Audio-Digest Foundation: Moving the media world from CD to iPod

Audio-Digest Foundation: Past Issues

I use this company for my medical CME. I've previously described how I leverage my iPod to facilitate completing my CME requirements. My method works, but it would be more convenient for me to get my lectures via Audible.com rather than via CD. This is a revised version of an email I submitted to their site:

I am a subscriber -- FP Audio Digest. Love it. I (legally) import the CDs into iTunes, upload the track names to the iTunes DB service, and store the lectures on my iPod. I listen when traveling, working, driving, etc. The iPod now has about 80 lectures. A 30 minute lecture is 13MB; I think with a better codec the size would be about 6MB.

This works well, but it's inefficient. I wish you'd consider Audible.com, an Apple iTunes store distribution partner, as your distributor. This could be quite efficient for you, though I don't know if there's enough cash flow to motivate Audible (you know the numbers).

There are many possible approaches, but please consider the radical option:

1. Separate access to the audio from CME services. Users pay one price for access, another for CME (either per lecture or per series).
2. Subscribers get access to all lectures in their domain -- ex. FP Audio domain. (Remember, once the infrastructure is in place it costs very little to supply a lecture to a subscriber). Also sell lectures separately. This means you can make money not only from physicians, but also from interested laypersons.
2. Subscribers get CME credit only when they pay you, either on a subscription or per-lecture basis.

With this option you wouldn't have to mail me a CD. This ought to save you some money. This distribution model will also allow you to earn money from the large pool of non-physician interested laypersons.

The increased convenience is worth money to me as well, so you could charge me slightly more for the service (esp. if you provide access to 2-3 years of the FP Audio library).

Some lectures are, of course, much better than others. Audible supports user comments. I would actually prefer to pay for lectures and CME based on user comments rather than one price for all.

I have no commercial interest in Audible.com. It would just help me out. If you're a subscriber and like this idea, you can go to the Audio-Digest site and submit your comments.

I suppose if Audio-Digest doesn't take this up, I could always take a whack at this business myself :-). (Depends how bored I get, rather unlikely I'd say.)

The demise of Wikipedia

Why Wikipedia Must Jettison Its Anti-Elitism || kuro5hin.org

Alas, it was not to be. An article by a former Wikipedia founder outlines a root problem:

The root problem: anti-elitism, or lack of respect for expertise. There is a deeper problem--or I, at least, regard it as a problem--which explains both of the above-elaborated problems. Namely, as a community, Wikipedia lacks the habit or tradition of respect for expertise. As a community, far from being elitist (which would, in this context, mean excluding the unwashed masses), it is anti-elitist (which, in this context, means that expertise is not accorded any special respect, and snubs and disrespect of expertise is tolerated). This is one of my failures: a policy that I attempted to institute in Wikipedia's first year, but for which I did not muster adequate support, was the policy of respecting and deferring politely to experts. (Those who were there will, I hope, remember that I tried very hard.)

And an article by a former Encyclopedia Britannica editor goes further:

... Then comes the crucial and entirely faith-based step:
Some unspecified quasi-Darwinian process will assure that those writings and editings by contributors of greatest expertise will survive; articles will eventually reach a steady state that corresponds to the highest degree of accuracy.

And there's the rub. Where is the "natural selection" process that selects for truth? Humans do not have an innate instinct for truth; if we did, we would not have had to develop the scientific method (devise model, specify testable predictions, tests, measurements, publication, review, revise model, iterate). Humans do have a predilection for creating narratives, hence the rich beauty of religious and spiritual writing (which may be true, but are not testable).

On the other hand, when I was working recently on a talk on knowledge representation, Wikipedia had one of the most helpful discussions of directed graphs that I've found. It was much more accessible than most of the literature on this domain; once I understood the Wikipedia description it I could validate the work against published reference materials. After reading the digested, populist version, I could read the work of recognized experts and interpret that work. So in this case Wikipedia filled an interesting niche -- a "popular" rendering of an esoteric topic that would, in the normal course of things, never be presented at anything other than the language of a post-graduate specialist.

So the Wikipedia will probably fail in its stated mission. It may, however, still have use -- as a way to popularize esoteric topics that other encyclopedias don't cover. The reader, however, must take the next step of comparing the writing of Wikipedia to an authoritative, less accessible source.

Outsourcing and quality control: the Apple experience

MacInTouch Home Page

A particularly appalling story of Apple's repair program. For various reasons, I believe this story is true:

I have a customer who had a 12.1' iBook G3/600 which exhibited the classic logic board exchange out of warranty issue, which Apple has a special extension for. This means the unit displayed flake video and sometimes would black out entirely.

This customer is meticulous and his equipment shows it. The unit was immaculate when it got to me even though it had been purchased second-hand and was in use by a kid.

I spoke to Apple and they agreed that it was within the scope of the extended warranty repair program, even though the serial number wasn't within the range published.

We did the DHL ship to the repair depot, and a week later the machine was returned to me. It had a very noticeable scratch on the bezel surrounding the LCD, and the Airport didn't work. I called Apple again and we did ANOTHER round trip to the depot. They made a note about the scratch, but it wasn't so bad, so I figured we could live with it.

Upon the second return (13 days, but Christmas intervened, so understandable), the unit worked OK, but had a very noticeable misalignment of the case work and ANOTHER scratch in the front lower case (right where you would press the tabs to release the bottom case).

I contacted Apple again, and they offered to replace the plastics and repair the unit if I shipped it to them a third time. I told them it had taken too long already, and could they compensate me some other way and I would pay to have the case put together properly in town... The guy's name was Dean and was super nice and agreed to send me out a new battery, which this unit needs anyhow.

So, when I go to straighten out the case work, as soon as the bottom is removed, it becomes clear there are multiple screws and parts MISSING. The LED which signals sleep wasn't even reinstalled, and at lease one important screw is AWOL.

Whoever is doing the repairs for Apple on this program is doing a terrible, sloppy job and there is clearly NO quality control in place for this.

As an Apple stock holder this is really appalling, as it clearly is costing way more then a new iBook to get this squared away. Three round trips via DHL and two logic board exchanges, plus ...

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I don't think this is purely an Apple issue. It's really an outsourcing story. Apple outsources their services. That means they lose control over quality. Episodes like this one, especially when broadcast on the very influential Macintouch site, cost them a fortune.

Outsourcing is very tricky.

Bush rule: The Revenge of Andrew Jackson

The New York Times > Opinion > Op-Ed Contributor: The Cabinet of Incuriosities

... Whatever the roots of Mr. Bush's overriding devotion to loyalty, it partly stems from his disdain for the concerns of old-style meritocrats, the kind of people who wince when the president places his confidence in someone like Mr. Kerik. Mr. Bush has never been comfortable in America's so-called meritocracy. Undistinguished in college, business school and in the private sector, he spent nearly 30 years sitting in seminar rooms and corporate suites while experts and high achievers held forth.

Now it appears that he's having his revenge - speaking loudly in his wave of second-term cabinet nominations for a kind of anti-meritocracy: the idea that anyone, properly encouraged and supported, can do a thoroughly adequate job, even better than adequate, in almost any endeavor.

It's an empowering, populist idea - especially for those who, for whatever reason, have felt wrongly excluded or disrespected - that is embodied in the story of Mr. Bush himself: a man with virtually no experience in foreign affairs or national domestic policy who has been a uniquely forceful innovator in both realms...

... Now that Mr. Bush has won his final campaign and holds high a gleaming national mandate, he can be ever more himself. And for Mr. Bush, personality is destiny. What you do is not as important as whether you are deemed morally sound and trustworthy. In other words, a "good" man - or woman - beats a leading expert every time. Welcome to the new meritocracy.

Stratosphere on Everest -- more

Telegraph | Connected | Sky 'fell in' on Everest

Google found me this:

The eight climbers killed on the single deadliest day on Everest may have been victims of the "sky falling in", according to a study.

An analysis of weather patterns in May 1996 suggests the mountaineers died when the stratosphere sank to the level of the summit, 29,000ft above sea level.

The freak weather caused pressure and oxygen levels to plunge within the "death zone" - the area above 26,000ft where the oxygen is extremely thin.

Normally Everest's summit lies just below the atmospheric layer. But on May 10, the day of the disaster, there were two fast-flowing air streams, called jet streaks, moving over the mountain.

Dr Kent Moore, a physicist at the University of Toronto in Canada, believes these would have pushed the stratosphere boundary down with catastrophic results.

During a similar event in 1998 a temporary weather station near the top of Everest recorded a sudden fall in pressure of 16 millibars.

"Such a drop is significant where the air is already very thin," New Scientist reports today. On Everest's summit, it would have been the equivalent to raising the mountain by around 500 yards. It would have instantly cut the amount of oxygen available to the mountaineers by around 14 per cent, Dr Moore believes.

At the summit the air already contains only a third of the oxygen it holds at sea level. The eight were members of a group who were climbing without supplementary oxygen.

Conditions had been good, with the sky free of clouds and the wind light. However, by around 4pm, the "death zone" was engulfed by storms, winds of up to 90mph and temperatures that crashed to minus 40C.

Within 24 hours, eight out of 30 climbers on the mountain were dead. They included Scott Fischer, from Seattle, and Rob Hall, from New Zealand, the expedition leaders.

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The story of that day was famously told in a magazine by Jon Krakauer; he later turned the story into a captivating book. His version of events has been disputed, unsurprisingly.

I have a slight connection to the expedition -- one my medical school classmates was the physician in Krakauer's book. (Krakauer misspelled my classmates name, I don't know if that was deliberate.)

Everest in the Stratosphere?

BBC NEWS | UK | Magazine | 100 things we didn't know this time last year: "75. Freak conditions above Everest can cause the sky to 'fall in'. An analysis of weather patterns in May 1996, by University of Toronto researchers, said eight people died when the stratosphere sank to the level of the summit."

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I'd like to learn more about that one.

One story among many - the Sambodhi shelter

Disabled children were helpless tsunami victims

GALLE, SRI LANKA ... Some desperate children gripped the rafters as the water level rose inside the one-story Sambodhi shelter, while others on mattresses floated away to their deaths, witnesses said. Just 41 of the 102 residents of the home [for disabled children] survived, caretaker Kumar Deshapriya said Saturday...

Deshapriya, who uses a wheelchair because he has muscular dystrophy, said it began after he returned from placing orders for fish, grain and vegetables at the market...

...Shelter employee Saroja Senivirathna said that she and a few others climbed onto the roof to escape the waves but that the cries of trapped children below were so unbearable that they descended to try to save as many as they could.

"While I was on the roof, I thought the whole place was going to collapse," Senivirathna said. "While these children were screaming, I decided it would be better to all die together rather than save my life alone. That's why I got down."

...Deshapriya is determined to rebuild the shelter, which has received money over the years from Mormons in the United States, a Dutch charity, Galle municipal authorities and Sri Lankan air force veterans.

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Had the waves hit 100 years ago, the population of the shorelines would have been quite small. Had they come 20 years from now, warning systems would have been in place. The waves came at the worst of times.

This is only one story among thousands, but there is a human need to create monuments to memory. Perhaps a restored Sambodhi shelter will be one monument. They will not lack now for funds, though, sadly, we will not lack for fraudulent charities claiming their name. Our family donates to CARE (www.care.org) and the Red Cross (most recently via Amazon's home page), but I'll make an exception for the Sambodhi shelter if I can find a legitimate charity sponsoring them.

PS. More Swedes died on the beaches of Thailand than Americans died in our most recent catastrophe -- the destruction of the World Trade Center.

Voting in the USA: it's much worse than you think

20 Amazing Facts about Voting in the USA

If the statements here are correct, then the voting situation in the US is rather worse than I'd believed -- and I didn't think it was very healthy.

Amazon: the service just gets better

Amazon.com: Welcome

In the midst of the flurry of vendor issues I've recently posted on (toyglobe.com, the 7K AMEX fraud charges), I received a notice from Amazon that an order had shipped. That led me to notice a few things about Amazon, a company I order from several times a month:

1. Their shipping speed has really improved.
2. Almost everything I order is free shipping.
3. Even though free shipping is supposed to delay shipping of multiple items, and even though that was historically a problem, that no longer seems to happen. Amazon splits the shipment and sends items separately.
4. They provide a great record of invoices online.
5. They provide manuals and related items online.
6. Their website has had no glitches in my experience in the past year.
7. The value-add of their customer reviews, and the summary of what people who viewed an item actually bought instead, is extraordinary.
8. Their prices are very competitive and often the best I can find.
9. Amazon is a great place to sell and buy used goods, less hassle than eBay and the prices are not as inflated as on eBay.

They just keep getting better. I recently read a Bezos interview where he noted an internal Amazon study. They decided they while advertising did increase their sales, they got a bigger increase by putting their ad revenue into free shipping and improved service.

Credit card fraud: more on my most recent experience

Faughnan's Notes: CC Fraud Take II

A few more thoughts on this recent $7K fraud experience.

1. How did the crooks manage delivery of the stolen goods? In the Netfill scam there were no good to deliver and the faked transactions were for virtual goods.

2. Why didn't AMEX's fraud alarms go off? I have to assume they disable them, or tune them down, around the holidays. I've had AMEX question my purchase of underwear while traveling on business, but I didn't get a call about 6 separate $550 transactions in one day against one company.

3. Why NEWEGG? Why not spread the transactions around and make the fraud less obvious? Was NEWEGG an easy target for some reason?

4. Was the attack fully automated? That's the most interesting possibiliity. It seemed pretty stylized -- two near identical attacks two weeks apart, each beginning with a domain name change. Problem is, unlike Netfill, this seems to have involved delivery of physical goods. Hard to see how that could scale. I don't think this was an automated attack.

The more I think about the delivery of physical goods problem, the more I'm inclined to think this was a kid somewhere.

Update: This must be the season for credit card fraud -- I might have another one! My son's Brett Favre figure broke; I had trouble finding a replacement on the net and ended up placing an order with toyglobe.com. My AMEX card was charged the day I placed the order: 12/3/04; it was charged slightly more than expected. Nothing has come from Toyglobe.com (office is in my old home town: St. Laurent, Quebec). Their web site doesn't have a phone number. A web search finds a worrisome web page of complaints. Hmmm. Suspicious timing?

Le, Guong
Toyglobe.com
3080 Barclay # 6
Montreal, Quebec h3s1j8
or
Toyglobe.com
5455 Vanden Abeele St.
St. Laurent, QC H4S 1S1

Bush: into the abyss

Salon.com | Neocons take complete control

.... The rejection of Kanter is a compound rejection of Scowcroft and James Baker -- the tough, cunning, results-oriented operator who as White House chief of staff saved the Reagan presidency from its ideologues, managed the elder Bush's successful campaign in 1988, and was summoned by the family in 2000 to rescue George W. in Florida. When all else failed (the voters, for example), Baker arranged the outcome that put Bush in the Oval Office. In the 1995 memoir of his years as secretary of treasury and state, Baker observed that in the Gulf War the administration's 'one overriding strategic concern was to avoid what we often referred to as the Lebanonization of Iraq, which we believed would create a geopolitical nightmare.' In private, Baker is scathing about the current occupant of the White House, people who have spoken with him have recently related to me. Now the one indispensable creator of the Bush family political fortunes is repudiated.

Those Republican elders who warned of endless war are purged. And those who advised Bush that Saddam was building nuclear weapons, that with a light military force the operation would be a 'cakewalk,' that capturing Baghdad was a 'mission accomplished,' and that the Iraqi army should be disbanded, are rewarded.

Powell, the outgoing secretary of state fighting his last battle, a rearguard action against his own administration on behalf of his tattered reputation, is leaking stories to the Washington Post about how his advice went unheeded. Secretary of Defense Donald Rumsfeld, whose heart beats with the compassion of a crocodile, clings to his job by staging Florence Nightingale-like tableaux of hand-holding the wounded, while declaiming into the desert wind about 'victory.' Since the election, 203 U.S. soldiers have been killed and 1,674 wounded.

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There is no James Baker to save us from an ideologue president. We are into the abyss.

I'm left to hope Bush really can alter reality through sheer force of will. Meanwhile the rest of the world has to start taking adaptive action.

Lessons from the airtravel debacle of Christmas 2004: the risks of efficiency

The Cincinnati Post - Comair computer crash

Air travel this past Christmas was awful. I was on a simple direct flight from NWA, but we experienced 1-3 hour delays in both directions, one from a flaw in luggage loading, the other a mechanical. Workers were burned out everywhere, from food services to flight workers -- even the toilets were trashed.

We were lucky. US Air was disabled by labor strife (I'd assume the flight attendants figure their jobs are toast anyway, so they might as well try to take out the airline). Comair was disabled by a software bug. The simple answers are "better software" and "some airlines need to go away".

But maybe there are deeper lessons to learn:

.... Tom Parsons, of Bestfares in Arlington, Texas, said the lesson he learned long ago was to avoid northern connections during the winter.

'I still can't believe what happened to Comair. You notice that Delta is sitting in the background, saying that's Comair, that's Comair,' Parsons said.

He said part of the problem is that airlines have stripped down so far that they were near 100 percent capacity for holiday rushes.

'The systems are geared to run 100 percent, and hopefully nothing goes wrong. This time, just too many things hit (Cincinnati/Northern Kentucky airport). Each one became part of the domino effect. We now know not to connect through Cincinnati in the winter or to fly Comair or U.S. Air,' Parsons said.

Maybe the deeper lesson is the risk of high-efficiency systems. Most highly efficient systems have little redundancy and unused capacity. If something goes wrong, they are prone to lockup and collapse. The same thing happened to our electrical grid in the northeast about a year ago.

In theory a system could be both adaptive and efficient -- able to run without much redundancy but also able to quickly configure to adopt to changing circumstances. In theory. In practice I work in developing complex software to augment clinical work. I worry about the risks of increasing efficiency by reducing redundancy.

I think again (and again) of an odd lecture I attended at the annual scientific assembly of the American Academy of Family Practice. I don't know how the speaker got on the schedule, his topic we rerisks associated with complex and stressed systems -- not a very clinical topic! He was inspired by a popular book of the time. I enjoyed the presentation by a fellow physician-crank. I think he (and the book he'd read) were right then, and they're right now. We pay a price by sacrificing redundancy and adaptability in favor of efficiency. It's a lesson Rumsfeld ought to have learned from Iraq (he's an idiot however, so he probably hasn't learned anything). It's a lesson we ought to learn from evolution, where highly adapted and specialized animals disappear when their ecosystem is disrupted. (Too bad this lesson is lost on the anti-evolutionists.) There are real benefits in the long term to adaptability, to excess capacity, to shock absorbers, to redundancies.

Unfortunately the market is a tool for solving local minima equations. It does not necessarily reward the ability to tolerate infrequent system shocks.

Be the Best You can Be: endocannabinoids, Buspar and behavioral disorders

Be the Best You can Be: Endocannabinoids, buspirone (Buspar), and behavioral disorders in children with ADHD, PDD, EBD (explosive child)?

A highly speculative posting from a non-expert. An intriguing domain ...

Miracle surgery for migraine?

BBC NEWS | Health | Surgery 'helps combat migraines'Coincidentally, I'd just finished an interesting CME on headache when I saw this:

Surgery and botox injections can help treat migraines, a US study says.

Researchers injected about 100 patients with botox to find out which muscles triggered the migraines and then used surgery to remove the muscles.

The surgery reduced the intensity and frequency of migraines in 92% of patients and eliminated them altogether for a third of people involved.

The research, published in Plastic and Reconstructive Surgery journal, also cut the number of sick days taken.

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A 33% lifetime cure for migraine? That would be miraculous. I'm skeptical. My bet:

1. This was a very select group. They had to respond to botox before surgery. The BBC reporter missed this. Since about half the population gets migraines, I'd bet this is a small subgroup who have an unusual migraine trigger. So even if it works, perhaps 1/10 to 1/20 of identified chronic migraine patients would be candidates.

2. I'd be astounded if the results will be this good in f/u studies. We know that migraine, like most pain conditions, is very susceptible to "placebo" affects. (We don't know what this "placebo" affect is -- it's very powerful and if we could master it then it would be very valuable. It's hard to manage though.) I bet a randomized placebo-controlled trial will show benefit in about 1/3 of 1/15 migraineurs (1/50!) and longtime cure in 1/10 of those treated (1/150 of migraineurs).

Ok, maybe I'm a Grinch. I knew of some neurologists years ago who were quite keen on these types of therapy, including using pre-botox interventions to kill some of these peripheral nerves. ENT surgeons, esp. in the 60s and 70s, used various similar interventions for cluster headaches (some used cocaine back then -- but it had its own problems). This wouldn't be the first time that an old intervention would be shown to have real value. And, on the other hand, we know that migraine prophylaxis drugs basically suck. (They are so ineffective that one suspects the entire value of many of them is from the placebo effect.)

We'll see ...

Dyer on the humanization of Hitler

Mass murder in the name of a principle is as human as apple pie, borsht and steamed rice. Treating the perpetrators as space aliens simply disguises the nature of the problem. The potential mass killers live among us, as they always have. They often have perfectly good manners, and some even have high ideals. And the only way the rest of us have to keep them from power is to remember always that the end does not justify the means.

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I think I wrote too harshly of Dyer earlier today. I'm reading through his 2004 material and finding quite a few gems. Evil is an everyday, human affair. Considering how awful we are now, it is chilling to think of how nasty we were when we ate Neandertal.