Quote Of The Year

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

or

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

Sunday, April 07, 2024

The Flogging Of This Dead Horse Is Really Getting Silly!

This appeared last week:

CareVision Working to Integrate My Health Record for NDIS Aged Care and Community Care

Apr 4, 2024 | Company News, Home Care Software, Home Care Technology

The Australian government recommends the universal adoption of My Health Record by the aged care sector. My Health Record provides authorised healthcare professionals with access to a patient’s key health information. CareVision is working towards integrating My Health Record as it provides many benefits:

  •                Saves time in the transfer of care especially in emergencies
  •     Quick and reliable verification and validation of clinical information
  •     It helps in avoiding the duplication of tests as well as diagnostic imaging
  •    Improves the continuity of patient or client care

The information included in My Health Record is uploaded by healthcare professionals, including doctors and pharmacists. Some of the clinical documents that will be accessed include:

  •                shared health summaries
  •   vaccination and immunisation information
  •     prescription and dispense records
  •   discharge summaries
  •    transfer of care information
  •    radiology and pathology results.

It is also possible for the actual patients or their family members and carers to upload advanced care documents.

Here is the link:

https://carevision.com/carevision-working-to-integrate-my-health-record-for-ndis-aged-care-and-community-care/

The real question here is just what is the actual usage level on the myHR and how many GPs are actually filling it in as each patient visits.

It is now a little over a year since this commentary appeared, and it appears usage has rather flatlined or worse since then.

My Health Record is meant to empower patients – but with little useful information stored, is it worth saving?

Published: March 3, 2023 6.08am AEDT

Author

  1. Megan Prictor

Senior Lecturer in Law, The University of Melbourne

Australia’s My Health Record is a national, integrated electronic record, intended to overcome the problem of having personal health information “siloed” in different systems.

People can access their own My Health Record via MyGov or an app. Any of their treating health professionals can access it, too.

My Health Record can hold various past information, including a shared health summary, records of health conditions, allergies and medications, summaries of cancer treatment, test and scan results, hospital discharge notes, vaccination records, organ donation choices, and notes entered by patients themselves.

But is the system actually being used? Why is it, when people access their My Health Record, they often find little helpful information? Earlier this year, Health Minister Mark Butler promised an overhaul as part of the Strengthening Medicare Taskforce. But what needs to happen for it to be finally fit for purpose?

Lots more here:

https://theconversation.com/my-health-record-is-meant-to-empower-patients-but-with-little-useful-information-stored-is-it-worth-saving-199508

The current usage statistics are found here:

https://www.digitalhealth.gov.au/initiatives-and-programs/my-health-record/statistics

You will note there has been no update since January, 2024 and that people looking at their information has basically flatlined or dropped since January 2023. Practitioner usage also seems to have flatlined or also declined.

As far as I can tell active usage by GPs of the myHR is stable to declining and the huge pile of historical documents (many years old) just pile up! Any sign of the promised improvements?

It is of note that even the ADHA has stopped updating the stats in the last 3 months – what does that tell you?

The huge “white elephant” status of the myHR seems to be confirmed.

David.

AusHealthIT Poll Number 741 – Results – 7 April, 2024.

Here are the results of the recent poll.

Do You Believe Deployment Of More AI In Healthcare Will Make It Safer And Better?

Yes                                                                             11 (34%)

No                                                                              18 (50%)

I Have No Idea                                                            3 (0%)

Total No. Of Votes: 32

People seem to think that deployment of more AI won’t help much, Rather sad!

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

A fair number of votes. But also a rather mixed outcome! 

3 of 32  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, April 05, 2024

Looks Like The ADHA CEO Has Left - Can Anyone Confirm?

Noted this today! (From a release from the APodA!)

"Australian Digital Health Agency Acting CEO Peter O’Halloran said, “Our initial focus has been on supporting GPs and pharmacies to register but they are not the only healthcare providers that face large amounts of paperwork whenever health professionals join or leave their employment."

Web site is not updated as of Friday 5/4/2024

David,

I Think We Still Have A Great Deal To Learn About The Denisovans…

This appeared last week

The Observer Evolution

Scientists link elusive human group to 150,000-year-old Chinese ‘dragon man’

Researchers have found fresh evidence that may connect the mysterious Denisovans to the early human species Homo longi

Robin McKie Science editor

Sun 31 Mar 2024 02.00 AEDT Last modified on Sun 31 Mar 2024 07.16 AEDT

They remain one of the most elusive groups of humans to have walked on earth. Evidence from the DNA traces left by Denisovans shows they lived on the Tibetan plateau, ­probably ­travelled to the Philippines and Laos in south Asia and might have made their way to northern China more than 100,000 years ago. They also interbred with modern humans.

What Denisovans looked like or how they lived has remained a­ ­mystery, however. Only a jaw ­fragment, a few bits of bone and one or two teeth ­provide any evidence of their physical characteristics.

Their DNA, which was first found in samples from the Denisova cave in Siberia in 2010, provides most of our ­information about their existence.

But recently scientists have pinpointed a strong candidate for the species to which the Denisovans might have belonged. This is Homo longi – or “Dragon man” – from Harbin in north-east China. This key fossil is made up of an almost complete skull with a braincase as big as a modern human’s and a flat face with delicate cheekbones. Dating suggests it is at least 150,000 years old.

“We now believe that the Denisovans were members of the Homo longi species,” said Prof Xijun Ni of the Chinese Academy of Sciences in Beijing, last week. “The latter is ­characterised by a broad nose, thick brow ridges over its eyes and large tooth sockets.”

The possible Denisovan-Homo longi link is one of several recent developments by researchers working on these humans with whom Homo sapiens shared the planet for hundreds of thousands of years. It is even thought they could have played a key role in our own evolution.

Scientists in Tibet have discovered a Denisovan gene in local people, the result of interbreeding between the two species in the distant past. Crucially, this gene has been shown to help modern men and women survive at high altitudes.

In addition, evidence to ­support the Denisovan-Homo longi link has also been traced to the Tibetan ­plateau, where scientists began studying a jawbone initially found in a remote cave 3,000 metres (10,000ft) above sea level by a Buddhist monk, who kept it as a relic.

The bone was found not to come from a modern human. But only when researchers began to study the cave where the jawbone had been originally discovered did they find its ­sediments were rich in Denisovan DNA. In addition, it was found the fossil itself contained proteins that indicated Denisovan origins.

“It was the first time a Denisovan fossil find had been made outside Sibera and that was very important,” said Janet Kelso of the Max Planck Institute of Evolutionary Anthropology in Leipzig, Germany. “Equally intriguing was the fact that the jawbone has teeth that are similar to the teeth found in Homo longi. So I think the evidence suggests a link between the cranium and Denisovans”

This view was backed by Prof Chris Stringer of the Natural History Museum in London. “The evidence supports the idea that Denisovans were members of Homo longi but we are still short of absolute proof. Nevertheless, that will come with time, I believe.”

A big problem for researchers has been the fact that no DNA has yet been found in Chinese fossils such as Homo longi, added Stringer. “Their genes have not survived the ­passing of time. However, using the ­techniques of proteomics may ­provide key new data. These focus on a fossil’s ­proteins, which survive for far longer than its DNA and could tell us much more about the species.”

Recent research also suggests these people might have played a key role in the evolution of our own species.

The impact of the Denisovan gene found in Tibetans today provides one example. But Denisovan DNA has also been found in other modern populations, including people in New Guinea, northern Australia and the Philippines, and appears to have helped them fight infections from diseases such as malaria.

Denisovans settled in areas that covered a very varied geography, said Stringer. “Some were hot and low-lying, others were cold and mountainous. They represented very diverse habitats, from the Tibetan plateau to islands like Sulawesi [in Indonesia].”

By contrast, the Neanderthals, the third large grouping of humans that evolved over the past few hundreds of thousands of years, confined themselves to the cooler climates of a region that stretched east from Europe to southern Siberia.

They did not expand from this relatively uniform environment. So is the rich variety of homelands adopted by the Denisovans a sign that they were capable of much more diverse and adaptive behaviour than Neanderthals, scientists are now asking?

Homo sapiens also appears to have interbred with Denisovans on more than one occasion. “Indeed, there is good evidence that some modern humans interbred with genetically distinct Denisovans on multiple occasions,” said Kelso. “This suggests that the two groups coexisted for an extended time, with some studies suggesting a last contact as recently as 25,000 years ago.”

More here:

https://www.theguardian.com/science/2024/mar/30/scientists-link-elusive-human-group-to-150000-year-old-chinese-dragon-man

As far as I can tell these Denisovans are the closest distinct group to modern humans and so are of interest to those curious to know where we came from! Apparently these people were about pretty recently in a geological sense and there is considerable genetic similarity to some PNG tribes

There is a lot more to read in Wikipedia on all this if you are really curious!

https://en.wikipedia.org/wiki/Denisovan

I have to confess I find to way our story is slowly emerging is fascinating.

David.

 

Thursday, April 04, 2024

This Is A Fantastic Story On How One Of Our Most Important Tech. Companies Emerged.

This appeared last week

Morris Chang turned 55. Then he started the world’s most important company

By Ben Cohen

The Wall Street Journal

1:24AM March 31, 2024

The world’s most valuable tech companies were founded in dorm rooms, garages and diners by entrepreneurs who were remarkably young. Bill Gates was 19. Steve Jobs was 21. Jeff Bezos and Jensen Huang were 30.

But what might just be the world’s most invaluable company was founded by Morris Chang when he was 55 years old.

Never has anyone so old created a business worth so much as Taiwan Semiconductor Manufacturing Company, known simply as TSMC, the chip manufacturer that produces essential parts for computers, phones, cars, artificial-intelligence systems and many of the devices that have become part of our daily lives.

Mr Chang had such a long career in the chip business that he would have been a legend of his field even if he’d retired in 1985 and played bridge for the rest of his life. Instead he reinvented himself. Then he revolutionised his industry.

But he wasn’t successful despite his age. He was successful because of his age. As it turns out, older entrepreneurs are both more common and more productive than younger founders. And nobody personifies the surprising benefits of mid-life entrepreneurship better than Mr Chang, who had worked in the US for three decades when he moved to Taiwan with a singular obsession.

“I wanted to build a great semiconductor company,” he told me.

What he built was unlike any existing semiconductor company. You probably use a device with a chip made by TSMC every day, but TSMC does not actually design or market those chips.

That would have sounded completely absurd before the existence of TSMC. Back then, companies designed chips that they manufactured themselves.

Mr Chang’s radical idea for a great semiconductor company was one that would exclusively manufacture chips that its customers designed. By not designing or selling its own chips, TSMC never competed with its own clients. In exchange, they wouldn’t have to bother running their own fabrication plants, or fabs, the expensive and dizzyingly sophisticated facilities where circuits are carved on silicon wafers.

The innovative business model behind his chip foundry would transform the industry and make TSMC indispensable to the global economy.

Now it’s the company that Americans rely on the most but know the least about. Morris Chang isn’t a household name, either, but he should be.

TSMC’s founder shaped the chip business over the past 70 years and still finds himself playing an important role today. His longevity puts him right at the top of the list of the people most responsible for cultivating the world’s most vital technology.

“Hardly anyone has been more influential,” says Chris Miller, the author of the book Chip War

I recently spoke with Mr Chang by video chat to find out what others can learn from his adventures as a middle-aged entrepreneur and why it’s never too late to try something new.

As the demand for chips intensifies and US-China relations deteriorate, the world increasingly depends on TSMC, and there are lots of questions about the future of this company that Mr Chang founded on a geopolitically vulnerable island. But the topic of our conversation was TSMC’s past.

Mr Chang, now 92, officially retired as TSMC’s chairman in 2018, but the white-haired pioneer was sitting at his desk in a suit and tie as he sipped from a glass of Diet Coke during our 90-minute interview.

I wanted to know more about his decision to start a new company when he could have stopped working altogether. What I discovered was that his age was one of his assets. Only someone with his experience and expertise could have possibly executed his plan for TSMC.

“I could not have done it sooner,” he says. “I don’t think anybody could have done it sooner. Because I was the first one.”

Texas, then Taiwan

Long before he moved to Taiwan in middle age, Morris Chang moved to the US as a teenager.

Mr Chang was born in mainland China and had a peripatetic childhood as his family bounced around the war-torn country. When he fled to the US in 1949, America felt to him like paradise. He later became a US citizen.

Mr Chang grew up dreaming of being a writer — a novelist, maybe a journalist — and he planned to major in English literature at Harvard University. But after his freshman year, he decided that what he actually wanted was a good job.

He transferred to the Massachusetts Institute of Technology, where he studied mechanical engineering, earned his master’s degree and would have stayed for his PhD if he hadn’t failed the qualifying exam. Instead, he got his first job in semiconductors and moved to Texas Instruments in 1958.

Back then, chips were known as things made from potatoes. But he came along as the integrated circuit was being invented, and his timing couldn’t have been any better, as Mr Chang belonged to the first generation of semiconductor geeks. He developed a reputation as a tenacious manager who could wring every possible improvement out of production lines, which put his career on the fast track.

Three years after he moved to Dallas, the company sent him to Stanford University for his PhD in electrical engineering. This time, he aced the qualifying exam and returned as Dr Chang. By the late 1960s, he was managing TI’s integrated-circuit division. Before long, he was running the entire semiconductor group.

Mr Chang was such a workaholic that he made sales calls on his honeymoon and had no patience for those who didn’t share his drive. These days, TSMC is investing $US40 billion ($61.3bn) to build plants in Arizona, but the project has been stymied by delays, setbacks and labour shortages, and Mr Chang told me that some of TSMC’s young employees in the US have attitudes toward work that he struggles to understand.

“They talk about life-work balance,” he says. “That’s a term I didn’t even know when I was their age. Work-life balance. When I was their age, if there was no work, there was no life.”

Mr Chang climbed the executive ranks at TI, but he was passed over for top jobs and felt like he was being put out to pasture. He wanted TI to focus on semiconductors, but the company wanted to keep selling consumer products.

“Home computers and all that stuff,” he says. “That was a serious distraction and a serious diversion of corporate resources.” In 1983, once he accepted that he wouldn’t be promoted, and his company wasn’t going to bet on a market that he believed was the future, he quit Texas Instruments.

Almost immediately, he was hired by electronics manufacturer General Instrument as president and chief operating officer. Almost immediately, he realised that he’d made a huge mistake. “I was a mismatch — a complete misfit,” Mr Chang says. After one year, he quit General Instrument, too.

Now he was turning 54 and had no clue what he was going to do next. He knew he wanted to work again and had venture-capital offers that he might have accepted if Taiwan hadn’t beckoned. But he could afford to wait for a better opportunity.

Mr Chang says he wouldn’t have taken the risk of moving to Taiwan if he weren’t financially secure. In fact, he didn’t take that same risk the first time he could have.

In 1982, Mr Chang received a tempting job offer from a powerful Taiwanese official named K.T. Li, the man credited with orchestrating the country’s postwar economic development and galvanising the nation’s tech industry. He wanted Mr Chang to be the president of Taiwan’s leading tech institute and spin research into profit.

By then, Mr Chang knew that he wasn’t long for Texas Instruments. But his stock options hadn’t vested, so he turned down the invitation to Taiwan. “I was not financially secure yet,” he says.

“I was never after great wealth. I was only after financial security.” For this corporate executive in the middle of the 1980s, financial security equated to $US200,000 a year. “After tax, of course,” he says.

Mr Chang’s situation had changed by the time Mr Li called again three years later. He’d exercised a few million dollars of stock options and bought tax-exempt municipal bonds that paid enough for him to be financially secure by his living standards. Once he’d achieved that goal, he was ready to pursue another one.

He calls moving to Taiwan his “rendezvous with destiny,” but the truth is that nothing about TSMC was destined.

“There was no certainty at all that Taiwan would give me the chance to build a great semiconductor company, but the possibility existed, and it was the only possibility for me,” Chang says. “That’s why I went to Taiwan.”

He had spent most of his career in Texas and thought he would retire in the US after 15 years in Taiwan. That was almost 40 years ago.

When older is better

Is Morris Chang an outlier?

Not long ago, a team of economists investigated whether older entrepreneurs are more successful than younger ones. By scrutinising Census Bureau records and freshly available Internal Revenue Service data, they were able to identify 2.7 million founders in the US who started companies between 2007 and 2014. Then they looked at their ages.

The average age of those entrepreneurs at the founding of their companies was 41.9. For the fastest-growing companies, that number was 45. The economists also determined that 50-year-old founders were almost twice as likely to achieve major success as 30-year-old founders, while the founders with the lowest chance of success were the ones in their early 20s. Every shred of evidence led them to a counterintuitive takeaway.

“Successful entrepreneurs are middle-aged, not young,” they wrote in their 2020 paper.

This is not the image of startup founders that most people have in their minds. They are more likely to think of Steve Jobs tinkering in a garage or Mark Zuckerberg coding in his dorm room. Microsoft, Apple, Nvidia, Alphabet, Amazon and Meta Platforms had founders who were 30 or younger, and Silicon Valley’s venture capitalists throw money at talented young entrepreneurs in the hopes they will start the next trillion-dollar company.

They have plentiful energy, insatiable ambition and the vision to peek around corners and see the future. What they don’t typically have are mortgages, family obligations and other adult responsibilities to distract them or diminish their appetite for risk. Mr Chang himself says that younger people are more innovative when it comes to science and technical subjects.

But in business, older is better. Entrepreneurs in their 40s and 50s may not have the exuberance to believe they will change the world, but they have the experience to know how they actually can.

Some need years of specialised training before they can start a company. In biotechnology, for example, founders are more likely to be college professors than college dropouts. Others require the lessons and connections they accumulate over the course of their careers.

“There are ideas that you can only have once you’ve been around and you’ve had a real job,” said MIT Sloan School of Management professor Pierre Azoulay, one of the paper’s authors. “Those are not typically challenges solved by twenty-somethings, because you need to be up close and personal with the problems of a corporate customer to imagine a solution.”

There was one more finding from their study of US companies that helps explain the success of a chip maker in Taiwan. It was that prior employment in the area of their startups — both the general sector and specific industry — predicted “a vastly higher probability” of success.

“The closer the industry match,” they wrote, “the greater the success rate.”

The founding of a foundry

Morris Chang had 30 years of experience in his industry when he decided to uproot his life and move to another continent. He knew more about semiconductors than just about anyone on earth — and certainly more than anyone in Taiwan. As soon as he started his job at the Industrial Technology Research Institute, Chang was summoned to K.T. Li’s office and given a second job.

“He felt I should start a semiconductor company in Taiwan,” Mr Chang says. “So that was the start of TSMC.”

When he sat down to figure out what TSMC’s business model should be, Mr Chang started by recognising what it couldn’t be.

“I decided right away that this could not be the kind of great company that I wanted to build at either Texas Instruments or General Instrument,” he says.

TI handled every part of chip production, but what worked in Texas would not translate to Taiwan. The only way that he could build a great company in his new home was to make a new sort of company altogether, one with a business model that would exploit the country’s strengths and mitigate its many weaknesses.

Mr Chang determined that Taiwan had precisely one strength in the chip supply chain. The research firm that he was now running had been experimenting with semiconductors for the previous 10 years. When he studied that decade of data, Mr Chang was pleasantly surprised by Taiwan’s yields, the percentage of working chips on silicon wafers. They were almost twice as high in Taiwan as they were in the US, he said.

Mr Chang knew his company wouldn’t have the resources to compete with Silicon Valley when it came to designing, selling or marketing chips. But he believed there was one potential competitive advantage for the company that would become TSMC: manufacturing chips — and only manufacturing chips.

The seeds of a pure chip foundry had been planted in his mind by Gordon Campbell, a semiconductor entrepreneur who visited Mr Chang during his otherwise regrettable year at General Instrument.

Chipmaker TSMC formally opened its first Japanese plant on Saturday (February 24), highlighting the Taiwanese…

Mr Campbell was familiar with the agonies and the inefficiencies of building and operating a fab. He felt startups were better off designing chips and outsourcing the manufacturing. To some in his business, this was unthinkable. “Real men have fabs,” the famous saying went. One man thought the future was fabless.

“People were ingrained in thinking the secret sauce of a successful semiconductor company was in the wafer fab,” Mr Campbell told me. “The transition to the fabless semiconductor model was actually pretty obvious when you thought about it. But it was so against the prevailing wisdom that many people didn’t think about it.”

He was thinking about it when he spoke with Mr Chang in late 1984. And soon Mr Chang was thinking about it, too. He began to think that every fabless company would need a foundry.

Taiwan’s government took a 48 per cent stake, with the rest of the funding coming from the Dutch electronics giant Philips and Taiwan’s private sector, but Mr Chang was the driving force behind the company. The insight to build TSMC around such an unconventional business model was born from his experience, contacts and expertise. He understood his industry deeply enough to disrupt it.

“TSMC was a business-model innovation,” Mr Chang says. “For innovations of that kind, I think people of a more advanced age are perhaps even more capable than people of a younger age.”

Mr Chang says the idea behind TSMC was also the result of the personal philosophy that he’d developed over the course of his long career. “To be a partner to our customers,” he says. That founding principle from 1987 is the bedrock of the foundry business to this day, as TSMC says the key to its success has always been enabling the success of its customers.

More here:

https://www.theaustralian.com.au/business/the-wall-street-journal/morris-chang-turned-55-then-he-started-the-worlds-most-important-company/news-story/9b1de69660a81bcbfd4b87673dfabce9

What a great story showing you are never to old to become an ‘overnight success’!

David.

Wednesday, April 03, 2024

This Is An Amazing Story Of Being At The Right Place, With The Right Skills And Technology, At The Right Time!

This appeared last week:

The Observer Artificial intelligence (AI)

How did a small developer of graphics cards for gamers suddenly become the third most valuable firm on the planet?

John Naughton

By turning his computer chip-making company Nvidia into a vital component in the AI arms race, Jensen Huang has placed himself at the forefront of the biggest gold rush in tech history

Sun 31 Mar 2024 03.00 AEDTLast modified on Sun 31 Mar 2024 09.16 AEDT

A funny thing happened on our way to the future. It took place recently in a huge sports arena in San Jose, California, and was described by some wag as “AI Woodstock”. But whereas that original music festival had attendees who were mainly stoned on conventional narcotics, the 11,000 or so in San Jose were high on the Kool-Aid so lavishly provided by the tech industry.

They were gathered to hear a keynote address at a technology conference given by Jensen Huang, the founder of computer chip-maker Nvidia, who is now the Taylor Swift of Silicon Valley. Dressed in his customary leather jacket and white-soled trainers, he delivered a bravura 50-minute performance that recalled Steve Jobs in his heyday, though with slightly less slick delivery. The audience, likewise, recalled the fanboys who used to queue for hours to be allowed into Jobs’s reality distortion field, except that the Huang fans were not as attentive to the cues he gave them to applaud.

Still, it made for interesting viewing. Huang is an engaging speaker and he has built a remarkable company in the years since 1993, when he first sketched his idea for Nvidia in a Silicon Valley diner. And the audience were in awe of him because they regard him as a man who saw the future long before they did, and hoped to catch a glimpse of what might be coming next.

And in this they were not disappointed. What’s coming next is Nvidia’s Blackwell B200 chip, complete with its 208bn transistors, and the family of monster machines that it will enable, including a formidable supercomputer that fits into a rack and has almost two miles of copper cabling neatly intertwined in its innards. Cue wild applause.

Watching this spectacle, the thought that came to mind was this: how did a small company specialising in graphics cards for gamers come to be the third most valuable company on the planet? And how did it happen so quickly at the end? After all, Nvidia was only worth $278bn in October 2022 and is now worth $2.3 trillion, trailing only Apple and Microsoft.

In February, Nvidia reported record quarterly revenue of $22.1bn, up 22% from the previous quarter and up 265% from a year ago

It’s a good story, and no doubt someone is already working on the screenplay. But even a cursory account produces a picture of a company that from the beginning was good at anticipating the needs of a particularly demanding class of users – gamers – and eventually realised that in developing processors that could address their needs it had produced a new kind of computer: a graphics processing unit (GPU) that could perform many calculations in parallel, as opposed to conventional CPUs that did everything serially.

A pivotal moment came in 2013, when Huang decided that GPUs could be useful for an emerging technology called machine learning, and that henceforth the company would focus on that. It was a bold bet at the time, and initially Wall Street thought it foolish. But when machine learning really started to take off and desperately needed parallel processing machines to handle the associated heavy computation, Nvidia hit the jackpot. If you wanted to do this kind of AI then you needed Nvidia GPUs – lots of them. And, more importantly, you needed a way to enable them to work seamlessly together – a kind of operating system. A Stanford software genius named Ian Buck created one for Huang. They called it CUDA (for compute unified device architecture), and from then on buying Nvidia kit became a no-brainer for anyone aspiring to get into the AI business.

Which is how Huang found himself virtually the only trader with a supply of ready-made shovels in the biggest gold rush in tech history. In February his company reported record quarterly revenue of $22.1bn, up 22% from the previous quarter and up 265% from a year ago.

The Blackwell B200 chip is his latest super shovel. And in his keynote, Huang unveiled what can be done with it. He rolled out the DGX GB200 NVL72 (Nvidia doesn’t do human-friendly labelling), which is a powerful supercomputer with 72 Blackwell processors in a single water-cooled rack. I couldn’t find any information about pricing, but then I guess that if you have to ask you can’t afford it.

Google, can, though. So can Microsoft, Meta, Oracle, Tesla, Amazon and Dell. From what their bosses say, they’ve already joined the queue for supplies. In this case, Huang has indeed seen the future. And it works for him. Whether it works for the rest of us, though, remains to be seen.

More here:

https://www.theguardian.com/commentisfree/2024/mar/30/nvidia-jensen-huang-ai-gold-rush-computer-chip-maker

This really is an example of cometh the hour, cometh the man with just the chips you needed to support the AI revolution.

It is another of those 20 year ‘overnight successes’!

Enough said.

David.

Tuesday, April 02, 2024

The Scale And Severity Of The Autism Epidemic Seems To Have Gone Unnoticed By Many.

I found this article a bit of a wake-up call!

Thousand-fold increase: What is driving the rise of autism?


By Natassia Chrysanthos

March 31, 2024

In the late 1980s, when Professor Cheryl Dissanayake started researching autism, she estimated in her doctoral thesis that three or four babies out of 100,000 would be diagnosed with the condition.

“Now, I’m telling you it’s three in 100,” she says.

That thousand-fold increase isn’t because anything has changed in us, biologically. But our understanding of autism has changed. The evolution of the diagnosis is having a profound influence on Australian society, from our schools and workplaces to our popular culture and policy debates.

A massive expansion in the medical criteria means children who were diagnosed with Asperger’s syndrome in the late ′90s are considered part of the autism spectrum today. Evolutions in research mean children are identified younger, sometimes as early as 18 months. And as awareness has improved and the neurodiversity movement flourished, adults who weren’t seen in childhood have figured out they, too, are autistic.

Now, there are signs Australia has higher rates of autism than comparable countries. It’s raised thorny questions. Could the $42 billion National Disability Insurance Scheme have inflated diagnosis rates? On the other hand, rates of diagnosis for women and girls are on the rise, but remain significantly lower than for boys and men. Are true rates of autism higher than we think? And is “the autism spectrum” even a useful term, given it captures such a range of human experiences?

There aren’t definitive answers. But most people point to 2013 as the point things really shifted. In the same year that Australia started rolling out a world-first disability insurance scheme, the official diagnostic criteria for autism expanded significantly.

Ten years later, the way those two forces have converged is driving a complex debate about the NDIS – now one of the federal government’s biggest budget pressures – and how public funding should be delivered to support Australians with autism.
size=2 width="100%" align=center>

Autism is a neurodevelopmental disability, which means that the brain develops differently to what we would typically expect. There is no single known cause, but researchers generally accept it’s a genetic condition that may also be influenced by someone’s environment.

But because there’s no genetic giveaway, autism is diagnosed based on behaviour. There are two core traits that autistic people display: they have difficulty with communication and social interaction, and have restricted interests or repetitive behaviours.

It’s a new condition in the scheme of things. The first paper to describe autism was written by Boston child psychiatrist Leo Kanner in 1943. He observed 11 children who were solitary, needed routine and had some language difficulty. This included the first person diagnosed with autism, Donald Triplett, who died last June. Austrian physician Hans Asperger was undertaking similar work at the same time.

But it wasn’t until 1980 that a diagnosis called “autism disorder” was added to the psychiatry bible: the Diagnostic and Statistical Manual of Mental Disorders, better known as the DSM. It was mainly children – and mainly boys – with intellectual disability and significant language impairments who were diagnosed, and they needed to have very significant difficulties to meet the threshold.

That stayed true until 1994. Researchers had realised there were some people who showed the core behaviours of autism – communication differences and repetitive interests – but did not have an intellectual or language impairment. Quite the contrary, they could be highly verbal or intelligent. And so several new diagnoses were introduced, reflecting those varying levels of ability.

There was Asperger’s syndrome for children who became hyper-fixated on certain interests and struggled to interact with others, but could also be highly intelligent. Classic autism was a diagnosis reserved for children who had more difficulty with language and communication. Childhood disintegrative disorder, or Heller’s syndrome, described those whose late onset developmental delays might have led to reversals in language, bladder control or motor skills. Children who did not meet the full criteria of those conditions were diagnosed with “pervasive developmental disorder not otherwise specified”. Australian children born in the ’90s and noughties were raised in this framework.

Then in 2013, “the spectrum” was born. The fifth and most recent edition of the DSM collapsed all those conditions under the umbrella term autism spectrum disorder, and marked the most significant change yet to how we understand autism.

Some autistic people are intellectually disabled, some are highly intelligent. One person could be non-speaking while another is highly verbal. Autism can present in hundreds of different ways, and no two people are the same. “That’s what we call the autism spectrum. We went from a unitary condition, where everyone had a similar and high level of impairment, to, actually: you can show all these behaviours. And so the numbers of children we diagnosed went from really small to large,” says Professor Andrew Whitehouse, head of the autism research team at Telethon Kids Institute.

But it’s not just children, any more. One of the fastest-growing categories of participant on the National Disability Insurance Scheme is now autistic adults. “Twenty years ago, adult diagnoses were extremely rare. Whereas in our contemporary world, adult diagnoses are almost as frequent as child diagnoses,” Whitehouse says.

“When these adults were children, we had a different conception of autism: that it was only for children who had very significant difficulty, like intellectual disability. As the diagnosis of autism has evolved, all of a sudden, the difficulties that [these adults] have been experiencing are seen in a new light and that they may actually meet criteria for autism.”

Still, there are two fundamental criteria for an autism spectrum disorder diagnosis: certain social and communication difficulties, and patterns of restrictive and repetitive behaviour. The DSM also describes three layers of severity, which are determined by how much support someone requires. These are referenced as level one, two and three autism, providing a shorthand for families to describe the level of disability their child experiences.
size=2 width="100%" align=center>

Most people in the autistic community, however, don’t think of autism as a linear spectrum. Some talk about the condition as a constellation. Others describe a “spiky profile” that mixes incredible strengths and gifts in some areas – such as visual thinking, deep interests, an eye for detail, strong memory – with intense struggles in others.

Dr Melanie Heyworth, an autistic researcher who founded the organisation, Reframing Autism, describes being autistic as having a busy brain, which can affect everything from movement to sensory experiences, communication, emotion and empathy. “Every autistic person’s brain is different than the next, and the way those elements interact look different for every autistic person,” she says.

“The primary differences that most autistic people would talk about are in the way that we communicate. I use spoken language as my primary form of communication, but other autistic people don’t [and are non-speaking], or they are multi-modal communicators.”

Heyworth, for example, needs to see a person’s face in order to engage with them. “I would not be able to have this conversation with you effectively over the phone,” she says. Some autistic people struggle to understand sarcasm or small talk, or find spoken language takes longer to process altogether. For that reason, they might find public speaking easier than casual conversation because it doesn’t require them to digest what they’re hearing at the same time as they’re trying to talk.

Autistic people often empathise, process their emotions, or show their feelings differently. Some find it difficult to regulate their emotions, which can be intense; others withdraw, and this is a common response spotted in children. Eye contact is often uncomfortable, and for some people it even leads to nausea or dizziness.

Sensory overload is also common. Some people might be hyper-sensitive, “where everything you touch feels like pain”, while others are overwhelmed by bright lights. “That’s the reason you get the stereotype of the child in school with the big ear muffs. Or you get me rocking back-and-forth at the moment,” Heyworth says. Some of those repetitive movements, such as body-rocking and hand flapping, are known as “stimming”, and can help autistic people regulate their emotions or cope with anxiety.

Many autistic people “mask”, which means they try to hide their unique behaviours, perhaps because they were bullied at school. “Those things impact mental health and it’s exhausting, they experience burnout,” Dissanayake says. Studies suggest masking is more common in girls, which is why autism in females is identified less frequently.

Children are usually diagnosed with autism following a multidisciplinary assessment, where clinicians from different professions – such as paediatricians, speech pathologists, clinical psychologists – watch them in a range of settings to understand whether they show signs of autism. Dissanayake says the point of treatment is to help children develop ways to communicate and learn from people around them.

“We’re not focused on making the child less autistic. What we want to do is improve their cognition. If they don’t develop an ability to communicate, it lessens their ability to learn, and they end up with a learning disability.”

These days, more autistic children in Australia are getting the help they need much earlier in their lives.

But as more families receive that support by signing up to the NDIS, which offers automatic entry with a level two autism diagnosis, there have been uneasy questions about whether Australian children are being steered towards a clinical diagnosis for funding in an otherwise expensive and hard-to-access system. More than 9 per cent of five- to seven-year-old children are now on the scheme, mostly for autism or developmental delays.

A research paper published last year, by Australian National University scholar Maathu Ranjan, lit a fuse under that debate.

Ranjan, who is on study leave from her role as a senior actuary at the National Disability Insurance Agency, looked at dozens of studies estimating autism prevalence around the world. While diagnosis rates have gone up everywhere over the past 20 years, she found the Australian growth rate for children was higher than in similar countries.

Her paper, which is not peer-reviewed, quoted international studies that showed autism prevalence rates of one in 36 children in the United States, one in 50 in Canada, and one in 57 in the United Kingdom. In Australia, it was up to one in 25.

She said there was “considerable controversy” around the drivers of rising autism rates worldwide. But in Australia, she pointed to the NDIS. “It is plausible that the growth of prevalence rates above the global average in Australia can be attributed to the financial incentives created by government policy, specifically the implementation of the NDIS.”

Whitehouse agrees that the NDIS has led to more kids being diagnosed and distorted our understanding of true prevalence rates in Australia. “I think it’s without question that the use of an autism diagnosis level two shifted the focus, and the centre of gravity, towards that diagnosis. Clinicians, we all want the best for the kids that we are seeing. And if there are children who require support, there is a focus towards how can we get them that support.”

He says the levels of severity outlined in the DSM were intended for doctors to use, not for policymakers to allocate disability funding. But while the NDIS was rolling out quickly, it was an effective way of identifying people who needed significant support and signing them up to the scheme.

…..

This is part one of three in a series about how our understanding of autism has changed and what it means for Australia.

More here:

https://www.smh.com.au/politics/federal/thousand-fold-increase-what-is-driving-the-rise-of-autism-20240221-p5f6sa.html

I have to say I found this a useful review of the present state of play. Well worth a browse!

David.