Tuesday, October 17, 2017

Beware W10 Upgrade

Like last years "upgrade" MS again messes everything up. Printers down, software needs re-configuring, and all the "goodies" must be manually disabled. In my opinion these are truly evil folks. All I want is my computer to run what I use it for. No games, just work. Is there any way that these demons can just stop it! An operating system is really simple, did one fifty years ago. Okay, a bit more complicated, but folks, stop it with all the crashes!

Hint: Stop any "upgrades". Unless you really like spending days fixing what they did.

Friday, October 13, 2017

A Letter on Tax Proposals

Senator Cory Booker
359 Dirksen Senate Office Building
Washington, DC 20510

Dear Senator Booker,

Congressman Rodney Frelinghuysen
2306 Rayburn House Office Building
Washington, DC 20515-3011

Dear Congressman Frelinghuysen,

As a constituent I would like to give my opinion regarding the proposed Tax Plan. Specifically as relates to deductions.

Local Taxes and Real Estate Taxes are by Personal Choice

Despite the high tax burden in New Jersey for both income and real estate taxes, I and many people have made that choice. That is especially so for those in high income brackets for whom this tax is discretionary. If I do not like it I can move. Lower income people do not benefit from this deduction, especially given the proposed increase in the standard deduction. Thus, any elimination of this would not benefit the wealthier but the contrary.

Charitable Deductions Benefit the Wealthy. They are by choice and all too often are Government subsidized ego trips.

Charitable deductions are also discretionary. The new tax proposal allows them. They benefit the wealth. The allow for the pyramids built in the names of donors and via complex tax benefits allow near in write offs while sheltering significant incomes. Now I make substantial donations primarily to cancer research. However I do so anonymously and would continue to do so no matter what the tax situation is. Many however want their names in lights as well and benefitting from this deduction. Thus, charitable deductions benefit the wealthy much more than anyone else. The benefits are both financial and ego building. Ego gratification should not be subsidized by the tax payer. Especially the poorer ones who cannot even afford healthcare.

Medical Expense Deductions Dramatically Burden the Poorer and are Highly Regressive. They are not by choice but are true calamities.

As a result of the ACA I have seen healthcare costs explode for the middle class. Ballooning insurance and exploding deductions. Then along comes a medical crisis and the costs truly explode because none of the plans provide truly catastrophic coverage. People and families suffering a health crises now face a financial crisis. I have seen many family and patients die of this disease and have seen the financial burden that they have had to bear. 

Yes it happens that the new tax proposal will take this away from these poor people while allowing the rich to maintain massive healthcare plans paid for with tax deductible dollars at the corporate level and getting massive deductions for their "charitable" yet ego building deductions. Here the poor are truly underwriting the rich! Frankly this is grossly immoral and reflects in my opinion the total disconnection between the current administrations financial analysts and the real world. Goldman Sachs has not clue how a truck driver lives. A child gets Hodgkin's disease or leukemia and they are driven to bankruptcy. I have seen this again and again. While this is happening the rich and their "donations" go to fine dinners and tell each other how wonderful they are.

Entrepreneurial Capital Gains and Hedge Funds do not Equate

I have spent several decades in venture capital. I have personally started and developed near a dozen companies and have invested in and overseen a total of thirty-five. In all cases I not only took the financial risk but conceived of the idea, structured the company, raised capital, operated the entity and monetized the result. Hedge funds are merely financial intermediaries. The entrepreneur is wedded to their concept and creation, twenty four hours a day. The hedge fund operator may at best attend a board meeting and collect a check. As such the tax code should incent the entrepreneur and tax the hedge fund operator as normal income.

Not only do we have the above problems in the Administration's proposal, but the wealthy would  get the benefit of eliminating the Estate Tax. The poor would see no benefit there, nor would the middle class. The middle class clearly bear the burden of this proposal and those 1% folks get a massive tax cut, paid for by the Middle Class. I feel this to be grossly immoral.

I am asking that you consider my concerns as not just those of a single constituent but reflective of the many who cannot voice what they face. Medical Expense should be inviolate. It is the least that we as a society can do for those in need. The others are by choice. If you keep one, just one, keep the Medical Expense for the millions who will benefit during times of need.

Thursday, October 12, 2017

Programmers and Programming: Getting a Package

There is this push to have everyone learn to code. Frankly that is wrong. The issue is to have everyone learn to think. Take as an example UPS and their on-line system. Now if you have a delivery and a number for tracking you can go on-line and hold the delivery, for a fee of course, until a later date. Sounds good? No.

What they do then is hold every delivery, not just the one you asked and paid for and they then charge you this modest fee for each and every one. A massive amount you never thought about.

Then you try their on-line remedy. It comes back and says you cannot use them you must go back to the web page and use the command that got you there in the first place and thus an infinite loop.

The code is all correct. It does what some human told it to do. But, and this is the key issue, the human had no idea how other humans use the system. Namely the human did not think.

Coding is not what has to be inculcated in our students. Thinking is. That is the hard part. There are four parts to developing software.

First, the requirements. What do you want done and why.

Second, the design of the process to ensure it does what is required under all anticipated conditions and in the event it does not it hands the system to a human to remedy and then reiterates this back to the designers for a change.

Third, coding. That is the old typist role. Just type in the required steps.

Fourth, the fault checking. This is the hard part. You spend time finding all your mistakes; coding and logical. You seek all the things that can go wrong. Then FIX them.

Of course you then do this again and again. You need smart people, and it is often a burn out job. But if you want your business to succeed then you must do this. If you do not do this then you have a real problem. Look at UPS. In my opinion they are not only clueless but careless. Why the Post Office is even better, now!

Wednesday, October 4, 2017

Obesity and Cancer

The CDC has released a report on obesity and cancer. In its MMWR they provide some details. They note:

Overweight and obesity are associated with increased risk of 13 types of cancer. These cancers account for about 40 percent of all cancers diagnosed in the United States in 2014, according to the latest Vital Signs report by the Centers for Disease Control and Prevention (CDC). Overall, the rate of new cancer cases has decreased since the 1990s, but increases in overweight- and obesity-related cancers are likely slowing this progress. About 630,000 people in the U.S. were diagnosed with a cancer associated with overweight and obesity in 2014. About 2 in 3 occurred in adults 50- to 74-years-old. The rates of obesity-related cancers, not including colorectal cancer, increased by 7 percent between 2005 and 2014. The rates of non-obesity related cancers declined during that time.

This is not a startling new fact. Ten years ago when discussing changes in Healthcare financing, I wrote extensively about this. Obesity drives up free radicals and free radicals result in both methylation and BRCA and PARP repair defects. Thus massive DNA errors and in turn many malignancies. It would be of interest to see how many X rays would equal a certain BMI in terms of cancer risks. But that notwithstanding, we now accept the risk of cancer from obesity.

But the real problem is that we penalize pre-existing conditions but not obesity. Those who are obese will soon be costing us trillions. That is real money and money we do not have. The real-real problem is that many of these obese are young people. One need just walk into any shopping mall or airport and one sees them all over. Worse, in looking at hurricane relief efforts, there is massive obesity in those being rescued, and worse yet in many of the first responders. This will lead to massive healthcare burdens as time goes by. Furthermore these burdens can be chronic thus burdening the system for long periods.

To again reference the MMWR:

Overweight- and obesity-related cancers accounted for 40% of all cancers diagnosed in 2014, and varied substantially across demographic groups. Endometrial, ovarian, and postmenopausal female breast cancers accounted for 42% of new cases of overweight-and obesity-related cancers in 2014, which is reflected in the higher overall incidence of overweight- and obesity-related cancers among females. For cancers that occurred among both males and females, however, the incidence of most cancers was higher in males.

 This problem demands some response. Now.

Monday, October 2, 2017

Nuclear Weapons

Nuclear Weapons are a complex technology to assemble then add to it a delivery system such as an ICBM and you have a technology which takes expertise that exceeds what most nations have. Russia got its head start by use of spies in the Manhattan Project. China via Russia. Now we have North Korea and we wonder.

The tables below depict at a high level the elements of an ICBM nuclear weapon. It is a real high level but raises questions. The entries are based upon my assessment of the potentials and can be referenced back to multiple reliable sources. (For example see: The Los Alamos Primer, Serber, Univ. Cal Press, 1992) The entries reflect my personal opinion based upon my prior exposure during the CTBT discussions in the late 1970s.

These Tables depict the high level elements of such an integrate system. I have not done work in this since the late 70s on the CTBT with the Soviets but one suspects that not a great deal has changed.  

The question is; has our Government entities performed such an analysis and if so then one suspects that the threat can be mitigated by asserting who supplied what. North Korea is incapable of many of the elements needed. Just not enough people or lacking in fundamental elements. Thus a threat from them is athreat from those facilitating them.

It is worth an analysis. So where is the press on this one?

Saturday, September 30, 2017

New Jersey Gets No Respect

As usual, the NY Times has a piece degrading something, this time it is New Jersey. The writer states:

Anyone who has ever driven on the New Jersey Turnpike knows that, at a certain point in the road, the entire Manhattan skyline appears to rise from the surrounding marshland like a close-yet-so-far Land of Oz, both tempting and terrorizing with its mysterious jutting cutouts. To traverse this roadway, as ... surely did as a young man, was undoubtedly to exist in a constant state of aspiration and alienation. No matter one’s personal glories, for those who call New Jersey home, and especially those who reside in Northern New Jersey, it’s difficult to forget that one is still not from “the city,” as the landmass across the river is known. Overcompensation tends to follow. Blind arrogance is an occasional byproduct.

Now I was not born nor bred in New Jersey. It was Staten Island, and yes for those in the rest of NY City Staten Island is a Borough and is NYC! Thus I was born and bred, whatever that means, in New York City. I did spend time in New Jersey, riding my bike across the old Goethals Bridge, down to Route 1 and out to the old Newark Airport, Lockheed Constellations and all. We did have a ferry to NYC, and a ferry to Brooklyn. No one really ever went to Brooklyn, it was also a little ferry, and an ugly one at that, not the grand ferry to Manhattan.

Residing in Northern New Jersey is also interesting. You see that from the Morris County line to the California border, county by county, it voted Republican. Not saying that it was all Republican but it is interesting to note the dramatic difference.

The above mentioned article, an ad hominem attack on someone allegedly born and bred in New Jersey, Livingston I believe, it is an adjacent town but a different county, all Democrats, is also an attack on anyone in New Jersey. Now New Jersey is not that bad, in fact it can be very livable. The people are generally friendly, similar to Staten Island. We had our notables on Todt Hill, "death" hill if you read Dutch, and in my town we had a similar family, if you get my gist. So it was like home.

The only problem in New Jersey is taking a train to New York City. It was easier to travel from St Petersburg to Moscow during the Russian Revolution than getting from my town to NYC. But then they had a Communist Revolution we have Amtrak and New York State. Go figguah.

For the many who may have never been in New Jersey, or for those limited to the Turnpike or Newark Airport, try a trip west. The Delaware river, the rising hills, the forests and preserved lands, go south to the pine lands. Not too bad. And unlike NYC, one can escape from New Jersey quite easily. We have roads. At one point the Turnpike has a total of sixteen lanes, yes eight in each direction. Road maintenance is at night so as not to slow traffic. That is the opposite of Connecticut, where two lane roads are closed at random times to trim a tree, resulting in hours of delay. Or the same in Pennsylvania.

So to the writer who seems to have an inferiority complex of birth in New Jersey, give it a rest! You had no choice, I did. It sure beats Connecticut!

Oh yes, "blind arrogance", it seems that the arrogance is on the other foot, the one who wrote this piece. 

Friday, September 29, 2017

The Microbiome and Cancer

The microbiome is that collection of stuff we carry around in our guts. Most of us never really think much about this but it turns out to have significant impacts on cancers. After a bit of thought it becomes clear why.

In a recent paper by Fullbright et al they have done a wonderful job on describing some of these effects. They conclude:

The densest populations of endogenous microbes are found within the intestines and are in close proximity to the epithelium and underlying mucosal immune system. As a result, the earliest observations linking the microbiota with the hallmarks of cancer have primarily focused on gastric cancers and CRC. Nonetheless, more recent studies have also implicated the microbiota in cancers at distal sites as a potential predictor of successful response to cancer therapy and as a means to augment the efficacy of existing anticancer therapeutics. Furthermore, the well-established link between several viruses and human cancers (i.e., Human papillomavirus and cervical, genital, anal, and oral cancers; Epstein-Barr virus and lymphomas; hepatitis C virus and hepatocellular carcinoma; Kaposi’s sarcoma–associated herpesvirus and Kaposi’s sarcoma) provides a strong rationale to investigate the role of nonbacterial members of the microbiota (virus, fungi, and archaea) in modulating the hallmark capabilities and cancer development. Finally, the cancer microenvironment itself can enhance the procarcinogenic activities of the microbiota, which further demonstrates the importance of the crosstalk between host and microbe in modulating cancer progression. In summary, because of the extensive capacity of the microbiota to influence many hallmarks of cancer, treatment for a variety of cancers may soon involve personalized medicine targeting the microbiota.

This is definitely worth following as we understand more regarding this complex environment.

Trump Care?

Just a note on Taxes and Healthcare. So you thought Obamacare was bad. Try Trumpcare. Not the failed plans but the tax proposals. You see they want to eliminate deductions for medical expenses. So not only do you pay Medicare, on everything, that 3% of every transaction, selling your house etc, but no God forbid you get slammed with medical bills, you must pay the new taxes on top of that! Yep, you sick folks will really get soaked this time. If they can't fix it then tax it! Good luck in 2018!

Just an observation. The poor old folks paying high real estate taxes and state income taxes, and medical expenses will pay through the roof, but the advantage is their heirs will not have to pay tax on whatever is left! So I guess the solution is to die broke! That is one way to eliminate the estate tax. Middle Class tax cut? What moron thought this one up. Karl Marx!

Monday, September 25, 2017

CBO Latest Proposal

The CBO released their latest estimates. They contend:

Over the 2017–2026 period, CBO and JCT estimate, the legislation would reduce the on-budget deficit by at least $133 billion, the projected savings from the House-passed reconciliation bill. (The effects on the deficit were estimated relative to CBO’s March 2016 baseline, as has been done for all legislation related to the 2017 budget resolution.) Those savings would occur mainly because, under the legislation, outlays from new block grants between 2020 and 2026 would be smaller than the reduction in net federal subsidies for health insurance. Funding would shift away from states that expanded eligibility for Medicaid under the Affordable Care Act (ACA) and toward states that did not. The number of people with comprehensive health insurance that covers high-cost medical events would be reduced by millions compared with the baseline projections for each year during the decade, CBO and JCT estimate. That number could vary widely depending on how states implemented the legislation, although the direction of the effect is clear. The reduction in the number of insured people relative to the number under current law would result from three main causes. First, enrollment in Medicaid would be substantially lower because of large reductions in federal funding for that program. Second, enrollment in nongroup coverage would be lower because of reductions in subsidies for it. Third, enrollment in all types of health insurance would be lower because penalties for not having insurance would be repealed. Those losses in coverage would be partly offset by enrollment in new programs established by states using the block grants and by somewhat higher enrollment in employment-based insurance. Many of the new programs would probably cover people with characteristics similar to those of people made eligible for Medicaid by the ACA. The decrease in the number of insured people would be particularly large starting in 2020, when the legislation would make major changes to federal funding for Medicaid and the nongroup market. CBO and JCT expect that market disruptions and other implementation problems would accompany the transition to the block grants created by the legislation—despite the availability of funding specifically designated to assist with that transition—given the short time for planning and making changes between now and then.

This is a lot of effort for nothing. The major problems are:

1. Central Government control of everything.

2. An absurd Electronic Health Record system designed by people who seem in my opinion to have no clue as to how medicine functions.

3. Excess reporting of details that are useless.

4. Lack of change in key sectors such as torts etc.

5. Funding of absurd entities like PCORI.

I let you all be the judge.


As the hurricanes swirl about the Atlantic and the under tow pulls and then throws one back upon the massive rocks the sea gulls watch as one rather dumb human sets out to surf among the waves. Now who is the smarter? Or is there a reason why there are more sea gulls than humans?

Saturday, September 23, 2017

Improved CRISPR

The use of CRISPR techniques to cleave and cut/add DNA sequences is a two step process. First the use of a CRISPR or equivalent to target the sequence and then the CAS9 to cut it.  Target and cut. However there are problems. The target may appear at multiple locations and the DSB, double stranded break cut, is often subject to faulty repairs. Thus, although CRISPER can be an elegant approach, its errors can have massive defects.

Doudna and her team have announced some improvement in Nature. They state:

The RNA-guided CRISPR–Cas9 ... has been widely repurposed for genome editing. High-fidelity (SpCas9-HF1) and enhanced specificity (eSpCas9...) variants exhibit substantially reduced off-target cleavage in human cells, but the mechanism of target discrimination and the potential to further improve fidelity are unknown. Using single-molecule Förster resonance energy transfer (smFRET) experiments, we show that both SpCas9-HF1 and eSpCas9... are trapped in an inactive state when bound to mismatched targets. We find that a non-catalytic domain within Cas9, REC3, recognizes target complementarity and governs the HNH nuclease to regulate overall catalytic competence. Exploiting this observation, we designed a new hyper-accurate Cas9 variant (HypaCas9) that demonstrates high genome-wide specificity without compromising on-target activity in human cells. These results offer a more comprehensive model to rationalize and modify the balance between target recognition and nuclease activation for precision genome editing.

As  The Scientist notes:

Tuesday, September 19, 2017

News and Fake News

In a piece in the NY Times an Irish born former Administration official bemoans the explosion of "fake news". The author states:

What exactly has changed since then to make foreign propaganda far more dangerous today? During the Cold War, most Americans received their news and information via mediated platforms.  Reporters and editors serving in the role of professional gatekeepers had almost full control over what appeared in the media. A foreign adversary seeking to reach American audiences did not have great options for bypassing these umpires, and Russian dezinformatsia rarely penetrated. While television remains the main source of news for most Americans, viewers today tend to select a network in line with their political preferences. Even more significantly, The Pew Research Center has found that two-thirds of Americans are getting at least some of their news through social media. After the election, around 84 percent of Americans polled by Pew described themselves as at least somewhat confident in their ability to discern real news from fake. This confidence may be misplaced.

 Now let's go back a bit. Remember Hearst and the Spanish American Wat? You don't you say, well you should. Had it not been for his papers we most likely would never have had the hill climbing Teddy. Strange how events turn out.

Now one should also remember Radio Moscow. I do. In 1952 I had a Hallicrafters Short Wave receiver. I listened to the BBC, to Radio Moscow, and a slew of other stations. Even at a young age one could tell Radio Moscow was propaganda, I did not need the Nuns to tell me that. But they did offer a free magazine, Soviet Life. So like a good young Catholic student I wrote a letter asking for my free subscription, doing so on my lined note paper using my best Waterman Blue Ink pen and placing the cross and "JMJ" atop the letter ans mandated by the Nuns. I unfortunately never got my Soviet Life then, perhaps it was the JMJ or perhaps it was intercepted before ever getting out of the US. But that did not stop my listening to what, even at that age, I knew was fake news. It was comedic, the Soviet exaggeration. Then of course there was Voice of America and Radio Free Europe. The list went on.

You see a rational person can readily identify "fake news". We see it everywhere today. It starts with advertising and then fills the cable news channels. Newspapers all have their own slant on what they consider news. As for social media, I have no use for it. 

Proper education is the solution. A Civics class, a real History class, reading from what the Founders based their decisions on, ie the Federalist Papers and their opposition. Then rely upon educated reason. "Confidence misplaced" is a rather snarky way to say. "I know the truth and you have no clue" Rather in a democracy people are bombarded with "facts", many contorted, many twisted and bent to meet some other objective. But that is life.

Oh, by the way, if anyone in Russia is monitoring this, any chance I can get my Soviet Life subscription? I liked the pictures and it was free. Thanks.

Thursday, September 14, 2017

CBO Healthcare Costs for those Under 65

The CBO published a report indicating the 2017 costs of Healthcare for those under 65. Note Medicaid is $300 billion plus and Medicare, for those disabled, is $100 billion plus. The dominant driver is the expended Medicaid from the ACA.

They continue:

According to CBO and JCT’s estimates, a monthly average of about 244 million noninstitutionalized civilians under age 65 will have health insurance in 2017. Almost two-thirds of them will have coverage through an employer, and about a quarter will be enrolled in Medicaid or the Children’s Health Insurance Program (CHIP). A smaller number will have nongroup coverage, coverage that is provided by Medicare, or coverage obtained from various other sources. On average, about 28 million people—10 percent of all noninstitutionalized civilians younger than 65—will be uninsured in 2017, CBO and JCT estimate (see Figure 1). Between 2017 and 2018, the number of uninsured people rises by 2 million in the agencies’ projections, mainly because premiums in the nongroup market are expected to be higher. From 2018 through 2027, the number of people with coverage is expected to grow from 242 million to 247 million. But the number of uninsured people is also expected to grow, from 30 million to 31 million, keeping the uninsured share of the under-65  population stable at 11 percent.

Now under Medicare we have an annual cost of $10,000 per person. Thus Medicare for all at 330 million people is $3.3 trillion a year! Yep, a large number.

At least when Thomas Paine made his suggestions in the 1790s, he had the courage to estimate the costs as well as the source of payment. Where are Thomas Paines when we need them?

Thursday, September 7, 2017

AI and the Academy

In a Press Release MIT announces that it has entered into a $240 million dollar effort with IBM to establish a joint AI Laboratory. They state:

IBM and MIT today announced that IBM plans to make a 10-year, $240 million investment to create the MIT–IBM Watson AI Lab in partnership with MIT. The lab will carry out fundamental artificial intelligence (AI) research and seek to propel scientific breakthroughs that unlock the potential of AI. The collaboration aims to advance AI hardware, software, and algorithms related to deep learning and other areas; increase AI’s impact on industries, such as health care and cybersecurity; and explore the economic and ethical implications of AI on society. IBM’s $240 million investment in the lab will support research by IBM and MIT scientists. The new lab will be one of the largest long-term university-industry AI collaborations to date, mobilizing the talent of more than 100 AI scientists, professors, and students to pursue joint research at IBM's Research Lab in Cambridge, Massachusetts — co-located with the IBM Watson Health and IBM Security headquarters in Kendall Square — and on the neighboring MIT campus.

This comes after much criticism of the IBM Watson venture as more hype than reality. But it does raise many major questions.

1. MIT is an academic institution and what research which is done there has always been of a public nature. MIT Lincoln Lab is an exception but that Lab, as was the Draper Instrumentation Lab, considered an off shoot, not on the main campus and not an academic department.

2. IBM one would assume is investing $240 million and expects a return to shareholder value. That must mean that IBM has not only first dibs on whatever is developed but also there is some form of proprietary ownership which seems to be antagonistic to normal academic freedom.

3. If one does a study in this "Lab" then can one take what expertise one has created and take it to a competitor?

4. Why IBM. Is IBM desperate to get something out of Watson that they would dump a quarter of a billion into this effort? Motives count.

5. MIT was a Land Grant School, and as a result had an obligation to support US industry and interests as a goal if not a primary goal. Does this enhance or subrogate that goal?

Needless to say this makes for good PR but is it good science and engineering? I wonder.

Wednesday, September 6, 2017

Over Rated?

There is an explosion of AI related products. One of the most significant is Watson, the IBM entry which continually gets great praise. STAT has published an excellent piece worth reading by anyone concerned.

The article concludes:

While not specific to Watson’s health care products, the report said potential clients are backing away from the system because of significant consulting costs associated with its implementation. It also noted that Amazon has 10 times the job listings of IBM, which recently didn’t renew a small number of contractors that worked for the company following its acquisition of Truven, a company it bought for $2.6 billion last year to gain access to 100 million patient records. In its statement, IBM said that the workers’ contracts ended and that it is continuing to hire aggressively in the Cambridge, Mass.-based Watson Health and other units, with more than 5,000 positions open in the U.S. But the outlook for Watson for Oncology is challenging, say those who have worked closest with it. ...the lead trainer at Memorial Sloan Kettering, said the system has the potential to improve care and ensure more patients get expert treatment. But like a medical student, Watson is just learning to perform in the real world. “Nobody wants to hear this,” ... said. “All they want to hear is that Watson is the answer. And it always has the right answer, and you get it right away, and it will be cheaper. But like anything else, it’s kind of human.”

 Medicine is complex, and especially cancer care. No patient is the same. It is not only the pathology but the patient's approach to the disease. Even in such centers such as MSKCC there are a multiplicity of treatments. Also even the current immunotherapy treatments may work 40% of the time. Why the 40% and why not the 60% is the question without an answer.

IBM used to be a service company, selling hardware and software services. It then morphed into a consulting company, a real service business. One wonders just what business they are in now.

This is an article well worth the reading.

Monday, September 4, 2017

We Told You So!

In a just released re-study of the PCa mortality and PSA tests the authors note:

Screening was estimated to confer a 7% to 9% reduction in the risk for prostate cancer death per year of MLT. This translated into estimates of 25% to 31% and 27% to 32% lower risk for prostate cancer death with screening as performed in the ERSPC and PLCO intervention groups, respectively, compared with no screening...After differences in implementation and settings are accounted for, the ERSPC and PLCO provide compatible evidence that screening reduces prostate cancer mortality.

And the reasons are what he had noted when these, in my opinion fatally flawed, trials were performed.

Perhaps they could now calculate how many mend died as a result.

As Eureka notes:

After differences in implementation and settings were accounted for, two important prostate cancer screening trials provide compatible evidence that screening reduces prostate cancer mortality. These findings suggest that current guidelines recommending against routine PSA-based screening may be revised. However, questions remain about how to implement screening so that the benefits outweigh the potential harms of overdiagnosis and overtreatment. 

 It is a shame!

Saturday, September 2, 2017

The FCC and Net Neutrality

It appears as if the current FCC management is about to undo what is called Net Neutrality. A while back I wrote a long piece in Internet Neutrality while still back at MIT. My point was simply that a carrier is just that, a carrier, and since the days of Elizabeth I this concept was accepted and became the element which led to the dominance of England in world trade. Now comes the FCC and the incumbents. The FCC has never been known for much more than a political equivocator depending on whose party is in charge. So one should not expect anything more than an expression, nay and echo, of what the powers to be or those in charge really want.

Wired magazine has a piece that somehow thinks this is all new. They state:

This past April, the Federal Communications Commission invited the American people to weigh in on whether the federal government should roll back the rules currently in place to protect net neutrality. By the time the online comment submission period ended last Wednesday, the agency had collected 21.9 million comments, an astounding level of participation on what at first glance appears to be a rather esoteric telecommunications policy issue. (For comparison, when the FCC received around 500,000 postcards and emails about its media ownership rule changes in 2003, it was considered a big deal. Even Janet Jackson's wardrobe malfunction at the 2004 Super Bowl garnered only about 1.4 million comments.) So what did the people say? The industry group Broadband for America, which opposes the FCC's current rules, recently commissioned an analysis of the comments from a company called Emprata. The study determined that a majority of the comments–about 60 percent–favor keeping the FCC's current rules, which classify internet service providers as "Title II" common carriers like mobile and landline phone companies and ban them from blocking or interfering with lawful content. If you look only at unique comments, as opposed to form letters using boilerplate text, those in favor of keeping the Title II rules outweigh those who want to jettison the rules 1.52 million to 23,000. The only hitch: the commenting process was such a debacle that the legitimacy of the entire body of comments is now in question.

Should one be surprised that the FCC's system  is so let us say reckless? Hardly. It is a Government controlled process. Some Beltway Bandit probably wrote the specs, then another Beltway Bandit did the software. And in the midst of this no one is really responsible for anything. So one expects rational actions from these folks.

In my experience and in my opinion I saw the FCC up close. If I went in with some issue, my opponent was in the waiting room after I finished to rebut my position. How did they find out? Simple, the Sunshine rule, the FCC tells everyone everything. In those days one filed a paper document. Yes it was cumbersome and yes form was important. But it meant that someone had to give some thought to the process and multiple filings were difficult. The on line approach allows for slamming of various types not to mention the system allows the uploading on anything, yes folks anything.

These then are the people who will control our information flow. One should understand that the main ISPs, such as Comcast, Verizon, AT&T are also  in the media business and promulgate their own interests. They carry a big stick, and they also have great carrots for FCC officials when they go out in the world. Just look at the heads of major industry lobbying groups!

So what will happen with Net Neutrality; ask the largest bidder!

Thursday, August 31, 2017

A Modifier of a Verb is Called an Adverb

In the NY Times there is a piece recounting the alleged work ethic of Silicon Valley. They start by stating:

Silicon Valley prides itself on “thinking different.” So maybe it makes sense that just as a lot of industries have begun paying more attention to work-life balance, Silicon Valley is taking the opposite approach — and branding workaholism as a desirable lifestyle choice. An entire cottage industry has sprung up there, selling an internet-centric prosperity gospel that says that there is no higher calling than to start your own company, and that to succeed you must be willing to give up everything.

First, grammatically it is "thinking differently" if one wants to modify how one thinks. If however if it is used as a predicate then "I think different." means somehow that this thing called different is "what" you think.

Now in the 14th Century all students took the Trivium, Grammar, Logic, and Rhetoric. Why you may ask. To express themselves to each other clearly and correctly. Now Scholasticism was ending with Ockham and minimalism but this use of language correctly and unambiguously allowed for the development of English Law which may be one of the greatest creations of Mankind. I am not a lawyer for full disclosure.

Now back to the work ethic. Just being busy for 24 hours is meaningless unless you are productively doing something. I managed for a decade to work more than 24 hours a day, traveling to beat the sun to my some two dozen countries. I have seen lawyers book more than 24 hours in a day the same way. But that is a trick.

The question is; what are you producing during that time. Writing code is not "producing", it is effecting and idea. Creating a new system architecture is "producing", whereas writing code to do what you were told to do is akin to typing a Tolstoy novel. You are not Tolstoy, you are a typist. Thus the content of what is produced is critical. It begs the question of a Post Doc performing hundreds of tests for some Principal Investigator. Is that also akin to programming or is value added? Or is that why they are just a Post Doc.

The article continues:

Good grief. The guy is developing an app that lets you visualize how a coffee table from a catalog might look in your living room. I suppose that’s cool, but is it really more important than seeing your kids? Is the chance to raise some venture-capital funding really “the ultimate reward”? 

There are two issues in this statement. First, is another App of any value, period! Fifty years ago one built a better communications system, an improved medical imaging system, an innovative therapeutic, or any other thing that was real, advanced humanity as a whole. But a new App, get real. Second is the issue of who is doing what. In my experience the true start up is one , perhaps two people. There is a visionary, a Founder, and that person assembles a team. That person is the "dream merchant" selling the vision, laying out its implementation, convincing customers, and yes raising money. For the most part every one else is an employee, a follower. Thus this begs the question; do all people have to hustle, or just the leader?

Recently while trying to sort through some possible start up ideas at MIT we had one where the alleged CEO disappeared. I finally found him and the reason was because his wife had a baby and he was taking his Paternity Leave as she was taking her Maternity Leave. My daughter was delivered by me and the Resident and I went back to the Institute and picked my wife and daughter up the next morning between classes. That was fifty years ago. Did not skip a beat. No leave anywhere, and that is truly a Hustle. Today I guess we all get leave, paid and all. Unless you are not in Silicon Valley of course!

GDP April 2017

Here is the current GDP. It is growing, albeit still slowly. The above is each element, not the total. Consumption shows good growth and Investment is increasing. Net ExIm has come back up again however. Overall things are not that bad.

Sister Rosita

In the 5th Grade I had Sister Rosita. A short rotund Sister of Charity whose sole purpose in life was to get me to spell correctly. This was well before the age of Dyslexia and special needs students such as myself. Sister Rosita would shout at me, "McGarty, when will you ever spell correctly!" And I would reply, "I will have people to correct my errors Sister." Then "WHAM", the good old three foot (or should it be feet?) ruler across the knuckles.

Now Sister Rosita is a thing of the past and I have Microsoft Word. It always spells the word correctly, unfortunately it is often the wrong word. No matter how I look at it the word always looks correct, at least for a month or so. Then I read it and see the error.

Now add to this mess such things as Twitter. I tried Twitter for a few months, found it useless. Also as some may note I cannot say much with few words. I think through something, write a draft, with mis-spellings and all, then post it. Some folks actually read this stuff. Now along comes the NY Times and spelling[1]. They note as follows:

Actually, we should lay off everyone’s spelling. In a digital age of autocorrect and electronic publications that can be edited from afar, not to mention social media platforms that prize authenticity and immediacy over polish, misspelling has become a mostly forgivable mistake. You simply do not need to be able to spell as well as people once had to, because we now have tools that can catch and correct our errors — so it’s just not a big deal if, on your first draft, you write “heel” instead of “heal.” People are very attached to spelling, of course. When I first floated the idea that politicians’ misspelling was a forgivable sin, I was dragged over the coals for it on Twitter. My wife got so upset that she quit talking to me for most of a day. When I emailed my editor to say I wanted to defend Mr. Trump’s misspelling, she wrote back, “You should listen to your wife.” So I did what I normally do when confronted with people who are wrong on the internet: I researched the subject. I looked at the history of standardized spelling and what misspelling says about you cognitively. I uncovered a rich history of political misspelling. And I read a book by an Oxford professor on the shifting cultural attitudes toward spelling and then talked to him for a long time. Yet there is an even deeper sort of elitism underlying the criticism of spelling mistakes. It stems from people correlating accurate spelling with a good education and outsize intelligence, which is actually incorrect. There is not much scientific evidence to suggest that spelling well is connected to high intelligence. In the same way that some people are naturally better at arithmetic than others, some are naturally better spellers than others (and some people have lexical disabilities, like dyslexia, that make spelling even more difficult). But if you spell well, you can still do lots of dumb things, and if you spell poorly, you can still be very smart. Standardized spelling has been with English for at least a few hundred years, and it has mostly served us well. So I understand that the idea of abandoning it, or at least relaxing our adherence to it, may sound frightening, like the first step on a short march to civilizational decline…Second, there’s little evidence that how one types on electronic media has much to say about how one functions otherwise. One study, in fact, showed that kids who frequently used “textese” tended to be better at grammar than those who didn’t. All of this suggests that we are simply giving too much weight to spelling and other typographical mistakes. Focus on what people say, not how they spell it.

So is the art of spelling lost at last? It is akin to the "other left" syndrome where some says turn left when they mean turn right and correct it by saying the "other left".

Spelling counts. But not on Twitter or even Facebook.

Wednesday, August 30, 2017

Look to the Left, Look to the Right

In the old days, when you started class at the University, there was a sense of terror of not succeeding. The old adage of looking Left and then Right and saying that one of them will not be graduating in four years left you with a sense that you had to press on from day one.

Now the Institute President states:

“We are very lucky to have you!”

I guess so. But why are the students very lucky to be there?

Then it states:

"MIT is a unique crucible, where you will be faced with challenges you didn’t quite expect, at an important time of your life,” she said. “My advice here is quite simple: Embrace failure! If you haven’t already, you’ll soon realize that failures frequently, and I might say usually, allow you to learn far more than your successes.” Failure, she said, “lets you know that your knowledge lacked depth, or your understanding was incomplete, or maybe your expectations were a little unrealistic. Filling in those gaps adds to your knowledge base, and how you go about recovering from those failures will teach you lifelong lessons.”

 I would gather that this is not something you would espouse at the Med School! Yes, we make mistakes, and yes we learn from these mistakes. But in life, Failure is often not an option. Prior Planning Prevents Poor Performance, a dictum my father embedded in my thinking from day one. Experiments fail, but in so doing one hopefully understands why.

But embracing failure should not be an option. You don't drive eighty miles per hour on black ice, failure there can be severe!

What is in a Change?

Back in the early 1960s, Walker Memorial at MIT was a meeting place at lunch time and even for dinner. It was as close to High Table in an English University one could get, but no High Table. It was a watering hole, a meeting ground, a place to trade ideas, a eat food which was lower in carbs than what is there today.

Walker Memorial is now 100 years old and MIT is celebrating. They note:

For many of those who have passed through Walker Memorial over the past 100 years, the most enduring images remain the murals in Morss Hall, which were painted by Edwin Howland Blashfield of the Class of 1869. Created and installed between 1923 and 1930, their allegories of alma mater receiving homage from scientific and academic disciplines have watched over countless MIT community functions, from dining hall breakfasts to the Assembly Ball and more. For most MIT alumni and students, Walker Memorial holds indelible memories. A century after its completion, the tribute to President Walker has been realized in the best possible way — with the building continuing to serve as a community gathering place.

However it is currently planned to be turned  a building for the Music Department. MIT notes:

Walker Memorial Hall is a significant campus building that has served many roles on the MIT campus over its nearly 100-year history. Currently in need of substantial renovation, Walker appears to be a good match with the programmatic needs of the Music and Theater Arts Department – a community in search of a new home. MIT is currently studying the possibility of renovating Walker to co-locate the Music and Theater Arts Department with its teaching and extracurricular activities. The new center would allow MIT to explore new frontiers of artistic and technological discovery.

Now I am not against music, but the loss of this "watering hole" is significant. It has been replaced by Starbuckian hang outs featuring high carb feasts and uncomfortable seating. I think that it is a loss.. Just a thought.