Government Healthcare, Think Post Office

The USPS is truly one of the most incompetent entities around. The only one worse is AMTRAK. The train folks had 601 delays on my local ride in the 152 days last year. That is about 4 delays per train per day. Now the USPS refuses to deliver packages...yep...it must be the snow...all three inches of it.

Now for those folks who want Government healthcare, just think of these two entities. Even worse, think of the IRS! Combine them and we would eliminate any population explosion. We would all be dead!

Oh, about that wall, how about a tunnel between New Jersey and New York. You can even charge for that. Guaranteed that New Jersey folks would pay for it, pay for anything!

How to Lose Customer Trust

I have noticed recently that Amazon has third party sales where the Amazon standard conditions do not apply. The third party has poor if zero return policies and it is near impossible to cancel an order. Cost of returns has exceeded the cost of the item and the communications with the vendor is nil. Why Amazon has mixed these in my opinion poor third party vendors with their own sales and in addition give no clear warning is beyond me.

This style of what I would see in my opinion as a "shady" practice will come back to haunt Amazon. I would rather go to Walmart or some other party then to be fooled by some third party Amazon purchase.

The other thing I have noticed and have experienced is that these third party vendors, such as those selling batteries, seem to just repackage used batteries and then sell them as new. It is difficult to prove that as a general consumer but if one does this can become a massive class action suit! Amazon should beware.

A reputation takes time to build but can be destroyed in a heart beat. Perhaps they have some bright MBA who saw a quick profit margin and never gave it a second thought. If Walmart were smart, namely no smart MBA type, they would jump on the bandwagon and tear Amazon apart on this issue!

More on the Microbiome

We have recently written extensively on the microbiome and cancer. Science has just published an article reinforcing our summary which is worth the read. Recall that the microbiome is that collection of microorganisms that live inside of our bodies, and without which we would most likely not survive.

As the authors note:

Cancer immunotherapy has become highly successful against an array of distinct hematological and solid metastatic malignancies. Administration of immune checkpoint inhibitors (ICIs) unleashes T lymphocyte–mediated immune responses by suppressing the interaction of T cell inhibitory receptors with their cognate ligands on tumor or stromal cells. The most widely used ICIs are monoclonal antibodies (mAbs) targeting programmed cell death protein 1 (PD-1) and its ligand PD-L1. PD-1 blockade is highly efficacious against advanced melanoma, non–small cell lung cancer (NSCLC), and renal cell carcinoma (RCC). Primary resistance, observed in 60 to 70% of cases, has been attributed to low mutational burden, poor intrinsic antigenicity of tumor cells, absence of priming by potentially immunogenic pretreatment with chemo- or radiotherapy , defective antigen presentation during the priming phase, local immunosuppression by extracellular metabolites, and functional exhaustion of tumor-infiltrating lymphocytes. Recent work in mice has highlighted the key role of the gut microbiota in mediating tumor responses to chemotherapeutic agents and immunotherapies targeting PD-L1 or cytotoxic T lymphocyte–associated protein 4 (CTLA-4). Therefore, we explored the possibility that dysbiosis associated with malignant disease or concomitant antibiotic (ATB) use could influence primary resistance to PD-1 blockade in tumor-bearing mice and cancer patients.Initially, we compared the therapeutic efficacy of PD-1 mAb alone or combined with CTLA-4 mAb in mice with established MCA-205 sarcoma and RET melanoma. Mice were reared in specific pathogen–free (SPF) conditions and treated for 14 days with broad-spectrum combination ATB (ampicillin + colistin + streptomycin) or left untreated. ATB treatment significantly compromised the antitumor effects and survival of mice treated with PD-1 mAb alone or in combination with CTLA-4 mAb.

Thus it is critical to deal with many cancers in a holistic manner and not just rely upon  the therapeutic.

Now I Do Not Want to Walk Into this BUT:

I received the following from Nature as a News Alert:

How a warming climate leads to cold snaps:The reduction in the amount of Arctic sea ice is weakening the whirling jet of air known to weather-lovers as the polar vortex, allowing cold blasts to dip into North America and Eurasia.

The article referred to states:
 

The loss of sea ice may be weakening the polar vortex, allowing cold blasts to dip south from the Arctic, across North America, Europe and Russia, a new study says....Here's what scientists involved in the research think is happening: The evidence is clear that the Arctic has been warming faster than the rest of the planet. That warming is reducing the amount of Arctic sea ice, allowing more heat to escape from the ocean. The scientists think that the ocean energy that is being released is causing a weakening of the polar vortex winds over the Arctic, which normally keep cold air centered over the polar region. That weakening is then allowing cold polar air to slip southward more often.

Thus, the cold weather is due to global warming. Guys, you really are trying to stretch this a bit. This is a new discovery, hot equals cold. OK, so it is warming, but for pity's sake, try and get your story straight. This is why people do not believe what you are saying. Better just to keep quiet!

China Waves its Sickle

China Daily states:


Engaging with China has always been a political compulsion for US administrations. Former US president Barack Obama's "pivot to Asia" strategy and incumbent President Donald Trump's "Indo-Pacific" strategy suggest the United States will increase its presence in Asia. Though the "Indo-Pacific" strategy is still a work in progress, it is set to pose new challenges to the China-proposed Belt and Road Initiative, and regional cooperation as a whole. The foremost of those challenges is the Democratic People's Republic of Korea's nuclear issue, where China and the US still have much room for cooperation, and fortunately some substantial efforts in that direction are being made. But the de-escalation of tensions on the Korean Peninsula and the ultimate resolution to the issue depend on continued cooperation between China and the US. Or else, it will become even more difficult to resolve the issue. China plays an important but limited role in the issue, and what the US expects it to do is simply not possible, as the two sides employ different approaches to resolve the issue. Besides, other issues such as the Tai-wan question may jeopardize Sino-US relations.

 When a country with a nuclear capability threatens to obliterate you, perhaps you should not just try to "engage" them. As it stands, no one has threatened China. The US on the other hand has both NOKO and Iran threatening death to America. With Iran we allow students to come here and study nuclear engineering, perhaps a rather risky strategy. For NOKO we really should be tracking and articulating the sources of their capabilities. Complex guidance systems are well beyond the expertise of NOKO, but well within that of China. Cooperation between the US and China are of course important. But that cooperation is made nil by cooperation between China and NOKO.

As for Taiwan, that is a question between China and Taiwan. Regrettably Taiwan can look at Hong Kong and wonder if any deal would be worth it.

A Must Read on Nuclear Weapons

The Doomsday Machine by Ellsberg is an excellent introduction to the complexities of nuclear weapons and their deployment. Ellsberg covers the period of the 1960s, especially the first half, and the nature of the command and control of nuclear weapons deployment. His views were based upon his consulting as a RAND employee and having the ability to move in and around the multiplicity of players in this area. One may think that the President is the sole point of activation of a nuclear release but as Ellsberg so clearly shows the ability to deploy was and most likely still is diffused to the lowest levels.

Ellsberg depicts a Major in South Korea in charge of a bunch of nuclear armed F100s, all equipped with tactical but deadly nuclear bombs, who has taken it upon himself to determine when his pilots will deploy their weapons. Ellsberg also infers that the pilots themselves could even individually make the decision to deploy. Ellsberg does discuss the details of how a multiple F100 deployment may very well blow some of the F100s to shreds when the other have deployed due to the wide area blast effects.

The discussion of the SIOP (Single Integrated Operational Plan) plans and the various attack options that the US had developed. In contrast he does not discuss the Red Integrated Strategic Offensive Plan (RISOP) plan which is a counter to SIOP. Yet his discussion of the military and its nonchalant acceptance of 100 million casualties, namely deaths, was typical of military planner during this period. He does a superb job in characterizing the mindset of the planners and those in command regarding their near comfort in seeing just 100 million dead Americans as long as they could exterminate a larger number of Russians and Chinese.

Ellsberg's telling of this situation and in this time frame is unique because he was at the level of an observer, having no political gain to be made, being at RAND and being but a consultant, albeit one with extraordinary access.

Ellsberg does spend a reasonable amount of space on the issues of limiting nuclear weapons especially first strike capabilities. However as he had already detailed first strike management could already be out of the hands of an President. In fact the President, who may think he or she has the "button" may be circumvented by some field commander, or worse, by a single pilot or sub commander. The movie Fail Safe startled Ellsberg by its reality. Worse was that it portrayed a Doomsday Machine which would only deter if the other side was aware of it.

To a degree, my time on nuclear weapons was a decade later than Ellsberg, ironically my first day after my PhD was the day Ellsberg's material hit the NY Times. Coming from MIT, and Ellsberg then being at MIT, I was looked at a bit askance. Yet over the next decade as I became involved in the Comprehensive Test Ban Treaty, especially during the Carter period, it was clear that the only way to use a nuclear weapon was not to use a nuclear weapon. The RISOP scenarios showed the annihilation of life on the planet. There was no way to win, first strike or otherwise. A Russian and US nuclear war was the destruction of all. Ironically in my later discussions with my Russian partners after the fall it was clear that they too understood this, positioning or not.

The risk is a rogue player, one who can really push the button. That perhaps is more of a reality today than during the 60s and 70s. Ellsberg's book is a must read for anyone interested in the nuclear debate, a debate whose only solution in my opinion is not to use the device.