Wednesday, February 25, 2015

Cablevision Seems Quite Smart

As a Cablevision customer there were times I had my doubts. I even had doubts that a CATV company could execute a WiFi system. But Cablevision has exceeded all doubts. They are quite smart in deploying WiFi.

About 10 years ago we tried a mesh WiFi system we called Linear A. It used a modified Roof Net software developed by MIT grad students who went on to found a Google funded start up called Meraki. It was sold to Cisco. But the bottom line was that mesh WiFi works. Make each customers cable modem a Meshed Wifi and you suddenly get a powerful system. I use Cablevision's WiFi as I come home from the City, one train stop after the other. Cheaper than any Verizon service.

In all, this meshed distributed approach has great potential.  If Cablevision can execute this as well as it had its fiber backbone and WiFi network, then I believe it could be a real threat to major urban users.
In 2006-2009 we deployed many of these mesh units but the problem was that there were few dual mode sets, only cellular air interfaces. Now WiFi air interfaces are exploding.

As they state in Fierce Wireless:

Just weeks after launching its low-cost Freewheel Wi-Fi calling and data service, Cablevision.... told investors during the company's fourth quarter earnings call that he believes Freewheel will disrupt the cellular industry and his company is going to put more emphasis on its Wi-Fi initiatives.  Specifically, ... said that his company is going to prioritize Wi-Fi over the company's traditional video business, which is facing rising programming costs. He noted that margins for data products such as Wi-Fi are increasing. Although ... admitted that it was too early to assess demand for Freewheel, he said that the company is seeing usage outside its footprint primarily by non-U.S. citizens who want a low-cost phone available for when they conduct American business.

 Frankly, this is just a great idea, whose time has come. Cablevision has shown both interest and competence and it will be interesting to see how they execute on this. Unlike a Google approach, spend billions and make lots of noise, Cablevision just moves ahead elegantly and with great promise.

Now It's Oatmeal!

There is a report in Eureka linking a mold on oats to renal cancer. They state:

some oat-based breakfast cereals in the U.S. contain a mold-related toxin called ochratoxin A (OTA) that's been linked to kidney cancer in animal studies. The findings could have implications for consumer health. 

 The article states:

Ochratoxin A (OTA) has been found in all major cereal grains including oat, wheat, and barley worldwide and considered as a potential concern in food safety. A total of 489 samples of corn-, rice-, wheat-, and oat-based breakfast cereal were collected from U.S. retail marketplaces over a two-year period, and OTA was determined by high-performance liquid chromatography. Overall, 205 samples (42%) were contaminated with OTA in the range from 0.10 to 9.30 ng/g. The levels OTA were mostly below of the European Commission Regulation (3 ng/g) except in 16 samples of oat-based cereals. The incidence of OTA was highest in oat-based breakfast cereals (70%, 142/203), followed by wheat-based (32%, 38/117), corn-based (15%, 15/103), and rice-based breakfast cereals (15%, 10/66). On the basis of the incidence and concentration of OTA, oats and oat-based products may need greater attention in further surveillance programs and development of intervention strategies to reduce health risks in consumers.

 Molds are well known toxins and causes of a variety of cancers. The presence of this molecule in uncooked oats may or may not be significant but in processed oat cereals which are eaten uncooked is a concern. Especially since there is a strong push to eat oats to manage cholesterol.

Eureka continues:

Animals exposed to OTA in experiments developed kidney tumors. Although the U.S. doesn't currently regulate the contaminant, the European Union has set maximum limits for OTA in food. 

This may become a major FDA issue especially since the EU regulators have chimed in.

Monday, February 23, 2015

Oops! Guess I was Right

Looks like after the USPTF issued their "brilliant" dictum of not doing PSA tests that the result is more aggressive PCa and more dead men! Told Ya! Never trust a Government Panel, been there and saw what they do.

Now Healio describes the increase in PCa. As the piece states:

The US Preventive Services Task Force recommends against routine-based PSA prostate cancer screening for healthy men regardless of age. In 2009, the USPSTF issued that recommendation for men aged 75 years or older. In 2011, the task force issued draft guidance expanding that recommendation to include all men, and it finalized that recommendation in May 2012. A study by ...and colleagues was the first to measure changes in prostate cancer presentation since the USPSTF made these recommendations. “If you don’t screen the people, then when they do show up with prostate cancer, the horse is out of the barn,” ...said during a press conference. “They’re more likely to be at intermediate risk because, by missing early disease, then you are going to catch it when it’s palpable or causing symptoms. That, of course, makes it much more difficult to treat.”

We stated this at the time of the USPTF report. We provided detailed evidence of the contrary of the re[port. We demonstrated that the two NEJM studies were flawed. But think of all the PSA tests it saved. Then think of all the bone mets and DICs resulting. But then again we have our beloved GS9s and subsidized Government cafeterias... Welcome to the ACA, and we have not yet gotten to those "death panels". or have we?

Medicare and Obesity

The ACA has allowed Primary Care physicians to get fully reimbursed for counselling Medicare Patients who are obese. Kaiser has a piece discussing its lack of success. They state:

For older adults, being mildly overweight causes little harm, physicians say. But too much weight is especially hazardous for an aging body: Obesity increases inflammation, exacerbates bone and muscle loss and significantly raises the risk of heart disease, stroke, and diabetes....o help the 13 million obese seniors in the U.S., the Affordable Care Act included a new Medicare benefit offering face-to-face weight-loss counseling in primary care doctors’ offices. Doctors are paid to provide the service, which is free to obese patients , with no co-pay. But only 50,000 seniors participated in 2013, the latest year for which data is available....who is obese herself, says she doesn’t expect her older patients to lose a lot of weight. “I think you’ll see weight loss of 10 to 20 pounds, but whether you’re going to see people lose 50 to 100 pounds as they’re older, I doubt it.”. Still, ... says, even with small amounts of weight loss in her older patients, she expects to see a decrease in the complications of chronic medical diseases, including diabetes-related leg amputations.

The facts are:

1. Obesity is an inflammatory enhancing state. Inflammation enhances the potential for and the exacerbation of various cancers.

2. Ongoing obesity has multiple sequella including costly kidney and cardiovascular problems.

3. Yes, Primary Care physicians have problems communicating with patients and worse patients just do not listen. Look at the number, 13 million obese Medicare patients and only 50,000 were dealt with, not necessarily successfully.

 The problem of obesity starts young and then continues. Why not stop it in the teenage years? Why not before 40? Why wait until 65 and later. The costs of obesity on future generations will be explosive. The ACA may have had good intentions but adherence demands perhaps a heavy hand.

Sunday, February 22, 2015

The End of an Era

I got a note today from COMSAT alumni that they are finally removing the 32 m antenna AND-03 at the old Andover Earth Station. I used that antenna to connect to European stations using the above antenna in the 70s to monitor Soviet Nuclear Weapons tests.

This is the end of an era. The old 4/6 GHz bands no longer serve the original purpose. COMSAT was an interesting company, an evolution from a Government vision for satellite communications, managed by a collection of DoD types which lost sight of the commercial world and was slowly disassembled into nothing.

It was a great training ground to understand Washington...pure ruthless politics...played just for the sake of the game. Amazing what a monopoly can do...then it dies.

Friday, February 20, 2015

Telling Us the Obvious

From the Office of Disease Prevention and Health Promotion comes this years guidelines. First off the name of this institution is right out of 1984 or the like. We have a group of folks sitting around on an annual basis telling us what to eat. The answer is simple, less. We are in generally too fat, too lazy, and costing the health care system too much. End of report. But no, it is our Government at work and they cannot say in a few words what they can spend tens of thousands on. You have to read this report.

For example they state:

The 2015 DGAC’s work was guided by two fundamental realities. First, about half of all American adults—117 million individuals—have one or more preventable, chronic diseases, and about two-thirds of U.S. adults—nearly 155 million individuals—are overweight or obese. These conditions have been highly prevalent for more than two decades. Poor dietary patterns, overconsumption of calories, and physical inactivity directly contribute to these disorders. Second, individual nutrition and physical activity behaviors and other health-related lifestyle behaviors are strongly influenced by personal, social, organizational, and environmental contexts and systems. Positive changes in individual diet and physical activity behaviors, and in the environmental contexts and systems that affect them, could substantially improve health outcomes.

 So what is new with any of this? Nothing. Yet the problem is solved by individual choice. Yes, if we burn 2000 kcal per day we better not eat 2100 kcal per day. 3500 kcal is one added pound. Been that way for a few centuries at least.

They continue:

The DGAC found that several nutrients are underconsumed relative to the Estimated Average Requirement or Adequate Intake levels set by the Institute of Medicine (IOM) and the Committee characterized these as shortfall nutrients: vitamin A, vitamin D, vitamin E, vitamin C, folate, calcium, magnesium, fiber, and potassium. For adolescent and premenopausal females, iron also is a shortfall nutrient. Of the shortfall nutrients, calcium, vitamin D, fiber, and potassium also are classified as nutrients of public health concern because their underconsumption has been linked in the scientific literature to adverse health outcomes. Iron is included as a shortfall nutrient of public health concern for adolescent females and adult females who are premenopausal due to the increased risk of iron-deficiency in these groups. The DGAC also found that two nutrients—sodium and saturated fat—are overconsumed by the U.S. population relative to the Tolerable Upper Intake Level set by the IOM or other maximal standard and that the overconsumption poses health risks.

Any reasonable diet would overcome this. Eating fast foods will not. Again nothing new here.

The report them bemoans:

Obesity and many other health conditions with a nutritional origin are highly prevalent. The Nation must accelerate progress toward reducing the incidence and prevalence of overweight and obesity and chronic disease risk across the U.S. population throughout the lifespan and reduce the disparities in obesity and chronic disease rates that exist in the United States for certain ethnic and racial groups and for those with lower incomes.  

Again, and for centuries, one knows that input less output is net accumulation. Added weight, above BMI 25 means increase inflammation, increased inflammation increases the risks of cancer, such as breast and prostate. We know that. So how does one regulate this? Simple, tax weight. Too simple, we become anti obese, yes, because it is to societies benefit. If one wants to be that way then one must carry the costs of being so. At least in a fair market.

They conclude:

It will take concerted, bold actions on the part of individuals, families, communities, industry, and government to achieve and maintain the healthy diet patterns and the levels of physical activity needed to promote the health of the U.S. population. These actions will require a paradigm shift to an environment in which population health is a national priority and where individuals and organizations, private business, and communities work together to achieve a population-wide “culture of health” in which healthy lifestyle choices are easy, accessible, affordable, and normative—both at home and away from home. In such a culture, health care and public health professionals also would embrace a new leadership role in prevention, convey the importance of lifestyle behavior change to their patients/clients, set standards for prevention in their own facilities, and help patients/clients in accessing evidence-based and effective nutrition and comprehensive lifestyle services and programs.

Nonsense! It does not take bold actions. Just put the fork down! The Government has de minimis role, since Government education programs are poor in influencing the public. The only factor is charging for obesity. Frankly there is no other way. It worked on tobacco!