Four major defects in the Fed’s approach are all too evident. First, they continue to fail to take into account that economic growth slows considerably once gross government debt reaches 90-100% of GDP, and that this relationship may turn nonlinear above that threshold – i.e., that growth deteriorates more than proportionately as debt levels escalate. Second, high levels of private debt to GDP have a similarly debilitating effect. Third, the Fed has relied on a wealth effect that is either nonexistent or extremely weak. Fourth, all three quantitative easing (QE) operations have raised, not lowered, long-term Treasury bond yields, thus serving to keep the interest rate higher than it otherwise would be.

via The Feds Flawed Model | Casey Research.

Excellent video on Central Banks, Quantitative Easing, interview with Mark Carney, and more.

Nice article in A&A dealing with wound infection risk of giving dexamethasone for nausea prophylaxis (4-12 mg).  The following sentence confirms was we already knew: BMI and Smoking increase wound infection risk.

“Smoking (OR [95% CI]: 2.0 [1.3, 3.2], P = 0.003) and BMI (OR [95% CI]: 1.2 [1.1, 1.3], P = 0.0003) were the only significant predictors of wound complications in the multivariate model, whereas dexamethasone remained a nonsignificant predictor (OR [95% CI]: 0.7 [0.5, 1.1], P = 0.12).”

So how much more are we going to flog the SCIP protocols to try to ‘fix’ a problem we don’t control?

via A&A.

I’ve read numerous reviews now of users comparing and Android phone to an iPhone. They seem to focus mostly on the OS itself rather than the apps available for each and how those have changed over the last few years.  When I had my Nexus One phone, most iOS apps I was used to using on my iPhone were simply not available for Android.  This has changed.

I recently switched from an iPhone 4S to a Google Nexus 4–’just for fun’.  Although I did miss iOS initially after several weeks I am now quite comfortable with my Android Nexus 4.  The key?  The apps I spent most of my time in on the 4S are also available for the Android phone.  Those apps, in no particular order, are Google Chrome, Medequations, Fidelity, Evernote, Pocket, an RSS reader, and (of course) Word With Friends.  All those apps function and appear nearly identically to their iOS counterpart.

I bought a carrier subsidy-free Nexus 4 for $350 whereas a full price iPhone would have cost twice that much–and I have wireless charging today instead of a hope for it sometime later in 2013

So while Google has done a great deal to improve the Android OS up to its’ current 4.2.2 from the version 1 that I used some years ago, the app makers are what make it possible to switch from one to the other fairly easily.  Competition is good!

I figured out a very secure way to hold a reinforced endrotracheal tube in place in a tracheostomy stoma. Opsite!

I was using Desflurane today and noticed that the agent visible in the fill window was cloudy appearing? What do you think?

I changed the allocation for our college savings 529  plans from Aggressive Growth to Capital Preservation today.  From March of 2011 to today the USAA Agressive Growth portfolio has returned 28%. Time to sit on the sidelines for a year.

I should add that last time I had this feeling was in early 2008, before the Crash. Having used my once-yearly allowed allocation change I decided to transfer the funds form one custodian to another (Fidelity to USAA)–A good decision for two reasons. First, the USAA College Saving Plan was better in terms of fees and return. Second, the assets are converted to cash during the transfer, which allowed me to sidestep that 40% drawdown.

Notes from Dr. RW:  Drink coffee, cut your nasal MRSA carriage rate in half.

In the past year I have seen many acquaintances with Yahoo accounts have their accounts compromised and used to send spam. This has not been a significant problem with Google Accounts to my knowledge, but I realize its’ an arms race of sorts.

In my attempt to keep my online information secure I’ve begun to use two-factor authentication when offered. I started with PayPal by using the security token, and am now using Symantec’s VIP Access iPhone application. I also just started using 2-factor authentication with my Google and Dropbox accounts using Google’s Authenticator iPhone application for code generation.

But how does it work? Fortunately the AgileBits blog has a very good post on just this topic called Doing the two-step until the end of time:

“The magic of the system is that anything using this type of Time-based One Time Password (TOPT) tool will compute the same six digit code at a particular time with the initial set-up secret. Dropbox’s login system will calculate the six digit code on its own; and a tool that you use, such as Google Authenticator, will also calculate the six digit code on its own. No network connection is needed after the first time setup.”

AgileBits is the creator of the terrific 1Password application for Mac, Windows, iOS, and Android.

I was giving anesthesia in the operating room for a total abdominal hysterectomy earlier this week. The blood loss was significant and, seeing that my IV bag was nearly empty, I reached over to spike a new bag. I didn’t remember hanging it but assumed my colleague had while giving me a break. Can you spot the problem?

Once I realized what I almost did, I took another photo:

This is a great example of why I dislike having nurses hang fluid on my IV poles–they should hang fluids the surgeon needs on a separate pole.  In this case, the surgeon wanted to do a cystoscopy at the end of the case to check the integrity of  the bladder and ureters.  The other two examples I have seen involve the administration of hypertonic saline to an infant and a three liter bag of saline irrigation causing an IV pole to be top-heavy and tip over when bumped–and the three liter bag landing in the (formerly sterile) surgical field, an open acetabulum.