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Comment Re:Two reasons (Score 1) 219

I prefer FiveThirtyEight to Real Clear Politics. As they point out frequently, national polls mean little or nothing in the primary race because primary elections don't work the way polls do. The rules are also malleable right up to the moment before the actual selection takes place at the convention.

FiveThirtyEight places a great deal of weight on what it calls the Endorsement Primary. This is a points system where each endorsement of a candidate by a member of the House of Representatives is worth one point, each Senator's endorsement is worth five points, and each governor's is worth 10 points. By this scale, there are theoretically up to 1435 points to award, though members of one party are unlikely to endorse someone from another party. In any case, Clinton leads the Endorsement Primary for Democrats by 447 to Sanders's mere 2 points (and O'Malley has one point). Republicans are a much more mixed bag with Bush at 41, Rubio at 29, Christie at 25, and Huckabee at 24. Everyone else is at 15 or fewer points (Trump and Carson have zero), and only 168 points worth of endorsements have even been made among candidates still in the race, so there's still a lot of wait-and-see going on.

I expect the party will push for some of the others to drop out to make the Iowa slate a little cleaner, but Iowa and New Hampshire are worthless as predictors of the nation, doing little better than chance at predicting the actual nominee. They act as filters: if you can't make a halfway decent showing there, you're probably not going to do it elsewhere. But ultimately, the party has a great deal of control by pushing superdelegates to vote in a certain way, and even a seemingly close match-up going into the convention could turn out to be a nearly runaway victory for whomever the Establishment prefers.


Video High-Security, Open-Source Router is a Hit on Indiegogo (Video) 109

The device is called the Turris Omnia, and its Indiegogo page says it's a "hi-performance & open-source router." Their fundraising goal is $100,000. So far, 1,191 backers have pledged $248,446 (as of the moment this was typed), with 49 days left to go. They've shipped 2,000 pieces so far but, says interviewee Ondej Filip, "95% of them are in the Czech Republic."

This is not only an open-source project, but non-profit as well. A big motive for it is heightened security, as the interview (and transcript) make clear. It's also apparent that the hardware here is overkill for a router; it can run a complete Linux distro, no problem, so it can function as a server, not just as a router. Interested? You might want to put a reservation in soon. This isn't the cheapest router (or even server) out there, but a lot of people obviously think a Turris Omnia, with its crypto security, automatic updates, and server functions would be nice to have.

Comment Re:Holy crap ... (Score 1) 219

Clinton is almost a lock. Something hugely catastrophic would need to happen for her to fail to get the nomination.

Jeb Bush is another story. He's faltering, but he may also be waiting for others to tear down Trump and Carson before trying to mount a serious comeback. Still, Rubio seems to be slowly becoming the Establishment favorite, and that counts for a lot.

Comment Re:I think this is fair. (Score 0, Offtopic) 219

Al-Qaeda affiliates and ISIS actually do fight each other. ISIS and al-Nusra Front have been at opposition for a while. Remember that ISIS came out of what was al-Qaeda in Iraq, and announced a merger with al-Nusra without discussing it with anyone else. Al-Nusra told them to get bent, AQI declared they were going ahead with it, Zawahiri told everyone to chill out, and AQI announced it was breaking from al-Qaeda. Al-Nusra has remained allied with al-Qaeda, and sometimes coordinates with the Free Syrian Army and other rebel groups, especially when fighting ISIS.

This is one of the weirdest things about ISIS: even al-Qaeda is against them, says they go too far, and thinks they're more extreme than the Quran allows. They have basically the entire world--including most terrorists--against them.

Comment Re:Maine has been doing this since 1976 (Score 1) 34

The failures that you have described, I have seen in several places. Telehealth equipment purchased with some sort of rural healthcare grant and dumped on a clinic by technical staff, and left to gather dust because it was not implemented properly. In my experience, it's really easy to get this wrong. As you know, tech people are neither providers nor managed care operators.

You are correct that when I use the term "telemedicine", I tend to use it in the broadest possible way. You alluded to this in your comment - and I'll reiterate that just using the novel terminology (e.g. da Vinci machine and telemed robots) does not do justice to the work that has gone into getting telemedicine where it is now. Telecommunications technology has been used for healthcare since it's inception, and in these broad terms, it certainly counts as telemedicine (early telephone and telegraph use, not to mention NASA's work on remote monitoring for astronauts). We take the low-hanging-fruit solutions where we can, but there is so much regulatory and bureaucratic friction ensuring that telemedicine adoption happens very slowly. (Cross-state physician and nursing licensing is always a problem, CMS regulations prevent billing in many cases, state boards of medical examiners are passing protectionist measures to make it difficult to perform telemedicine - especially across state lines, etc). In building a system, I start small, and take the small victories on the low-hanging-fruit. More often than not, it's the healthcare providers who need to buy into the technology and they are the ones who come up with ideas for how to use the technology. It's very often that I hear something like "I've got a regular ENT clinic, and don't need that scope, but could I use this for after-hours coverage when I only have an RN on duty? I'd bet that with video supervision, we could really reduce the number of ER transports, which is exactly what our client is asking for."

With respect to cardiology, in many cases, a cardiac echo machine and tech are easier (and cheaper) to transport than a cardiologist. It really depends on the circumstance. If it's easy to refer a patient to a clinic with the appropriate equipment down the street, then it makes sense. In a large hospital that already has echo cardio equipment onsite, then it's a no-brainer. In a massive self-contained environment (e.g. native American reservation, prison system, VA network, or university system), this isn't always possible - and this is where we can bring the equipment and tech to the patient. These are the environments where we have seen the greatest successes.

You are also correct in that nobody is going to just "connect" two EHR's overnight. Most of the federal law revolving around these was not really for portability in the charts, but in billing codes. Even that is very complicated and cumbersome. However, getting a partner provider (or a remote employee) access to an EMR is very easy to do.

Yeah, we're closer than it would appear in our opinions on this. It would appear that you've been on the wrong end of more than one bad telemedicine implementation. Throwing technology at a non-problem does nothing for anyone. Pie-in-the-sky promises and deploying poorly implemented systems and walking away moves us backwards on all levels. I've spent the better part of the last decade blowing the dust off of these implementation and making them work. What I do is not bleeding edge robots, but finding small victories wherever possible and then working with stakeholders to identify other opportunities to grow their program (or overcome obstacles that have prevented them from using the technology in the first places). I'm sure that we both totally agree that telemedicine is not a fix-all that will replace in-person care. I've never made this promise to anyone, and never will. However, I've been increasingly surprised by what we've been able to accomplish even with older equipment.

Comment Re:Maine has been doing this since 1976 (Score 1) 34

The idiot TFA basically wants to talk about other things - patents and point of care robots, but really does nothing to discuss the lack of ubiquity that evangelists have been promising.

This is probably the only part of your post that I agree with. Telemedicine is more than telepresence robots, but it's working right now for many people who wouldn't otherwise have access to care. I'm sorry that it's not doing more for you right now.

Telemedicine can work for a simple doctor / patient interview but falls apart for anything more complex because medicine is quite a bit more than simply a doctor / patient interview. The remote site typically doesn't have the diagnostic gear that the consultant needs. The consultant typically doesn't have access to all of the records. And the remote site may not have the staff or equipment to treat the patient, even if the diagnosis is clear.

I don't mean to attack you, but what you're saying suggests that you either don't work in healthcare, or have never worked within a successfully implemented telehealth program. Further, it sounds like you're confusing telehealth with m-health and home care. I'll say this much as a concession: telehealth isn't for everyone, all the time. If the patient site has qualified staff, telemedicine can absolutely increase access to specialist care for people in rural areas. Your medical record argument does not hold much water, as EMR's and EMAR's are very real things that most modern practices have access to. I've also built shadow record systems to provide consultants with images of patient charts as well. Do some patients need to see a specialist in person for many procedures? Most certainly. The technology absolutely has its limitations, and telemedicine will never replace in-person care. Further, for most of us, many procedures require an onsite visit. Does that mean that the technology has not lived up to it's promise? Absolutely not. You're misinformed.

Telemedicine can work for a simple doctor / patient interview but falls apart for anything more complex because medicine is quite a bit more than simply a doctor / patient interview. The remote site typically doesn't have the diagnostic gear that the consultant needs. The consultant typically doesn't have access to all of the records. And the remote site may not have the staff or equipment to treat the patient, even if the diagnosis is clear.

Yes and no, but the basic thesis is incorrect. I've spent the last 8 years building and managing a telemedicine network and my company's providers use the technology to see over 6,000 patients per month. Using fairly basic specialty exam cameras and properly trained presenters, many patients in rural settings can be seen and diagnosed by specialists who are far away - who these patients would have not had access to. Perhaps they will have to travel onsite to have certain procedures performed, but the initial consult and follow-up visit can be performed remotely.

So at anything other than the most basic level, it has been thrown together technological bits that have long sought out a reasonable use case.

Again, yes and no. I completely agree that if you just throw technology at a problem without having healthcare operators be a part of the implementation, it will fail. However, there are quite a few more reasonable use cases. I can name a few low-hanging fruits that are being widely used right now:

  • Behavioral health (this is a no-brainer, and productivity is higher than in-person in some clinical settings)
  • Dermatology (generals special derm cam, but a general exam camera works, too)
  • Radiology (um, teleradiology is radiology now
  • Cardiology (tele-EKG was one of the first uses of telemedicine, many decades ago - this tends to do well with a tele-steth, but it works exactly like any other stethoscope - any RN can operate one)
  • Nephrology (Nephrologists don't need to travel to rural clinics for regular follow-ups for dialysis patients)
  • Neurology (Rural hospitals and urgent care clinics are saving lives every day due to stroke protocols providing access to neurologists for stroke victims, where stroke protocols allow for rapid diagnoses and treatment via medications like TP-A)
  • Infectious disease (I'm using the technology to have several HIV & Hepatitis patients seen via ID providers to gain access to 340(b) pricing for life-saving drugs
  • Oncology (This is another no-brainer for rural patients. Oncologists do not administer meds, but need to monitor patients. With a proper EMR, there is no need for an in-person visit when the patient has access to qualified healthcare providers to transmit patient data.)

I could go on and on with this, but you probably get the idea. You seem to have confused home m-health confused with telemedicine as a whole (the former is only a small subset of the latter). Telehealth is here, and it is providing access to care right now. I work with providers to serve patients using the technology every day. I'm sorry that it hasn't touched your life yet...however, you probably don't live in an under-served community - so you've got that going for you.

Comment Re:No, I'm really not (Score 1) 313

The thing is, I don't want to count on everyone having the latest version.

Yes you do. That way developers using those bleeding-edge features can find the rough edges and get them fixed, and you can use their tested descendants a year later. If those features aren't delivered to end users, no one can test and learn from them and they don't become mainstream.

Comment Re:Stalking Horse? (Score 1) 137

Thus for most normal Blackberry users (non-corporate), their secure end to end communications begin and end at Blackberry's servers.

That's not a definition of "end to end" that I'm familiar with. Beyond that, how does Blackberry's "network operator" setup differ from Apple's Messages where Apple handles the message routing and delivery, except that Apple devices encrypt and decrypt on the user's hardware (which is the normal definition of "end to end")?

Comment Re:The man is a marketing genius (Score 1) 207

Hey! My '98 V70 is the most comfortable car I've ever owned. It does not drive like a tank, more like a well worn-in Lay-Z-Boy.

Not saying that the sample lot was all that high-end, well there was the '96 Mazda Millennia, that was a nice car too.

I happen to like the way the V70 looks. This may explain why my wife picks my clothes when we go out, and makes me take the 2001 Volvo S60.


Video Meet Mårten Mickos, Serial Open Source CEO (Video) 23

Marten was the MySQL CEO who built the company from a small-time free software database developer into a worldwide software juggernaut he sold to Sun Microsystems. Next, he became CEO of Eucalyptus Systems, another open source operation, which Hewlett Packard bought in 2014. Now Mårten is CEO of hackerone, a company that hooks security-worried companies up with any one of thousands of ethical hackers worldwide.

Some of those hackers might be companies that grew out of university CS departments, and some of them may be individual high school students working from their kitchen tables. Would a large company Board of Directors trust a kid hacker who came to them with a bug he found in their software? Probably not. But if Mårten or one of his hackerone people contacts that company, it's likely to listen -- and set up a bug bounty program if they don't have one already.

Essentially, once again Mårten is working as an intermediary between technically proficient people -- who may or may not conform to sociey's idea of a successful person -- and corporate executives who need hackers' skills and services but may not know how to find non-mainstream individuals or even know the difference between "hackers" and "crackers." Editor's note: I have known and respected Mårten for many years. If this interview seems like a conversation between two old friends, it is.

Comment Re:Har har har? (Score 1) 231

Yes, but you save time by not indenting

I'm asking this seriously: what text editor do you use that you can easily not indent? I use Emacs (and Vim and Sublime Text and Atom) and automatically get thr correct indentation just by writing code like I normally would. If I type if foo: and hit enter, the cursor will be placed correctly for the next thing I type. This isn't Python-specific, either. I get the same behavior when writing C, Go, JS, shell scripts, and so on.

I love dealing with a language that's explicit about what I mean. Consider how incredibly dangerous it is to write code that's not actually indented the way it's meant to be executed. Lots of eyes looked at that C code and didn't notice that the formatting was inconsistent with its parsing. That would not have been a problem in a language that uses indent to describe intent.

Comment Re:We don't need "backdoors" (Score 1) 259

Put simply, there exist plenty of systems and techniques that don't depend on a third-party who could possibly grant access to secure communications. These systems aren't going to disappear. Why would terrorists or other criminals use a system that could be monitored by authorities when secure alternatives exist? Why would ordinary people?

That's a really easy answer -- terrorists use these simple platforms for the same reason normal people do: because they're easy to use. Obviously a lot of our techniques and capabilities have been laid bare, but people use things like WhatsApp, iMessage, and Telegram because they're easy. It's the same reason that ordinary people -- and terrorists -- don't use Ello instead of Facebook, or ProtonMail instead of Gmail. And when people switch to more complicated, non-turnkey encryption solutions -- no matter how "simple" the more savvy may think them -- they make mistakes that can render their communications security measures vulnerable to defeat.

I'm not saying that the vendors and cloud providers ALWAYS can provide assistance; but sometimes they can, given a particular target (device, email address, etc.), and they can do so in a way that comports with the rule of law in free society, doesn't require creating backdoors in encryption, and doesn't require "weakening" their products. And of course, it would be good if we were able to leverage certain things against legitimate foreign intelligence targets without the entire world knowing exactly what we are doing, so our enemies know exactly how to avoid it. Secrecy is required for the successful conduct of intelligence operations, even in free societies.

Comment Re:Har har har? (Score 1) 231

You know, as much as I hear that whine, in 16 years of writing Python I've literally never once been bitten by it. Yes, you hate having to indent your code the way you would naturally have indented it anyway, left to your own devices. Sure, writing at-a-glance understandable clauses is torture. Oh yeah, I too hate formatting my stuff the way my coworkers / teachers / project maintainers / colleagues expect to find it. But as much as I love writing the horrible, unformatted mess that you also enjoy, I just can't make this hypothetical copy-and-paste problem manifest itself in reality. Curse you, Python!

And on the seventh day, He exited from append mode.