[ G r k B u l l ]

Vampire Diarrhee

2009-12-14T21:34:00.001-05:00

I still don't get it. First the Twatlight series and now Vampire Diaries. What's with the all new vampire frenzy. There must be a huge deficit in our society that the vampire passion fullfills but I am not sure what that is. What is it with vampire romantic stories that makes them more appealing than regular shows. I have no clue. And as I am writing this my wife just changed the tv to Vampire Diarrhees...aarghhh

Twatlight

2009-05-09T09:55:00.003-05:00

This post is way overdue. My wife (we are both in our mid-late twenties) had me watch the movie when she got the DVD. She had previously seen the flick in the theater and went nuts over it.
I have to say, I don't get it. The story is mediocre, the acting is among the worst I have ever seen and the parades of teenies that cry over Special Ed, make this even more of a turnoff for me. Thank god I am not the only one.
I do have to admit that I really like the soundtrack of the movie and some of the cinematography was pretty good, so it made a good audiovisual experience in some parts.
What is there about vampires (Twilight, Buffy, True Blood) that makes teenies and women crazy?

IOM Report from Dec 2008

2008-12-24T08:40:00.007-05:00

The Institute of Medicine (IOM) recently published a report on residency duty hours regulations. Basically, the report states that residents are still fatigued and that action is needed to guard patient safety. This report is a very serious document, and a response from ACGME was immediate. The next Annual Educational Conference of ACGME will take place in March, and it is expected that a lot of discussions and decisions on this matter will dominate the conference.

Here are a few comments on this new report (and on the survey that ACGME asked all residents to take):

1. Currently, there are no work-hour regulations that apply to attending physicians, who can therefore work an unlimited amount of time. An that choice is not always theirs to make; it can be imposed to them by their Division Chief or Chairman, just like my work hours can sometimes be imposed by my chief resident. Does this mean that current residents grow and develop their work mentality into a fake bubble of work-hour protection that has no application to real life? If I will have to work 100 hours as an attending, then learning to be a physician with a limit of 80 hours per week, is probably bad training. Is the public going to realize that attendings can also be over-worked and fatigued and demand work-hour limitations for them as well?

2. All the literature so far (see review in JACS, Nov 2008) demonstrates that the 80-hour work week regulations have decreased fatigue (at least chronic fatigue). However, there is no concensus on the effect of the regulations on the quality of training. The IOM 08 recoomendations seem that they will further decrease fatigue (maybe even have an effect of acute fatigue). However, only a few of the recommendations ("limit non learning time" etc) are designed to enhance education. If we keep cutting down the hours, without paying extreme attention to the methods of training and making changes to that domain as well, we risk "cutting down on education".

3. If the new IOM recommendations are approved and applied, there will be many duty-calls that will be uncovered by residents. This would mean that more residents need to be hired or more physician extenders need to be hired. The first solution costs money and also raises the concern that education opportunities will be divided to more people (this is mostly true for surgical residents, as the same number of total cases will be divided to more residents). The second solution is at least 4 times more expensive than the first solution. So, to the minimum these recommendations are very very expensive. Who will be asked to pay for this? Most hospitals (especially in today's economy) will refuse to put money into this; they will likely shut down their programs; and this is not limited to "small community hospitals". And I am sure that DoD and Medicare will be very excited to pour money into residencies. Money makes our world go round, so I think this will be the reason why the recommendations cannot be applied.

To conclude, I think that the ACGME will eventually adopt many of the new IOM recommendations, because the public wants at all cost to protect the patient safety. To the minimum, the new regulations will involve more strict and frequent monitoring of residency programs, less flexibility with violations and higher penalties for violating programs. The extend to which the recommendations will be adopted will be determined by the funding agencies. I do believe that these changes will improve residents' fatigue. On the other hand, I am very skeptical about the effect on training. I believe that in our era of expanding technology, endless paperwork in the hospitals and the transformation of patients into clients-customers, the way residents are being trained seems archaic. Changes are imminent and, I believe, necessary.

Magnolia's Cafe

2008-12-10T06:35:00.002-05:00

My wife recently introduced me to this place where we often meet to have lunch together when I am off or post call. Park Av is famous for the nice little delis, but this one is now my favorite. Good environment, good food (try the soups as well) and a good variety of local beers. Give it a try if you are in Rochester, NY.

rTorrent 0.8.4

2008-12-09T16:30:00.008-05:00

I have been using rtorrent for the past few years almost exclusively for all my downloads. It is the lightest client, very reliable and loaded with features. My configuration file allowed rtorrent to watch for new torrents in a specific folder, seed it until a 2:1 ratio is achieved and then stop the torrent. Also, it self-managed bandwidth in a way that internet speeds were good during the day, and maximum downloads/uploads were achieved at night. For my setup, I had it installed initially on my debian box and now on my basement old iMac through macports. My main machine is the latest iBook that Apple released, and all the computers are connected to each other with afp, using this amazing guide. I also use mostly ssh and occasionally vnc (JollysFastVNC) to control and configure everything.

Last night, I was updating my basement iMac and rtorrent was updated to version 0.8.2. This resulted to failure of rtorrent to start due to some incompatibility with the version of libtorrent that was provided with the update. In order to make rtorrent usable again, I had to uninstall rtorrent and install rtorrent-devel, which provided me with the latest unstable version 0.8.4. However, it seems that the ratio handling for this version has changed. Now, my rtorrent.rc configuration file that I have been using for 2 boxes for almost 2 years (with some editing) is not really usable. This means that rtorrent works full on all the time, making internet crawl for the rest of my applications!

I really like rtorrent but until somebody looks into the new configuration rules more, I switched to Transmission for MacOSX. I still have rtorrent on my debian box which I don't really use for downloads any more, and I hope I can switch back to rtorrent on the iMac, since checking the torrent progress through screen over ssh on my iPhone was uber cool.

UPDATE 12.14.08
I tried Transmission and it worked ok; it would watch a folder and download anything I threw in. However, it would not follow my settings for download folder, and clutter the tiny drive of the old iMac. Also, the download speeds were very slow, approx 20-40 KB/s. So, I switched back to rTorrent once and for all. Hopefully I will figure out the whole config problem...

A review book and coffee

2008-11-20T20:44:00.003-05:00

It's ABSITE season again!

Apps Come True

2008-11-14T18:33:00.002-05:00

This is a follow up to my old post about iPhone desired apps. Now that the v2.0 (2.1 currently), allows for apps to be installed on the iPhone through the AppStore , we can finally and legally have apps from a selection of more than 4,000. This is definitely a great step, but let me present how my current app needs are met:

1. Office capabilities. No update to this sort. I can still natively view a variety of different docs on my iPhone but nothing for editing. There is some hope for excel files soon but not yet.

2. Cut and Paste. Not yet, and I doubt this will be part of the v2.2.

3. ePocrates. This was one of the first apps available for the iPhone and IMHO I prefer using this on my iPhone compared to my Palm TX.

4. Video recording. Nothing available so far.

5. iSilo for iPhone. Hallelujah!!! I still don't own this app, but I am looking closely into the development and plan to buy soon. You can find the actual app (v1.30) here.

6. Flash on Safari. Not an option and I think we will not see this happen on the current iPhone 2/3G, likely due to the CPU power needed and most importantly the strain it would put on the battery, although there are opinions out there that suggest the opposite.

7. Ssh and VNC. Both of these are available for the iPhone. There is a great post that compares all the current ssh apps for the iPhone. I am using TouchTerm and I think it is a great little tool. Keep in mind that the iPhone is a portable device/phone and not meant to be used to run Emacs to edit your thesis. Also there is MochaVNC for the ones who need it (i don't).

8. Instant Messenger. A ton of options available. I have AIM installed but rarely use it. All the chatting I do nowdays happens through the Facebook app.

9. File browser. I am not really interested to mess around with the files of the iPhone. But I do like to be able to have files on the go and be able to view them (since we have established in point No1 that I can't edit them). For this purpose I use the Box.net app, to access my box.net account. FYI, if you don't have an account, do yourself a favor and get one (or ask me to sent you an invite); this is the best IMHO online storage service and it has a free option for 1Gb. I also use Air Sharing to mount my iPhone as an external drive on my ibook and transfer files to it for future use. This allows me to carry with me pdf files for reading on the go. This is a great little app especially since I grabbed it for free during their September promo.

So, I think v2.0 (v2.1 currently) is a great step forward for the iPhone. With a great amount of apps (a good collection of free apps), the functionality of the iPhone is greatly improved. I do believe that a copy/paste function would make things almost ideal, and there is room for improvement for Apple.

Dreaming of iPhone Apps

2008-04-01T18:19:00.003-05:00

So with the recent release of the iPhone SDK and the announcement of the App Store for June, I can't help but think of all the things I want my iPhone to do and right now it cannot:

1. Office capabilities (doc, xls, ppt). Although I don't think I will be writing 10-page long documents on my iPhone, it is necessary to be able to edit, e.g my CV on the go. Or update a spreadsheet with my work hours log.

2. Cut and Paste. This is not an application, but thinking of the iPhone 2.0 I believe this is a definite MUST have for any portable device.

3. ePocrates or any drug reference tool. Judging from the ePocrates demo presented with iPhone 2.0, I am pretty sure this will be done rather fast.

4. Video recording. This is another sad reality; even the cheapest camera phone now days can do this.

5. iSilo for iPhone. There is a lot of hype about this ever since the iPhone was fist announced, but still nothing available from iSilo.

6. Flash on Safari. Many sites are now built with flash and also many games/apps online are bases on flash technology.

7. Ssh and VNC. This would allow me to control all my computers remotely in full.

8. Instant Messenger, preferably compatible with many protocols (AIM, MSN, Yahoo, Gtalk, etc). At least an AIM clone will be available soon.

9. File browser. This is not typical for an Apple based device (see iPod) but it would be nice to browse the files on the iPhone, download files from the net and look into smb shares.

Match and the Surfing

2008-03-14T00:14:00.004-05:00

Match day is coming up for this year. I still recall how during my interviews I met residents who made their rank lists based on how great the surfing is in the area. Come on people. You have to be at least smart enough to realize that your rank list (even though for competitive programs, you are not the one who decides) will affect your future for the rest of your life. So surfing or weather are just too unimportant to have any role in your decision making.

How to find a Research Position in the US

2007-03-26T07:30:00.001-05:00

I got asked this question in a forum, so I figured I should post this on my page as well. If you are into Surgery, then look at the Department of your interest.
Past publications are not that important (they are not bad either!). You need to find people who are faculty in Surgery at some uni that you are interested in, and that are ACTIVELY involved with research. So,
1. You find out what university you would like (think broadly, not just the what-you-think-is big names)
2. Go to the Department of Surgery website and find out if they have any research going on (90% there is a link 'Research')
3. Find out who are the Surgeons doing research
4. Go to pubmed, and search for their names
5. If their past paper was 2 years ago, dont bother and look for somebody else
6. When you find somebody who is actually doing research, email them, letting them know who you are, what you are doing now and what you want to do. This is called a letter of intent (you show your intentions). Attach your CV. Let them know that you WANT to do research (besides that you need it for residency) and that their research topic is interesting to you (eg sepsis).

NOTES:
A. USMLEs are NOT necessary, since you will have no patient contact. However, it is a lot better if you are done with USMLEs, since this way you show you are a serious person and not just looking around, and when you will be doing research, you will not need to study for something tedious as Biochem.

B. Any communication with people you find on the net that can be crucial. So make sure you have no typos, and your grammar is perfect. Your future may depend on this, so make sure your email and CV are PERFECT. Keep reading them on your own before you send them to make sure it doesn't get better. Have somebody who speaks English better than you read it (don't ask too many people though).

C. Mention in your letter that you are looking for a volunteer job (aka no money). Let me remind you that you are not looking for a job (if that is what you are interested in, dont do research), but a way to increase your competitive-ness for residency or applying for a fellowship or professorship in the future. If they are looking for somebody to do research, then most likely you don't have the experience to be as good as a lab tech with years of experience. So if I had a salary to give out, guess whom I would give it to? Having 5-7 publications or even more, is priceless, and look at it as a great investment. If you think you cannot afford it, try to afford it. If you still cannot, don't do research. Look for a preliminary spot (in case you ultimately want to do residency). However the prelim spot will have NO OTHER value. Publications put your name out there; make your existence known to the world. Once you get your foot in the system, and you show you are productive, you can ask for money. If they like you, they will find a way to pay you. However, if you go to do resaerch at a very small place, where there is no funding, it will be more difficult (if a center has basic science/bench/animal research, they have funding somehow, so it is a good sign).

D. For an H1 visa you will need a salary when you sign a contract. That makes your chances very bad. Why would anybody want to hire you when they don't really know you and you are a salary and difficult visa (it is difficult for some assistance to file for H1 compared to J1, MUCH more difficult)? I personally would not - never. Know that there are many others that will do this for free and just a J1. Ask your self if you really need a H1? Don't blindly believe rumors that a J1 research has a 2-year requirement. Two friends of mine had no requirement with a J1 visa. Your country might be different than mine - Greeece, so look into it carefully. Asking for an H1 is not good for you.

E. Expect to send A LOT of emails. Most will never respond. Some may. Don't email more than twice to the same people. If you email to more than 1 in the same place, don't copy/paste the same email for god's sake. Consider, taking a trip to the US (everybody has friends or relatives here) and then travel in the US to go to universities/hospitals that interest you, and make an appointment with some of the Faculty who does research. Show your face, be pleasant and hope for the best.

~ Good luck

Customer Service !@#$%^

2007-03-08T10:57:00.000-05:00

Even since I can remember myself growing up in my home country, relatives from the US would always bitch about the bad service, the slow response and the less-than-average quality abroad. So, after spending 20 plus years there, being fed up with all the bureaucracy, delays and non existent service (more about that later), I was thrilled that I would now reside in a system where everybody works to service and support the public/customer.

Well, let me inform everybody in the US and in other less developed countries that things are far away from perfect in the States.

When I first signed up for cable tv from Comcast, the lady on the phone (aka The Stoned) kept wanting me to go 20 minutes drive and pick up the equipment on my own. I called later in the week and another representative had no idea and said that they ship the necessary box to your home address. The Stoned also wrote down an incorrect social security number for me. Two months later, I wanted to cancel some movie channels, so I logged on my account on their website to change this. For my surprise, online you can only ADD and not REMOVE features; of course, why would anybody want to make easy for you to pay less, while the same time they want to make it as simple as possible to pay more. I then called the customer service and The Stoned was no longer working there; the person who I spoke with could not process my request because the social on file does not match the one I was giving them. As if some identity theft would involve me getting 5 less tv channels. I offered to fax them whatever the hell they wanted, but that wasn't good enough. They wanted me to take time off work, take a train and a bus to one of the three ghettos in the area (why are all the Comcast offices in the ghetto anyways?) and solve this in person. This way, the managed to have me pay $30 extra for 10 months. Also, after I moved they were refusing to cancel my subscription and sent me a nice $400 bill, which of course I got back.

Verizon is awesome. I have to admit that their dsl rates make overpriced cable internet look like a joke. And I don't want to hear anything about ping and bandwidth. 5 years ago people had AOL dialup. In my new apartment I wanted to get dsl for internet access, so I signed up with Verizon. In a week, I called to see the update and nobody had any idea about my account or my dsl (note: I ordered dsl without having home phone line). A month later they said everything is ok, but still the dsl modem showed line (not just internet) error. After another month and waiting approximatedly (I did calculate this) 4 hours and 20 minutes on the phone, I managed to cancel as well.

By the way, check the dsl status in other countries to see who is less developed. And, also why the hell do I lag like crazy in Steam with comcast cable?

Customer service = corporate service.

Debian on IBM ThinkPad 770

2007-03-07T11:08:00.002-05:00

Alternative Title: Old Laptop - Who Needs Vista Anyways...

[Disclaimer: if you are not into computers, don't read this. It will bore you to death]

I recently came across a post on a forum of users advising somebody to throw away his 'old' PC (pentium 1.4G with 64MB gpu) in order to get the new Windows Vista. Everybody gets it wrong; it is not about getting a computer to have Vista, it is about having a computer to do your freaking job.

I purchased an old IBM ThinkPad 770 laptop with a pentium 266, 96MB RAM, 4Gb hard drive, only floppy (no CDROM), two PCMCIA cards (LAN and modem). This piece of junk has half the power of my PDA for drying out loud! I gave $30 to get it and then $20 for a power adapter (the original was lost, and the battery doesn't hold a charge). Probably $50 is too much for this machine (aka The Brick), but the feeling of giving birth to something dead is priceless.

I tried using Windows 95 for 2 minutes and then I decided to make this actually usable. I am not that experienced with linux distos, but I have given it a try in the past (redhat and, mostly, ubuntu). Of course without a CDROM, there were not much I could do; my usual method of downloading the iso and making a boot/install CD was not an option. So, looking around I found this and decided to install Debian 3.1 using the PCMCIA lan card.

Step 1.
Obtain the img files for the three floppies I will need, boot, root and network drivers.
(this will only work for i386 CPU - for other types check here)

Make the floppies using the program rwwrtwin.

Step 2.
Insert the floppy boot into the drive and reboot the computer. When prompted insert the root floppy and when asked for additional drivers use the net-drivers floppy. It is crucial that by that point you already have your computer hooked up to the network, using a lan cable.

I have also done this using my iBook to connect to a wireless network and then share internet through the ethernet port of the iBook, where I hooked the IBM.

The installation should now begin. Select one of the servers to download the necessary files from (I used the MIT one, since it is fast - obviously - and close to my location).

Follow the directions from then on.

When prompted to pick a task to download appropriate files, select "Select packages manually" to start up Aptitude and from there choose what you need to avoid bloating your computer. If you don't care, then maybe selecting "Desktop" in the tasks would also work for you, but I don't recommend it. Aptitude is the best thing in debian so you might as well start using it as soon as possible. Before you install anything update the cache (pressing u).

Step 3.
Suggestions for old hardware:
Search (pressing / ) and mark for download (pressing +) the following
x-window-system-core this will install a basic X system on your machine
gdm this is a login manager - you don't need this one (you can use xdm or simply type startx every time you turn on your computer after you login) but I think this is disk space well spent
xfce4 this is a desktop environment (not just a window manager) that is very slick and fast, so I really like it in contrast to gnome/kde (you can try fluxbox, blackbox or anything else you like)
dillo very lightweight internet browser
links text based internet browser
qtorrent resources-friendly torrent client with gui
leaftpad very fast text editor (although I nano most of the times)

Step 4.
To get X working properly I had to manually edit the configuration file.
Login as root.
cd /etc/X11/
(or locate XF86config and cd to that folder)
Make sure that these sections are part of your file or that your monitor, graphics card and screen are configured in this way (only for IBM TP 770 users). Thanks to Martin Fluch for having this config on his website. I have edited the file based on my preferences and have it ready for you. Don't use it as is, but change your XF86Config-4 based on it.

UPDATE:
11/01/08 I have now updated my IBM to running Lenny. Since I had trouble finding floppies for netinstall, I used the etch floppies, and did minimal install by selecting no package in dselect (not even base or minimal). Then, after rebooting (this is probably a bad habbit from the winblows era), I edited the /etc/apt/sources.list file and changed the word etch or stable with lenny. Then I did aptitude update
aptitude dist-upgrade
aptitude upgrade
I have to say that it now I have a lot more features on rtorrent (mainly encryption) which is the main thing I use on that machine.

Something borrowed something new

2007-03-07T10:37:00.000-05:00

It took me a while to figure out whether I should write in english, greeklish or greek. I decided to write the first post in english, however I am sure in the process I will post in all three, depending on my time availability and of cource context ;) so if you start seeing weird characters or text that makes no sense, it will be all greek to me as well.

The purpose of this blog (everything seems to need a purpose these days) is to exchange 'images' with family and friends, as well as complete strangers to some extent. Come on. You have to admit that you have had the weirdest convos with people you have never met before; and without having some weirdness in our lives, things would be very very boring.

[image = unit of thought, e.g a photograph, an idea, a story]