Monday, August 3, 2015

Why Not to Use Windows 10

When Microsoft does things they almost always, always in my opinion, do it for their sole benefit. One twist in W10 is the peer to peer updating. Yes indeed, you get to work for Microsoft FREE. No not really, you may actually have to pay!

PCWorld has a great piece describing what it does. Simply W10 has a peer to peer system. Kinda like BitTorrent, except for Microsoft. When you get an update, they then use you to send that update to many others. You suddenly become a peer or even a Tracker as in BitTorrent and you never know it. It is your bandwidth which is used and if your service is measured you are then paying for it.

Simply:

1.Microsoft W10 has a P2P system

2. Microsoft downloads an update

3. You then via the P2P send it to peers or lechers.

4. You pay for the up load BW

5. Microsoft has enlisted you in their business and you get to pay.

Beware W10, what else is there?

But also beware if the P2P can be hijacked and some third party now uses you to send God knows what! The Feds get your IP address and you without any knowledge may be thrown into a long painful process.

The PCWorld piece tells how to disable this. There surely are many more such traps. Beware of those folks bearing gifts. W10 may not be "free" after all!

Sunday, August 2, 2015

China and Patents

China Daily reports:

China recorded 928,000 invention patent applications in 2014, more than that of any other country, for the fourth consecutive year, according to data released by the State Intellectual Property Office on Monday.

The office found that about 663,000 inventions had high quality and market value. About 4.9 patents per 10,000 population were filed, according to the data. Enterprises have been pillars of research and the development of new technologies and products, according to the office. In 2014, about 485,000 invention patent applications were filed by enterprises, more than the number filed by individuals, academies or research institutes.


 It is not clear just where those patents apply nor was there a breakdown by area. However this is a clear national goal and as with most things there is strong Chinese unity and drive. I always wonder why Russia is so far behind. The Russian have always had brilliant technologists but they are clearly way behind in biotech and other areas of focus in the 21st century.

Saturday, August 1, 2015

Dumb, Dumb, Dumb!

I took my annual trip to Seaside Park today. It is a ritual. I started in 1960 when I was first a Lifeguard in New York City. We would take our day off, a Wednesday and drive down in O'Neil's fathers white Lincoln Continental. It was beautiful, the water was clean, we could swim, and we could make fun of wimpy New Jersey Seaside Life Guards. We were after all from Coney Island, and other New York Beaches, we were all well over 6' and we walked with the confidence of having survived July 4th with over 1 million bathers!

Why Seaside, it was just because it was there, and far enough from New York that the Jersey Sewers did not deposit Jersey stuff on the sands. You see in those days Jersey had no sewer plants and they, well to be crude, dumped their stuff in the harbor. It would then wash onto our beaches! We refrained from swimming except under dire circumstances, and one of our guys was a 3rd year med student so we had all kinds of antibiotics.

But now it is a routine, down to Seaside, trying to support them after their multiple disasters. But this year, in my opinion, some Govenment entity decided to install electronic parking meters.

Now the screen for instructions faces the sun, is about 3" by 2", and the font looks like 4pt Arial. The font is almost the same color as the screen. Lines of dozens of people are waiting as each tries to read what to do, half leave in disgust!. I have never, in my opinion, seen a system so incompetently designed. I asked the local police if this was a common complaint, YES. It is clear to me, in my opinion, that the town may just not want any visitors! Only in New Jersey. Perhaps these were the same programmers who did ObamaCare web site? Not really, at least you could read that.

Oh Yes, this is politically correct, it is solar powered, but guys the sun is 90 degrees off, it shines on your screen! I guess they were educated in New Jersey Schools!

Let's see how the pig race turns out!

Oh by the way, I have been reminded that the candidate from Queens has used a similar tale to bemoan solar. Now this is not a solar rant, in fact our oldest is the solar guy for the NH Electrical Co-Op. We also have wind turbines in NH. The problem there is distribution. Namely we have a century old electrical distribution network and technology can do so much more. The problem here is design. Small letters, poor contrast, complex entry mechanisms, and facing the sun to make it unreadable, unworkable. So unlike the Candidate from Queens, my gripe as the "Voice from Staten Island" is if all else fails.... listen to the customer! But that is something Government entities fail to do, since there is no cost at messing up.

Friday, July 31, 2015

Politics and Pigs

August is County Fair month. And County Fairs always have pig races. In a sense I look forward to next week's debate as an adjunct to the County Fair.

Which pig are you betting on?

Thursday, July 30, 2015

The Press and The Prostate

There are times when you have to say; "You cannot make this up!". In a WAPO piece today the reporter extols the work of some Brits who have on some work on a very small sample and have identified a few genes, mRNA, SNPs etc and from this have developed a staging type system. One should add this to the list of hundreds of others.

Now the researchers state:

We show the relative contributions of gene expression and copy number data on phenotype, and demonstrate the improved power gained from integrative analyses. We confirm alterations in six genes previously associated with prostate cancer (MAP3K7, MELK, RCBTB2, ELAC2, TPD52, ZBTB4), and also identify 94 genes not previously linked to prostate cancer progression that would not have been detected using either transcript or copy number data alone. We confirm a number of previously published molecular changes associated with high risk disease, including MYC amplification, and NKX3-1, RB1 and PTEN deletions, as well as over-expression of PCA3 and AMACR, and loss of MSMB in tumour tissue. A subset of the 100 genes outperforms established clinical predictors of poor prognosis (PSA, Gleason score), as well as previously published gene signatures (p = 0.0001). We further show how our molecular profiles can be used for the early detection of aggressive cases in a clinical setting, and inform treatment decisions.

Frankly much of the above was known in some way shape or form. There are also quite a few commercial tests available already. Now WAPO states:

Through genomic profiling of 259 men with prostate cancer, scientists have identified five groups of prostate cancer with distinct DNA signatures. The discovery represents a major advance as researchers can now begin trying to tailor therapies to those subtypes. The approach has worked well in breast cancer and helped millions avoid the unnecessary cost, pain and time spent on treatments that are destined to fail. [Obama touts ‘lifesaving’ potential of personalized medicine] Such work is the backbone of President Obama's $215 million precision medicine initiative announced in January, which aims to pioneer a new approach to how we treat disease by moving away from a "one-size-fits-all" approach to medicine to one that takes into account things like a person’s genetic makeup, or the genetic profile of a tumor.

Now this is UK, Sweden, and Norway work.  It also is at best personalized but not precise. One can be "precise" but inaccurate. I can tell you precisely where something is but it may not be there. But alas I guess English is no longer used "good" uh well.

Now if the WAPO author had understood where the work in this area is going perhaps they would have had a better view. In fact we have detailed work by Gundem et al in Nature just a short while back. They noted:

Using whole-genome sequencing, we characterized multiple metastases arising from prostate tumours in ten patients. Integrated analyses of subclonal architecture revealed the patterns of metastatic spread in unprecedented detail. Metastasis-to-metastasis spread was found to be common, either through de novo monoclonal seeding of daughter metastases or, in five cases, through the transfer of multiple tumour clones between metastatic sites. Lesions affecting tumour suppressor genes usually occur as single events, whereas mutations in genes involved in androgen receptor signalling commonly involve multiple, convergent events in different metastases. Our results elucidate in detail the complex patterns of metastatic spread and further our understanding of the development of resistance to androgen-deprivation therapy in prostate cancer.

 Namely they noted that prostate metastatic cells in the body had a disparate set of genetic changes. In fact the profiles were quite complex. Thus any small sample as in this article is in my opinion suspect.

As Cancer UK notes:

First, the researchers looked at copy-number alterations in tumour samples from 156 men who had undergone surgery in Cambridge to remove their prostate after being diagnosed with cancer. They then analysed the levels of thousands of mRNAs in these same samples. Next, they compared the two sets of results. Could they find regions of genetic disruption that, by altering gene activity – the level at which they are switched on or off – could be driving the growth of tumours? The answer was yes – they spotted around 1,000 genes where changes in the copy-number – that is, they were deleted or repeated – also changed gene activity. The researchers then homed in on 100 genes with the greatest change compared with healthy samples and which seemed to be crucial to prostate cancer growth, and looked to see how their activities varied across the 156 men. They found that by using this group of 100 genes – or gene signature – prostate cancer patients who’d had surgery to remove their prostate could be divided into five distinct sub-groups.
  • One group had lots of DNA deletions and consequently low activity of certain genes
  • Another had high amounts of DNA repetition which resulted in increased activity of specific genes.
  • Two more groups had very few copy-number alterations, or changes in activity.
  • The fifth and final group had some – but not too many – copy-number alterations.

But one may ask; how do these compare with all the others? Also the sample size is quite small. As Science Daily states:

"This research could be game-changing if the results hold up in larger clinical trials and could give us better information to guide each man's treatment -- even helping us to choose between treatments for men with aggressive cancers. Ultimately this could mean more effective treatment for the men who need it, helping to save more lives and improve the quality of life for many thousands of men with prostate cancer."

Namely the authors themselves seem to readily admit the small sample size issue.

But there are two points to be made:

1. All too frequently authors extend the significance of their results. This is the equivalent of "shingling the roof in the fog". Be careful.

2. The Press, especially WAPO, uses this as some adulation of the Obama Administration. It was NOT in the US and IT IS NOT CONCLUSIVE!

It is truly amazing in my opinion how political even basic medicine has become, especially in reporting.

Wednesday, July 29, 2015

Medicare and Telemedicine

Telemedicine is a rather complicated issue. It can be quite helpful but then again it may be an added cost. The CBO is examining this to some degree and it is worth following.

As CBO states:

Whether expanding Medicare coverage for telemedicine services would increase or decrease federal spending is difficult to predict, but doing so depends on two main considerations:
  • The payment rates that would be established for those services, and
  • Whether those services would substitute for (or reduce use of) other Medicare-covered services or would be used in addition to currently covered services.
If all or most telemedicine services substituted for or prevented the use of more expensive services, coverage of telemedicine could reduce federal spending. If instead telemedicine services were mostly used in addition to currently covered services, coverage of telemedicine would tend to increase Medicare spending. Many proposals to expand coverage of telemedicine strive to facilitate enrollees’ access to health care. Therefore, such proposals could increase spending by adding payments for new services instead of substituting for existing services.

Many Medicare patients are with chronic diseases such as Type 2 diabetes, COPD, congestive heart failure and the like. Even cancer patients just need monitoring, not face time. There development of methodologies to do this remotely is exploding.

However, this is with an elderly population. They generally are not adept at the use of the new technologies, especially ones requiring a modicum of expertise, or patience.

Thus there is both an opportunity and a challenge. It is worth following.