A Time to Fly (Again)

Once again, I am blogging from the Omaha airport. Today I am on my way to Washington, DC, for the Publication Committee of the American Society of Nephrology.

I attended this meeting last year, when ASN Kidney News had published a mere 2 issues. Tomorrow I will regale them with tales of our transition to a monthly publication. We have new columns and features. We respond to current events in a more news-like manner; the renal community’s response to the earthquake in Haiti was covered in the March issue.

Monthly publication does bring a downside, even beyond the added workload. When we cover “breaking” stories, like Haiti or healthcare, requested articles may be delayed in publication. My apologies to those who wondered why their articles don’t appear on schedule, but it happens. We also suffer from the advertising cycle now. Our very first issue, January 2009, had little trouble attracting ads. This year, things became a bit tighter. It turns out that advertising budgets are uncertain for the new year, and companies are hesitant to buy space for a January issue. I had always noticed that trade magazines were smaller in January, but I attributed that to content. Turns out if you have fewer ads, you can run less content, and this cycle is true across most publication categories. Makes me feel a bit silly. I should know that most things are about money!

After the January slump, things are looking up. We ran special sections in February and March. The April issue is up online in flash or PDF files. It features multidisciplinary care of kidney patients, and the articles presented rock! Hard copies should hit mailboxes the third week of the month.

We are always looking for good content ideas. It may be a special section with several featured articles, or just a single column. Nothing is too weird or silly for our consideration, as long as it somehow connects to the world of kidneys.

It is almost time to hit the security line. Later, nephrons!

Random Thoughts Between Road Trips

I feel a little overwhelmed right now. I just returned from Renal Week 2009, the major US nephrology meeting.

• Work accomplished? Check-
• New ideas generated? Check-
• Good time had? Check-

Back at the homestead in Omaha, one might think I kicked back and relaxed; however, I find myself trapped between my dirty laundry and my empty suitcase. Yup, I head for Boston and the AAMC meeting this Friday.

Of course, distractions presented themselves as well. My new glasses arrived, and yesterday the braces came off a whole 2 months early.

Last night we saw the stage show, Irving Berlin’s White Christmas. I truly believe that all of the world’s ills would be fixed if life were more like a musical. Of course, bursting into song at critical moments will likely get you committed- and those around you rarely join in and dance with you! White Christmas, the movie, does not make a lot of sense (a general retiring on the eve of battle? Give me a freakin’ break!), yet every Thanksgiving it goes in the DVD player while we wash the good dishes. The music swings,you feel warm and fuzzy, and who can resist those dance numbers with Vera-Ellen and Bob Fosse?

The stage version eliminates some of the movie’s problematic elements. General Waverly ships stateside for a war wound, and the minstrel show number is eliminated (though it is more politically correct than the black-face number in Holiday Inn, the flick in which White Christmas, the song, originally debuted). More pieces from the Irving Berlin songbook show up. The result is an evening that not only generates that warm-fuzzy holiday feeling, but leaves you humming and toe-tapping.

This fall I began tap lessons for the first time in my life. I now recognize the steps on the stage, and I have an idea how difficult those production numbers can be. Given the sweating after my hour class in shorts, I cannot imagine how hot those poor cast members are in ski sweaters and lights.

I should probably work now, or at least plan my wardrobe for Boston. A Big Thanks to the touring company of White Christmas- you made my evening! I will keep you in mind while I shuffle-hop-step tonight.

Photocollage created with images from PhotoXpress.

The Personal Paradigm and Peer Review

RenalWeek 2009 in San Diego is underway. I just enjoyed a forum on conflict of interest in medicine. One talk, by Rober M. Califf, MD, of Duke University, discussed bias in clinical trial reporting. Most of the speakers focused on financial conflicts of interest. Dr. Califf described a number of nonmonetary conflicts of interest as well.

One of these nonfinancial conflicts involved scientific hubris. For example, you review a paper or a grant and its (potential) results shoot down your own research and ideas. Do you accept the possibility that you are wrong? This work has the potential to make your prior work irrelevant, as well as decreasing your ability to get funding and promotion. The document is well-written and convincing, at least to the other reviewers. Do you allow it to proceed, or do you demand further work to reconcile it with your current hypothesis? Data that may not be feasible, if your personal paradigm is wrong?

We scientific types supposedly worship at the alter of truth and knowledge. We are human, though, and humans like to have explanations for everything. As nature abhors a vacuum, our brains hate missing information or pieces. In other words, we are biologically predisposed to develop hypotheses and patterns for everything around us. We also seem predisposed to defending views in which we are invested.

This source of conflict is rampant in peer review. Qualified peers must have knowledge of the subject area in question, and they will have pre-formed hypotheses about the material. Most reviewers can accept new experiments that advance their ideas, even if the world moves in a new direction. When those pre-formed ideas quash legitimate questions, then they become a source of conflict of interest.

What can one do? One can exclude reviewers based on probable bias. This practice is commonplace for manuscript submission. If a member of your study section could be trouble, you can request that they not review your grant. You should send your stuff to lots of different funding agencies as well; the same proposal may be funded by one agency and triaged by another, just because peer review is subjective and biased in this way.

Human nature simply will not allow all sources of bias to be removed from the world. I hope we in science can consider our own intellectual prejudices and overcome this conflict of interest.

Photos courtesy of PhotoXpress.

On The Road Again

Tomorrow I hit the airport en route to Renal Week, the Annual Meeting of the American Society of Nephrology. After some administrative work, my week will be devoted to all things kidney. From the most basic science to the most novel clinical trial, 14,000 devotees of urine (or lack thereof) will be gathered to celebrate their favorite organ.

Attendees and other kidney fans are invited to Tweet the Week. We will be twittering about the meeting and other events surrounding it. I am sure Renal Week will provide fodder for this august venue as well.

I will also try to update everyone on the weather. After all, I will be in San Diego. I get to gloat at those I leave behind in Nebraksa.

A new podcast should also be available soon. I chat with current president Tom Coffman and president-elect Sharon Anderson about the ASN. Look for it and other meeting stuff on the site or in our iTunes area.

For the rest of the day, well, my brain has already flown west…

Tweet the Week in San Diego

Those planning to attend Renal Week, the annual meeting of the American Society of Nephrology, are invited to Tweet the Week. A lot of those signing up for the activity have not tweeted before. Some of the nuts and bolts of the service are obvious after the sign-up process, but there are ins and outs of the Twitterverse that may not be readily apparent.

Basics of Twitter

So you have a screen name (if not, click on the logo below; all you need is a valid email to sign up). Now it is time to create your profile page. Try to come up with a photo or image of some kind to represent you online. Put some information about who you are, but nothing you don’t want strangers to see. For an example, click on the Tweet the Week logo below; it will take you to the RenalWeek profile.

You also have to make a choice about whether or not to protect your updates. If you do not, anyone on Twitter can follow you and see what you put out there. You can go through your list of followers every so often and block anyone you want (like the half-naked women whose profiles list their favorite sex act), but you will also encounter a broader, more interesting swath of people this way. If you protect, then only people who you approve can see your updates; however, this means you will have to manually OK each and every follow.

For Tweet the Week, we have chosen to keep the feed closed. Some of the followers are closed, but most are public. RenalWeek is following all of the participants. Anything tweeted by RenalWeek will be visible only to official followers. 

Specific Tweet the Week Issues

If you are tweeting something general on your public feed, anyone who follows you will see it, including RenalWeek. If you want to send a message to RenalWeek that you only want the Tweet the Week crowd to see, you can direct message it. Do this by placing “D” in front of the screen name: D RenalWeek. If it is something of interest to the RenalWeek crowd, it can then be retweeted. Most twitter clients allow you to repeat someone’s tweet; this is how stuff “goes viral” and spreads quickly.

Mechanics of Twittering On the Go

You can tweet from a computer, and there certainly will be internet access in the San Diego Convention Center. Most stuff worth chatting about does not happen when you are near a screen. Luckily, Twitter was made for the mobile world, with a character limit shorter than a standard text message. You can register your cell phone and have tweets texted to you; this may drive you crazy after a while. You can also set it up so you can send tweets to the service via text message. Your usual text fees apply, so figure out ahead of time what this may cost you.

If you have a smart phone, you are in luck. BlackBerries, iPhones, and Pre’s all have Twitter clients that make participation easy and fun. There are too many to list here, and more popping up every day; a quick Google search will take you to lots of choices.

Even if you decide to limit your tweets to your laptop, you may want to check out a dedicated Twitter client. Many will let you group your followers or work with multiple accounts. I am using TweetDeck, and I have my personal account (PHLane; feed shown on the blog page above) and the RenalWeek account for Tweet the Week. A bunch of these are available; some may be downloaded via the Twitter web site, and there is a Wiki that lists many more.

I hope you decided to attend RenalWeek and to Tweet the Week with us. If you have any specific questions, ask in the comments below so others can share your answer.

Ears vs. Eyes: Learning to Love Podcasts

I am a visual person. I remember faces and I remember names, but I can’t always put them together again. I often find the very act of making a list allows me to remember what I need, even though the list gets left in the car. I can still see what I have written in my mind.

The popularity of audio books escapes me. I read fast, and I process things so much easier by seeing them than by hearing them. A multi-chapter book would require a recap at the start of each commuter session (or a long enough trip to listen to the whole book in one session).

A couple of years ago, I won an Ipod Nano. I quickly transferred a bunch of CDs and set up my Itunes account. I am not fond of listening through headphones, but my new car has a Ipod jack. The podcast, however, has only recently gotten my attention.

Other faculty have been creating podcasts that physicians can download to answer specific questions. I didn’t get it, because I wouldn’t remember what I listened to long enough to benefit (see first two paragraphs). I far prefer to access an online “written” reference, especially if its presentation is friendly for my BlackBerry screen. Other physicians began downloading these short updates, though, and they still seem to be popular.

Now I have become a podcast personality. ASN Kidney News, the magazine I edit, started producing these with the May issue. I chat with the author(s) of something in the magazine, and we post it on the ASN web site and in Itunes. I was thrilled when the first one was downloaded more than 700 times. After all, kidneys are a niche audience. We just posted the second Kidney News podcast; in 10 days it has received >4,000 unique visits and >12,000 total visits!

I have also wandered around the Itunes store to see what other podcasts are out there. I am especially delighted to find my favorite NPR shows. I often miss Fresh Air on my local station; now I subscribe and listen the next morning at work (or on my way home in the car, if I have to do something away from my desk)! For the past year, I have planned Saturday morning rounds so I could hear as much of Wait, Wait, Don’t Tell Me as possible. If you haven’t tried this one, you do not know what you are missing; it is roll-on-the-floor, pee-your-pants funny. While this level of humor has, on occasion, proved problematic while driving, it is always appreciated. Now my patients don’t have to “wait, wait” while I laugh!

I still don’t remember as much of what I hear as what I read or see. I do appreciate what podcasts can do for the world, though.

By the way, I am a member of KIOS, the Omaha NPR station. Have you joined your local NPR affiliate?

Greetings again! Yes, it's been a long time (more than 4 months) since the last posting, but I haven't been goofing off. I've been working on a magazine that will debut later this month for the American Society of Nephrology call ASN Kidney News.

At first, this endeavor required a couple of hours here and there. As the first issue draws near, and we are trying to get the next issues started, those hours are adding up. This project has come with a steep learning curve; while I had worked with traditional medical journals, I had not done anything with ad-driven magazines before. I have a great managing editor, Dawn McCoy, and I have to say that this has been one of the most enjoyable and gratifying things I have done.

One task I took on after my editorial advisory board suggested it was creating puzzles for the magazine. I cannot imagine what it took to make a crossword puzzle before computers; it's hard enought to fit in theme words with autofill!

Anyway, my first word search got bumped from the magazine because we had too much other content (a good problem). I'm posting it here; the theme is an educational program of the ASN, Renal Weekends. I promise the solution will be posted in less than 4 months.