Tuesday, December 29, 2009

Can Touching Your Toes Test Your Arteries?

The New York Times


Not only is inflexibility linked to arterial disease, but improving flexibility decreased arterial disease.
"The control group consisted of people who stretched. They were not expected to show any change in cardiac function, but over the course of 13 weeks they in fact increased the pliability of their arteries by more than 20 percent.

HEALTH | December 23, 2009
Well: Phys Ed: Can Touching Your Toes Test Your Arteries?
By GRETCHEN REYNOLDS
Researchers have found a clear correlation between inflexible bodies and inflexible arteries in subjects older than 40.

NYTimes: A Patient Dies, and Then the Anguish of Litigation

So artfully expressed, and clearly so much suffering.
"Medicine can be a minefield of uncertainties; no matter how thoughtful and careful we are, physiology is infinitely complex and fate is capricious, and occasionally something blows up in your face."
"the lawyers had decided they were not going to win the case...They couldn’t have figured this out four and a half years earlier? Before all this wasted time, the emotional anguish, and the more than $150,000 ...but neither side gave in. As this slowly unfolded, my mood turned from stoic resignation to a toxic muck of apathy and irritation."

A Patient Dies, and Then the Anguish of Litigation

A doctor accused of "malicious" conduct in the care of a patient
coped with practicing, and living, under the cloud of a medical
malpractice lawsuit.

http://s.nyt.com/u/ACe

Do it now - don't procrastinate pleasure

"...cash in your gift certificates, drink that special bottle of wine, redeem your frequent flier miles and take that vacation you always promised yourself"

Carpe Diem? Maybe Tomorrow

Recovering procrastinators of pleasure should try a simple New Year's
resolution: Have fun ... now!

http://s.nyt.com/u/ACf

Monday, December 28, 2009

NYTimes.com: Thinking Hard About Retirement and Death

New rules for Roth IRA and uncertainty in pending legislation about estate taxes makes estate planning difficult currently. One solution - give your kids $13000 tax-free per year - it adds up.

Thursday, December 24, 2009

Use more FFP in massive transfusions


It is remarkably rare in medical papers to see mortality cut in half
by a simple maneuver. Frozen plasma has traditionally been withheld
during transfusions, like a 'sacred' blood product, to be used only
when lab values show it's required to replace depleted factors in the
blood. This surprising result shows 1-month trauma mortality cut in
half when plasma is automatically given 1:1 along with red cells,
regardless of lab values. From a review paper by Shaz B H et al., A&A
18:1760-8;2009



J Trauma. 2009 Jun;66(6):1616-24.

Improvements in early mortality and coagulopathy are sustained better in patients with blunt trauma after institution of a massive transfusion protocol in a civilian level I trauma center.

INTRODUCTION: Transfusion practices across the country are changing with aggressive use of plasma (fresh-frozen plasma [FFP]) and platelets during massive transfusion with current military recommendations to use component therapy at a 1:1:1 ratio of packed red blood cells to FFP to platelets.
METHODS: A massive transfusion protocol (MTP) was designed to achieve a packed red blood cell:FFP:platelet ratio of 1:1:1 We prospectively gathered demographic, transfusion, and patient outcome data during the first year of the MTP and compared this with a similar cohort of injured patients (pre-MTP) receiving > or = 10 red blood cell (RBC) in the first 24 hours of hospitalization before instituting the MTP.
RESULTS: One hundred sixteen MTP activations occurred. … Seventy-three MTP patients were compared with 84 patients with pre-MTP who had similar demographics and injury severity score (29 vs. 29, p = 0.99). MTP patients received an average of 23.7 RBC and 15.6 FFP transfusions compared with 22.8 RBC (p = 0.67) and 7.6 FFP (p < 0.001) transfusions in pre-MTP patients. …Overall patient mortality was markedly improved at 24 hours, from 36% in the pre-MTP group to 17% in the MTP group (p = 0.008) and at 30 days (34% mortality MTP group vs. 55% mortality in pre-MTP group, p = 0.04). Blunt trauma survival improvements were more marked and more sustained than victims of penetrating trauma. Early deaths from coagulopathic bleeding occurred in 4 of 13 patients in the MTP group vs. 21 of 31 patients in the pre-MTP group (p = 0.023).
CONCLUSIONS: In the civilian setting, aggressive use of FFP and platelets drastically reduces 24-hour mortality and early coagulopathy in patients with trauma. Reduction in 30 day mortality was only seen after blunt trauma in this small subset.  PMID: 19509623
Transfusion. 2010 Feb;50(2):493-500. Epub 2009 Oct 5.

Increased number of coagulation products in relationship to red blood cell products transfused improves mortality in trauma patients.

This study investigates the relationship of plasma:RBC, PLT:RBC, and cryoprecipitate:RBC transfusion ratios to mortality in massively transfused patients at a civilian Level 1 trauma center.
STUDY DESIGN AND METHODS: Demographic, laboratory, transfusion, and outcome data were collected prospectively from February 1, 2007, to January 31, 2009, and retrospectively from February 1, 2005, to January 31, 2007, on all injured patients who underwent massive transfusion (defined as >or=10 RBC products within 24 hr). Mortality was analyzed in relation to the plasma:RBC, PLT:RBC, and cryoprecipitate:RBC transfusion ratios using both univariate and multivariate analyses.
RESULTS: A total of 214 patients received massive transfusion secondary to traumatic injury. High versus low transfusion ratios were associated with improved 30-day survival: plasma:RBC 59% versus 44%, p = 0.03; PLT:RBC 63% versus 33%, p < 0.01; and cryoprecipitate:RBC 66% versus 41%, p < 0.01. By multivariable stepwise logistic regression analysis, increased plasma:RBC (p = 0.02) and PLT:RBC (p = 0.02), and decreased age (p = 0.02), ISS (p < 0.01) and total RBCs (p = 0.03) were statistically associated with improved 30-day survival.
CONCLUSIONS: In the civilian setting, plasma, PLT, and cryoprecipitate products significantly increased 30-day survival in trauma patients. Future prospective randomized clinical trials are required to determine the optimal transfusion ratios. PMID: 19804568



Tuesday, December 22, 2009

Fukujinzuke

This pickle is the secret to making a bowl of rice delicious. It
complements the flavors perfectly. Hard to find, but worth the search.
http://en.m.wikipedia.org/wiki/Fukujinzuke?wasRedirected=true


Top Gear

My new favorite show - Top Gear reviews cars in a funny, offbeat way. Great photography. And they always find a way to smash something up. They usually find a unique twist on a competition between cars. See for yourself from these clips:
The second half of the following video is so funny, at 3:00 minutes - they obviously spend a lot of time thinking up an amusing challenge.

NYTimes: Efforts Lag at Making Highway Work Zones Safer

Slow down in work zones, and pay attention! This article explores the
increased risk in work zones.

Efforts Lag at Making Highway Work Zones Safer

Through the collective indifference of government and industry,
hundreds of people die each year in accidents in work zones.

http://s.nyt.com/u/vqB

Thursday, December 17, 2009

NYTimes: He Delivers Christmas Trees for Rent

Greener Christmas trees!

He Delivers Christmas Trees for Rent

Scott Martin delivers live, potted Christmas trees that are returned to the nursery once the season is over.

http://s.nyt.com/u/v04

"Extra-credit points: The delivery trucks run on biodiesel; the trees are cared for by adults with disabilities; the drivers will pick up donations for Goodwill and used wrapping paper for recycling; and the Web site also sells eco-friendly, fair-trade ornaments."


Sunday, December 13, 2009

NYTimes: A Joint Account That Underwrites Our Marriage

A touching essay about the strength of a longstanding marriage.
"Being single is all about the future, about the person you're going to meet at Starbucks or after answering the next scientific compatibility questionnaire. Being married, after a certain point, is about the past, about a steadily growing history of moments that provide a confidence of comfort, an asset that compounds over time. "

MODERN LOVE: A Joint Account That Underwrites Our Marriage

A man looks back on 35 years of marriage and how he and his wife have managed to stay married so long.

http://s.nyt.com/u/vd9

NYTimes.com: AT&T Takes the Blame, Even for the iPhone's Faults


The New York Times

Hmmmm - so which is better AT&T or Verizon? Consumer Reports again listed Verizon as the best carrier, but
"Global Wireless Solutions, one of the third-party services that run network tests for the major carriers...dispatches drivers across the country with phones and laptops equipped with data cards. They have covered more than three million miles of roads this year...The results placeAT&T’s data network not just on top, but well ahead of everyone else. “AT&T’s data throughput is 40 to 50 percent higher than the competition, including Verizon...""

BUSINESS | December 13, 2009
Digital Domain: AT&T Takes the Blame, Even for the iPhone's Faults
By RANDALL STROSS
Despite evidence that suggests Verizon provides superior cellphone service, an independent assessment proves otherwise.

Saturday, December 12, 2009

NYTimes: Geothermal Project in California Is Shut Down

Sounds like tapping geothermal heat (pumping water down into
cracks in the bedrock where the water expands into steam) causes earthquakes. Is that the reason a large geothermal dig was just abandoned? Or perhaps just because the rock is too hard to drill easily to that depth. Have to stay tuned...

Geothermal Project in California Is Shut Down

After safety concerns, the company in charge of a project to extract
renewable energy from deep bedrock has informed federal officials that
the project will be abandoned.

http://s.nyt.com/u/vwP

NYTimes: Church Works With U.S. to Spare Detention

You gotta have hope. Seems that the impenetrable ramparts of
bureaucracy actually enclosed a heart!
Church Works With U.S. to Spare Detention
An unusual agreement between a New Jersey church and U.S. immigration
officials has freed some Indonesians.

https://www.nytimes.com/2009/12/13/nyregion/13indonesians.html

Friday, December 11, 2009

Value-addedTax: Many See the VAT Option as a Cure for Deficits

Many See the VAT Option as a Cure for Deficits

Runaway deficits have thrust a politically unsavory savior into the
spotlight: a tax on goods and services.

http://s.nyt.com/u/i_7

Thursday, December 10, 2009

NYTimes.com: The Song Decoders

The New York Times

Pandora music service uses musicologists as human listeners to decode what makes a song fit into a classification - works better than computer decoding of songs because of very human attributes that make us like songs.

October 18, 2009
The Song Decoders
By ROB WALKER
By breaking music down into its component parts, Pandora Internet radio tries to figure out what kind of music you - not your social group, heroes or aspirational self - really like.

Wednesday, December 9, 2009

Vacuum cooking enhances natural flavors

As I've mentioned before, 'sous vide' (cooking vegetables or meat in a vacuum) is resurfacing again, today in the NYT article, and has spawned an instructive website. Interestingly, "Modern sous-vide cooking originated in Switzerland in the 1960s as a way to preserve and sterilize food in hospital kitchens."
What's the benefit? - "Managing heat transfer — cutting into a steak, timing eggs, inspecting the juices of a roast chicken — is simply what cooks do, working by smell, sound, taste and touch, all of which are reduced or eliminated in sous vide. I found it unnerving to cook without my senses, but extremely liberating not to worry about doneness or cooking times."

Biblos.com

This extensive site has the entire contents of concordances and many other reference tools online.

Tuesday, December 8, 2009

Free Google Navigation Apps for Android

Android phones will have pretty powerful access to google capabilities, like turn by turn navigation, street views of upcoming turns, and voice-recognition searches. See the video demo, which demonstrates voice-entered searching of vague things like "navigate to the museum with the King Tut exhibit".

Using nature to harvest oil from engineered bacteria.

PopSci.com: Bacteria-Busting Genetic Bombs Make Biofuel Processing a
Blast

Algae make plastic directly

PopSci.com: Algae Used To Produce Green Plastics, Sans Petroleum
How great is that? Rather than harvest oils from algae from which plastics are manufactured, engineer them to produce the plastic directly.

Friday, December 4, 2009

Donations - where your money goes: Donor Illusion

Charities attract donations by emphasizing the personal relationship between you and a needy beneficiary. But in fact, problems arise in recipient communities when singling out one person who benefits, to the exclusion of others.
In her story yesterday(listen),Ashley Milne-Tyte describes -
"...Tim Ogden edits Philanthropy Action, a Web site for donors. He says I got caught up in what he calls the donor illusion: the promise of a direct connection between a donor and an individual recipient.

TIM OGDEN: And it's an illusion that's created by the marketing, and it's created because it's a powerful one for attracting donations. But the reality is if you really care about doing the most good then there shouldn't be that direct connection.

Because he says charities need the flexibility to respond to the situation on the ground. That could mean using a donor's money for flood relief instead of buying a family a goat. Or simply not allowing money to be misused."

I had read a similar account on wikipedia earlier this week,

"Providing money directly to the families of sponsored children simply does not work, no matter how dire the circumstances. A ‘direct benefit' approach creates jealousy among community members that do not have sponsored children and fosters an ethos of dependency. So while sponsored children may receive some direct benefits – like school materials or a jacket for warmth – this in no way represents the entirety of our work in a community, and it was disingenuous for the Foreign Correspondent story to imply this."


Thursday, December 3, 2009

NYTimes: Organizing the Chaos of Online Travel Tips

Sites to organize travel info you've found, and search engines geared
to travel.
Trekaroo, a yelp.com equivalent for traveling with kids.
Kijubi.com - ratings of California and Florida attractions

Organizing the Chaos of Online Travel Tips

Gliider, TravelMuse and NileGuide are among new Web tools that help
travelers organize trip information.

http://s.nyt.com/u/i3h

Tuesday, December 1, 2009

NYTimes: In Month of Giving, a Healthy Reward

Altruism gives you a longer healthier life. 
"people in the study who had more "self-references" (those who talked about themselves at length or used more first-person pronouns) had more severe heart disease and did worse on treadmill tests."

In Month of Giving, a Healthy Reward

For a woman with multiple sclerosis, a gift-giving plan changed her outlook and improved her health — and science appears to back her up.

http://s.nyt.com/u/iR7

Design constraints of a velomobile


This page describes a do-it-yourselfer's approach to building his foam-shelled recumbent bike.
Relative speed of velomobile designs, and the inherent trade-offs, discussed at
http://bentrideronline.yuku.com/topic/4847#.Tk1E3Cd5mc0

"I've been following posts in several places, listening to discussions among VM enthusiasts, and reading accounts of races and am going to make a guess on how the VM's would rate for speed, with comparable riders:

lots faster than a regular bike: Birk Butterfly, WAW, Quest, Tri-Sled
faster than a regular bike: Mango, Cab-Bike speedster option
no disadvantage over a regular bike for speed: Leitra, Cab-Bike, Alleweder, Go-one

I haven't heard enough about the Leiba, Berkut or Cyclodyne to make a guess.

There are trade-offs in the Velomobile world. Speed is generally "bought" in exchange for less space, poorer turning radius, cramped entry, limited adjustability, or other trade-offs that might or might not be acceptable to the purchaser.

I'm happy to go as fast as I would on my other bikes while staying warm and dry and having space for carrying all my groceries. (I wouldn't want to go SLOWER than on another bike.) It's a nice bonus that the Cab-Bike really picks up speed with a tailwind or sidewind, and that it can cut through a headwind much better than a similarly-loaded regular recumbent. (My commuting route rarely brings me into any wind, so this is more an issue for tours.)

Mary"

NYTimes.com: The Claim: Exercise More During the Day, and You Will Sleep Better at Night

The New York Times 

The Claim: Exercise More During the Day, and You Will Sleep Better at Night

"physical activity during the day and sleep onset at night were closely linked: every hour of sedentary activity during the day resulted in an additional three minutes in the time it took to fall asleep at night. And the children who fell asleep faster ultimately slept longer, getting an extra hour of sleep for every 10-minute reduction in the time it took them to drift off..." 


2017 update: 

Interrelationship between Sleep and Exercise: A Systematic Review 


"exercise promoted increased sleep efficiency and duration regardless of the mode and intensity of activity, especially in populations suffering from disease." 

NYTimes: We May Be Born With an Urge to Help

Toddler experiments are showing that humans are innately helpful and altruistic. The desire to cooperate with what others are doing ("shared intentionality") evolved as a necessity in gathering sufficient food.
"Shared intentionality evolved very early in the human lineage, he believes, and its probable purpose was for cooperation in gathering food... We evolved to be nice to each other because there was no alternative."
"Where do they get this idea of group rules, the sense of "we who do it this way"? Dr. Tomasello believes children develop what he calls "shared intentionality," a notion of what others expect to happen and hence a sense of a group "we.""
We May Be Born With an Urge to Help

Biologists are forming a better view of humankind than the traditional opinions of it as warlike and selfish.

http://s.nyt.com/u/iwJ

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