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VTE Dublin 2017, and its Ultrasound Workshop. 19th of September, 2017 POST·MERIDIEM 11:01

I want to make a shout-out Cian McDermott, Andy Neill and everyone else involved in organising and running the Ultrasound Workshop at the VTE Dublin conference. Excellent sessions, great instructors, wonderful to have formal instruction on ultrasound for DVT, PE, and an introduction to echocardiogram.

I’m a GP trainee in Donegal who does Emergency Medicine as a side specialty, taking the exams and working lots of shifts in Northern Ireland. There’s a lot of cross-over between the two sets of generalists, and if anything, there’s even more reason for GPs to be putting ultrasound probes to people than ED doctors; ‘I haven’t felt my [unborn] baby move in just over a day’ should never go to the Emergency Department, absent bleeding or pain; poor local access to echo means I have a patient currently who probably has a new right-to-left ventricular shunt across a VSD, but her best chance of having that confirmed in the next 18 months is my buying something like a Philips S4-1 and putting it to her chest.

Thankfully, my first ED shift after the workshop wasn’t as eventful as that of Dan Horner. I only had a thirty-something man with back pain and light-headedness, who happily had a normal abdominal aortic diameter, and a non-EU expectant mother with a headache, at 18 weeks gestation, who couldn’t access the usual antenatal care because the Home Office was siting on her documentation. She was very glad to see her singleton intrauterine pregnancy with good fetal movement, good heartbeat and an abdominal circumference appropriate for dates.

So, in sum; ultrasound, great, VTE Dublin ultrasound workshop, fantastic!

Ben Goldacre’s Bad Pharma 30th of September, 2012 ANTE·MERIDIEM 01:06

I ordered Ben Goldacre’s new book, Bad Pharma, and noticed the braille on the cover. Here it is (possibly upside-down, but I don’t think so):
⠄⠒⠎⠥⠍⠑ ⠄⠊⠍⠍⠇⠽
I’m disappointed! The good doctor requested suggestions for two words to put up there, but as far as I can see it’s just ‘:Sume Immly.’ I’ll be unimpressed if it’s just nonsense, but I’m open to correction.

Word of the day: دیدن، بین /didæn/, /bin/ are the infinitive and present stem of ‘to see’ in Persian.

Last comment from kicksvovo on the 17th of October at 9:38
⠄ is the abbreviation marker (used before both words), and ⠒ is the abbreviation for "con"

So it says "consume immediately".

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Forcing Amazon RDS databases to non-UTC server timezone 6th of July, 2011 POST·MERIDIEM 06:37

Amazon Relational Database System (RDS) is a fine service, allowing you to move MySQL and Oracle databases to the care of a company that administers them and backs them up competently and in huge number, and charges a not-unreasonable price for it.

Now, if you’ve chosen MySQL as your database, you’ve probably made other less-than-optimal programming decisions in the past too, like not storing timestamps as UTC, and relying on the database server to have the same time zone as most of the clients. (The latter of which is, in many contexts fine; cf. Japanese developers developing apps for Japan, a country of 120 million people with one time zone.)

Unfortunately, Amazon doesn’t support setting the SQL server time zone of an RDS database instance, it requires UTC. kaz_goto in that thread offers a solution, but that solution hangs when the database instance is rebooted. I’ve developed that solution a little further; my approach requires the following stored procedure in the database:

 
DELIMITER | 
CREATE PROCEDURE mysql.store_time_zone () 
IF NOT (POSITION('rdsadmin@' IN CURRENT_USER()) = 1) THEN 
   SET SESSION time_zone = 'Europe/Dublin'; 
END IF | 
DELIMITER ;
And, as in kaz_goto’s post there, the database parameters need to be modified to include something with a space—follow his instructions, but make sure the result reflects the following:
$ rds-describe-db-parameters PARAMGROUP --source=User
DBPARAMETER  Parameter Name  Parameter Value             Source  Data Type  Apply Type  Is Modifiable
DBPARAMETER  init_connect    CALL mysql.store_time_zone  user    string     dynamic     true 
$ 

Once this is done, rebooting will not be a problem, though starting up databases with that parameter group but without the associated stored procedure will lead to hangs on connection.

Word of the day: die Umnachtung is German for derangement.

Last comment from kicksvovo on the 13th of October at 5:10
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Lázsló Almásy describes Darb el Arbeʿin, the slave caravan route 22nd of July, 2010 ANTE·MERIDIEM 12:59

A few paragraphs from László Almásy’s book „Schwimmer in der Wüste“, from the description of the Darb el Arbeʿin درب الاربعون , the historical caravan route from the Sudan to the Nile valley:

„Die im Mittel- und Südsudan niedergelassenen arabischen Sklavenhändler trieben hier jedes Jahr ihre lebende Ware zu dem berühmten Sklavenmarkt in Assiut. Die unglücklichen Neger legten diese schreckliche Wüstenstrecke zu Fuß zurück, nur die Kinder und jungen Mädchen durften auf Kamelrücken reisen, da sie am Markt die höchsten Preise erzielten…
Fast unvorstellbar sind Leid und Qual einer solchen Sklavenkarawane, wenn sie sich auf den mehrere hundert Kilometer langen Wüstenstrecken von Brunnen zu Brunnen, von Oase zu Oase vorwärts wälzte. Die stärksten Männer trieb man in dem ‚Scheba‘, einem an ihrem Hals befestigen doppelten Gabelholz, das je zwei Menschen zusammenband, um sie so in ihrer Bewegungsfreiheit einzuschränken, damit sie ihre grausamen Wärter nicht angreifen konnten. Wer sich die Füße wundgetreten hatte, schleppte sich weiter, solange er konnte. Wenn er zusammensackte und ihn nicht einmal mehr die ‚Kurbasch‘, die aus Nilpferdleder gefertigte Peitsche, zum Aufstehen bewegen konnte, wurde er einfach zurückgelassen. Die die Karawanen begleitenden Geier bereiteten dem Unglücklichen bald ein Ende.

Gordon Pascha, den Ägyptens Vizekönig Ismail Khedive von 1874 bis 1879 in den Sudan sandte, um mit dem Sklavenhandel Schluß zu machen, teilt in seinem Bericht mit, daß von den 80 000 bis 100 000 Sklaven, die von Dar Fur jährlich nach Norden verschleppt wurden, nur rund 7 000 bis 8 000 lebend in Assiut ankamen.“
“Here, every year, the Arabic slave traders who had settled in southern and central Sudan drove their living wares to the famous slave market of Assiut. Of these slaves, only children and young women travelled by camel, since they fetched the best price at market; the rest of the unhappy blacks made their way [c. 900 km] by foot.

The suffering and torture of these slave caravans, tramping forward from watering hole to watering hole, from oasis to oasis, for hundreds of kilometres, are almost unimaginable. To make sure there was no chance of them attacking their guards, the strongest men were driven along while wearing the ‘sheba’, a wooden double-Y collar that bound two men together, limiting their movement. If a slaved damaged his foot, he kept moving forward, as long as he could. If he collapsed, not feeling the scourge of the ‘kurbash,’ the hippopotamus-leather whip, he was simply left there
[to become one of the many camel and human skeletons that showed the route of the caravans, even when Almásy was travelling it]. The vultures accompanying the caravan ended things for the unlucky soul quick enough.

Gordon Pasha, sent to Sudan by the Egyptian viceroy Ismail Khedive from 1874 to 1879 to end the slave trade, reported that of the 80,000 to 100,000 slaves sent yearly from Darfur, only 7,000 to 8,000 made it alive to Assiut.”

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