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It’s All About Attitude

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Happy Thanksgiving
Printed on my Dremel 3D45 3-D printer, except for the small shiny one in the back row. Added coloring by my wife.

I wish everyone a Happy Thanksgiving season and hope we are all mindful of those not so fortunate. Around the world, more than enough food is produced to feed the global population but hundreds of millions of people still go hungry. The number of undernourished people has grown, a crisis driven largely by conflict, climate change, and the COVID-19 pandemic.

World Community Kitchen has created a new model for disaster relief helping devastated communities recover and establish resilient food systems. WCK has served more than 200 million meals. They have been a godsend in Ukraine and around the world. You can donate to World Central Kitchen here.

The Digital Democracy Project

 The Digital Democracy Project

Written: November 2022

It is hard to believe, after ten days since the midterm elections, a half-dozen districts have still not completed counting its votes. The list of election problems overall is quite long, and finger pointing is plentiful. I am quite confident in a long-term solution using blockchain technology and the secure and powerful supercomputers we carry in our purses and pockets, but that is not the subject of this article. I want to share with you what I have learned about the Digital Democracy Project.

The nonpartisan nonprofit public service project is described as a voter-driven system of government for the 21st Century. The project is in the early days and only available to registered Florida voters. They plan to expand across the U.S. starting in 2024. I spoke with Ramon Perez, Executive Director, this morning. He said, “Information and access have always been the most powerful forces in government.  Voters will now have that power in their own hands—literally.”

The concept is to enable registered voters to “vote” on the same bills as our state representatives. I put vote in quotes because it is actually a poll. You can see the legislative bills currently underway to ultimately become law. Perhaps an example will make it clearer. Suppose there is a bill pending having to do with public transportation. The Digital Democracy app provides a description of the content of the bill and allows you to drill down deeper and see the actual wording of the bill. The app also shows the sponsor(s) and their political affiliation. You can see if the bill has a single sponsor, multiple sponsors all of the same party, or multiple sponsors with a nonpartisan mix.

The result shows the legislators how the public feels about a particular bill. The app shows voters, legislators, and the media how people “voted” and how the legislators acted. From state legislatures to the U.S. Congress, there have been numerous bills for which polls showed overwhelming support or lack of support and elected representatives have voted the opposite of the will of the people. The Digital Discovery Project makes the support and the action visible for all the bills at the state and district level.

Currently, the app shows Florida voters eight things to “vote” on. The first item in the poll asks the voter which types of legislation you are most interested in. The choices include:

  • Elections and Civil Rights
  • Healthcare
  • Environment
  • Education
  • Social Welfare
  • Taxes and Governance
  • Criminal Justice and Law Enforcement
  • Energy

The result of this first question tells the legislators what the population cares most about. The app shows the pending bills in each of the eight areas. At this point, some areas have just one pending bill, some have multiple bills. For each bill, I looked at the sponsorship. If a bill had a single sponsor, I did not vote for it. If a bill had a lot of sponsors but all from the same party, I voted thumbs down or in a few cases I abstained. If a bill had broad bipartisan sponsorship, I voted thumbs up.

For each bill, the app shows how many voted yes, no, or abstain. I believe, if the Digital Democracy Project catches on, it can strengthen our democracy. It does not take millions of participants to be statistically reflective of the will of the people. There may be cases where the legislators feel the will of the people is not best for the country. In such cases, I believe the legislators need to do a better job of explaining why they think what they know is best.

The Digital Democracy Project was created through a partnership between Voting Rights Brigade, a 501(c)(3) non-profit, and Voatz, a Boston-based mobile voting software company.  Voatz has focused on enfranchising military voters, overseas citizens, and disabled voters. Voatz technology has been used in 115 successful elections in the U.S. and internationally. Voatz has been selected by several states and municipalities to run elections because the company follows stringent rules for cyber security, privacy, and auditing. Voatz does not store, share, or sell any data a voter provides, and none of the polling data is monetized.

To try out the app, you first download and install it. The app asks for some personal data for two reasons. First, they need your personal data to ensure the security of their mobile voting system. They verify you are a real human being, not a bot or hacker. They do this by asking you to take a selfie and upload it along with a photo ID. Sophisticated software compares the two pictures. Once verification is complete, they delete your images. Second, they check to verify you are a U.S. citizen and a resident of the State by matching you to the state voter database. They do this using your name, birth date, and zip code. Once verification is complete, they delete your data.

Your ballot (poll choices) is secret and protected. The technology is designed so they nobody knows which piece of legislation you are voting on. When you are registered on the app, you are issued an electronic voting token which is used to submit your “votes”.  This token is used to record votes on a blockchain. Anyone can see the blockchain because it’s available to the public, but the owner of the token is anonymous so nobody can see who voted for a given piece of legislation.  This provides confidence all votes cast are real, and the blockchain itself cannot be manipulated, while still protecting the secret ballot.

I think ultimately the approach the Digital Democracy Project is using will be used for real elections. In the meantime, the Project offers voters the opportunity to participate in polls, gain access to legislative information, and become familiar with the power of mobile and blockchain  technologies.

Disclosure: I was one of the 153 investors who helped sustain Voatz on the Wefunder crowdsourcing platform.

News from johnpatrick.com

It’s All About Attitude

All six books now have updated covers. Great work by Billy Wright. Hopefully, potential readers will find them refreshing and interesting. Ads are now running on Amazon, Facebook, and Google. The narrator for the Audible version of Reflection Attitude got a cold and this has delayed things a bit. I hope to get the sound track for review this weekend. Please take a look at the new site if you have not already. Feedback and suggestions are welcome. 

Ukraine

Some more words from the Great Communicator. He gives a video update to the country every night. Here is one of his profound statements from this week:

“We always want to warmly welcome our friends and partners in Ukraine. But, the World Bank delegation arrived in Kyiv on the day when Russia launched another massive missile attack on Ukrainian territory. We appreciate you staying here. This is an important signal for us.

During the meeting with World Bank Vice President for Europe and Central Asia Anna Bjerde we discussed the preparation of projects related to the restoration of Ukrainian transport, energy infrastructure and the sphere of health care.

I thank the World Bank and its management for their support and quick response to the needs of Ukraine since the first days of the full-scale war.”

Space

NASA’s long awaited Artemis I mission finally launched from historic LC-39B in Cape Canaveral, FL this week, kicking off a 26 day mission to a unique orbit around the moon in a shakedown cruise before humans fly on Artemis II no earlier than 2024. In development for more than 10 years, the Space Launch System (SLS) is the most powerful rocket NASA has ever flown and is currently the largest and most powerful operational rocket in the world, producing a staggering 8.8 million pounds of thrust at liftoff. Its payload is an Apollo-style space capsule called Orion, which is designed to take four humans to lunar orbit where it will rendezvous with a commercial lunar lander, which in turn will take the first woman and the first person of color to the surface of the moon on Artemis III no earlier than 2025.

Artemis I has three main objectives; 1.) Demonstrate Orion’s ability to re-enter the Earth’s atmosphere at a blistering 25,000 MPH and splash down safely in the Pacific Ocean off the coast of San Diego, CA. 2.) Demonstrate the ability of SLS and its upper stage, the Interim Cryogenic Propulsion System (ICPS) to launch into and maneuver in space. 3.) Demonstrate the ability to recover Orion by a US Navy platform dock ship.

On a personal note, this writer and space geek traveled from Boston to see the launch, and it was a sight to behold. Standing on the Max A Brewer Bridge over the Indian River (about 10 miles from LC-39B) with thousands of people cheering on, SLS put on a spectacular display of power, lighting up the sky at 1:47AM as if it were daytime. And then it was gone. Definitely worth the trip.

Aaron J. Patrick

Crypto

The gloom and doom from startup FTX continues. Multiple federal investigations will unravel what happened but it will take time. There are no excuses for how FTX was mismanaged but a faster pace at developing appropriate regulation would have helped. Slow to regulate is often because those to be regulated resist. That is not the case here. Crypto company executives have been begging for clarity and regulation. Bitcoin continues to be stable. Bitcoin owners would prefer that it stabilized at a higher level. Bitcoin volatility is actually no more extreme than that of stocks, especially techs. Volatility will likely continue until regulation is in place. Everybody wants regulation but Congress cannot get its act together. Coinbase is being impacted by the FTX debacle but I remain bullish on the potential of the company. It is operating in a transparent manner and is run by grownups.

Wall Street

Some stocks up  but all of the major averages posted losses for the week. Rate fears still everywhere. GAMMAT still high at $7.5 trillion. Tesla still under pressure. Twitter seems to be a mess but I am not going to judge yet although some of Musk’s moves seem erratic. I still think he  has some surprises ahead. Tech layoffs are huge. They are all admitting they grew too fast and ramped headcount and big salaries way to fast.

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The Voting Mess

The Voting Mess

Written: November 2022

There are many problems with our election system. Fraud is not of them. Human error is. A few of the problems include old technology, complicated ballots, polling place confusion, insufficient trained staff, and politically mandated procedures. I will highlight a few problems in this post.

Hundreds of thousands of voters appearing for the March 22 2016 primaries in Arizona were confused, inconvenienced, and outraged at the excessive wait times. Many Arizonans left the polls in disgust.  Others waited as much as five hours.  The late Harris Miller, formerly President of the Information Technology Association of America, a leading industry trade group for information technology companies during the late 1990s, had a lot of experience with the American voting system because the voting machine companies were members of the Association. He is in favor of Internet voting. “Visiting polling places to vote has served us well for many years, but it is time for a more modern approach”, he said. Miller pointed out in addition to aging voting machines, we have aging and ill prepared election workers. Historically, most polling place workers have been women, but as more women began to work outside of the home, the supply of election workers has become strained. I confirmed this with Regina Ofiero, an election worker since 1985. Ms. Ofiero is a moderator at the Danbury High School polling place in Fairfield County, Connecticut. As moderator, she is in effect the manager of the entire voting process at the polling place, including recruiting poll workers. She said at least 70% of the poll workers are women. Not only are the existing workers aging, but very few young people are expressing interest in the job.

During the March 15, 2016 primaries in Florida, according to the Supervisor of Elections Office, the voters in one precinct in Flagler County were given the wrong ballots, resulting in about 30 people who voted for the wrong county commissioner candidates. Election officials went through every ballot individually and corrected the errors. The county election was not impacted and there was no effect on the Presidential race, but it is one of many examples of human error.

In Orange County, Florida, during the 2016 primary, about a dozen of the 251 precincts ran out of ballots. As early as 9 a.m., the Pinecastle Masonic Lodge and several additional precincts ran out of both Democrat and Republican ballots. At some precincts, the order to print more ballots was incorrect. Instead of printing more Presidential ballots, more city ballots were printed. Voters were told to come back later. More than a dozen citizens protested outside the Orange County Supervisor of Elections Office. The Supervisor had absentee ballots printed and hand-delivered to voters’ homes or at workplaces later in the day.  Also, several polling places in Orange County had problems verifying voter registration. The tablet computers used to swipe a voter’s driver license had problems connecting to the Internet. These locations had to request delivery of printed registration books from the archives.

In Polk County, Florida, a precinct poll worker couldn’t find the Democratic primary ballots. When the worker opened the polling place, the volunteer only handed out the Republican ballots and told Democrats they couldn’t get a ballot. Voters called the Supervisor of Elections Office, which told the poll worker where to find the ballots. These are a few examples of ballot problems and human errors which happened in many states during the 2016 Presidential primary.

All of the current voting methods can be subject to error because they depend on a certain level of a person’s knowledge of the voting process. Some ballots are not well designed and can be confusing. Very few ballots require a simple choice: vote for A or vote for B.  The design of some other ballots is not so straightforward. Some ballots list several dozen choices. In addition to the federal and statewide races, ballots may include propositions, city and county elections, school boards, water and fire districts, judges and more. Which races and contests are on which ballots depend on where a voter lives. In Arizona, there are 22 tribes and 20 tribal reservations. Many of them stretch across counties. The largest is the Navajo Nation. It spans three counties, each one with different voting practices. Precinct rules require street addresses.  In some tribal or rural areas, there are no street addresses.

Ballot instructions, candidate and party listings, party symbols, and, in general, variations that result from a complex and highly decentralized election system provide ample opportunity for all but the most sophisticated voters to misunderstand, mismark, or spoil their ballots and for all voters to feel confused and frustrated. Confusion can lead to errors.

Like most problems in the world, the root cause is the politicians. In Arizona, voters were urged to not return their ballots early, instead drop them off on election day. Then the same politicians accused the election officials of dragging out the counting process and ignoring the fact each ballot must be verified by comparing signatures to voter registrations, hundreds of thousands of them. In Pennsylvania, an election law prohibits mail-in ballots from being counted until the polls were closed. In Florida, I sent in my ballot in late October. I checked the website a few days later and saw “Your vote has been counted”.

Some politicians are urging paper only voting, get rid of the machines. Hire tens of thousands of temporary workers to count the votes manually, rent a football stadium sized facility for all the workers and ballots. One study showed human counting of large numbers has an error rate of 2%. The delays would be longer. An Arizona audit took three months to hand-count 2.1 million ballots. It was reported to be plagued with inaccuracy. Fraud is not an issue. Modernization is. States with modernized procedures comfortably announce their results the night of the election.

If you are interested in this subject, you may want to check out Election Attitude – How Internet Voting Leads to a Stronger Democracy. It is available in Kindle, paperback, Audible, and soon in hardcover.

News from johnpatrick.com

It’s All About Attitude

The marketing strategy is coming together. I plan to drive traffic to johnpatrick.com where people can learn about the books and then one-click to Amazon to buy one. I am advertising on Amazon, Facebook, and Google. Th narrator, Hal Maas, is hard at work creating the Audible version of Reflection Attitude. As the flagship of the series, Reflection Attitude will be available in Kindle, Paperback, Hardcover, and Audible. Please take a look at the new site if you have not already. Feedback and suggestions are welcome. 

The Brooklyn Bridge

Some years ago, I read The Great Bridge: The Epic Story of the Building of the Brooklyn Bridge by the late popular historian David McCullough. The book provides a history of the amazing engineering behind the building of the bridge. It took 14 years to build. Great book. For years I have said to myself, someday I am going to walk over the Brooklyn Bridge. The someday turned out to be Thursday of this week. It was 1.57 miles and a beautiful experience. I took some pictures and, if interested, you can see them here. All the pictures were taken from the bridge.

Ukraine

Some more words from the Great Communicator. Here is one of his profound statements from this week:

“Today we have good news from the south. The number of Ukrainian flags returning to their rightful place in the framework of the ongoing defense operation is already dozens. 41 settlements were liberated. I thank all our heroes who make this advance possible.

But, rejoicing, we should all remember now and always what this movement means, we should remember that every step of our defense forces is the lives of our warriors. Lives given for freedom for Ukrainians. Everything that is happening now has been achieved by months of fierce struggle. It was achieved through courage, pain, and loss. It’s not the enemy leaving. It is the Ukrainians who drive the occupiers out at a heavy cost.

Just as in the east of our country, in the Kharkiv region. Just as before, in the north – Kyiv region, Sumy region, Chernihiv region. Now – Mykolaiv region, Kherson region. We have to go all the way – on the battlefield and in diplomacy – for our flags, Ukrainian flags, and never again enemy tricolors.

Space

Atmospheric entry is defined as the movement of an object from space into and through the atmosphere of a planet, dwarf planet, or natural satellite. Examples of atmospheric entry are a shooting star, a space capsule returning astronauts from the International Space Station, or a nuclear powered rover going through entry, descent, and landing on Mars. In all of these examples, kinetic energy is converted to heat as the object’s velocity creates friction or drag with molecules in the air. Using a heat shield to absorb or dissipate heat from atmospheric drag is the most mass-efficient method of slowing a spacecraft down, but the size of the heat shield therefore spacecraft mass has always been limited to the size of the shroud carrying the spacecraft into orbit. NASA is trying to reduce those constraints with Hypersonic Inflatable Aerodynamic Decelerator (HIAD) technology, which was demonstrated this week on the Low-Earth Orbit Flight Test of an Inflatable Decelerator (LOFTID). Made of braided synthetic fibers that are 15 times stronger than steel, the inflatable structure is the largest blunt body aeroshell ever flown at 19.7 feet in diameter. HIAD is made of three flexible layers and is “foldable, packable, deployable, and tailorable”, which means it takes up less space in a rocket and is also scalable. This technology demonstration will help inform designs on future missions and could one day be used to help land humans on Mars. – Aaron J. Patrick

Crypto

This was a bad week in crypto. The gloom and doom comes from startup FTX run by 30-year-old CEO billionaire (before) Sam Bankman-Fried. I have liked him but he made a few bad decisions. Now he is filing Chapter 11 and he resigned. I never invested in FTX or any of its crypto. Bitcoin owners are not happy with the jolt downward from FTX effect. Bitcoin volatility is actually no more extreme than that of stocks, especially techs. Volatility will likely continue until regulation is in place. Everybody wants regulation but Congress cannot get its act together. Coinbase had a small investment in FTX and it will participate in Chapter 11 to try to reclaim some of it. Coinbase stock is up 13%.

Wall Street

Stocks up nicely, especially NASDAQ but still a long way to go. Rate fears still everywhere. GAMMAT now up to $7.6 trillion, a gain of more than half a trillion. Tesla still under pressure. Twitter has hinted at possibility of bankruptcy. I suspect Elon Musk has some surprises ahead. Meanwhile, his other companies are doing quite well. Tech layoffs are huge. They are all admitting they grew too fast and ramped headcount and big salaries way to fast.

News from johnpatrick.com
Can Healthcare Benefit from the Metaverse?

Can Healthcare Benefit from the Metaverse?

Written: November 2022

Sometime in the late 1990s when I was Vice President for Internet Technology at IBM, I was invited to visit the Argonne National Laboratory in Lemont, Illinois, outside of Chicago. Argonne is a national science and engineering research lab operated for the United States Department of Energy. It is one of the 17 DOE laboratories which comprise a preeminent federal research system, providing the nation with strategic scientific and technological capabilities.

Part of the tour I received included a review of some advanced work Argonne was doing with virtual reality. Before entering the VR lab, I was asked to wear VR goggles and a pair of VR gloves. The gloves used haptic technology, also known as kinesthetic communication or 3D touch. The VR gloves can create an experience of touch by applying forces, vibrations, or motions to the wearer’s hands. It is like the haptic feedback you get from your steering wheel if you cross a highway lane.

After entering the VR lab, I saw a Golden Labrador sitting on his or her haunches with a big tongue hanging out. The executive director conducting the tour asked me to pet the dog. I reached out with my glove and petted the dog on the head. He or she liked it and wagged its tail. Then the executive director asked me to take off my goggles. When I did, I saw an empty room. There was nothing there. The Golden Lab was virtual. The dog was not real. It was a virtual reality experience.

Complimenting VR is AR or augmented reality. The simplest example I can think of is at Amazon. While shopping for a new table lamp for your living room, you can look at your smartphone and see a lamp you have selected. On your phone is your real living room along with a virtual table lamp. This is an augmented reality experience.

For healthcare, I believe more and more mHealth devices and smartphone apps, such as I have written about in Health Attitude: Unraveling and Solving the Complexities of Healthcare will have a positive impact on how healthcare is delivered and the quality of care for patients. VR and AR will play an important role also. Meta (formerly Facebook) is making significant investments in metaverse technology, but they will face competition from all the tech giants and from startups.

One interesting startup I just learned about is Vuzix® Corporation (NASDAQ: VUZI). The company has developed smart glasses and augmented reality (AR) technology and products. They have just announced an innovative trial with its M400 smart glasses. The trial is taking place in Japan with an emergency medical care plan and is a collaborative effort between Juntendo University, Shizuoka Hospital, the Shunto Izu Fire Department, and AVR Japan Co., Ltd.

The objective is to enable the combination of the emergency medical technicians (EMTs) and providers at the hospital to improve patient outcomes and lifesaving rates by providing the earliest treatment possible. The idea is to transmit real-time medical information directly from an ambulance to the hospital. From the moment an EMT engages the patient, whatever the EMT sees through the smart glasses, along with whatever the EMT says, is transmitted directly from the smart glasses to providers in the hospital. Medical information such as vital signs and ECG readouts, as well as the patient’s facial expressions and other visual changes in condition, are available to doctors and nurses who are on standby at the hospital.

The trial is designed to measure if the real-time data transmission enables examinations, diagnoses, and preliminary medical treatment decisions can be made by various departments in the hospital before the patient even arrives. In addition, the study designers believe the hospital team can direct the EMTs to provide in-transit emergency treatments such as blood transfusion, intravascular treatment, and various other procedures for which EMTs are trained.

Epilogue

One of my grandsons is a pre-med and a certified EMT. He likes the smart glasses idea and is ready to try it.

News from johnpatrick.com

It’s All About Attitude

Thanks for the positive feedback about the changes at johnpatrick.com. Changes and improvements will be continuing. The overall marketing strategy from now on will be to focus on the “It’s All About Attitude” book series and my blog. I have just selected a narrator to create an Audible version of Reflection Attitude. As the flagship of the series, Reflection Attitude will be available in Kindle, Paperback, Hardcover, and Audible. The blog has more than 2,000 articles. Please take a look at the new site if you have not already. Feedback and suggestions are welcome. 

Ukraine

Some more words from the Great Communicator. Here is one of his profound statements from this week:

“Today the Kremlin is saying that they demanded security guarantees from Ukraine. We should think for a moment about their statements.

Two hundred fifty two days ago Russia demanded security guarantees from the United States of America. After eight months of Russia’s so-called “special operation,” the Kremlin is demanding security guarantees from Ukraine.

These are really striking changes. This shows both the failure of Russian aggression and how strong you and I are when we remain united. Millions of Ukrainian men and women who fight and work for our freedom. And millions of people around the world who help us resist Russian terror.

Together we will ensure the defeat of the terrorist state and its punishment for terror. And we guarantee that all of Ukraine is and will be free.

Eternal glory to all our heroes! Eternal memory to all those who gave their lives for Ukraine!

Glory to Ukraine!

Space

SpaceX is dominating the global launch services market with half of all launches last year (31 of 62), and has completed more than 50 missions in 2022. This unprecedented launch cadence of every 6 days or so would not be possible without rocket reusability. SpaceX did not come up with the idea of reusability but has seemingly mastered it with its workhorse Falcon 9, having recovered first stages 152 times (79 consecutive) as of this writing. The current fleet leader has supported 14 missions with “no practical limit” to how many times a first stage can be reused.

Other players in the industry understand how rocket reusability is key to rapid, low cost access to space, and are developing vehicles intended to be partially or fully reusable. Rocket Lab’s Electron small satellite launcher has completed 28 missions, and its first stage has recently been modified for capture by helicopter after launch and separation. Their next generation rocket, Neutron, will have the capability to return the first stage to its launch site under its own propulsive power similar to Falcon 9. Also, Relativity Space has the world’s first 100% 3-D printed rocket under development, which will be fully reusable, and SpaceX is developing a super heavy rocket called Starship, which is designed to be launched, recovered, and relaunched multiple times a day.

 – Aaron J Patrick

Crypto

The big news this week in crypto is Coinbase. The company announced a third-quarter net revenue of $576 million, down 28% compared to the previous quarter. Transaction revenue fell 44% to $366 million, driven by lower trading volume. Most investors believe Coinbase will survive the crypto winter and play a key strategic role. The stock close the week up 6%. There is competition appearing and that is good news. Fidelity Investments is rolling out Fidelity Crypto, commission-free trading on bitcoin and ether for retail investors. FTX ceo said he might want to acquire Coinbase. I continue to believe the future for Coinbase is bright.

Wall Street

Stocks were up and down. Rate fears still everywhere. GAMMAT now down to $7 trillion. Tesla under pressure. Some investors worried Musk will spend too much time on Twitter. I predict he will make very good changes to the company and make it successful. 

News from johnpatrick.com
How Can Smartphones Improve Our Health?

 How Can Smartphones Improve Our Health?

Written: October 2022

In July 2015, I published a peer-reviewed journal article titled “How mHealth will spur consumer-led healthcare”. The following paragraph is the abstract of the article. If you are interested in the full article, you can find it here.

Abstract – 2015

Consumer attitudes about their healthcare are beginning to shift. They are taking more responsibility for their health and seeking to collaborate with their doctors. In some cases, consumers will engage in self-diagnosis. Mobile health apps and devices, in combination with cloud computing, will play a major role to empower consumers. Consumer expectations for healthcare are rising by the day. mHealth has provided empowerment to patients through the power of the PSC, which I describe as personal supercomputers. The number of devices and apps are exploding onto the healthcare scene. Although some providers are not comfortable with consumer technology for self-diagnosis, the new technologies will lead to a new model for collaboration between patient and physician.

Reflections – 2022

It has turned out to be true mobile health apps and devices, in combination with cloud computing and AI, are empowering consumers. Mobile apps are helping people manage their own health and wellness, promote healthy living, and gain access to useful information when and where they need it. The mHealth apps and devices are being adopted almost as quickly as they can be developed. Users include health care providers and consumers.

The FDA, “encourages the development of mobile medical apps (MMAs) that improve health care and provide consumers and health care professionals with valuable health information.” The FDA also has a public health responsibility to oversee the safety and effectiveness of medical apps and devices. Since my mHealth article in 2015, the FDA has approved several hundred apps and devices. The challenge facing the FDA is sorting out the plethora of apps and devices, and prioritizing and reviewing those which are clearly related to medical diagnosis and care. If you include fitness apps and devices, there are more than 40,000 apps out there.

An interesting new mHealth app has been developed by a team of researchers at the University at Buffalo. They have used Bluetooth earbuds and a deep learning AI system to diagnose some common ear conditions including earwax blockage, ruptured eardrums, and a common ear infection known as otitis media. The researchers are calling the combination of some simple non-invasive tests and a powerful app the EarHealth System.  

The EarHealth System uses a set of standard Bluetooth earbuds augmented with inward-facing microphones. The app sends an audio chirping signal into the ear. The microphones record how the signal reverberates through the ear canals, and the app software uses the signals to map out the ear structure and create a profile of the user’s unique inner ear shapes.

The concept behind the EarHealth System is to take an initial mapping of the ears to establish a baseline, and then take periodic tests to look for changes. The researchers conducted a trial with 92 volunteers. The system was able to diagnose the three common ailments with an 82.6% accuracy. In many cases the system was able to identify the ailments long before they had developed into serious problems.

Zhanpeng Jin, PhD, lead author on an EarHealth study published by the Association for Computing Machinery (ACM) said, “With EarHealth, we have developed what we believe is the first-ever earbud-based system that monitors ear health conditions in an effective, affordable and user-friendly way. Because it has the potential to detect these conditions very early, it could greatly improve health outcomes for many people.”

The researchers say they’re working to improve the accuracy of the system, by evaluating how ear hair, historical eardrum inflammation, and other factors might affect the test results. The technology sounds good to me, no pun intended. I am sure a submission to the FDA for approval is in the researchers’ plan. If the system is proven to be accurate, effective, affordable, and user-friendly, it could achieve widespread adoption as an mHealth tool for regular, super-quick ear checkups.

News from johnpatrick.com

It’s All About Attitude

johnpatrick.com is continuing the revamp. It is now the home of the “It’s All About Attitude” book series and my blog. The new addition is a hardcover version of Reflection Attitude . Feedback on the quality of the cover is very positive. A great fit for your coffee table! The blog has more than 2,000 articles. Please take a look at the new site and let me know what you think. Thanks to all who have given me some feedback.

Ukraine

Some more words from the Great Communicator. This is what he said on Friday. “

held several meetings with the military – regarding the current situation on the frontline, our active actions. Today the enemy reports about the alleged completion of their mobilization… About the alleged needlessness of new waves of sending Russian citizens to the front. We feel completely different on the frontline.

Although Russia is trying to increase the pressure on our positions by using mobilized people, they are so poorly prepared and equipped, so ruthlessly used by the command that it allows us to suggest that Russia may soon need a new wave of sending people to war.

We are preparing for this – we are preparing for the fact that the current Russian leadership will look for any new opportunities to continue the war. In particular thanks to its accomplices in Iran.

 That is why we are working with our partners every day to strengthen our air defense, our other defense capabilities. Glory to all who help us fight for freedom! We will definitely return the Ukrainian flag to all parts of Ukraine!

Crypto

Dogecoin crypto has soared over enthusiasm for Elon Musk acquiring Twitter. The hope is Dogecoin will become more widely adopted. It is certainly possible. Tesla already accepts Dogecoin for purchase of selected clothing and accessories in the Tesla online shop. Shiba Inu is tagging along with a nice increase. I don’t see any real use for it but I presume the hope is that if Dogecoin becomes more widely used, so will Shiba Ina. Not so sure on that one. Bitcoin continues to be 40% of the total market cap of all 21,555 crypto currencies. The total of all crypto has made it back up to one trillion dollars. Most people involved in crypto are hoping for a regulatory framework to emerge from our political leaders. I am not holding my breath. 

Wall Street

Stocks were broadly higher. Most everything was up except Amazon. They are seeing some softness. Not surprising and, in my opinion, not relevant to the long term potential of Amazon. Meta (Facebook) at $99 is at 1/3 of its 52-week high. The NASDAQ has to rise 5,000 points to get to its 52-week high. Twitter has $5 billion in advertising. Very small market share. Musk’s vision is to keep it no more than 50% of revenue but that still means advertising at Twitter will need to more than double. I expect to see some unexpected innovation unleashed by Musk. I don’t know what, but it will be impressive.

News from johnpatrick.com
Will It Be Possible to Have a Vaccine for Cancer?

 Will It Be Possible to Have a Vaccine for Cancer?

Written: October 2022

Uğur Şahin and Özlem Türeci are the first Germans with Turkish roots among Germany’s 100 wealthiest people. The two billionaires are said to live modestly. I predict they will become far more wealthy. Uğur and his wife Türeci are both professors, scientists, doctors, oncologists, immunologists, and several other specialties most of us never heard of. In 2001, while continuing to teach at the University of Mainz, Şahin began to engage in entrepreneurial activities, co-founding two pharmaceutical companies, in 2001 and 2008, with his partner and spouse Özlem Türeci. The second of these companies, BioNTech, together with Pfizer Inc., developed one of the highly successful mRNA vaccines used to fight the COVID-19 pandemic in 2020.

Şahin is the Chief Executive Officer of BioNTech and Türeci is the Chief Medical Officer. Prior to the pandemic the duo had been working on personalized cancer immunotherapy. They are bullish. Professor Türeci told BBC News, “We feel that a cure for cancer or to changing cancer patients’ lives is in our grasp”, and Professor Şahin said he thought cancer vaccines could be widely available “before 2030.”

Scientists have been trying to develop a cancer vaccine for decades but the breakthroughs from Project Warp Speed may accelerate progress. BioNtech was working on a cancer vaccine when the pandemic became the top priority. A lot was learned and now that learning is fueling cancer vaccine research again.

One approach in the research is to teach the immune system to recognize and destroy cancer cells. Just like the covid antigens were able to detect and fight the covid virus, cancer antigens can potentially distinguish cancer cells from normal cells. Ideally the research might enable prevention of cancer from growing in the first place.

There will be a difference between covid and cancer vaccines. The covid vaccines are one size fits all. A cancer vaccine is likely to be unique to each patient. However, with the advances in supercomputing and cloud storage, this should not be a problem.

Another approach is the development of vaccines designed to treat people who already have cancer. The FDA has approved a therapeutic cancer vaccine called Provenge for people with advanced prostate cancer. Provenge is an immunotherapy treatment which utilizes the power of the patient’s own immune system to identify and target prostate cancer cells.

The BioNtech website says, “From the very beginning, our focus has always been on exploiting the full potential of the body’s immune system to successfully help address cancer and infectious diseases.” BioNtech is not alone. Pharmaceutical companies see cancer treatment as a major opportunity for billions in revenue. As of 2020, there were more than 1,300 medicines and vaccines for various cancers under development by innovative biopharmaceutical research. I am optimistic.

Epilogue: The pharmaceutical industry is profitable, as it should be. It does great things. It has extended our life expectancy. But, how profitable should it be? For pharmaceutical companies, the median gross profit margin was 76.5%, the median earnings before taxes was 29.4%, and the median net income margin was 13.8%. These numbers far exceed other S&P 500 companies. As I wrote in Health Attitude: Unraveling and Solving the Complexities of Healthcare in 2015, Medicare should be allowed to negotiate the price of drugs. This is a no-brainer. The Inflation Reduction Act identifies just 10 Part D drugs for 2026, another 15 Part D drugs for 2027, another 15 Part D and Part B drugs for 2028, and another 20 Part D and Part B drugs for 2029 and later years. It is clear from the details the pharma lobby had a strong hand in writing the provisions. Political support came from politicians who get millions of donations to their reelection campaign funds from the lobby. Any business-minded person working on behalf of the taxpayers, not the politicians, would simplify the provisions. All of the 20,000+ FDA-approved drugs beginning in 2023. If the pharmaceutical industry feels the pinch, they can gain billions by stopping the ridiculous carpet bombing of TV ads we do not need.

 
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