The University College London Hospital (UCLH) in Bloomsbury London is launching a pilot program replacing some A&E (Emergency Room) physicians with robots.
In response to staff shortages and long wait times, the initiative launched by UCLH and Alan Turing will utilize artificial intelligence to triage patients and reduce wait times.
Robotic technology is already being used in the operating room, rehabilitation centers and for pharmaceutical dispensing. It’s just a matter of time that they become our main caregiver.
But will patients be pleased?
Where’s there’s demand, there’s supply. Patients tired of wait times, crowded waiting rooms, loss of sick leave hours to sit around a medical office or emergency room for half a day will want speed and efficiency. Kiosks may replace front desk clerks, taking your initial information (chief complaint, name, insurance info.), scanning it and offering you a number, like one given at a bakery.
Those embarrassed by having symptoms suggestive of having an STD will have less of an issue conveying this information to a machine than a human being. Gas, discharge, odors may be easier to discuss with someone or something that won’t wince.
Many patients cite seeing a medical provider and not being examined or asked to undress before an exam. Time constraints, or avoidance of being accused of wrongdoing, have caused some providers to refer out for heart, gynecological, and rectal examinations. Primary care providers who enter the room, say a few words and then promptly leave saying they will “bring in the nurse to review instructions” may not be missed by the patient receiving similar service from a robot.
We use Google, Wikipedia and Siri to answer our health questions currently. No wait time, no office visit, no cost….so a robot answering our questions in layman’s terms will be an easy task.
However, and this is the kicker……
There is no way to replicate the sixth sense humans have when it comes to something being wrong with you. Artificial intelligence cannot provide a “gut feeling.”
Let’s take a urinary tract infection, for example. I have had patients who were new to my office complaining something “felt funny” when they urinated and cited blood in their urine. A urinalysis may show inflammatory cells, and a robot may correctly diagnose the patient with a bladder infection. But I as a clinician may be suspicious that this new patient has something that is leaking blood into the urine, from the gynecologic tract maybe? And I’ve diagnosed endometrial and cervical cancer in cases where patients thought they were merely having bladder infections.
One patient presented to me in the emergency room feeling “odd” and suspecting a “UTI.” She was in her 60’s and started to complain of nausea. Her urine had inflammatory cells so while a culture takes 3 days to complete, I gave her a prescription for antibiotics in case the infection would spread during that time. But her nausea was concerning. The patient requested an injection of nausea medication prior to leaving so I obliged, giving her Compazine. While observing her for a few minutes, post injection, she began to have shortness of breath. We decided to look at her heart and came to the conclusion after more testing that she had suffered a heart attack in her sleep the night before and the “odd feeling” she felt the next day wasn’t due to her UTI (which she coincidentally had) but was from a heart attack. She was treated immediately and recovered nicely.
Would a robot have picked up on that? Multiple web resources include nausea in the list of symptoms associated with a UTI, so could be “blown off” by a robot bundling it with the patient’s urinary complaints. But I learned that nausea could be the first sign of a heart attack, especially in women.
Another case I had as an urgent care physician was the following:
A gentlemen came in saying he “felt fine” but his wife made him come in because he was burping the night before. Multiple bouts of eructation jogged an ancient memory of mine…..when as a little girl I saw a movie where the pilot was burping multiple times before he passed out and died. So I came to learn that chronic bouts of burps, or hiccups for that matter, could be a sign of an inferior MI (heart attack). I ran an EKG and blood work, and my instinct was right. Again I was looking at a patient who unknowingly had a heart attack the night before but thought he had something benign the next day.
So gut instinct, thinking laterally, tapping in on past experience, and acting on hunches is not something a robot can do. Humans may be satisfied with shorter wait times and receiving antibiotics when they demand them, but the education and intervention a medical provider can provide is priceless. Too bad cost gets in the way of real medicine.
Billy Cannon died this week. He was a Louisiana sports legend. There are some things you just don’t forget. Where you were on 9/11, or when President John Kennedy was shot. Down here in the Bayou State, add to those special dates Halloween night 59 years ago when Billy Cannon made football history with his 87 yard run to beat Ole Miss and keep the Tigers undefeated. His story is the rise and fall, then the rise again by LSU’s all-time great sports hero.
Even those who are not Tiger fans have to admit it was one heck of a run. Cannon either sidestepped or pushed away tackler after tackler as he weaved his way towards the end zone. I wish I had a dollar for every time the magical run has been replayed on television. You can imagine the crowd’s reaction on most Saturday football nights in Tiger Stadium as once again the fans in the stadium, and the millions on national television, see Ole’ Billy tear through the Rebel opposition.
This feat by Cannon allowed the Tigers to beat Ole’ Miss 7 to 3, and made him a celebrity for life. Paul Revere had his famous ride and Billy Cannon had his remarkable run.
Cannon went on to play professional football with the Houston Oilers and the Oakland Raiders. Then he went to dental school and built a successful dental practice in Baton Rouge. Because of his popularity, Cannon’s practice flourished to an estimated $300,000 a year – quite a sum in the 1960s! But then his celebrity world came crashing down, and I played a small role in his demise.
It was 1983, and I was in my first term as Louisiana Secretary of State. I was at my office one afternoon when my secretary said there were two Treasury agents to see me, and they demanded immediate attention. They pulled out a hundred dollar bill saying it was a fake, and that it had shown up in the Secretary of State’s bank account.
I had my staff go over all the various billing and deposit records, and we were able to determine that a local attorney used the hundred-dollar bill to pay for a corporate filing. We later learned that in was the first Cannon-made counterfeit bill to be discovered in the Baton Rouge area. Others quickly appeared, and a major money printing operation was broken open a few months later. The seventh-largest counterfeiting ring in American history was no more.
For years thereafter when I made speeches around the state, I relished in telling those in attendance how I knew the bill was counterfeit. “You know down at the bottom of the 100 dollar bill where it says ‘In God We Trust?’ Well on the Cannon 100 dollar bill, it said ‘Go to Hell Ole Miss.’”
Cannon quickly confessed and helped prosecutors crack the case wide-open. At the sentencing, Cannon told federal Judge Frank J. Polozola: “… what I did was wrong, terribly wrong. I have done everything within my power to correct my mistakes.”
To thousands of LSU fans, Cannon’s confession pierced the very heart of their allegiance and adulation of LSU’s greatest sports hero. Like the little boy who pleaded with Shoeless Joe Jackson of the Chicago White Sox on the courthouse steps in the famous “Black Sox” baseball scandal of 1919, all many LSU fans could think of was, “Say it ain’t so, Billy.”
As part of Cannon’s redemption, he took on the job of dentist up at Angola State Penitentiary, an hour’s drive north of Baton Rouge. The guards and inmates, alike, love him up there. Do fans still hold a grudging disappointment with Cannon? Well, when he was introduced a few years ago at Tiger Stadium just after being admitted to the College Football Hall of Fame, the cheering went on and on. Repeated efforts by the stadium announcer to quiet the fans down fell on deaf ears. Neither the President nor the Pope would have gotten such an avid ovation. Billy was back, and all had been forgiven.
Billy Cannon, like few others, has experienced the dramatic highs and lows of being a major sports hero in Louisiana. F. Scott Fitzgerald wrote that in life, there are no second acts. And Thomas Wolfe wrote that you can’t go home again. Billy Cannon proved them both wrong. And now, he will go home to meet his maker.
“People associate me with football regardless of where I go…except when their tooth hurts. They don’t care whether I played football or not. They just want the toothache to stop.”
Peace and Justice
In yesterday’s column, I expressed my deep concerns about elements of Consumer Reports’ testing process. It was based on an article from AppleInsider. I eagerly awaited part two, hoping that there would be at least some commentary about the clear shortcomings in the way the magazine evaluates tech gear.
I also mentioned two apparent editorial glitches I noticed, in which product descriptions and recommendations contained incorrect information. These mistakes were obvious with just casual reading, not careful review. Clearly CR needs to beef up its editorial review process. A publication with its pretensions needs to demonstrate a higher level of accuracy.
Unfortunately, AppleInsider clearly didn’t catch the poor methodology used to evaluate speaker systems. As you recall, they use a small room, and crowd the tested units together without consideration of placement, or the impact of vibrations and reflections. The speakers should be separated, perhaps by a few feet, and the tests should be blind, so that the listeners aren’t prejudiced by the look or expectations for a particular model.
CR’s editors claim not to be influenced by appearance, but they are not immune to the effects of human psychology, and the factors that might cause them to give one product a better review than another. Consider, for example, the second part of a blind test, which is level matching. All things being equal, a system a tiny bit louder (a fraction of a dB) might seem to sound better.
I don’t need to explain why.
Also, I was shocked that CR’s speaker test panel usually consists of just two people with some sort of unspecified training so they “know” what loudspeakers should sound like. A third person is only brought in if there’s a tie. Indeed calling this a test panel, rather than a couple of testers or a test duo or trio, is downright misleading.
Besides, such a small sampling doesn’t consider the subjective nature of evaluating loudspeakers. People hear things differently, people have different expectations and preferences. All things being equal, even with blind tests and level matching, a sampling of two or three is still not large enough to get a consensus. A large enough listening panel, with enough participants to reveal a trend, might, but the lack of scientific controls from a magazine that touts accuracy and reliability is very troubling.
I realize AppleInsider’s reporters, though clearly concerned about the notebook tests, were probably untutored about the way the loudspeakers were evaluated, and the serious flaws that make the results essentially useless.
Sure, it’s very possible that the smart speakers from Google and Sonos are, in the end, superior to the HomePod. Maybe a proper test with a large enough listener panel and proper setup would reveal such a result. So far as I’m concerned, however, CR’s test process is essentially useless on any system other than those with extreme audio defects, such as excessive bass or treble
I also wonder just how large and well equipped the other testing departments are. Remember that magazine editorial departments are usually quite small. The consumer publications I wrote for had a handful of people on staff, and mostly relied on freelancers. Having a full-time staff is expensive. Remember that CR carries no ads. Income is mostly from magazine sales, plus the sale of extra publications and services, such as a car pricing service, and reader donations. In addition, CR requires a multimillion dollar budget to buy thousands of products at retail every year.
Sure, cars will be sold off after use, but even then there is a huge loss due to depreciation. Do they sell their used tech gear and appliances via eBay? Or donate to Goodwill?
Past the pathetic loudspeaker test process, we have their lame notebook battery tests. The excuse for why they turn off browser caching doesn’t wash. To provide an accurate picture of what sort of battery life consumers should expect under normal use, they should perform tests that don’t require activating obscure menus and/or features that only web developers might use.
After all, people who buy personal computers will very likely wonder why they aren’t getting the battery life CR achieved. They can’t! At the end of the day, Apple’s tests of MacBook and MacBook Pro battery life, as explained in the fine print at its site, are more representative of what you might achieve. No, not for everyone, but certainly if you follow the steps listed, which do represent reasonable, if not complete, use cases.
It’s unfortunate that CR has no competition. It’s the only consumer testing magazine in the U.S. that carries no ads, is run by a non-profit corporation, and buys all of the products it tests anonymously via regular retail channels. Its setup conveys the veneer of being incorruptible, and thus more accurate than the tests from other publications.
It does seem, from the AppleInsider story, that the magazine is sincere about its work, though perhaps somewhat full of itself. If it is truly honest about perfecting its testing processes, however, perhaps it should reach out to professionals in the industries that it covers and refine its methodology. How CR evaluates notebooks and speaker systems raises plenty of cause for concern.
"And thine eye shall not pity; but life shall go for life, eye for eye, tooth for tooth, hand for hand, foot for foot.” –Deuteronomy 19:21
First off, the very reason Americans are an armed people is the very reasons the Communists conjure up propaganda in an attempt to disarm the American people, which is not negotiable (Article II of the Bill of Rights).
School shootings happen in “Gun Free” zones.
Furthermore, the criminality, irrationality and unreasonableness of these Communists within are not the reasons they are naming as to why they want Americans disarmed, and you know it. It is about them having absolute control!
They are magnifying the crimes against the law rather than magnifying the law against the crime (Isaiah 51:4). For if they were to magnify the law against the crime, we would not have these reoccurring school shootings or, for that matter, crimes, in general, would be minimized for they would fear the consequences (Isaiah 26:9; Deuteronomy 19:21).
Sante Fe Texas High School shooter Dimitrios Pagourtzis knew all the well that there was going to be no consequence for killing 10 innocent people in that high school when he shot and killed them.
He knew that the reprobates (Romans 1:28) in government would want to rehabilitate him, to financially feed their created bureaucracies ($64 billion a year correctional institutions), after his crimes committed against the innocent (and on taxpayers' monies) they will school him, feed him three square meals a day; and, at length, they will put him back into the populace to do it all over again.
Soft judges produce hardened criminals.
A society that shows more mercy to that of the criminal then that of the victim is in fact breeding criminals (Isaiah 59:14).
They are only being encouraged to commit the crimes through indoctrination and propaganda as an excuse to disarm the population after the crimes are committed.
Hollywood, television, radio, video-games you name it, all on standby to feed, and to assure the very results of the seeds that have been sown into the hearts of these young people (Galatians 6:7).
“Where there is darkness crimes will be committed. The guilty one is not merely he who commits the crimes but he who caused the darkness.”
You see, we can teach what we know, but we can only reproduce what we are. What we have taught the youth is really what the last four generations have acted out in their lifestyles. Sadly, the youth are emulating the older generation’s example in advocating crime.
Jesus said, “…wisdom is justified of all her children” (7:35). This is a truth no man can deny.
What is deterring the next kid from shooting up his school? I am about to tell you (Proverbs 16:6).
Can you imagine the people in this country agreeing to the Word of God and its judgments once again (Our Constitutional and enumerated Laws; Deuteronomy 4:6) would simply deter crimes and establish righteousness within our gates (Amos 5:15).
Simply televise it nationally and make a public example of the next criminal that wants to shoot up his or her school with “And thine eye shall not pity; but life shall go for life, eye for eye, tooth for tooth, hand for hand, foot for foot.” –Deuteronomy 19:21
Here is history lesson 101: America’s founding forefathers sent the message loud and clear that crimes (1 John 3:4) will not be tolerated, and justice deters crime.
AppleInsider got the motherlode. After several years of back and forth debates about its testing procedures, Consumer Reports magazine invited the online publication to tour their facilities in New York. On the surface, you’d think the editorial stuff would be putting on their best face to get favorable coverage.
And maybe they will. AppleInsider has only published the first part of the story, and there are apt to be far more revelations about CR’s test facilities and the potential shortcomings in the next part.
Now we all know about the concerns: CR finds problems, or potential problems, with Apple gear. Sometimes the story never changes, sometimes it does. But the entire test process may be a matter of concern.
Let’s take the recent review that pits Apple’s HomePod against a high-end Google Home Max, which sells for $400 and the Sonos One. In this comparison, “Overall the sound of the HomePod was a bit muddy compared with what the Sonos One and Google Home Max delivered.”
All right, CR is entitled to its preferences and its test procedures, but let's take a brief look at what AppleInsider reveals about them.
So we all know CR claims to have a test panel that listens to speakers set up in a special room that, from the front at least, comes across as a crowded audio dealer with loads of gear stacked up one against another. Is that the ideal setup for a speaker system that’s designed to adapt itself to a listening room?
Well, it appears that the vaunted CR tests are little better than what an ordinary subjective high-end audio magazine does, despite the pretensions. The listening room, for example, is small with a couch, and no indication of any special setup in terms of carpeting or wall treatment. Or is it meant to represent a typical listening room? Unfortunately, the article isn’t specific enough about such matters.
What is clear is that the speakers, the ones being tested and those used for reference, are placed in the open adjacent to one another. There’s no attempt to isolate the speakers to prevent unwanted reflections or vibrations.
Worse, no attempt is made to perform a blind test, so that a speaker’s brand name, appearance or other factors doesn’t influence a listener’s subjective opinion. For example, a large speaker may seem to sound better than a small one, but not necessarily because of its sonic character. The possibility of prejudice, even unconscious, against one speaker or another, is not considered.
But what about the listening panel? Are there dozens of people taking turns to give the speakers thorough tests? Not quite. The setup involves a chief speaker tester, one Elias Arias, and one other tester. In other words, the panel consists of just two people, a testing duo, supposedly specially trained as skilled listeners in an unspecified manner, with a third brought in in the event of a tie. But no amount of training can compensate for the lack of blind testing.
Wouldn’t it be illuminating if the winning speaker still won if you couldn’t identify it? More likely, the results might be very different. But CR often appears to live in a bubble.
Speakers are measured in a soundproof room (anechoic chamber). The results reveal a speaker’s raw potential, but it doesn’t provide data as to how it behaves in a normal listening room, where reflections will impact the sound that you hear. Experienced audio testers may also perform the same measurements in the actual listening location, so you can see how a real world set of numbers compares to what the listener actually hears.
That comparison with the ones from the anechoic chamber might also provide an indication how the listening area impacts those measurements.
Now none of this means that the HomePod would have seemed less “muddy” if the tests were done blind, or if the systems were isolated from one another to avoid sympathetic vibrations and other side effects. It might have sounded worse, the same, or the results might have been reversed. I also wonder if CR ever bothered to consult with actual loudspeaker designers, such as my old friend Bob Carver, to determine the most accurate testing methods.
It sure seems that CR comes up with peculiar ways to evaluate products. Consider tests of notebook computers, where they run web sites from a server in the default browser with cache off to test battery life. How does that approach possibly represent how people will use these notebooks in the real world?
At least CR claims to stay in touch with manufacturers during the test process, so they can be consulted in the event of a problem. That approach succeeded when a preliminary review of the 2016 MacBook Pro revealed inconsistent battery results. It was strictly the result of that outrageous test process.
So turning off caching in Safari’s usually hidden Develop menu revealed a subtle bug that Apple fixed with a software update. Suddenly a bad review become a very positive review.
Now I am not going to turn this article into a blanket condemnation of Consumer Reports. I hope there will be more details about testing schemes in the next part, so the flaws — and the potential benefits — will be revealed.
In passing, I do hope CR’s lapses are mostly in the tech arena. But I also know that their review of my low-end VW claimed the front bucket seats had poor side bolstering. That turned out to be totally untrue.
CR’s review of the VIZIO M55-E0 “home theater display” mislabeled the names of the setup menu’s features in its recommendations for optimal picture settings. It also claimed that no printed manual was supplied with the set; this is half true. You do receive two Quick Start Guides in multiple languages. In its favor, most of the picture settings actually deliver decent results.
The National Weather Service will soon issue an “excessive heat warning” for many parts of the Southwest United States. Phoenix received their first warning two weeks ago when their temperatures rose to 108 degrees.
This occurs “within 12 hours of the onset of extremely dangerous heat conditions”. This means that the heat index (air temperature and humidity) will be greater than 105 degrees for more than three hours a day for at least two days in a row and the night-time temperatures will not drop below 75 degrees. Although many of us may live in areas where this occurs each year, the onset can be one of the most dangerous times. Symptoms such as heat cramps, heat exhaustion and heat stroke must be identified.
At first when one feels symptoms, it may come in the form of heat cramps. Heat cramps are painful spasms that occur in the muscles of the arms and legs and even abdomen. We believe that when one loses fluids and salts from excessive sweating, cramps ensue. It's important in these cases to get the person out of the heat, hydrate them with sips of fluid and electrolytes and massage the body parts affected.
If one does not leave the heat and come indoors, the next risky event that can occur is heat exhaustion. This worsens as the victim sweats profusely becoming more and more dehydrated. They could also have cramps but nausea may ensue, they may look pale and clammy and their heart rate will increase to try to compensate for the lost fluid. These individuals may become dizzy, weak and even faint. Immediately bring the person indoors, lie them down, elevate the feet, give sips of fluid, cool down the body applying cool and wet cloths to the underarms and body, and contact medical authorities if symptoms continue or worsen.
Heat stroke will occur if a vulnerable person does not get out of the heat in time. It is a medical emergency and can be fatal. If an individual has heat stroke 9-1-1 must be called immediately. Bring the victim indoors away from sunlight, lie them down, remove unnecessary clothing, cool their body with cold compresses and watch for signs of rapidly progressive heat stroke in which they have difficulty breathing, seize or lose consciousness. If they are unconscious you cannot give them fluids. Only if they are alert, awake and able to swallow will you be able to give fluids. Do not give medications to reduce the fever such as aspirin or acetaminophen since their body may not be able to metabolize them properly and this could make matters worse.
Young children and elderly individuals may have issues adjusting to the outside environment and may be more prone to dehydration. Those with medical conditions such as heart, lung, thyroid disease can be at risk as well. If you’ve ever suffered from heat stroke you can be vulnerable again. And many medications could make you susceptible such as diuretics, vasodilators and beta-blockers for blood pressure and antidepressants.
The biggest risk comes when we are unprepared. Having an unusual cool week prior to a heat warning could preclude many from taking proper precautions. Staying indoors, checking air conditioning and fan devices to make sure they work properly, wearing cooler clothing is just the beginning. Stocking up and planning to hydrate frequently is paramount because when death occurs to excessive heat, dehydration is the main culprit.
Bring your pets indoors, and watch your kids, friends and family members frequently. If they are beginning to succumb to the heat, they may be quiet and not be able to voice it.
Avoid drinking alcohol in the heat. It can dehydrate you more and worsen the situation.
Avoid excessive exercise when outdoors and make sure to make use of shady areas.
The summer and early fall offer exciting and fun ways to enjoy nature. Don’t let the heat get to you. Remember….if you can’t take the heat, get out of the…..well heat…….
Twenty five people have died, and 45 others are suspected to be infected with Ebola in the Democratic Republic of Congo (DRC). The World Health Organization (WHO) has confirmed and reported the outbreak of Ebola on May 8.
This latest outbreak began in villages near Bikoro. New cases later surfaced miles away in Mbandaka, an urban city with a reported population of 1.2 million, located along the banks of the Congo River.
Vaccination has begun with ZMapp, a treatment used in the 2014 outbreak that shows promise as a prophylactic measure.
Dr. Karen Duus, Associate Professor of Microbiology and Immunology at Touro University Nevada, explains, “The vaccine is a recombinant Ebola virus protein vaccine that causes a similar type of neutralizing antibody response (as the ZMapp treatment). The neutralizing antibodies coat the virus particle and keep it from binding to the target cells and infecting them.” Its efficacy, however has not been extensively tested.
The DRC had a small outbreak last year but it was contained within 42 days.
The West African Ebola epidemic spanned from the end of December 2013 to 2016 infecting over 28,000 people and killing over 11,300. The epidemic was one of the worst in Ebola’s history and its high mortality rate took countries such as Sierra Leone, Guinea, and Liberia by surprise. A vaccine was not available, and medications such as ZMapp were experimental and not in great supply. Hospitals were not stocked with protective clothing able to prevent the minutest of exposure to the deadly virus. Travel bans were difficult to institute and top that off with a lack of education on what we were dealing with and it was unfortunately the perfect storm for one of the deadliest outbreaks in recent history.
Ebola however emerged far before this. Ebola was named after the Ebola River in Zaire and was first recognized in 1976 when it caused two outbreaks affecting 318 and 284 people respectively. Multiple small outbreaks have occurred since then, according to the CDC:
1995 – Democratic Republic of Congo – infected 315
2000 – Uganda – infected 425
2007 – Democratic Republic of Congo – infected 264
And multiple smaller sporadic cases occurred in the years between.
In January 2016 health officials declared the Ebola outbreak had ended, however cases continued to smolder.
Why this occurs is the virus may not leave the body completely. Its been found to live in semen up to a year and some survivors can suffer a reinfection months later. For example, in 2015 Dr. Ian Crozier successfully fought Ebola but two months after discharge, suffered a severe eye infection which turned out to be Ebola lurking in his eye.
A study in 2015 found Ebola be able to survive outside a human body for days and longer if within a liquid such as water or blood. Mosquitoes are not known to transmit the virus however it can live in bats as well as monkeys and apes. Pets have not been known to contract Ebola from their sick owners but its been postulated that pigs could, if in contact with a victim.
Dr. Duus states that although the virus reservoirs are not clear, “people are most likely infected by butchering or eating infected animals.”
Ebola is a virus from the Flavivirus family that causes a hemorrhagic fever with symptoms of sudden fever, myalgias, headache and sore throat. It could then progress to nausea and vomiting, liver and kidney issues and internal and external bleeding, ultimately resulting in death in 90% of cases.
Thursday morning Hawaii’s Kilauea shot ash and smoke into the air and blew a volcanic cloud that could reach 30,000 feet into the sky. The volcano has been spewing lava for weeks, prompting thousands of nearby residents to evacuate. Volcanic ash can prompt a multitude of health risks…not only from a particulate standpoint but also from the sulfur dioxide levels. Sulfur dioxide is a colorless, though stinky gas that can cause irritation to skin, eyes, and respiratory system linings.
Let’s break these health risks down:
Volcanic ash can irritate the respiratory passages causing the following symptoms:
Those with asthma, COPD, chronic bronchitis or other respiratory ailments may find themselves having exacerbations of their symptoms. Oxygen requirements will increase. Those requiring oxygen or inhalers will need to have extra supply during this time (medical offices may be closed during ash clean up so don’t wait until the last minute.)
Volcanic ash has large and small particles that can irritate the eyes increasing their sensitivity to light and making vision difficult. Moreover ash can irritate the cornea and conjunctiva causing redness, discharge and itching.
Skin may become irritated during these times and those with skin allergies or eczema may find themselves having flare-ups.
During a volcanic eruption, smoke plumes not only change the air quality but also visibility. During times of day when there is less light, road visibility obscures pedestrians and nearby cars. Drivers are urged to avoid the road during these smoky times.
Water quality can become affected by the ash or pH changes if supply becomes contaminated. Moreover, water use increases for cleanup so shortages may ensue.
Those who donate blood in nearby areas may be less likely to donate during this difficult time leading to local blood shortages. Those who can donate blood are urged to contact the American Red Cross, United Blood Services, or Blood Bank of Hawaii.
Does anyone recall ever benefiting because one company merged with another? It’s not necessarily similar to Apple’s purchase of Beats and selling expensive headphones, because that deal was more about acquiring technology, which is something that’s been done for years.
So consider the act that saved Apple, acquiring NeXT in 1996, which brought a state-of-the-art Unix-based OS that, over the years, morphed into macOS and iOS. That move came in the wake of the failure of Copland, Apple’s own effort to build a successor to Mac OS. It took a while to jell, but here in 2018, we are still benefiting from the fruits of that transaction.
It also brought Steve Jobs back to Apple, and the rest is history.
From Apple A-series processors, to Touch ID, Face ID and — yes — even Siri, Apple’s ongoing acquisitions of technology companies have delivered compelling features that have advanced the company, and enhanced the user experiences of hundreds of millions of customers.
But when two companies consummate a normal merger, there are almost always promises of realizing synergies, and somehow benefiting customers. In the end, the stockholders and the executives become richer, but people lose their jobs because they are deemed redundant. With fewer competitors, prices just may increase.
When buying a company with different products and services, it may be easier to get approval from the powers-that-be in the U.S. government. Even then, there may be restrictions to reduce corporate excesses of one sort or another. When Comcast, the number one cable and broadband company in the U.S., completed its acquisition of NBC/Universal in 2011, the deal came with restrictions to ensure fair treatment to competing companies.
So Comcast needed to be fair with in negotiating carrier deals to carry NBC content, which includes such cable networks as Bravo, CNBC, MSNBC, SyFy and USA.
Over the years, I’ve heard all sorts of tech support horror stories from Comcast cable customers. There’s no indication things became any better after the merger. Of course, the entertainment division isn’t involved in direct interactions with individual consumers.
When AT&T bought DirecTV, the world’s largest satellite TV network, in 2015, the support systems were combined. Not only were jobs lost, but service got a whole lot worse. These days, when I dial up AT&T for satellite or wireless support, I have to navigate through a mostly deaf voice assistant, and I’m often forced to talk to several people just to resolve a simple issue. How does that save money?
I remain a customer for two reasons. First no other TV service is available at this apartment, which is wired for CenturyLink, and includes a single DirecTV satellite dish feeding all the units in each building. Reception via an interior digital antenna is hit or miss. Second, although it was hard to find, I receive an AARP discount for AT&T wireless, and that discount is enough to match T-Mobile’s “Uncarrier” price.
Speaking of which, AT&T attempted to merge with T-Mobile in 2011, but the government said no. Forced to compete on its own terms, T-Mobile began its “Uncarrier” promotion, which did away with standard two-year contracts, and overhauled the industry.
As a result, your wireless bill is no doubt cheaper regardless of the carrier. T-Mobile is growing rapidly; the move spurred Sprint to slash its prices, so both became more compelling alternatives to market leaders Verizon and AT&T.
Now T-Mobile and Sprint are trying to become one. But T-Mobile’s flashy CEO, John Legere, insisted that there will still be more competition in the market than most believe: “This isn’t a case of going from four to three wireless companies—there are now at least seven or eight big competitors in this converging market.”
Or maybe not.
True, cable providers are entering or planning to enter the cell phone market, but it’s not at all likely that they’ll suddenly became major competition for the big four — make that big three if this merger is consummated.
At the same time, it is true that T-Mobile and Sprint together will provide healthier competition to the Verizon and AT&T. As it stands, T-Mobile has good cellular coverage in larger cities but relatively poor coverage in rural areas. A larger footprint will also provide more network resources and revenue to speed deployment of 5G networks.
In theory, that should be a good thing.
Then again, as Sprint learned when it bought Nextel in 2005, combining two incompatible networks is no easy task. Basically Nextel was shunted to the side in the wreckage of that deal.
So T-Mobile uses GSM, same as AT&T. Sprint uses CDMA, same as Verizon. Sprint claims some 20 million customers have handsets that are compatible with T-Mobile, which will be the winning company. After a migration period to the combined service, which will take from two to three years, it’ll still leave millions of users with incompatible handsets, unless the equipment supports LTE and is deployed in an area where there’s an acceptable LTE signal. I just hope there will be special discounts for people with bricked phones to upgrade.
While Legere also claimed that more employees will be needed with the combined company, that may be a tricky response. Perhaps there will be, workers to perform the hardware migration and upgrades. But what about sales and support people? How many of them will be getting pink slips? Doesn’t it make sense that there will be thousands of redundant positions, or does T-Mobile expect many of these employees will be willing to transfer to the hardware division?
Will prices really go down?
Of course, this deal hasn’t been Okayed by the authorities, and there may be restrictions to protect customers with potentially obsolete gear among other things. It would be nice to see guarantees that prices won’t increase, but such restrictions are usually temporary. What will the market be like in five years?
I am, however, pleased that the new company will be in T-Mobile’s image and not Sprint’s. I tried Sprint in the early 2000s, before switching to AT&T. As bad as the latter’s support is now, Sprint was far, far worse.
May is Skin Cancer Awareness Month as 5 million cases of skin cancer are diagnosed each year in the United States. This week, Consumer Reports released its 2018 Annual Sunscreen Guide on the best sunscreens to offer protection against UV (ultraviolet) rays. They looked at 73 various sunscreen lotions, sprays and sticks, which touted 80 minutes water resistance and an SPF of 30.
The top 5 sunscreens reported are:
La Roche-Posay Anthelios 60 Melt-In Sunscreen Milk, $36 (lotion)
Equate (Walmart) Sport Lotion SPF 50, $5.00 (lotion)
BullFrog Land Sport Quik Gel SPF 50, $8.50 (lotion)
Coppertone WaterBabies SPF 50 Lotion, $9 (lotion)
Trader Joe’s SPF 50+, $6 (spray)
Sunscreens use chemicals to disperse or absorb UV rays. Inorganic compounds in sunscreen such a titanium dioxide or zinc oxide attempt to scatter the UV rays. Organic compounds such as PABA and oxybenzone attempt to absorb UV rays so they can’t damage the skin.
UVA rays penetrate deeply into both the epidermis and dermis. They can cause premature aging of the skin, wrinkles, and skin cancer.
UVB rays are shorter and primarily affect the epidermis. They are responsible for causing sunburns as well as skin cancer.
SPF stands for Sun Protection Factor. The higher the SPF, the less sun photons enter the skin and cause damage. SPF primarily measures the protection against UVB rays. We multiply the SPF factor by how long it takes one’s skin to burn by the SPF number to determine the protection factor.
In theory, an SPF of 30 suggests your skin, if it burns within 10 minutes without protection, will not burn until 300 minutes has lapsed (30 times 10). However, we find this isn’t always the case. People sweat or swim and the sunscreen dissipates. Moreover many don’t put on the proper amounts (see below.)
So instead we use SPF as a grade to how much protection the product can offer.
An SPF of 15 blocks 93% of UVB rays
An SPF of 30 blocks 97% of UVB rays
An SPF of 50 blocks 98% of UVB rays
As we see, the relationship is not linear, however the higher the SPF, the more protection we have against UV rays.
Although the SPF alludes to protection against burning, hence UVB rays, a sunscreen may still protect against both UVA rays and UVB rays if it’s a broad spectrum sunscreen.