Image by Andrew BrodheadResearchers have developed a novel device that literally spins away the clots that block blood flow to the brain and cause strokes.As Stanford explains in a blurb, the novel milli-spinner device may be able to save the lives of patients who experience "ischemic stroke" from brain stem clotting.Traditional clot removal, a process known as thrombectomy, generally uses a catheter that either vacuums up the blood blockage or uses a wire mesh to ensnare it — a procedure that's as rough and imprecise as it sounds. Conventional thrombectomy has a very low efficacy rate because of this imprecision, and the procedure can result in pieces of the clot breaking off and moving to more difficult-to-reach regions.Thrombectomy via milli-spinner also enters the brain with a catheter, but instead of using a normal vacuum device, it employs a spinning tube outfitted with fins and slits that can suck up the clot much more meticulously.Stanford neuroimaging expert Jeremy Heit, who also coauthored a new paper about the device in the journal Nature, explained in the school's press release that the efficacy of the milli-spinner is "unbelievable.""For most cases, we’re more than doubling the efficacy of current technology, and for the toughest clots — which we’re only removing about 11 percent of the time with current devices — we’re getting the artery open on the first try 90 percent of the time," Heit said. "This is a sea-change technology that will drastically improve our ability to help people."Renee Zhao, the senior author of the Nature paper who teaches mechanical engineering at Stanford and creates what she calls "millirobots," said that conventional thrombectomies just aren't cutting it."With existing technology, there’s no way to reduce the size of the clot," Zhao said. "They rely on deforming and rupturing the clot to remove it.""What’s unique about the milli-spinner is that it applies compression and shear forces to shrink the entire clot," she continued, "dramatically reducing the volume without causing rupture."Indeed, as the team discovered, the device can cut and vacuum up to five percent of its original size."It works so well, for a wide range of clot compositions and sizes," Zhao said. "Even for tough... clots, which are impossible to treat with current technologies, our milli-spinner can treat them using this simple yet powerful mechanics concept to densify the fibrin network and shrink the clot."Though its main experimental use case is brain clot removal, Zhao is excited about its other uses, too."We’re exploring other biomedical applications for the milli-spinner design, and even possibilities beyond medicine," the engineer said. "There are some very exciting opportunities ahead."More on brains: The Microplastics in Your Brain May Be Causing Mental Health IssuesShare This Article

Transcript [MUSIC]      [BOOK PASSAGE]   PETER LEE: “In ‘The Little Black Bag,’ a classic science fiction story, a high-tech doctor’s kit of the future is accidentally transported back to the 1950s, into the shaky hands of a washed-up, alcoholic doctor. The ultimate medical tool, it redeems the doctor wielding it, allowing him to practice gratifyingly heroic medicine. … The tale ends badly for the doctor and his treacherous assistant, but it offered a picture of how advanced technology could transform medicine—powerful when it was written nearly 75 years ago and still so today. What would be the Al equivalent of that little black bag? At this moment when new capabilities are emerging, how do we imagine them into medicine?”   [END OF BOOK PASSAGE]     [THEME MUSIC]     This is The AI Revolution in Medicine, Revisited. I’m your host, Peter Lee.    Shortly after OpenAI’s GPT-4 was publicly released, Carey Goldberg, Dr. Zak Kohane, and I published The AI Revolution in Medicine to help educate the world of healthcare and medical research about the transformative impact this new generative AI technology could have. But because we wrote the book when GPT-4 was still a secret, we had to speculate. Now, two years later, what did we get right, and what did we get wrong?     In this series, we’ll talk to clinicians, patients, hospital administrators, and others to understand the reality of AI in the field and where we go from here.   [THEME MUSIC FADES] The book passage I read at the top is from “Chapter 10: The Big Black Bag.”  In imagining AI in medicine, Carey, Zak, and I included in our book two fictional accounts. In the first, a medical resident consults GPT-4 on her personal phone as the patient in front of her crashes. Within seconds, it offers an alternate response based on recent literature. In the second account, a 90-year-old woman with several chronic conditions is living independently and receiving near-constant medical support from an AI aide.    In our conversations with the guests we’ve spoken to so far, we’ve caught a glimpse of these predicted futures, seeing how clinicians and patients are actually using AI today and how developers are leveraging the technology in the healthcare products and services they’re creating. In fact, that first fictional account isn’t so fictional after all, as most of the doctors in the real world actually appear to be using AI at least occasionally—and sometimes much more than occasionally—to help in their daily clinical work. And as for the second fictional account, which is more of a science fiction account, it seems we are indeed on the verge of a new way of delivering and receiving healthcare, though the future is still very much open.  As we continue to examine the current state of AI in healthcare and its potential to transform the field, I’m pleased to welcome Bill Gates and Sébastien Bubeck.   Bill may be best known as the co-founder of Microsoft, having created the company with his childhood friend Paul Allen in 1975. He’s now the founder of Breakthrough Energy, which aims to advance clean energy innovation, and TerraPower, a company developing groundbreaking nuclear energy and science technologies. He also chairs the world’s largest philanthropic organization, the Gates Foundation, and focuses on solving a variety of health challenges around the globe and here at home.  Sébastien is a research lead at OpenAI. He was previously a distinguished scientist, vice president of AI, and a colleague of mine here at Microsoft, where his work included spearheading the development of the family of small language models known as Phi. While at Microsoft, he also coauthored the discussion-provoking 2023 paper “Sparks of Artificial General Intelligence,” which presented the results of early experiments with GPT-4 conducted by a small team from Microsoft Research.    [TRANSITION MUSIC]   Here’s my conversation with Bill Gates and Sébastien Bubeck.  LEE: Bill, welcome.  BILL GATES: Thank you.  LEE: Seb …  SÉBASTIEN BUBECK: Yeah. Hi, hi, Peter. Nice to be here.  LEE: You know, one of the things that I’ve been doing just to get the conversation warmed up is to talk about origin stories, and what I mean about origin stories is, you know, what was the first contact that you had with large language models or the concept of generative AI that convinced you or made you think that something really important was happening?  And so, Bill, I think I’ve heard the story about, you know, the time when the OpenAI folks—Sam Altman, Greg Brockman, and others—showed you something, but could we hear from you what those early encounters were like and what was going through your mind?   GATES: Well, I’d been visiting OpenAI soon after it was created to see things like GPT-2 and to see the little arm they had that was trying to match human manipulation and, you know, looking at their games like Dota that they were trying to get as good as human play. And honestly, I didn’t think the language model stuff they were doing, even when they got to GPT-3, would show the ability to learn, you know, in the same sense that a human reads a biology book and is able to take that knowledge and access it not only to pass a test but also to create new medicines.  And so my challenge to them was that if their LLM could get a five on the advanced placement biology test, then I would say, OK, it took biologic knowledge and encoded it in an accessible way and that I didn’t expect them to do that very quickly but it would be profound.   And it was only about six months after I challenged them to do that, that an early version of GPT-4 they brought up to a dinner at my house, and in fact, it answered most of the questions that night very well. The one it got totally wrong, we were … because it was so good, we kept thinking, Oh, we must be wrong. It turned out it was a math weakness [LAUGHTER] that, you know, we later understood that that was an area of, weirdly, of incredible weakness of those early models. But, you know, that was when I realized, OK, the age of cheap intelligence was at its beginning.  LEE: Yeah. So I guess it seems like you had something similar to me in that my first encounters, I actually harbored some skepticism. Is it fair to say you were skeptical before that?  GATES: Well, the idea that we’ve figured out how to encode and access knowledge in this very deep sense without even understanding the nature of the encoding, …  LEE: Right.   GATES: … that is a bit weird.   LEE: Yeah.  GATES: We have an algorithm that creates the computation, but even say, OK, where is the president’s birthday stored in there? Where is this fact stored in there? The fact that even now when we’re playing around, getting a little bit more sense of it, it’s opaque to us what the semantic encoding is, it’s, kind of, amazing to me. I thought the invention of knowledge storage would be an explicit way of encoding knowledge, not an implicit statistical training.  LEE: Yeah, yeah. All right. So, Seb, you know, on this same topic, you know, I got—as we say at Microsoft—I got pulled into the tent. [LAUGHS]  BUBECK: Yes.   LEE: Because this was a very secret project. And then, um, I had the opportunity to select a small number of researchers in MSR [Microsoft Research] to join and start investigating this thing seriously. And the first person I pulled in was you.  BUBECK: Yeah.  LEE: And so what were your first encounters? Because I actually don’t remember what happened then.  BUBECK: Oh, I remember it very well. [LAUGHS] My first encounter with GPT-4 was in a meeting with the two of you, actually. But my kind of first contact, the first moment where I realized that something was happening with generative AI, was before that. And I agree with Bill that I also wasn’t too impressed by GPT-3.  I though that it was kind of, you know, very naturally mimicking the web, sort of parroting what was written there in a nice way. Still in a way which seemed very impressive. But it wasn’t really intelligent in any way. But shortly after GPT-3, there was a model before GPT-4 that really shocked me, and this was the first image generation model, DALL-E 1.  So that was in 2021. And I will forever remember the press release of OpenAI where they had this prompt of an avocado chair and then you had this image of the avocado chair. [LAUGHTER] And what really shocked me is that clearly the model kind of “understood” what is a chair, what is an avocado, and was able to merge those concepts.  So this was really, to me, the first moment where I saw some understanding in those models.   LEE: So this was, just to get the timing right, that was before I pulled you into the tent.  BUBECK: That was before. That was like a year before.  LEE: Right.   BUBECK: And now I will tell you how, you know, we went from that moment to the meeting with the two of you and GPT-4.  So once I saw this kind of understanding, I thought, OK, fine. It understands concept, but it’s still not able to reason. It cannot—as, you know, Bill was saying—it cannot learn from your document. It cannot reason.   So I set out to try to prove that. You know, this is what I was in the business of at the time, trying to prove things in mathematics. So I was trying to prove that basically autoregressive transformers could never reason. So I was trying to prove this. And after a year of work, I had something reasonable to show. And so I had the meeting with the two of you, and I had this example where I wanted to say, there is no way that an LLM is going to be able to do x.  And then as soon as I … I don’t know if you remember, Bill. But as soon as I said that, you said, oh, but wait a second. I had, you know, the OpenAI crew at my house recently, and they showed me a new model. Why don’t we ask this new model this question?   LEE: Yeah. BUBECK: And we did, and it solved it on the spot. And that really, honestly, just changed my life. Like, you know, I had been working for a year trying to say that this was impossible. And just right there, it was shown to be possible.   LEE: [LAUGHS] One of the very first things I got interested in—because I was really thinking a lot about healthcare—was healthcare and medicine.  And I don’t know if the two of you remember, but I ended up doing a lot of tests. I ran through, you know, step one and step two of the US Medical Licensing Exam. Did a whole bunch of other things. I wrote this big report. It was, you know, I can’t remember … a couple hundred pages.   And I needed to share this with someone. I didn’t … there weren’t too many people I could share it with. So I sent, I think, a copy to you, Bill. Sent a copy to you, Seb.   I hardly slept for about a week putting that report together. And, yeah, and I kept working on it. But I was far from alone. I think everyone who was in the tent, so to speak, in those early days was going through something pretty similar. All right. So I think … of course, a lot of what I put in the report also ended up being examples that made it into the book.  But the main purpose of this conversation isn’t to reminisce about [LAUGHS] or indulge in those reminiscences but to talk about what’s happening in healthcare and medicine. And, you know, as I said, we wrote this book. We did it very, very quickly. Seb, you helped. Bill, you know, you provided a review and some endorsements.  But, you know, honestly, we didn’t know what we were talking about because no one had access to this thing. And so we just made a bunch of guesses. So really, the whole thing I wanted to probe with the two of you is, now with two years of experience out in the world, what, you know, what do we think is happening today?  You know, is AI actually having an impact, positive or negative, on healthcare and medicine? And what do we now think is going to happen in the next two years, five years, or 10 years? And so I realize it’s a little bit too abstract to just ask it that way. So let me just try to narrow the discussion and guide us a little bit.   Um, the kind of administrative and clerical work, paperwork, around healthcare—and we made a lot of guesses about that—that appears to be going well, but, you know, Bill, I know we’ve discussed that sometimes that you think there ought to be a lot more going on. Do you have a viewpoint on how AI is actually finding its way into reducing paperwork?  GATES: Well, I’m stunned … I don’t think there should be a patient-doctor meeting where the AI is not sitting in and both transcribing, offering to help with the paperwork, and even making suggestions, although the doctor will be the one, you know, who makes the final decision about the diagnosis and whatever prescription gets done.   It’s so helpful. You know, when that patient goes home and their, you know, son who wants to understand what happened has some questions, that AI should be available to continue that conversation. And the way you can improve that experience and streamline things and, you know, involve the people who advise you. I don’t understand why that’s not more adopted, because there you still have the human in the loop making that final decision.  But even for, like, follow-up calls to make sure the patient did things, to understand if they have concerns and knowing when to escalate back to the doctor, the benefit is incredible. And, you know, that thing is ready for prime time. That paradigm is ready for prime time, in my view.  LEE: Yeah, there are some good products, but it seems like the number one use right now—and we kind of got this from some of the previous guests in previous episodes—is the use of AI just to respond to emails from patients. [LAUGHTER] Does that make sense to you?  BUBECK: Yeah. So maybe I want to second what Bill was saying but maybe take a step back first. You know, two years ago, like, the concept of clinical scribes, which is one of the things that we’re talking about right now, it would have sounded, in fact, it sounded two years ago, borderline dangerous. Because everybody was worried about hallucinations. What happened if you have this AI listening in and then it transcribes, you know, something wrong?  Now, two years later, I think it’s mostly working. And in fact, it is not yet, you know, fully adopted. You’re right. But it is in production. It is used, you know, in many, many places. So this rate of progress is astounding because it wasn’t obvious that we would be able to overcome those obstacles of hallucination. It’s not to say that hallucinations are fully solved. In the case of the closed system, they are.   Now, I think more generally what’s going on in the background is that there is something that we, that certainly I, underestimated, which is this management overhead. So I think the reason why this is not adopted everywhere is really a training and teaching aspect. People need to be taught, like, those systems, how to interact with them.  And one example that I really like, a study that recently appeared where they tried to use ChatGPT for diagnosis and they were comparing doctors without and with ChatGPT (opens in new tab). And the amazing thing … so this was a set of cases where the accuracy of the doctors alone was around 75%. ChatGPT alone was 90%. So that’s already kind of mind blowing. But then the kicker is that doctors with ChatGPT was 80%.   Intelligence alone is not enough. It’s also how it’s presented, how you interact with it. And ChatGPT, it’s an amazing tool. Obviously, I absolutely love it. But it’s not … you don’t want a doctor to have to type in, you know, prompts and use it that way.  It should be, as Bill was saying, kind of running continuously in the background, sending you notifications. And you have to be really careful of the rate at which those notifications are being sent. Because if they are too frequent, then the doctor will learn to ignore them. So you have to … all of those things matter, in fact, at least as much as the level of intelligence of the machine.  LEE: One of the things I think about, Bill, in that scenario that you described, doctors do some thinking about the patient when they write the note. So, you know, I’m always a little uncertain whether it’s actually … you know, you wouldn’t necessarily want to fully automate this, I don’t think. Or at least there needs to be some prompt to the doctor to make sure that the doctor puts some thought into what happened in the encounter with the patient. Does that make sense to you at all?  GATES: At this stage, you know, I’d still put the onus on the doctor to write the conclusions and the summary and not delegate that.  The tradeoffs you make a little bit are somewhat dependent on the situation you’re in. If you’re in Africa, So, yes, the doctor’s still going to have to do a lot of work, but just the quality of letting the patient and the people around them interact and ask questions and have things explained, that alone is such a quality improvement. It’s mind blowing.   LEE: So since you mentioned, you know, Africa—and, of course, this touches on the mission and some of the priorities of the Gates Foundation and this idea of democratization of access to expert medical care—what’s the most interesting stuff going on right now? Are there people and organizations or technologies that are impressing you or that you’re tracking?  GATES: Yeah. So the Gates Foundation has given out a lot of grants to people in Africa doing education, agriculture but more healthcare examples than anything. And the way these things start off, they often start out either being patient-centric in a narrow situation, like, OK, I’m a pregnant woman; talk to me. Or, I have infectious disease symptoms; talk to me. Or they’re connected to a health worker where they’re helping that worker get their job done. And we have lots of pilots out, you know, in both of those cases.   The dream would be eventually to have the thing the patient consults be so broad that it’s like having a doctor available who understands the local things.   LEE: Right.   GATES: We’re not there yet. But over the next two or three years, you know, particularly given the worsening financial constraints against African health systems, where the withdrawal of money has been dramatic, you know, figuring out how to take this—what I sometimes call “free intelligence”—and build a quality health system around that, we will have to be more radical in low-income countries than any rich country is ever going to be.   LEE: Also, there’s maybe a different regulatory environment, so some of those things maybe are easier? Because right now, I think the world hasn’t figured out how to and whether to regulate, let’s say, an AI that might give a medical diagnosis or write a prescription for a medication.  BUBECK: Yeah. I think one issue with this, and it’s also slowing down the deployment of AI in healthcare more generally, is a lack of proper benchmark. Because, you know, you were mentioning the USMLE [United States Medical Licensing Examination], for example. That’s a great test to test human beings and their knowledge of healthcare and medicine. But it’s not a great test to give to an AI.  It’s not asking the right questions. So finding what are the right questions to test whether an AI system is ready to give diagnosis in a constrained setting, that’s a very, very important direction, which to my surprise, is not yet accelerating at the rate that I was hoping for.  LEE: OK, so that gives me an excuse to get more now into the core AI tech because something I’ve discussed with both of you is this issue of what are the right tests. And you both know the very first test I give to any new spin of an LLM is I present a patient, the results—a mythical patient—the results of my physical exam, my mythical physical exam. Maybe some results of some initial labs. And then I present or propose a differential diagnosis. And if you’re not in medicine, a differential diagnosis you can just think of as a prioritized list of the possible diagnoses that fit with all that data. And in that proposed differential, I always intentionally make two mistakes.  I make a textbook technical error in one of the possible elements of the differential diagnosis, and I have an error of omission. And, you know, I just want to know, does the LLM understand what I’m talking about? And all the good ones out there do now. But then I want to know, can it spot the errors? And then most importantly, is it willing to tell me I’m wrong, that I’ve made a mistake?   That last piece seems really hard for AI today. And so let me ask you first, Seb, because at the time of this taping, of course, there was a new spin of GPT-4o last week that became overly sycophantic. In other words, it was actually prone in that test of mine not only to not tell me I’m wrong, but it actually praised me for the creativity of my differential. [LAUGHTER] What’s up with that?  BUBECK: Yeah, I guess it’s a testament to the fact that training those models is still more of an art than a science. So it’s a difficult job. Just to be clear with the audience, we have rolled back that [LAUGHS] version of GPT-4o, so now we don’t have the sycophant version out there.  Yeah, no, it’s a really difficult question. It has to do … as you said, it’s very technical. It has to do with the post-training and how, like, where do you nudge the model? So, you know, there is this very classical by now technique called RLHF [reinforcement learning from human feedback], where you push the model in the direction of a certain reward model. So the reward model is just telling the model, you know, what behavior is good, what behavior is bad.  But this reward model is itself an LLM, and, you know, Bill was saying at the very beginning of the conversation that we don’t really understand how those LLMs deal with concepts like, you know, where is the capital of France located? Things like that. It is the same thing for this reward model. We don’t know why it says that it prefers one output to another, and whether this is correlated with some sycophancy is, you know, something that we discovered basically just now. That if you push too hard in optimization on this reward model, you will get a sycophant model.  So it’s kind of … what I’m trying to say is we became too good at what we were doing, and we ended up, in fact, in a trap of the reward model.  LEE: I mean, you do want … it’s a difficult balance because you do want models to follow your desires and …  BUBECK: It’s a very difficult, very difficult balance.  LEE: So this brings up then the following question for me, which is the extent to which we think we’ll need to have specially trained models for things. So let me start with you, Bill. Do you have a point of view on whether we will need to, you know, quote-unquote take AI models to med school? Have them specially trained? Like, if you were going to deploy something to give medical care in underserved parts of the world, do we need to do something special to create those models?  GATES: We certainly need to teach them the African languages and the unique dialects so that the multimedia interactions are very high quality. We certainly need to teach them the disease prevalence and unique disease patterns like, you know, neglected tropical diseases and malaria. So we need to gather a set of facts that somebody trying to go for a US customer base, you know, wouldn’t necessarily have that in there.  Those two things are actually very straightforward because the additional training time is small. I’d say for the next few years, we’ll also need to do reinforcement learning about the context of being a doctor and how important certain behaviors are. Humans learn over the course of their life to some degree that, I’m in a different context and the way I behave in terms of being willing to criticize or be nice, you know, how important is it? Who’s here? What’s my relationship to them?   Right now, these machines don’t have that broad social experience. And so if you know it’s going to be used for health things, a lot of reinforcement learning of the very best humans in that context would still be valuable. Eventually, the models will, having read all the literature of the world about good doctors, bad doctors, it’ll understand as soon as you say, “I want you to be a doctor diagnosing somebody.” All of the implicit reinforcement that fits that situation, you know, will be there. LEE: Yeah. GATES: And so I hope three years from now, we don’t have to do that reinforcement learning. But today, for any medical context, you would want a lot of data to reinforce tone, willingness to say things when, you know, there might be something significant at stake.  LEE: Yeah. So, you know, something Bill said, kind of, reminds me of another thing that I think we missed, which is, the context also … and the specialization also pertains to different, I guess, what we still call “modes,” although I don’t know if the idea of multimodal is the same as it was two years ago. But, you know, what do you make of all of the hubbub around—in fact, within Microsoft Research, this is a big deal, but I think we’re far from alone—you know, medical images and vision, video, proteins and molecules, cell, you know, cellular data and so on.  BUBECK: Yeah. OK. So there is a lot to say to everything … to the last, you know, couple of minutes. Maybe on the specialization aspect, you know, I think there is, hiding behind this, a really fundamental scientific question of whether eventually we have a singular AGI [artificial general intelligence] that kind of knows everything and you can just put, you know, explain your own context and it will just get it and understand everything.  That’s one vision. I have to say, I don’t particularly believe in this vision. In fact, we humans are not like that at all. I think, hopefully, we are general intelligences, yet we have to specialize a lot. And, you know, I did myself a lot of RL, reinforcement learning, on mathematics. Like, that’s what I did, you know, spent a lot of time doing that. And I didn’t improve on other aspects. You know, in fact, I probably degraded in other aspects. [LAUGHTER] So it’s … I think it’s an important example to have in mind.  LEE: I think I might disagree with you on that, though, because, like, doesn’t a model have to see both good science and bad science in order to be able to gain the ability to discern between the two?  BUBECK: Yeah, no, that absolutely. I think there is value in seeing the generality, in having a very broad base. But then you, kind of, specialize on verticals. And this is where also, you know, open-weights model, which we haven’t talked about yet, are really important because they allow you to provide this broad base to everyone. And then you can specialize on top of it.  LEE: So we have about three hours of stuff to talk about, but our time is actually running low. BUBECK: Yes, yes, yes.   LEE: So I think I want … there’s a more provocative question. It’s almost a silly question, but I need to ask it of the two of you, which is, is there a future, you know, where AI replaces doctors or replaces, you know, medical specialties that we have today? So what does the world look like, say, five years from now?  GATES: Well, it’s important to distinguish healthcare discovery activity from healthcare delivery activity. We focused mostly on delivery. I think it’s very much within the realm of possibility that the AI is not only accelerating healthcare discovery but substituting for a lot of the roles of, you know, I’m an organic chemist, or I run various types of assays. I can see those, which are, you know, testable-output-type jobs but with still very high value, I can see, you know, some replacement in those areas before the doctor.   The doctor, still understanding the human condition and long-term dialogues, you know, they’ve had a lifetime of reinforcement of that, particularly when you get into areas like mental health. So I wouldn’t say in five years, either people will choose to adopt it, but it will be profound that there’ll be this nearly free intelligence that can do follow-up, that can help you, you know, make sure you went through different possibilities.  And so I’d say, yes, we’ll have doctors, but I’d say healthcare will be massively transformed in its quality and in efficiency by AI in that time period.  LEE: Is there a comparison, useful comparison, say, between doctors and, say, programmers, computer programmers, or doctors and, I don’t know, lawyers?  GATES: Programming is another one that has, kind of, a mathematical correctness to it, you know, and so the objective function that you’re trying to reinforce to, as soon as you can understand the state machines, you can have something that’s “checkable”; that’s correct. So I think programming, you know, which is weird to say, that the machine will beat us at most programming tasks before we let it take over roles that have deep empathy, you know, physical presence and social understanding in them.  LEE: Yeah. By the way, you know, I fully expect in five years that AI will produce mathematical proofs that are checkable for validity, easily checkable, because they’ll be written in a proof-checking language like Lean or something but will be so complex that no human mathematician can understand them. I expect that to happen.   I can imagine in some fields, like cellular biology, we could have the same situation in the future because the molecular pathways, the chemistry, biochemistry of human cells or living cells is as complex as any mathematics, and so it seems possible that we may be in a state where in wet lab, we see, Oh yeah, this actually works, but no one can understand why.  BUBECK: Yeah, absolutely. I mean, I think I really agree with Bill’s distinction of the discovery and the delivery, and indeed, the discovery’s when you can check things, and at the end, there is an artifact that you can verify. You know, you can run the protocol in the wet lab and see [if you have] produced what you wanted. So I absolutely agree with that.   And in fact, you know, we don’t have to talk five years from now. I don’t know if you know, but just recently, there was a paper that was published on a scientific discovery using o3- mini (opens in new tab). So this is really amazing. And, you know, just very quickly, just so people know, it was about this statistical physics model, the frustrated Potts model, which has to do with coloring, and basically, the case of three colors, like, more than two colors was open for a long time, and o3 was able to reduce the case of three colors to two colors.   LEE: Yeah.  BUBECK: Which is just, like, astounding. And this is not … this is now. This is happening right now. So this is something that I personally didn’t expect it would happen so quickly, and it’s due to those reasoning models.   Now, on the delivery side, I would add something more to it for the reason why doctors and, in fact, lawyers and coders will remain for a long time, and it’s because we still don’t understand how those models generalize. Like, at the end of the day, we are not able to tell you when they are confronted with a really new, novel situation, whether they will work or not.  Nobody is able to give you that guarantee. And I think until we understand this generalization better, we’re not going to be willing to just let the system in the wild without human supervision.  LEE: But don’t human doctors, human specialists … so, for example, a cardiologist sees a patient in a certain way that a nephrologist …  BUBECK: Yeah. LEE: … or an endocrinologist might not. BUBECK: That’s right. But another cardiologist will understand and, kind of, expect a certain level of generalization from their peer. And this, we just don’t have it with AI models. Now, of course, you’re exactly right. That generalization is also hard for humans. Like, if you have a human trained for one task and you put them into another task, then you don’t … you often don’t know. LEE: OK. You know, the podcast is focused on what’s happened over the last two years. But now, I’d like one provocative prediction about what you think the world of AI and medicine is going to be at some point in the future. You pick your timeframe. I don’t care if it’s two years or 20 years from now, but, you know, what do you think will be different about AI in medicine in that future than today?  BUBECK: Yeah, I think the deployment is going to accelerate soon. Like, we’re really not missing very much. There is this enormous capability overhang. Like, even if progress completely stopped, with current systems, we can do a lot more than what we’re doing right now. So I think this will … this has to be realized, you know, sooner rather than later.  And I think it’s probably dependent on these benchmarks and proper evaluation and tying this with regulation. So these are things that take time in human society and for good reason. But now we already are at two years; you know, give it another two years and it should be really …   LEE: Will AI prescribe your medicines? Write your prescriptions?  BUBECK: I think yes. I think yes.  LEE: OK. Bill?  GATES: Well, I think the next two years, we’ll have massive pilots, and so the amount of use of the AI, still in a copilot-type mode, you know, we should get millions of patient visits, you know, both in general medicine and in the mental health side, as well. And I think that’s going to build up both the data and the confidence to give the AI some additional autonomy. You know, are you going to let it talk to you at night when you’re panicked about your mental health with some ability to escalate? And, you know, I’ve gone so far as to tell politicians with national health systems that if they deploy AI appropriately, that the quality of care, the overload of the doctors, the improvement in the economics will be enough that their voters will be stunned because they just don’t expect this, and, you know, they could be reelected [LAUGHTER] just on this one thing of fixing what is a very overloaded and economically challenged health system in these rich countries.  You know, my personal role is going to be to make sure that in the poorer countries, there isn’t some lag; in fact, in many cases, that we’ll be more aggressive because, you know, we’re comparing to having no access to doctors at all. And, you know, so I think whether it’s India or Africa, there’ll be lessons that are globally valuable because we need medical intelligence. And, you know, thank god AI is going to provide a lot of that.  LEE: Well, on that optimistic note, I think that’s a good way to end. Bill, Seb, really appreciate all of this.   I think the most fundamental prediction we made in the book is that AI would actually find its way into the practice of medicine, and I think that that at least has come true, maybe in different ways than we expected, but it’s come true, and I think it’ll only accelerate from here. So thanks again, both of you.  [TRANSITION MUSIC]  GATES: Yeah. Thanks, you guys.  BUBECK: Thank you, Peter. Thanks, Bill.  LEE: I just always feel such a sense of privilege to have a chance to interact and actually work with people like Bill and Sébastien.    With Bill, I’m always amazed at how practically minded he is. He’s really thinking about the nuts and bolts of what AI might be able to do for people, and his thoughts about underserved parts of the world, the idea that we might actually be able to empower people with access to expert medical knowledge, I think is both inspiring and amazing.   And then, Seb, Sébastien Bubeck, he’s just absolutely a brilliant mind. He has a really firm grip on the deep mathematics of artificial intelligence and brings that to bear in his research and development work. And where that mathematics takes him isn’t just into the nuts and bolts of algorithms but into philosophical questions about the nature of intelligence.   One of the things that Sébastien brought up was the state of evaluation of AI systems. And indeed, he was fairly critical in our conversation. But of course, the world of AI research and development is just moving so fast, and indeed, since we recorded our conversation, OpenAI, in fact, released a new evaluation metric that is directly relevant to medical applications, and that is something called HealthBench. And Microsoft Research also released a new evaluation approach or process called ADeLe.   HealthBench and ADeLe are examples of new approaches to evaluating AI models that are less about testing their knowledge and ability to pass multiple-choice exams and instead are evaluation approaches designed to assess how well AI models are able to complete tasks that actually arise every day in typical healthcare or biomedical research settings. These are examples of really important good work that speak to how well AI models work in the real world of healthcare and biomedical research and how well they can collaborate with human beings in those settings.  You know, I asked Bill and Seb to make some predictions about the future. You know, my own answer, I expect that we’re going to be able to use AI to change how we diagnose patients, change how we decide treatment options.   If you’re a doctor or a nurse and you encounter a patient, you’ll ask questions, do a physical exam, you know, call out for labs just like you do today, but then you’ll be able to engage with AI based on all of that data and just ask, you know, based on all the other people who have gone through the same experience, who have similar data, how were they diagnosed? How were they treated? What were their outcomes? And what does that mean for the patient I have right now? Some people call it the “patients like me” paradigm. And I think that’s going to become real because of AI within our lifetimes. That idea of really grounding the delivery in healthcare and medical practice through data and intelligence, I actually now don’t see any barriers to that future becoming real.  [THEME MUSIC]  I’d like to extend another big thank you to Bill and Sébastien for their time. And to our listeners, as always, it’s a pleasure to have you along for the ride. I hope you’ll join us for our remaining conversations, as well as a second coauthor roundtable with Carey and Zak.   Until next time.   [MUSIC FADES]

Image by Getty / FuturismRx/MedicinesBroken ice cream machines aren't the only thing bedeviling stalwart fast food chain McDonald's.Financial services firm Redburn Atlantic put the company's stock in the bear category, coinciding with a slumpy week in which it lost about three percent of its value — because analysts are betting that GLP-1 agonist weight loss drugs like Ozempic are going to disrupt the fast food business model, CBS News reports.The eyebrow-raising conclusion comes as the analysts reason that people with lower incomes who go on the drugs will tend to shun food outside the home. Meanwhile, people at a higher income level who take Ozempic and similar go back to their food spending habits after a year or so."Behaviour changes extend beyond the individual user — reshaping group dining, influencing household routines and softening habitual demand," wrote the analysts, as reported by CBS. "A 1 percent drag today could easily build to 10 percent or more over time, particularly for brands skewed toward lower income consumers or group occasions."This could have a huge impact on the bottom line of fast food chains like McDonald's, which could stand to lose as much as $482 million annually as they see the disappearance of 28 million visits from formerly hungry customers.This is all complete speculation at this point, because only about six percent of American adults are currently taking these weight loss medications. And they're prohibitively expensive, prices starting at around $900 per month, meaning that extremely few poor people are currently able to afford them.But there's a movement by some policymakers to lower the price of the drugs, which have been proven to not just help people lose weight, but they come with a rash of benefits from preventing certain cancers to treating addictions, among other positives.So if lawmakers force a reduction in price in the future, expect fast food chains like McDonald's to be left holding the bag.And maybe that's a good thing, because the kind of fried foods that McDonald's traffics in are just plain bad for your health.More on Ozempic: Doctors Concerned by Massive Uptick in Teens Taking OzempicShare This Article

On November 4, 2003, a doctor gave Jon Gluck some of the worst news imaginable: He had cancer — one that later tests would reveal as multiple myeloma, a severe blood and bone marrow cancer. Jon was told he might have as little as 18 months to live. He was 38, a thriving magazine editor in New York with a 7-month-old daughter whose third birthday, he suddenly realized, he might never see.“The moment after I was told I had cancer, I just said ‘no, no, no,’” Jon told me in an interview just last week. “This cannot be true.”Living in remissionThe fact that Jon is still here, talking to me in 2025, tells you that things didn’t go the way the medical data would have predicted on that November morning. He has lived with his cancer, through waves of remission and recurrence, for more than 20 years, an experience he chronicles with grace and wit in his new book An Exercise in Uncertainty. That 7-month-old daughter is now in college.RelatedWhy do so many young people suddenly have cancer?You could say Jon has beaten the odds, and he’s well aware that chance played some role in his survival. (“Did you know that ‘Glück’ is German for ‘luck’?” he writes in the book, noting his good fortune that a random spill on the ice is what sent him to the doctor in the first place, enabling them to catch his cancer early.) Cancer is still a terrible health threat, one that is responsible for 1 in 6 deaths around the world, killing nearly 10 million people a year globally and over 600,000 people a year in the US. But Jon’s story and his survival demonstrate something that is too often missed: We’ve turned the tide in the war against cancer. The age-adjusted death rate in the US for cancer has declined by about a third since 1991, meaning people of a given age have about a third lower risk of dying from cancer than people of the same age more than three decades ago. That adds up to over 4 million fewer cancer deaths over that time period. Thanks to breakthroughs in treatments like autologous stem-cell harvesting and CAR-T therapy — breakthroughs Jon himself benefited from, often just in time — cancer isn’t the death sentence it once was.Our World in DataGetting better all the timeThere’s no doubt that just as the rise of smoking in the 20th century led to a major increase in cancer deaths, the equally sharp decline of tobacco use eventually led to a delayed decrease. Smoking is one of the most potent carcinogens in the world, and at the peak in the early 1960s, around 12 cigarettes were being sold per adult per day in the US. Take away the cigarettes and — after a delay of a couple of decades — lung cancer deaths drop in turn along with other non-cancer smoking-related deaths.But as Saloni Dattani wrote in a great piece earlier this year, even before the decline of smoking, death rates from non-lung cancers in the stomach and colon had begun to fall. Just as notably, death rates for childhood cancers — which for obvious reasons are not connected to smoking and tend to be caused by genetic mutations — have fallen significantly as well, declining sixfold since 1950. In the 1960s, for example, only around 10 percent of children diagnosed with acute lymphoblastic leukemia survived more than five years. Today it’s more than 90 percent. And the five-year survival rate for all cancers has risen from 49 percent in the mid-1970s to 69 percent in 2019. We’ve made strikes against the toughest of cancers, like Jon’s multiple myeloma. Around when Jon was diagnosed, the five-year survival rate was just 34 percent. Today it’s as high as 62 percent, and more and more people like Jon are living for decades. “There has been a revolution in cancer survival,” Jon told me. “Some illnesses now have far more successful therapies than others, but the gains are real.”Three cancer revolutions The dramatic bend in the curve of cancer deaths didn’t happen by accident — it’s the compound interest of three revolutions.While anti-smoking policy has been the single biggest lifesaver, other interventions have helped reduce people’s cancer risk. One of the biggest successes is the HPV vaccine. A study last year found that death rates of cervical cancer — which can be caused by HPV infections — in US women ages 20–39 had dropped 62 percent from 2012 to 2021, thanks largely to the spread of the vaccine. Other cancers have been linked to infections, and there is strong research indicating that vaccination can have positive effects on reducing cancer incidence. The next revolution is better and earlier screening. It’s generally true that the earlier cancer is caught, the better the chances of survival, as Jon’s own story shows. According to one study, incidences of late-stage colorectal cancer in Americans over 50 declined by a third between 2000 and 2010 in large part because rates of colonoscopies almost tripled in that same time period. And newer screening methods, often employing AI or using blood-based tests, could make preliminary screening simpler, less invasive and therefore more readily available. If 20th-century screening was about finding physical evidence of something wrong — the lump in the breast — 21st-century screening aims to find cancer before symptoms even arise.Most exciting of all are frontier developments in treating cancer, much of which can be tracked through Jon’s own experience. From drugs like lenalidomide and bortezomib in the 2000s, which helped double median myeloma survival, to the spread of monoclonal antibodies, real breakthroughs in treatments have meaningfully extended people’s lives — not just by months, but years.Perhaps the most promising development is CAR-T therapy, a form of immunotherapy. Rather than attempting to kill the cancer directly, immunotherapies turn a patient’s own T-cells into guided missiles. In a recent study of 97 patients with multiple myeloma, many of whom were facing hospice care, a third of those who received CAR-T therapy had no detectable cancer five years later. It was the kind of result that doctors rarely see. “CAR-T is mind-blowing — very science-fiction futuristic,” Jon told me. He underwent his own course of treatment with it in mid-2023 and writes that the experience, which put his cancer into a remission he’s still in, left him feeling “physically and metaphysically new.”A welcome uncertaintyWhile there are still more battles to be won in the war on cancer, and there are certain areas — like the rising rates of gastrointestinal cancers among younger people — where the story isn’t getting better, the future of cancer treatment is improving. For cancer patients like Jon, that can mean a new challenge — enduring the essential uncertainty that comes with living under a disease that’s controllable but which could always come back. But it sure beats the alternative.“I’ve come to trust so completely in my doctors and in these new developments,” he said. “I try to remain cautiously optimistic that my future will be much like the last 20 years.” And that’s more than he or anyone else could have hoped for nearly 22 years ago. A version of this story originally appeared in the Good News newsletter. Sign up here!See More: Health

These annual rankings were last updated on June 6, 2025. Want to see your firm on next year’s list? Continue reading for more on how you can improve your studio’s ranking. Traversing the German nation, one will encounter a similar historic program to other European capitals — Romanesque churches, Renaissance monuments and more — blended with functionalist and modernist structures. Early twenty-first-century Germany gave rise to the thriving Bauhaus. Founded by Walter Gropius, this school introduced brand-new architectural thinking, an ideology rooted in function, clarity and mass production. Materials like concrete and glass were favored, socially progressive housing blocks were constructed, and a newfound appreciation for modernism emerged. The spirit of the great Bauhaus teachers — Mies van der Rohe, for example — vigorously lives on and inspires contemporary designers today. Additionally, modern industrial architecture took off post-war and has played a prominent role in the nation’s economic growth, continuing to do so today. The architectural devastation from WWII resulted in mass reconstruction efforts. The post-war restoration and rebuilding embraced a functional attitude, which continued the legacy of the Bauhaus movement despite its closing over a decade prior. Today, German architecture continues to champion the nation’s modernist brilliance through innovative designs that push technological boundaries and celebrate culture. With so many architecture firms to choose from, it’s challenging for clients to identify the industry leaders that will be an ideal fit for their project needs. Fortunately, Architizer is able to provide guidance on the top design firms in Germany based on more than a decade of data and industry knowledge. How are these architecture firms ranked? The following ranking has been created according to key statistics that demonstrate each firm’s level of architectural excellence. The following metrics have been accumulated to establish each architecture firm’s ranking, in order of priority: The number of A+Awards won (2013 to 2025) The number of A+Awards finalists (2013 to 2025) The number of projects selected as “Project of the Day” (2009 to 2025) The number of projects selected as “Featured Project” (2009 to 2025) The number of projects uploaded to Architizer (2009 to 2025) Each of these metrics is explained in more detail at the foot of this article. This ranking list will be updated annually, taking into account new achievements of Germany architecture firms throughout the year. Without further ado, here are the 30 best architecture firms in Germany: 30. Format Elf Architekten © Format Elf Architekten Simple and touching. Format Elf Architekten is an architecture firm that focuses on residential architecture. Some of Format Elf Architekten’s most prominent projects include: Longhouses, Bad Birnbach, Germany FORMSTELLE, Töging am Inn, Germany House B, Munich, Germany Die Basis, Munich, Germany The following statistics helped Format Elf Architekten achieve 30th place in the 30 Best Architecture Firms in Germany: Featured Projects 1 Total Projects 4 29. Bruzkus Batek Architects © Jens Bösenberg | Whitelight Studio GmbH BRUZKUS BATEK Since 2007, this internationally active office specialised in designing hotels, offices, shops, restaurants and private housing – and particularly in the detailing of high-quality interiors. After 10 successful years, it is time for a change. As of 2018, Bruzkus Batek is splitting into BATEK ARCHITECTS and ESTER BRUZKUS ARCHITECTS. Some of Bruzkus Batek Architects’ most prominent projects include: Razorfish, Berlin, Germany Office Ester Bruzkus Architekten, Berlin, Germany Colette Tim Raue Munich, Munich, Germany Apartment PP, Berlin, Germany Dean, Berlin, Germany The following statistics helped Bruzkus Batek Architects achieve 29th place in the 30 Best Architecture Firms in Germany: A+Awards Finalist 1 Featured Projects 3 Total Projects 28 28. Ester Bruzkus Architekten © Ester Bruzkus Architekten Founded in 2002 in Berlin, Ester Bruzkus Architekten is an architecture and interior design practice with global ties: Berlin, New York, Paris, Tel Aviv, Boston, Dubai, Moscow, Vladivostok, Tenerife. We have extensive experience with design at many scales: from the design of tables and furniture to exquisite residences and workspaces to international theaters, restaurants and hotels. Straight lines, precise planning, material contrasts – and plenty of surprises. The architecture of Ester Bruzkus and her team makes use of contrasts of thick and thin, sharp and soft, curved and straight, rough and smooth, common and opulent, colorful and restrained, playful and well-resolved. Special projects result from a dialogue of space and light, materiality and color, existing constraints and new opportunities – and especially a synergy between the needs of the client, the space and the aspirations of great design. Some of Ester Bruzkus Architekten’s most prominent projects include: Razorfish, Berlin, Germany Office Ester Bruzkus Architekten, Berlin, Germany Colette Tim Raue Munich, Munich, Germany Apartment PP, Berlin, Germany Dean, Berlin, Germany The following statistics helped Ester Bruzkus Architekten achieve 28th place in the 30 Best Architecture Firms in Germany: A+Awards Finalist 1 Featured Projects 3 Total Projects 34 27. Architekten Wannenmacher + Möller © Architekten Wannenmacher + Möller GmbH Architects Wannenmacher + Möller, based in Bielefeld Germany, has been in practice for almost 60 years. Today the office is run by second generation Andreas Wannenmacher and Hans-Heinrich Möller. It was founded by Gregor Wannenmacher in Düsseldorf, Germany in 1955. Over the years the office grew continuously and became one of the largest architectural firms in the German region Eastern Westfalia. Most of the activities were focused in this region. During the last years, however, the office had the opportunity to design buildings and control their realization outside this region, some of them in foreign countries throughout Europe, Asia, and the USA. Some of Architekten Wannenmacher + Möller’s most prominent projects include: Ford Hagemeier Halle , Germany Wohnhaus Möllmann, Bielefeld, Germany House P+G, Weinheim, Germany House in Paderborn, Paderborn, Germany Borchen Sports Hall, Borchen, Germany The following statistics helped Architekten Wannenmacher + Möller achieve 27th place in the 30 Best Architecture Firms in Germany: A+Awards Finalist 1 Featured Projects 4 Total Projects 14 26. Design.Develop.Build – GA Tech | PBSA | RWTH © Design.Develop.Build - GA Tech | PBSA | RWTH Students from the Georgia Institute of Technology, RWTH Aachen University and PBSA Düsseldorf design, develop and build civic architecture. Some of Design.Develop.Build’s most prominent projects include: Guga S’Thebe Children’s Theatre, Cape Town, South Africa The following statistics helped Design.Develop.Build achieve 26th place in the 30 Best Architecture Firms in Germany: A+Awards Winner 2 A+Awards Finalist 1 Featured Projects 1 Total Projects 1 25. Ecker Architekten © Ecker Architekten Ecker Architekten is an architecture and design firm based in Germany. Ecker Architekten’s design portfolio includes a variety of architectural projects, such as cultural, commercial, government and health, educational, and more. Some of Ecker Architekten’s most prominent projects include: The Forum at Eckenberg Gymnasium, Adelsheim, Germany Field Chapel, Buchen (Odenwald), Germany Kindergarten Dandelion Clock, Germany Kanzlei Balkenhol, BW, Germany Branch Bank in Hettingen, Hettingen, Germany The following statistics helped Ecker Architekten achieve 25th place in the 30 Best Architecture Firms in Germany: Featured Projects 4 Total Projects 8 24. Sehw Architektur © Helin Bereket “Sehw stands for meaningfulness, emotion, attitude and change.” Our mission: building architecture sustainably, thinking innovatively and creating social added value. “Sehw stands for an aesthetic of sustainability in architecture.” // Sustainability // Acting sustainably We are not just planning for today but for the generation of tomorrow and beyond. For us, sustainable architecture means forward-looking planning and the development of future-proof utilization concepts. In times of rapid climate change, we are committed to resource-conserving construction methods and the use of renewable energies. Recyclable building materials and circular economy are the basis for a long life cycle and corresponding sustainability certifications of our buildings. We value and protect existing structures and materials. Some of Sehw Architektur’s most prominent projects include: KIT, Karlsruhe, Germany Weitblick Innovation Campus, Augsburg, Germany Inclusive School Centre Döbern, Döbern, Germany The Copper Coil, Rostock, Germany Around the Corner – Student Apartment Building, Berlin, Germany The following statistics helped Sehw Architektur achieve 24th place in the 30 Best Architecture Firms in Germany: Featured Projects 5 Total Projects 18 23. PHILIPPARCHITEKTEN Anna Philipp © PHILIPPARCHITEKTEN Anna Philipp A passion for houses. There’s nothing more significant to describe what our architecture office is about: houses — simple, yet complex. The archetype of all construction is our passion. That’s what we stand for. On this we work holistically with a team of architects and engineers. Center of our designing is the human being. We understand architecture as a second skin, which must be tailored. At the same time it’s essential to reflect the unique character of the location. The goal is a harmonious triad of mankind, nature and architecture. The focus and specialization on houses and villas is faced by a wide diversification in the range of services offered. Some of PHILIPPARCHITEKTEN Anna Philipp’s most prominent projects include: Villa Philipp, Waldenburg, Germany Villa Lombardo, Lugano, Switzerland A monastery of modernity, Augsburg, Germany Villa Schatzlmayr, Passau, Germany Villa Mauthe, Bahlingen, Germany The following statistics helped PHILIPPARCHITEKTEN Anna Philipp achieve 23rd place in the 30 Best Architecture Firms in Germany: Featured Projects 5 Total Projects 22 22. KRESINGS © Roman Mensing KRESINGS is a studio for architecture, interior design, urban planning and product design with offices in Munster and Dusseldorf. Since its founding by Rainer Maria Kresing in 1985 four further partners joined the management: Kilian Kresing, Christian Kawe, Matthias Povel and André Perret. More than 60 employees — architects, designers, planners and engineers — guarantee a broad range of creative and qualified services. Experience meets creative ease. The studio has been awarded with national awards like those of the BDA (Bund Deutscher Architekten) and the DAM (Deutsches Architektur Museum). KRESINGS: Experts and team players in areas of office and industrial buildings, facilities for research, education and culture as well as individual designs for residential buildings. Some of KRESINGS’ most prominent projects include: Student Residence Boeselagerstraße, Münster, Germany Headquarters Mitsubishi Electric Europe, Ratingen, Germany Petting Zoo, Öhringen, Germany Freiherr-vom-Stein-High-School, Münster, Germany Residential Building Hoher Heckenweg, Münster, Germany The following statistics helped KRESINGS achieve 22nd place in the 30 Best Architecture Firms in Germany: Featured Projects 5 Total Projects 33 21. 3deluxe © 3deluxe The interdisciplinary design collective 3deluxe, consisting of about 30 individuals centered around Dieter Brell, Peter Seipp and Andreas and Stephan Lauhoff, has been creating groundbreaking impulses in the fields of architecture and interior design, graphic and media design. In creative synergy hybrid forms of two and three dimensional design are created: graphic works develop a spatial impact, while architectural drafts are based on communication principles. In this way, complex collages are contrived, so called ‚multilayered atmospheres‘, that foster multiple sensory experiences and allow for a multitude of potential interpretations. Paramount is the broadening of an absolute understanding of space and image towards a dynamic, processual approach. Some of 3deluxe’s most prominent projects include: V- Plaza Urban Development, Kaunas, Lithuania Kaffee Partner Headquarters, Osnabrück, Germany Butterfly Pavilion, Sharjah, United Arab Emirates Leonardo Glass Cube, Bad Driburg, Germany Cyberhelvetia The following statistics helped 3deluxe achieve 21st place in the 30 Best Architecture Firms in Germany: A+Awards Finalist 2 Featured Projects 3 Total Projects 20 20. Christoph Hesse Architects © Deimel und Wittmar Christoph Hesse Architects was founded in 2010 by Christoph Hesse, has offices in Korbach and, since 2018, in Berlin. The architectural practice currently employs an international team of 15 people and has won numerous awards. Some of Christoph Hesse Architects’ most prominent projects include: VITOS Outpatient psychiatric clinic for traumatized refugees, Korbach, Germany Villa F / the off-the-grid house in the central highlands of Germany, Medebach, Germany StrohTherme, Medebach, Germany Room of Silence, Korbach, Germany The following statistics helped Christoph Hesse Architects achieve 20th place in the 30 Best Architecture Firms in Germany: A+Awards Winner 2 Featured Projects 2 Total Projects 4 19. Zeller & Moye © Zeller & Moye Zeller & Moye is a design studio based in Mexico City and Berlin that works at the intersection of architecture, arts, design and latest technology through an experimental, multidisciplinary and collaborative working culture. Some of Zeller & Moye’s most prominent projects include: HAUS KÖRIS, Brandenburg, Germany SANDRA WEIL Store, Mexico City, Mexico TROQUER FASHION HOUSE, Mexico City, Mexico CASA VERNE, Mexico City, Mexico CASA HILO, Mexico The following statistics helped Zeller & Moye achieve 19th place in the 30 Best Architecture Firms in Germany: Featured Projects 5 Total Projects 12 18. Ippolito Fleitz Group – Identity Architects © Ippolito Fleitz Group - Identity Architects Ippolito fleitz group is a multidisciplinary, internationally operating design studio based in Stuttgart.We are identity architects. We work in unison with our clients to develop architecture, products and communication that are part of a whole and yet distinctive in their own right. This is how we define identity.With meticulous analysis before we begin.With animated examination in the conceptional phase. With a clarity of argument in the act of persuasion.With a love of accuracy in the realisation.With a serious goal and a lot of fun along the way. Working together with our clients.As architects of identity, we conceive and construct buildings, interiors and landscapes; we develop products and communication measures. Some of Ippolito Fleitz Group – Identity Architects’ most prominent projects include: Das GERBER, Stuttgart, Germany Hunke – Jewellers and Opticians, Ludwigsburg, Germany Bella Italia Weine, Stuttgart, Germany ippolito fleitz group | Residential Building, Denkendorf, Germany WakuWaku Dammtor, Hamburg, Germany The following statistics helped Ippolito Fleitz Group - Identity Architects achieve 18th place in the 30 Best Architecture Firms in Germany: A+Awards Finalist 1 Featured Projects 4 Total Projects 26 17. VON M © Zooey Braun VON M is an architecture and design firm based in Germany. VON M’s design portfolio includes a variety of architectural projects, such as cultural, residential, educational, commercial, hospitality and sport, and more. Some of VON M’s most prominent projects include: Museum Luthers Sterbehaus, Eisleben, Germany BHM Pavillon, Wolfegg, Germany Kinder- und Familienzentrum, Ludwigsburg, Germany Hotel Bauhofstrasse, Ludwigsburg, Germany HS77, Stuttgart, Germany The following statistics helped VON M achieve 17th place in the 30 Best Architecture Firms in Germany: Featured Projects 6 Total Projects 11 16. Plastique Fantastique © Plastique Fantastique Plastique Fantastique is a collective for temporary architecture that samples the performative possibilities of urban environments. Established in Berlin in 1999, Plastique Fantastique has been influenced by the unique circumstances that made the city a laboratory for temporary spaces. Plastique Fantastique’s synthetic structures affect surrounding spaces like a soap bubble does: Similar to a foreign body, it occupies and mutates urban space. Their interventions change the way we perceive and interact in urban environments. By mixing different landscape types, an osmotic passage between private and public space is generating new hybrid environments.Regardless the way people view a bubble, walk around its exterior or move inside it, the pneumatic structure is a medium to experience the same physical setting in a temporary extraordinary situation. Some of Plastique Fantastique’s most prominent projects include: LOUD SHADOWS, Terschelling, Netherlands Blurry Venice, Venice, Italy Aeropolis, Copenhagen, Denmark superKOLMEMEN, Helsinki, Finland MOBILE PPS (Personal Protective Space) for Doctors The following statistics helped Plastique Fantastique achieve 16th place in the 30 Best Architecture Firms in Germany: Featured Projects 5 Total Projects 5 15. 4a Architekten © 4a Architekten GmbH Shaping atmosphere, lending identity, creating quality of space — these are the values that characterize the buildings of 4a Architekten. The starting point and guiding principle of our work is the concept of architecture as living space. Our buildings come into being through intensive team work shaped by interdisciplinary thinking and action. What characterizes a location in terms of its culture and history? What are the client’s expectations and objectives? What is viable within the budget and what are the benefits for users? These questions and this approach bring us to solutions with an individual character — and they apply just as much to the planning of buildings as to the design of interior spaces. Some of 4a Architekten’s most prominent projects include: Therme Lindau on Lake Constance, Lindau, Germany Balingen Civic Hall, Balingen, Germany Emser Thermal Baths, Bad Ems, Germany Spreewald Spa Hotel, Burg, Germany Stegermatt Aquatic Centre, Offenburg, Germany The following statistics helped 4a Architekten achieve 15th place in the 30 Best Architecture Firms in Germany: Featured Projects 7 Total Projects 15 14. schneider+schumacher © schneider+schumacher / Frankfurt - Vienna - Tianjin Our architectural approach is characterized by the enjoyment we have in finding solutions to the complex demands of today’s buildings. We adapt our buildings to fit into their surroundings, yet we also create landmarks. Pragmatic poetry, nurtured not only by design clarity and a conscientious attitude towards the task in hand, but also by a delight in fine details. This design process is constantly informed by the dialogue that takes place on a daily basis between the various professional disciplines in all our specialized divisions – architecture, construction and project management, design, a.o. — and international offices. schneider+schumacher is headquartered in Frankfurt (GE), and has two branches in Vienna (AU) and Tianjin (CN). Some of schneider+schumacher’s most prominent projects include: Autobahn Church, Wilnsdorf, Germany Oil Harbour Bridge, Raunheim, Germany DOXX – Quayside Development at Mainz Customs Port, Mainz, Germany Städel Museum Extension, Frankfurt, Germany Siegerland Motorway Church, Wilnsdorf, Wilnsdorf, Germany The following statistics helped schneider+schumacher achieve 14th place in the 30 Best Architecture Firms in Germany: A+Awards Winner 1 A+Awards Finalist 2 Featured Projects 5 Total Projects 12 13. ingenhoven associates © ingenhoven associates Celebrating 40 years of excellence since 1985, the studio is pioneer in sustainable architecture, designing and delivering projects of all sizes and typologies across nearly every region of the world, adhering to the highest green building standards, including LEED, Green Star, Minergie, BREEAM, DGNB and CASBEE. With a tailored approach to each location, the multinational, interdisciplinary team creates nuanced architectural solutions with added value and positive social impact. Some of ingenhoven associates’ most prominent projects include: Düsseldorfer Schauspielhaus, Düsseldorf, Germany Freiburg Town Hall, Freiburg, Germany Kö-Bogen 2, Düsseldorf, Germany Marina One, Singapore, Singapore Daniel Swarovski Corporation, Männedorf, Switzerland The following statistics helped ingenhoven associates achieve 13th place in the 30 Best Architecture Firms in Germany: A+Awards Finalist 2 Featured Projects 5 Total Projects 28 12. gmp · Architects von Gerkan, Marg und Partner © HG Esch Photography The architects von Gerkan, Marg and Partners (gmp) are an architectural practice that was founded in Hamburg and has branches worldwide. With our generalist approach and more than 50 years of experience, we complete projects in dialogue with our clients and the participating planning disciplines, at all scales and cultural contexts, covering all design phases and working on all continents. The range of our projects extends from family residences to high-rise buildings, from stadiums to concert halls, from office buildings to bridges, and from door hardware to urban planning. With holistic sustainability in mind, we aim to create new and refurbished architecture that is long-lasting and goes beyond temporary fashions, taking into account the global challenges and issues of urbanization, digitalization, and mobility. Some of gmp · Architects von Gerkan, Marg und Partner’s most prominent projects include: Guna Villa, Jūrmala, Latvia Universiade 2011 Sports Center, Shenzhen, China Olympic Stadium, Kiev, Ukraine, Kyiv, Ukraine Olympic Stadium, Berlin, Germany Twin Towers, Commodity Exchange Plaza, Dalian, China The following statistics helped gmp · Architects von Gerkan, Marg und Partner achieve 12th place in the 30 Best Architecture Firms in Germany: Featured Projects 8 Total Projects 36 11. kadawittfeldarchitektur © kadawittfeldarchitektur We are kadawittfeldarchitektur. Originally founded in Aachen in 1999, we today stand for more than just architectural design. The interdisciplinary approach of our work, linking architecture, interior and product design on the one hand and at the interface of town planning and urban projects on the other hand, reflects the full range of our creative output. kadawittfeldarchitektur develops added value space. In a team of more than 170 persons, we create architecture with added value space for living, communication and work environments. In the way we deal with volumes, materials, structures and functions, we strive to integrate our schemes into their surroundings with the objective of creating contemporary and sustainable architecture and meeting the needs of both the users and the general public. Some of kadawittfeldarchitektur’s most prominent projects include: CELTIC MUSEUM, Glauburg, Germany ADIDAS LACES, Herzogenaurach, Germany SPZ, HALLEIN, Hallein, Austria SENIOR CITIZENS RESIDENCE ALTENMARKT, Altenmarkt im Pongau, Austria SALZBURG CENTRAL STATION, Salzburg, Austria The following statistics helped kadawittfeldarchitektur achieve 11th place in the 30 Best Architecture Firms in Germany: Featured Projects 8 Total Projects 32 10. GRAFT © GRAFT What is graft? The English word ‘graft’ provokes a variety of meanings and multiple readings. It stands for transplants in the field of medicine, for cheating, but also for hard work.  In the terminology of botany, grafting is described as the addition of one shoot onto a genetically different host. Some of GRAFT’s most prominent projects include: Ice Stadion “Arena Schierke”, Wernigerode, Germany Show Palace Munich, Munich, Germany Autostadt Roof and Service Pavilion, Wolfsburg, Germany Eiswerk, Berlin, Germany Villa M , Berlin, Germany The following statistics helped GRAFT achieve 10th place in the 30 Best Architecture Firms in Germany: A+Awards Finalist 2 Featured Projects 7 Total Projects 17 9. HENN © HENN HENN is an international architecture studio with over 75 years of experience in designing innovative work environments across office, science, healthcare, industry, education, and culture. An interdisciplinary team of 400 professionals works from offices in Munich, Berlin, Frankfurt am Main, and Shanghai. The design process is collaborative and driven by curiosity. HENN draws from the rich expertise of three generations and a global network of partners. All three generations share a common mindset: openness and curiosity. This spirit drives the studio to continuously question and redefine architectural typologies. HENN was founded in 1947 by Walter Henn in Dresden. Early on, he specialized in industrial buildings and played a key role in establishing the Braunschweig School through his academic work. Some of HENN’s most prominent projects include: Porsche Pavilion, Wolfsburg, Germany Zalando Headquarters Berlin, Berlin, Germany Bugatti Atelier, Molsheim, France MobileLife Campus, Wolfsburg, Germany The CUBE, Dresden, Germany The following statistics helped HENN achieve 9th place in the 30 Best Architecture Firms in Germany: A+Awards Winner 2 A+Awards Finalist 2 Featured Projects 6 Total Projects 30 8. Auer Weber © Aldo Amoretti Photography Founded in 1980, we are an internationally active architectural firm with offices in Stuttgart and Munich. We employ around 150 people from 20 countries and work on projects of various sizes and tasks from initial design through to completion. Each year, we create entries for between 30 and 40 competitions in our two offices, from which we generate a large proportion of our orders. These range from buildings for the community to educational and administrative buildings, sports and leisure facilities and large infrastructure projects. The diversity of our architecture is the result of in-depth study of the building tasks and where these tasks originate. Some of Auer Weber’s most prominent projects include: Aquatic Centre “Aquamotion” Courchevel , Saint-Bon-Tarentaise, France Arena du Pays d’Aix, Aix-en-Provence, France Extension of the District Office in Starnberg, Starnberg, Germany ESO Headquarters Extension, Garching, Germany Olympic Aquatics Stadium, Route de Torcy, France The following statistics helped Auer Weber achieve 8th place in the 30 Best Architecture Firms in Germany: A+Awards Winner 2 A+Awards Finalist 1 Featured Projects 9 Total Projects 24 7. Peter Ruge Architekten © Peter Ruge Architekten GmbH Identity+Sustainability=Architecture Peter Ruge Architekten is a locally and internationally active planning office based in Berlin. Our mission is simple: to develop and build sustainable architecture of the future. The agenda of the team along with three partners Peter Ruge, Kayoko Uchiyama and Matthias Matschewski includes new buildings, optimization of existing properties and urban planning designs. The projects are holistic, i.e. adapted to the climate, culture and needs of the users, and have received numerous awards and certifications. Our detailed understanding of sustainable design processes supports the decisions of our clients. In education field, Prof. Ruge shares our knowledge with a global design community at DIA, Anhalt University of Applied Sciences in Dessau, Shenyang Jianzhu University in China and Kyoto Seika University in Japan. Some of Peter Ruge Architekten’s most prominent projects include: Busan Opera House, South Korea, Busan, South Korea Congress Center Hangzhou, Hangzhou, China House O, Germany, Potsdam-Mittelmark, Germany LTD_1 Hamburg, Germany, Hamburg, Germany Muzeum Lotnictwa Krakow, Poland The following statistics helped Peter Ruge Architekten achieve 7th place in the 30 Best Architecture Firms in Germany: Featured Projects 12 Total Projects 18 6. HPP Architects © Christa Lachenmaier Photography HPP Architects is one of Europe’s leading architectural partnerships with a full range of architectural and master planning services. Since its foundation by Professor Hentrich, the 4th generation of HPP partnership today includes a global team of more than 25 nationalities and 480 architects, engineers, urban designers and specialists. Today it comprises 13 offices including 8 regional offices in Germany and 5 international branches in Turkey, China and Netherlands. HPP Architects’ headquarter is located in the Düsseldorf Media Harbor, further offices are located in Amsterdam, Beijing, Berlin, Cologne, Frankfurt, Hamburg, Istanbul, Leipzig, Munich, Shanghai, Shenzhen and Stuttgart. HPP completed more than 1200 buildings worldwide and aspires to create architectural quality of lasting value beyond the here and now: timeless and yet clearly part of their time, innovative and equally grounded in history. Some of HPP Architects’s most prominent projects include: LVM 5 , Münster, Germany Medical Library Oasis (O.A.S.E.), Düsseldorf, Germany Hochschule Ruhr West, Mülheim, Germany Henkel Asia-Pacific and China Headquarters, Shanghai, China Dreischeibenhaus, Düsseldorf, Germany The following statistics helped HPP Architects achieve 6th place in the 30 Best Architecture Firms in Germany: A+Awards Finalist 3 Featured Projects 12 Total Projects 25 5. Behnisch Architekten © David Matthiessen The Stuttgart-based practice known today as Behnisch Architekten was founded in 1989 under the leadership of Stefan Behnisch. Originally established as a branch office of Günter Behnisch’s practice Behnisch & Partner, it became independent in 1991 and has subsequently developed into an international practice with offices in Stuttgart, Munich, Los Angeles/California (1999 – 2011), and Boston. These offices are directed by Stefan Behnisch and his partners in varying combinations. The Partners are Robert Hösle, Robert Matthew Noblett and Stefan Rappold. Stefan Behnisch is involved in all three offices. From the outset, the social dimension of architecture has been a fundamental aspect of the firm’s design philosophy. Some of Behnisch Architekten’s most prominent projects include: SC Workplaces, California City of Santa Monica Public Parking Structure #6, Santa Monica, California Primary School Infanteriestrasse, München, Germany Harvard University Science and Engineering Complex, Boston, Massachusetts John and Frances Angelos Law Center, University of Baltimore, Baltimore, Maryland The following statistics helped Behnisch Architekten achieve 5th place in the 30 Best Architecture Firms in Germany: A+Awards Finalist 9 Featured Projects 8 Total Projects 24 4. wulf architekten © Tobias Vollmer wulf architekten emerged from the architecture practice established 1987 in Stuttgart by Tobias Wulf. Currently the office is managed by Tobias Wulf, Jan-Michael Kallfaß, Ingmar Menzer and Steffen Vogt. From 1996 to 2018, Kai Bierich and Alexander Vohl were partners of Tobias Wulf at wulf architekten. Currently, the company has about 140 employees, nine of them being senior architects. With three office locations – Stuttgart, Berlin and Basel (CH) – wulf architekten is also working on projects abroad. Some of wulf architekten’s most prominent projects include: Parking Garage Facade P22a at the Cologne Exhibition Centre, Cologne, Germany Four primary schools in modular design, Munich, Germany School Center North, Stuttgart, Germany Canteen and Media Center for North vocational school center, Darmstadt, Germany Chamber of Industry and Commerce, headquarters, Stuttgart, Germany The following statistics helped wulf architekten achieve 4th place in the 30 Best Architecture Firms in Germany: A+Awards Winner 1 A+Awards Finalist 1 Featured Projects 11 Total Projects 18 3. TCHOBAN VOSS Architekten © TCHOBAN VOSS Architekten GmbH TCHOBAN VOSS Architekten design, plan and build for national and international clients in the public and private sectors. The company, with offices in Hamburg, Berlin and Dresden, is named after Sergei Tchoban, architect BDA, and his partner Ekkehard Voss, architect BDA (1963-2024). With over 150 highly qualified, interdisciplinary employees and many years of experience, it offers architecturally and functionally sustainable solutions for a wide range of building projects in Germany and abroad. TCHOBAN VOSS Architekten is member of the Association of German Architects (BDA), the Chambers of Architects in Hamburg, Berlin and Saxony, the Förderverein Bundesstiftung Baukultur e.V. as well as of the European Architects Network (EAN). Some of TCHOBAN VOSS Architekten’s most prominent projects include: EDGE Suedkreuz Berlin, Berlin, Germany SKF Test Centre for large-scale bearings, Schweinfurt, Germany Seestraße, Berlin, Berlin, Germany Koenigstadt-Quartier, Berlin, Germany EMBASSY – Living alongside Koellnischer Park, Berlin, Berlin, Germany The following statistics helped TCHOBAN VOSS Architekten achieve 3rd place in the 30 Best Architecture Firms in Germany: A+Awards Winner 1 A+Awards Finalist 6 Featured Projects 12 Total Projects 29 2. Barkow Leibinger © Barkow Leibinger The scope of Barkow Leibinger’s work spans from cultural projects to industrial ones. Their focus on industrial architecture includes master planning and building representational and functional buildings for production, logistical and office spaces. Some of Barkow Leibinger’s most prominent projects include: Production Hall Trumpf, Hettingen, Germany Stadthaus M1 – Green City Hotel, Freiburg, Germany Harvard ArtLab, Boston, Massachusetts Production Hall, Grüsch, Switzerland Fraunhofer Research Campus, Waischenfeld, Germany The following statistics helped Barkow Leibinger achieve 2nd place in the 30 Best Architecture Firms in Germany: Featured Projects 12 Total Projects 17 1. J.MAYER.H © J.MAYER.H J. MAYER H’s studio, focuses on works at the intersection of architecture, communication and new technology. From urban planning schemes and buildings to installation work and objects with new materials, the relationship between the human body, technology and nature form the background for a new production of space. Some of J.MAYER.H’s most prominent projects include: MIAMI MUSEUM GARAGE, Miami, Florida n.n. Residence, Moscow, Russia Hasselt Court House , Hasselt, Belgium Highway Rest Stops, Tbilisi, Georgia Rest Stops, Gori, Georgia Featured image: Tram Stops, Kehl, Germany The following statistics helped J.MAYER.H achieve 1st place in the 30 Best Architecture Firms in Germany: A+Awards Winner 5 A+Awards Finalist 3 Featured Projects 19 Total Projects 30 Why Should I Trust Architizer’s Ranking? With more than 30,000 architecture firms and over 130,000 projects within its database, Architizer is proud to host the world’s largest online community of architects and building product manufacturers. Its celebrated A+Awards program is also the largest celebration of architecture and building products, with more than 400 jurors and hundreds of thousands of public votes helping to recognize the world’s best architecture each year. Architizer also powers firm directories for a number of AIA (American Institute of Architects) Chapters nationwide, including the official directory of architecture firms for AIA New York. An example of a project page on Architizer with Project Award Badges highlighted A Guide to Project Awards The blue “+” badge denotes that a project has won a prestigious A+Award as described above. Hovering over the badge reveals details of the award, including award category, year, and whether the project won the jury or popular choice award. The orange Project of the Day and yellow Featured Project badges are awarded by Architizer’s Editorial team, and are selected based on a number of factors. The following factors increase a project’s likelihood of being featured or awarded Project of the Day status: Project completed within the last 3 years A well written, concise project description of at least 3 paragraphs Architectural design with a high level of both functional and aesthetic value High quality, in focus photographs At least 8 photographs of both the interior and exterior of the building Inclusion of architectural drawings and renderings Inclusion of construction photographs There are 7 Projects of the Day each week and a further 31 Featured Projects. Each Project of the Day is published on Facebook, Twitter and Instagram Stories, while each Featured Project is published on Facebook. Each Project of the Day also features in Architizer’s Weekly Projects Newsletter and shared with 170,000 subscribers.     We’re constantly look for the world’s best architects to join our community. If you would like to understand more about this ranking list and learn how your firm can achieve a presence on it, please don’t hesitate to reach out to us at editorial@architizer.com. The post 30 Best Architecture and Design Firms in Germany appeared first on Journal.

This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology. Manus has kick-started an AI agent boom in China Last year, China saw a boom in foundation models, the do-everything large language models that underpin the AI revolution. This year, the focus has shifted to AI agents—systems that are less about responding to users’ queries and more about autonomously accomplishing things for them.There are now a host of Chinese startups building these general-purpose digital tools, which can answer emails, browse the internet to plan vacations, and even design an interactive website. Many of these have emerged in just the last two months, following in the footsteps of Manus—a general AI agent that sparked weeks of social media frenzy for invite codes after its limited-release launch in early March.As the race to define what a useful AI agent looks like unfolds, a mix of ambitious startups and entrenched tech giants are now testing how these tools might actually work in practice—and for whom. Read the full story. —Caiwei Chen Inside the race to find GPS alternatives Later this month, an inconspicuous 150-kilogram satellite is set to launch into space aboard the SpaceX Transporter 14 mission. Once in orbit, it will test super-accurate next-generation satnav technology designed to make up for the shortcomings of the US Global Positioning System (GPS). Despite the system’s indispensable nature, the GPS signal is easily suppressed or disrupted by everything from space weather to 5G cell towers to phone-size jammers worth a few tens of dollars. The problem has been whispered about among experts for years, but it has really come to the fore in the last three years, since Russia invaded Ukraine.Now, startup Xona Space Systems wants to create a space-based system that would do what GPS does but better. Read the full story. —Tereza Pultarova Why doctors should look for ways to prescribe hope —Jessica Hamzelou This week, I’ve been thinking about the powerful connection between mind and body. Some new research suggests that people with heart conditions have better outcomes when they are more hopeful and optimistic. Hopelessness, on the other hand, is associated with a significantly higher risk of death. The findings build upon decades of fascinating research into the phenomenon of the placebo effect. Our beliefs and expectations about a medicine (or a sham treatment) can change the way it works. The placebo effect’s “evil twin,” the nocebo effect, is just as powerful—negative thinking has been linked to real symptoms. Researchers are still trying to understand the connection between body and mind, and how our thoughts can influence our physiology. In the meantime, many are developing ways to harness it in hospital settings. Is it possible for a doctor to prescribe hope? Read the full story. This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here. The must-reads I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology. 1 Elon Musk threatened to cut off NASA’s use of SpaceX’s Dragon spacecraftHis war of words with Donald Trump is dramatically escalating. (WP $)+ If Musk actually carried through with his threat, NASA would seriously struggle. (NYT $)+ Silicon Valley is starting to pick sides. (Wired $)+ It appears as though Musk has more to lose from their bruising breakup. (NY Mag $) 2 Apple and Alibaba’s AI rollout in China has been delayedIt’s the latest victim of Trump’s trade war. (FT $)+ The deal is supposed to support iPhones’ AI offerings in the country. (Reuters) 3 X’s new policy blocks the use of its posts to ‘fine-tune or train’ AI modelsUnless companies strike a deal with them, that is. (TechCrunch)+ The platform could end up striking agreements like Reddit and Google. (The Verge) 4 RJK Jr’s new hire is hunting for proof that vaccines cause autismVaccine skeptic David Geier is seeking access to a database he was previously barred from. (WSJ $)+ How measuring vaccine hesitancy could help health professionals tackle it. (MIT Technology Review) 5 Anthropic has launched a new service for the militaryClaude Gov is designed specifically for US defense and intelligence agencies. (The Verge)+ Generative AI is learning to spy for the US military. (MIT Technology Review) 6 There’s no guarantee your billion-dollar startup won’t failIn fact, one in five of them will. (Bloomberg $)+ Beware the rise of the AI coding startup. (Reuters) 7 Walmart’s drone deliveries are taking offIt’s expanding to 100 new US stories in the next year. (Wired $) 8 AI might be able to tell us how old the Dead Sea Scrolls really are Models suggest they’re even older than we previously thought. (The Economist $)+ How AI is helping historians better understand our past. (MIT Technology Review) 9 All-in-one super apps are a hit in the Gulf They’re following in China’s footsteps. (Rest of World) 10 Nintendo’s Switch 2 has revived the midnight launch eventFans queued for hours outside stores to get their hands on the new console. (Insider $)+ How the company managed to dodge Trump’s tariffs. (The Guardian) Quote of the day “Elon finally found a way to make Twitter fun again.” —Dan Pfeiffer, a host of the political podcast Pod Save America, jokes about Elon Musk and Donald Trump’s ongoing feud in a post on X. One more thing This rare earth metal shows us the future of our planet’s resources We’re in the middle of a potentially transformative moment. Metals discovered barely a century ago now underpin the technologies we’re relying on for cleaner energy, and not having enough of them could slow progress.  Take neodymium, one of the rare earth metals. It’s used in cryogenic coolers to reach ultra-low temperatures needed for devices like superconductors and in high-powered magnets that power everything from smartphones to wind turbines. And very soon, demand for it could outstrip supply. What happens then? And what does it reveal about issues across wider supply chains? Read our story to find out. —Casey Crownhart We can still have nice things A place for comfort, fun and distraction to brighten up your day. (Got any ideas? Drop me a line or skeet ’em at me.) + Sightings of Bigfoot just happen to correlate with black bear populations? I smell a conspiracy!+ Watch as these symbols magically transform into a pretty impressive Black Sabbath mural.+ Underwater rugby is taking off in the UK.+ Fed up of beige Gen Z trends, TikTok is bringing the 80s back.

FORM Brands Studio has given London’s Air Ambulance Charity a new look. Rather than transporting patients to hospital, the charity’s doctors and paramedics treat seriously injured people at the scene from its two helicopters and eight cars. It is the only organisation performing this role in London. Established in 1989, it is called to a rising number of patients across the capital every year, helping more than 2,000 people in 2024. London’s Air Ambulance Charity (LAAC) needs £17m a year to operate, 96% which comes from donations. “But 60% of Londoners don’t know we’re a charity,” says LAAC’s director of fundraising and marketing, Jayne Clarke. FORM Brands Studio identity for London’s Air Ambulance Charity in OOH posters Its new organisational strategy is about raising awareness, enhancing fundraising efforts and strengthening its connection with London’s communities. “We’re trying to make sure the strategy is about hope and looking forward to the future,” Clarke says. To accompany this new strategy, the charity also decided to change up its visual identity. “Our previous branding was very corporate,” Clarke admits.FORM Brands Studio won the job after a pitch. Strategy director Beth Andlaw set up the east London agency in 2022 with creative director Alex Andlaw. Before that she had been in comms and PR, and had worked with LAAC on and off for about 20 years. FORM Brands Studio identity for London’s Air Ambulance Charity on stage FORM introduced a new wordmark, colour palette, typeface, icons, motion, creative copy, messaging, fundraising memorabilia and photography. However, the existing helicopter icon was retained. “It has a lot of love and legacy,” says Clarke. The agency’s brand idea, Propelling Promise, was inspired by the urgent, intense nature of the work carried out by LAAC’s clinical and operational crews. That was used to give structure to creative copy lines and the new tone of voice. Each lead line includes an element of “propelling” to imply urgency and momentum, and “promise” to imply warmth and hope. That resulted in lines including “Trauma doesn’t stop. Neither do we” and “Here for London. Today, tomorrow, always.” FORM brought in Peggy Nyamekye to work on the copywriting. Meanwhile, the visual identity, developed with designer Mayan Mistry, comprises a gradient design system, drawing on the rotational motion of helicopter blades. Borough names are repeated in radiating patterns and overlaid with the gradient. Red is still central to the charity’s identity, but FORM introduced the vivid orange worn by medics on-scene. “These colours blend in the gradient, creating a visual signature that speaks to urgency, action, optimism and hope,” says Alex Andlaw. https://d3faj0w6aqatyx.cloudfront.net/uploads/2025/06/LAA_OOH_TUBE_1920x1080.mp4 With the help of motion graphics designer Matt Fowler, the agency introduced movement to the branding, to reflect the aircraft’s blades in flight. The logo’s new wordmark is in Barlow, inspired by the existing big white lettering on the helicopter tail booms. Before, the charity’s name was written lower case in a thinner font. “Now it’s bigger, bolder and more impactful,” says Alex Andlaw. FORM also redesigned the icons to have more personality but still be functional. “The icons help the team talk about quite hard subjects,” he says, such as casualties, and the designs had to balance warmth and realism. “We did quite a few hearts, some look too detailed and some too basic,” he explains. The agency also created a series of collectible badges, inspired by the embroidered badges worn by the charity’s doctors and pilots.FORM Brands Studio identity for London’s Air Ambulance Charity in Instagram posts Meanwhile, photographer James Pearson-Howes was briefed to capture real people, places and moments from across London. The new branding had to resonate with very different types of donors, from the charity’s collection buckets to seven-figure corporate donations, says Clarke. “And the doctors wearing the brand have very strong opinions, as do the pilots. FORM took in all these views and managed to make all those people happy.” https://d3faj0w6aqatyx.cloudfront.net/uploads/2025/06/LAA_OOH_BILLBOARD_1920x1080.mp4 FORM Brands Studio identity for London’s Air Ambulance Charity FORM Brands Studio identity for London’s Air Ambulance Charity in OOH posters