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Monday, October 10, 2011
Audible removes in app purchases from IOS devices
Thursday, September 1, 2011
My suggestions for useful power devices to survive a prolonged blackout.
Now that things have settled down I'm compiling a list of necessary items for surviving a multiday power outage. N.B. Everything listed here are items I used during me 90 hour blackout
As opposed to my "Beer, salsa & chips" list this one is trying to be serious, anyone who has any suggestions/additions please add them in the comment.
1) a 16,000 mAmp i.Sound portable power pack, at 16,000 mAmps you will get at least 10 recharges of a phone/ipod (& maybe 5 of an iPad) before you need to recharge it.
2) A Wagan 400 Watt PowerDome. This Lead/Acid battery pack supplies 2 standard outlets & 2 12 volts (cigarette lighter type) outlets as well as enough juice to jump start if the car battery fails. You can run a very small TV off it for a few hours as well recharging lanterns, see below for my recommendations for those.
3) Coleman LED Rechargeable Lantern. This lantern has multiple brightness settings from dim to full. The dim supplies enough light to navigate familiar places while the full setting will provide enough lighting for multiple people to set around it & read etc. It recharges via a 'wall wart' or a 12 volt adapter so the Wagan PowerDome can recharge this. I chose a rechargeable over a propane lantern due to fire risks (if you start a fire during a blackout there may be NO help coming & I know that you need flashlights & batteries but IMO this supplies better lighting for meals & just 'sitting around in the dark' than multiple flashlights
4) Vizio 7" portable digital LED TV. The screen is small but is big enough to watch news & storm updates. It has an internal rechargeable battery which is good for about 3 hours & then you'd need to recharge it with the PowerDome. I got this one for 2 reasons 1) it has an incorporated antenna which can be flipped up & rotated to improve reception. 2) it was on sale at CostCo. If you're going to get another model make sure that it has multiple charging options (i.e. wall wart & 12 volt) and a good capacity internal battery. I'd love to find one which operates on AA's (like a very old LCD hand held analog TV I've had for about 15 years) but I haven't seen one yet.
5) iPod nano or classic or another MP3 player. There are battery powered CD players but how many of us still have a large CD collection. In this case I'd go for the nano since it also includes an FM radio (in the greater NY area there are FM all news stations). I know that the iPod touch is much more popular & has a higher capacity but the nano &/or classic will run for longer using much less power due to the 'lack' of an large LED screen. My nano ran for 20 hours before I needed to recharge it which was 3 days of listening to audiobooks. (You don't need a link to find this one). If you have a iPod touch I'd strongly suggest a Morphie JuicePack as an 'additional battery' to prolong the power supply.
Other non-powered but useful items include a cooler & blue ice packs to keep foods cold without opening the refrigerator/freezer as well as a fireplace/bbq lighter to light your stove if you're lucky enough, like we were, to have a gas range & the gas is still on,
Hopefully I can now pack most of these items away & won't need them (except for the iPod nano which I wear as a wrist watch) for years.
As opposed to my "Beer, salsa & chips" list this one is trying to be serious, anyone who has any suggestions/additions please add them in the comment.
1) a 16,000 mAmp i.Sound portable power pack, at 16,000 mAmps you will get at least 10 recharges of a phone/ipod (& maybe 5 of an iPad) before you need to recharge it.
2) A Wagan 400 Watt PowerDome. This Lead/Acid battery pack supplies 2 standard outlets & 2 12 volts (cigarette lighter type) outlets as well as enough juice to jump start if the car battery fails. You can run a very small TV off it for a few hours as well recharging lanterns, see below for my recommendations for those.
3) Coleman LED Rechargeable Lantern. This lantern has multiple brightness settings from dim to full. The dim supplies enough light to navigate familiar places while the full setting will provide enough lighting for multiple people to set around it & read etc. It recharges via a 'wall wart' or a 12 volt adapter so the Wagan PowerDome can recharge this. I chose a rechargeable over a propane lantern due to fire risks (if you start a fire during a blackout there may be NO help coming & I know that you need flashlights & batteries but IMO this supplies better lighting for meals & just 'sitting around in the dark' than multiple flashlights
4) Vizio 7" portable digital LED TV. The screen is small but is big enough to watch news & storm updates. It has an internal rechargeable battery which is good for about 3 hours & then you'd need to recharge it with the PowerDome. I got this one for 2 reasons 1) it has an incorporated antenna which can be flipped up & rotated to improve reception. 2) it was on sale at CostCo. If you're going to get another model make sure that it has multiple charging options (i.e. wall wart & 12 volt) and a good capacity internal battery. I'd love to find one which operates on AA's (like a very old LCD hand held analog TV I've had for about 15 years) but I haven't seen one yet.
5) iPod nano or classic or another MP3 player. There are battery powered CD players but how many of us still have a large CD collection. In this case I'd go for the nano since it also includes an FM radio (in the greater NY area there are FM all news stations). I know that the iPod touch is much more popular & has a higher capacity but the nano &/or classic will run for longer using much less power due to the 'lack' of an large LED screen. My nano ran for 20 hours before I needed to recharge it which was 3 days of listening to audiobooks. (You don't need a link to find this one). If you have a iPod touch I'd strongly suggest a Morphie JuicePack as an 'additional battery' to prolong the power supply.
Other non-powered but useful items include a cooler & blue ice packs to keep foods cold without opening the refrigerator/freezer as well as a fireplace/bbq lighter to light your stove if you're lucky enough, like we were, to have a gas range & the gas is still on,
Hopefully I can now pack most of these items away & won't need them (except for the iPod nano which I wear as a wrist watch) for years.
Thursday, August 25, 2011
My take on the latest turn in Mr. S. Jobs' medical condition
Now that Mr. Jobs has stepped down (in effect admitting the seriousness of his condition) I feel free to discuss further my feelings about what's going on with Mr. Jobs. Again I'm not directly involved in his treatment but this is based on personal observations and publicly posted information
1) The Carcinoid had recurred and had recurred in the transplanted liver.
2) He had been undergoing a palliative treatment called 'chemoembolization' which involved essentially injecting chemotheraphy directly into the main artery of the liver.
3) (This is based on my observations) This treatment has not had the desired effect on slowing/halting the progression of the disease to any significant effect. I am saying that based mainly on his progressive muscle wasting which is apparent on any recent pictures of him and his final decision to 'step down' as the CEO of Apple. The pictures I refer to are not the photoshopped ones but those from publically broadcasted events.
OK, now some more technical background.
What is chemoembolization?
The liver has the relatively unique property of having a dual blood supply. First the hepatic artery and secondly the portal vein. Unlike any other organ the liver derives the vast majority of it oxygen and nutrient supply from the portal vein instead of the artery. Conversely, and to most patient's benefit, tumors in the liver derive those vital elements from the hepatic artery. This gives us the option to infuse chemotherapy directly into the hepatic artery directing the chemo to the tumor and sparing the healthy liver. In patients with metastatic tumors this is not commonly curative but can provide excellent palliation (alleviation of symptoms & slowing or halting the progression of the disease) & extending the potential survival for years. The issue for Mr. Jobs is that there is little data as to the effect of this treatment on a transplanted liver which may have alterations in the 'normal' blood flow. This has most likely limited the amount of treatment that they are willing to infuse into Mr. Jobs liver and may be part of the reason that his condition has progressed.
His future options/prognosis
1) A new liver transplant is 'potentially' possible if there is no recurrent tumor anywhere else but I would put the possibility into the less than 'single digits'. His first transplant was done at one of the only centers in the US willing to transplant for metastatic carcinoid (there's no good evidence that transplant is better than primary chemoembolization) & I would be very surprised if they were willing to retransplant in the face of recurrent tumor. The reason for this is that recurrence after removal of the affected organ (his liver) indicates micro implants of the tumor elsewhere which have not been controlled and the likelihood of a second recurrence is extremely high.
2) More chemo. That can always be done & may be preceding but in view of the apparent failure of his current treatment he would need to be entered into an 'experimental' study to find something different.
3) Under the best circumstances, if no further treatment is possible Mr. Jobs will suffer from progressive liver failure slip off into a painless coma and not 'wake up'. That was the condition he was approaching when the first transplantation was done. Depending on the amount of liver function that he has left this time can be estimated from weeks to months although without some new treatment, and based solely on statistical data, I would be surprised but not amazed to find that he made it to the end of the year. It all really depends on how rapid the tumors in his liver, & elsewhere grow and impair his functioning. What I have been waiting for, fearfully, was that he would suffer a catastrophic complication of his treatment, i.e. rapid liver failure due to ischemia of the liver, overwhelming infection as a result of the immunosuppression needed to prevent rejection of his transplanted liver and would die unexpectedly in a spectacular fashion (Sorry if that sounds callous but that's what we usually call rapid, catastrophic death when you're surrounded by all the high tech medical equipment doing everything possible to try and save you).
My personal hope is that he goes easily surrounded by family & friends and that he gets the most quality time possible.
I've attached links to a technical article (above the level of 'lay public' but not too esoteric) which further explain chemoembolization and the only article I've found on the treatment of metastatic carcinoid by that method. I have been able to find NO REFERENCES to chemoembolization into a transplanted liver & talking to my radiology colleagues it is a rarely done & is an essential experimental procedure.
References:
1) Chemoembolization of liver tumors (for the lay public but a good review) http://www.rad.washington.edu/clinical/radiology-clinics/interventional-radiology-clinic/chemoembolization-of-liver-tumors
2) Hepatic artery embolization and chemoembolization for treatment of patients with metastatic carcinoid tumors: the M.D. Anderson experience. (The best article I've found, you'll get what you need reading the abstract) http://www.ncbi.nlm.nih.gov/pubmed/12967136
1) The Carcinoid had recurred and had recurred in the transplanted liver.
2) He had been undergoing a palliative treatment called 'chemoembolization' which involved essentially injecting chemotheraphy directly into the main artery of the liver.
3) (This is based on my observations) This treatment has not had the desired effect on slowing/halting the progression of the disease to any significant effect. I am saying that based mainly on his progressive muscle wasting which is apparent on any recent pictures of him and his final decision to 'step down' as the CEO of Apple. The pictures I refer to are not the photoshopped ones but those from publically broadcasted events.
OK, now some more technical background.
What is chemoembolization?
The liver has the relatively unique property of having a dual blood supply. First the hepatic artery and secondly the portal vein. Unlike any other organ the liver derives the vast majority of it oxygen and nutrient supply from the portal vein instead of the artery. Conversely, and to most patient's benefit, tumors in the liver derive those vital elements from the hepatic artery. This gives us the option to infuse chemotherapy directly into the hepatic artery directing the chemo to the tumor and sparing the healthy liver. In patients with metastatic tumors this is not commonly curative but can provide excellent palliation (alleviation of symptoms & slowing or halting the progression of the disease) & extending the potential survival for years. The issue for Mr. Jobs is that there is little data as to the effect of this treatment on a transplanted liver which may have alterations in the 'normal' blood flow. This has most likely limited the amount of treatment that they are willing to infuse into Mr. Jobs liver and may be part of the reason that his condition has progressed.
His future options/prognosis
1) A new liver transplant is 'potentially' possible if there is no recurrent tumor anywhere else but I would put the possibility into the less than 'single digits'. His first transplant was done at one of the only centers in the US willing to transplant for metastatic carcinoid (there's no good evidence that transplant is better than primary chemoembolization) & I would be very surprised if they were willing to retransplant in the face of recurrent tumor. The reason for this is that recurrence after removal of the affected organ (his liver) indicates micro implants of the tumor elsewhere which have not been controlled and the likelihood of a second recurrence is extremely high.
2) More chemo. That can always be done & may be preceding but in view of the apparent failure of his current treatment he would need to be entered into an 'experimental' study to find something different.
3) Under the best circumstances, if no further treatment is possible Mr. Jobs will suffer from progressive liver failure slip off into a painless coma and not 'wake up'. That was the condition he was approaching when the first transplantation was done. Depending on the amount of liver function that he has left this time can be estimated from weeks to months although without some new treatment, and based solely on statistical data, I would be surprised but not amazed to find that he made it to the end of the year. It all really depends on how rapid the tumors in his liver, & elsewhere grow and impair his functioning. What I have been waiting for, fearfully, was that he would suffer a catastrophic complication of his treatment, i.e. rapid liver failure due to ischemia of the liver, overwhelming infection as a result of the immunosuppression needed to prevent rejection of his transplanted liver and would die unexpectedly in a spectacular fashion (Sorry if that sounds callous but that's what we usually call rapid, catastrophic death when you're surrounded by all the high tech medical equipment doing everything possible to try and save you).
My personal hope is that he goes easily surrounded by family & friends and that he gets the most quality time possible.
I've attached links to a technical article (above the level of 'lay public' but not too esoteric) which further explain chemoembolization and the only article I've found on the treatment of metastatic carcinoid by that method. I have been able to find NO REFERENCES to chemoembolization into a transplanted liver & talking to my radiology colleagues it is a rarely done & is an essential experimental procedure.
References:
1) Chemoembolization of liver tumors (for the lay public but a good review) http://www.rad.washington.edu/clinical/radiology-clinics/interventional-radiology-clinic/chemoembolization-of-liver-tumors
2) Hepatic artery embolization and chemoembolization for treatment of patients with metastatic carcinoid tumors: the M.D. Anderson experience. (The best article I've found, you'll get what you need reading the abstract) http://www.ncbi.nlm.nih.gov/pubmed/12967136
Sunday, July 24, 2011
My Review of the Sonos Play:3 speakers
Now that I've had the Play:3 up and running for 48 hours here's my take on the newest entry into the Sonos System.
The Play:3 appears to be Sonos' foray into a speaker system for the smaller room/area. In my case it's in our master bedroom which is a 10x12 space.
The setup was painless, as usual, and the speaker was up and running within minutes.
Sound: I ran my usual 'test mix' of music ranging from rock through classical (I've never found anything better than Dvorak's New World Symphony, the Von Karajan version, to test speaker ranges) and a radio station to check voice reproduction. As expected for a unit of this size the bass was a little lacking and faded out the further you got from the unit but the rest of the range was bright and clear. All parts of the sound improved when I put the speaker on a table in the corner of the room and allowed the sound to bounce off the walls (I faced it out but it still helped).
More interesting, and problematic, to me were the choices Sonos made on what to add and leave out of this unit.
1) There is the addition of a mounting hole on the back (check the photo below) for attaching to a bracket (Not included & currently Sonos does not offer).
At 10 pounds the speaker will require firm attachment to remain secure but the depth of the hole seems to be deep enough to provide for this.
The problem is the placement of the mounting hole. Although the unit can be placed vertically and the speakers adapt (confirmed by my testing) this only works with the right side down, not the left. For some reason Sonos placed the screw hole to the side of the unit instead of squarely in the back. This means that any mounting bracket will have to supply a 'shelf' as part of it's structure or clamp around the sides of the unit to prevent levering and potential damage to either the unit or wall since if simply screwed into a stud the weight will be carried at the lower part of the unit (if mounted vertically) or off to the side (if horizontal). Perhaps this choice was dictated by the interior design (I didn't open the unit to check) but it was, IMO, a poor choice a center place mounting hole would have been better.
Also the power socket and Ethernet port jack are close to the mounting hole. This means either running the wiring through the wall or having to mount at least 2 inches away from the wall for adequate clearance for the power cords (this may have been intentional since they recommend a minimum of 1" of clearance around the unit for ventilation and that will place even further leverage on a single screw mount).
2) What was left out as opposed to the S5/Play:5 unit:
A) There is no Ethernet out jack on the back so you have to use a separate port from your router to connect this if it's the first component.
B) There is no line in jack. In my case it's an issue since I was going to add a second Bluetooth receiver and continue to stream audiobooks from my phone to the player as I do with the S5 in the kitchen. I know that I can add a wireless bridge for iPhones but I have an Android phone and that's not possible since the wireless bridge is iPhone/iPod only. The lack of an line in jack means leaving my phone in the kitchen to stream the book in the bedroom, a nonstarter if I need to use the phone. Also, I was considering giving a Play:3 to my son for his college apartment & using Bluetooth to stream from his iPhone. The price differential of $30 for a Bluetooth adapter vs $120 for the dock is a nonstarter as far as I'm concerned.
C) There is no headphone jack on the back meaning that, unlike the S5/Play:5 you can't listen privately through the system
Conclusions:
The Play:3 is an interesting option for the smaller room if you already own a Sonos system with more than adequate sound quality for speakers of it's size but it's lack of input/output ports on the back make it 'iffy' if you're going to use it as your only speaker for the system.
The problem is the placement of the mounting hole. Although the unit can be placed vertically and the speakers adapt (confirmed by my testing) this only works with the right side down, not the left. For some reason Sonos placed the screw hole to the side of the unit instead of squarely in the back. This means that any mounting bracket will have to supply a 'shelf' as part of it's structure or clamp around the sides of the unit to prevent levering and potential damage to either the unit or wall since if simply screwed into a stud the weight will be carried at the lower part of the unit (if mounted vertically) or off to the side (if horizontal). Perhaps this choice was dictated by the interior design (I didn't open the unit to check) but it was, IMO, a poor choice a center place mounting hole would have been better.
Also the power socket and Ethernet port jack are close to the mounting hole. This means either running the wiring through the wall or having to mount at least 2 inches away from the wall for adequate clearance for the power cords (this may have been intentional since they recommend a minimum of 1" of clearance around the unit for ventilation and that will place even further leverage on a single screw mount).
2) What was left out as opposed to the S5/Play:5 unit:
A) There is no Ethernet out jack on the back so you have to use a separate port from your router to connect this if it's the first component.
B) There is no line in jack. In my case it's an issue since I was going to add a second Bluetooth receiver and continue to stream audiobooks from my phone to the player as I do with the S5 in the kitchen. I know that I can add a wireless bridge for iPhones but I have an Android phone and that's not possible since the wireless bridge is iPhone/iPod only. The lack of an line in jack means leaving my phone in the kitchen to stream the book in the bedroom, a nonstarter if I need to use the phone. Also, I was considering giving a Play:3 to my son for his college apartment & using Bluetooth to stream from his iPhone. The price differential of $30 for a Bluetooth adapter vs $120 for the dock is a nonstarter as far as I'm concerned.
C) There is no headphone jack on the back meaning that, unlike the S5/Play:5 you can't listen privately through the system
Conclusions:
The Play:3 is an interesting option for the smaller room if you already own a Sonos system with more than adequate sound quality for speakers of it's size but it's lack of input/output ports on the back make it 'iffy' if you're going to use it as your only speaker for the system.
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