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Comment Unisys is the "something else" up Apple's sleeve (Score 5, Interesting) 304

Or do they have something else up their sleeve for next year?"

Yes, they have something else up their sleeve. Did anybody notice Apple's "enterprise services agreement" with Unisys? Did anybody notice the 54% drop in Unisys's profits, along with a drop in server sales? So, Unisys is an enterprise computing company looking for a way to save its server business. Apple is consumer electronics company with enterprise ambitions, enterprise software, but no enterprise distribution network. Apple just announced it is dropping its server hardware line, a little over a week after announcing the deal with Unisys. I know it is fashionable to dismiss Apple's enterprise computing ambitions. I was at an Apple Developer's seminar a couple years ago where they were showing off the new version (then) of MacOS X Server. The entire focus of that seminar was on how Apple was adding features to MacOS X Server (and even licensing things from Microsoft) to make OS X Server more suitable for the enterprise. I predict Unisys will start offering MacOS X Server on Unisys server hardware soon. Apple may even end up buying Unisys.

Comment ignorance is denial (Score 1) 670

The "correlation does not equal causation" argument works only with some degree of ignorance, whether intentional or not.

In the case of global warming, there is a clearly identified causative mechanism: the greenhouse gas effect. The GHG effect clearly explains how the addition of greenhouse gases to the atmosphere results in atmospheric warming. This cause-effect mechanism and it's role in climate change has been described in 1824 by Fourier, in 1859 by Tyndall, in 1896 by Arrhenius, in 1897 by Chamberlin, in 1938 by Callendar, in the 1960s by Keeling, and from the 1970's to present by modern climate scientists.

Some climate denialists who truly are uneducated in science can honestly claim ignorance, but then they shouldn't be doubting the conclusions of those who are not ignorant: the climate scientists. Most climate denialists are not truly uneducated in science. I consider these people on various levels from "intentional ignorance" to "malicious ignorance", to "ignorant with extreme prejudice".

The "whether not it is caused by humans... doesn't seem to matter." is a cop-out. It does matter. Human behavior (releasing massive, steady streams of naturally sequestered carbon) is the driving factor in climate change. We cannot effectively mitigate climate change without modifying this human behavior.

The "clean air, clean water, clean land", argument is a distraction from the role of GHGs. It's easy to design car engines that minimize smog-forming emissions like hydrocarbons and nitrous oxides. It's not so easy to design a combustion engine that reduces GHGs like carbon dioxide. In fact, there is a fundamental proportion of CO2 emitted to energy produced in a combustion engine that cannot be violated by the laws of physics and chemistry.

Historically, the group that has denied anthropogenic climate change is the same group that has opposed efforts for clean air, water, and land.

If we want to start making the world better for you and me, we have to stop being ignorant, acknowledge the role of human GHG emissions, and act to reduce those emissions. Ignorance (intentional or not) of the human role in climate change IS tantamount to being a climate change denier.

Comment Re:Process of getting a liver transplant (Score 1) 436

>> [Getting a liver transplant is not a long, involved, and lengthy process for Steve Jobs.] Because his net worth exceeds $100 million, he doesn't have to worry about what his insurance company will or will not pay. He simply writes a check.

Steve Job's wealth gives him two advantages: no time wasted securing financial means for a transplant, and freedom to choose where the transplant is done. Once he gets on the transplant waiting list, he has no advantages over anyone else listed in the same region.

Typical transplant patients might have to spend some time securing the 20% of the costs not covered by insurance, or negotiate with the medical facility to waive the 20%. However, some insurance plans do cover 100% (one of Kaiser's better plans, offered through large employers, covers 100%). Jobs obviously didn't have to worry about this. Even if he personally did not have the money, I'm sure Apple would have covered it.

Mere mortals with normal insurance plans are limited in where they can apply for their transplant. If you're in California or New York you can expect to wait months to years for a transplant. Some plans (including Kaiser) allow limited choices outside your local area, but don't necessarily promote this option. Jobs had the luxury of choosing exactly where he would apply for his transplant. His criteria were short wait time and good transplant team. Perhaps privacy might've been an issue, too.

Beyond these two advantages, Jobs transplant priority is dictated strictly by rules of the United Network for Organ Sharing (UNOS). For transplant candidates with cancer, UNOS has a priority score starting at 22 upon acceptance of transplant application, increasing in increments of 3, 2, and 2 points every 3 months. After 9 months, his score would be 29. In low-demand, high-supply areas like Florida, he would likely get his transplant within 3 months of being accepted. In California or New York, he would likely wait 6-9 months. With his listing in Tennessee, it is very possible for Jobs to get his transplant within 3 months.

Transplant priority is determined almost entirely by UNOS rules. There is very little local discretion. Any facility that tries to bend the rules to favor a wealthy candidate would lose their accreditation to do transplants and would stop receiving donor organs. This is a self-policing system, because other facilities in the same organ-sharing region would scrutinize any suspicious transplant ordering by a neighboring facility.

There is still the question of why he would be given a transplant if the cancer was spread from another organ. Most likely, he was monitored for at least a few months before being accepted on the transplant list. During this time, they might have cut out or otherwise treated the liver tumor. They would also be watching very carefully to see if cancer would show up elsewhere. He might have received chemotherapy to help prevent appearance of cancer elsewhere. As long as the cancer is limited to the liver (after successful treatment for pancreatic cancer), and is limited in size, UNOS would not rule out a transplant.

In summary, Jobs freedom to choose where he got his transplant probably helped him get his transplant 3-6 months earlier than a California resident who didn't have that option. Other than that, he was subject to the same UNOS prioritization as everyone else.

Comment Re:The Timing of Steve Jobsâ(TM)s Liver Trans (Score 1) 436

The 3-6 month recovery period applies to non-cancer liver transplant recipients in long-wait areas like California and New York. In these areas, the wait list is so long that you have to be extremely sick before getting a transplant. You're probably mentally incoherent because of encepalopathy and your digestive system is probably dysfunctional because you've been tube fed. You're probably hospitalized. When these patients finally get their transplants, it can take days to weeks for the transplanted liver to start functioning, and months to be in a physical state resembling normal.

This was NOT Steve Jobs case.

Jobs had liver cancer and probably caught it at the earliest possible opportunity, since he had reason to expect the possibility. He obviously did his research to figure out which area had the shortest wait time and good care (Tennessee). He probably got the transplant before his bodily functions started failing. Thus, he probably recovered from the transplant very quickly. It's very plausible that he got his transplant only two months ago.

For more details, see my comment elsewhere in this discussion.

Comment Process of getting a liver transplant (Score 5, Interesting) 436

Getting a liver transplant is a long, involved, and lengthy process.

First, you need to have good medical care and good insurance. If your doctor has been carefully monitoring your liver with CT scans every six months because he realizes you're at risk (perhaps because you have Hep B), you will have a good chance at early detection of liver cancer. If you have no such proactive care, good luck!

Next, your doctor has to present you the option, you have to recognize its urgency, and you have to ask for the transplant, aggressively. If your doctor says, "This is not yet urgent", or "We can wait and monitor this", or if you say, "Can we just wait and see?", it might be too late by the time you recognize the danger (much like climate change and peak oil). That's because...

It takes 6 months to process a liver transplant application, then months to years to actually receive the transplant.

The application process has two parts: medical evaluation and financial means. The medical evaluation is a comprehensive evaluation to determine that you're a good candidate for transplant, that the cancer has not spread beyond the liver, and that you're psychologically fit for the transplant. The financial means evaluation... well, if you don't have the financial means, you do NOT get listed on the transplant list. Period. The only way to get a liver transplant without financial means is if you're an emergency case with sudden liver failure. Oh, you also need to have a designated caregiver who commits to taking time off work to take care if you, if/when necessary.

Once the application process starts, it can take 5 months to actually get on the transplant list. If the winter holidays occur fall in this time period, make that 6 months. If they accidentally list you on the non-cancer waiting list (with lower priority than the cancer waiting list), it might be another month (total 7 months) by the time somebody catches this mistake and it gets corrected. Most likely it will be YOU who catches the mistake, because nobody else is paying attention. If YOU fail to catch this error, the patient may be on the wrong (lower priority) waiting list indefinitely.

Once you're listed, it could take weeks to years to get the transplant. For non-cancer patients, the priority is determined strictly by a function of three blood test results: bilirubin, creatinine, and INR. As these levels go up, you develop ascites (fluid in abdomen), encephalopathy (cloudy mind), and then it gets worse. The problem is, you typically lose weight as you get sicker, and as you lose weight, the creatinine level goes DOWN, so your priority gets lower, initially! If you're lucky enough to be in Oregon or Florida, with no motorcycle helmet laws, you might get your transplant in a few months. If you're in Southern California or New York, you might be waiting a year or longer, progress to extreme illness and hospitalization, and be on the verge of death before getting the transplant. These are the patients who take 6 months to recover from the transplant. Often it takes days to weeks for the transplanted liver to start functioning. These patient have been IV fed for so long that the digestive tract is initially dysfunctional. They have to start with limited plain-cracker diets. Because their gut microbes have been ravaged, their gastric emissions are horrendous foul smelling.

If you're a liver cancer patient (like Jobs) the good thing is, you'll probably get your transplant sooner than the non-cancer patients, because liver cancer transplant priority goes up strictly by time on waiting list. "Sooner" is relative to when you got listed. If you trusted your Kaiser doctor and didn't sense any urgency, you probably didn't apply for the transplant until it was almost too late (there are limits are tumor size for transplant). If you are well-informed and proactively asked for a transplant application, you might get your transplant before you start to feel any symptoms of a dysfunctional liver. This is probably what Jobs did. In this case, your recover can be rapid, and you could be back to work in a few weeks. The bad thing is, while you're waiting, the cancer is growing. If you're in a non-helmet law state like Oregon or Florida, you might get your transplant within three months (on top of the 5-7 month application period), which is not too bad if you caught (and acted on) the cancer diagnosis early. If you're in California or New York, be prepared to wait 6-9 months (on top of the 5-7 month application period) before transplant. During this time, you get re-evaluated every three months to see how much your cancer has grown (not if, but how much).

Throughout this time, your senses are at a high state of alert for that phone call from the transplant center saying it's time to come in for the transplant. If you and the two other designated family members miss the call, they will pass you up. If you don't have a damn good excuse for not accepting that call (like poor cell phone reception) you can be taken off the list.

At the same time, you know the cancer is growing (cancers don't voluntary ungrow). You may undergo a chemoembolization treatment periodically, every 2-6 months, to keep the growth of the cancer in check, but the effectiveness of this procedure decreases each time it's used. Again, it's best if you fought to get on the transplant list at the earliest possible opportunity.

If you have Medicare AND gap insurance (because 20% of a lot of money is, for most people, still a lot of money), and a place to stay, you can list your transplant application in Florida or Oregon (or Tennessee). If you have Kaiser, they will give you the option of listing in Florida, but they probably will not go out of their way to promote this option. Heck, you'd be lucky if they went out of their way to mention how urgent it is to get on the transplant list in the first place.

In summary, it can be pretty damn hard to get a liver transplant. If you did, that means you got very lucky and/or somebody or somebodies worked their asses off to master the intricacies of the process, the financial situation, etc. to get you that transplant.

Good luck!

Comment Re:SpaceX is a pretty serious outfit (Score 1) 244

They've done some absolutely amazing things in the last couple of years on a budget that makes all the governments combined look pretty silly.

Sure. It's amazing that such a well-funded "private" company can have a 100% failure rate in a 40 year old industry, using off-the-shelf technology and public funding.

We should keep in mind that there's nothing particularly new or exotic about SpaceX's rocket. Their failures have been caused by poor design of basic parts and lack of basic testing and rigorous analysis. This can't be compared to early NASA launch failures, when the science of rocketry had not been as firmly established as they are today.

Seriously folks, this may be rocket science, but it's rocket science that has been firmly established by the time time most of us were born.

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