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Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

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H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, July 24, 2024

Being All Things To All Men Is Hard – Even For Google. I Wonder What The Next Quantum Leap Will Be?

This appeared last week:

Google

‘Google says I’m a dead physicist’: is the world’s biggest search engine broken?

For decades now, anyone who’s wanted to know everything about anything has asked Google. But is the platform losing its edge – and can we still trust it to tell us the truth?

Tom Faber

Sat 20 Jul 2024 21.00 AEST Last modified on Sun 21 Jul 2024 02.40 AEST

I didn’t know I was dead until I saw it on Google. When I searched my name, there it was: a picture of my smiling face next to the text “Tom Faber was a physicist and publisher, and he was a university lecturer at Cambridge for 35 years”. Apparently I died on 27 July 2004, aged 77. This was news to me.

The problem was the picture. When you search the name of a notable person, Google may create what it calls a “knowledge panel”, a little box with basic information taken from Wikipedia. Somewhere along the way, the algorithm had confused pictures of my face with the biography of another man who shared my name. According to his obituary, he was “a distinguished physicist with a literary hinterland”. Google provides a feedback form to resolve this type of bug. I filled it in several times, but it made no difference.

I’m not the only one who has been struggling with Google recently. Many users are saying its principal product, its search engine, isn’t working as well as it should. They claim the ingenious vehicle that has enabled us to navigate the internet’s infinite scroll of information is beginning to rust and decay. That’s not to mention the company’s endless court battles with rival companies and world governments, or the rise of ChatGPT, which many tout as a search engine killer; even Bill Gates said last year that once a company perfects the AI assistant or “personal agent”, “you will never go to a search site again”.

Yet it’s hard to imagine anything taking Google’s place. Last year it turned 25, and Alphabet, its parent company, currently ranks as the fourth most valuable in the world, worth more than $2tn (£1.5tn). Google has a whopping 90% share of the global search market. More than a tool, it’s practically infrastructure; the connective tissue that is fundamental to how we find information online. This gives the company enormous power over politics, social attitudes and the fortunes of countless businesses – anyone and anything, in fact, that relies on the eyeballs of the internet to operate. Some say Google is too big to fail.

It doesn’t take a distinguished physicist with a literary hinterland to see that right now Google search looks both deeply vulnerable and totally unstoppable. How can we be sure the company really has our interests at heart? And can we still trust it to tell us the truth?


The story of Google reads like the stereotypical tech company origin myth. A couple of computer geeks, Sergey Brin and Larry Page, started a business in a garage in the late 90s and built it into one of the world’s richest companies.

At the time the web was growing fast and a few early search engines were trying to organise the chaos. Page and Brin’s bright idea was to sort webpages not just by their relevance to a search query, but also by the quality of their information. This system, PageRank, prioritised webpages based on how many other pages linked to them. The underlying concept, borrowed from academia, was that if many people linked to a specific source, then it must have high-quality information.

It worked. Coupled with Google’s clean, simple interface of a text box and a handful of blue links, the site felt like magic. “Everybody could see then that Google’s results were far better than the others’. That was the basis of everything,” says Dirk Lewandowski, interim professor of data science at the University of Duisburg-Essen, who has studied search engines for 20 years.

Google quickly garnered a great deal of trust and goodwill. Its mission to “organise the world’s information” was inspiring. If you wanted to know something, you’d ask Google. Most of the time, it would deliver the answer you sought. Gradually, the other search engines died off. Search became synonymous with Google, and “Google” became a verb, and began to expand beyond text to images and video, even mapping the physical world with Google Maps and Street View.

Success generated more success, and Google captured vast amounts of data on its users that it employed to improve search algorithms. The company realised that this data could be valuable. With its search engine, it was capturing users’ thoughts, desires, their innermost questions. Google used this information to reinvent the advertising industry.

Cory Doctorow, an author, activist and mordant critic of big tech, explains the company’s ad system like this: “Say I have an 18- to 34-year-old manchild in central London who’s got an Xbox and has been searching for information about gonorrhoea. Who will pay to advertise to this person? Advertisers or bots bid for placement – and the winners serve an ad to you.”

Many of Google’s products besides search, from YouTube to Maps, collect data on users, which enables personalisation of your ads – this model is the foundational example of what technology commentator Shoshana Zuboff has called “surveillance capitalism”. Ads became big business for Google. Last year its parent company, Alphabet, earned 77% of its revenue from them – that’s $237.85bn.

Along the way, the company accrued not just economic power, but also social and political power. Rosie Graham, a lecturer in contemporary literature and the digital at the University of Birmingham, says we don’t just ask Google for information, but also for “ways to live our lives”. When we look for answers to social, religious or political questions, Google judges who are the trusted voices, and who we should not hear from. “Google has the power to change the way we think about things,” Graham says.

“It acts like it’s just another company, but it’s not. It influences countries’ elections. It has a huge stake in what’s profitable, what jobs can exist … in many ways it’s more powerful than governments. Gone are the times when it can be this small company that’s all cutesy and shoestring.”

Somewhere along its path to success, Google lost the public goodwill it earned in its early days. Once, its playful motto, “Don’t be evil”, featured prominently in its code of conduct. In 2018, it was quietly downgraded.

Companies become too big to fail, then too big to jail, then too big to care. Google is too big to care

Has Google search got worse? And if so, what does that look like? Imagine you used to go to your local library and, when you asked for a book, it was produced immediately. Now, when you ask for that same book, the librarian tries to sell you a magazine subscription, waves about some different books they say other people like, then finally produces a big stack of tomes with your desired book wedged awkwardly in the middle. You might have an opinion about this change in service.

This is the portrait detractors paint of the current state of Google search. Doctorow, for one, calls the most recent results “garbage”. Former Google employees have posted scathing articles arguing that the company is floundering. Yet every day, billions of people use the search engine, and it’s a safe bet that many of them think it works just fine. How is it that some people believe this essential internet infrastructure is circling the drain while others haven’t noticed any change?

It can be hard to say anything definitive about search result quality, because each person’s experience is so different. If two people Google the same sentence, they will get different results based on all manner of variables. Meanwhile, Google constantly tweaks the algorithm.

Still, critics do have specific reasons for saying the service is going downhill. Google search is good only as long as it can serve up high-quality information, and many claim it no longer does so reliably. They often blame this on Google’s inability to combat spammers and the much-maligned search engine optimisation (SEO) industry. SEO companies aim to make websites appear more highly in Google search rankings to help their businesses. But this can lead to degradation in site quality, as if content is tailored only to please Google’s algorithms. Take recipe pages. When searching for cooking instructions, you’d probably want to see them displayed concisely at the top of the page, yet most food blogs bury recipes beneath a long anecdote. Food writers do this because they believe Google ranks this format highly. But readers resent it.

On the spammier fringes is what’s known as “black hat” SEO, bad actors who use techniques with fabulously evil names such as “domain squatting”, “reputation abuse”, “obituary spam”, “keyword swarming” or “parasite hosting” to bring their content to the top of Google’s search results and turn a quick buck. Spam pages usually have little meaningful content and are aggressively monetised, hosting intrusive ads to profit from each visitor’s click. A recent study claims that Google does indeed have a big spam problem, but adds that other search engines face the same issues.

Google and the spammers are locked in a never-ending battle. The spammers come up with a new technique, Google tweaks the algorithm to stop it working, then the spammers come up with something else. Google’s vice-president of search, Pandu Nayak, describes the dynamic as a “spy v spy situation”. Today the internet is facing the looming threat of a new wave of AI-generated spam, which threatens to overwhelm search engines.


Even when the links returned by a Google search are of high quality, the other criticism is that it’s hard to find them among the clutter. Where the company once sought to send users onwards to relevant links as quickly as possible, in recent years it has started answering more questions within the Google search interface itself – so if you’re trying to find out something about sports scores, the weather or film showtimes, solve a mathematical equation, or perhaps find out the key publications of a certain distinguished physicist, Google will provide that information in a little box for you, without you needing to click any links.

Sometimes all these little boxes get in the way of the answer you’re trying to find. I just typed in “best smartphone 2024” and was shown, at the top, a carousel of shopping opportunities, followed by four links, then a panel of questions that “people also ask” with vaguely related queries (“Which phones last the longest years?”), then some YouTube videos, five more links, then more related queries and a further shopping carousel. The links I was actually seeking were buried by clutter. It’s a far cry from the sleek, minimal interface of early Google.

Sometimes, Google will populate boxes with information gleaned from the internet that turns out to be incorrect. Besides calling me a dead physicist, these info boxes have claimed that Barack Obama was the king of America, and asserted that Kannada, the official language of the Indian state of Karnataka, was the ugliest language in the country – Google had to issue an official apology for that one. It didn’t take me long to find an inaccurate response. On the third random question I typed in, “How long is Waterloo Bridge?”, a box came up with the confident answer “2,456ft” (748 metres). It was only when I clicked through to Wikipedia that I saw this figure was in fact the length of the first Waterloo Bridge, which was demolished in the 1930s. The current bridge is just 1,230ft (370 metres) long.

Google says users find the additional panels useful. Critics argue that it is trying to extract as much revenue as possible from users by keeping them within the Google ecosystem to the detriment of the user experience. Early on, Google’s founders realised that commercial incentives might compromise the integrity of search results. In a 1998 student paper, Brin and Page wrote that ad-funded search engines would be “inherently biased towards the advertisers and away from the needs of consumers”. Yet Google started displaying ads anyway because, as one academic told me, this is the only good way to monetise search.

I spoke with representatives of the competing search and answer engines Kagi, DuckDuckGo and Perplexity, all of whom frame this issue as a misalignment in Google’s company incentives. They say Google makes design and business choices to earn revenue for advertisers and shareholders at the cost of search user experience. When I put this critique to Google’s Nayak, he dismisses it as “an easy narrative” and continues, “Since the beginning of Google, there has been a clear separation between organic search [eg regular results] and ads … we make sure that the ad side of the house does not affect search.”

When I ask whether Google search results are getting worse, he repeatedly makes the same point: the fact that Google has a 90% market share in search shows its product works well. “If the search experience was not good, I have every confidence people would not use it.”

Is there a reason people might use Google search even if it weren’t a great experience? The US Department of Justice (DoJ) recently gave its closing statements in a historic legal case against Google, which the Financial Times called “the most significant antitrust trial in 25 years”. The DoJ’s argument is that Google uses its wealth to operate anti-competitively as an illegal monopoly, principally by paying other tech companies to be the default search engine on their devices. Naturally, Google argues that people use its search engine because it’s the best. But if that’s the case, why did it need to pay Apple $20bn in 2022 alone to be the default search engine across its phones and computers? The case is likely to conclude before the end of the year.

Google’s biggest competitor, Microsoft’s Bing, has only about 3% of the global search market. A number of other startups scrape fractions of 1%, many with their own spin on the search engine formula: Perplexity offers written-through answers to questions, Kagi operates a paid subscription model with no ads, DuckDuckGo focuses on protecting data privacy. All three say it’s impossible to truly compete with Google right now.

Aravind Srinivas, chief executive of Perplexity, says, “Competing with Google is a no-fly zone. They’re just too big, they dominate, have all the best technology and a lot of money. They can just scorch you to death by offering whatever you’re offering for free.”

Does it really matter whether there is competition to Google’s search engine? Doctorow believes it does. He coined the memorable term “enshittification” to explain the state of big tech companies in the modern age: “Here is how platforms die: first, they are good to their users; then they abuse their users to make things better for their business customers; finally, they abuse those business customers to claw back all the value for themselves. Then, they die.” He calls Google “the poster-child for enshittification”.

Doctorow says algorithmic systems are particularly vulnerable to this, because their workings are opaque to users and easy to quietly tweak. Who knows why you see what you see at the top of your Google search results, Instagram feed or TikTok For You page? Is it because it’s judged to be the best content for you, or because it’s what the platform thinks will make it the most money?

“That’s why it’s so tempting for companies to enshittify them,” Doctorow says. “They’re just yoloing it and saying, ‘Well, fuck it, we’re just going to make all the things at the top of your feed garbage, because we’re too big to care.’” Referencing a comment made by Lina Khan, chair of the US Federal Trade Commission, he adds, “Companies become too big to fail, then too big to jail, then too big to care. Google is too big to care.”

The last stage of the enshittification doctrine is that a platform dies. Is this going to happen to Google? Rosie Graham thinks it’s inevitable, at some point. She points out how X, formerly Twitter, faded in relevance practically overnight after Elon Musk took over. “No company lasts for ever,” she says. “There are all sorts of organisations that had huge global influence and power that we don’t have any more – think about the East India Company. It’s not a matter of if Google will be influential for ever, it’s a question of when Google will be replaced.”

Not everyone agrees the search engine is getting worse. Of the dozen academics and industry professionals I interviewed for this piece, half said they didn’t think search quality was declining. Several pointed out people have been eagerly predicting Google’s death for years – there’s even a Wikipedia page called “Predictions of the end of Google” with examples dating back to 2007. Lewandowski says, “There have always been complaints about low-quality results and the interface getting more cluttered. But in the end, it’s basically the same.”

Perhaps what is really bothering people is that the internet as a whole feels, in 2024, like a worse place to be. Those who grew up on the web of the late 90s and early 00s might remember openness, community and free thinking. Today, we’re probably more likely to associate the internet with anxiety, loneliness and stress. Maybe we miss the time when the internet felt more human. This may explain why many people searching for information look to Reddit rather than Google. That huge, chaotic forum feels like one of the last truly human places on the internet, where you can get somebody else’s honest opinion in all its weirdness, untainted by murky brand associations or affiliate links.

Yet even if it’s true that the internet has declined, that doesn’t let Google totally off the hook. Its search engine doesn’t just organise information on the web, it actively shapes it. If the web is a worse place today, if it’s over-commercialised and full of low-quality content, if journalism platforms struggle to make money from good writing and are reduced to clickbait and affiliate links, that’s partly Google’s fault.

“Google has never really understood the responsibility it’s got to ensure publishers can continue to publish content without needing to over-commercialise in horrifying ways,” says Simon Schnieders, chief executive of the SEO company Blue Array. “They really need to point the finger at themselves and why they created this beast in the first place.”


As if the search question wasn’t tricky enough, today many people are predicting that the arrival of new AI technologies is going to change everything. Since the launch of ChatGPT, technologists have wondered whether AI assistants will one day take the place of search engines. ChatGPT is a product of OpenAI, which is in partnership with Microsoft, operator of Bing. Last year Microsoft announced it would integrate AI answers into its search engine results, with its chief executive, Satya Nadella, calling it “a new day in search”.

At its latest conference, Google seemed to be rushing to respond to this threat when it announced a suite of new AI tools. The company has been using AI behind the scenes to improve its search and algorithms for years, but with the launch of the new “AI Overviews” feature, which it has already started rolling out and plans to make available to more than 1 billion users by the end of the year, it will put the technology front and centre. With this feature, Google search will respond to certain queries with a text box above the usual links, providing a written-through summary of information from various websites. The slogan the company keeps repeating around this is “Let Google do the Googling for you”.

Asked ‘How many rocks should I eat?’ Google gave this AI Overview: ‘One per day because rocks contain minerals and vitamins’

Responses have been mixed. Google says in internal tests people found the feature useful. They claim it’s good for queries that require a number of specific variables – say you’re trying to find a place your family can eat in Paris that does vegan food, is open at 7am and is within walking distance of a Métro station. Such questions, which might previously have required 10 minutes of clicking around on numerous searches, can be done in seconds by AI (ChatGPT is also pretty good on this stuff).

But, of course, the internet immediately seized on the feature and found that, in response to certain queries, it produced hilarious, inaccurate and sometimes dangerous answers. In response to the question “How many rocks should I eat?”, Google presented this AI Overview: “According to UC Berkeley geologists, eating at least one small rock per day is recommended because rocks contain minerals and vitamins that are important for digestive health.” Meanwhile, someone who asked about “cheese not sticking to pizza” was recommended to “add about 1/8 cup of non-toxic glue to the sauce to give it more tackiness”. Naturally, it didn’t take long for somebody to make and eat the glue pizza.

The erroneous information came from obviously dubious sources. Eating rocks was suggested by an article on satirical site the Onion, while the glue pizza idea was a post by “Fucksmith” on Reddit 11 years ago. Google was roundly mocked online and responded with a blog post essentially saying that these were growing pains and that the product would improve.

The new direction heralded by ChatGPT and AI Overviews is to a world in which we no longer search for answers ourselves, but rather receive a single, supposedly balanced answer that has been pre-chewed by an algorithm. “Summarisation, or the dumbing down of search, is a bad thing for society in general,” Schnieders argues. “It’s important to get a range of diverse perspectives from search, from your own trusted or new sources, practise critical thinking and form your own opinions. AI Overviews claims to do this but it’s too much of a black box to be trusted.”

Yet the biggest concern around AI Overviews came not from users who had cheese sliding off their pizzas, but from writers and publishers online. They’re worried that if Google summarises the information from their websites and delivers it to users, then those users will have no reasons to visit the sites, depriving them of the traffic necessary to fund more content creation.

This question has sent the media into a tailspin. Nilay Patel, editor-in-chief of American technology news website the Verge, said AI Overviews would “change the web as we know it”, while the influential tech reporter Casey Newton said Google had “essentially put the web into a state of managed decline”. Reports have predicted that publishers could see their search traffic fall anywhere between 25% and 60% as a result of AI. If even a fraction of this is true, it could have enormous consequences for the already squeezed media landscape. Various small publishers have accused Google of killing their businesses.

When I ask Hema Budaraju, Google’s senior director of product management for search, whether Google has a responsibility to ensure a healthy web ecosystem, she answers with “a very direct, strong yes”. She emphasises Google’s “commitment to the web” and “ensuring we have a thriving ecosystem”. “As we introduce our generative capabilities, connecting people to the web is central to our approach,” she says.

I’m inclined to believe this is Google’s intention. It’s not in its long-term interest for the internet’s information economy to collapse. If media platforms can no longer afford to produce high-quality content, then Google’s AI Overviews will have nothing left to summarise. Eventually, people would stop using Google search.


During a visit to one of Google’s London offices, I told a member of the communications team that I had been inspired to look into the state of Google search by the broken knowledge panel saying I was a dead physicist. When I later spoke to Nayak, I decided to ask him how I could detach my face from the other Tom Faber. Before I’d finished my sentence, the communications person pinged into the chat, saying the issue had been fixed. I adjusted my question: maybe it’s been fixed for me because of having a direct line to Google, but how would someone resolve this if they didn’t have strings to pull?

Nayak apologised, saying the panels were created automatically using algorithms and sometimes they messed up: “These are the kinds of things we’re constantly improving.” He went on to insist that, on issues like this, Google’s “honest results policy puts everyone on the same playing field”, so it had nothing to do with me having contacts at Google. Immediately after, the call was ended abruptly for going over time.

When I followed up, I was told someone from the team had submitted a feedback form using the public channels, just like anyone else might, and this resulted in it getting fixed. This was perplexing. It seemed more than a coincidence that, after years of trying to fix the problem myself by submitting feedback forms, it would finally change weeks after mentioning it to a Google employee, and that this change would be unrelated to that conversation. But at least the issue was fixed.

For now, search engines aren’t going anywhere. “I think search is inevitable,” Doctorow says, but adds that we’ll always want human voices to cut through the noise and deliver curated sources of information. “We’re still going to have experts, reviewers and tastemakers, adventurous spelunkers in information space, and just the terminally curious – that one friend you have who can’t stop holding forth about something, whether it’s a new gamer mouse or a band or a new, extremely hoppy IPA. We’re going to have all of those things, but they’re all going to need search engines.”

It seems search is going to remain broadly the same – ChatGPT isn’t about to displace Google search, and AI Overviews are not about to fundamentally change the search experience. But there remains the larger question of what the rest of the internet will look like. As AI steers the online economy into uncharted waters, the fate of the media is hanging in the balance. And whatever the future of the web looks like, it’s sure Google is going to play an enormous role in shaping it.

As I was editing this story, I double-checked to see if my knowledge panel was still fixed and discovered, confoundingly, that the problem had returned. The next time I checked, it was fixed again. I began to regularly Google myself in incognito mode, on different browsers and devices. Sometimes my face popped up as a dead physicist; sometimes it didn’t. The ever-changing, algorithmic nature of it made it feel like Schrödinger’s knowledge panel, both correct and incorrect at all times.

The frustration of trying to resolve the knowledge panel issue echoed the process of trying to get a solid read on the state of Google’s search engine. The company is too opaque, and its system has too many shifting parts, to make a clear pronouncement. It is many things to many people, constantly succeeding and failing its billions of users. Sometimes, as much as you search and search, there is no single answer to be found.

Here is the link:

https://www.theguardian.com/technology/article/2024/jul/20/google-is-the-worlds-biggest-search-engine-broken

What all this says to me is that trying to corral the scope of human knowledge and make it findable for the average punter may just be a leap too far!

If you consider just how hard fact-finding 20 years ago was compared to now one has to concede we have come a very long way and more worrying is the fact that a quantum improvement from here is pretty hard to imagine.

I really find it hard to imagine life without Google search (or some equivalent) and also struggle to envisage what the “next big thing” will look like!

I wonder where the garage is that the next step is being dreamt up?

David.

Tuesday, July 23, 2024

I Am Not Sure I Feel Entirely Comfortable With This Approach To Having A Baby?

This appeared last week:

How to make a superbaby

Helena de Bertodano

2:30PM July 19, 2024.

Although Noor Siddiqui and her husband have no fertility problems, she has undergone IVF so that she can freeze her embryos. Then, using the technology of her own startup company, Orchid, she is pre-screening each embryo for any potential health problems.

Siddiqui, 29, does not have children yet, nor is she even pregnant, but she knows a lot about her future family. She will have two sons and two daughters and, like any parent, she wants them all to be healthy. Unlike most parents, however, she is almost guaranteed to get what she wants.

We are not talking about simply screening for major birth defects or conditions such as Down’s syndrome – we are talking a full-scale analysis of each embryo’s predisposition to all the 1,200-plus diseases and conditions about which we currently have genetic information, including a wide range of cancers, diabetes, ­coronary artery disease and even Alzheimer’s. Based on the results, prospective parents can decide which embryos to implant. Testing costs $US2500 ($3700) per embryo, on top of the cost of IVF, leading to concerns that the rich will breed “superbabies” (although Orchid is also planning a select philanthropy program).

The difference between the Orchid testing – which is already available in dozens of clinics across the US – and what Siddiqui refers to as “the old testing” is off the charts. She suggests you think of it “like a book”. “The old testing is only looking at the table of contents, [whereas Orchid] is spellchecking the entire book. So if your genome is 3 billion letters, Orchid is looking at all of them.”

“Look,” Siddiqui adds, pointing to a graph she has pulled up on her iPhone that shows the analysis of one of her embryos. “All these genes that cause horrible diseases are negative. Same for hereditary cancer.” She flicks to another one and I see a solid red line. What’s that? “This ­embryo was in the 99th percentile for breast cancer. So it has a 37 per cent lifetime risk ­versus this embryo, which has an 18 per cent lifetime risk.”

She splits the screen so she can compare embryo three – the one with the heightened risk – with embryo five, which shows no heightened risk factor for any disease. So, I say, you would clearly choose embryo five over three. “You can choose whatever embryo you want,” says ­Siddiqui, who is hypersensitive to any suggestion that Orchid’s services have any similarity to eugenics. But embryo three would be an ­unusual choice, wouldn’t it? “Sure,” she ­concedes. “But embryo three knows at age zero to screen early for cancer.”

We are chatting in the San Francisco apartment of Masha Bucher, a Russian friend of ­Siddiqui’s and an investor in Orchid who plans to use the service herself. Aged 34, Bucher is married but says she is not ready for a child right now. Dynamic and bossy, she explains why she supports Siddiqui: “We have access to data on so many less important things. I’ve been calculating my calories since I was ten years old, I track how much time I sleep, I have financial apps. Why wouldn’t I use something that helps with such a major decision over the health and future of [my child]?”

In their friend circle, freezing eggs or embryos is the norm. “Many who are younger than me are already doing egg freezing or embryo banking with their partners,” Siddiqui says. “They get engaged and they make embryos and they plan to have kids in ten years, whatever.”

So far, Siddiqui has frozen 16 embryos. “Unfortunately, almost all are girls.” Just two are boys – and one of them is at a heightened risk for prostate cancer. Not that that in itself is a deal-breaker. “But if you want to have two boys, then you should probably have more than two embryos. Basically, each embryo has a 70 per chance of becoming a baby.”

So she is going to freeze more eggs in September. Yes, she says, IVF is uncomfortable. “But it’s really not an ordeal. Women do waxing, Botox, laser hair removal – and it’s completely frivolous. Who cares whether you have hair or not? I care way more if my baby is going to get cancer. I care way more if my child will go blind in college. So why wouldn’t I spend an extra two weeks and a couple of thousand dollars to make sure my child doesn’t suffer? That should not be stigmatised.”

Pretty and slight, Siddiqui seems to be one of those intellectually brilliant people who, on a practical level, is a complete disaster. I rarely feel like the grown-up in any situation that involves organisation, but after a chaotic day with Siddiqui I almost feel like a babysitter. The ­location and time of the interview change so often I lose track; patients and doctors whom she has lined up to speak to me suddenly evaporate. She doesn’t know which apartment ­Bucher lives in so we end up knocking on random doors while she tries to contact someone 8000km away who might have the address – except her phone battery dies and she doesn’t have a charger. At one particularly low point in the day I find myself stuck in a fire escape stairwell with her, unable to re-enter the main building because the door has locked behind us.

The day starts smoothly enough, albeit well behind schedule. Siddiqui offers to collect me from my hotel; a white Jaguar pulls up and I get into the back seat next to her. We begin chatting and as the car pulls out into busy traffic, I suddenly realise there is no driver. The car is driving itself. “I hate driving,” she says. “It’s so annoying.” So, being a young San Franciscan, naturally she uses Waymo, the self-driving car app that is rapidly supplanting Uber. “It feels super-futuristic when you first jump in, but then you forget about it,” she says.

It is pouring with rain and I ask her if – with all her technological know-how – there might be a way to stop it. Actually, she says, there might be. She knows someone who has a ­company called Rainmaker. “I don’t know if they can stop the rain, but they can start it.”

The daughter of Pakistani immigrants, both engineers, Siddiqui grew up in Virginia, where discussions around the dinner table were ­highly intellectual. “My family loves to debate. My older sister and my dad would spar about any topic: political, technical, nuclear power… I would try to insert myself and then, when I went to school, I’d sound so smart because I would just repeat the conversation.”

The one cloud on the family horizon was her mother’s worsening vision. She had been diagnosed with retinitis pigmentosa, and Siddiqui says that watching her mother struggle with the disease triggered her fascination with genetics. “Just think about it – someone you love, their independence is getting ripped away from them. It just struck me as incredibly unfair.”

As a teenager, she applied to the Thiel Fellowship, a program that funds 20 gifted young people a year to work on their ideas, deferring college. She won a place and founded a startup called Remedy, using Google’s augmented ­reality glasses to help healthcare providers care for patients. Later she attended Stanford, graduating with a master’s degree in computer science. By then she had met her future husband, Feross Aboukhadijeh, a fellow student. He is now the founder and CEO of Socket, a ­security platform, and seen as one of the most brilliant brains in Silicon Valley.

After eight years of dating, they married in a “giant, crazy” three-day wedding in Hawaii in 2022. “It took me way too long to decide to marry.” She was determined to be the one to propose first. “I told him I wasn’t going to ­accept any inbound [proposal]; I had to ask first.” So, not one to do anything by halves, she organised a flashmob proposal (it’s a thing these days, especially in California), flying in friends and family from around the country and contracting artists to perform his favourite music. He said yes, of course, and then organised his own return proposal with a scavenger hunt. They now live in San Francisco and plan to start a family in the next couple of years.

Using her own relationship as an example, Siddiqui robustly contests the argument that the IVF/freezing embryos route lacks romance. “Think of how much love and energy it takes to say we’re going to plan ahead to make sure this child is healthy,” she says. “This is the ­biggest gift I could give my child.”

And, she maintains, it is still a magical process. “Of the millions of eggs that existed in me when I was a baby, I capture 20 of them. Think about how miraculous that is. My husband has billions of sperm and it’s these specific magical combinations of literally trillions [of options] that get to be our kids… And we haven’t gotten pregnant yet. The first embryo might not take. So there’s still a lot of mystery.”

Of course, for couples who take the Orchid route to have a baby, sex in itself is unnecessary. “Sex is for fun,” is one of the lines that Orchid uses. “Embryo screening is for babies.”

“It’s a little tongue in cheek,” Siddiqui says. “But that’s what I personally think. You’re taking more risks [having a baby through sex].”

As for finding out about potential problems post-conception, the emotional toll is high. “The current process is much worse: once the pregnancy is already in progress, you can get a very small amount of genetic information and find out about a very small list of those thousands of diseases. And then you have a very tough choice to make: you can either terminate or continue that pregnancy. I would way rather have the information before I’m pregnant.”

I tell her that when I was pregnant with my second son in the US, I had an ultrasound that showed he might have Trisomy 18, also known as Edwards Syndrome, a chromosomal condition that affects the heart and lungs and is so ­severe that most children do not live beyond the first two weeks of life and fewer than 10 per cent beyond the first year. At the local hospital I was asked if, given the risks, I wanted to ­continue with the pregnancy. They offered me counselling and made it sound almost a certainty that he would be born with the condition (even though there was a much higher chance that he would be born without it).

Twenty-one years have passed since then. Obviously, if I had terminated the pregnancy I wouldn’t have my healthy, kind, beautiful son Joe. Or if I’d had the choice of several embryos, it’s unlikely I would have chosen one with an ­elevated risk of such a condition.

“But you’d have a different son,” Siddiqui says cheerfully, “whom you’d also love.”

She has the same answer to the suggestion that her mother might not have been born if her grandmother had been given a choice of embryos and saw that she had a heightened risk of blindness. “I’d have a different mother.” Clearly, Siddiqui herself would not exist either, but she thinks I am far too stuck on people who wouldn’t have been born. “People are always thinking about [one] person who wouldn’t exist. You immediately say, ‘I wouldn’t have my son.’ But what about all these future people who wouldn’t exist if you don’t use this technology?”

Perhaps doubting the efficacy of her ­positivity, she continues, “Think about this: my grandma had my mum when she was 16. Now women go to college and choose when they get married. You killed all the babies that you [could have] had at 16 and 17. And 18 and 19. All those eggs… There are trillions of children and children’s children who didn’t happen because we as a society have said we value women having autonomy over who and when they marry, when they have kids… I don’t think anyone in society would say that women should all be forced to have kids at 16.”

‘There is a genetic component to substance abuse,’ Siddiqui says. There are even, she adds, ‘certain aspects of personality that have a genetic basis.’

Well, no, but that’s different from ­selecting embryos when there is no apparent medical need to do so. There is something about the randomness of birth that is seen as ­almost ­sacred. Siddiqui is ready for this. “I think ­because it’s sacred, it is incumbent upon us to use the best science [we have] to give this ­person we’re bringing into the world the best chance at a healthy life. If a child needs more resources, then we should be summoning those resources earlier, not leaving it to the last minute, once it’s too late to intervene. There are so many of these situations where if you intervene earlier, you can either totally avoid the illness or significantly alter the trajectory of that child’s life.”

She talks at immense speed for hours, the words tumbling out of her. Even my voice ­recorder can’t keep up with her and at times I have to ask her to slow down. “Sorry, sorry,” she says breathlessly, slowing down a fraction before galloping on again. “When children are born without a skull, they might suffer and die within a week [or be] a stillborn. So it strikes me as very cruel to say to a family who’s going through IVF that you shouldn’t have this information – especially if you’ve already buried a child… Three per cent of babies are born with birth defects. Six per cent of ­babies are born with a neurodevelopmental disorder. We don’t have treatments. We have vaccines for smallpox and polio. And that’s about it. So unfortunately, the most humble thing to do is actually to screen embryos and identify the risks early. Because medicine is still in the Stone Age. We can’t cure most chronic diseases. A lot of people we serve weren’t going to have kids because they were so worried about the child suffering… So the idea that you should stigmatise access to information about the health of your embryo is offensive to me.”

So what you’re doing is editing out the risk? “Not editing,” she quickly corrects me. “Editing would mean you’d be manipulating embryos that already exist. This technology is just ­expanding the menu of choice.”

Although a lot of what she says makes good sense, I find that anyone I talk to about Orchid recoils when I explain what it is doing. Is she surprised that the subject causes some upset? “It honestly doesn’t make sense to me. People are already choosing embryos based on sex, which is a lot less important. They obsess over the most silly things: playing classical music or rock music during pregnancy; whether to have an organic or non-organic apple.”

Late last year, the first Orchid baby was born to a San Francisco couple. Siddiqui posted a film of herself meeting the baby, Japhy. His mother, Leah, was 38 when she married. “We both have family history of type 1 and 2 diabetes and my husband has a history of bipolar in his family, so we wanted to see if there was anything we could do to mitigate some of those issues,” Leah says. “It’s a huge relief to have the information to make informed decisions.”

Siddiqui is thrilled to have met Japhy. “This baby represents the future of how all babies will be created, hopefully.”

Dr Michael Feinman, an IVF doctor, says Orchid provides a valuable tool in preventing severe diseases. “While there are ethical considerations and societal implications, the primary focus should always be on the wellbeing of the future child and reducing the burden of disease on families and society.”

Orchid is also working on a way to predict if a future child is predisposed to addiction. “There is a genetic component to substance abuse,” Siddiqui says. There are even, she adds, “certain aspects of personality that have a genetic basis”. Maybe, I speculate, one could stop a future serial killer being born. Or someone like Vladimir Putin. Siddiqui looks doubtful. “I think you still have free will. You’re predisposed to things but I wouldn’t go so far as to say you could predict character.”

She dismisses as “sensational and silly” a recent headline about her that ran, “This woman will decide which babies are born.” “It’s the exact opposite of that. It’s the parents who decide; I don’t decide anything.”

Yet given the strong feelings the technology engenders, I ask if she sees any downside to what her company is doing. “I don’t think so. I think this is something that society has been waiting for. For generations. So much had to develop in the history of humans for us to be able to get here. It’s up to us to decide the ­morality and how it’s used. It’s just data on ­embryos at the earliest possible stage.”

She acknowledges that for some people, it is just too much information. “For people who want to take the risk and do it traditionally at home, more power to them.” But, she cautions, “Genetics is really messy, and so many things can go wrong. Your genetics is a lottery. Why don’t we try to make it a little more fair?”

Society will eventually embrace this ­technology, she believes. “Previous generations would consider IVF as taboo and stigmatised. And now it’s the opposite.” We are back in the car and she makes an analogy. “Self-driving cars were considered really scary and crazy, but look at the data: how many car accidents are there with human drivers? Thousands. Waymo had to pass one million miles without an ­incident. In the future, our grandkids are going to think it was so unsafe on the road before ­self-driving cars.”

She feels that Orchid is her “life’s work”. “It is the most meaningful work I’ve ever done,” she says. “We want to bring it internationally around the world.” She herself plans to decide which embryos to implant after her second round of IVF. “I built the whole company because I wanted to do that.”

A few minutes after we part, she sends me links to two YouTube videos set to music: one showing her marriage proposal to her partner, the other his proposal to her. The videos are sweet, if corny, and clearly prove the romance in their relationship. As she runs into his arms on top of a picturesque cliff, I note that Justin Bieber’s Anyone is playing and the accompanying lyric is, “You can’t predict the future.” ­Except now, of course, you actually can. b

Here is the link:

https://www.theaustralian.com.au/weekend-australian-magazine/how-to-make-a-superbaby/news-story/498a8f2957046f40fb72389a8a4fcf8b

I offer this article for comment as I am really unsure how I feel about this approach to “baby-making””

I guess many would like the control and risk reduction that is offered while others would really hate the lack of ‘natural processes’ involved.

How do you feel about what is offered here?

David.

Sunday, July 21, 2024

Well That Was Really The King Of IT Outages So Far!

 Here is the basic outline of what happened in case you have been hiding under a rock for the last few days!

The software patch that shook the world

Asa Fitch, Sam Schechner and Sarah E. Needleman

21 July, 2024

Hemant Rathod, an Indian executive, was sipping tea in a conference room on Friday morning in Delhi, about to send a long email to his team, when his computer went haywire.

The HP laptop suddenly said it needed to restart. Then the screen turned blue. He tried in vain to reboot. Within 10 minutes, the screens of three other colleagues in the room turned blue too.

“I had taken so much time to draft that email,” Rathod, a senior vice president at Pidilite Industries, a construction-materials company, said by phone half a day later, still carrying his dead laptop with him. “I really hope it’s still there so I don’t have to write it again.”

The outage, one of the most momentous in recent memory, crippled computers worldwide and drove home the brittleness of the interlaced global software systems that we rely on.

Triggered by an errant software update from the cybersecurity company CrowdStrike, the disruption as those in Asia were starting their days and Australians were well into them.

Over the course of less than 80 minutes before CrowdStrike stopped it, the update sailed into Microsoft Windows-based computers worldwide, turning corporate laptops into unusable bricks and paralysing operations at restaurants, media companies and other businesses.

US 911 call centres were disrupted, Amazon.com employees’ corporate email system went on the fritz, and tens of thousands of global flights were delayed or cancelled.

“In my 30-year technical career, this is by far the biggest impact I’ve ever seen,” said B.J. Moore, chief information officer for the Renton, Wash.-based healthcare system Providence, whose hospitals struggled to access patient records, perform surgeries and conduct CT scans.

Fixing the problem involved technical steps that confounded many users who aren’t tech-savvy. Some corporate IT departments were still working to unfreeze computer systems late on Friday. CrowdStrike said the outage isn’t a cyberattack.

Adding to the chaos – and further underlining the vulnerability of the global IT system – a separate problem hit Microsoft’s Azure cloud computing system on Thursday shortly before the CrowdStrike glitch, causing an outage for customers including some US airlines and users of Xbox and Microsoft 365.

The CrowdStrike problem laid bare the risks of a world in which IT systems are increasingly intertwined and dependent on myriad software companies – many not household names.

That can cause huge problems when their technology malfunctions or is compromised. The software operates on our laptops and within corporate IT setups, where, unknown to most users, they are automatically updated for enhancements or new security protections.

In a 2020 hack, Russian perpetrators inserted malicious code into updates of SolarWinds software in a way that compromised a swath of the US government and scores of private companies.

The rising frequency and impact of cyberattacks, including ones that insert damaging ransomware and spyware, have helped fuel the growth of CrowdStrike and such competitors as Palo Alto Networks and SentinelOne in recent years. CrowdStrike’s annual revenue has grown 12-fold over the past five years to over $US3 billion ($4.5bn).

But cybersecurity software such as CrowdStrike’s can be especially disruptive when things go wrong because it must have deep access into computer systems to rebuff malicious attacks.

Not all updates happen automatically, and computer attacks often occur because people or businesses are slow to adopt patches sent by software companies to fix vulnerabilities – in essence, failing to take the medicine the doctors prescribe. In this case, the medicine itself hurt the patients.

The global outage began with an update of a so-called “channel file”, a file containing data that helps CrowdStrike’s software neutralise cyber threats, CrowdStrike said. The update was timestamped 4:09am UTC – just after midnight in New York and just after 2pm Friday in eastern Australia.

That update caused CrowdStrike’s software to crash the brains of the Windows operating system, known as the kernel. Restarting the computer simply caused it to crash again, meaning that many users had to surgically remove the offending file from each affected computer.

The nature of the patch meant that the impact was uneven, with people in the same office even experiencing the outage very differently. Apple Macs, which don’t use the affected Windows software, were OK, and servers and PCs that weren’t on and internet-connected didn’t receive the toxic update.

CrowdStrike soon realised something was amiss and the update to the file was rolled back 78 minutes later. That meant it wouldn’t affect computers that were off or in sleep mode during that period. But for many of those that were switched on, the damage was done.

In a blog post, CrowdStrike told those users to boot into the Windows “safe mode,” delete the offending file – called C-00000291*. sys – and reboot.

IT teams often can fix problems on employees’ computers using remote-access software – tools that became especially common during the work-from-home boom of the pandemic. But for laptops and other PCs, that approach doesn’t work if the machines can’t restart.

For those systems, CrowdStrike’s fix had to be done in person – either by a tech-support person on site, or by a regular employee trying to apply the instructions.

Moore, the Washington State healthcare CIO, was away on vacation and initially wasn’t worried when emails about malfunctioning computer applications started landing in his inbox on Thursday night.

By late that night, he had learned that the outage had engulfed the nonprofit health system’s approximately 50 hospitals and 1000 clinics across seven US states. Hundreds of IT employees began deploying patches, which required manual remediation, he said.

Some of the system’s affected computers and devices were fixed by 6am Friday US time, and most were humming again by 10am. “It will be the end of the day before we get it all done,” Moore said on Friday morning.

As companies were grappling with the impact, CrowdStrike’s co-founder and chief executive officer, George Kurtz, was on TV trying to reassure customers – and shareholders – looking haggard after a long night.

“We identified this very quickly and rolled back this particular content file,” Kurtz said in a CNBC interview about nine hours after the faulty update.

“Some systems may not fully recover, and we’re working individually with each and every customer to make sure that we can get them up and running and operational,” he added.

The timeframe for the recovery could be hours or “a bit longer”, he said. Kurtz said on X that the outage isn’t “a security incident or cyberattack”.

Home Affairs Minister Clare O’Neil has provided an update on the CrowdStrike tech outage.

Microsoft CEO Satya Nadella took to X to offer his own reassurance that the company was working closely with CrowdStrike to bring systems back online.

Tesla CEO Elon Musk responded, “This gave a seizure to the automotive supply chain,” and later said, “We just deleted CrowdStrike from all our systems.”

For Rathod, the senior vice president at Pidilite, the travails didn’t end with his potentially lost email.

After switching to his iPad to keep working, he had to rush to the airport for a flight – only to find long lines and flummoxed security staff checking boarding passes manually. Flight information screens weren’t working, so he had to find airline staff to direct him to the right gate.

“It was a mess at Delhi airport,” Rathod said. “How can we depend so much on one company?”

Tom Dotan and Robert McMillan contributed to this article.

The Wall Street Journal

Here is the link:

https://www.theaustralian.com.au/business/the-wall-street-journal/the-software-patch-that-shook-the-world/news-story/fe6cce2fc54d97dbae8f57489532640f

I reckon all that can be said about this outage has pretty much been said and the article above is a pretty good summary for the record.

I find it interesting that my system just kept chugging along as I have no need of or awareness of Cloudstrike! To me what happened makes a care for simplicity in critical systems (hospitals and he like) and to plan any updates to happen at times when the use of the machine is not vital. (Given the rapid response just making sure updates happened on the weekend would have saved you!)

I am sure everyone from philosophers to we humble plebs are going to be pleased the simplicity of our operations and lack of pushed updates saved us completely.

There has to be a case for a total rethink of all the updating that seems to be presently inflicted on as all. Have you ever had a Windows Update that you really felt you needed? Maybe 3-4 times a year? I do not know but I feel we need some clever souls to redesign what is done, now we have seen the possible harm!

I also think we need to do something about the Windows Hegemony – Linux anyone? Surely Coles and Woolies would be better off with a Linux terminal network?

There are some hard questions that need answers.

What do you think?

David.

p,s. Remember this attack needs considerable effort to fix - if you are affected:

Here is the drill:

"The only remedy for Windows users affected by the “blue screen of death” error involves rebooting the computer and manually deleting CrowdStrike’s botched file update."

Glad you had never heard of Cloudstrike?

D.

AusHealthIT Poll Number 756 – Results – 21 July 2024.

Here are the results of the poll.

Are You Concerned About The Safety Of The Use Of Artificial Intelligence In The Health Sector?

Yes                                                                                30 (88%)

No                                                                                  4 (12%)

I Have No Idea                                                              0 (0%)

Total No. Of Votes: 34

A very clear cut vote suggesting it is really is some worry about the safety of AI in the Health Sector!

Any insights on the poll are welcome, as a comment, as usual!

A very good voting turnout. 

0 of 34 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those who voted! 

David.

Friday, July 19, 2024

I Could Not Agree More And It Is A Really Serious Concern!

This appeared last week:

Both men running for US president are unfit for the job

One is a good man in obvious cognitive and physical decline, and the other is a bad man who lies as he breathes – and who is in his own cognitive tailspin.

Thomas Friedman Contributor

When I look at my country’s presidential contest, the first thought that comes to mind is that only the Devil himself could have designed this excruciating mess.

Both men running for president right now are unfit for the job: One is a good man in obvious cognitive and physical decline, and the other is a bad man who lies as he breathes, whose main platform is revenge – and who is in his own cognitive tailspin.

But the most important difference for the country – where you really see the Devil at work – is in the difference between the Democrats and the Republicans. The plain fact is that only one party in America’s two-party system is ready to defend our constitutional order any more. The other party is interested only in gaining and holding power for the sake of it.
The GOP’s moral emptiness is manifested in several ways. The party has been purged of virtually every Republican politician unwilling to submit to its Dear Leader – Donald Trump, who attempted to overturn our last presidential election.

The wife of a Republican-appointed Supreme Court justice advocated overturning the results of the election on utterly bogus grounds, which shows you just how little respect that party now has for our sacred institutions.

It is the political equivalent of assuming that because you played Russian roulette once and survived you can play it again.

And it is ready to renominate Trump even though many of those who worked most intimately with him in his first term – including his vice president, secretary of defence, secretary of state, chief of staff, national security adviser, press secretary, communications director and attorney general – have warned the country in speeches, interviews and memoirs that Trump is erratic, immoral and someone who must never be let near the White House again.

One of the biggest mistakes Americans would be making if they were to elect Trump again is assuming that because we survived four years of his norm-busting, law-abusing, ally-alienating behaviour once, we can skate by again without irreparable damage. It is the political equivalent of assuming that because you played Russian roulette once and survived you can play it again. That’s insane.

But that is precisely why this election is so important and precisely why the Democratic Party, which still prioritises defending our democracy, must urgently produce a presidential candidate with the wits, vitality and appeal to independents to build an electoral majority to preserve our constitutional order. Nothing else matters today – nothing, nothing, nothing.

But the leader the Democratic Party has right now, President Joe Biden – someone I admire but who clearly has lost a step cognitively and physically – has combatively dug in his heels, lashed out at his critics and dared them to challenge him at the convention, despite the mounting calls for him to step aside.

One would hope that his wife and family, who surely know the extent of his physical and mental frailties, would prevail upon him to step aside, but they won’t – seemingly oblivious to the risk this is posing to the country and the whole Biden legacy.

My God, the Devil must be enjoying this. I am not.

If Biden were to win, we’d all need to pray that he can get out of bed every day to carry out his agenda as well as he did in the past. If Trump were to win, we’d all need to pray that he stays in bed all day so that he can’t carry out his impulsive agenda, which seems driven first and foremost by which side of the bed he gets out of.

We can do better than this – and we must. Because this is also no ordinary election season. We are at a profound hinge of history that is going to put us on a roller coaster of job market volatility, geopolitical volatility and climate volatility.

The artificial intelligence revolution of the past four years is widely expected to slam into the white-collar job market in the next four like a category 5 hurricane. The lengthy Hollywood writers strike last year was just a tiny foretaste of what this destabilising revolution in white-collar work will look like.

At the same time, we are in the middle of defining the post-post-Cold War order, now that the US-dominated post-Cold War order has come unstuck since the Russian invasion of Ukraine.

Managing a hostile Russia – aligned with an increasingly hostile China, aligned with malign actors like Iran and North Korea, and super-empowered nonstate actors like Hamas, the Houthis and Hezbollah – will take not only incredibly wise US leadership but also a US leader able to forge multiple alliances. The post-post-Cold War world can’t be managed by a lonely American superpower telling all its allies to spend more on defence or we will leave you to the tender mercies of Vladimir Putin.

And finally, speaking of hurricanes, there is every indication that our core climate change challenge – how we manage the disruptive weather that is already unavoidable and avoid the disruptive weather that would become unmanageable – is now on our doorstep. The decisions we make in the next four years may be our last chance to avoid the unmanageable.

Those are just a few of the anticipated challenges facing the next president. And God save us from the unanticipated ones, like massive climate-driven migrations amplifying geopolitical instability. America always needs clear-headed and vigorous leadership, but we need it now more than ever.

Democrats, if they are being responsible, need to imagine Biden two or three years from now, given the inevitable march of time. Do those running the Biden campaign and those Democratic Party leaders who tell Biden to hang tough really believe that in two years he will have the capacity to carry out the rigorous job of president, with all its pressures, even on a good day? He is already saying he doesn’t want to schedule events past 8pm, but the presidency has never been and will never be an 8am-to-8pm job.

And can you imagine the conspiracy theories that will be circulating on social media and Fox News over “Who is actually making decisions?” at the Biden White House when people see a president in two years who is more physically and verbally impaired? The only-Biden Democrats – and the Biden campaign – owe the country an answer to that question. I take no joy in asking it, but ask it we must.

Ditto for Trump. What will it mean for America in the age of AI to have a president who swore in an affidavit in a 2022 court case: “Since at least Jan. 1, 2010, it has been my customary practice to not communicate via email, text message, or other digital methods of communication”?

What will it mean to have a president who is a crude oil-loving climate change sceptic when nearly 70 million Americans were under heat alerts last Sunday, a day on which temperatures in Las Vegas hit 120 degrees Fahrenheit for the first time in recorded history?

What will it mean in an age when there is no important problem that can be solved by one country alone – whether mitigating climate change, regulating AI, dealing with massive global migrations or confronting nuclear proliferation – to have a president who believes in America first and only, and that most allies are freeloaders, that US tariffs are paid by China, not American consumers and that global multilateral institutions – NATO, the WTO, the European Union, the WHO, the UN – are an alphabet soup of useless “globalists”?

Of course, I will vote for Biden if he is the Democratic nominee. And you should, too. We have to do anything we can to stop Trump. But Democrats continuing to insist on putting him there are behaving with dangerous recklessness.

I repeat: Just because we managed to barely survive the Trump stress test to our constitutional order once – not without some serious damage – does not mean our democracy can survive another four Trump years with his now Supreme Court-fortified sense of impunity. Especially if we combine the self-induced stress levels from a second Trump term with the boiling external stresses already building up around us.

That would indeed be playing Russian roulette again – only this time with a fully loaded pistol. That’s a game only the Devil himself would design.

This article originally appeared in The New York Times.

Here is the link:

https://www.afr.com/world/north-america/both-men-running-for-us-president-are-unfit-for-the-job-20240710-p5jsgd

So the US public are faced with the choice between a crook and a man who is slowly dementing and slowing down as you watch.

If ever there was the need for a circuit breaker the time is now!

I am not sure the US system has the mechanisms that seem to be necessary.

David.

Thursday, July 18, 2024

This Is A Useful Review Of Stocks Involved In Health AI And Some Emerging Ones!.

These appeared last week:

Top AI healthcare stocks - Part 1

By streamlining workflows and improving diagnostics, Pro Medicus is the Apple of AI healthcare.

By Graham Witcomb · 5 Jul 2024

Practically all medical fields will benefit from artificial intelligence (AI) but, for now, most applications are more science fiction than fact. The medical imaging industry, however, is already experiencing the advantages — and Pro Medicus is leading the charge.

Currently, most algorithms approved for use by the US Food & Drug Administration (FDA) are focused on medical imaging. Plenty more will come: traditional radiology relies heavily on pattern recognition, which is an area where AI performs exceptionally well.

Key Points

·         AI to improve diagnosis

·         Opening platform to AI ecosystem the best bet

·         Stock priced for growth

AI has two main applications within medical imaging — prioritisation and diagnosis.     

AI is being used to triage cases by reading through the endless stream of scans and putting those patients with the highest risk of pathology at the top of the pile for a radiologist to review.

One German university hospital found that using AI to prioritise cases reduced the average turnaround time for reporting critical findings from 80 minutes to 35-50 minutes. This may not sound like much, but there's a major shortage of radiologists in Australia, Europe, and the US, so small increases in efficiency mean radiologists can see more patients and reduce wait times.

Diagnostic accuracy

So far, Pro Medicus's bread and butter has been a software platform that processes medical images remotely and streams the necessary pixels to the radiologist's viewing station, allowing doctors to access high-resolution scans almost instantly. This approach improves efficiency and output, enabling faster diagnosis and more convenient viewing (see Analyst picks: Uncovered gems).

While superior processing speed is Pro Medicus's main competitive advantage — allowing it to charge a 50% premium to competitors — the company is investing in machine learning to enhance its software's capabilities, including the ability to spot anomalies and assess patient risk.

The company has taken a shotgun approach to AI. Its three-pronged strategy includes: (1) developing its own AI algorithms internally; (2) partnering with third-party providers and universities to co-develop them; and (3) providing an open imaging platform accessible to independent AI developers.

The first prong of that strategy is arguably the weakest. In 2021, Pro Medicus received FDA approval for an internally developed algorithm to detect and categorise breast density. Since then, however, the company has barely said a word about internally developed AI — there may be further advances, but we're more excited by a number of partnerships with external developers.

Earlier this year, Pro Medicus invested US$5m into Elucid, a US-based AI provider that specialises in a Fractional Flow Reserve (FFR) evaluation tool for cardiac CT scans, which measures the pressure gradients in a coronary artery. The procedure's use is limited by its cost, complexity, and invasiveness, so an AI-driven non-invasive estimation of FFR will be a major benefit to patients.

Elucid has raised around US$120m in total funding. Pro Medicus's stake is small, but it shows the company's seriousness about building relationships with AI providers and funding their growth. Pro Medicus intends to partner with Elucid and integrate its AI algorithms into Pro Medicus's imaging platform.

Apple-esque

While developing AI algorithms and partnering with start-ups are both opportunities worth exploring, our best hopes are pinned on the third prong in Pro Medicus's AI strategy — its imaging platform.

Most revenue currently stems from image processing, not charging for AI services, and Pro Medicus boasts impressive financials: gross margins over 99%, with a free cash flow margin and return on equity each brushing 50%. Over the past three years, revenue from imaging has grown by 30% a year. Anything that strengthens the imaging platform's competitive position is a good thing. 

Rather than focus solely on building the best AI models, the company has opened its imaging platform to third parties by providing accessible APIs (application programming interfaces). These APIs allow other AI developers to easily integrate their AI models into Pro Medicus's software.

We think it's the right strategy. Pro Medicus's strength is in speed and convenience, not AI development and diagnosis; open access is a way to use external developers — who may be better at AI than Pro Medicus — to improve Pro Medicus's core product.

Two things are clear: Pro Medicus's platform shows the output of AI, which is ultimately what matters to the radiologist; and there are hundreds of companies working on AI algorithms to improve diagnosis across an endless array of diseases. Given the choice between using dozens of different applications or using a single platform that shows the output of dozens of different AI models, we suspect the latter will win out.

Just as Apple's success with the iPhone stemmed from providing a platform for apps, Pro Medicus's approach allows radiologists to access a wide range of AI models through a single, streamlined interface.

It's hard to fault Pro Medicus's strategy and, so far, the company has gone from strength to strength. With roughly $150m of revenue, Pro Medicus has a 7% market share in North America, double what it was three years ago.  

Unfortunately, the market has already caught on to Pro Medicus's potential: the stock's market cap of $14bn is 177 times the $80m of net profit expected in 2024. Consensus estimates are for net profit to more than double by 2028, making that price-to-earnings ratio more digestible — but anything other than rapid growth would still clobber the share price.

We'd love to own Pro Medicus at the right price, but we'll probably need to wait for a disappointing result before we get an opportunity.

For companies like Pro Medicus, AI is a core component of their product, making it integral to the user experience; other companies benefit from AI's capabilities quietly in the background. In Part 2, we'll explain how one such company's AI investments will deliver improvements in efficiency, costs, and research.

Here is the link:

https://www.intelligentinvestor.com.au/investment-news/top-ai-healthcare-stocks-part-1/153685

Top AI healthcare stocks - Part 2

No health stock has more to gain from AI than CSL, with drug and vaccine development just the start.

By Graham Witcomb · 10 Jul 2024 · 5 min read

In Part 1, we looked at how AI is transforming the medical imaging industry through the innovations of Pro Medicus. Now, we turn our attention to CSL, the undisputed leader in blood products and a top-tier producer of vaccines.

AI's potential applications within CSL are extensive, offering significant improvements in efficiency, speed, and research. 

Key Points

·         Predictive drug design

·         Faster vaccine development will improve effectiveness

·         Manufacturing efficiencies

Traditionally, drug discovery has been a lengthy and expensive process.

The first phase of drug development involves identifying potential drug candidates through laboratory studies to evaluate the biological activity and efficacy of these contenders. A bottleneck in this research is the sheer quantity of proteins available for study: blood plasma contains more than 4,000 different proteins, sometimes in indescribably small quantities, each of which could have an important biological effect when concentrated and administered to patients for a specific illness.

AI can help to prioritise research. By analysing huge datasets, algorithms can predict how different molecules will interact with biological targets, identifying promising candidates more quickly than conventional methods based on trial and error.

AI can analyse research data more precisely than humans to find unusual patterns or similarities in drug performance. For CSL, this means a more efficient path to discovering new therapies, reducing time and cost.

R&D accelerator

Once a drug candidate shows promise in basic research studies, it progresses to clinical trials, which are conducted in three phases to test the drug's safety, dosage, and side effects. The clinical trial sequence is the most expensive part of research and development (R&D), often costing hundreds of millions and taking more than a decade.

CSL hit this reality check with its plasma-derived cholesterol drug CSL-112. Earlier this year, the company announced the results of an enormous 18,000-person Phase III clinical trial and found that CSL-112 was no better than placebo at reducing cardiovascular events following a heart attack. CSL spent $500m or so and a decade of research on this single project.

As mentioned earlier, AI is likely to help in the drug discovery process by proposing molecules worthy of investigation or spotting anomalies in data. Its most valuable contribution, however, may be eliminating low-potential drugs earlier in the clinical trial process. Only 1-in-10 drugs that move from basic research to clinical trials make it through all three phases to commercialisation. R&D is a lottery where most research spending is wasted.

The final Phase III trial typically accounts for around 60% of clinical trial costs. By more thoroughly analyisng the vast quantities of data produced by earlier trials — or trials of similar molecules — AI may be able to predict the likelihood of success with more accuracy, helping CSL to allocate resources more effectively.

When one of CSL's therapies is finally approved, the research doesn't end there — the company is constantly looking to repurpose drugs, aiming to find new uses beyond their original indications. Most rare diseases — CSL's specialty — don't have any approved treatments, so AI has the potential to help CSL expand the market for its existing products by finding new therapeutic uses for them. Given the cost of development, an expanded list of 'off label' uses could add meaningfully to CSL's return on investment.

Vaccine development

AI's fast analysis is especially helpful for CSL's vaccine division. CSL has a 26% share of the flu vaccine market, making it the world's second-largest flu vaccine maker.

Influenza viruses mutate frequently, leading to a phenomenon known as antigenic drift. Small changes in the virus's surface proteins can lead to new strains that existing vaccines may not protect against.

The issue is that the flu virus is evolving constantly, whereas vaccine development takes many months. As soon as a new flu vaccine hits the shelves, it is already out of date because the virus has shifted slightly since it was developed.

To address this, flu vaccines are reformulated each year based on predictions of which strains will be most prevalent. This prediction process involves global surveillance and data collection by health organisations. Despite these efforts, there is almost always some degree of mismatch between the vaccine strains and the circulating strains, resulting in reduced vaccine effectiveness for that season.

CSL can use AI to model viruses and predict immune responses, speeding up vaccine design. By accelerating the development process, vaccine strains will more closely match the virus they're targeting.

AI is likely to become a standard feature in flu vaccine development, so we doubt it will give CSL any competitive advantage or increased profitability, but you never know — small differences in software performance could lead to large discrepancies in real-world outcomes. In a field where effectiveness is paramount, doctors are likely to recommend the most effective vaccine, so the company that delivers that could dominate the market. And more effective vaccines overall could improve demand.

Manufacturing

Two final applications of AI that could supercharge CSL's operations extend beyond R&D into manufacturing and compliance.

The company intends to use AI to improve the efficiency of its supply chain and assist in meeting its regulatory, legal, and compliance requirements. Predictive maintenance algorithms keep production equipment running efficiently, reducing downtime and increasing output. Real-time monitoring through machine learning models can detect anomalies early, preventing potential quality issues.

AI can aid CSL in making more informed strategic decisions, too. Predictive analytics can forecast market trends, assess demand, and guide management in where it invests the company's cash pile.

Management expects net profit of US$2.9bn-3.0bn in 2024, up 13 -17%, putting the stock on a price-to-earnings ratio of 32 at the midpoint.

AI has the ability to enhance almost every aspect of CSL's operations — from drug discovery and expanded labelling to vaccine development, manufacturing and quality control.

CSL's size and 100-year operating history is a major competitive advantage as it has troves of research data on which is can train AI models more effectively. The company spends 9% of revenue on R&D and its US$1.2bn research budget is bigger than almost any competitor.

With significant financial resources, CSL can invest in cutting-edge AI technologies and infrastructure, hire top talent, and collaborate with leading AI research institutions. We can't think of a healthcare stock better positioned to benefit from developments in AI. HOLD.

Here is the link:

https://www.intelligentinvestor.com.au/recommendations/top-ai-healthcare-stocks-part-2/153690

It is interesting that the review did not extend to some of the smaller AI companies in the health sector of which there are many in various states of development.

There is also a useful review here:

AI is already being used in healthcare. But not all of it is ‘medical grade’

Dean, School of Computing Technologies, RMIT University, RMIT University

David Hansen

CEO, Australian e-Health Research Centre, CSIRO

Enrico Coiera

Professor of Medical Informatics, Macquarie University

Artificial intelligence (AI) seems to be everywhere these days, and healthcare is no exception.

There are computer vision tools that can detect suspicious skin lesions as well as a specialist dermatologist can. Other tools can predict coronary artery disease from scans. There are also data-driven robots that guide minimally-invasive surgery.

To precisely diagnose diseases and guide treatment choices, AI is used to analyse patients’ genomic and molecular data. For instance, machine learning has been applied to detect Alzheimer’s disease and to help choose the best antidepressant medication for patients with major depression.

Deep learning methods have been used to model electronic health record data to predict health outcomes for patients and provide early estimates of treatment cost.

Much more here:

https://theconversation.com/ai-is-already-being-used-in-healthcare-but-not-all-of-it-is-medical-grade-207912

We just have to wait and see how this evolves – as we can be sure there will be a lot of investment in this area over the next few years!

Watch this space….

David.

Wednesday, July 17, 2024

There Really Are Some Who Can’t Recognise The Time To Stop It Has Arrived!

This appeared last week:

Personally Controlled Electronic Health Record

No ‘shoebox of PDFs’: My Health Record in good shape, says former ADHA CDO


By Peter Gearin

Thursday July 11, 2024

Steven Issa stepped down as chief digital officer of the Australian Digital Health Agency (ADHA) two years ago, but any criticism of My Health Record still stings.

“I genuinely believe in it,” Issa told The Mandarin following his presentation at the Qualtrics X4 conference in Sydney. “For families like mine — and those who are frequent fliers in the healthcare system — I can’t tell you how much of a benefit it can be.”

More here:

https://www.themandarin.com.au/250453-no-shoebox-of-pdfs-my-health-record-in-good-shape-says-former-adha-cdo/

Really you wonder why, after more than a decade, there is still a belief that the myHR can be a nationally useful system that should continue to be supported and funded!

It is clear the time has come to stop wasting money on what is obviously a failed idea – or at least a failed implementation of an apparently unworkable idea.

Surely we need to stop it before we all go blind!

David.