DanÅke Carlsson has added a photo to the pool:
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Washington Post columnist Dana Milbank calls himself "a highly creative hypochondriac" — who just paid for an expensive MRI scan to locate abnormal spots as tiny as 2 millimeters.
He discusses the pros and cons of its "diffusion-weighted imaging" technology combined with the pattern recognition of AI, which theoretically "has the potential to save our lives by revealing budding cancers, silent aneurysms and other hidden would-be killers before they become deadly. "
But the scans cost $2,500 a pop and insurance won't pay. Worse, for every cancer these MRIs find, they produce a slightly greater number of false positives that require a biopsy, with the potential for infection and bleeding and emotional distress. Even when the scans don't produce a false positive, they almost always come up with some vague and disconcerting abnormality.... Will we feel better after viewing our insides? Or will we become anxious about things we hadn't even thought to worry about?
Part of living has always been in the mystery, in not knowing what tomorrow will bring. Now, because of sophisticated imaging, genome sequencing and other revolutionary screening tools, we can have predictability, or at least the illusion of it. But do we want that? The American College of Radiology says we do not. Its still-current 2023 statement says there is not "sufficient evidence" to recommend full-body screening, cautioning that the scan could lead to needless testing and expense. But David Larson, chair of ACR's Commission on Quality and Safety, told me that could change as more data comes in. "When people ask me, 'Would you recommend it?' I would say it depends on your tolerance for ambiguity," he said, giving the example of somebody found to have a borderline aortic aneurysm who is advised to wait and monitor it. If "that won't keep you up at night, then I wouldn't necessarily recommend against it...."
About 1 in 20 gets that dreaded call. A study Prenuvo presented earlier this year of 1,011 participants found that 4.9 percent of scans required a follow-up biopsy. Of those, 2.2 percent were actually cancer, and the other 2.7 percent were false positives. Of the 22 cancers the scans caught, 86 percent of patients had no specific symptoms. But if finding something truly awful is rare, finding something abnormal is almost guaranteed. [Vikash Modi, Prenuvo's senior medical director of preventative medicine] said only 1 in 20 scans come back completely clean. The vast majority of patients wind up in the ambiguous realm where something may look suspicious but doesn't require urgent follow-up.
He opted for the cheaper $1,000 torso scan, which the senior medical director calls "our bread-and-butter area," since 17 of the 22 cancers detected in one Prenuvo study were in that area and is where they often find cancers that wouldn't be discovered until they were incurable like "that scary pancreatic stuff...."
Milbank's scan found 12 "abnormalities" included "a 2.5 mm pulmonary nodule in the right lower lobe" and "a 4.6 mm intraductal papillary mucinous neoplasm in the pancreatic tail" — but with 10 abnormalities labeled "minor" (and six being musculoskeletal wear-and-tear problems "I already knew about from the usual aches and pains".)
Even the two "moderate" findings didn't sound that grim when I read on. The "indeterminant lesion" in my lung requires no follow-up, while the thing in my pancreas is "low-risk."... The "most interesting" finding was the pancreatic cyst, because, at this size and location, there's a 3 percent chance it will become cancerous in the next five years. But if annual follow-up scans of my pancreas (covered by insurance) show it's getting bigger, the cyst can be removed before it becomes cancer. For me, this made the MRI worthwhile. Sure, there was a 97 percent likelihood the cyst never would develop into a problem even if I hadn't learned about it. But now, with minimal inconvenience, I can eliminate that 3 percent risk of getting pancreatic cancer, the most lethal of major malignancies.
He discusses the pros and cons of its "diffusion-weighted imaging" technology combined with the pattern recognition of AI, which theoretically "has the potential to save our lives by revealing budding cancers, silent aneurysms and other hidden would-be killers before they become deadly. "
But the scans cost $2,500 a pop and insurance won't pay. Worse, for every cancer these MRIs find, they produce a slightly greater number of false positives that require a biopsy, with the potential for infection and bleeding and emotional distress. Even when the scans don't produce a false positive, they almost always come up with some vague and disconcerting abnormality.... Will we feel better after viewing our insides? Or will we become anxious about things we hadn't even thought to worry about?
Part of living has always been in the mystery, in not knowing what tomorrow will bring. Now, because of sophisticated imaging, genome sequencing and other revolutionary screening tools, we can have predictability, or at least the illusion of it. But do we want that? The American College of Radiology says we do not. Its still-current 2023 statement says there is not "sufficient evidence" to recommend full-body screening, cautioning that the scan could lead to needless testing and expense. But David Larson, chair of ACR's Commission on Quality and Safety, told me that could change as more data comes in. "When people ask me, 'Would you recommend it?' I would say it depends on your tolerance for ambiguity," he said, giving the example of somebody found to have a borderline aortic aneurysm who is advised to wait and monitor it. If "that won't keep you up at night, then I wouldn't necessarily recommend against it...."
About 1 in 20 gets that dreaded call. A study Prenuvo presented earlier this year of 1,011 participants found that 4.9 percent of scans required a follow-up biopsy. Of those, 2.2 percent were actually cancer, and the other 2.7 percent were false positives. Of the 22 cancers the scans caught, 86 percent of patients had no specific symptoms. But if finding something truly awful is rare, finding something abnormal is almost guaranteed. [Vikash Modi, Prenuvo's senior medical director of preventative medicine] said only 1 in 20 scans come back completely clean. The vast majority of patients wind up in the ambiguous realm where something may look suspicious but doesn't require urgent follow-up.
He opted for the cheaper $1,000 torso scan, which the senior medical director calls "our bread-and-butter area," since 17 of the 22 cancers detected in one Prenuvo study were in that area and is where they often find cancers that wouldn't be discovered until they were incurable like "that scary pancreatic stuff...."
Milbank's scan found 12 "abnormalities" included "a 2.5 mm pulmonary nodule in the right lower lobe" and "a 4.6 mm intraductal papillary mucinous neoplasm in the pancreatic tail" — but with 10 abnormalities labeled "minor" (and six being musculoskeletal wear-and-tear problems "I already knew about from the usual aches and pains".)
Even the two "moderate" findings didn't sound that grim when I read on. The "indeterminant lesion" in my lung requires no follow-up, while the thing in my pancreas is "low-risk."... The "most interesting" finding was the pancreatic cyst, because, at this size and location, there's a 3 percent chance it will become cancerous in the next five years. But if annual follow-up scans of my pancreas (covered by insurance) show it's getting bigger, the cyst can be removed before it becomes cancer. For me, this made the MRI worthwhile. Sure, there was a 97 percent likelihood the cyst never would develop into a problem even if I hadn't learned about it. But now, with minimal inconvenience, I can eliminate that 3 percent risk of getting pancreatic cancer, the most lethal of major malignancies.
Read more of this story at Slashdot.
"First the penny. Next, paper checks?" asks CNN:
When the U.S. Mint stopped making pennies last month for the first time in 238 years, it drew a lot of attention. But there have been quiet moves to stop using paper checks as well. The government stopped sending out most paper checks to recipients as of the end of September, part of an effort to fully modernize federal benefits payments. And on Thursday the Federal Reserve put out a notice that suggested it is considering — but only considering — the "winding down" of checking services it now provides for banks.
The central bank's statement said that as an alternative to winding down those services, it is mulling more investment in its check processing services, but noted that would come at a higher cost. But it is also considering not making any such investments, in order to keep costs roughly unchanged. That would lead to reduced reliability of those services going forward. "Over time, check use has steadily declined, digital payment methods have grown in availability and use, and check fraud has risen," said the notice from the Fed. "Also, the Reserve Banks will need to make substantial investments in their check infrastructure to continue providing the same level of check services going forward."
A report from the Federal Reserve Bank of Atlanta in June found that as of last year, more than 90% of surveyed consumers said they prefer to use something other than a check for paying bills, and just 6% paid by check. That's a sharp drop from the 18% of bills paid by checks as recently as 2017. Consumers also reported they view checks as second-worst for convenience and speed of payment, ahead of only money orders. And they're ranked as the least secure form of any payment other than cash.
But even if it's true that options such as direct deposit, automatic bill paying and electronic payment systems such as Venmo, PayPal and Zelle have all reduced the need for traditional checks, paper checks are still an important part of the payment system. They make up about 5% of transactions and represent 21% of the value of all those payments, according to a statement from Michelle Bowman, the Fed's vice chair for supervision, who dissented from the Fed's Thursday statement.
When the U.S. Mint stopped making pennies last month for the first time in 238 years, it drew a lot of attention. But there have been quiet moves to stop using paper checks as well. The government stopped sending out most paper checks to recipients as of the end of September, part of an effort to fully modernize federal benefits payments. And on Thursday the Federal Reserve put out a notice that suggested it is considering — but only considering — the "winding down" of checking services it now provides for banks.
The central bank's statement said that as an alternative to winding down those services, it is mulling more investment in its check processing services, but noted that would come at a higher cost. But it is also considering not making any such investments, in order to keep costs roughly unchanged. That would lead to reduced reliability of those services going forward. "Over time, check use has steadily declined, digital payment methods have grown in availability and use, and check fraud has risen," said the notice from the Fed. "Also, the Reserve Banks will need to make substantial investments in their check infrastructure to continue providing the same level of check services going forward."
A report from the Federal Reserve Bank of Atlanta in June found that as of last year, more than 90% of surveyed consumers said they prefer to use something other than a check for paying bills, and just 6% paid by check. That's a sharp drop from the 18% of bills paid by checks as recently as 2017. Consumers also reported they view checks as second-worst for convenience and speed of payment, ahead of only money orders. And they're ranked as the least secure form of any payment other than cash.
But even if it's true that options such as direct deposit, automatic bill paying and electronic payment systems such as Venmo, PayPal and Zelle have all reduced the need for traditional checks, paper checks are still an important part of the payment system. They make up about 5% of transactions and represent 21% of the value of all those payments, according to a statement from Michelle Bowman, the Fed's vice chair for supervision, who dissented from the Fed's Thursday statement.
Read more of this story at Slashdot.
Overal ter wereld duiken huurlingen op in oorlogen. Hoe werkt de moderne huurlingenindustrie? Van Blackwater tot Wagner tot Colombiaanse huursoldaten in Soedan.
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Veronica Williams PHOTOGRAPHER has added a photo to the pool:
John from Brisbane has added a photo to the pool:
We actually ended our driving holiday of two weeks through Queensland and northern NSW in mid September. Winter was and is always the best time for photography I believe when the sun is in the northern sky and we don't get so many harsh shadows in the middle of the day. Just right for August holidays normally. Two weeks of holidays has taken 12+ weeks to roll out the images. I hope you have enjoyed a few of them. I'm happy as I need a little break, flickr can become a big commitment!
Whoops, nearly forgot, this is the beautiful Tweed Valley just outside of and looking west from Murwillumbah in Northern NSW. We took the express route up the Pacific Highway from here, all the current roadworks are complete which makes for a great run!
John from Brisbane has added a photo to the pool:
History tells us that when Captain Cook sailed up the east coast of Australia in 1770, upon espying the dangerous headland that now marks the eastern end of the Queensland/New South Wales border, he named it Point Danger. He was yet to encounter the Great Barrier Reef! At the same time, as a reminder to following seafarers he named the prominent mountain inland, Mt Warning.
Once upon a time, it was fashionable to climb Mt Warning and watch the sun rise on special days of the year but it is now closed for reasons not dissimilar to that at Uluṟu. "Wollumbin (Mount Warning) summit track and Aboriginal Place remains closed. Decisions about the future of the summit track will be made by the NSW National Parks and Wildlife Service in accordance with the wishes of Aboriginal custodians".
This scene from the Tweed Valley area near Murwillumbah looks towards the prominent peak across sugar cane fields.
John from Brisbane has added a photo to the pool:
Being a Queenslander, I could almost live on the smell of a sugar mill! But sugar cane is also cultivated in the Northern Rivers district of New South Wales. Three mills ply their trade in the area, Condong in the Tweed River area, Broadwater (this one) in the Richmond River area and Harwood, the southern most on the Clarence River. Condong used to be connected to the NSW rail system (but not now) - all three otherwise and unlike most Queensland mills rely solely on road transport to bring in the cut cane.
The truck seen on the old highway is a sugar cane truck, coming to or leaving the mill.
Tone'o Down-Under has added a photo to the pool:
Photo taken from the 18th floor of the Ritz hotel, Perth, Western Australia.
TOKIO (ANP/RTR/BLOOMBERG) - Japan beschuldigt China ervan dat Chinese gevechtsvliegtuigen hun radar hebben gericht op Japanse vliegtuigen boven internationale wateren. Het Japanse ministerie van Defensie betitelt de actie als "gevaarlijk".
Op X zei de Japanse minister van Defensie Shinjiro Koizumi dat de handeling verder ging dan "wat noodzakelijk is om een vlucht veilig te houden". Hij zei dat Japan bij China protest heeft aangetekend over het "spijtige" incident, dat kan duiden op een aanval.
Het incident gebeurde boven gebied dat door Japan en China wordt geclaimd. Het wordt beschouwd als het ernstigste in jaren en kan de spanningen tussen beide landen verder doen oplopen.
De verstandhouding tussen China en Japan verslechterde toen de Japanse premier Sanae Takaichi waarschuwde dat Japan in actie kan komen als China Taiwan aanvalt. Taiwan, dat door China wordt beschouwd als een afvallige provincie, ligt maar 110 kilometer van het meest westelijke Japanse eiland Yonaguni af.