On the Obstetric Airway and Other Caffeinated Thoughts

Another set of notes, on a topic that is dreaded to all who understands it; a failed obstetric airway can easily mean death. I did not include the Difficult Airway Society (DAS) guidelines on the obstetric airway: they are much simplified and are a must read. Now on to coffee talk. Everybody who knows me personally knows that I’m dependent on it (I’ll keep trying to deny it in public).

Around the same time I bought this 16 inch MacBook Pro I decided to buy an electric coffee grinder. Prior to this I manually ground my coffee with a Hario Ceramic Coffee Mill. The grinder was obviously good in burning calories (you can never burn enough), but the problem is the long grinding times required to make my batches of coffee; if I decided to relax while grinding, the times required may take up to 30 minutes (I will make typically 3 batches per bag of 226 g bag of coffee); if I rush it I could push it to minimum 20 minutes. That’s a long time to spend only watching YouTube while grinding away.

To save time, I eventually settled on the Breville BCG-820 Smart Grinder Pro. I may or may not make a detailed review of this. Why I may skip a review on this is because I bought this to do one thing only: grind my coffee to make my cold brew coffee. And so far I’ve settled on 1 particular setting to do this:

I still get a medium grind with approximately 3 batches per 226 g bag. And woah, 50 seconds is a huge difference versus 20-30 minutes

I’ve kept to the same formula of making cold brew coffee with dark roast coffee and a Hario Cold Brew coffee bottle. In the past I used their proper “coffee bottle” which is an airtight container. However, after accidentally breaking a couple (don’t ask) and finding none in ready stock in Malaysia at the time, I settled on the alternative, the Hario 600 ml Cold Brew Coffee Pot. The recipe is simple:

1. Fill up with grounds; it should be pretty full

2. Fill up with water, almost full

3. Refrigerate over 24 hours

4. Pour into a bottle to store. It won't spoil as long as it’s cold.

5. To drink, dilute it with either water/milk to at least 50% (or even more dilute to those uninitiated to my caffeine requirements)

The jug all filled up and ready to go to the fridge

I love my cold brew coffee being made with dark roast beans. Typically it’ll be the Coffee Bean Espresso/Vienna blends. But it’s nearing the Christmas Holidays…

…And my number 1 favorite blend is their Holiday Blend. And frankly, for at least 3 years now, every time I’ve seen it in store or on the online store, I would buy every bag. I’d hoard all the bags I could get. Last year, I bought the last bag they had (I knew it as it was no longer sold online as soon as I picked up the bags I ordered for store pickup). This is year is the same; I’ll buy all the bags I can get so that I’ll have supply for months. There was a point when my maniac self would chew on a few of these beans just because. Do you get my point?

I do suggest that you try it out if you love coffee. If you can find one.

Epilepsy & Other Related Stuff + Other Thoughts

Just finished scanning another set of long notes. Had a lot of trouble scanning these notes.

1. I always add some water to my fountain pens to prevent them drying out in the Malaysian climate. It seems that I’ve added too much water as the brown and grey colors become too light when scanned. Sorry for that.

2. I’ve finally installed MacOS Big Sur on my working laptop (my previous Retina 2012 MacBook Pro, acting as a home server, can’t have it installed). Since I’m on the Developer Program, it’s on the 11.1 version. However, there are still some significant bugs. It seems that the drivers for my dedicated scanner, the many years old HP Deskjet 46460 (that produces the best scans I’ve seen), has gotten screwed. All shading from fountain pen inks become lost as my writing become something like pastel ink. In the same line a green ink suddenly becomes black. Apparently many also have the same problem, on both HP and Apple forums; I don’t know who is responsible. As a workaround, I used my “server” laptop to scan the new set of notes.

3. It’s the time of year again when I get my email notifying that Squarespace is going to charge me again for hosting this website. This website has been running at a loss since its beginning. As much as those occasional thanks and compliments motivate me, this website has not been financially sustainable, and I’ve always searched for ways to make some money to pay off at least the bills for hosting this. Recently Squarespace has introduced Member Areas, and is along many measures I’m thinking about. Maybe an ad-free site for a fee? In the meantime, I’ve added a PayPal link if you’re interested in giving donations. Much thanks.

Point of Care Ultrasound (POCUS) for Regional Anaesthetists

The following presentation was given by Dr Shahridan Fathil during the KoreAnesthesia 2020 International Conference on 7 November 2020. If you came here just for the video, here you go:

If you’re interested in how this presentation was made and how it affected the conversion into video, then follow on.

The presentation was actually a PowerPoint presentation with prerecorded audio. You can do this by using the Record Slide Show feature. Transitions are automatically added and played in accordance to the audio duration. Issues and tips to make it work better in the future:

1. The best transition between slides is…..none in my opinion. The presence of transitions puts gaps between the audio clips when the transition is in progress. This may not be a problem if there is no background sound in between periods of talking, which in the majority of setups naturally will have some wind noise (that I removed in post); the lack of wind noise between slides when it is present in the background actually sounds unnatural. But even if there was no wind noise in the original recording…

2. The timing needs to be perfect: transitions need to happen exactly after the end of each recorded audio. The way recorded slideshows work in PowerPoint is that each slide has an audio segment when you decide to record a presentation. But the problem with PowerPoint itself (and not the author) is that the app does not exactly match the timing of transitions with the actual duration of the audio clip. I noticed this when I tried to record while talking non stop and click through the slides: the slide duration was always shorter than the audio duration. On top of that in one of the slides, the audio was playing in the automated slideshow but not when exported as a video. And in another slide (in the video export), the transition occurred much later after the audio had already ended (despite setting the transitions manually and the part working when played as an automatic slideshow). These are all killer bugs with PowerPoint itself if you want to use it for public presentations with prerecorded presentations. Small deviations in the timing of transitions are seen (heard, actually) as clipped audio, along with the instances of no audio and delayed transition. In the final version above there was still some unusual weird sound effects even after matching the times. As for the missing audio, I simply copied from the presentation file and pasted it in. The case of the delayed transition was simply cropped out. The best way to get the exact time duration (if you want to fix it in post) is by playing the clip till it stops; I found that scrolling to the end of the audio clip does not actually show the duration of the audio clip (it’s off by fractions of a second). Even small deviations in the timings make the difference between hearing “ball rolling” versus “balll-”. But if you want to get it right the first time…

3. …I suggest that you pause before making any transitions. Trying to be mindful of this is annoying, but so is fixing the timings of all slides. And if you decided to play your presentation as a video instead of a slideshow, you may have audio that is not transitioned over or have buggy transitions. Going through your presentation before public consumption will have to be a must because of these bugs; Microsoft needs to fix them.

The timing here…

…And here need to match exactly. PowerPoint will mistime the duration short by fractions of a second. But fractions count.

No audio in one slide, and in another the transition came much later after the audio

Once the timings (including playing of video clips) are set, all you have to do is just play the presentation (if you want to stream with PowerPoint) or export as video (e.g. for uploading to video playing sites). If possible, I suggest playing the slideshow directly versus playing it as a movie whenever possible (due to the aforementioned bugs).

COVID-19 has brought out creativity in trying out solutions for teleconferencing, and we are seeing the pros and cons of the available solutions. Microsoft PowerPoint certainly has its uses for prerecorded presentations, but personally the bugs present can’t make me recommend it.