This is funny! Watch for the surprise ending. BD
This is what happens when I venture over to Pharmagossip!
This is funny! Watch for the surprise ending. BD
This is what happens when I venture over to Pharmagossip!
The one question I thought was interesting though was the question of having a doctor use a computer while in the examining room by the Fox newscaster, and how it could conflict. As a patient, yes I would find it annoying to sit across a desk and watch the doctor type, but I guess I could get used to it, but could feel he/she might be distracted, so enter mobility. This was brought up in the video and here’s some answers to that end of things, mobility.
The Tablet PC takes care of that and it’s just like the folder in the fact that it can be carried around, laid down for a moment, as one would do with a paper chart, and portable. This way it is still somewhat functioning like carrying around a folder without having to sit there and watch the doctor jump up an down from a chair when consulting. Just my opinion, but I think there’s a bit of eye loss between the patient and physician when working around a desktop PC that does not move anywhere and is stationary.
This unit does great with hands free Dragon and Vista speech recognition for me too, use it a lot.
I like technology, but even for me as a patient, watching a doctor crawling in and out from behind a desktop computer would even irritate me. Here’s a link to a commentary below I wrote about the exact same subject and forget about the COWS, they don’t always come home.
One of my favorite commentaries and this lives everywhere too:
Here’s a picture of one of my clients using a portable tablet that I nearly had to tackle to get this picture from 2007. His preference is the small unit, but everyone is different, but he is on staff at over 10 hospitals as a specialist, so he needs those records so he has answered the question and opinion on how to use medical records with mobility. Works for him.
Back to the video, this was done following the Senate testimonies and brings in some additional questions and coverage from the testimony from Microsoft. You can also visit Peter Neupert’s blog for additional information and updates as well. BD
A couple weeks ago I had the opportunity to interview Ronen Tamir, Chief Commercialization Officer, at Rosetta regarding their recently released tests for tumors found in lung cancer to identify cancer of the unknown primary.
Just as with the lung cancer tests, the company is using microRNA biomarkers, obtained from a simple blood draw that will accurately differentiate colorectal cancer patients from healthy individuals. The test results are showing 91% sensitivity and 72% specificity.
With the acquisition of Parkway Clinical Labs, Rosetta has positioned itself with a location in Philadelphia that will be geographically friendly to many hospitals and universities on the east coast and will serve the entire nation and the rest of the world. The colon test should prove to be a screening test for colon cancer and will eventually encourage patients to consider and follow up with colonoscopies as well. BD
PHILADELPHIA, Pennsylvania and REHOVOT Israel, January 16 /PRNewswire/ -- Rosetta Genomics Ltd. (NASDAQ: ROSG) and collaborators, today unveiled initial data relating to the company's colorectal cancer screening diagnostics test, miRscreen(TM) colon, which is based on a simple blood draw, and is expected to be released next year. The company's scientists and collaborators have identified microRNA biomarkers in serum, which have the potential to accurately differentiate colorectal cancer patients from healthy individuals. The data is being presented at the ASCO 2009 Gastrointestinal Cancers Symposium, in San Francisco.
"The initial data presented by Rosetta is very significant" said Aaron Ciechanover, Nobel laureate and chairman of Rosetta's scientific advisory board. "Rosetta's scientists and their collaborators, have for the first time, identified in serum, potential microRNA biomarkers of colorectal cancer. If treated early, 90% of colon cancer patients survive. The humane, medical, and financial impact of an effective, non-invasive colon cancer screening test can not be overstated."
Over 90 million Americans are at risk for colon cancer, a disease that kills 50,000 Americans every year.
There is still enough money kicking around though to keep that venture capital company going as well as other interests, as not to forget about the reserve funds, which most are required to carry by law to keep insurance companies from being insolvent, but don't know what happened in AIG’s case, but maybe they were exempt?
There are pilot programs in place with sending patients to India for surgery as well with Blue Cross and you can read more here. You really can’t say business has been bad for health insurance companies when you look at their ability to build such large reserve funds so quickly, but unfortunately there might be more to that story too as Maryland is investigating the amount of reserve funds maintained, while claims and other areas remain with constant patient and physician struggles to get a patient’s health care bill taken care of. BD
BOSTON - January 17, 2009 - Tufts Medical Center and Blue Cross Blue Shield of Massachusetts have reached an agreement on a new contract.
No specific details were disclosed in a joint statement today, but the two say their plan members and patients will face no disruption.
After nearly a year of failed contract negotiations, this month Tufts Medical Center had begun telling its patients that beginning in February, they would no longer accept blue cross HMO coverage.
Tufts claimed Blue Cross was not paying their doctors a "reasonable rate." Blue Cross called the move a "negotiating tactic."
We watched the Olympics in Silverlight and now the inauguration of the President. Would be nice to have EHRS in a nice dynamic format too, related reading talks about how this can be done with open source free software from Microsoft.
Make sure you have the Silverlight browser add on installed to view. This last year with events, videos, etc. has really changed the the way and how much time we spend interacting online. BD
WASHINGTON, D.C. — Jan. 16, 2009 — Microsoft Corp. today announced that the Presidential Inaugural Committee (PIC) has selected the company’s Silverlight technology to enable live and on-demand video streaming of the official inauguration swearing-in ceremony on the PIC Web site at
As part of its efforts to hold the most open and accessible inauguration in history, on Saturday, Jan. 17, the PIC will also stream video of a Baltimore event on the Whistle Stop Tour that will take President-elect Barack Obama and Vice President-elect Joe Biden to Washington, D.C., from Philadelphia.
As long as you have an Internet connection, you’ll be able to watch the ceremony as if you were there. Visit www.pic2009.org on Tuesday, January 20th to watch the swearing-in live.
Microsoft Silverlight Selected by Presidential Inaugural Committee to Enable Online Video Streaming of Inauguration Events: Official swearing in, President-elect Obama’s Whistle Stop Tour event to be streamed online.
This is an injectable that stops the production of testosterone, thus there is not much of a waiting time. The concept is a surge that produces a very large amount of testosterone which in essence shuts down the future production of the hormone in the body. It was approved in December 2008 but not known when it will be available.
Degarelix is the new injectable treatment for patients with advanced prostate cancer, a killer of 28,000 men last year. Developed by Ferring Pharmaceuticals, degarelix blocks the hormone testosterone that feeds prostate cancer cells.
The number-one priority for prostate cancer patients is to stop the body's testosterone production because the hormone helps the cancer grow. Testosterone is like a running back and degarelix is the defensive line. It shuts testosterone production down—hard and fast.
This treatment stimulates an extremely large amount of testosterone production in a few days—an overproduction that causes the body to automatically stop generating testosterone.
A major concern with this treatment (called luteinizing hormone releasing hormone agonist) is that some patients with advanced prostate cancer might not survive the initial hormone surge.
Was there not just something in the news this week about allowing off label use, well guess it doesn’t apply here. The new ruling states the information provided has to be documented in medical journals in order to be distributed, but still it seems a bit gray. At any rate, for elderly patients Lilly bit the dust on this one, no details on how it was promoted for off label use. BD
Eli Lilly was the picture of remorse on Thursday, when the pharmaceutical company admitted to the improper marketing of its antipsychotic drug Zyprexa, agreeing to pay more than $1.4 billion in settlements.
The Indianapolis-based company admitted guilt in a misdemeanor violation of the Food, Drug and Cosmetic Act for its improper marketing of Zyprexa to elderly patients with dementia during the period of September 1999 to March 2001.
Zyprexa is approved by the U.S. Food and Drug Administration as a treatment for schizophrenia in patients over 18. Lilly admitted to promoting the drug to elderly patients for off-label use as a treatment for dementia. The drug caused increased risk of death in this patient group. Zyprexa was approved in 1996 and will lose patent protection in 2011. It had annual sales of $4.7 billion in 2007.
We can all sigh a breath of relief for now with everything else that is shaking in healthcare, this one could certainly be implemented down the road, once health IT is a bit better defined. BD
Although the compliance deadline has been pushed back by two years to 2013, the long-awaited and, by all accounts, expensive and difficult transition to the International Classification of Diseases, 10th Revision, code sets has officially begun.
HHS has released the final rule for implementing ICD-10 CM (Clinical Modification) and ICD10-PCS (Procedure Coding System), shifting the compliance deadline from Oct. 1, 2011, in the proposed rule, to Oct. 1, 2013. The proposed rule was issued last August and presented for public comments, which apparently affected the deadline change.
Well if it isn’t Medicare trying to step in and to try and limit what patients can have access to and what can be prescribed, the new health reform movement can add one more entity wanting the government to set protocols on how doctors can treat patients. One thing below though that is an issue is what insurance companies pay for and he might be missing the boat a little bit here, as that is an issue, but he sells drugs, so I guess that would account for the perceptions above.
The one item though he may have a point on though is the meshing of science and clinical knowledge, as that has been a little slow as well, but with the pace that most physicians are keeping today, study time and going into areas that are still not exactly clinically outlined, may have it’s issues too, so I would guess until we walk a mile in their shoes, it’s hard to be a critic. Last year when I did my interview with Helicos, we did discuss the Coumadin test and the role is is playing today in personalized medicine. BD
Snow said the time has come for doctors to follow set protocols on how to treat patients, and to be paid based on whether they do it. Basically, ‘If X, then do Y,’ and ‘If Y, then do Z,’ sort of stuff. Snow concedes the public doesn’t trust the private sector to come up with these kinds of rules. So he wants some smart folks to get together in an “apolitical” body like the Fed, and do it themselves. “I’m fine with this big, national board creating this standard,” Snow says.
Doctors often bristle at the idea of these sorts of rulebooks, because they argue the rules don’t take into account the nuances and intangibles of caring for individual patients. Plus, they think insurers basically use such rules as excuses not to pay for things.
“I have no patience for a doctor who says, ‘I’m above it all, I don’t want to practice cookbook medicine,’” Snow says. Too many doctors, he says, just don’t keep up with the science. For instance, Medco last March asked 1,000 doctors who prescribe the potent blood-thinner Coumadin about a genetic test that the FDA has endorsed to keep patients from getting dangerous, excessive doses. Only three of them had heard of the test, he says. That’s an important test.
Nuance, or as everyone knows them as Dragon Naturally Speaking, will be licensing and adding the speech technologies from IBM into their software. IBM as I remember a while back had a system called “VIA Voice” and there may be a few other names of their speech recognition technologies as well.
It is a ways down the road, but it appears that the combination will offer the best of both worlds with being able to integrate 2 speech recognition technologies.
BURLINGTON, MA and ARMONK, NY, January 15, 2009 — Nuance Communications, Inc. (NASDAQ: NUAN), a leading provider of speech solutions, and IBM (NYSE: IBM), a pioneer in speech technology, today jointly announced that Nuance and IBM have entered into a licensing and technical services agreement to enhance and expand innovative speech solutions designed to better serve enterprises, consumers, carriers, and partners worldwide.
With the objective of advancing customer access to speech innovation, Nuance and IBM technologists will cooperate to incorporate IBM technology into Nuance’s speech solutions. Nuance expects the first integrated speech innovations combining Nuance and IBM technologies to be available within two years. IBM will continue to serve its own customers. In a second component of the agreement, Nuance will purchase speech-related patents from IBM.
“IBM and Nuance share a vision to proliferate advanced speech capabilities across a broad range of devices and environments,” said Dr. John E. Kelly III, IBM senior vice president and director, IBM Research. “We recognize that Nuance is a leader in the speech marketplace and we believe this technology agreement will accelerate the delivery of speech innovations to the world’s consumers.”
According to the this article, the update of software was the culprit and had to do with the time out feature and not refreshing properly, a programming glitch that was corrected. Good to know it was fixed and was not the actual data base itself, only the engine pulling the information to the screens for use and input, and noticeable as perhaps the general demographics, and other items did not match the patient being seen, so it sounds like the glitch somewhat stuck out like a sore thumb when it occurred and was highly noticeable by a user, even though it was intermittent.
After a software patch was applied a month later and the problem went away. The agency was not by far the only software program to require a patch as that has gone on over the years with all types of software even outside of healthcare, but healthcare software is critical as it is our lives contained in the programs. BD
The software problems came about after VA distributed version 27 of its Computerized Patient Record System (CPRS) to medical facilities in late August. The software was to be installed by Oct. 6.
Clinicians noticed that when switching from one patient record to another, a new record was not loading under the second patient’s name, Josephine Schuda, a VA spokeswoman, said. Forty-one of 153 VA facilities reported experiencing this problem.
“This problem was occurring intermittently,” she added.
The problem occurred when a patient’s record remained set in the system after CPRS was trying to shut itself down because of inactivity, Schuda explained.
If you haven’t seen the broadcast today from the Senate and are interested, as almost everyone is these days in electronic medical records and healthcare, take a look and listen to what some of the guests are saying to the committee. It will give you an idea of where we are and some of the questions posed by members of the Senate.
What was great to hear was that everyone represented here was pretty much in agreement all the way around. We have the technology to connect and bring the world of electronic medical records and personal health records together and just need the funds. As you can see from the list, there were representatives from both within government and outside. Jack Cochran from Kaiser Permanente made a great presentation and referred to not only their electronic medical records, but also the PHR, which is accessed by patients and had become very popular and used heavily since it was made available. Kaiser as you know works with the Microsoft HealthVault as well to make the records portable, let’s say in case one needed to see a physician out of network, those records could be shared at the patient’s discretion.
The HealthVault was mentioned by Peter Neupert from Microsoft and it was interesting to see inquiries on the committee asking “what is it”. It just somewhat caught me off guard here since this is a consumer product for all and I think our members of congress are also consumers, right? Personally I believe since this is a product for everyone and it is free, the best way to understand how they work and relate, is to go get one, right? They are for consumers anywhere so anyone can jump in to the digital age of an online personal health record and we need the funding to do so.
Anyway, I try to keep all the readers here up to date on what is going on with both electronic medical records and personal health records and probably have more information on this blog about PHRs than any other on the internet.
Hmmmm, this blog might be a good place for Congress to search and find the latest and full summaries of information on both Microsoft HealthVault and Google Health, maybe?
Nothing is better than having leadership set the example to see the value and we need an education program to help the consumers learn how to use and manage a PHR, they also help decrease medical errors and physicians having to guess at treatment plans when credible information is readily available.
The lists of guests are below and you can click here to visit the site to listen to the video and there are some of my HealthVault PHR links in the related reading section below. BD
Committee: Committee on Health, Education, Labor, and Pensions
Jack Cochran, Executive Director, The Permanente Federation, Oakland, CA
Janet Corrigan, President, The National Quality Forum, Washington, DC
Valerie Melvin, Director of Information Technology, The Government Accounting Office, Washington, DC
Peter Neupert, Vice President, Microsoft Health Solutions, Redmond, WA
Mary Grealy, President, Health Leadership Council, Washington, DC
The bullet points expressed by Peter Neupert from Microsoft and pretty much agreed upon by all.
Incentives for sharing
Focus on interoperability
Private sector to build the system
This is still a bit away from coming to a hospital near you, but the technology would be to swallow the instrument doing the surgery, wild stuff! We have all heard of the iPill and others that one swallows that takes pictures and relays data back, and there’s also one with a blue tooth chip as well, but this would be swallowing the instrument with little legs attached to move around and take care of business.
The patient would swallow a set of pills, each with their own function and assemble in the stomach. Information can be communicated to a computer and used as an indicator of the exact position and arrangement of the robot snake. BD
Scientists from the Institute of Robotics and Intelligent Systems at ETH Zurich (IRIS) are developing tiny robot pills that will be swallowed and then perform surgical operations inside the body. These robot pills will be controlled from outside the body, which should make surgeries far less invasive, safer, faster, and more efficient.
Seven years ago, pill shaped micro-cameras were first developed by the Israeli company Given Imaging and are now used successfully by physicians across the world to study the gastro-intestinal tract. However, these cameras are passive and do not effect their surroundings by releasing drugs or taking samples from areas that seem to require further investigation. For several years a European Union project called ARES (Assembling Reconfigurable Endoluminal Surgical System) is developing tiny robots with insect-like limbs that can be remotely controlled and will allow the robots to move around the stomach freely. Several research groups are exploring the use of such devices for gathering biopsy samples.
This should soon change, because the ARES scientists are currently developing micro-robots with controllable insect-like legs with which the “robot pills” would be able to move around in the stomach. Other groups are working on special devices for tissue biopsy. In the future, such instruments could be used to make a precise examination of damaged regions in the gastro-intestinal tract while at the same time taking tissue samples for subsequent investigation.
More information can be found at the website to see which products are affected, and it is being done as a precautionary measure. BD
NEW YORK (Reuters) – Kellogg Co said on Wednesday it was removing its Austin and Keebler branded peanut butter snacks from store shelves and put a hold on their shipments due to the current Salmonella food poisoning outbreak.
Kellogg said it is taking precautionary measures including putting a hold on any inventory in its control, removing products from retail store shelves, and encouraging customers and consumers to hold and not eat these products until regulatory officials complete their probe.
The products are Toasted Peanut Butter Sandwich Crackers, Peanut Butter and Jelly Sandwich Crackers, Cheese and Peanut Butter Sandwich Crackers, and Peanut Butter-Chocolate Sandwich Crackers.
I went back and checked in to some posts from early 2008 and it appears even back less than a year ago, there seemed to be something going on that was slowing down the process of asking for more money until it hit the floors of Congress. BD
“After getting beat up on Capitol Hill a few weeks back for refusing to request more money, the head of the FDA has changed course.”
“In an apparent split from President Bush’s proposed budget, Andrew von Eschenbach wrote to Congress asking for $275 million right away to ensure the safety of imported food, drugs and medical devices, the New York Times reports.”
WASHINGTON, Jan 15 (Reuters) - President-elect Barack Obama and the new Congress should increase spending for food safety measures and cut subsidies to corn-based ethanol, the Grocery Manufacturers Association said on Thursday.
"Although spending has increased in recent years, that spending has not kept pace with inflation," said Scott Faber, the group's vice president for federal affairs.
"As a result, we've been losing scientists and inspectors and have been unable to keep pace with the growing amount of (food) imports as well as changing consumer preferences," Faber told reporters.
Wait one second, the computer system caused the problem, I am just curious as it takes algorithms to run and query, so who did the programming to cause the errors? It seems there’s been a lot of this going on of late, with the computer glitches creating errors.
Do we not run these queries on sample data on a virtual server to first view the outcomes to ensure we have the desired results? Also, as mentioned, the audit trails will tell all, if anyone looks at the reports too. One reason why the reporting functions of systems is so important today, along with analysts to timely audit and review before the algorithms get out in the masses. Industries such as Wall Street and Health Insurance firms who were the absolute fore runners in establishing the best IT technology sure seem to be coming to the forefront with money issues, like Madoff, perhaps something in common with “bad formulas” or algorithms?
The formulas kick out what they are programmed to do, so I do wonder what type of “business intelligence” is operating out there? Ingenix had problems too with a “flawed” data base? How did it become flawed I might wonder, was it the algorithms programmed in to kick out results that did this? These things do not happen by accident. BD
The federal agency said WellPoint (nyse: WLP - news - people ) had "demonstrated a longstanding and persistent failure" to comply with regulations and that its conduct had long been posing "a serious threat to the health and safety of Medicare beneficiaries."
According to the government, WellPoint failed to provide beneficiaries of Medicare Advantage and Medicare Part D with proper enrollment, a low-income subsidy benefit and prompt payment of claims, as well as several other violations concerning marketing and enrollee premiums. The insurer is also accused of overcharging beneficiaries for their share of drugs and not getting them the drugs they needed for conditions like diabetes, heart disease, respiratory distress, and seizures.
The problems were discovered through self-audits by WellPoint and audits by Medicare that showed the computer systems through which the insurer organizes its programs may have caused the problem.
The Governor is no stranger to Twitter and had numerous posts this morning. BD
“As a result of all this, California, the 8th largest economy in the world, faces insolvency within weeks”
One more state is continuing their investigation of United Healthcare and the use of Ingenix. Ingenix is set to close as part of the New York deal and the $50 million will go towards setting up a not for profit entity. Also, other insurance companies were using Ingenix too and the company had sales of 1.3 billion last year, lot of money made by Ingenix. BD
State Attorney General Richard Blumenthal said he is continuing his own investigation into UnitedHealth Group, its Ingenix subsidiary and several other health insurers despite UnitedHealth's $50 million settlement with New York Attorney General Andrew M. Cuomo earlier this week.
The settlement resolved certain claims relating to insurance reimbursements for out-of-network health care. But Blumenthal said he's still investigating the alleged scheme, which centered around Ingenix, which employs about 400 in Rocky Hill.
"My investigation into UnitedHealth Group, its Ingenix subsidiary and several other insurers is continuing to ensure that any company that may have misused or manipulated reimbursement rates is held accountable, including possible restitution for consumers," Blumenthal said in a statement released late Tuesday.
Just from an outsider looking in from what I have read here, it sounds like either a little bit of data corruption with unique identifier numbers not matching or a new update that went a little south as the queries sounded like they were a little mismatched, or it also could be new or modified screens having errors connecting to the back end. I have had to clean up small data bases with corruption and thank goodness for back ups, but one the size of the VA is huge and a ton of queries to locate even perhaps one small area can take some time. The Vista EHR system is good but I have also seen others that are easier for the end user too.
Interesting how DOD and the VA have been recently discussing which system should they use as one, in other words, Vista from the VA or ALTHA from the DOD? From a programmer’s standpoint, this is like the kiss of death too to have something like this happen and it appears no patients were severely affected, but you need to have accuracy and fix the problem immediately for sure. In a situation where updates or big revisions are being rolled out, it helps to virtualize it first before going live on the real network too. BD
WASHINGTON - The top Republican on the House Veterans Affairs Committee demanded Wednesday that the VA explain how it allowed software glitches to put the medical care of patients at its health centers nationwide at risk.
“I am deeply concerned about the consequences on patient care that could have resulted from this ‘software glitch’ and that mistakes were not disclosed to patients who were directly affected,” said Rep. Steve Buyer, R-Ind. “I have asked VA for a forensic analysis of all pertinent records to determine if any veterans were harmed, and I would like to know who was responsible for the testing and authorized the release of the new application.”
Patients at VA health centers were given incorrect doses of drugs, had needed treatments delayed and may have been exposed to other medical errors due to the glitches that showed faulty displays of their electronic health records, according to internal documents obtained by The Associated Press under the Freedom of Information Act.
The VA’s recent glitches involved medical data — vital signs, lab results, active meds — that sometimes popped up under another patient’s name on the computer screen. Records also failed to clearly display a doctor’s stop order for a treatment, leading to reported cases of unnecessary doses of intravenous drugs such as blood-thinning heparin.
3 people have died due to the salmonella poisoning. This is not in the grocery stores, but institutions and restaurants. For more information click here to visit the website. BD
The company said none of the peanut butter being recalled is sold through retail stores. Its peanut butter is made for bulk distribution to institutions, food service industries and private label food companies. The company said the peanut butter is sold under the brand name Parnell's Pride and by the King Nut Co. as King Nut.
Health officials on Tuesday confirmed the deaths of two people in Virginia and one in Minnesota associated with a national salmonella outbreak that has sickened more than 400 people in 43 states.
Breast Cancer and genomic studies are right up front in anyone’s interest. From the new study and identification of the protein, it appears that new types of therapy could be on the way soon in the fight against breast cancer. Cancer studies are becoming very advanced and with the use of identifying proteins that tend to create cancer cells it will help in generating specific treatment plans. BD
Canadian researchers have identified a new protein in the progression of breast cancer. According to a recent study from the University de Montreal and the University of Alberta, published in the Journal of Biological Chemistry, the protein ARF1 plays a critical role in cancer cell growth and the spread of tumors. Targeting this protein with drug therapy may provide hope to women with breast cancer.
“Until now, ARF1 has been associated with harmless albeit important housekeeping duties of cells,” says senior author Audrey Claing, a professor of pharmacology at the University de Montreal. “The University de Montreal and the University of Alberta team is the first to characterize the role of ARF1 in breast cancer.”
Dr. Claing and her colleagues used invasive breast cancer cell lines to study ARF1’s role. These cells are sensitive to a particular growth factor, called epidermal growth factor or EGF, which has previously been shown to stimulate tumor growth and invasion. Their findings suggest that EGF works through ARF1 in these cells. In addition, when ARF1 activity was chemically blocked, breast cancer cell migration and growth was reduced. Conversely, when ARF1 was overproduced in these cells, their movement was enhanced.
I have the pre-release and beta of this program and love it to release stress. It works well with my tablet pc and you really don’t even need to know a lot about physics. Nice to see NBC give is a review as well.
IPhone version too. Watch the video and see how it works. It can also work on a desktop, but the tablet pc or Iphone is the ultimate. BD
One of the most inspired and imaginative games to come along in a while looks like it was plucked from a 5-year-old’s coloring book.
It’s a world of crinkled notebook paper and crayon scribbles. It’s a place where castles and dinosaurs and rockets look like they’ve been scrawled into existence by immature hands.
But “Crayon Physics Deluxe” – a puzzle game that launched for the PC last week and for the iPhone the week before that – is a game that’s smart and sophisticated precisely because of the way it uses the most rudimentary of childhood expressions to engage our inner creative genius.
The thrust of the game is this: There is a ball over here and there is a star over there. You must move the ball to the star by using (virtual) crayons to draw the physical objects that make it possible to transport the ball to its goal. (In the iPhone version of the game you draw by touching finger to screen, and in the PC version you use the mouse to draw with your crayons.)
The device uses the same catheter as does the angiogram and it appears to be able to better narrow down where exactly stents are needed and gives an overall better evaluation than relying on the X-Ray alone. Stents are lifesavers when needed by all means, but if new technology can refine exactly how many and where, it could reduce the number, as stents do need to be monitored, so the less number to be monitored, the less that could go wrong or slip out of place. BD
Doctors may be implanting too many artery-opening stents and could improve patient outcomes — and ultimately save lives — if they did more in-depth measurements of blood flow in the vessels to the heart. That's the finding of a study, to be published Jan. 15 in the New England Journal of Medicine, that evaluated the benefits of a new diagnostic tool to measure blood flow and determine whether stenting was the best option.
The study suggests that doctors should go one step beyond the traditional method of relying solely on X-rays from a coronary angiogram to determine which arteries should be stented for patients with coronary artery disease. In many cases, cardiologists will routinely prop open with a stent any arteries that look significantly narrowed on the angiogram, said Fearon. "The problem is you can't always tell from the angiogram whether this is absolutely necessary."
By using a method called "fractional flow reserve," or FFR, which involves inserting a coronary pressure guidewire into the artery, doctors can measure whether blood flow is actually reduced to a dangerous level beyond any apparent narrowing. In certain cases, medication may be a better option to stenting.
"The pressure wire is a thin wire with a sensor near the tip that can measure the pressure of blood flow," Fearon explained. "If the narrowing is truly significant it will cause a drop in blood pressure beyond the narrowing. If the pressure was 80 percent or less than the pressure in front of the narrowing (an FFR value of .80 or less), a stent was implanted."
Researchers found that patients who received the additional blood flow test received one-third fewer stents than the group examined only with an angiogram.
One more minimally invasive surgery technique. There is not a version of this procedure for men yet. This has to help in cutting down the infection rates I would guess as well. It is not out for prime time surgery yet, but the technology is here. BD
NEW HAVEN — Breaking new ground in what many surgeons consider the next frontier in minimally invasive surgery, Yale School of Medicine and Yale-New Haven Hospital surgeon Kurt Roberts, MD, successfully performed an appendectomy with no abdominal incision. The appendix was removed through a small incision in the patient's vagina.
This advanced technique, known as an "invisible incision" appendectomy, left the patient with no external scar, no damage to the abdominal wall and minimal postoperative pain, thereby allowing for an almost immediate return to normal activity.
"Without incisions in the abdomen, there is no opportunity to develop surgery-related hernias or wound infections. Patients who undergo procedures such as these are expected to recover and resume most normal activities within just a few days," explained Roberts.
Roberts, an assistant professor of surgery at Yale, said there are some reports of this surgery being successfully performed outside of the United States but that previous attempts within the U.S. always necessitated at least one abdominal incision to either help remove the appendix or insert a camera to guide the surgery.
The article brings up a good point about nurses, are they members of the medical team or just another pair of helping hands? Sometimes as cut backs are beginning to occur the duties of a nurse may slip over in to other areas where it is really outside the realm of the occupation as well.
Leadership roles are important as well. In the Los Angeles area, there’s a look for nurses over the border in Mexico to help fill in the gaps. By today’s standards in healthcare, nurses are not just an assistant, they are the ones who see the patients day by day, hour by hour, administer medications, etc. and the demands can be high and hours can be long, not to mention stress. From a prior post, the Gordon and Betty Moore foundation has donated 100 million to build a nursing school in northern California.
The co-founder of Intel and his wife are giving $100 million to the University of California, Davis to establish a nursing school.
The gift from the Gordon and Betty Moore Foundation is the largest donation ever to the university and is believed to be the largest gift in the nation for nursing education.
The money will be donated over 11 years and will go to create the school at the UC Davis Medical Center in Sacramento.
Primary Care MDs, General Surgeons and nurses all in short supply, so what’s going to be left to pick up the slack, orthopedic surgeons? BD
One occupation, demand is still high -- so high that job candidates have been plied with incentives that range from gas cards to $20,000-signing bonuses to an opportunity to meet a celebrity. (News cameras recently captured former "Love Connection" host Chuck Woolery participating in a recruiting event.)
These sought-after candidates are nurses, and experts say the lavish efforts to recruit them are symptomatic of a desperate industry.
The lack of nursing graduates may be only a part of the problem. Because of poor working conditions, hospitals in particular also struggle to retain the nurses they've hired. Veteran nurse Dean Caputo, 52, remembers working at a hospital where the staff was so thin it compromised patient safety. Caputo, who lives in Beverly Hills, Mich., said there were supply shortages that left nurses scrounging, and that overall, the nurses felt ignored by management.
The nursing population, as a whole, is aging. Recent statistics, Walker said, show that the average age of a registered professional nurse is 47.3 years old, and just 10 percent of nurses in the United States are under the age of 30.
Ok, this one I could not resist, the Medical Quack likes stories about ducks! As the owner of the duck in the video states, “maybe if everyone had a Duck in their life, things might go a little easier”.
Well you can tune in here every day and enjoy a little “Duck” forte’. The duck in the truck, probably one of my long lost relatives…BD
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Quants: The Alchemists of Wall Street Video Documentary - Why It Needs to Matter What Companies Do and Not Focus Only On the Price of Stock With So Called Value - Attack of the Killer Algorithms Chapter 44
This video digs in a bit further with how fictitious business models are used by banks and companies do this too. The models are so complex that CEOs don’t even understand them. “Quants, The Alchemists of Wall Street.
This is a video from PBS Frontline where Kathy O’Brien, a former Quant who worked for a Hedge Fund on Wall Street will tell you what is done with your 401k money and more.
The banks and companies use technology to take advantage because they can.
“Of course we are going to take advantage because our tools are our brains…if they could figure out a way to take advantage of pension funds they would, a very good interview with explaining smart money and dumb money.
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It’s a very good presentation about how some of the algorithms work and kind of finishes up with “if you’re an algorithm, life is looking pretty good, but can’t say the same for the human side”.
He gives you some every day examples of how we encounter algorithms every where we go.