Star Ford

Essays on lots of things since 1989.

“Solstice”: a card game invented on the 2013 winter solstice

This game builds in intensity and has lots of opportunities for vengeance, laughing, and monkey noises.

  • 2 or 3 players, 2 decks shuffled together
  • Setup: Place the deck face down in the middle, or in several piles. These are the draw piles. Make room for a single discard pile. Players start with no cards.
  • Object: To get a perfect hand and go out first, or have a near perfect hand when some other player goes out. A perfect hand consists of a straight of six to thirteen cards of the same suit (any suit, wrap-arounds not permitted, Aces are high), plus an optional number of pairs, and no other cards. A pair may only be opposite color to the straight’s color. For example, a perfect hand with a spades straight may contain no clubs, and may contain any number of red pairs (pair of 2s, 3s, etc). A perfect hand with a red straight may contain only black pairs and vice versa. However, a perfect hand cannot have more than one pair of the same number (cannot have two pairs of 3s for example).
  • To begin, when the dealer says “go”, everyone take as many cards as they wish from any draw pile.
  • To play, any player may do any of these actions, at any time, without taking turns:
    • (1) Discard a single card face up using one hand onto the discard pile. The first card to be discarded can be any card from any player. The subsequent cards must be one higher or one lower than the top card showing. For example, if a 10 is showing, only a J or 9 may be discarded next, regardless of suit. Aces are both high and low for discarding only, so the sequence may wrap around.
    • (2) Draw one card at a time from any draw pile.
    • (3) Draw any number of cards from the top of the discard pile. (not out of the middle of the pile though)
    • (4) Wait
  • To go out, the first player to achieve a perfect hand covers the discard pile and says “done”.
  • Additional notes
    • “No lefties” – right-handed players must discard with the right hand throughout the game (and lefties with left)
    • “Forced draw” – If no player wishes to draw and the game comes to a stop, any player may say “draw” to force all players to draw.
    • Reshuffle – When the draw piles are exhausted, play stops while the discard pile, except its top card, is shuffled and returned to become the draw piles.
    • “Leafing” – Splaying out the discard pile to view cards is acceptable, but picking up any part of the pile requires the player to take the lifted cards.
  • Scoring
    • Every player gets one point for each card in their longest straight and one point for each card in legal pairs, and loses one point for all other cards (deadweight).
    • The player to go out gets an additional point for every other players’ deadweight cards.
    • The player to go out gets no points if they have gone out illegally, i.e. their hand is not perfect.
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Fraud in medicine: worse than you thought

This was written by a doctor about personal experiences. (Headings added.)

I don’t think people understand the sophistication with which scientific journals are being co-opted for profit… There are blatantly unethical things going on such as articles that are ghost written, undisclosed conflicts of interest, and results that are incompletely reported or falsified. But more sinister are the less overt problems…

Targeted advertising

The AMA maintains a massive database with detailed personal and profession information about every doctor in the country mined from many sources. Our prescribing habits are mined from free, drug, look-up programs such as the epocrates app for smart phone. Our schedules, contacts, and relationships are mined from our smart phones and through other sources. Then advertising is very specifically targeted. The advertisement is often very soft-sell – often in the form of something that looks like an objective, scientific continuing medical education resource from a respected professional organization. For example, the pages of journals are individually collated so my journal might have an ad for Allegra and the same journal for my colleague might have an ad for Claritin. An advertiser can tell the publisher that xe wants the ad to go only to women in their first two years of practice, who have >20% Medicare patients in their practice and who prescribe Allegra more than six times per year. Sometimes, in non-peer reviewed journals, the actual content of the articles in the journal are targeted in a similar fashion. Non-peer reviewed journals can be glossy, easy to read, better written than most peer reviewed journals, more clinically relevant, and free. I don’t think most clinicians pay much attention to the nuances of a journal’s editorial practices and rigor – they read something on their desk if it looks interesting, relevant and easy to digest.

Publishing “evidence”, accidentally

Doctors can be co-opted into using their reputation to sell drugs without even knowing it. For example, I can give a talk at a conference. A couple weeks later a colleague (maybe someone I really respect) who is getting paid by a drug company might contact me saying, “Great talk! I have a similar interest. Do you want to write a paper together?” I say, “yes” having no idea that they are getting paid by a drug company to contact me. A month later the colleague sends a draft manuscript (possibly ghost written by a drug company representative). It is my talk almost verbatim but with a table that includes some new drug or a new off label use of an old drug. The text may include a sentence or two about “promising new research” or “alternatives if standard treatments fail.” If I wasn’t a journal editor and therefore alert to this type of scam, I might sign off on submitting it with minimal edit because it looks almost exactly like my talk. I agree with 99%. The colleague just contributed this one little, minor thing. It is an easy publication for me, and I need that for my academic standing. Once the drug is in print in an article written by a respected professional, it is easier for others to include it citing the first article.

Paying for “peer review”

Another example, of something that I was almost sucked into… I was asked by my professional organization if I would be willing to review an article. I was offered $500 to do so. I did not know that the $500 came from a drug company that gave the organization an “unrestricted grant” to write a review article about the disease their drug treats and send it to members of the organization. The article is written by organization staff who knows who is paying the bill and whose job depends on the organization being able to raise money from drug companies. I review it and can collect my $500 having done nothing unethical – money comes from an unrestricted fund at a non-profit professional organization and I provided a professional service for the money. The grant was “unrestricted” so the drug company can’t formally intervene in the editorial process. I don’t have to disclose any competing interests in the future and may not even know which drug company gave the money. What I say about the article or how carefully I review it doesn’t really matter to the organization. Maybe I will barely read the article or maybe I will write a good review. As long as I return a “review”, it can go out under the by line of John Doe with Dr. My Name, Professor at Respected University and as a publication of the respected professional organization. The article is officially peer reviewed (and there is no standard definition of what that means). Maybe I will write a detailed and scathing review, but if I do the editor is under no obligation to make changes. After writing a scathing review and turning down the money, I wasn’t offered another opportunity.

The professional organization maintains its reputation for producing quality academic work because, in addition to publishing this type of article/drug ad, it also publishes a very fine, well-edited journal. Members assume these supplemental manuscripts are subject to the same editorial practices and policies as the regular journal. The organization justifies the deceitful practice of writing these companion pieces as a necessary evil to raise the money to support their quality work. They disclose the financial support for the project in fine print somewhere. Since the drug company didn’t write the article, they can’t be held accountable if the article recommends drugs that don’t have FDA approval or for uses the FDA hasn’t approved. The drug company would be sued and disciplined if they wrote and distributed the article themselves. The article might not recommend something that isn’t FDA approved, and the sponsor’s drug may be a reasonable treatment. However, the article might oversell the sponsor’s drug over other equally good or better options. They might do this by focusing on things like convenient packaging, easier dosing schedule, the taste, evidence regarding how much it changes various lab values rather than how well it improves a person’s health, etc. This type of bias is usually pretty subtle so readers won’t detect it.

Ignoring the evidence

Another technique is to write a whole article reviewing the evidence that a drug doesn’t work and is of no use at all. Then the conclusion of the abstract is, “While more study is needed, X holds promise as the key to saving the world.” Most readers won’t get beyond the abstract. The concluding sentence of the abstract, is the only sentence many readers will see.

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How Bees Find a New Home

Bees balance the needs of timeliness and accuracy when finding a new home. Of a swarm of 10,000 bees, about 200-500 of the elder worker bees (2-5%) scout possible sites over about 30 square kilometers. About 25 bees might find a potentially suitable new site.

Each worker makes her own independent judgment of the benefits of the new site. She returns and communicates her findings: the direction, distance, and level of optimism about the site. Other scouts then go to the site and make their own judgment. While they continue to recruit and visit, the enthusiasm for less hospitable sites gradually wanes, while more scouts commuincate the location of the better site.

Ultimately, all the scouts communicate through their movements about the chosen site. When about 15 or so scouts are outside the new home and about another 30 to 50 are inside, the decision is made, and the scouts start instigating the move.

Lessons?

  • The process takes enough time to ensure a hasty decision is not made; on the other hand it does not go on for more than a few days.
  • The bees stay together and come to a decision even if the new home is not perfect.
  • The enthusiasm of the bees in the minority decays over time if others find the site inhospitable. No one is overruled, yet no one stubbornly remains attached to the less hospitable home. Each bee changes her “opinion” on her own.
  • A late option or an option only visited by one bee can ultimately affect the whole colony if others are supportive after they visit.
  • The move relies on many independent judgments, not following a leader. The queen bee is not involved in this decision at all.

From Science News, May 9, 2009

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Yahtzee score sheet

20090102yahtzee – a scoresheet, because we ran out of the ones that came in the box

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Scrabble short words

A list of all 2 and 3 letter scrabble words. Read the rest of this entry »

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