Waking Up is Hard to Do

If these 5 Minnesota nurse-anesthetists can pass gas as well as they can sing, I want my next surgery in their hospital.

LOGICOMIX: An Epic Search for Truth

Yesterday was to have been a day of writing and programming. Instead, I surprised myself by buzzing through a 300+ page graphic novel on the life of Bertand Russell and his quest for the foundations of mathematics.

This "comic" was an impulse buy in our local indie bookstore yesterday. It's browsing for and finding jewels like this that remind me why I still love physical bookstores so much.

The authors and illustrators tell a great story, mixing romance, two world wars, politics, philosophy, logic, math and human failings into a narrative compelling enough to distract me from A Lot of Other Stuff I Needed to Get Done.

A fine tale well told. I've passed it on to my son, to see how it fares with the tastes of a 15.9 year old.

I'm off to a play this afternoon, and then it's back to the joys of XCode and Objective C.

All Clear

Okey, doke. Lesion out and the margins are clear. The dermatopathology fellow was kind enough to give me a tour of my biopsy. It turns out that one *can* use an iPhone for photomicroscopy as long as one's expectations aren't too high.


Here is a chunk of my normal skin at medium power. I took this by just holding my iPhone 3GS up to the microscope's eyepiece. By no means diagnostic, but good enough for blogging purposes.

Once they stitch me up, I'll head over to my office and work on ARRS and AUR abstracts like a crazed ferret for the rest of the afternoon.

The Smell of Long Pig in the Morning

Turns out I'm live-blogging my outpatient surgery today via my iPhone.


I'm having a minor skin lesion removed today in our university's rather slick dermatology outpatient surgery center. The drill here is:

1. Remove the lesion
2. Take a 45 minute break while a dermatopathologist processes and analyzes the tissue.
3. Repeat until the margins of the lesion are clear.

I'm grateful for this built-in break. I came to my appointment NPO (ate nothing after midnight) and I'm hungry.

To make matters worse, the electrocautery unit they use to stop the minor bleeding creates a smell that is disturbingly similar to barbequed pork.

I used my first break to run to the espresso stand next door for a bite. There I spotted a "bacon, sausage, egg and cheese, French toast bagel sandwich" for sale. No shit. However, like a car wreck you can't turn away from, I just couldn't stop looking at it. OK, OK, I bought the damned thing.

However, the unwillingly tasty scent of sizzling long pig was still fresh in my nostrils. Fresh enough, that when the espresso lady asked: "Can I heat that up for you?", I had to say,

"Uhhhh… No!"

A Pilingual Month for Me

Blogging has taken a backseat this month to computer programming. Most of the words I've written over the past month have been in Ruby, PHP or SQL, with English way back in 4th place. I've therefore appropriated Douglas Hofstadter's neologism "pilingual" to title this post.

Besides my usual penchant for screwing around with cool technology, my latest programming has been aimed at several potential papers for the 2010 ARRS and AUR meetings, whose abstract deadlines loom next week.

Blogging here will thus continue to be lean until all abstracts have been safely excreted.

Rap ID Advice for H1N1

If you get H1N1 influenza or any other infectious disease (ID) this year, chances are really, really good that it won't be from a radiologist. If you are auscultated, touched or sneezed upon by a physician, we're not the 'droids you're looking for.

However, there are a lot of other major disease vectors out there to contend with, i.e., your friends and family and co-workers. To protect yourself from them, here are a few helpful hints from Dr. John D. Clarke, medical director of Long Island Railroad:





HT to Medgadget

Maybe There is Hope for Humans, After All

I recently posted about a very cool high speed robotic hand that could beat most humans in a finger race.

However, I was somewhat comforted today when I ran across this video of the real thing, playing guitar at speeds I would not have believed possible.

Rest easy, John Henry -- we're still ahead of the steam drills at a few things.


World Record Guitar Speed 2008 Tiago Della Vega

The Chronophage: a Clock That Eats Time

What a wonderful device...

(thanks to Suture for a Living)

Violin-Playing Robot

Okay, dammit. It's not just the banjo players that will be losing gigs. Looks like fiddlers had also better keep an eye on their rear-view mirrors.

I'm almost afraid to look at YouTube these days, lest I see an X-ray-reading robot looking back at me...

Lightning Fast Robot Hand

A friend's reaction to the following video:

I bet this thing could do wicked good banjo triplets.

No kidding. This thing could play a banjo faster than Bela Fleck, which is really saying something.

With a bit more development, it's not just musicians that this thing might put out of work -- surgeons could lose a few gigs too.

As Dr. Wes has pointed out, this thing could also have amazing benefits for the differently abled.

This robot hand would be an especially good match with the brain-computer interface described on the 8/9/09 episode of 60 minutes (the good stuff starts at the 15:00 mark).

This is great technology -- especially from the point of view of a precocious geezer who may need some of it one of these days.

Hat tip to Anita Anderson

The Samurai Journal of Radiology

Sipping from a firehose -- that's what it feels like to keep up with the medical literature these days.

Even an info nerd like myself can't keep up with all of it. However, I do have a few online tools that make my own personal information overload a lot easier to deal with.

NetNewsWire

I've used this awesome newsreader program for years. It currently grabs over 100 newsfeeds and converts them into what I like to call The Samurai Journal of Radiology™. This journal caters to my own peculiar tastes, and includes not just radiology articles, but also a fair amount of infogeek stuff and a comics section.

NetNewsWire is a Mac only program, but shares a lot of features and synchronizes with Google Reader, a non-denominational newsreader that I also use, especially on my iPhone.

These two programs do the following really, really well:

1. they insure that I will at least scan the titles of all the latest radiology articles in my field
   
2. they make it easy to read my literature at any level of granularity I desire: title only, title and abstract only, or full article
   
3. they keep track of what I've read and what I've not read
   

The main downside of NetNewsWire or Google Reader is that they make it way too easy for Type A people like me to become a newsfeed slut. Even though I've trimmed my feed list way back, I still have over 100 feeds that I somehow can't bear to delete. Sigh....

HubMed

Just about all of the radiology journals now provide RSS feeds on their websites. Radiology and the American Journal of Roentgenology also provide subspecialty feeds (such as just neuro or just musculoskeletal), keeping my reading list blissfully free of all barium articles.

However, there are some parts of my specialty that are more fascinating than others, and HubMed helps me keep up with them. Let's say that I have a special interest in one particular dysplasia: the bird-headed dwarf syndrome of Seckel. Not surprisingly, Radiology and AJR tend to have pretty spotty coverage of this rare syndrome.

However, if I type in the term "bird-headed dwarf" into HubMed's search window, it generates a special newsfeed for me on that very topic:

http://www.hubmed.org/feeds/atom.cgi?q=bird-headed%20dwarf

When I point my newsreader at this feed, it will always show me the latest 20 articles on this topic from PubMed, from all of the zillion medical journals in its database.

Very cool.

Fever

For the past week, I've been using a very cool new newsreader called Fever.

Fever, unlike conventional newsreaders, actually works better when you fill it up with a zillion newsfeeds. When you import your list of feeds into Fever, you first sort them into two piles:

1. stuff that you like to read every day
   
2. stuff that you read once in a while

Fever calls these 2 categories respectively "Kindling" and "Sparks". It then distills from them topics that are hot enough to be worth reading using the following principles:

1. if only one person writes about a topic, it's cold
   
2. if two people write about it, it's warm
   
3. if three or people more write about it, it's hot

The greater the number of posts on a topic, the hotter it is.

The downside: You'll need access to a server running Unix Apache, PHP and MySQL in order to install Fever. You don't have to be an alpha geek to get it up and running, but it doesn't hurt.

The upside: Fever has so far done a pretty good job of spotting gems that I would have otherwise missed. Well worth the $30 it cost and the few hours of time I spent configuring myserver and installing it. This alpha geek gives it two thumbs up.

How Science Publishing Works

I've become a big fan of the online comic Saturday Morning Breakfast Cereal by Zach Weiner.

I especially enjoyed his treatment today of the Least Publishable Unit.

MR Fail

We who work around MR scanners well know that odd sensation when something you forgot to take out of your pocket starts tugging you firmly toward the giant magnet.

Most of us have also idly speculated about the following question...

So, what if you actually did push a really big ferromagnetic object (like a whole ICU bed) into the scan room?

This picture from Fail Blog pretty well answers that question.


Hat tip to Better Health.

Dead-On Anatomic Art

This smoking shelter is located on the campus of a local community college. I love the artwork...

Sunscreen Advice from a Radiologist

My views on sun protection are a bit more conservative than most -- after all, what do you expect from someone whose favorite sunscreen is a lead-lined room?

However, after reading A Guide to Summer Sun Protection in the latest issue of the New Yorker, I just may switch to some of that SPF 233...

Oregon

A bit of history of the Upper North Left from XKCD.

This would explain that odd (really odd) surge in population we saw in Washington and California back in 1852...

Write When Inspired

Interesting piece by Jeffrey Zeldman on writing quality. His main point:

Write when inspired; rest when tired.

Fine words in the abstract, but not always practical in a deadline-driven world, such as medical care. I'd love to only work when I'm well rested, but some things just have to be done now, regardless of how I feel. I would counter with another aphorism:

In theory, theory and practice are the same. In practice, they're not.

Some of my orthopedic colleagues would put it more bluntly:

Sometimes best is the enemy of good enough.

The reader commentary ( and Mr. Zeldman's reply) make for a great point-counterpoint on this theme. I especially enjoyed Glenn Fleishman's comments.

Inspiration is uneven; work must be even.

(hat tip to Daring Fireball)

Mysterious iProd in the Works...

This just in from Ars Technica:

An updated USBConfiguration.plist in the most recent version of iPhone OS 3.1 beta offers compelling evidence that Apple has continued development on an unknown device, referred to as "iProd," that was first discovered in March.

The mind boggles.

Of course, my mental image of an "iProd" may be a bit skewed, having grown up in the ranch country of West Texas. Out there, a prod is a sort of cow taser, used by some to herd stubborn animals. We preferred positive incentives -- a shake of a feed bucket is all it took to make our cattle come running. The only cattle prod I've seen in several decades is the one hanging over the waiting line in Rudy's, my favorite Austin barbeque spot.

Of course, I would never actually use an iProd at work. As with cattle, so with radiology residents -- I prefer positive incentives, such as chocolate.

However, one would look swell hanging up in our reading room over the PACS stations. Until I find out the identity of Apple's latest mystery device, I'll keep an eye peeled for something similar on the iTunes Store. As the Apple ads say, "there's an app for everything..."

The Power of the Pentatonic Scale

An old friend (and discerning reader of this blog) pointed me to the following video, wherein Bobby McFerrin demonstrates the power of the pentatonic scale at the World Science Festival 2009.

As Mr. McFerrin shows, the pentatonic scale is a great scale for improvisation -- it's hard to sing a wrong note. On a guitar, just noodling around on the simple 1-4, 1-3, 1-3, 1-3, 1-4, 1-4 pentatonic pattern is a fine way to spend a happy hour or two. It's impressive how many classic rock and blues licks fall out of this simple scale.

Pentatonicity is also the basis for a number of great old-time fiddle tunes, of which Billy in the Low Ground is an examplar. This version of BITLG shows the Blue Ridge Mountain Boys flinging a tasty torrent of notes about a pentatonic C scale.

I'll have to ask our physicists to program a pentatonic pulse sequence for me to use on our MRI machine. Seems like that ought to be handy for imaging the elusive banjo center of the brain.

(Hat tip to Anita Anderson)

Haphazardly Hunting Hieronymus

We visited the wonderful Metropolitan Museum of Art in New York today. As with any museum of this stature, there is way too much stuff to see, even with a dozen visits.

My secret master plan for handling big art museum overload: chop the impossible down to something I can actually do. In my case, that means hunting for Hieronymus Bosch. I can't see everything in the museum, but I can darned well see all of their Bosch collection. Other than than, I just wander around randomly until I get tired.

It's a humble plan, but it's my plan.

Why Bosch? Beats me. I ran across some of his quirky and troubling work during my formative years, and it appealed to me oddly. His works are rare enough world-wide, with only 25 currently attributed to him. They are so rare on this side of the Atlantic that finding any of them is often an interesting challenge all by itself.

Finding anything at the Met also turned out to be a real challenge. Besides being huge, its hallways are convoluted enough that the best docent advice I got was to walk in some general direction for a while, and then to ask someone else. It was rare that any of the specific directions I got from them turned out to be helpful.

For a while, it was tricky finding a docent who had even heard of Bosch. Finally, though, I found two of them on the second floor. Both, however, told me that the Met had no actual Bosch -- just one that was "painted in the style of Bosch".

Our Bosch-ward course through the museum was probably pretty similar to the classic 3-dimensional drunkard's walk. However, our wanderings finally led us to the room of the imitation Bosch, which was titled Christ's Descent into Hell.

This painting was accompanied by the following blurb:

The panel was painted during a Bosch revival in the sixteenth century, when the artist's fiery scenes of hell were enormously popular throughout Europe, and especially in Italy, where they were prized for their nightmarish and visionary qualities.

However, we were delighted to find, just two paintings away, an actual Bosch, titled Adoration of the Magi.


Not one of his more bizarre works, but pretty swell nonetheless. Its blurb:

Long thought to be a later pastiche, this Adoration of the Magi can now be placed among Bosch's earliest autograph works ca. 1470-75. The salient features of its underdrawing, the tunnel-like perspective, and certain of the rather wooden figure types with sensitively rendered faces are closely related to Bosch's Ecce Homo in the Städel Kunstinstitut, Frankfurt, of approximately the same date.

Thus endeth my current round of Hunt for Hieronymus. My cumulative Bosch-score for the U. S. now shows New York in a tie with Washington, D.C., with one H-point apiece. Given the current planetary paucity of Bosch's, I may be running out of U. S. cities that actually have one. However, I'll keep an eye out for him on my next trips to Los Angeles, Chicago and San Francisco.

Bone Scans and DNA Testing by Major League Baseball

The New York Times published a very interesting piece a few days ago called Baseball's Use of DNA Raises Questions.

The impetus for these tests:

Dozens of Latin American prospects in recent years have been caught purporting to be younger than they actually were as a way to make themselves more enticing to major league teams.

Apparently, such players have been able to borrow the birth certificate of a younger child from some other family.

Can these tests actually reveal one's age? In the case of DNA, no. However, it can be used to check whether a given player is actually related to the parents listed on the birth certificate. According to the Times, this alone was enough to void the signing of a Yankee prospect last year from the Dominican Republic.

In the case of a bone "scan", I presume the Times actually means a bone age study, in which an X-ray of a subject's hand and wrist (and sometimes other body parts) is compared to a standardized atlas of age-matched X-rays for various ages. How reliable is a bone age study? Not very.

I interpret these occasionally in my practice. When I give my estimate of someone's skeletal age, it is accompanied with considerable variation -- usually one standard deviation equals about a year. In the specific case of a boy with a chronological age of exactly 16 years (192 months), the mean of the expected skeletal age is 195.3 months, where one standard deviation = 12.9 months. From these figures, we can calculate that 95 % of 16 year old boys should have a skeletal age varying between 169.2 and 220.8 months, i.e. 14.1 and 18.4 years old. This 95 % confidence interval of 4.3 years makes a bone age study pretty darned unreliable.

While bone age studies may be of dubious value, they don't lead to a lot of ethical dilemmas. DNA testing, on the other hand, does.

So far, MLB only seems to be using DNA testing to help verify a player's age. However, it's not hard to imagine how they might use other genetic information as well.

Mark Rothstein, a professor of bioethics at the University of Louisville School of Medicine, said: “The funny thing about this all is that the most famous baseball player with a genetic disorder was Lou Gehrig. Would they have signed him if they knew he was predisposed to A.L.S.?”

Hand Dryer Fu

After a tasty but messy dinner tonight, I went to the restroom to wash my hands. No paper towels for this restaurant -- they had an Xlerator XL-SB dryer. This creature cranks out a torrent of air and sounds like a jet engine revving up. The manufacturer claims this will dry your hands in 10 - 15 seconds, a lot faster than those girly man hand dryers we've all tried to use for years.

I'm a bit skeptical of this claim, as was the reviewer for the Poop Report. Though this device truly honks , my hands took more like 20 - 25 seconds to dry. In my case, this just meant more time for mischief.

As the air blasted the water off my hands, I noticed that my hand position was similar to the one I used to use for two-hand whistling. With a few conscious positional adjustments, my hands began to howl with loud keening sound. This was fun, so I played with my intonation and tone for a while. Finally, however, I realized that it was giving the willies (so to speak) to a guy at a nearby urinal. So I stopped. For now.

We have five more days in Manhattan. Hopefully I can find another one of these units. If so, The Phantom of the XL-SB will ride again...

Autostitching the Big Apple v 4.0

Since it was next door to our hotel, we took a college tour of the Juilliard School this morning. Looks like a swell place, but probably not the best fit for my son, whose musical tastes, shall we say, are somewhat orthogonal to most Juilliard norms. I did use part of the tour time to grab this quick Autostich panorama of the Paul Recital Hall there, using 6 images:


Then we hopped the D train up to the Bronx, and watched the Yankees beat the Orioles 6 - 4. It's a very nice stadium -- if they can consistently fill it up with enough hungry and thirsty fans every game, they might just be able to make payroll on their team of millionaires. I grabbed two panoramas -- an exterior view (3 images), and an interior view (28 images):



The Orioles hit two successive home runs in the last inning, which elicited some interesting crowd behavior from the Yankee fans.

The first was caught by a lady about 50 feet from us. The Yankees fans began yelling, "Throw it back! Throw it back!" Then, when she tossed it back to the left fielder, they all cheered. We were puzzled by this behavior, so my brother quizzed a local about it. Apparently, home run balls hit by Yankees are highly prized and kept. Balls hit by opposing teams are regarded as offal, and are expelled back onto the field as waste.

The same thing happened with the next home run ball to right field. From our left field seats, it looked like a mighty amoeba snarfing up a food particle and then spitting it back out in disgust.

Autostitching the Big Apple v 3.0

I hope it doesn't seem as if I've gone completely off the deep end about Autostich here in NYC. It never came up at all during most of the things we did today, including several tasty meals, the Hayden Planetarium show or the Broadway production (Westside Story) we saw this evening.

However, we also spent the afternoon at the wonderful American Museum of Natural History, where there were way too many large photogenic objects that were beyond my ability to resist. Here are my favorites, along with the number of images I used to create them.

Ginormous Northwest Native American dugout canoe, 6 images:


Same canoe, different angle, 3 images:


Views from both ends of the Hall of Biodiversity -- a stunning way to convey the concept of just how many species we have on this planet, 4 and 5 images, respectively:



Beryl exhibit in Hall of Minerals. Stills like this are easy to get with the iPhone even in low light -- pasting the phone against the glass case steadies it as well as any tripod -- 7 images:


Ichthyosaurus skeleton, 2 images:


Pterodactyl skeleton, 2 images:


Brontosaurus, 8 images:


Tyrannosaurus rex, 8 images:


Stegosaurus, 12 images:


Triceratops skull, 4 images:


Triceratops skeleton, 4 images:


Mammoth and mastodon skeletons, 4 images:

Tomorrow, Autostitch meets the new Yankee Stadium!

Autostitching the Big Apple, v 2.0

I tried out a few more panoramas again today in Manhattan, using my iPhone 3GS and Autostich.

The image on the left was built from four shots of a tower crane which was hauling up a big container of wet cement up many stories into the sky. The waviness of the tower is, fortunately, an artifact of the process, as well as my inexact positioning of the camera.

Vertical panoramas seem to be a weak point of Autostitch -- at least when one is pretty close to the subject. The following shot of Rockefeller Center (built from 11 shots) demonstrates this well -- the actual main building is much taller than it appears here. Autostitch's big brothers may well have settings to control for this prominent shortening effect.


While the kids were sacking and pillaging the M&M and Hershey store in Times Square, I stayed outside and shot 20 shots that were combined into the following panorama, covering about 135 degrees. The black areas in this and the prior shot make it easy to see where I should have gathered a bit more data.


My most successful shot was the sign at the Staten Island Ferry. The algorithms in Autostitch had little trouble with a purely horizontal pan. Four shots were combined to form this image.


Despite some of the distortions revealed with these shots, I'm quite happy with the results. I'll try to grab a few more panoramas while we're here. The Yankees vs. Orioles game on Wednesday afternoon in the new stadium should be a fine time to experiment.

AutoStitching the Big Apple

We just spent the day visiting a few cultural icons here in Manhattan. This seemed like a fine time to play with a new iPhone app called Autostich, which merges multiple separate pictures into a much larger panoramic image.

I've actually used one of this program's big brothers (Calico) for several years to stitch together mountain photos from my big Nikon into cool panoramas. Both programs are based on image-processing research from the University of British Columbia, which has licensed its algorithms to other developers, including Industrial Light & Magic. We also use similar software at work to stitch together life-sized vertical panoramas of the entire human spine from several smaller shots.


To kick things off, here are 4 iPhone 3GS photos of the Time Warner Center at dusk...

The resulting AutoStitched panorama shows a bit of distortion, but still looks pretty swell.


With a bit of PhotoShopping, it looks even better.


We visited the 5th Avenue Apple Store, which is extremely keen for many reasons. Even in a town with a lot of eye-grabbing architecture, this store stands out.


All of the action at this 24 x 7 x 365 store takes place in a giant underground room beneath the cube. Here's a hasty 6-picture panorama of this store, which earns more money per square foot than Tiffany's:


We also spent some time at the American Museum of Natural History. Here's a panorama of the foyer, which is filled with dinosaurs, including a big brachiosaur. This image was stitched together from fifteen 3.0 megapixel images.


My one-word review: awesome.

It's been quite a while since I have gotten so much pleasure for a buck ninety-nine. It's also pretty incredible to know the sort of image-processing power I now carry in my pocket.

Holy crap.

Made Men

We flew to NY City today for a week with my brother and his kids. A courtesy copy of the July/August issue of Manhattan magazine awaited us in our room. My spouse made sure that I read the following two paragraphs from a restaurant review on page 100...

"Il Molino!" a friend squealed when I told her I'd be visiting the storied West Village Italian restaurant for dinner. I'd been in New York for more than a decade and had passed the large plate-glass windows with their drawn eyelet curtains hundreds of times, but had never actually dined there. "I love that place," she chimed "They give you so much free stuff!"

A week later my friend Lawrence and I crowd into the waiting area near the restaurant's entrance, coming within earshot of a group of thick-necked guys with bellowing voices. "Made men?" I ask Lawrence. "From the sound of it, actually radiologists, " he says.