Archive for the ‘technology’ Category

Some thoughts on what reform in healthcare would look like.

Monday, April 1st, 2019

I have previously posted some articles on the French healthcare system, which is the best in Europe.

Here is an article on the French system.

The French citizen or resident joins Caisse Nationale d’Assurance Maladie deTravailleurs Salariés (CNAMTS)—health insurance organisation for salaried workers. That covers about 80% of the population now and it pays 80% (often more like 70%) of a fee schedule for the doctor visit although specialists are allowed to charge more. French doctors are divided for payment and fee schedule purposes into three “sectors” after 1980. Sector 1 doctors agreed to abide by the fee schedule established in 1960, modified for inflaton and technological changes. They are mostly primary care doctors although some had waivers from the fee schedule prior to 1971 because they were more experienced or had great reputations. Few are still practicing. Sector 2 doctors could set their own fees but reimbursement was still determined by the fee schedule. These two categories correspond roughly to Medicare assignment in the US. If you accept assignment, you agree to accept Medicare payment as the full payment (or 80% of it plus the Medi-Gap payment).

The French have private insurance companies that provide what we call “Medi-Gap policies for Medicare. Theirs cover everyone.

It seems unlikely to me that Democrats would accept a health plan that allowed balance billing, which is the only way to control costs, short of pure rationing. The French basically provide a fee schedule that is the same for everyone but which allows doctors to charge more if the patient is willing to pay. For example, I called the office of a new internist last week to schedule an appointment. The clerk required that I submit all my insurance information, not my health status, and the doctor would decide if he would see me. If he is that busy, perhaps he could justify charging more.

Here is another article from that series explaining the French system.

French primary care physicians are paid less than American but medical school in France does not require a college degree and is free. I suspect that system might be more attractive in the US than many realize.

Unfortunately, such a radical reform is unlikely. There are other options under consideration.

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The Future of Science

Thursday, August 17th, 2017

We are now entering a crazy period of our history. Europe is sinking beneath a wave of Muslim immigration by young military age men.

America is now seeing riots like Charlottesville. These are being organized by people who have sketchy associations like Jason Kessler who seems to be an “activist” on both sides.

Rumors abound on white nationalist forums that Kessler’s ideological pedigree before 2016 was less than pure and seem to point to involvement in the Occupy movement and past support for President Obama.

So the “white Nationalist” is an Obama supporter ?

Now, we have to turn to the future of science. We had the Larry Summers episode at Harvard.


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Harvard President Lawrence H. Summers has triggered criticism by telling an economics conference Friday that the under-representation of female scientists at elite universities may stem in part from “innate” differences between men and women, although two Harvard professors who heard the speech said the remarks have been taken out of context in an ensuing national media frenzy.
MIT biologist Nancy Hopkins ’64 said she felt physically ill as a result of listening to Summers’ speech at a National Bureau of Economic Research (NBER) luncheon, and she left the conference room half-way through the president’s remarks.

This was one of the first reports of snowflakes requiring fainting couches when faced with opposing opinions.

Summers was subsequently forced to resign in spite of an obsequious apology.

More recently, we have had the defenestration of a Google engineer with 100% evaluations fired after expressing sentiments simialr to those Summers had stated.

The memo he wrote is not like the description in the other link.

For example, on the scales measured by the Big Five personality traits women consistently report higher Neuroticism, agreeableness, warmth (an extraversion facet[68]) and openness to feelings, and men often report higher assertiveness (a facet of extraversion [68]) and openness to ideas as assessed by the NEO-PI-R.[69] Gender differences in personality traits are largest in prosperous, healthy, and egalitarian cultures in which women have more opportunities that are equal to those of men. Differences in the magnitude of sex differences between more or less developed world regions were due to differences between men, not women, in these respective regions. That is, men in highly developed world regions were less neurotic, extroverted, conscientious and agreeable compared to men in less developed world regions. Women, on the other hand tended not to differ in personality traits across regions.

He was demonized for such comments.

OK, Now what have we to face ?

Male dominated Science is to be rejected.

Prescod-Weinstein asserts that, rather than placing value in the contents of peer-reviewed scientific articles, we should recognize that “science has often made its living from encoding and justifying bias” and is “conducted primarily by white men.”

Here’s hoping that airplanes continue to fly with “feminist science” determining design of wings.

This seems related to “Feminist Mathematics.”

There is, now, an extensive critical literature on gender and the nature of science three aspects of which, philosophy, pedagogy and epistemology, seem to be pertinent to a discussion of gender and mathematics.

Who knew that Mathematics had gender ?

We now have a Dean of Engineering at Purdue who is interested in “Feminist Engineering.”

The goal of the FREE research group is to do research, teaching and outreach that helps people (students, the public, engineering colleagues, and other engineering education researchers) develop a more inclusive, engaged, and socially just vision of engineering education.

OK. Maybe it is just the approach to Engineering Education but what is Socially Just Engineering ?

What is going on with the Pakistanis ?

Thursday, July 27th, 2017

The arrest of Imran Awan sets off a potential firestorm.

Who is this guy ?

For years, Imran Awan had access to the secret data and correspondence of many House committees, including foreign affairs. What did he do with it? As I said, that’s the worst case scenario (I guess).

He refers to a possible link to the Pakistani ISI. The ISI has a very controversial history. Some of it concerns the Afghanistan Taliban.

In documents leaked in April 2011 on the Wikileaks website, US authorities described the ISI as a “terrorist” organisation on a par with al-Qaeda and the Taliban.
In the same month the US military’s top officer, Adm Mike Mullen, also accused the ISI of having links with the Taliban.
He said it had a “long-standing relationship” with a militant group run by Afghan insurgent Jalaluddin Haqqani, which targets US troops in Afghanistan.

What is the relationship between Awan and the Democrats in Congress ? Why did Debbie Wasserman Schultz keep paying his salary until he was arrested trying to flee the country ?

Imran Awan was arrested at Dulles Airport on a bank fraud charge, and was found to have smashed hard drives in his possession.

“It’s about everything that the Democrats and the media spent months… trying to prove [with] the Russia investigation,” he said.

Steyn said Awan’s story involved a powerful political figure trying to interfere in a federal investigation.

“We have actual criminal elements,” he said. “Everything they’ve been looking for is… staring them in the face with this mysterious guy.”

Why did Schultz threaten the capitol police chief with “consequences” if her hard drive possessed by Awan was not returned to her ?

DWS: It’s a simple yes or no answer. If a member loses equipment and it is found by your staff and identified as that member’s equipment and the member is not associated with any case, it is supposed to be returned. Yes or no.

Chief Verderosa: It depends on the circumstances.

DWS: I don’t understand how that is possible. Members’ equipment is members’ equipment. My understanding is the the Capitol Police is not able to confiscate members’ equipment when the member is not under investigation. It is their equipment and it is supposed to be returned.

Chief Verderosa: I think there are extenuating circumstances in this case, and working through my counsel and the necessary personnel, if that in fact is the case, and with the permission of through the investigation, then we’ll return the equipment. But until that happens we can’t return the equipment.

DWS: I think you’re violating the rules when you conduct your business that way and you should expect that there will be consequences.

What “consequences?”

Here are some thoughts about this:

1. Why did Debbie Wasserman Schultz keep this man in her employ right up until he was arrested Tuesday night when he has been under suspicion for months. Does he have something on her or other people?

2. Why did Nancy Pelosi lie when she said she never heard of Awan? Email revealed by Wikileaks says Awan had access to Pelosi’s iPad. (Wiklileaks has never been shown to be inaccurate.)

3. What is on the smashed hard drives Awan is trying to retrieve from the FBI? (Oh, those Democrats and their hard drives.)

4. Why is Awan suddenly being legally represented at the highest level by Clinton ultra-loyalist Chris Gowan — a fact-checker for Bill Clinton’s memoir of all things? (They are already using the same right-wing conspiracy baloney they used in the Lewinski case.) Does this make sense if Awan’s just a low-life fraudster? Why not let him dangle?

5. Just what is the relationship, if any, between the Awan case and the unsolved Seth Rich murder? Is it entirely an accident that Debbie Wasserman Schultz’s brother Steven is accused of blocking the investigation? Denials from Debbie aren’t worth much anymore.

6. Where did the Wikileaks come from anyway? Was it really Russia?

And more questions.

Key among the findings of the independent forensic investigations is the conclusion that the DNC data was copied onto a storage device at a speed that far exceeds an Internet capability for a remote hack. Of equal importance, the forensics show that the copying and doctoring were performed on the East coast of the U.S. Thus far, mainstream media have ignored the findings of these independent studies [see here and here].

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2015 is gone, thank God.

Friday, January 1st, 2016

2015-a-maes-Marty_thumb

I am content to see the year 2015 gone. I can remember as a college student thinking that 1960 would never come. That was a good year. I didn’t graduate from USC as planned but I did get married and I did get accepted to medical school.

Some of the story is here in my short biography. More of it is here in my “stream of consciousness.” The next installment is here as I describe Basic Training.

When I got back from Basic Training in December 1959, I had my first date with Irene Lynch. A year later to the day, we were married and a week later, I got a letter from SC Medical School telling I had been accepted to the class beginning in September 1961. So, 1960 was a pretty good year.

In 2015 I spent what I think will be my last year teaching medical students at what is now named “Keck School of Medicine of USC” and is where I attended from 1962 to 1966. I went back to teaching there in 1998 in a program called Introduction to Clinical Medicine, which seems to be disappearing into the “Family Medicine” Department which is a shame.

I now have a book of memoirs called “War Stories: 50 years in Medicine” and which is a Kindle book only so far. Much of my medical school experience is included along with stories from my years as a surgeon. It started to be “40 years a surgeon” but I decided to include the rest and changed to 50. In June 2016, it will 50 years since I graduated from Medical School and that seemed a appropriate.

I enjoyed my time with students and I am quitting only because of frustrations with the Electronic Medical Record, about which I used to be enthusiastic, and with changes in the County Hospital which used to be a wonderful teaching institution. The Electronic Medical Record, now more often called The Electronic Health Record, probably because much of it is not about medicine, is a big problem.

The EHR, as it is called, has acquired a bad reputation.

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The crash of the XB70

Wednesday, December 30th, 2015
North American XB-70A Valkyrie just after collision. Note the F-104 is at the forward edge of the fireball and most of both XB-70A vertical stabilizers are gone. (U.S. Air Force photo)

North American XB-70A Valkyrie just after collision. Note the F-104 is at the forward edge of the fireball and most of both XB-70A vertical stabilizers are gone. (U.S. Air Force photo)

This is an interesting article on the crash of the supersonic bomber prototype.

The two test pilots were in the cockpit of a T-38 trainer flying off the left wing of the new XB-70 Valkyrie bomber, aircraft number 62-0207. They just saw the civilian registered NASA F-104N Starfighter of pilot Joe Walker slide upside down across the top of the huge white bomber, shear off both it’s twin tails and skid sideways, then break in two, killing Walker instantly. Behind the XB-70 Walker’s F-104N tumbled end over end, a pinwheel of bright orange flame nearly six hundred feet long tracing its convulsive death spiral.

The flight was a photo shoot for GE which made the jet engines of all the aircraft being photographed.

The fatal error was including an F 104 star fighter which had unreliable handling characteristics in low speed flight.

The poor safety record of the Starfighter brought the aircraft into the public eye, especially in German Air Force service. Fighter ace Erich Hartmann famously was retired from the Luftwaffe because of his protests against having to deploy the unsafe F-104s. The F-104 was also at the center of the Lockheed bribery scandals, in which Lockheed had given bribes to a considerable number of political and military figures in various nations in order to influence their judgment and secure several purchase contracts; this caused considerable political controversy in Europe and Japan.

It was considered a “widowmaker” at low speed especially takeoff and landing.

The F-104 series all had a very high wing loading (made even higher when carrying external stores). The high angle of attack area of flight was protected by a stick shaker system to warn the pilot of an approaching stall, and if this was ignored, a stick pusher system would pitch the aircraft’s nose down to a safer angle of attack; this was often overridden by the pilot despite flight manual warnings against this practice. At extremely high angles of attack the F-104 was known to “pitch-up” and enter a spin, which in most cases was impossible to recover from. Unlike the twin-engined McDonnell Douglas F-4 Phantom II for example, the F-104 with its single engine lacked the safety margin in the case of an engine failure, and had a poor glide ratio without thrust.

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Here We Go !

Monday, August 24th, 2015

ghost

UPDATE: Here is a good description of what I think is coming.

The US stock market is being buoyed upward by technology shares that are pure luxury items, a bit like the China Ghost Cities.

America’s technology darlings aren’t exactly making good on Silicon Valley’s legacy. Microsoft, Cisco, IBM and a few other businesses of the old guard have a reasonable claim to being the companies that run the world, but Twitter and Facebook? Not so much – whatever their crazy valuations.

You see, as much as global financial concerns are going to hit tech companies harder than other sorts of enterprise, so too will their own lack of ambition. The ugly truth is that Silicon Valley has largely given up trying to fix big problems and has retreated into photo-sharing apps and productivity tools. That may sound harsh, but just look at some of the absurd and pointless startups that are getting vast checks written and tell me that founders don’t need a kick up the ass and a reminder that no one has solved batteries yet.

I have been pessimistic for several years. That may be just my own psychological makeup but I am not the only one.

California is getting a bit agitated about what is happening in China.

Gyrations in the stock market have taken California’s fragile finances for a ride before — when the dot-com bubble burst, when the Wall Street crash sank the national economy less than a decade ago.

So when the market continued its dive Monday, state officials began glancing around for their seat belts.

More than most states, California depends heavily on taxes from the wealthy, pulling about half of its income tax revenue from just 1% of residents in recent years.

California is a top down society because it depends on income tax. Texas doesn’t and its state government is funded by sales tax, which everyone pays, even illegals.

The Obama Administration has been playing a Ponzi Scheme for years.

A Ponzi scheme is a fraudulent investment operation where the operator, an individual or organization, pays returns to its investors from new capital paid to the operators by new investors, rather than from profit earned by the operator.

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The Energy Crisis in Africa.

Sunday, May 3rd, 2015

india-solar-power-2012-640x426

This is a powerful piece on the cost of environmental extremism to the world’s poor.

The soaring [food] prices were actually exacerbated (as the Food and Agriculture Organisation of the UN confirmed) by the diversion of much of the world’s farmland into making motor fuel, in the form of ethanol and biodiesel, for the rich to salve their green consciences. Climate policies were probably a greater contributor to the Arab Spring than climate change itself.

The use of ethanol in motor fuels is an irrational response to “green propaganda. The energy density of biofuel, as ethanol additives are called, is low resulting in the use of more and more ethanol and less and less arable land for food.

Without abundant fuel and power, prosperity is impossible: workers cannot amplify their productivity, doctors cannot preserve vaccines, students cannot learn after dark, goods cannot get to market. Nearly 700 million Africans rely mainly on wood or dung to cook and heat with, and 600 million have no access to electric light. Britain with 60 million people has nearly as much electricity-generating capacity as the whole of sub-Saharan Africa, minus South Africa, with 800 million.

South Africa is quickly destroying its electricity potential with idiotic racist policies.

Just to get sub-Saharan electricity consumption up to the levels of South Africa or Bulgaria would mean adding about 1,000 gigawatts of capacity, the installation of which would cost at least £1 trillion. Yet the greens want Africans to hold back on the cheapest form of power: fossil fuels. In 2013 Ed Davey, the energy secretary, announced that British taxpayers will no longer fund coal-fired power stations in developing countries, and that he would put pressure on development banks to ensure that their funding policies rule out coal. (I declare a commercial interest in coal in Northumberland.)
In the same year the US passed a bill prohibiting the Overseas Private Investment Corporation — a federal agency responsible for underwriting American companies that invest in developing countries — from investing in energy projects that involve fossil fuels.

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Myopia

Friday, April 24th, 2015

myopia

A couple of interesting articles about the increasing incidence of myopia in children.

Myopia isn’t an infectious disease, but it has reached nearly epidemic proportions in parts of Asia. In Taiwan, for example, the percentage of 7-year-old children suffering from nearsightedness increased from 5.8 percent in 1983 to 21 percent in 2000. An incredible 81 percent of Taiwanese 15-year-olds are myopic.

The first thought is that this is an Asian genetic thing. It isn’t.

In 2008 orthoptics professor Kathryn Rose found that only 3.3 percent of 6- and 7-year-olds of Chinese descent living in Sydney, Australia, suffered myopia, compared with 29.1 percent of those living in Singapore. The usual suspects, reading and time in front of an electronic screen, couldn’t account for the discrepancy. The Australian cohort read a few more books and spent slightly more time in front of the computer, but the Singaporean children watched a little more television. On the whole, the differences were small and probably canceled each other out. The most glaring difference between the groups was that the Australian kids spent 13.75 hours per week outdoors compared with a rather sad 3.05 hours for the children in Singapore.

This week the Wall Street Journal had more. There are some attempts to deal with the natural light effect.

Children in this small southern Chinese city sit and recite their vocabulary words in an experimental cube of a classroom built with translucent walls and ceilings. Sunlight lights up the room from all directions.

The goal of this unusual learning space: to test whether natural, bright light can help prevent nearsightedness, a problem for growing numbers of children, especially in Asia.

The schools have tried to get Chinese parents to send the kids outdoors more but it doesn’t seem to work.

And it isn’t limited to Asians.

In the U.S., the rate of nearsightedness in people 12 to 54 years old increased by nearly two-thirds between studies nearly three decades apart ending in 2004, to an estimated 41.6%, according to a National Eye Institute study.

But Asians with their focus on education are the most effected.

A full 80% of 4,798 Beijing teenagers tested as nearsighted in a study published in the journal PLOS One in March. Similar numbers plague teens in Singapore and Taiwan. In one 2012 survey in Seoul, nearly all of the 24,000 teenage males surveyed were nearsighted.

So, what to do ?

Though glasses can correct vision in most myopic children, many aren’t getting them. Sometimes this is because parents don’t know their children need glasses or don’t understand how important they are for education. Other times, cultural beliefs lead parents to discourage their children from wearing them, according to Nathan Congdon, professor at Queen’s University Belfast and senior adviser to Orbis International, a nonprofit focused on preventing blindness. Many parents believe glasses weaken the eyes—they don’t.

Getting kids to spend even small amounts of time outdoors makes a difference.

Why myopia rates have soared isn’t entirely clear, but one factor that keeps cropping up in research is how much time children spend outdoors. The longer they’re outside, the less likely they are to become nearsighted, according to more than a dozen studies in various countries world-wide.

One preliminary study of 2,000 children under review for publication showed a 23% reduction in myopia in the group of Chinese children who spent an additional 40 minutes more outside each day, according to Ian Morgan, one of the researchers involved in the study and a retired professor at Australian National University in Canberra. (He still conducts research with Sun Yat-sen University in the Chinese city of Guangzhou.)

That is a very significant effect of small changes in behavior. Now the researchers are trying something new.

Dr. Morgan, Dr. Congdon and a team from Sun Yat-sen are now testing, as reported recently in the science magazine Nature, a so-called bright-light classroom made of translucent plastic walls in Yangjiang to see if the children can focus and sit comfortably in the classroom. So far it appears the answer is yes.

In 2007, Donald Mutti and his colleagues at the Ohio State University College of Optometry in Columbus reported the results of a study that tracked more than 500 eight- and nine-year-olds in California who started out with healthy vision6. The team examined how the children spent their days, and “sort of as an afterthought at the time, we asked about sports and outdoorsy stuff”, says Mutti.

It was a good thing they did. After five years, one in five of the children had developed myopia, and the only environmental factor that was strongly associated with risk was time spent outdoors6. “We thought it was an odd finding,” recalls Mutti, “but it just kept coming up as we did the analyses.” A year later, Rose and her colleagues arrived at much the same conclusion in Australia7. After studying more than 4,000 children at Sydney primary and secondary schools for three years, they found that children who spent less time outside were at greater risk of developing myopia.

What is the mechanism ? Maybe it is this.

The leading hypothesis is that light stimulates the release of dopamine in the retina, and this neurotransmitter in turn blocks the elongation of the eye during development. The best evidence for the ‘light–dopamine’ hypothesis comes — again — from chicks. In 2010, Ashby and Schaeffel showed that injecting a dopamine-inhibiting drug called spiperone into chicks’ eyes could abolish the protective effect of bright light11.

Retinal dopamine is normally produced on a diurnal cycle — ramping up during the day — and it tells the eye to switch from rod-based, nighttime vision to cone-based, daytime vision. Researchers now suspect that under dim (typically indoor) lighting, the cycle is disrupted, with consequences for eye growth. “If our system does not get a strong enough diurnal rhythm, things go out of control,” says Ashby, who is now at the University of Canberra. “The system starts to get a bit noisy and noisy means that it just grows in its own irregular fashion.”

Another possible treatment is the use of atropine drops in the eye.

Atropine, a drug used for decades to dilate the pupils, appears to slow the progression of myopia once it has started, according to several randomized, controlled trials. But used daily at the typical concentration of 1%, there are side effects, most notably sensitivity to light, as well as difficulty focusing on up-close images.

In recent years, studies in Singapore and Taiwan found that a lower dose of atropine reduces myopia progression by 50% to 60% in children without those side effects, says Donald Tan, professor of ophthalmology at the Singapore National Eye Centre. He has spearheaded many of the studies. Large-scale trials on low-dose atropine are expected to start soon in Japan and in Europe, he says.

More than a century ago, Henry Edward Juler, a renowned British eye surgeon, offered similar advice. In 1904, he wrote in A Handbook of Ophthalmic Science and Practice that when “the myopia had become stationary, change of air — a sea voyage if possible — should be prescribed”.

The end of the X 47B program.

Wednesday, April 15th, 2015

x 47b

I have previously posted on this program. Now it seems to be coming to an end. I suspect budget priorities are the reason.

There are no plans to extend the testing for its Unmanned Carrier Air Vehicle demonstrator (UCAS-D) program after this month’s planned autonomous aerial refueling (AAR) tests, Naval Air Systems Command officials said on Tuesday.

Following the end of the testing contract the service plans to donate the two Northrop Grumman X-47B unmanned aerial vehicles — Salty Dog 501 and Salty 502 — to a museum or resign them to the Aerospace Maintenance and Regeneration Group (AMARG) at Davis Monthan Air Force Base, Ariz. — the Pentagon’s so-called aircraft “boneyard,” said Capt. B.V. Duarte, program manager of NAVAIR’s PMA-268 that oversees UCAS-D and the Navy’s planned Unmanned Carrier Launched Surveillance and Strike (UCLASS) programs.

The airframes have many more hours of service life so the reasons may be Obama’s budget priorities.

Last month, Senate Armed Services Committee chair Sen. John McCain (R-Ariz.) issued a strongly worded letter to Secretary of Defense Ash Carter on the UCLASS program and encouraged Carter to keep flying the UCAS-D airframes.

“Our nation has made a sizeable investment in this demonstration program to date, and both air vehicles have consumed only a small fraction of their approved flying hours,” wrote McCain.
Following the test program “there will be no unmanned air vehicles operating from carrier decks for several years. I think this would be a lost learning opportunity in what promises to be a critical area for sustaining the long-term operational and strategic relevance of the aircraft carrier.”

It will probably take a new president to get this program back on track. Or a serious attack on the US.

Entropy takes over.

Friday, February 27th, 2015

Another excellent post from The Belmont Club, Which I read every day.

The barbarians of ISIS destroy ancient artifacts, in an outrage like those committed by the Taliban in Afghanistan.

The Taliban’s rejection this month of international appeals to halt the destruction of much of Afghanistan’s pre-Islamic heritage — their leader Mullah Mohammed Omar termed them idols — indicates that those most determined to impose their vision of a perfect Islamic state are firmly in control.

That article was from the period before the US invasion. Many artifacts were repaired but that will stop and the destruction will resume after we leave.

The Mosul destruction is to be expected everywhere the Takfiri tide rises enough to control an entity.

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