Tuesday, July 19, 2016

Prostate Cancer and the ACA

As we have been writing for the past seven years the ACA and the USPSTF have  stated that PSA tests and prostate exams have no merit. In Science Daily they report:

The number of new cases of metastatic prostate cancer climbed 72 percent in the past decade from 2004 to 2013, reports a new Northwestern Medicine study. The report considers whether a recent trend of fewer men being screened may be contributing to the rise, or whether the disease has become more aggressive -- or both. The largest increase in new cases was among men 55 to 69 years old, which rose 92 percent in the past decade. This rise is particularly troubling, the authors said, because men in this age group are believed to benefit most from prostate cancer screening and early treatment.In addition, the average PSA (prostate-specific antigen) of men who were diagnosed with metastatic prostate cancer in 2013 was 49, nearly double that for men diagnosed in 2004 with an average PSA of 25, indicating a greater extent of disease at diagnosis.

In the the article by Weiner et al  they note:

Beginning in 2007, the incidence of metastatic prostate cancer has increased especially among men in the age group thought most likely to benefit from definitive treatment for prostate cancer. These data highlight the continued need for nationwide refinements in prostate cancer screening and treatment.....Although the social and biologic factors underlying these PSA escapes and rising metastatic prostate cancer cases are unknown, the implications of these recent trends highlight the continued need for nationwide refinements in prostate cancer screening and treatment to prevent the morbidity and mortality associated with metastatic prostate cancer. This will be particularly critical for population health economics in the United States considering the added cost of care for metastatic prostate cancer and an aging constituency whose population over the age 65 years will double to over a projected 80 million by the year 2050. In addition, our findings and forthcoming changes in the number of elderly individuals should provide impetus to improve treatments for men with metastatic prostate cancer whose cancer-specific survival has not changed significantly in the past two decades.

Thanks to the ACA and their minions we have managed to see the excruciating increase in death from a manageable disease.

Bridge vs Trump

The BBC was the first to report the collapse and closure of the Tappan Zee Bridge, a part of the NY State Thruway and one of the four major connectors to New York. In fact a major US Interstate, I87/I287. Millions of cars at a time.

What of the NY Times? Nothing! But there must be two dozen Trump stories. Now perhaps the Times missed Brexit, the BBC did not, but those folks in London caught a major infrastructure calamity in the US largest city. Now perhaps the Times thinks Trump is a bigger calamity, one would think so given their coverage. Or perhaps those who follow the Times all live in a small cluster in Manhattan and may not even know what a bridge is. Could be possible.

Then there is the issue of Civil Engineering 101. The center of gravity of a crane if placed in the incorrect spot can result in a crane collapse. They even have instruments for this. The law suits on this will be fantastic. Then there is the issue that the State just left the old bridge alone because in two years they will have a new one. But when a crane slices the old one in half, try getting to work, to Boston to New York, etc.

Oh yes, RT, the Russian News Outlet also carried a piece. But still no NY Times.

Sunday, July 17, 2016

Brexit, Harvard and Marsilius

History is worth examining. For millennia humanity has created, endured, suffered under, prospered with, survived as a result of political structures. Brexit is a change in such a structure which has evolved over the past few decades.

Why Brexit? I keep thinking of Marsilius of Padua and his rejection of  papal control over governments. By 1320 under John XXII the papacy in Avignon was attempting to control all the Government in what was then Christian countries. Kings could make some local laws but if the folks back in Avignon did not like them, overthrown! The Church was to Edward II and III in the 14th century what the EU was to England in the 21st. Of course then came Luther, albeit it took the printing press, but now we have the Internet.

Some Harvard person writes:

It may be too difficult to determine the exact relationship between Trump and Farage’s harmful scare tactics, but observers in both countries should pay close attention. It is evident now with the Brexit vote that racist rhetoric and discriminatory policies are not just limited to the United States. They are, in an age of globalization and rapid change, quickly taking hold in international politics, and becoming an influential determinant of policy. Aggressive anti-immigrant rhetoric and the scapegoating of minorities and immigrants must be taken seriously. Britain’s vote to exit the European Union, a decision highly influenced by the xenophobic rationale of UKIP, is just another indicator that there is a serious wave of nativism ascendant in both British and American politics. With international focus on Britain’s recent decision, there is great potential for conversation and change to take place. However, there is also the possibility that rising anti-immigrant sentiment and xenophobia will worsen.  With the risk of increased hostility and prejudice on the horizon, the world’s eyes are fixed on American elections as a key indicator of things to come.  

Somewhat like the NY Times, blaming everything on the current contender for the Republican party but totally failing to ask why? And moreover; what are the historical precedents and where did that lead. Somehow there is that statement of those neglecting to understand the past mistakes are doomed to repeat them, or whatever.

We have been through this process before. Marsilius in 1324 wrote his now famous work on the heretical views of the papacy in Avignon, namely baseless and moreover fraudulent claims of political supremacy, and then failing to understand the development of self rule and regulation.

Revolutions result oftentimes from oppressive rule. They also result from just nonsensical rules as well. Remember the Tea Party! No, Harvard, not those folks walking around today, those folks in Boston back in the 18th century, it must be in some High School text somewhere in a old book store.

More on W10

These guys must be in a panic for some reason, possibly not a good one.

PCWorld reports:  

As July 29 gets closer and the free Windows 10 upgrade offer reaches its final days, Microsoft is pulling out all the stops in order to convince users to upgrade. It’s even willing to give you a new laptop. ... Microsoft retail stores are offering to install Windows 10 on any compatible machine for free. If the store’s technicians don’t complete the upgrade by the end of that business day, they’ll give you a free 15-inch Dell Inspiron notebook. The offer runs between now and July 29.

Now as we have reported earlier, W10 knocked out some older software, especially my Chem Draw, not cheap, as well as a half a dozen drivers. We now have 6 W10 machines, all the on line ones, 2 XPs which are old desk hold overs, limited use, and one W7 lab interface. The W7 is blocked from any updates, never goes on line, and connects to all lab equipment. If that crashes the old XPs will work. The W10 systems will not.

So why upgrade? Been there and done that but the driver problem and SW incompatibility is a nightmare. Sorry Redmond, I know you want customers to do it your way but we have a life too. Good thing they do not run the IRS/ Yet!

Saturday, July 16, 2016

Coriolanus

Coriolanus is one of Shakespeare's last plays and frankly one of the more complex. It was based upon one of the Plutarch tales[1] and as such is consistent with the many uses Shakespeare made of classic events. As Plutarch observed:

It may be observed, in general, that when young men arrive early at fame and repute, if they are of a nature but slightly touched with emulation, this early attainment is apt to extinguish their thirst and satiate their appetite; whereas the first distinctions of more and solid and weighty characters do but stimulate and quicken them and take them away like a wind in the pursuit of honour; they look upon these marks and testimonies to their virtue not as a recompense received for what they have already done, but as a pledge given by themselves of what they will perform hereafter, ashamed now to forsake or underlive the credit they have won, or, rather, not to exceed and obscure all that is gone before by the lustre of their following actions. Marcius, having a spirit of this noble make, was ambitious always to surpass himself, and did nothing how extraordinary soever, but he thought he was bound to outdo it at the next occasion; and ever desiring to give continual fresh instances of prowess, he added one exploit to another, and heaped up trophies upon trophies, so as to make it matter of contest also among his commanders, the latter still vying with the earlier, which should pay him the greatest honour and speak highest in his commendation. Of all the numerous wars and conflicts in those days there was not one from which he returned without laurels and rewards. … But Marcius, believing himself bound to pay his mother Volumnia all that gratitude and duty which would have belonged to his father, had he also been alive, could never satiate himself in his tenderness and respect to her.

From this did Shakespeare develop his character. The more recent version by Ralph Fiennes[2] presents Coriolanus in a contemporary setting and presents him as an awkward savior of Rome which then through a manipulation of the masses turn on him which leads to his destruction. Coriolanus is a warrior, not a politician. The politicians manipulate the mob, yet within the mob there are other layers of manipulators. There are what I have called from time to time the "professional back stabbers". This is a group of what may be genetically oriented persons whose sole goal in life is to destroy others. Nothing personal, nothing for a desired end, just the process of personal destruction. Washington is a current day example of where they most congregate. Thus this class attacks Coriolanus who appears both clueless and disinterested. Fiennes does a splendid job at depicting this.

Now comes a version at the Shakespeare Theatre of New Jersey. In this presentation the Fiennes role is displaced by an actor who I would have seen growing up on Staten Island. A big brutal thug, whose demeanor is not that of a lost Fiennes but of some muscle in the local mob. Perhaps appropriate for New Jersey but I fell totally missing the point. The presentation was mediocre at best and the mob complexity was totally missing its thrust.

Yet come the NY Times and its review[3]. They conclude:

If several among the other performances are wanting, the combined effectiveness of the 25-member company is greater than the sum of its lesser parts. The director’s decision to have the actors frequently throng the theater’s aisles lends immediacy and a sense of speed to this resonant production, which sprints along at a fast-paced two hours and 35 minutes, including the intermission.

Frankly this presentation was cacophonous. It lacked any cohesion, it spent too much time on the rabble, and the undercurrent against the current political scene is sophomoric. As expected the Times cannot seem to even give a recipe without making a comment on the current election. The NY Times reviewer states:

Shakespeare’s political drama, of a candidate for high office unsuccessfully coping with seesawing public opinion, assumes fresh resonance in our own interesting times that witness Brexit regret overseas even as so many American voters are voicing their own discontent over their presumptive presidential nominees.

Yes, the mob is a key element of Coriolanus. Yes, the mob can be manipulated. Yes, the results are tragic for all. But that is not why Shakespeare wrote this play. At the time James I was King, and it was the James from whence we get the so named Bible.

Shakespeare seems not to like the populous. As note by Prescott his use of the term popular, as understood to me in relation to the masses seemed always to end in some disaster[4]. The masses can and could be manipulated. The manipulators often do so just for the process itself without any end in mind. The tragedy here is that Coriolanus was a good soldier who was thrown out of his ken, and at first accepted and then destroyed by the masses, to no benefit to them.

But what most seem to miss about Coriolanus as a play and political metaphor is in the play the Tribunes manipulate the masses. In the current election cycle on the Republican side, this seems not to be the case. In fact the masses are rejecting the Tribunes. It is thus an interesting and telling drama. Can the masses be manipulated? All the time. We see it in every strategy. As one of the Democrat Tribunes states; never let a tragedy do to waste. As immoral as such a statement may be, it is echoed so many times.

Thus I would rate the Fiennes presentation as a five star one and the NJ Shakespeare team as at best a one star! To do Shakespeare well, one must understand the underlying human tragedy, not try to make it some anti-politician statement. Done that way it becomes just an echo from the very mob itself, it is popular to paraphrase Shakespeare.


[2] https://www.amazon.com/Coriolanus-Ralph-Fiennes/dp/B0059XTUR2 It is interesting to read the one star reviews of this film. It truly tells one about the masses! The resonance of the reviewers with Shakespeare is amazing. The reviewers of course have no idea what they are reflecting upon.

[4] See Shakespeare, Grazia and Wells, Cambridge, 2011, pp 271-272. Language was key and the reference usage in time is essential.

Friday, July 15, 2016

Peace

In the opening portion of Marsillius of Padua's magnificent work, Defensor Pacis, he states: 

Every realm must desire tranquility, under which peoples prosper and the profit of the nations is safeguarded. For she is the seemly mother of good arts. She it is who, multiplying the human race in unending succession, extends its resources and refines its manners. And if a man is perceived not to have sought her, he is marked for ignorant of such great concerns…

In the first of his letters, in the passage just set down, Cassiodorus gave expression to the advantages and fruits of the tranquility or peace of civil regimes, in order that he might - by using these, as the best fruits, to explain the greatest of all human goods, viz. the sufficiency of this life, which none can achieve without peace and tranquility - inspire the wills of men to be at peace with each other, and hence tranquility. His pronouncement was in harmony with the view of the blessed Job, when he said in chapter 22: "be at peace: thereby the best fruits shall come unto Thee."

That was in 1328, it applies equally today.