I Worry If This Is A Good Idea Or Not For A Test!

This appeared last week:

Alzheimer's

Alzheimer’s blood test can spot people with early symptoms, study suggests

New test accurately picks up on memory problems by examining two proteins in blood plasma, US researchers find

PA Media

Sat 7 Jun 2025 14.51 AEST

A new blood test for Alzheimer’s disease can accurately detect people with early symptoms, research suggests.

Experts from the Mayo Clinic in the US have provided further evidence that blood tests can work to accurately diagnose dementia by examining two proteins in blood plasma.

The proteins – amyloid beta 42/40 and p-tau217 – are associated with amyloid plaque buildup, which is a hallmark of Alzheimer’s disease.

Researchers found the blood test was highly accurate, with 95% sensitivity, which means it was 95% accurate in picking up people with memory problems, with very few cases missed.

It was also 82% for specificity, which means it was also highly accurate in ruling out people without dementia.

The study was carried out on more than 500 people in an outpatient memory clinic, meaning it is real-world data.

The blood test has been approved by the Food and Drug Administration regulator in the US.

Dr Gregg Day, who led the study in the journal Alzheimer’s and Dementia, said the test was as good as more invasive tests in use.

“Our study found that blood testing affirmed the diagnosis of Alzheimer’s disease with 95% sensitivity and 82% specificity,” he said.

“When performed in the outpatient clinical setting, this is similar to the accuracy of cerebrospinal fluid biomarkers of the disease and is much more convenient and cost-effective.”

Overall, researchers found that p-tau217 levels were higher in patients with Alzheimer’s disease versus those without the disease.

Day said the next steps in the research were to evaluate blood-based testing in more diverse patient populations and people with early Alzheimer’s who showed no cognitive symptoms.

Dr Richard Oakley, associate director for research and innovation at the Alzheimer’s Society in the UK, said the results “suggest this test is very accurate” and could be used alongside other tests and observations from a trained health professional.

“This study shows how blood tests are making diagnosis of Alzheimer’s disease quicker, easier and more accessible than ever before in a real-world setting,” he added.

“While focused on Alzheimer’s disease, the test was evaluated in people with other types of dementias too, showing that it may help with differentiate causes of cognitive decline, though more research in diverse groups of individuals and in community-based setting is still needed.

“Currently diagnosis options in the UK are often slow, expensive and can be invasive, meaning thousands miss out on the benefits one can bring.

“It’s great to see blood tests like this approved for clinical use in the US. We hope to see the same in the NHS, which is why we’re part of the Blood Biomarker Challenge.”

The Blood Biomarker Challenge is a multimillion-pound research programme supported by the Alzheimer’s Society, Alzheimer’s Research UK and the National Institute for Health and Care Research. Its goal is to bring blood tests for dementia diagnosis to the National Health Service by 2029.

Oakley said: “Blood tests will be critical to accelerate diagnosis and give more people access to the care, support and treatments they desperately need faster than ever before.

“We must see long-term investment in the tools and workforce needed to ensure everyone living with dementia can get an early an accurate diagnosis, which is even more important with disease-modifying treatments on the horizon.”

Dr Julia Dudley, head of research at Alzheimer’s Research UK, said: “We urgently need to improve how we diagnose dementia and it’s great to see international research working towards this goal.

“Blood tests in this study look at p-tau217 and amyloid beta 42/40 and showed the tests offered high accuracy in confirming Alzheimer’s disease.

“This study adds to the growing evidence that blood tests can detect the diseases that cause dementia in people with early memory and thinking problems.

“An important point to consider is that people taking part in research don’t always reflect the full diversity of those affected by dementia, who might have additional conditions or other characteristics.

“That is why work is needed to understand whether these blood tests work in a real-world setting.

“In the UK, studies like the Blood Biomarker Challenge are helping to build this evidence. The study is testing blood tests, including p-tau217, in thousands of people from sites across the UK.

“This work will be a crucial part of making diagnosis easier and faster, which will bring us closer to a cure.”

Hare is the link:

https://www.theguardian.com/society/2025/jun/07/alzheimers-blood-test-can-spot-people-with-early-symptoms-study-suggests

This is all very good but do I really want to know I am doomed to Alzheimer’s disease any earlier than absolutely necessary. For me I just want to float off to la-la land and never be aware it has happened – with maybe a week or two notice to get my affairs in order and say my goodbyes to those I love.

What do others think about how the onset of dementia should be handled?

If offered a test that could tell how long you had - would you want it? Not sure I would!

A hard one!

David.

This Man Made A Real Difference To How We All Now Use Computers.

This appeared a few days ago:

Bill Atkinson, who made computers easier to use, dies at 74

John Markoff

Jun 8, 2025 – 9.37am

Bill Atkinson, an Apple Computer designer who created the software that enabled the transformative visual approach pioneered by the company’s Lisa and Macintosh computers, making the machines accessible to millions of users without specialised skills, died on Thursday night at his home in Portola Valley, California, in the San Francisco Bay Area. He was 74.

In a Facebook post, his family said the cause was pancreatic cancer.

Atkinson programmed QuickDraw, a foundational software layer used for both the Lisa and Macintosh computers. Composed of a library of small programs, it made it possible to display shapes, text and images on the screen efficiently.

The QuickDraw programs were embedded in the computers’ hardware, providing a distinctive graphical user interface that presented a simulated “desktop”, displaying icons of folders, files and application programs.

Atkinson is credited with inventing many of the key aspects of graphical computing, such as “pull-down” menus and the “double-click” gesture, which allows users to open files, folders and applications by clicking a mouse button twice in succession.

Before the Macintosh was introduced in January 1984, most personal computers were text-oriented; graphics were not yet an integrated function of the machines. And computer mice pointing devices were not widely available; software programs were instead controlled by typing arcane commands.

The QuickDraw library had originally been designed for Apple’s Lisa computer, which was introduced in January 1983. Intended for business users, the Lisa predated many of the Macintosh’s easy-to-use features, but priced at $US10,000 (almost $US33,000 ($50,000) in today’s money), it was a commercial failure.

A year later, however, QuickDraw paved the way for the Macintosh graphical interface. It was based on an approach to computing that had been pioneered during the 1970s at Xerox’s Palo Alto Research Centre by a group led by computer scientist Alan Kay. Kay was trying to create a computer system that he described as a Dynabook, a portable educational computer that would become a guiding light for Silicon Valley computer designers for decades.

Xerox kept the project secret, but Dynabook nevertheless ultimately informed the design of the Lisa and the Macintosh. In an unusual agreement, Xerox gave Apple co-founder Steve Jobs and a small group of Apple engineers, including Atkinson, a private demonstration of Kay’s project in 1979.

The group, however, was not permitted to examine the software code. As a result, the Apple engineers had to make assumptions about the Xerox technology, leading them to make fundamental technical advances and design new capabilities.

In Insanely Great, a book about the development of the Macintosh, Steven Levy wrote of Atkinson, “He had set out to reinvent the wheel; actually he wound up inventing it.”

Atkinson’s programming feats were renowned in Silicon Valley.

“Looking at his code was like looking at the ceiling of the Sistine Chapel,” recalled Steve Perlman, who as a young Apple hardware engineer took advantage of Atkinson’s software to design the first colour Macintosh. “His code was remarkable. It is what made the Macintosh possible.”

In an early Apple commercial for the Macintosh, Atkinson described himself “as a cross between an artist and an inventor”.

He was also the author of two of the most significant early programs written for the Macintosh. One of them, MacPaint, was a digital drawing program that came with the original Macintosh. It made it possible for a user to create and manipulate images on the screen, controlling everything down to the level of the individual display pixel.

Ordinary users without specialised skills could now create drawings, illustrations and designs directly on a computer screen. The program introduced the concept of a “tool palette”, a set of clickable icons to select simulated paintbrushes, pens and pencils.

MacPaint had a significant impact in helping to transform computers from business and hobbyist systems into consumer products that could be marketed as tools to enable individual creativity.

After the introduction of the Macintosh, while under the influence of a modest dose of LSD, Atkinson conceived of a program that would weave text, images and video seamlessly in a simple-to-use database. That experience would lead to Apple’s HyperCard software, a forerunner of the World Wide Web.

The program, first conceived independently by computer pioneers Ted Nelson and Douglas C. Engelbart, was intended to allow nonprogrammers to easily compile information that would be interconnected by digital links known as hypertext.

After a visit with Engelbart while he was designing his system, Atkinson added command-key shortcuts to offer users more computing power after they learned to use pull-down menus.

In 1985, while sitting on a park bench near his home in Los Gatos, California, Atkinson peered up at the stars in the night sky and then looked at the streetlights that surrounded him. He decided that the various lights were like pools of knowledge separated by great distances and remaining unconnected.

“I thought if we could encourage sharing of ideas between different areas of knowledge, perhaps more of the bigger picture would emerge, and eventually more wisdom might develop,” he wrote in Mondo 2000, a Silicon Valley magazine published in the 1980s and ’90s. “Sort of a trickle-up theory of information leading to knowledge leading to wisdom.”

William Dana Atkinson was born March 17, 1951, in Los Gatos, the third of seven children of John Atkinson, an anesthesiologist, and Ethel Dana Atkinson, an obstetrician.

At age 10, after Bill was given a subscription to Arizona Highways magazine, he began cutting out nature photographs and placing them on his bedroom wall. That led to a lifetime passion for nature photography and eventually a second career as a commercial and artistic photographer. A 2004 book, Within the Stone, presented his close-up photographs of stones that had been cut and polished.

Atkinson was studying for a doctorate in neurobiology at the University of Washington when Jobs persuaded him to become the 51st employee at Apple. He decided to leave school after Jobs told him, “Think how fun it is to surf on the front edge of a wave, and how not-fun to dog paddle on the tail edge of the same wave.”

During the early 1980s, when Jobs was leading a small group of young software and hardware designers to create the Macintosh computer, he and Atkinson were virtually inseparable. But when Jobs was forced out of Apple in 1985, leading him to create a new computer company called Next, Atkinson declined to leave with him, citing his commitment to the HyperCard project.

Jobs did not take rejection easily, and their relationship chilled for a number of years.

Atkinson worked on HyperCard as a contractor and stipulated that the product initially be distributed with the Macintosh at no extra cost.

In the late 1980s, the computer industry was awash with interest in building lighter, more portable machines. In 1989, Atkinson, along with Andy Hertzfeld, another former Macintosh developer, and Marc Porat, a Stanford University-educated economist who had recently joined Apple, persuaded Apple’s CEO at the time, John Sculley, to help fund a start-up that they named General Magic. The company developed a handheld computer in competition with the Newton, an internal Apple project.

Both projects would eventually fail commercially, but they are widely viewed as the forerunners of Apple’s wildly successful iPhone and iPad products, introduced after Jobs returned to Apple.

Atkinson left General Magic in 1996 and worked independently on a number of projects, including one for Numenta, an early artificial intelligence company.

He was married three times. He is survived by his wife, Cai, two daughters, a stepson, a stepdaughter, two brothers and four sisters.

Atkinson almost did not survive to see the introduction of the Macintosh. On his way to work one morning, he was in a crash in which the top of his sports car was sheared off. He was taken unconscious to a hospital. A police officer at the scene said Atkinson had been lucky not to have been decapitated.

Jobs raced to the hospital, where he found Atkinson alert. “Is everything OK?” he asked, according to an account by Hertzfeld. “We were pretty worried about you.”

Even in a hospital bed, though, Atkinson’s mind was on software, specifically a key aspect in the design of the QuickDraw system.

“Don’t worry, Steve,” he said, “I still remember how to do regions.”

This article originally appeared in The New York Times.

Here is the link:

https://www.afr.com/technology/bill-atkinson-who-made-computers-easier-to-use-dies-at-74-20250608-p5m5qi

It is interesting to read the story on one of the giants who got us to where we are now with having computers that are so wonderfully easy to use to get our work done. It is easy to forget just how far computer useability has evolved in the past 60 or so years!

David.

This Is A Trend We Should Be Pretty Grumpy About!

This appeared last week:

Hospitals ‘buffing’ surgery wait times to hit KPIs, doctors warn

By Kate Aubusson

June 8, 2025 — 5.00am

NSW hospitals are refusing to accept patients for cancer surgery and other time-critical procedures, pressuring surgeons to downgrade the seriousness of urgent cases to meet their publicly reported targets.

The tactics used to manipulate surgery waitlist data, revealed by senior public hospital surgeons, conceal the true extent of delays for patients with serious medical conditions in overstretched hospitals, where administrators are under immense pressure to meet state government-enforced benchmarks.

Several senior specialists report RPA and Westmead are among the public hospitals refusing to add urgent “category 1” patients to waitlists unless their surgeon can guarantee an available operating theatre session within the clinically recommended 30-day wait time.

“The doctors have the capacity to perform the procedure, but if the hospital doesn’t have the theatre time or resources to get them done [in time], they won’t accept a patient’s booking form,” said general surgeon and Australian Medical Association NSW vice president Dr Fred Betros.

“That way, they won’t breach the publicly reported KPI. Everything looks like it’s under control, so we don’t get the resources and future funding we need to keep up with demand.”

One senior surgeon prohibited from speaking publicly by their employment contract characterised the practice as “buffing the numbers”.

The Bureau of Health Information (BHI), a state government agency, collects and publishes elective surgery data for every NSW public hospital. Its latest quarterly report shows that 99.1 per cent of essential surgeries were performed on time in NSW.

According to the report, no RPA patient has waited longer than clinically recommended for surgery in the last two years.

One senior specialist not authorised to speak publicly said RPA’s administration was “obsessed with its surgery KPIs”.

“Hospitals are not allowed to refuse a recommendation for admission [the form specialists complete to admit a patient for surgery], but they do it all the time,” they said.

NSW Health’s surgery policy states urgency categories must be “based on the patient’s clinical need … and not influenced by the availability of hospital or surgeon resources”.

Another senior clinician not authorised to speak said: “I always thought that the focus of an individual hospital’s executive would be, ‘Okay, we’ve got patients breaching. That means we should tell the ministry we’ve got patients breaching, so we need more resources,’ and the ministry would go, ‘Okay, there’s your resources because your KPIs show that you’re breaching’, but they don’t. They get told to make the problem go away.

“The burden of disease is still there. The people [who need care] are still out there. The problem won’t go away with jiggery pokery.”

NSW Health’s surgery access policy

If a patient is likely to breach the recommended wait time, the clinical director of surgery must consider, in conjunction with the surgeon, patient and senior management:

- Additional theatre time at the same or another facility

- Pooled surgery lists, where patients may be treated by any doctor of the same specialty 

- Transfer patients to another doctor with a shorter surgery list (if available)

- Paying for the patient to be transferred to a private hospital

Dr Jenny King, chair of Westmead Hospital’s Medical Staff Executive Council, described scheduling patients for urgent surgery within a couple of weeks due to the severity of their condition only to have booking staff push the date closer to the 30-day cut-off to bring forward a less urgent patient about to become overdue.

King said one “seriously unethical” strategy involved cancelling overdue paediatric dental surgery lists to prioritise patients breaching wait times that are KPIs, for instance, head and neck cases.

“These paediatric dental patients often have special needs or serious medical issues, but it doesn’t matter if they breach because their wait times are not a KPI, so no one looks at them,” King said.

“Their parents are at their wits’ end, and they have no option but to pay a fortune in the private sector. Often, the private hospitals won’t take difficult kids with behavioural issues.”

A spokesperson for Western Sydney Local Health District (WSLHD) – which oversees Westmead – said a small number of paediatric dental procedures were rescheduled to alternative theatre lists to prioritise more clinically urgent cases.

King said Westmead surgeons had not been pressured to change urgency categories since the appointment of a new associate director of operations for surgery two months ago to oversee efforts to get the hospital to the “magic triple zero” (zero patients overdue in categories one, two and three).

“Our response has always been that if you can’t fit patients on lists in the appropriate time for the condition, then there simply aren’t enough lists,” King said.

In 2022, WSLHD unsuccessfully attempted to contractually bar doctors from adding patients to surgery wait lists unless they could guarantee they had time to perform the procedure within the recommended timeframe.

Health Minister Ryan Park said he expected surgery management to be consistent with health policies, “and if there’s any evidence to suggest otherwise, I’d seek a please explain”. Park ordered an independent review of recategorisation of surgery at Orange Hospital after the ABC reported on similar issues.

The WSLHD spokesperson rejected that surgeons had been asked to prioritise waiting list targets over patient care, saying all RFAs were accepted and waitlisted in line with NSW Health policy.

“WSLHD maintains its commitment to ensuring the efficient and safe management of surgery to deliver the best possible outcomes for patients,” they said.

Risky delays for colonoscopies

Meanwhile, patients with suspected bowel cancer are waiting for months for colonoscopies, which should be performed within 30 days of a positive screening result.

“There are gastroenterologists whose patients have gone well beyond that timeframe because colonoscopy wait times aren’t measured as a KPI reported to the ministry or published publicly,” Betros said.

Professor Nick Talley, gastroenterologist and chair of the luminal faculty at the Gastroenterology Society of Australia, said category 1 patients could wait two or three times longer than they should for a colonoscopy in the public system.

“That’s just not good enough,” Talley said. “Colon cancer will progress from a curable stage to an incurable stage within several months, and that is the kind of time period some people are waiting.”

The WSLHD spokesperson said there are some delays accessing gastroenterology procedures as demand is increasing, and work was underway to address this by implementing a networked approach across the LHD.

‘The tip of a very big iceberg’

Surgeons also reported being asked to re-categorise urgent patients to category 2 “semi-urgent” (recommended within 90 days) if about to breach the 30-day timeframe.

Betros said the tactic was not endemic, but tended to arise at times of overwhelming demand for individual hospitals.

“[Hospital clerical staff] will say: ’We can’t do it within 30 days, but if we can guarantee they will get their surgery five days late, can we change them to category 2?” he said.

Betros said a five-day delay was highly unlikely to affect a patient’s clinical outcome, but the approach obscured the lack of appropriate funding to keep up with demand for surgical services.

“This is the tip of a very large iceberg,” he said. “Our patients are more overweight, they’re more cirrhotic [liver damage] because they’ve got more emphysema [a type of lung disease] than they’ve ever had, and it’s because our public health measures aren’t pushing the tidal wave back.”

The final report from the Special Commission of Inquiry into NSW’s health funding warned the system risked being overwhelmed by ageing and chronically ill patients, characterising the failure to embed prevention into the system as “beyond comprehension”.

“It all gets kicked down the road to become an even bigger problem, and it just compounds with every year,” Betros said.

A NSW Health spokesperson said all LHDs were expected to adhere to the elective surgery access policy.

“Every endeavour is made to ensure patients are treated within the timeframes required for their level of urgency as assigned by their treating doctor,” they said.

Here is the link:

https://www.smh.com.au/national/nsw/hospitals-buffing-surgery-wait-times-to-hit-kpis-doctors-warn-20250604-p5m4xp.html

This hardly comes as a surprise – as you can be sure all the administrative bureaucrats will know their bonuses (and employment etc.) depend on good figures being reported each quarter.

All Joe Public can do is hope the figures reported reflect reality!

I am not sure how we can change things to ensure accuracy, but being sure we are  even getting close to accurate figures would be good!

Having worked in such bureaucracies I know real efforts to keep figures and outcomes accurate are usually genuine!

I love the use of the term 'buff' from the wonderful book "The House of God" by Samuel Shem!  That book really had some great insights as to the reality of busy acute hospitals and EDs!!

David.

Concern About Blog Wandering Off Topic!

 Of late I have been posting material I find interesting. Some of this is Digital Health and some is more general material. When I note Digital Health related material I will always post it (please e-mail relevant links for me to post!). Other more general material I will post if I find it generally useful / interesting. As always if you don't like what you see please just ignore the post or the blog! 

Your call..... 

David.

I Suspect This Blog Will Only Be Of Interest To About Half My Readers!

This appeared last week:

https://www.theaustralian.com.au/health/relationships/oh-just-one-more-thing-doctor-the-latest-on-dealing-with-erectile-dysfunction/news-story/4be35822e1e0ac84cf4e6ef5bd6c162f

‘Oh, just one more thing doctor’: The latest on dealing with erectile dysfunction

Whether you need a little bit of help or a lot, there’s likely a solution out there for those with erectile dysfunction. We give you the latest.

Stephen Lunn

Updated 11:10 AM April 19, 2025

“Oh and there’s just one more thing, doctor …”

This offhand comment at the end of a visit to the GP is often the start of the journey for men dealing with erectile dysfunction.

The topic of ED can be discomfiting, or downright embarrassing, but it’s vital for men to know that it is not only a common condition, but also a treatable one in most cases.

So what is ED exactly? What causes it? How common is it? Who should you talk to about your concerns? And what can you do about it?

Answering these questions can be more than informative, they can be transformative for men worried their days of having sex are over forever.

What is erectile dysfunction?

Writing about this topic will require some bluntness, but in the interests of clarity it is preferable to be straightforward than to deal in euphemisms.

ED is the inability of a man to have an erection firm enough, or for a long enough period of time, to engage in penetrative sexual intercourse. The penis won’t get hard, or it won’t stay hard.

For those wondering if this is the same as impotence, the answer is yes. But impotence is a word no longer in common medical use due to the stigma of inadequacy with which it became associated.

The biomechanics of an erection are complex. It starts in the brain, where the desire to have sex manifests. That message is transported along the spinal cord into the pelvis, opening arteries in the penis and allowing blood to fill two sponge-like chambers that run along its shaft.

By enlarging the penis, the veins are closed off, so the blood is trapped.

This process of filling, or trapping, the blood may fail for a number of reasons, either physical or psychological.

The impact can be acute. It means not having sex in the way you want to, if at all. It can be devastating for men, who may feel a loss of masculinity, with all the flow-on emotions that entails.

It can put a huge strain on couples, the loss of physical intimacy sometimes spelling the end of a relationship. And for men looking for a new partner, it can feel like a huge hurdle at the starting gate.

What causes it?

Melbourne urological surgeon Christopher Love says the days of thinking that ED is primarily a psychological issue are long gone, though for some, around one in 10 cases, it is still the primary cause.

“We now know that about 90 per cent of chronic ED cases are related to physical or medical factors. We’re talking about smoking, being overweight, having high cholesterol or high blood pressure,” Dr Love says.

“There is one factor you can’t change, which is ageing. ED is more common the older you get. Your arteries tend to harden, restricting blood flow.”

Dr Love also notes that surgery or cancer treatment that affect the pelvic area, such as prostate cancer treatment, can be a common cause of ED.

How common is it?

There are conflicting statistics on ED prevalence in Australia. The federal Department of Health and Aged Care in its examination of the link between smoking and ED notes that “one in five men over the age of 40 have some problem with erections and one in 10 men over 40 are unable to get an erection”.

Yet that page links to a government-sponsored health advice page, healthdirect, which reports that erectile dysfunction affects up to two in three males aged over 45.

Another research paper, published in the Medical Journal of Australia in 2013, examined ED across a cohort of more than 108,000 men in the 45 and Up Study.

It found the overall prevalence of ED was 61 per cent for over-45s. This figure was broken down into 25 per cent who reported mild erectile dysfunction (experienced ED “sometimes”), 19 per cent with moderate ED (“usually”) and 17 per cent had complete erectile dysfunction.

“Overall, the risk of moderate/complete ED was higher among men with low socio-economic status, high body mass index, those who were sedentary, current smokers, and those with diseases including diabetes, heart disease, and depression/anxiety, compared with men without these risk factors,” the study says.

“Almost all men aged 75 or older reported moderate/severe ED; however, increased physical activity was associated with lower odds of ED in this group.”

That finding was closer to a US study cited by the Cleveland Clinic that finds ED affected around 40 per cent of men at age 40 and nearly 70 per cent at age 70. Complete ED increased from 5 per cent at age 40 to 15 per cent at age 70.

Smoking is a significant risk factor. The Health Department’s information says that for every 100 non-smokers aged over 40 with ED there are between 130 and 150 smokers.

Melbourne urologist Gideon Blecher describes his typical ED patient. “They’re average guys, some are a little overweight but not drastically so. They’ll have busy lives and jobs. They’ll say that in the last few years their erection is not as strong or they’re not lasting as long.

“They’ll have been burying their heads in the sand for years, so it is often huge for them to seek treatment. It can be really emotional,” Dr Blecher says.

Who should you talk to?

The first port of call can be your GP, or you may seek more anonymous advice from an online health service.

“Some men take a deep breath and just come out with it,” Melbourne GP David Fox says.

“But I’d say most spend a lot of time talking about other things, then right at the end of the appointment it will come as a ‘By the way’, or ‘There’s just one other thing,” he says.

“I understand that for men this is very uncomfortable and difficult to talk about, especially the first time. I’m likely to be the first person apart from their intimate partner who they’ve spoken to about it.

“So it’s important to give that more time, even though it might delay the timely start of the next patient’s appointment.

“I ask how long it has been an issue, what is the impact on him and on his partner, what level of ED we are talking about, and has he tried anything in terms of treatment,” Dr Fox says.

For those who don’t want to face their GP, or another doctor face-to-face, the other option is to seek advice online, not from Dr Google, but from a health practitioner operating remotely.

Dr Love, a penile implant surgeon, is also a medical adviser to men’s online health service MOSH, which offers consultation with health practitioners and treatment options without a face-to-face consultation.

“These online platforms do address issues such as a patient being too embarrassed to talk face-to-face, and GPs being time poor,” he says.

Dr Fox is concerned that online clinics may be too focused on the one issue without looking at broader health factors that may be relevant.

“This is important because ED can be an indicator of other issues such as cardiovascular disease.”

But Dr Love says the online consultations, done correctly, will cover this off.

“It’s not like you get a prescription without being asked broader questions about your general health,” he says.

Tests to examine the cause of ED range from simple blood tests to a full psychological examination, to a penile duplex ultrasound that checks blood flow into and out of the penis.

But most of the time ED and its causes can be established without invasive testing.

What are the treatment options?

The experts will all tell you that in the majority of cases there is a successful treatment option available for ED.

Oral medications

The first and most obvious, and most successful, option is an oral medication. Sildenafil, known by its commercial name Viagra, boosts chemicals in the body that open up the blood vessels to get more blood to the penis.

Similar drugs are available, with different strengths, including Vardenafil, Tadalafil and Avanafil. Tadalafil is unique in that it can be taken in a very low dose daily to provide for more spontaneous sexual activity.

Because it is no longer under patent, Viagra costs around $2.50 per tablet. It does require planning, as it needs to be taken an hour before sex.

Dr Fox says these drugs work for around 70-80 per cent of the patients he prescribes them to without any further concerns. But some have side effects like headache or facial flushing.

“And other patients will say it doesn’t work fully or at all, so we can try different oral medications for those for whom the first-line drug is not working or is giving them side effects.

“If they still aren’t working, at that point I’d refer them to a urologist,” Dr Fox says.

It can’t be forgotten that over the past few decades these tablets have been a game changer for many men.

“The tablets are great,” Dr Blecher says. “The vast majority of guys will respond to most forms of tablet, which successfully open up their blood vessels. The men will have penises that are harder, and last longer.”

If oral medications aren’t working, this is not the end of the road. Men have other options, including new ones coming onto the market. But some aren’t for the squeamish.

Self-injection therapy

“It sounds awful at first. I see guys wince when I suggest it in our appointments,” Dr Blecher says.

“But it’s only a small needle, and is really the next option for those not responding to tablets.”

The patient, or his partner, injects medication directly into the side of the penis in order to generate an erection about five to 15 minutes later. The small needle distributes a small amount of the drug, and according to the urologists the patients quickly get used to doing the injections.

“It’s like a superstrong version of Viagra going directly into the penis,” Dr Love says, with an erection usually lasting anywhere between 30 and 90 minutes.

He says about three in four men who try it are satisfied with the therapy as an option for them, though again this treatment involves pre-planning for sex.

But like any injection-based treatment, there is the risk of bruising and bleeding. And for this particular treatment there is also the risk of a prolonged erection, up to four hours, which may require medical intervention.

Vacuum devices

These devices basically do what you’d expect, how you’d expect.

A small vacuum tube is placed over the penis and pressed against the abdomen to create a seal. Then the air is sucked out of the device with a handheld pump, drawing blood into the penis. It is trapped there by placing a rubber ring at the base of the penis.

“The penis is basically sucked up into an erection,” Dr Love says.

He says this is a useful option for those who can achieve a partial erection through foreplay, and has the advantage of being non-invasive.

“But while it can be quite effective for patients who get used to using it, it doesn’t really create a rock-hard erection, so it’s not ideal for young to middle-aged patients,” he says.

Dr Blecher says about 10 to 15 per cent of his patients are using the vacuum technique.

“It can be cumbersome to use and is not very sexy. But some guys are in long-term, great relationships wanting to enjoy their sex lives, and they’re very happy with this as an option for them,” he says.

Shockwave therapy

This treatment for ED, which has been in use for about a decade, sounds shocking but is completely painless.

The doctor will run a low intensity shockwave machine, which looks like a large pencil, along the side of the penis, the idea being that it will promote blood flow in the area and improve erections. It requires weekly treatments for about six weeks.

“This is for a guy who’s erections aren’t quite there, but who wants to move off the tablets or achieve a better response to them,” Dr Blecher said. “They like it because there is no side-effect profile, but the improvement is mild to moderate at best.”

Dr Love said a newer treatment along similar lines is gaining momentum, which involves a machine delivering radiofrequency energy to the penis. But he says that as yet there is not strong evidence of its effectiveness.

“The idea is that it makes the tissue heat up and that makes the body produce more collagen, which is important for the structural requirements of an erection. It may play more of a role in future treatments.”

Inflatable penile implants

This is the most complex and invasive of the treatments, but is also the most reliable in terms of guaranteeing an erection.

The surgical procedure has been around for 50 years, and has been taken up by hundreds of thousands of men worldwide, with high satisfaction rates.

Dr Love says they offer the most reliable, spontaneous answer to ED, and with a low risk of any side effects.

There are a number of different types, and the mechanics are intricate. The simplest description is that they are inflatable tubes replacing the natural tubes inside the penis, implanted through surgery.

When the man wants an erection, he can fill the tubes with a salt water solution from a reservoir that has been permanently inserted into his abdomen. The pumping mechanism is inside the scrotum.

The result is immediate, and the penis can be inflated to the desired firmness, within 30 seconds. After sex, the man can reverse the process, pumping the solution back into the reservoir.

“We see men who have been struggling for years, they’ve tried everything else, and are embarrassed and frustrated that nothing works. By the time we see them their relationship has taken a hit,” Dr Blecher says.

“But this procedure is low risk, and they get a reliable erection and enjoy it.”

Dr Love agrees. “It’s a great treatment because it will work no matter how bad the erectile problem is. All other aspects of sex are the same, touch, feel, ejaculation, it’s all the same.”

There are downsides though, including that once an implant has been inserted the man will no longer be able to have a natural erection. This is why it is for the most difficult cases.

A final word

Dr Love says having an enjoyable sex life is an important part of life, and men should be willing to explore their options.

“Oral medication works for most, but if they don’t there are other good treatments, so don’t stop just because the tablets aren’t doing the trick,” he says.

Dr Blecher says men of all ages who continue to be interested in having sex should check what’s available.

“In our practice we see quite a lot of men in their mid to late 80s who still enjoy a healthy sex life and want to maintain it.”

https://www.theaustralian.com.au/health/relationships/oh-just-one-more-thing-doctor-the-latest-on-dealing-with-erectile-dysfunction/news-story/4be35822e1e0ac84cf4e6ef5bd6c162f

This is a pretty sound article which covers the issue pretty well!

The main point is that there are a lot of decent solutions to erectile dysfunction and man should not be worried about seeking help for this problem. Help can transform your life if you have problems – so chat to your GP and get help. You and your partner will both be happier I suspect!!!

David.

AusHealthIT Poll Number 797 – Results – 08 June 2025.

Here are the results of the recent poll.

Are You Concerned The US Is Suggesting China Appears To Be Planning To Invade Taiwan Reasonably Soon?

Yes                                                                       8 (36%)

No                                                                       14 (64%)

I Have No Idea                                                    0 (03%)

Total No. Of Votes: 22

Clearly a majority do not think an invasion is likely soon!

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

Pathetic voter turnout – answer must have been too easy. 

0 of 22 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.

It Seems We Are Gradually Making Progress In Reading These Ancient Scrolls!

This appeared last week:

Digital archaeology

The decoding of ancient Roman scrolls is speeding up

More data, and a more powerful particle accelerator, should pay dividends

May 28th 2025|Herculaneum

IF YOU WANTED to read an ancient Roman scroll, you might reach for a dictionary, and perhaps a magnifying glass. You would probably not think of using a particle accelerator. But that is what is required to unravel the papyrus scrolls found in Herculaneum, a Roman town buried by the eruption of Mount Vesuvius in 79AD. Even then, success is far from guaranteed: since 2023 researchers attempting to unravel the scrolls have been stuck on the first few. Now, armed with more data and a more powerful particle accelerator, they expect to make more rapid headway.

The scrolls in question, stored in a library in a Roman villa that is thought to have belonged to the father-in-law of Julius Caesar, were carbonised by scorching gases that engulfed the town during the volcanic eruption that also buried the nearby town of Pompeii. All attempts to unroll them physically, starting in the 18th century, caused them to disintegrate. So instead researchers have been unrolling them virtually, through computer analysis of high-resolution 3d X-ray scans—which is where the particle accelerator comes in.

Such virtual unrolling is a two-stage process pioneered by W. Brent Seales, a computer scientist at the University of Kentucky. The first stage, called segmentation, involves tracing the edges of the rolled-up papyrus sheet inside the 3D scan, and then extracting 2D images of the scroll’s surface. The second stage, ink detection, analyses the resulting images to distinguish the ink of the scroll’s text from the papyrus background. This is particularly tricky for the Herculaneum scrolls, which were written in carbon-based ink, so there is very little contrast against the background of carbonised papyrus.

Dr Seales thought artificial-intelligence techniques might be able to help. In 2023 he launched a contest, called the Vesuvius Challenge, along with Nat Friedman and Daniel Gross, two technology entrepreneurs who provided backing. A few X-ray scans were made available online, and a community of thousands of enthusiasts has subsequently developed a range of software tools to speed up the fiddly processes of segmentation and ink detection. In late 2023 the project achieved a breakthrough when the first passages of text, in Greek, were extracted from scans of a scroll called “Banana Boy”. Three computer-science students shared a $700,000 reward for doing so. (The scroll’s nickname refers to its banana-like shape rather than its content, which appears to be a previously unknown philosophical work.)

At the time, Mr Friedman predicted that entire scrolls would be decoded by the end of 2024. But progress has been significantly slower than anticipated. “I think I entered 2024 a little cocky,” he admits. One problem was that improving the segmentation software turned out to be unexpectedly difficult. But Mr Friedman now thinks the main obstacle was the quality of the original X-ray scans.

Banana Boy, which belongs to a Parisian museum, was one of four scrolls that had been scanned at the Diamond Light Source (DLS), a particle accelerator in Oxfordshire. A so-called synchrotron light source, it accelerates electrons to almost the speed of light in a storage ring 562 metres in circumference. As the electrons are steered around the ring, they emit electromagnetic radiation, the frequency of which can be carefully tuned, so as to produce X-rays. The resulting powerful beams are then used for various scientific purposes—such as scanning ancient texts.

Of the four originally scanned scrolls, however, Banana Boy is the only one in which ink has been detected. The scan of a second scroll was not as good, Mr Friedman says. Two other, smaller scrolls also seemed to contain very little ink. One possibility is that they were unfinished works, and so were mostly blank. But it is also possible, says Dr Seales, that chemical treatment of those scrolls in the 1980s, during efforts to unwrap them physically, could have affected the ink. Having found text only in Banana Boy, says Mr Friedman, “We were banging our heads against the other three scrolls.”

Then the winds changed. During 2024 the team secured permission to scan a fifth scroll, kept at the Bodleian Library in Oxford, at the DLS. For the first time, individual letters were directly visible in the scans after the segmentation step, probably because this scroll was written with a different type of ink. Finding ink in another scroll was heartening, Mr Friedman says.

This month two volunteer researchers were awarded a $60,000 prize for detecting the scroll’s title—the first time the specific work on a Herculaneum scroll has been identified. It turned out to be “On Vices” by Philodemus, a philosopher who lived in the town (and the likely author of Banana Boy, too). Mr Friedman says longer fragments of text are now being found within the scroll. In April the team scanned another 20 scrolls at the DLS, flown by private jet from the Victor Emmanuel III National Library in Naples. This deluge of new data will help make the segmentation and ink-detection algorithms much better.

At the same time the team has secured a boost in scanning power. This month they undertook a further six-day scanning campaign using the Extremely Brilliant Source (EBS) at the European Synchrotron Radiation Facility in Grenoble, the world’s brightest synchrotron. The EBS can produce X-rays 10trn times brighter than those used in medical imaging—and with twice the maximum energy of the DLS, the EBS can perform scans more quickly. To determine how best to use this more powerful machine, the researchers spent the first three days trying out different scanning parameters, akin to adjusting the settings on a photo scanner to get the best results.

Increasing the incident energy of the individual X-rays in the beam (measured in kiloelectron volts, or keV) produces sharper images, but too much energy reduces the contrast and makes features harder to distinguish, says Dr Seales. Adjusting the so-called propagation distance between the item being scanned and the detector, can also affect sharpness and contrast. A third parameter is the spatial resolution, defined as the width of each volumetric pixel in the scan, measured in microns (millionths of a metre). Scanning at two-micron resolution produces far more detail than at eight microns, but the resulting digital files are 64 times larger.

Over a series of scans, all these parameters were varied in turn. The conclusion, says Dr Seales, was to use X-rays with an incident energy of 110keV (higher than the 53keV used at the DLS); a propagation distance of one metre (a longer distance made the contrast worse); and to scan at four microns and then downsample to eight microns, to get good sharpness at a smaller file size. Having established these settings, the team spent three days scanning a further 20 scrolls. The resulting scans, says Mr Friedman, are easily the best so far. “It’s a step change for us—we think it’s a game changer,” he says.

In particular, there is fine detail even in compressed regions, where layers of papyrus are very close together. This should help make the segmentation process easier and more accurate. Mr Friedman thinks reading entire scrolls by the end of this year is now feasible. “Nothing is going to stop me—we are going to solve this,” he insists. The next step is to “triage” the new scans to find the scrolls that can be read most easily, says Dr Seales. Further improvements are no doubt possible in the scanning process, he suggests: in future it may make sense to do a high-resolution scan that is optimised for segmentation, and then a lower-resolution one with more contrast for ink detection.

Eventually, the team aims to scan all 300 surviving unwrapped scrolls. The ultimate hope is that extracting text from the scrolls, and revealing previously unknown books from antiquity, will provide the justification for a full excavation of the villa in Herculaneum, which may contain thousands more scrolls. Gaining access to a lost library of that size “would be the largest discovery in human history”, says Dr Seales. For now, the villa remains under wraps in a quiet hollow next to the ancient town. But elsewhere, vast energies are being unleashed to uncover its secrets.

Here is the link:

https://www.economist.com/science-and-technology/2025/05/28/the-decoding-of-ancient-roman-scrolls-is-speeding-up

What fantastic news!!! I hope I am around to know what some of them say that is interesting!

David.

 

This Has To Be Really Good News for Some Patients!

These are really nasty cancers – if there is such a thing!

Cancer

‘Gift of life’: experts hail neck and head cancer breakthrough

Global trial shows immunotherapy drug significantly lowers chance of cancer spreading or returning

Andrew Gregory Health editor in Chicago

Sat 31 May 2025 09.00 AEST

An immunotherapy drug can ward off head and neck cancers for twice as long as the standard treatment, in the biggest breakthrough in two decades.

Pembrolizumab stimulates the immune system to fight cancer, targeting a specific protein that enables the drug to wipe out cancer cells.

The drug kept cancer at bay in some patients for an average of five years, compared with 30 months when added to standard of care, a clinical trial found.

The results were presented at the annual meeting of the American Society of Clinical Oncology, the world’s largest cancer conference.

The trial, which involved more than 700 patients across 192 sites in 24 countries, was led by researchers at the Washington University School of Medicine. Dr Douglas Adkins, the study’s co-principal investigator and a professor of oncology, said the results were significant and notable because it was the first time such a drug had generated this effect.

Researchers around the world tested the drug in patients with newly diagnosed locally advanced head and neck cancers. Hundreds of thousands of patients are diagnosed with these cancers globally each year.

Of 714 patients in the trial, 363 received pembrolizumab followed by standard of care, and 351 received only the current standard of care – surgery to remove their tumour followed by radiotherapy with or without chemotherapy.

Standard of care has not changed for these patients in more than 20 years, and more than half are unlikely to survive for five years.

The immunotherapy worked particularly well for those with high levels of the immune marker PD-L1, but it increased dramatically the likelihood of patients with all types of head and neck cancers remaining well, without the disease progressing or returning.

Kevin Harrington, a professor of biological cancer therapies at the Institute of Cancer Research, London, led a UK team involved in the trial, which was funded by the pharmaceutical company MSD.

“For patients with newly diagnosed, locally advanced head and neck cancer, treatments haven’t changed in over two decades,” he said. “Immunotherapy has been amazingly beneficial for patients with cancer that has come back or spread around the body but, until now, it hasn’t been as successful for those presenting for the first time with disease which has spread to nearby areas.

“This research shows that immunotherapy could change the world for these patients – it significantly decreases the chance of cancer spreading around the body, at which point it is incredibly difficult to treat.

“The results of this trial show that pembrolizumab dramatically increases the duration of disease remission for years longer than the current standard treatments. It works particularly well for those with high levels of immune markers, but it’s really exciting to see that the treatment improves outcomes for all head and neck cancer patients, regardless of these levels.”

Laura Marston, 45, from Derbyshire, joined the trial after she was diagnosed with stage 4 tongue cancer in 2019. “I am amazed I am still here six years later,” she said. “This treatment has given me the gift of life.”

Prof Kristian Helin, the chief executive of the Institute of Cancer Research, said: “Immunotherapy continues to deliver … To learn that patients with immunotherapy added to their treatment plan had, on average, double the length of time free from evidence of disease compared to those without it – with some patients still yet to see their cancer return – is wonderful.”

Here is the link:

https://www.theguardian.com/society/2025/may/31/neck-and-head-cancer-breakthrough-drug-immunotherapy

The good thing about this is that we are now seeing some immune therapies really make a big difference in the clinic.

Can I say not before time! Way back when I researched immune therapies on poor unfortunate mice (early 1970’s), we reckoned it would not be long till great benefit was seen. We were wrong as only now are some occasionally good results flowing from immunotherapy 50 years later.

Oh well, at least I am alive to see some successes!

David.