Cervical ribs and cancer risk

I remember being taught that cervical ribs were a relatively harmless congenital anomaly. True, it's been years since I practiced clinical medicine, but is this widely known? Is it true?

Pharyngula

There isn't much variation in cervical vertebra number, though. There is an exception: sometimes, the 7^th cervical vertebra is found to undergo a partial homeotic transformation and forms a pair of ribs, which are normally found only on thoracic vertebrae. Humans develop cervical ribs with a frequency of about 0.2%; do they also develop cancers? The answer is yes, with a frequency 125 times greater than the general population.

The power of the contest: Booting XP on a MacTel

[Update 1/24: Colin added an Amazon donation link and I kicked in $20.]

A very clever person has created a several thousand dollar prize for getting XP to boot on a MacTel box -- out of thin air:

The Contest

My MacBook is shipping on the 15th of February. I told my boss that this would replace my IBM desktop and I could boot Windows XP on it. I am still confident it can be done. I am pledging $100 of my own money and offering anyone else who would like the instructions on how to Dual boot these two operating systems the ability to donate some of their money into the pot as a reward for the person / group that can make dual-booting Mac OS X and Windows XP happen on an Intel Mac.

He started with $100 in seed money, and is now raising serious funds. There are thousands of geeks who seriously want to do this. Apple, for unknown reasons, is not helping (security?, strategy?, support concerns?, Digital Rights Management?). The primary obstacles are drive format and the MacTel's BIOS replacement.

Unfortunately he only accepts PayPal or I'd kick in $20. Happily he's added an Amazon link to the PayPal option so I kicked in $20 (I despise PayPal.) The contast has now gotten enough attention that it's a matter of both money and glory. I would not be surprised to see some silicon valley millionaires sweeten the pot considerably.

We've seen contests used in aerospace, human powered vehicles, and other settings. In a connected world, where the costs of reaching millions of people is very low, the power of these contests is likely to grow. If this particular effort succeeds, it may, in retrospect, be a truly historic event.

Google news now learns what you like

Google News is "out of beta", meaning Google is committing to it for at least a few years. Google news now "learns" what you might like to read. Another small step for Skynet.

Official Google Blog: And now, News:

You can sign up for Personalized Search to view and manage your history of news searches and the articles you've read. When you're signed in to your Google Account, you'll receive recommended news stories based on the previous stories you've read. These recommendations will be highlighted just below the top news stories on the page, in a clearly marked section. You can also get a full page of recommended stories by clicking on the section. All of this is done automatically using algorithms.

Update. It took a few minutes for Google news to start showing the new section, but now I have an extra news section that looks like this:

Recommended for jfaughnan@gmail.com » Learn more
UK support for rights groups raises suspicion in Kremlin
Guardian Unlimited - 1 hour ago - Russian non-governmental organisations, yesterday expressed concern that spying allegations against British diplomats ...
Los Angeles Times - Telegraph.co.uk - The Moscow Times - all 376 related »

Sudan seeks to end split at African Union
Financial Times - 1 hour ago - By Andrew England in Nairobi and Reuters. Sudan said yesterday it was willing to withdraw its candidacy for the ...
Reuters - News24 - Voice of America - all 425 related »

Saudi Araba in Energy Deal With China
Houston Chronicle - 13 hours ago - By ALEXA OLESEN Associated Press Writer. BEIJING — Saudi Arabia and China inked a deal on energy cooperation on ...
Financial Times - Arab News - Hindu - all 339 related »

The stories listed are moderately interesting to me; it will be neat to see where this goes.

Travelers tales: a list of favored cities and times

Obsidian Wings, a politically moderate security-focused blog, drifted into the topic of fun business travel and places. It's the comments that make the piece. Many of the comments are about places that would require a time machine to visit.

I can vouch for some of these lost places -- Chiang Mai in 1981, Jerusalem in 1983. I regret not having visited Kashmir when I might have @1981 -- the way the war is going there I won't ever see it. I'm told old Laos was a rare gem. Manhattan in the 1940s and 1950s. Shanghai before the boom. Koh Samui when it was hard to reach.

A time traveler would have no end of wonderful cities and places to visit. Many were most wonderful for a short period of time, modernity has come fast and hard to much of the world. I can't deny the urgency of poverty, but I suspect one day many Chinese will deeply regret what has been destroyed. In my home town of Saint Paul/Minneapolis an awful lot of local history and charm was plowed over for roads and trains from 1950 to 1970.

Travel while you can. You cannot cross the same river twice (or even once).

PS. If once read a book titled '1,000 Places to See Before You Die'. It was awful. Really 1,000 hotels to visit before you die. The author apparently never left her room. I have to admit, I remember some of those hotels fondly -- but really ...

iTunes users are Democrats?

iTunes grown (14% of net users) is huge news for Apple. iTunes embedding is fundamental to Apple's success. They may have crossed the "tipping point". Most interesting, however, is that their user base appears to be democrat:

BBC NEWS | Technology | Apple iTunes users growing fast

Curiously, the market research firm also found that iTunes users comprise a readily identifiable audience in terms of their likes and dislikes for certain goods and services.

For instance, Nielsen said, iTunes users were 2.2 times more likely to own a Volkswagen than the average internet user. Audi and Subaru were also popular with regular users of the Apple store.

Marketers usually consider ownership of these vehicles as a very reliable market for someone who votes Democrat first.

Microsoft needs to go for the Republicans.

Parasite and master

I'm addicted to these stories of parasites controlling their hosts. Were we less fussy when we carried worms? Is OCD (obsessive compulsive disorder) an adaptive response to the lassitude and carelessness worms create? (In other words, OCD is the disorder that emerges when the worms are gone, when the worms are present the same neurologic structures counteract the worm effect).

The big focus now is on Toxoplasma. How does this lovely litte brain infesting critter change our behavior? What's the curious relationship to some schizophrenia-like conditions? Carl Zimmer, one of our best science writers, summarizes the stor to date: The Return of the Puppet Masters.

Parasites are cool.

The transformation of the American economy

Another economist wonders what the heck Americans are going to do with themselves:

Exporting Expertise, if Not Much Else - New York Times:

.. The share of the economy devoted to medical care services has grown by eight percentage points in the past four decades, with commensurate changes in employment. But this isn't necessarily great news for the economy. With exceptions like online consultations and robotic surgery, medical care services are not as easy to export as, for example, medical equipment.

The leisure and recreational industries have also expanded, with the share of employment up by four percentage points. Here, too, exporting is difficult: after all, gambling, artistic performances and restaurant dinners usually take place on site.

More promising, management and professional services like law and finance resumed their strong growth after taking a hit in the recession. These areas are the ripest for exporting. Need some business advice? No problem. Want some derivatives structured? Great. First, however, we need to train those consultants and bankers.

... We are becoming a nation of advisers, fixers, entertainers and high-tech engineers, with a lucrative sideline in treating our own illnesses...

In my own world I've seen job opportunities for US citizen software engineers shrink radically in just a few years. On the other hand, it's very hard to outsource plumbing.

This is great news for most of the world. The best thing we can do for most of humanity is to facilitate globalization, but we should balance that with aid to those in the US who will be displaced. The trick is figuring out how best to provide that aid.

In the Futures market both "US Socialism" and "Servants are US" are up 20 points.

Republican strategy: energize the wackos

It is fundamentally reassuring that Republican operatives consider their base to be raving loonies who should be brought out of the asylum only for elections:

Crooked Timber: Wackos:

Michael Scanlon … explained the strategy in an e-mail to a tribal client.

“Simply put, we want to bring out the wackos to vote against something and make sure the rest of the public lets the whole thing slip past them,” he wrote. “The wackos get their information [from] the Christian right, Christian radio, e-mail, the internet and telephone trees.”

I prefer the rule of cynical and evil people with good sense to the rule of wackos. Karl Rove is of the Scanlon camp -- but where's George?

Keeping the Elderly on the Road, but Out From Behind the Wheel - New York Times

A year or two ago, bicyclists on the roads of Montreal were dropping like flies on a windshield. Elder drivers were churning out road kill.

Montreal has narrow roads, and an aged population (the remnants of the engish quebecois) in the west end of the island. Aging sucks. Visual perception is a complex processor intensive internal simulation of the external world. Aging hits perception everywhere -- the lens stiffens, the vitreous opacifies, the retina atrophies, the brain rots. Perception goes. Let's not discuss the impact of cell phones (hey, it's the only way I can call my mother).

We compensate in our forties and fifties by driving more cautiously and by avoiding sleep deprivation and mind-altering substances (except caffeine). This only goes so far. By age 65 the tide has turned ..

Keeping the Elderly on the Road, but Out From Behind the Wheel - New York Times

... People 65 and older account for more accidents per miles driven than any group other than teenagers, according to the Insurance Institute for Highway Safety.

... In 1988, Ms. Freund watched a motorist run over her 3-year-old son, Ryan, as he played in front of their house. The 84-year-old driver later told investigators that he thought he had run over a dog. The accident left Ryan in a coma, but he eventually recovered. Ms. Freund went on to study the issue of elderly drivers while in graduate school.

By the time she left the University of Southern Maine with a degree in public policy, she had refined her idea. She knew that older drivers' cars often got little use. Using the model of a reverse mortgage, a home equity loan that enables people to tap into the value of their homes, Ms. Freund applied the formula to cars.

Under her program, elderly people trade in their cars and the value is booked into an account from which they can draw to receive rides. On average, $7 to $8 is deducted for each ride. Family and friends can add to the account by donating cars or cash, or their time as volunteers.

Taking cars away from the elderly is not an easy business. Nobody is great at it, neither physicians nor licensing boards not families. Most American cities are so car centric it would be less bothersome to lose a leg than a car. This problem will get worse every year for the next 30 years; we'll hear more about it. We need to put a lot of "smarts" in cars and in the transit environment to compensate for what we're losing. Maybe gas at $12/gallon will help ...

How to write a business plan

The most useful summary I've read on how to do a business plan. Valuable for your next startup or for justifying an internal project or acquisition.

Kawasaki is going to burn out on his blogging soonner or later, but I hope he keeps his work online. At the moment his is among the best entrepreneurial writing online. (Joel Spolsky and Paul Graham are two other favorites.)

Let the Good Times Roll by Guy Kawasaki: The Zen of Business Plans:

... "# Pitch, then plan. Most people create a business plan, and it's a piece of crap: sixty pages long, fifty-page appendix, full of buzzwords, acronyms, and superficialities like, “All we need is one percent of the market.” Then they create a PowerPoint pitch from it. Is it any wonder why that the plans are lousy when they are based on crappy pitches? The correct sequence is to perfect a pitch (10/20/30), and then write the plan from it. Write this down: A good business plan is an elaboration of a good pitch; a good pitch is not the distillation of good business plan. Why? Because it's much easier to revise a pitch than to revise a plan. Give the pitch a few times, see what works and what doesn't, change the pitch, and then write the plan. Think of your pitch as your outline, and your plan as the full text. How many people write the full text and then write the outline?
# Put in the right stuff. Here's what a business plan should address: Executive Summary (1), Problem (1), Solution (1), Business Model (1), Underlying Magic (1), Marketing and Sales (1), Competition (1), Team (1), Projections (1), Status and Timeline (1), and Conclusion (1). Essentially, this is the same list of topics as a PowerPoint pitch. Those numbers in parenthesis are the ideal lengths for each section; note that they add up to eleven. As you'll see in a few paragraphs, the ideal length of a business plan is twenty pages, so I've given you nine pages extra as a fudge factor.

# Focus on the executive summary. True or false: The most important part of a business plan is the section about the management team. The answer is False.* The executive summary, all one page of it, is the most important part of a business plan. If it isn't fantastic, eyeball-sucking, and pulse-altering, people won't read beyond it to find out who's on your great team, what's your business model, and why your product is curve jumping, paradigm shifting, and revolutionary. You should spend eighty percent of your effort on writing a great executive summary. Most people spend eighty percent of their effort on crafty a one million cell Excel spreadsheet that no one believes.

# Keep it clean. The ideal length of a business plan is twenty pages or less, and this includes the appendix. For every ten pages over twenty pages, you decrease the likelihood that the plan will be read, much less funded, by twenty-five percent. When it comes to business plans, less is more. Many people believe that the purpose of a business plan is to create such shock and awe that investors are begging for wiring instructions; the reality is that the purpose of a a business plan is to get to the next step: continued due diligence with activities such as checking personal and customer references. The tighter the thinking, the shorter the plan; the shorter the plan, the faster it will get read.

# Provide a one-page financial projection plus key metrics. Many business plans contain five year projections with a $100 million top line and such minute levels of detail that the budget for pencils is a line item. Everyone knows that you're pulling numbers out of the air that you think are large enough to be interesting, but not so large as to render urine drug-testing unnecessary. Do everyone a favor: Reduce your Excel hallucinations to one page and provide a forecast of the key metrics of your business--for example, the number of paying customers. These key metrics provide insight into your assumptions. For example, if you're assuming that you'll get twenty percent of the Fortune 500 to buy your product in the first year, I would suggest checking into a rehab program.

Search engines for Patriots

The same government that gave us the extra-legal NSA searches, has also extracted mass search data from MSN, AOL, and Yahoo -- but not Google.

Nobody is all that shocked. When you're online, everyone knows you're a pervert. Expectations of privacy are amusing. As is this satirical web search service:

Patriot Search - Our Search Syntax

The Terrorist Operator

By typing terrorist:true preceding any search query, you tell us and the governments of the world that you are in fact a terrorist, or involved in terrorist activity, or planning to get involved in such activity, or that you once met a terrorist (or you met someone who met a terrorist). If you are no terrorist, you can type terrorist:false. Please note that 'true' is the default value if you
omit the 'terrorist' operator -- after all, everyone is a potential terrorist.

The Bushies just like to watch.

Cringely surveys the Bush surveilance program

Why did Bush bypass FISA? The story he gives doesn't hold water; FISA would have supported his stated goals. So either Bush is mad with power lust or he needed to do something else. Most of us suspect a combination of both, but really more of the latter. He wanted to do untargeted surveilance of some sort. That's the strong consensus of the mainstream geek security community.

The next question is whether the NSA was studying the content of messages, or whether they were studying "message metadata". If it was the latter, they could apply social network tools to study communication networks (directed graphs) and correlate message length and duration with other parameters. The message metadata might then be used to target further surveilance and/or intercepts, with our without FISA approval. Interstingly, depending on how the post-Nixon laws were written, metadata surveilance may have been omitted -- providing a loophole the NSA could exploit.

A secondary question is whether this is a good use of resources. Schneier argues it wasn't, that the available evidence suggests a high level of false positive probes and a lot of wasted attention -- not to mention harm to the 'false positives'. I confess analyzing metadata to focus seconary probes sounds plausibly effective to a novice like me, but this is Schneier's domain.

Now Cringely, one of my favorite tech gurus, weighs in (the title of the article is based on surveilance of the weekly conversations between Hitler and ITT during WW II, a rather shocking and suspect business): (emphases mine)

PBS | I, Cringely . January 19, 2006 - Hitler on Line One

To this point what we have been considering are technically called "intercepts" -- listening to phone calls and recording the information they contain. Most phone taps in the U.S. aren't conducted that way at all. On top of the approximately 3,500 CALEA and FISA intercepts conducted each year, there are another 75,000 domestic phone taps called "pen/traps" by the telephone company.

While interceptions capture the voice portion of a telephone call or the data portion of an electronic communication, such as the content of e-mail, pen/traps capture just the outgoing digits dialed (the pen register portion of the technology) and the numbers of the incoming callers (the trap and trace portion of the technology). In CALEA terms, these are "call-identifying information." [jf: metadata]

Court authorizations for interceptions are difficult to obtain for many reasons. Pen/traps are easy to obtain. While the government has to obtain court authorization to install a pen/trap, the role of the court in this review and approval procedure is merely "ministerial" -- primarily a form of record-keeping. The government has a very low hurdle to meet to obtain judicial approval for pen/traps, and if that hurdle is met, the court MUST approve the order. Pen/traps are very useful in a criminal investigation, and inexpensive compared to a court-approved interception. So, it is not surprising that there are so many more pen/traps than there are interceptions.

To get this far, I had to talk to a lot of former and current telco people, and one thing I learned is that they generally don't like having to do either type of phone tap. Under both laws, telephone companies that do this kind of work are supposed to be reimbursed for it, yet many phone companies never send a bill. Whether that is because of patriotism or fear of liability, I don't know. Many phone companies also outsource their phone taps to smaller firms that specialize in that kind of work. These firms handle the legal paperwork, and generally more than pay for themselves by billing the Feds, too, on behalf of the telco.

It feels a little creepy to me knowing that our telephone systems can be accessed at will by "rent-a-tap" outfits, and that the technology has advanced to the point where such intercepts can apparently be done from a properly-authorized PC.

Is all of this worth worrying about? What led me on this quest in the first place was the fact that I simply couldn't understand why the Administration felt the need to go beyond FISA, given that the court nearly always granted warrants and warrants could be done retroactively. But does it really matter? I didn't know whether to be outraged or bored, and I feared that most Americans were in similar positions.

Given that this is all about National Security, we'll probably never know the full answer. Even if the proper research is conducted and answers obtained, they won't be shared with you or me. But here's a hint from a lawyer who used to be in charge of exactly these compliance issues for one of the largest RBOCs: "While it is true the FISA court approves nearly all applications submitted to it, this is due primarily to the close vetting the DOJ attorneys give to applications before they are submitted to the court. In fact, the FISA appellate court noted that the DOJ standards had been higher than the statute required. I am unaware that the court has 'retroactively' approved any electronic surveillance that was not conducted in an emergency situation. There are four emergency situations enumerated in the statute. Even in an emergency, the government has to apply for approval of what they have already started or in some case finished and these applications have to meet the same strict standards as any other application."

So the probable answer is that the several hundred NSA communication intercepts wouldn't have qualified for submission by the DoJ to the FISA court, and some of those might not have qualified for FISA court orders even if they had been submitted. It looks like the difference between using a rifle or a shotgun, with the Bush Administration clearly preferring the shotgun approach. Only time will tell, though, if what they are doing is legal.

So Cringely argues that it's harder to get intercepts than FISA's record shows, and that there's a low hurdle for monitoring metadata. Interesting. It is interesting that the "dirty work" has been outsourced by phone companies; I suspect those independent firms are staffed by people with some interesting but unstated employment records. The technique of outsourcing the dirty work to the "private sector" has allowed many agencies, including the FBI to bypass the law.

The historical demographics of Iraq: Why don't we know them?

As predicted, the ethnic coalition called "Shia" won the Iraqi election. The ethnic group called "Sunni" are unhappy. They are thought to now constitute about 20% of Iraqis, but western media commonly report that they think they are a majority.

Doesn't anyone find this curious? Evidently not. I tried a Google search on "demographics history Iraq Sunni population fertility" and found nothing of value. Why hasn't some bored journalist spent a day researching this with a librarian?

Iraq is a very young country, with a "slightly" older city - Baghdad. The demographics will be a bit tricky to sort out, but it could be done. My bet is that the Shia population within the rough bounds of modern-day Iraq has been increasingly very quickly over the past 100 years, while the Sunni population has been growing much more slowly due to higher Shia fertility and immigration. This is a typical pattern in which one ethnic group is wealthier and dominant; the sub-group reproduces faster. (For all I know humans are programmed this way.)

I'd further wager that the Sunni's have historically dominated this region, and that about 100 years ago they were about half the population. Lastly I'd bet that the Shia and Sunni represent slightly different genetic populations as well as religious traditions.

Of course I'm probably wrong about all of the above. I have no data. That's the point. How can we have a government so incompetent that the answers to those questions are not well known?

PS. Extra credit: explain how climate shifts and human induced deforestation contributed to the 9/11? Hint: Afghanistan was once relatively fertile.

PPS. I grew up in Quebec. Why would the above seem obvious to me?

The Gore speech

[Update 1/20: BlogThis! did something quite nasty to the encoded search string. Could be yet another bug. I hope I've fixed it.

As of 1/19/2006 there are over 400,000 Google hits on Al Gore We the People Must Save Our Constitution.

Not bad for a speech that the mainstream media has utterly ignored.

There's something about Gore journalists dislike. We suffer for their folly. Whenever I feel some regret about the collapse of the print newspapers, I remember how journalists covered the Gore campaign. Their current peril is not desirable, but it does have a silver lining.

... The President and I agree on one thing. The threat from terrorism is all too real. There is simply no question that we continue to face new challenges in the wake of the attack on September 11th and that we must be ever-vigilant in protecting our citizens from harm.

Where we disagree is on the proposition that we have to break the law or sacrifice our system of government in order to protect Americans from terrorism. When in fact, doing so would make us weaker and more vulnerable.

And remember that once violated, the rule of law is itself in danger. Unless stopped, lawlessness grows. The greater the power of the executive grows, the more difficult it becomes for the other branches to perform their constitutional roles. As the executive acts outside its constitutionally prescribed role and is able to control access to information that would expose its mistakes and reveal errors, it becomes increasingly difficult for the other branches to police its activities. Once that ability is lost, democracy itself is threatened and we become a government of men and not laws...

Rumor has it that the first murder is the hard one. After that, they get easier. The Bush administraiton is a serial constitutional murderer.

PS. David Brin described an alterantive universe in which Gore became President. It was a far better place, except the media hated him and the right wing was launching an indigenous American terrorist movement.

The new doctor shortage - Michigan

The pipeline to produce physicians is so long, and the costs to students so great, that it is not at all surprising that we go through boom and bust cycles. In my career I've seen family practice cycle from startup to boom to bust. Unsurprisingly the cycle may be shifting again, though I wonder what role Michigan's economic and liability issues play in their pending shortage:

Crain's Detroit Business

... The Michigan Department of Community Health on Wednesday said it will create a data clearinghouse of medical professionals to help the state’s health care providers deal with a looming physician shortage.

According to a recent state survey, about 37 percent of Michigan’s physicians are 55 or older, and more than 38 percent of physicians say they plan to practice medicine for only one to 10 more years. A separate state study indicated that Michigan will need to fill more than 100,000 professional and health care jobs in the next decade.

Normal boom/bust cycles, atypical demographic cycles, and the possibly permanent decline in the appeal of primary care practice may conspire to make this coming shortage more severe than most.

The obvious approaches are to train more paramedical staff (NP and PAs), to encourage immigration of more physicians, to do more outsourcing of services overseas (radiology, dermatology, etc), and to move more care to 'disease management' programs. I am confident all these approaches will be tried and all will have a role. I also suspect that, within 10 years, we will reinvent the GP/FP/General Internist/Pediatrician once again -- though possibly under a different "brand".