AI Regulation?

 In almost all regulating laws there is a front section defining what is regulated. But 2 years ago I detailed the problems with AI, namely how does one define it so it can be regulated? Legislators and administrations are really the worst, and dare I say incompetent, entities to define this.

We know that basically AI is composed of three things. First the processors or hardware. Second the complex software structures. Third the massive amounts of data. Therein lies the problem, Each is unique, each is ever changing, and each by itself cannot be adequately defined.

We can regulate the telephone network of days of yore, we can regulate the electrical network, but we cannot even try to define AI dispositively. So stop with the regulation. Otherwise you may need a separate Supreme Court just to regulate the regulation! 

Nonsense, and How Do You Wash the Windows

 Frank Gehry passed away recently. I had the misfortune to spend some time in one of his monstrosities, the Stata Center at MIT. I always wondered how one washes the windows. Why were the rest rooms hidden away and sized for one each. It was a grossly dysfunctional building.

But if you are one of the left wing types you glorify it. Especially if you never tried to function in one of them. As The New York Review notes:

The great liberator of late-twentieth-century architecture, Gehry was a latter-day Alexander who sliced through the Gordian Knot formed by an exhausted Modernism intertwined with a callow Postmodernism. Instead of trying to untangle those two discordant stylistic visions, which wastefully dominated American architectural discourse during the 1970s and 1980s, he showed an exhilarating way forward with freeform designs that drew on advanced contemporary art as their primary source of inspiration. He made the world safe for oddball buildings, and whatever one might think of the idiosyncratic architecture by the generation who followed him—Santiago Calatrava, Zaha Hadid, Daniel Libeskind, Thom Mayne, and their ilk—their careers would be unthinkable without the precedent he set. Although his dramatic departure from architectural convention was at first confrontational and forbidding, it gradually became more buoyant and embracing. As his clients’ budgets increased and he moved from corrugated metal to shiny titanium, unfinished plywood to polished Douglas fir, and rubber matting to travertine flooring, his architecture lost none of its expressive power and appealed to many who’d found his earlier tough-guy efforts more alienating than audacious. But he was never to everyone’s taste, including Marxist intellectuals averse to an architecture of pleasure, who saw him as an agent of capitalist corporate branding

 The buildings just did not work. Why should a great university like MIT have this colossal clump of metal and dirty windows, leaking like a sieve, disconnected from everything else on campus. One missed the old hallways of the original buildings. One had to scurry about hidden hallways in hopes of finding the adjoining location. 

Buildings must adhere to their functions. Not the bizarre ideas of some over paid architect.  

The F Word

 In the winter of 1961, when I was still in Secondary School, I had managed to get my college admissions done with scholarships. I had passed all my Regents Exams so I had a Regents Diploma. So I thought I could just slide the second half of my Senior year. My father, not so much. He decided that I should learn what work was like, not the kind of stuff college grads did in suits and polished shoes and clean nails. But real down and dirty work.

January 1961 in New York was cold and snowy. My father got me a job, with my Headmaster approval, working for the NY Sanitation Department clearing sewer drains along the road ways. I got up at 4 AM, dressed as warmly as possible, took the bus, the first one at 4:35 that go me to the Garage at 5:30. I clocked in and met my "fellow" workers. They were a couple of years older than me, High School dropouts for the most part, many married with kids! Unlike contemporary students off to the Swiss Alps I was off to the Port Richmond garage. My peers there were not ones who could advance my career. 

Every day I would be out with a team clearing sewer drains in freezing slush getting splashed by passing trucks. But one thing I did get was the use of the F word.

Now in my school one rarely if ever heard it used. It was at the time the lowest of the low words. But here I heard it used as a noun, verb, adjective, adverb, preposition, conjunctive, and every possible word form. In fact there was one fellow who could, with hand and arm motions, conduct a conversation with that one word alone! After a few weeks I could understand him. I did realize that one could not have a dictionary for such speech since it did involve human facial and hand expressions!

Thus I have always associated the use of this word to Staten Island the the Sanitation Department. I could out Soprano the Sopranos. Once some dude in New York tried to intimidate a few well dressed colleagues and myself. The use of my Staten Island dialect and the F word sent him scurrying for fear of his existence! Amazing what that word could do. It transformed me n my Brooks Bros attire into a street wise guy, with possible connections that one did not want to upset. It was the lowest class language available but intimidating.

In today's world we now have "ladies" and "politicians" using it without any form of proper training. It sounds foolish and out of place. They all failed to get educated in the Garage. In fact their use is laughable! As are they. 

Sneaky ISP

 My local ISP, CATV provider, is pushing that you get their "new" gateway and WiFi unit. The call it "great news". Unfortunately all they want to do is to get you to eliminate your secure home WiFi and install their unit under their control and which allows for the CATV company to establish a second WiFi to support their services on your dime! 

I testified as an expert on this issue almost a decade ago. Won the case. But it also allows me to opine on the facts as well as the principle. 

My advice, get your own WiFi and do not let these characters into your network. Or anyone else for that mater! 

Annual Letters

 I had an interesting connect this week. First my semi-annual secondary school luncheon. The attendees was down to eight from the usual twenty just five years ago. Each of us has had our crises and losses, including luncheon ones directly. Age does creep up. Then the second connect was one annual "letter" filled with pictures and happy faces across the posh spots of the globe. As if there was some immunity to family crises.

If I were to send out an annual letter it would be akin to my luncheon conversation. Age does creep up, and all family members have challenges. My five grandchildren each have set a separate pathway in life. My namesake grandson is a successful CPA and soon to marry a charming psychologist. My oldest grandson is a police officer married to an El Salvador descendant and with my first great grand child.  One grand-daughter is a forestry major grad somewhere in the upper Michigan peninsula in sub zero temps and feet of snow doing something on trees. Go Figguah! The other grand daughter is finishing business school wondering what is next. Finally the youngest grandson is in retail. He knows more about inventory, market demands, personnel management than any Harvard MBA. It helps to work in the trenches.

So if we had a family letter it would be work, work, work! Each different, none like their grandfather. 

Instead of regaling our fine times, I listen to and support my ailing colleagues and assist the next steps with family members. As one ages, meetings become medical appointments, entertainment becomes watching BritBox reruns, travel is hospital visits for friends. But that is life amongst the common folk.

Yes, I still have many colleagues I stay in contact with from California, Moscow, Greece, Singapore and the places I spent time at in business, rarely at what could be called pleasure. 

So to all those whose year has had its bumps, and few "grand moments", I commiserate, but laud your life of interesting challenges. 

AI, its Existence and its Expression

 We have expressed our concern regarding AI before at some length. The main concern was that it was not possible to define it, especially as one tried to legislate controls over it. Unlike the development of what we now see as the Internet, AI appears to have limited if any benefit to its users. In fact, one may not even be aware that there is some AI, whatever that means, intervening in their day-to-day life.

 In the early days of the Internet, the user saw the results and benefits immediately. They could send emails, download and upload files, get documents in readable form instead of fax. Before web browsers even, benefits were clear. Modems may have been slow but faxes were slower. Dial up allowed for users with a telephone line to get results. There was an obvious and overt progression of benefits. Cable modems allowed increased speed and browsers allow simplified interfaces. Then the dot com boom exploded with new applications. It changed the economy.

 So far so good. Then came social media. The end of the boom and the beginning of a propaganda-based paradigm. Anonymous postings did away with any ability to vet veracity or sources of statements. This was a major loss. One could “post” or state anything without any ability to verify. Then add to such apps as Facebook, not just “friend” to “friend” communications but sidebars of targets promotional propaganda. These apps as we noted decade ago could psychologically profile a user and them promote in a user specific manner whatever some third party wanted to get the user to believe. Users could be manipulated at low cost, real time, and with high targeting efficacy. A deadly tool. But still visible.

 Now comes AI. Whatever it is, it is hidden. Behind a wall of software. It now knows you; it knows how to manipulate you. It is goal driven to get you to do something. And you never see it, never get a benefit. It benefits the supplier solely often causing you harms.

 Besides the societal person to person effects of AI, there are massive ecological effects. For example, the explosive use of electrical power and generation of heat is just one. The AI farms effectively tax everyone by the increased demands for power.

 How does this power issue work? Simple. Power if delivered locally and produced separately. For the most part the local power company is akin to the old local telephone company. It just provides the local lines for distribution. The actual power is generated by third parties who own and operate generators. They are like distant telephone companies. There then is the network agglomerators who interconnect generators to distributors. Here is where it gets tricky. Periodically the local operators negotiate with the network agglomerators for power. They agree to buy X at price Y. As the demand X increases Y increases. This is not linear! A key fact. Thus, when X increases, Y increases even more so. Namely it gets more expensive per unit! Who pays, the consumer!

 Thus, AI creates a social cost or deficit. It makes us pay to be manipulated. We see no benefit, we neither get information, entertainment, or perform efficient transactions. We do get propagandized flows of persuasion promoting the creators’ intended ideas.

 Is this AI, again whatever it is, worth the costs we are now paying? Purported the AI sucks up massive data, say from medical publications, and when we ask a question, it forms an answer from this massive collection. But are the data we collected it from correct? Often it is not. No one vets the source data. There may a lot of junk. Unreliable “facts” used to create false conclusions.

 Overall, AI is a danger for three major reasons:

 First, it is a massive targeted propaganda instrument.

 Second, it creates excessive costs to consumers for such things as energy usage and water supply survival.

 Third, it relies upon massive amounts of highly unreliable input information creating equally unreliable results.

 Simply stated, AI, whatever it is, may be not just questionable but a deadly societal weapon.

Proper Attire

 In 1952, I cycled from Staten Island to Newark Airport. The old terminal. I would sit on my bike and watch the planes depart. My favorite place was adjacent to the Eastern Shuttle site. They flew Lockheed Constellations, large 4 engine aircraft. They flew every hour between Boston or Washington and back. 

One day I saw the Captain and he came over and I was thrilled! We spoke and I told him of all the model WW II aircraft I built. He flew B 17s, and I had one. I was just thrilled to meet a real pilot. My grandfather had take me up on Piper Cub flights, those high wing yellow birds, from an airport on Staten Island. I told the pilot all about the thrill.

 He then said: "Want to fly to Boston?"

What else could I say but sure! Thus I parked my bike and climbed aboard with a jump seat in the flight deck. Up and back, three hours and I was home for dinner. My secret. Today of course it would have violate dozens of laws and we would all be in prison. But back ten it was an adventure. 

I loved flying. The elegance of the passengers, the thoughts of who may have been on the flights. 

Today, as the Secretary of Transportation notes, dressing has collapsed. One sees morbidly obese people in sweat pants dropping well down their behind, or yoga pants leaving nothing to the immigration. Tattooed creatures lugging half the worldly belonging behind them. Food and drinks of all sorts. Clothes that last saw a cleaning months ago!  

The Secretary has a point. But alas those days are gone forever. Just try and find people in a suit,or dress. I sat in a surgical waiting room a few months back, and looked about. Men in cargo shorts, T shirts, tattoos, and scroungy beards! Enough sources of infection to kill a Russian Army! 

So who sets what standards. Class is often defined by what one wears. Class can be both defining and controlling. But one often gets more respect if properly attired, and less otherwise. 

An Interesting Man

 Jim Watson passed away. As the Guardian notes:

 James Dewey Watson, whose co-discovery of the twisted-ladder structure of DNA in 1953 helped light the long fuse on a revolution in medicine, crimefighting, genealogy and ethics, has died, according to his former research lab. He was 97. The breakthrough – made when the brash, Chicago-born Watson was just 24 – turned him into a hallowed figure in the world of science for decades. But near the end of his life, he faced condemnation and professional censure for offensive remarks, including saying Black people were less intelligent than white people. Watson shared a 1962 Nobel prize with Francis Crick and Maurice Wilkins for discovering that deoxyribonucleic acid, or DNA, is a double helix, consisting of two strands that coil around each other to create what resembles a long, gently twisting ladder. ... He has shown “a regrettable tendency toward inflammatory and offensive remarks, especially late in his career”, Dr Francis Collins, director of the National Institutes of Health, said in 2019. “His outbursts, particularly when they reflected on race, were both profoundly misguided and deeply hurtful. I only wish that Jim’s views on society and humanity could have matched his brilliant scientific insights.”

I first learned genetics from Watson at Harvard. I snuck up Mass Ave in the 60s. I knew about DNA from my secondary school bio teachers who in 1957 as a doctoral student at NYU studied Watson's work on the subject.  

I believe that Watson's major contribution was the revitalization of Cold Stream Harbor Labs, a place for brilliant geneticists. I often wish it was somewhere else other than Long Island but that is a personal bias. 

When I cam back to MIT in the early 2000s, he gave a talk at the neuro institute and a bunch of my  doctoral and post docs went to hear him. They cam back startled as to how he really discounted engineers and physicians. My comment was that is one reads the Double Helix, Watson was just being a good engineer, not a scientists. The scientists gave him the data and he and Crick just assembled it. That made my students happier.

Watson was acerbic at times but at CSHL he was a true leader. 

PSA: How not to do an experiment

 Back in 2009 in NEJM a European group reported the results of a study that alleges that PSA testing has no value after certain ages. Now the group adds additional data but claims only marginal improvement. It still delimits testing to less than 75.

However as I noted then and now again the test protocol was:

The screening interval at six of the seven centers was 4 years (accounting for 87% of the subjects); Sweden used a 2-year interval. In Belgium, the interval between the first and second rounds of screening was 7 years because of an interruption in funding.

As I had noted, I have seen patients got from 4 to 40, and 40 to dead in 4 years. Testing annually, along with %Free is essential just for monitoring. Measuring rates of increase are sine qua non. Change is the critical factor in any diagnosis.

PSA value can vary from one test method to another. From time of day. From state of exercise such as cycling. And other factors. The more frequent the measures the more these exogenous factors can be averaged out. Yet if we have 4 year intervals in my opinion and my experience the results are useless.

These studies were used to justify reducing PSA monitoring and eliminating it in the over 75 group. PCa is a horrible disease if not caught early. More frequent PSAs under common conditions using the same method of valuation is essential.  

 

How to Destroy a Company

 Some 25 years ago I described how telecom, voice calling on copper, would collapse. Since then I have seen how one entity, Verizon, a former employer, has managed to consistently snatch defeat out of the jaws of victory.

In my opinion the main reason is that they have no idea what business they are in.  They keep trying to get in the media business. I was in the media business, at Warners, and the people there are creative risk takers, who know when to hold them and when to fold them. Telephone types come from a environment of pretenders in business. Historically the telecom business had defined profit as percent return on invested plant. All expenses were covered. The real world does not work that way.

The current and prior two CEOs come from a world not akin to the core business. One wanted to be a media king, think Yahoo, and how did that go. The next came from the hardware business. Verizon is in the service business. Ultimate mismatch. The current is a Silicon Valley type, with a company invested in pole climbers. 

The main problem is a Board who present well to the WOKE world but lack the ruthless world of competitive network services. They waited too long to the last CEO to get ousted. I suspect the current CEO will try to use his rule book but this will also fail.

After forty years of stock holdings, I sold everything off today. I suspect Verizon may get bought out directly or after a Chapter 11 filing. Pity. 

Rare Earths: Not so rare!

 One of the largest deposits of the rare earths is in the US. Namely California. Some fifteen years ago I wrote a long note regarding this issue. The only reason the US relied upon China is that California closed the rare earth mines due to environmental concerns. 

So what do we do. We go to Australia. As DW notes:

 US President Donald Trump and Australian Prime Minister Anthony Albanese Monday signed an agreement on Australia's rare earth minerals. The agreement comes as China puts new restrictions on rare earth exports, prompting Trump to impose an additional 100% tariff on imports from China from next month. "In about a year from now, we'll have so much critical mineral and rare earths that you won't know what to do with them," Trump told reporters at the White House. Trump was hosting Albanese this morning at the White House and the leaders signed the document before the media. Albanese described the deal as an $8.5 billion pipeline "that we have ready to go."

 We end up paying Australia to dig holes in their land, leaving California untouched. Think about it.

 

Socialism 1920

 From The NY Times, July 5, 1920 

Here is the Socialist ticket: 

For Governor—JOSEPH D. CANNON.

Lieutenant Governor— Miss JESSIE WALLACE HUGHAN

Secretary, of State— CHARLES W. NOONAN

Controller—PHILIP RANDOLPH.

State Treasurer — HATTIE F. KRUGER 

All candidates of the Socialist Party, when elected to office, will vote and work for the adoption of such  measures as the following, not only for the immediate relief of pressing evils, but also as preparatory to the full realization of the Socialist goal. 

1. Legislation which will enable municipalities to acquire land, construct dwellings on public account, and lease them at rents calculated to cover cost of upkeep and replacement, but without profit, thus solving the now growlingly acute housing problem. 

2.’ Establishment of a comprehensive system by which the State in conjunction with municipalities and co-operative societies shall deal on a large scale In food and other necessaries of life, buying directly from the producers and selling directly to the consumers at cost, thus eliminating the capitalist middlemen, stimulating production and diminishing the cost of living:. 

3. The rapid extension of State and municipal ownership and operation of transportation and storage plants, of lighting and other so-called public utilities and of industrial establishments beginning with those which, are already most largely monopolized and those which have to do with the production of the prime necessaries of life. 

4.’The conservation by the State of the forests, mineral deposits and source's of - water power which it still owns, the reclamation of such as have been voted away, and the exploitation of these resources by the State, not for profit, but for the production of raw materials and power to be sold at cost. 

5. Legislation which will clearly exempt labor unions and farmer associations from prosecution under the so-called anti-trust laws, and will assure them of the right of collective bargaining in the sale and their farm produce respectively. 

6. Legislation guaranteeing labor the right to organize and strike, free from interference by the courts through the power of injunctions. 

7. Repeal of the war emergency concerning military service and military training in the schools, and repeal of the so-called criminal anarchy law, which has been demonstrated to be in practice a law for the suppression of free speech and for the promotion of spies and provocators. 

8. Amendment of the State Constitution and of the laws governing municipalities in such manner as to introduce the principle of occupational as well as geographical representation in legislative bodies and administrative boards: to introduce the referendum and the power of recall 

I have a personal link, Hattie Kruger was my Grandmother. So none of this is new. But just look. New York did public housing. How has that worked out. Crime and Crumbling buildings. Public transport, think MTA and AMTRAK, also coslty crumbling failures. 

Perhaps we have been there already.  

Taking Your Own Advice

 In PJ Media the Wrestling Lady in DC noted:

 “Two weeks in, millions of American students are still going to school, teachers are getting paid, and schools are operating as normal,” McMahon emphasized. “It confirms what the President has said: the federal Department of Education is unnecessary, and we should return education to the states.”

 But it did not stop her from "advising" Universities how to do their tasks. Perhaps this is nothing more than the "blind leading the blind"

Another Simple Calculation

 I was thinking about MIT and foreign grad students. Consider the following:

1. 40% of the grad students are foreign

2. There are about 5000 grad students so that is 2000 foreign students

3. Half of them are PRC students or 1,000 students from the PRC

4. All grad students are funded by some form of research, almost solely from the US Government

5. The student costs paid for at $60,000 tuition and $40,000 support, or $100,000 per student per year

6. The PRC students are thus supported by we the Taxpayers for $100 million per year

7. When I was there in 60s we had no USSR students

8. The PRC students are there under the rubric of the US State Dept viusa program

9. The research grants do not restrict who is supported

Now think about this. 

Threats: Cutting one's nose to spite one's face

 This ludicrous "Compact" that the folks in Washington issued will, if implemented against Universities, will destroy American excellence. Consider the opening paragraph:

American higher education is the envy of the world and represents a key strategic benefit for our
Nation. In turn, the U.S. university system benefits in a variety of ways from its extraordinary relationship
with the U.S. government. These include (i) access to student loans, grant programs, and federal contracts; (ii) funding for research directly or indirectly; (iii) approval of student and other visas in connection with university matriculation and instruction; and (iv) preferential treatment under the tax code. To advance the national interest arising out of this unique relationship, this Compact for Academic Excellence in Higher Education represents the priorities of the U.S. government in its engagements with universities that benefit from the relationship. Institutions of higher education are free to develop models and values other than those below, if the institution elects to forego federal benefits

 This is a clear threat. Do what we tell you or we will bankrupt you! Who in their right mind would do this. Yes Universities have their childish problems. Yet this is more than throwing the baby out with the bath water, it a Hammas like act of execution.

There is a tool that works, namely via funding. If one wants to limit foreign nationals in Grad school, funded under Government contracts then put that in the contract. Namely only US citizens. 

Visa controls are already in place. Why burden the University. If the R&D funding delimits foreign nationals then clearly the system will act accordingly.

In my opinion the issue is getting more US students in Grad school. Is a PRC student really better than any US student? If they are blame US education. If not, then fix it via funding.

This clearly is one of the most egregious documents I have ever read. In my opinion it reads like it was written by some Community College drop out trying to get revenge.  

An Interesting Observation

 MIT published the statistics on international students. It is interesting in that:

1. 12% of the undergraduates and 40% of the graduate students are foreign.

2. Of the grad students 25% are from the PRC, and totals 1,000 from PRC in both grad and undergrad.

In my time I don't think we had a single USSR student. 

In addition, are the US students that poor that they cannot get admission? MIT funding is mosl;y from the US Government and perhaps one should be focusing on training ad educating US citizens first.  

MIT Demands: Sounds Familiar

 In The Tech there is a great discussion of the demands the Government is placing upon MIT for funding. Simply stated they ask

1. Admission etc predicated solely upon academic performance.

As we had discussed before this makes eminent sense.  No essays, no pictures, no "save the world" interns. Just grades. 

2. Eliminate Campus organizations that create a hostile environment

In my days, SDS was a player seeking to destroy the campus. Campus organizations frankly should be few and far between. The amateur radio club may make sense, the amateur railroad club, etc. 

3. Free tuition if endowment greater than $2 million per student, except for students from "wealthy" families

I never paid tuition, through my PhD.  Scholarships, fellowships, teaching fellowships. All performance based and for the most part Government financed.

4. Freeze tuition rates for five years

This is sticky. First the rates are obscene. But they are artifacts not real. 

 Now 1 above is fine and I have noted this. 2 above may be a bit sticky since I never belonged to such an organization and back in the day SDS for example was not a Campus supported on.

Number 3 is a bit of a push, schools have gotten themselves in this mess with their crazy tuition support rules and over priced tuition.

4 may make sense since it is bloated as is. 

What is Priority Mail?

 Priority Mail is in my opinion and my experience a scam. It is nothing more than a fancy envelope, a tracking number, a high price and a letter that gets no where or worse to the wrong place! Not once did they ever deliver as they promised, not one single time! Many were lost, mis-delivered, delayed etc.

If we are closing down the Government I suggest the USPS first. Let Amazon deliver mail. They seem to get 90%+ of my packages on time. Next day even. Try that at the USPS. 

1066 Redux

 

 England has gone through multiple "invasions". Initially the Celts and to some degree the Picts inhabited the island. Then came the Saxons. the Germanic invaders, and to some degree the Anglo tribes. Also from time to time Viking invaders. Then in 1066 William the Bastard and his clan crossed over from Normandy and battled in Hastings. Welcome to the Normans. Needless to say the Norman invasion has had lasting effects for almost 1,000 years, until now.

The Guardian notes;

 Keir Starmer has attacked Reform UK’s plan to deport thousands of people already legally living in the UK as “racist” and “immoral”, as he said that Labour had a generational struggle ahead with the populist right. The prime minister, in Liverpool for his party conference, said he did not think that Nigel Farage’s party was trying to appeal to racists, and that he understood people tempted to vote for Reform were frustrated and wanted change. But he said the rightwing party’s proposal to entirely abolish the main route for immigrants to gain British citizenship could “tear this country apart”.

 What then is it to be English? It was a religion for a while, a King or Queen, a history, etc. But these are going through massive changes.

One sees the same in Ireland, a massive change to a socialist Government with similar open borders. The Irish spent almost 800 years to be free from English domination only to possible see the influx dominate the new culture. 

But the habit of calling one's adversary violence inciting epithets  seems to be de regeur. 

The Normans had their own ways to do things. This small band of invaders in short order took over a nation, changed the laws,  overthrew the leadership and dominated for a thousand years. Perhaps the end is truly near.

The Incompetence of the USPS

 Again and again I have had to deal with the USPS incompetence. Welcome to the Government employee work ethic. To compound it I sent a Priority mail letter to Atlanta, the worst of the worst USPS sites. After a week it has arrived at Atlanta, NY, a small town near the Finger Lakes and no where near Georgia. Soon the letter will be lost!

Perhaps closing down the Government is a good idea, permanently! Amazon seems to get things done, they can do the mail! 

Fortunately General Sherman had a better sense of direction! 

AI, Medicare and Denial

 

 The boys in DC have selected NJ as one of six states to trial an AI based pre-approval for Medicare payments. They plan to use AI companies. The NYT states:

The A.I. companies selected to oversee the program would have a strong financial incentive to deny claims. Medicare plans to pay them a share of the savings generated from rejections. The government said the A.I. screening tool would focus narrowly on about a dozen procedures, which it has determined to be costly and of little to no benefit to patients. Those procedures include devices for incontinence control, cervical fusion, certain steroid injections for pain management, select nerve stimulators and the diagnosis and treatment of impotence. Abe Sutton, the director of the Center for Medicare and Medicaid Innovation, said that the government would not review emergency services or hospital stays.

Specifically they intend to review:

 

• Facet joint procedures for back pain

• Nerve and muscle tests (electrodiagnostic testing)

• TENS units and similar electrical stimulation devices

• Hyperbaric oxygen therapy

• Spinal cord stimulators

• Deep brain stimulation (commonly for Parkinson’s)

• Sacral neuromodulation (for urinary conditions)

• Transcatheter aortic valve replacement (TAVR)

• Arthroscopic knee cleaning or debridement

• Vertebroplasty/kyphoplasty for spine fractures

• Epidural steroid injections

• Non-emergency ambulance transport

• Botox injections for medical issues

• Negative pressure wound therapy pumps

• Hernia repairs

• Lumbar spinal fusion

• Skin graft substitutes for chronic wounds

 As my readers know I am a doubter in AI at this stage. Thus the application to millions of Medicare recipients is in my opinion grossly negligent. One should try at a lower level, not 15% of the US as a first bite. This is similar to the massive COVID vaccine program, just failing to test and just dumping on hundreds of millions.

One must ask who these "AI" companies are. What are their bona fides? Since we have no definition of what AI is it is likely that they will just be some friendly folks with the current Administration.  We should know these companies in detail. What is their technology, what is the basis for their decisions, what have they accomplished before? One suspects this will all be hidden behind some curtain of proprietary nonsense.

The test should be small, transparent and Congress should have a say as well as the Medicare recipients.

But alas, no one in DC gives a phenning! 

 

Swarming, Drones, and Warfare

 About 20+ years ago I wrote a paper on swarming warfare. As noted such warfare was characterized by:

Swarming has been characterized by Arqilla and Ronfelt as follows:

1. Autonomous or semi-autonomous units engaging in convergent assault on a common target

2. Amorphous but coordinated way to strike from all directions

3. “sustainable pulsing” of force or fire

4. Many small, dispersed, inter-netted maneuver units

5. Integrated surveillance, sensors, C4I for “topsight”

6. Stand-off and close-in capabilities

7. Attacks designed to disrupt cohesion of adversary

 Now with the use of drones and sophisticated netted multimedia communications one obtains a significant advance in this technique. 

DoD, now called War, should have been addressing this issue in detail. The PRC sure has been. Consider this as an attack by yellow jackets, before one knows it the swarm has in a coordinated manner attacked the poor victim.  

This is a new paradigm in warfare. Low costs attack platforms and counter persons destruction. Does the Russian forces have this? Not yet but the PRC may use this as a training opportunity. Beware!

One strategy for attack is the use of low yield neutron devices. A 5kT device can be tucked in a small drone, and such a device destroys living matter but leaves structures unharmed. It also can be readily accessed after deployment. This was a 1980s proposed strategy. However then there were no drones. Now the cost of deployment is low and the success ratio very high. Such a strategy can clear an enemy force in hours and allow re-entry the next day. Thus one asks; what is a counter-force strategy? 

March of the Turkeys

 

Fall is here and the turkeys are marching again.

Some say Larix some say Larch

 

The NY Times has an article about the larix, a tree indigenous to the White Mountains in New Hampshire and other similar locations. They note:

At least, it did. Since the late 2000s, about a quarter of Britain’s larch trees have been infected by Phytophthora (Greek for ‘plant-destroyer’) ramorum, a fungal-like pathogen that spreads via wind-blown spores and water in the soil. “Ramorum is so beautifully good at killing larch effectively,” Dr. Heather Dun, a scientist from Forest Research in Scotland who is studying the pathogen, told me. In the United States, it’s known as “sudden oak death,” targeting native trees like coast live oak and tanoak.

 The NH larix is a hardy tree if you grow it at 1,000 ft above sea level where the frost line in winter exceeds 1 foot! And the soil is very sandy. I tried one in New Jersey in clay soil and a frost line at best a few inches. No luck.

Trees need certain soil, certain moisture levels, and certain temperatures. My ginkgo loves clay soil in NJ but hates sandy soil in NH. My white pines are weeds in NH but struggle in NJ. 

Trees are very sensitive to location. White birch hate NJ but love NH. The list goes on.

Now for diseases, they all too often  result from some one bringing it into the region or country out of gross ignorance! Put it in their garden, wind blows and devastation occurs. 

Isolating the killing factors is complex but usually no single cause is present. 

 

JCP&L Is Collapsed Again!

 The local power distribution company has a long lasting record of failures and incompetence. It must, in my opinion and my experience, be run by a bunch of accountants who are clueless about electricity! Multiple times today power has been lost. The entire town seems to be down. 

They have bumped up the rates by 20% and reduced the service I fell by even more. Sounds like the local cable provider. It seems that any entity governed by a Utility Commission just does not give a damn.

Equipment fails, replacement parts are unavailable and repair crews are lost in translation. 

We are relying more and more on electricity. The companies are populated with less than average folks in an industry which will allegedly explode with AI. This will lead to total disasters! 

Pity!

AI in Medicine: GIGO?

 

The more I examine AI in medicine the more it appears to be very risky. In a Med City News piece they note:

Another healthcare executive — Jess Botros, vice president of IT strategy and operations at Ardent Health — noted that she wants the system’s clinicians to be able to spend as much time as possible with patients and have the right tools in hand. That said, there’s a lot of responsibility when it comes to deploying AI.

“In order to do this in the right way, you have to have your house in order from a data perspective, from a trust perspective,” she said. “You think about change management impacts and making sure that people are really along for the ride and really understand why we’re doing what we’re trying to do. It becomes super important.”

 My concerns are as follows:

1. Good medical practice is trying to understand the patient. Patients are often the main obstacle to good medical practice. They delay treatment, they often do not express all the symptoms, they try their own diagnosis thus adding noise to the process, and fundamentally they do not listen, often through fear, and the physician does not explain well enough.

2. Patient data is all too often in error. From time to time I examine my own data and see entries that make no sense and critical entries missing. For example I never have had GERD and my lipids are rock bottom. But both were listed otherwise on various reports. Thus if this data is entered into an AI system the AI doc will naturally come up with the wrong answer. Just try correcting these errors, impossible.

3. Does the AI doc need a license to practice? In what state? If I were to try practice in Georgia I would face a period in prison. But if the AI doc is in Montana can the patient in New York be diagnosed?

4. My best issue is who does a patient sue? The AI doc does not really exist.

5. The AI doc is really just a good and fast research librarian. Ask a question and get an answer based upon existing information. But what if this patient is a one off? Never seen this before. (98% of medicine is  rote, but the 2% is the challenge and most likely missing in the information fed to the AI system.

6. Patients are asked to fill out health forms. Many have no idea how to answer. Long lists of what a patient may have had get confusing answers. I am often reminded of Marty Samuels and his dizzy discussions. Trying to find out what type of dizzy and the cause may result in many unnecessary tests and may even miss a severe and immediate cause. 

Thus bad input data, unseen conditions, poor patient communications are just a few of the issues with AI docs. 

In a Bayesian world, and much of medicine is that way, diagnosis and treatment is often based upon pre-existing data. If that patient data is wrong, not current, then the results could be either unproductive or worse deadly! 

Plutarch is Worth a Read; The more things change the more they remain the same

 Plutarch and his live details the Roman Republic in its final days. Political enemies beheaded and oligarchs trying to become rulers. As Grant notes in his preface: 

Two elements perhaps stand out above all others in Plutarch's late republican Lives. The first is the unbridled pursuit of personal power. Every Life in this selection displays the incessantly disruptive and ultimately ruinous effects of competition and ephemeral collaboration for purely selfish ends between a handful of prominent individuals, none of whom was quite powerful enough to achieve sole supremacy until Caesar put an end to the dominance of the oligarchy that had spawned him in the last stage of its decline. The second is the amount of coverage that Plutarch sees fit to give to wars both foreign and civil. 

To a certain extent this need occasion no surprise. In the eyes of the Roman ruling class military glory was the highest form of distinction to which its members might aspire. The biographer of leading Romans could hardly avoid writing about war, and a man's conduct in the field might well provide illuminating insights into those recesses of his character that Plutarch sought to penetrate. Yet much of his military narrative seems, as observed earlier, to be there for its own sake, regardless of any light it might shed on the protagonists’ moral or psychological make-up.

The reason for both these features of Plutarch's work lies in the standard perception of the republic and its fall that quickly developed under the empire. Everyone knew that the republican ruling class, by its dedication to the quest for wealth and personal power, had destroyed itself and the system of government it claimed to cherish. That Plutarch should share this perception is not remarkable. Explanation would be needed only if he did not.

Plutarch. Fall of the Roman Republic: Six Lives (Penguin Classics) . Penguin Books Ltd. Kindle Edition. 
 

So  who is our ruling class today and given current events are they repeating themselves. It is truly worth understanding our history, it does repeat.

Cancer Resarch

 

The NY Times bemoans the reduction in support of cancer research, and they note:

Other countries are seeing opportunity in the chaos. Varmus is among a number of prominent U.S. scientists who have received solicitations from the governments of France and Spain to consider relocating there. America’s 80-year run as the world’s leader of biomedical research — and 50-year run as the global leader of cancer research — may very well be coming to a close, and for no apparent reason. Varmus seemed as puzzled as anyone by the development. “We are great in science,” he said. “Why would we want to destroy one of our greatest assets?”

 Yes the US has dominated research ut frankly I see China galloping along at a fair pace. So should we revamp the NCI? One may want to look at the web site of NCI. It tells a story in a rather politically correct manner. I will let you determine how. But frankly perhaps cancer research needs some restructuring.

Cancer is a complex disease with often no common thread even amongst the same cancers. One need look no further than lymphomas to see such variety.

That complexity is what has been studied over the past 50+ years. Gene after gene, pathway after pathway. From masses of cells to now cell by cell. 

We have two extremes in cancer research. At one end is the silo approach of gene after gene. PTEN, MYC, MTOR, and the list goes on. Then we have  clinical trials with some success. For example we see in cancer like melanoma that immune system control, PD-1 blockage, works in say 30-40% of the cases. Why not all? In hematological cancers with CD19 surface markers we have some success with CAR-T cells, but again not all. Why?

We are missing the middle state. Namely systems analysis of cancers. Looking at "all" the elements from genes to environment such as the tumor micro environment, to epigenetics, and the impact of the patient's other genetic factors. It is very complex and just being addressed.

Perhaps a good look as to how cancer research should evolve would be worthwhile. But one must be careful not to throw the baby out with the bathwater. 

Fall In New Hampshire

 As the summer ends the New England Asters are in full bloom. A beautiful blue color astride every roadside.

A Loss, A True Genius and Leader

 David Baltimore passes at the age of 87. Baltimore and his colleagues came to understand reverse transcription, the writing of DNA segments into our own DNA. That became the key element in understanding AIDS.

He was attacked without basis by the Congressman Dingell, a ruthless attack without merit, which may have very well set back AIDS work a decade.

Baltimore was a fantastic leader and scientist.