Friday, October 9, 2015

Saint Vladimir

When I returned to Russia the first time after the collapse, I believe it was 1993, it was to Saint Petersburg, not Leningrad. What I noticed even then was that the Churches were filled, weddings, funerals, old women, young people. In less than 3 years religion returned.

Then for my ten years in an out of Moscow I saw the churches rebuilt to a state that exceeded even the best under the Czars. The Metropolitan of Moscow, the alleged, and historically the actual, successor to the Bishops of the Church, regained their positions and aligned themselves with the Government, Putin especially.

In the Montefiore piece in today's NY Times I believe he gets some but not all of the depth. Hie piece should be read, especially by those in Washington. They seem clueless. I suspect they have no idea of the 30 Years War, but I put that aside.

You see the Metropolitan in Moscow is the successor to the Bishop of Constantinople, a clear un-broken line back to Peter. The Bishop of Rome was abandoned during the Avignon Papacy, when the French Kings controlled what was the "Papacy", the Bishop of Rome, who moved to Avignon. That broke the unbroken line. Moscow sees itself unbroken, Rome was demolished for over 100 years. No wonder Moscow is not interested in a conversation.

But the Metropolitan speaks for the people and he speaks for Putin. The Orthodox Church has replaced Communism in a way Lenin and Stalin would never have believed. The Montefiore piece is only part of the tale. Cyril and Methodius sent Christianity to the Slavs and ironically it had become part of the Russian soul. They have a strong and well founded belief in their destiny, and Putin is not acting foolishly, he is acting to accomplish that destiny.

Remember the window in Prague when the Papal delegate was thrown out onto the dung heap. Thirty years of religious war. Who will be landing on the dung heap this time. Doubt it will be Saint Vladimir.

Wednesday, October 7, 2015

Kendall Square

I have seen Kendall Square for well over 55 years and have seen it from the days of a well worn 19th Century factory location to what it is today, a hub for biotech.
In a recent article at A Slice of MIT they discuss the evolution of the area. They state:

As part of the new initiative, the MIT Museum will move to a new building next to the T station, opening out onto a park with Ping-Pong tables, fire pits in winter, public art, and other amenities…all ventures will set aside 5 percent of their square footage for ‘innovation space.’” ...“‘You could imagine years from now going and tracing something back to Kendall Square that really changed the world,’ says MIT Treasurer Israel Ruiz “If through our efforts we will have made it possible to solve something that we otherwise wouldn’t have been able to solve, that will be the best prize.”

The problem that the seem to have missed, and missed in a really big way is that of traffic flow. It appears that Google has absconded with all the parking places in the Marriott garage, and the parking rates if one exist have gone from $11.50 a day to over $50! Beats mid-town New York. Public transportation on the T is useless if you are trying to get to one of the buildings inside the area, halfway between the Green and Red Lines. Traffic flow still has to deal with the narrow streets great for 18th century horse traffic.

It would have been nice if MIT and the City of Cambridge would have done some Urban Planning. Just putting in more buildings does not work. It comes to a stand still.

Thursday, October 1, 2015

Trees and Diversity

In a recent Nature article the authors estimate the number of trees on the globe. Their conclusion is:

The global extent and distribution of forest trees is central to our understanding of the terrestrial biosphere. We provide the first spatially continuous map of forest tree density at a global scale. This map reveals that the global number of trees is approximately 3.04 trillion, an order of magnitude higher than the previous estimate. Of these trees, approximately 1.39 trillion exist in tropical and subtropical forests, with 0.74 trillion in boreal regions and 0.61 trillion in temperate regions. Biome-level trends in tree density demonstrate the importance of climate and topography in controlling local tree densities at finer scales, as well as the overwhelming effect of humans across most of the world. Based on our projected tree densities, we estimate that over 15 billion trees are cut down each year, and the global number of trees has fallen by approximately 46% since the start of human civilization.

 Now I decided to map my small patch of land in New Jersey, about 13,000 sq feet. Some 2,000 sq feet is my Hemerocallis "Lab" where we do genetic research. There is a house, a driveway and some 124 trees. Yes, some 124 trees, of some 32 different species. I have the densest collection of Ginkgos and Metasequopia in North America. Did not know that until I did the count. Both from China and both extinct in nature. And both bearing seed and quite healthy.

The above is the details. Now if we compare this to the Nature article we see:
Note that from the above Nature date our density of 928 trees/Hectare is well near the highest level on the chart.

So what does this say? Well we humans are lovers of plants, in my case specimen trees and Hemerocallis. We have managed to repopulate near extinct species.

There may be hope after all.

Wednesday, September 30, 2015

Is Meaningful Use Meaningful?

The EHR/EHR is moving forward in its Government mandated manner but signs of revolt may still be simmering. In MedPageToday they report:

...Amherst, Mass, said that three of the physicians who left her practice in the last year did so because of frustration with the Meaningful Use requirements. She said the practice underwent an expensive audit associated with the program that lasted more than a year, which had the ironic effect of delaying other programs aimed at improving patients' health. If Stage 3 goes into effect, ... said, she will be obliged to stop accepting Medicare patients, leaving 1,500 elderly and disabled patients without a primary care doctor. "I couldn't take care of my patients and take care of myself," she said. Another physician mocked the requirement for a certain percentage of patients to use online patient portals to communicate with doctors. He said he has his secretary log in his patients, most of whom are geriatric, so that they can send "a note of clinical relevance... which says 'hi'."

There are levels of problems here. First is the ability of the physician to enter "meaningful" data. For the most part it is cut and paste. Second is the ability to look at trends. Medicine often is seeing if anything has changed; HbA1c, PSA, BP, weight, etc. Change and rates of change are critical. I see this in monitoring HbA1c and PSA levels, yes PSA levels. Sample blood glucose are useless, HbA1c is a 90 day average. It has value. Single PSA is meaningless, velocity is prognostic. Most EHR make one fumble for those metrics. Third, try and get them to interconnect! Even in an integrated hospital system. Take New York Presbyterian. Cornell does not communicate with Columbia, and patient portals are separate and patient appointments are catch as catch can.

They continue

...a pediatrician from Leominster, Mass., agreed that certain metrics were inappropriate for certain specialties. "I think of this every time I check the blood pressure on a screaming 3-year-old who has an ear infection." And a number of physicians, ..., commented on the futility of punishing providers for the failures of technology vendors. Stack said he has the knowledge and expertise to take a patient whose liver has ruptured through numerous protocols and into the operating room in just enough time to keep the patient from bleeding to death internally. " I shoudn't have to write the software code for the electronic health record at the same time."

 It continues:

a professor at Harvard University and a researcher for the Children's Hospital Informatics Program at Boston Children's Hospital, said EHRs should be as adaptable as the apps on an iPhone. "If the makers of Angry Birds want to add a new bird they don't have to fly to Cupertino... to figure out how to do that."

 I could not have said it better myself!

Tuesday, September 29, 2015

Got Your Goat

I like the Canadians. They seem to give us our best comedians and good stories.

In the National Post we have the one about the goat:

A goat that bunkered down at the Tim Hortons in Martensville, Saskatchewan, has been reunited with its owners. Warman RCMP were called to the coffee shop Sunday around 4 a.m. The goat had walked into the entranceway of the building through the automatic doors and settled down for a nap. Police arrived and loaded the animal into their cruiser.

Yep, police called for a goat. Now for those not familiar with goats, this is not uncommon.

How to Spend Money, Ours!

It was not enough for the FEDs under the Stimulus to dump billions into broadband, with questionable results at best, but now NY State appears to be jumping in as well with State Taxpayer money.

The New Yrok Broadband plan will, it appears, give away some $500 million to build out broadband. They state:

Governor Cuomo has launched the largest and most ambitious investment in statewide broadband deployment in the country. Through the creation of the $500 million New NY Broadband Program, the State of New York will incentivize broadband provide rs to expand and upgrade networks to ensure that they reach all underserved and unserved communities in the State . The Program is designed to ensure that every New Yorker has access to high - speed Internet . The Program will be implemented by the end of 2018.

They also do address wireless which we believe is the only solution to such areas as rural New York State. BUT, who has the license? You just can't do wireless, you need a license, and most have been given out already. Any why 25 Mbps and 100 Mbps. I am always amazed at why someone who decides to live in the wilderness need our taxpayer money for 100 Mbps access when they most likely do not have indoor toilets!

Perhaps a state voter referendum would help here.