THX Caught With Pants Down Over Lexicon Blu-ray Player
This is not news. Many of us in the A/V community over at AVS Forums knew about this a very long time ago. This is why it is important to research a product before purchasing it.
Slashdot Turns 100,000
Yup... I prefer that system. I'm glad the site hasn't changed much in all these years.
Microsoft Investigates Windows 7 "Black Screen of Death"
I had the "Black Screen of Death" happen in the past week on two full-patched (and legal) Windows Vista 32-bit machines after recent patches. Both times the display wouldn't come back up. The system did not display anything when access via Microsoft Remote Desktop, VNC, and Dameware Utilites Mini Remote Control--these are all various ways to access a machine remotely. However, the systems was still allowing access to file and printer shares and I could perform remote administration via various utilities and agents but I couldn't get anything to display. I was able to force a safe shutdown and restart remotely. Since then both machines have been fine. I had initially chalked this up to a random Windows error but today's news has led me to reconsider whether this is in fact a bug.
Why Doesn't Exercise Lead To Weight Loss?
I get really annoyed when people take a holier than thou attitude based on conjecture and anecdotal evidence. This spreads misinformation. The fact that you've been modded up to +4 is well-intentioned but not necessarily deserved. Now I'm not going to shove my degree in your face but I will point you to research articles.
Proteolytic and lipolytic responses to starvation.
Energy metabolism in feasting and fasting.
Installing Linux On Old Hardware?
Get off my 25k user-ID lawn.
Chicago Tribune Reporters Don't Want Readers' Pre-Approval
'It is a fundamental principle of journalism that we do not give people outside the newspaper the option of deciding whether or not we should publish a story, whether they be advertisers, politicians or just regular readers,' the e-mail read."
Here's a mission for Slashdot... Google every reporter who signed that e-mail and determine if any of them were in bed with the Bush administration in the run up to the Iraq War. This should clear up whether this is a truly genuine sentiment or just exaggerated outrage.
Why Digital Medical Records Are No Panacea
I've used electronic medical records in both the NHS (UK) and the United States. Cerner is the big player here and it is one of the most ugly, inefficient, and convoluted interfaces I've ever used. It makes some more famous UI messes discussed on Slashdot look line the Mona Lisa. For those of you who don't understand how electronic systems work and why there is so much resistance let me explain how a basic patient encounter works for me:
1. Do a history and physical (H&P) on the patient and record the results on paper.
2. Enter in pertinent information into the computer system about the type of management I want started.
3. Dictate my history and physical for transcription.
4. Wait several hours for the dictation to show up in the EMR. Until which time all other doctors and nurses must refer to my hand written notes.
5. Heaven forbid I have to call in a consultation from cardiology, GI, or some other specialty in the hospital. If I do, then we use our text-based pagers to figure out when the hand-written note has been dropped off because every specialty has to go through steps 1-4. As they follow these patients, they too have to physically recheck the chart since dictated H&Ps and progress notes take time to show up.
6. I can very easily see how a mistake could be made in drug dosing because computers are another step in the way. Plus dosages are selected via a regular dropdown box. All dosages of compounds are rechecked by pharmacy anyway. We can get quite a few calls from pharmacy if something is non-standard or rare.
The EMR is a few extra steps in the management of a patient and does not guarantee that mistakes won't be made. Management plans are checked and rechecked as are drug dosages.
The places where EMR is helpful is getting lab results, radiology results, and study-based information on a computer. However, we have several different systems for viewing different sorts of radiology films that can't be viewed in some types of EMR. Then there is the problem of making sure the COW (computer-on-wheels) we take on rounds has a working battery back and the Cerner database hasn't taken a dive into the deep end. If its all working then it's very helpful that old notes can be looked up without giving medical records a call to haul up a 10 volume chart on a chronic COPD patient we see every other week. Unfortunately, coding for billing is still a pain. The system is so complicated that professional medical coders are needed to maximize profits through proper billing to insurance companies and government agencies.
Another problem not addressed by EMR is the fact that every hospital and practice uses a different system. If I need records from an admission at another hospital then I still have to get a Release of Information form filled out and then hope to god the other hospital can fax over copies of the chart to me. These faxes are huge sometimes, completely disorganized, and at times illegible because notes are hand written. There is no electronic transmission. If I need radiological studies then I better pray the patient or ambulance brought copies on a DVD for us to view. Then we better hope a computer system with sufficient privileges and the right Microsoft Service Pack can run the disk. The NHS system tries to address this but I left long before the system was full operational.
The current crop of EMR systems aren't fitting in with our workflow and our IT teams aren't drawing up a way for us to deal with all the variety of systems we may need to deal with in a streamlined fashion. If a consulting company could come up with a system that worked from point of admission through discharge and follow-up (and billing) of a patient with "it just works" simplicity without forcing me to add tons of different steps then we'd have a reason for EMR. Until then, its just a disaster.
This is one place where a computer alone isn't a solution. We need a solution from start to finish that works with us. A government deadline won't solve this problem. However, if a consulting team made up of a group of doctors, programmers, UI designers, and device integrators/manufacturers got together to attack this problem in an Apple-esque way they'd be billionaires.
Twitter Considered Harmful To Swine-Flu Panic
Am I the only one that finds is somewhat amusing to see a blog post criticizing the new social media star Twitter of misinforming people?
On another note, blogger Kragen Javier Sitaker, @kragen has written an interesting entry on How False Rumors Can Cost Lives in light of the #swineflu crisis on Twitter by discussing the aftermath of Tuskegee on the African American community. Although I agree with many items on his personal responsibilities list, it seems almost impossible to stop inane comments from taking over any social media site open to the general public. Can we name this phenomenon after me... Hisham's Law?
Lack of Sunlight Could Lead To Early Death
Disclaimer: IAAJD (I am a junior doctor) but this is NOT medical advice. Please consult your physician for your specific situation.
Vitamin D supplements come in two forms: ergocalciferol and cholecalciferol. Studies suggest that cholecalciferol (vitamin D3) increases serum 25-hydroxyvitamin D (25-OH-D) more efficiently than does ergocalciferol (vitamin D2). Milk in the United States has been fortified with vitamin D3 (the natural form made through sunlight) since the 1940. This was mandated and reduced the incidence rate of juvenile rickets by 85% in the United States.
Calcitriol is the most active metabolite of vitamin D. It can frequently cause hypercalcemia and/or hypercalciuria, necessitating close monitoring and adjustment of calcium intake and calcitriol dose. Therefore, it isn't recommended that calcitriol be given for vitamin D supplementation in osteoporosis. However, calcitriol or other vitamin D analogs are an important component of therapy for secondary hyperparathyroidism in chronic kidney disease.
Now to the meat and potatoes of this post. The intake at which the dose of vitamin D becomes toxic is not clear. In 1997, the National Academy of Sciences defined the Safe Upper Limit for vitamin D as 2000 IU/day. Newer data however indicate that higher doses are safe at least over a several-month period. Doses as high as 10,000 IU per day for up to five months were not associated with toxicity. It is important to inquire about additional dietary supplements (some of which contain vitamin D) that patients may be taking before prescribing extra vitamin D. Excessive vitamin D, especially combined with calcium supplementation may cause hypercalcemia, hypercalciuria, and kidney stones.
So be careful and only take the amounts listed on your supplement bottles and inquire with your doctor before starting anything. We have a mentality here in the United States that more is better. When it comes to the human body moderation is key.
As a side note, I also don't really understand the significance of Vitamin D's fat solubility making it any more or less dangerous in higher dosages.