashok Vegesna, PharmD, Janice Clarke, RN, BBA, and Alexandria Skoufalos, EdD, Jefferson School of Population Health, attribute much of the confusion women face in making informed decisions about breast cancer screening and recall options to a lack of consensus among the organizations developing screening guidelines and the mixed messages they deliver. The authors call for a more thoughtful approach to breast cancer screening and research that takes into account the tangible and intangible costs that women now bear.

"The articles in this supplement are timely and reveal surprisingly complex issues," says Susan C. Harvey, MD, in her Editorial, "The Charge and the Challenges of Breast Cancer Screening." Collectively, the articles "illustrate the need for a more tailored approach to breast cancer awareness, education, and screening. The goal is to make appropriate screening and diagnosis easier on women and more responsive to the changing face of value-based health care."

"The direct and indirect cost burden of inconclusive mammography screenings and recalls is significant and indicates a need for new approaches to breast cancer screening," says Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women's Health, Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA, and President of the Academy of Women's Health.

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The supplement was funded by an educational grant from Hologic, Inc.

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Opportunities to reduce patient burden associated with breast cancer screening

EmTech: Risks of Gene-Editing Drugs Need Study, Pioneer Says

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One of the inventors of gene editing says scientists should proceed cautiously before testing it in people.

Feng Zhang

Citing the risk of deadly mistakes, a leading researcher speaking at MIT Technology ReviewsEmTech conferenceon Tuesday said the risks of gene editing need to be better understood before the technology can be used in medical studies.

Feng Zhang, a researcher at MIT, helped invent a powerful new way to alter DNA that he compared in his talk to a search-and-replace function for the genome.

Several startups have already sprung up to turn the technology into new kinds of gene-therapy drugs, including CRISPR Therapeutics and Editas Medicine, a biotechnology company that Zhang cofounded last year with venture capitalists who invested $43 million.

These companies hope to correct diseases, like cystic fibrosis, caused by faulty DNA. In other cases, Zhang said, changing a persons DNA could provide a protective effectfor instance, conferring immunity to HIV.

The concept is very powerful, but to make any correction in the body is very challenging, he said.

Looming over researchers is the 1999 death of Jesse Gelsinger, a volunteer in an early gene therapy study in Pennsylvania. That failure dealt a huge setback to genetic drugs. Later it was shown that such treatments, even when they work, could sometimes cause cancer by making unwanted changes to a persons genome.

One of the early lessons from gene therapy is to go slowly, said Zhang. The lesson is that we need to understand a system carefully before putting it into a person.

Gradually, however, gene therapy has staged a comeback. In 2012, a treatment called Glybera was the first to be approved in Europe. Its not yet for sale in the U.S., but numerous gene treatments are being tested in patients.

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EmTech: Risks of Gene-Editing Drugs Need Study, Pioneer Says

Pain and love: how companies – and people – change (Futurist Speaker Gerd Leonhard) – Video

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Pain and love: how companies - and people - change (Futurist Speaker Gerd Leonhard)
This is a short excerpt from my opening keynote at CA Expo in Sydney Australia, August 27, 2014, on the future of business, technology and the app economy, s...

By: Gerd Leonhard

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Pain and love: how companies - and people - change (Futurist Speaker Gerd Leonhard) - Video

Living in a VUCA world: volatility, uncertainty, complexity, ambiguity (Futurist Gerd Leonhard) – Video

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Living in a VUCA world: volatility, uncertainty, complexity, ambiguity (Futurist Gerd Leonhard)
This is a short excerpt from my opening keynote at CA Expo in Sydney Australia, August 27, 2014, on the future of business, technology and the app economy, s...

By: Gerd Leonhard

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Living in a VUCA world: volatility, uncertainty, complexity, ambiguity (Futurist Gerd Leonhard) - Video