Accessibility Extensions for Chrome Browser - Text-to-Speech and More

ChromeVox is just one of the Google Accessibility extensions. Be sure to check out ChromeVis, ChromeShades, and ChromeLite as well. The text-to-speech (TTS) programs convert text or web documents to human speech. Does it sound like a human voice? Not really, it is a computer-generated voice but it is as close to human as it gets. You can adjust the speed, repeat, or change the pitch of the voice.

ChromeVox

The ChromeVox screen reader is an extension to Chrome that brings the speed, versatility, and security of Chrome to visually impaired users.


Using Google Document List with ChromeVox that provides accessibility features for vision impaired users of Google Docs.

Other text-to-speech extensions include:

Chrome Speak - select to speak with offline TTS engine.

SpeakIt! Select text you want to read and listen to it. SpeakIt converts text into speech so you no longer need to read.


SpeakIt reads selected text using Google TTS (Text-to-Speech) with language auto-detection.

Text-to-Speech in Pocket app (formerly “Read Later”) http://goo.gl/ikFNN

Balabolka

If you are not a Chrome user, Balabolka is a free and portable Text-To-Speech (TTS) program that is browser-independent. No installation is required.

You don't have to be visually impaired to benefit from TTS programs. For example, I use Balabolka several times a week to convert long articles from medical journals or newspapers to standard MP3 files. The files are then uploaded to Google Docs and I download them when I have some time to listen to the articles.

ChromeVis

Magnify and change the color of any selected text. Use the mouse or the keyboard to move the selection around the page.


How ChromeVis works.

ChromeShades

ChromeShades is an easy tool to help you make your site more accessible to blind users.

References:

Hear Web Text with Google Chrome Speak
New Text-to-Speech API for Chrome extensions

How-To: Maintain a correct posture while working on your laptop

Adult or Child Laptop Use at Home, Work or Classroom.



Mobile or Smart Phone Use while Driving, Traveling or on the Move.

Link via Digital Inspiration.

Laptop Computer-Induced Erythema ab Igne

Erythema ab igne is a skin reaction caused by exposure to heat. It is also known as hot water bottle rash, fire stains, and toasted skin syndrome. Ignis is the latin word for "fire".

In this case report a 12-year-old boy presented with erythema ab igne on his left thigh caused by the use of a laptop computer. This is the youngest of the 10 reported patients with this laptop-induced dermatosis since its first description in 2004.

Erythema ab igne is a reticular, pigmented, sometimes telangiectatic dermatosis that is caused by prolonged exposure to a heat or infrared source (see pictures from different cases at DermNet).

In laptop-induced erythema ab igne, the localization on the thighs and asymmetry are characteristic. The heat originates from the optical drive, the battery, or the ventilation fan of the computer.

References:
Laptop Computer–Induced Erythema ab Igne in a Child and Review of the Literature. PEDIATRICS Vol. 126 No. 5 November 2010, pp. e1227-e1230 (doi:10.1542/peds.2010-1390)
Erythema Ab Igne. eMedicine Specialties > Dermatology > Environmental.
Image explanation:  I was not able to find online photos of erythema ab igne labeled for reuse, hence the image of a laptop from Amazon.com.

TED Talks: David Pogue: Cool new things you can do with your mobile phone

TED Talks: David Pogue: Cool new things you can do with your mobile phone

The New York Times tech columnist David Pogue rounds up some handy cell phone tools and services that can boost your productivity and lower your bills (and your blood pressure).

Portable doctor? Rovio is a WiFi-enabled mobile webcam - allows you see, hear, and speak from anywhere in the world

What is Rovio?

"Rovio is a WiFi-enabled mobile webcam that allows you see, hear, and speak from anywhere in the world... as if you were right there in the room."

It could potentially be used as a "portable doctor" -- without the physical examination part (an important limitation).

A recent study compared desktop videoconferencing to conventional face-to-face visits for a range of commonly presenting problems in a general practice. A total of 175 patients were recruited.

In the first arm, the patients completed a visit (virtual or face-to-face) with a physician; they then completed a second visit via the other modality with another physician. In the second arm of the study, subjects had both visits face-to-face; different physicians conducted the two face-to-face consultations.

Patients found virtual visits similar to face-to-face visits on most measures, including time spent with the physician, ease of interaction and personal aspects of the interaction. Physicians were also highly satisfied with the virtual visit modality.

The diagnostic agreement between physicians was 84% between face-to-face and virtual visits; it was 80% between the two face-to-face visits.


Rovio at CES 2008, from Engadget.

From Twitter:

vene2ia Rovio is a good idea for a portable doctor. However, it can't be an interventionalist 2 minutes ago from web

References:
A randomized trial of virtual visits in a general medicine practice. Ronald F Dixon and James E Stahl. J Telemed Telecare 2009;15:115-117.

Video: Scoble Interviews Epocrates Co-founder

Video: Scoble Interviews Epocrates Co-founder

"Epocrates is an app that helps medical doctors get access to the latest knowledge on diseases and diagnosis. It also checks to make sure they are prescribing the right drugs and that there aren't bad interaction effects between drugs if they are prescribing multiple drugs. Here co-founder Jeff Tangney talks to me about the company. In a separate video, to come shortly, we get a demo and talk to a Stanford Hospital doctor who is using the system."


Video: Stanford Doctor demonstrates how he uses Epocrates

Updated: 02/26/2009

Dave Winer's Virtual Hug Delivered Daily on Twitter

Dave Winer pioneered the development of weblogs, syndication (RSS), and and is called "the protoblogger" by the NY Times.

A week or so ago, Mr. Winer started spreading a little bit of happiness on Twitter by delivering a daily "virtual hug":

davewiner Almost got through the whole day without a virtual hug. So today's virtual hug goes to 19 minutes ago from web

davewiner Steve Jobs. Thanks for the Macintosh, after all these years, there's no doubt who got it together and who kept it together. 18 minutes ago from web

davewiner It's a great computer, and it's stood the test of time. 25 years. Man that's something! And so you're health is not so great, me too, but 18 minutes ago from web

davewiner We keep on truckin, one day at a time, make the best of it. Thanks Steve, and here's your {**hug**} 17 minutes ago from web

Steve Jobs Speech at the 2005 Stanford Graduation Ceremony: “This is the closest I’ve ever gotten to a college graduation.”

Steve Jobs tells 3 stories from his life:
- Connecting the dots
- Love and loss
- About death

His final advice to the graduating students: "Stay hungry, stay foolish."

References:
Steve Jobs Speech at Stanford Graduation Ceremony
Video: Highlights of Steve Jobs and Bill Gates Interview
“And one more thing” about Steve Jobs’ battle with cancer - Science-Based Medicine, 2011.

If you are included in this post but would like to have your tweet removed for any reason, please email me and will comply with your request the same day.

Physician-in-Training Tips: Take Your Favorite Portable Browser on USB Stick

Typical physicians in training are always on the go and have to use multiple computer workstations on different hospital floors to access EMR, UpToDate and search for medical information on the Web.

You can take your favorite browser and settings with you by using a portable version of the program on a USB drive. The use of these programs is not recommended with EMR and you have to make sure that the IT department of your institution does not prohibit them running from a USB drive. The portable applications listed below do not require installation.

My favorite portable desktop applications are:

1. Portable Firefox browser

2. Portable Opera browser

3. Portable IrfanView image editor. Use the ZIP version and unzip to an USB stick or a folder.

References:
Portable Applications and Other News
Portable Firefox on a USB Drive
How do you backup your computer files?
Image sources: the software projects linked above.

Video: Netter’s Anatomy for iPhone

C|Net Video: Netter’s Anatomy for iPhone

Link via KidneyNotes.

Related:
Epocrates Online Pharmacopeia is Now Free and Available on iPhone

Using Twitter to Microblog a CME Meeting

Theresa Chan is family physician turned rural hospitalist with a widely popular blog and prolific Twitter posting. Her style of writing is no-nonsense, insightful and witty. Dr. Chan holds the dubious distinction of the doctor with the most Twitter posts (5,400 as of today, running head-to-head with @scanman) and in her case the quantity does not rule out quality.

Always a brave soul, Dr. Chan does not shy away from trying new gadgets -- from a portable scanner, to MacBook Pro, to Acrobat Pro to annotate presentation PDFs and save trees. She has colleagues turned informal Twitter advisers from around world to help her in the process.

Now, Dr. Chan is the author of another first (or close second, if somebody keeps track) -- she is live tweeting a CME meeting. The meeting is the 12th Annual Management of the Hospitalized Patient (in San Francisco, October 23-25th), arguably the most popular hospital medicine CME course, founded and chaired by the nation's top academic hospitalist Bob Wachter.

A few excerpts from the Twitter coverage are shown below and you can see all the posts here.

Bob Wachter is among the readers of my blog (honored to be listed in his favorite links) and he should definetly make a note of Dr. Chan's coverage which offers immediate feedback of this CME event.

I will be attending the NEJM Horizons Conference to push the boundaries of traditional medical publishing this weekend and was planning to live tweet from the meeting a few interesting observations if time permits. However, I do not expect the reach the level or volume of coverage of the meeting demonstrated by Dr. Chan.

See below Dr. Chan's coverage of the hospitalist CME meeting and a few comments from her "followers," the oldest posts are at the bottom, the newest at the top:

	ruraldoctoring Because, in Rural, I think the neurologists do maybe 2 inpatient EEGs at my hospital a year. OK, maybe 5. about 1 hour ago from web
	ruraldoctoring #SHM: Discussing need for urgent EEG, even if this requires transfer to another hospital. Trying not to laugh. about 1 hour ago from web
	ruraldoctoring #SHM: "When the EEG begins to look like the EKG, things are not normal." about 1 hour ago from web

ruraldoctoring #SHM: "We don't think about [encephalitis] often enough." I do! Or at least I think I do. about 1 hour ago from web

	ruraldoctoring #SHM: "Delirium: A Stress Test for the Brain." I like it. about 1 hour ago from web
	ruraldoctoring #SHM: Now we're talking about my favorite hospitalist problem: Delirium. about 1 hour ago from web

	ruraldoctoring #SHM: Discussing reasons for readmit after pneumonia hospitalization: about 2 hours ago from web
	ruraldoctoring #SHM: Ah, the UCSF physician's demeanor. The brisk confidence, the articulate and slightly self-mocking humor. I'd forgotten. about 2 hours ago from web
	ruraldoctoring #SHM: Now talking about CA-MRSA pneumonia. Yes I've seen it, even in Rural. about 2 hours ago from web

ruraldoctoring #SHM: Oh, and btw, I *am* using Acrobat Pro to annotate PowerPoint PDFs provided by speakers. It works. about 3 hours ago from web

	ruraldoctoring #SHM: I will say they choose excellent speakers for this meeting. Good thing, otherwise I'd be sitting with 700 other bored hospitalists. about 3 hours ago from web
	ruraldoctoring #SHM: Post-stroke management must include permissive HTN--up to at least 220/120 unless tPA is planned. I knew this but the struggle! about 3 hours ago from web

ruraldoctoring #SHM: tPA decisions will probably be made on basis of perfusion patterns in near future, after identifying areas of salvagable tissue. about 3 hours ago from web

ruraldoctoring #SHM: "A lot of you work at these stroke referral centers." Ah, not. about 3 hours ago from web

ruraldoctoring #SHM: UCSF Stroke CT protocol: 1)noncon brain + 2)CT Angio from Ao arch to Circle of Willis, 3)CT perfusion study, 4)Post-contrast CT. about 4 hours ago from web

ruraldoctoring #SHM: European SITS-MOST study suggests tPA can be effectively implemented in non-referral hospital settings safely. Gotta read it myself. about 4 hours ago from web

sandnsurf Twittepathical interjection...we have many strange beasts and venomous creatures down under - but a neurohospitalist - woke me from my sleep about 4 hours ago from web

	scanman @ruraldoctoring No such animal in the entire Indian subcontinent. May never have been seen outside the US :) about 4 hours ago from web in reply to ruraldoctoring
	ruraldoctoring #SHM: We now move on to talk by "neurohospitalist" S. Andrew Jacobson. No such animal has ever been sighted in Rural. about 4 hours ago from web

ruraldoctoring #SHM: We now move on to talk by "neurohospitalist" S. Andrew Jacobson. No such animal has ever been sighted in Rural. about 4 hours ago from web

ruraldoctoring #SHM: Talking about orthopods disliking conventional post-op anticoag guidelines. They have their own guidelines, I didn't know this. about 4 hours ago from web

	AllergyNotes @ruraldoctoring @sandnsurf Re: "SHM live tweeting, I feel so cutting-edge now" Yes, you are. And you have followers :-) about 4 hours ago from web in reply to ruraldoctoring
	scanman @ruraldoctoring YOU ARE cutting-edge material, Theresa. The #1 tweeting Rural Doctor :) about 4 hours ago from TwitterFox in reply to ruraldoctoring

ruraldoctoring @sandnsurf @AllergyNotes Gee, I feel so cutting-edge now. about 4 hours ago from web in reply to sandnsurf

sandnsurf @AllergyNotes @ruraldoctoring - this is really exciting - I have watched cricket on teletext (UK) but livetweeting is the real deal about 4 hours ago from web in reply to AllergyNotes

	ruraldoctoring @AllergyNotes Yup, tweeting LIVE from the Grand Ballroom of the Fairmont Hotel, San Francisco. about 4 hours ago from web in reply to AllergyNotes
	AllergyNotes LiveTwitting - a new/easy way to cover conference sessions! Readers can follow your session coverages in real time: http://livetwitting.com/ about 4 hours ago from web
	AllergyNotes @ruraldoctoring Re: "Finally arrived at SHM meeting" Are you live twitting from the meeting? about 4 hours ago from web in reply to ruraldoctoring
	AllergyNotes @ruraldoctoring Re: "Finally arrived at SHM meeting after sweaty sprint up 16% grade San Francisco hills." Good job! about 4 hours ago from web in reply to ruraldoctoring
	ruraldoctoring Talk is about thromboembolic disease. Discussing thromboembolic therapy, which we don't use in Rural for PE. about 4 hours ago from web

	ruraldoctoring Think I've passed my stress test--no chest pain. Near-syncope a few times, but no chest pain. about 4 hours ago from web
	ruraldoctoring Finally arrived at SHM meeting after sweaty sprint up 16% grade San Francisco hills. about 4 hours ago from web

ruraldoctoring OK, now that I'm up before 6am, going to this CME seems like the dumbest idea in the world. about 8 hours ago from web

ruraldoctoring Going to bed. CME meeting starts tomorrow. about 16 hours ago from web

I think Dr. Chan should summarize her experience live blogging the CME meeting and getting immediate feedback from her followers in an abstract. This simple method of sharing public notes and professional interaction needs to be popularized beyond a niche product and deserves a wider adoption by physicians:

	AllergyNotes You have to love the term the Twitter team pioneered for social network buddies -- "followers." It makes you sound almost prophetic. 3 minutes ago from web
	AllergyNotes Easy and useful: Twitter can be used to take public notes and have you colleagues and followers comment on them in real time. 5 minutes ago from web

And the grand finale of this post is (drumroll)... a formal proposal to list Dr. Chan among the 50 Most Powerful and Influential Women in Medical Social Media:

AllergyNotes 50 of the Most Powerful and Influential Women in Social Media http://tinyurl.com/3rh6fy about 4 hours ago from web

References:
I will be attending NEJM Horizons Conference to push the boundaries of traditional medical publishing, suggestions welcomed
A Doctor's Opinion: Why I Started Microblogging on Twitter
Selection of My Twitter Favorites

Free Medical Eponyms Database Includes 1,600 Items

Eponymous medical signs are those that are named after a person or persons, usually the physicians who first described them. There are eponymous diseases as well.

The free website Medical Eponyms collects 1,600 items in one place and makes them available on several platforms:

Palm
iPhone
Windows Mobile

Link via The Palmdoc Chronicles.

Using Evernote as Electronic Medical Records Software

From EfficientMD:

Let me be clear: I'm not suggesting that Evernote is a substitute for any of the excellent commercial EHRs currently available. The following is presented as a proof of concept only for how a simple, inexpensive, customizable EHR built on Evernote might work.

Evernote has confirmed by email that, "At this time we do not plan to pursue HIPAA certification for our (consumer) Evernote service."

Of course, if you're concerned about transmitting information to the Evernote servers, you can always instruct Evernote to keep all data on your local computer. This bypasses the HIPAA issue and you'd still be able to use Evernote, but this means that you won't be able to access patient data from the web unless you use a program like GoToMyPc.com.

References:
How Doctors Can Use Evernote As A Professional Memory Accessible Anywhere, Part 2: Using Evernote as an Electronic Health Record (EHR). EfficientMD, 08/2008.

Google Docs Offer 300 Templates for Documents, Spreadsheets and Presentations

Google Docs is a useful online word processor, spreadsheet and presentation application. I have used it for years with satisfactory results and it has almost completely replaced Microsoft Office for me. Having a "golden copy" online is very convenient, especially if you work on your documents from your workplace, home and you check them from mobile devices. The local copies of Word documents just don't cut it anymore.

Google Docs launched 300 templates for documents, spreadsheets and presentations. Some of them are listed below:

Personal Budget Spreadsheet

Loan Comparison Tool

2009-yearly-calendar-landscape : Yearly Calendar

Personal Budget Tracker

gas-mileage-log : Mileage Log

to-do-list : ToDoList

Savings Calculator

2008-monthly-calendar-landscape

Job Applicant Scoring : Scoring

Mortgage Payment Calculator

Stock comparison template with built-in Google Finance functions

Net Worth : Sheet

Home Ownership Expense Calculator

2009-yearly-calendar-portrait : Yearly Calendar

Project Management Schedule

Investment Decision Criteria

Personal Monthly Budget

Business Cards

Research Paper

Project Report

Resume

Family Budget Planner


Google Docs in Plain English

Related:
Templates bring Docs to life. Google Official Blog.

Video: What Can You Do with Your Phone?

From Google Mobile Blog:

"Mobile phones are awesome. I use mine all the time, from using it as a flashlight to find my keys, to a calendar to see just how late I am for an appointment. But people do much more interesting things than that with phones nowadays. And so the Google mobile team poses the question to you: what can you do with your phone?"


What Can You Do with Your Phone? A Google engineer shares a few tips.

A special trick for all iPhone fans out there:


Painful to watch: Blend iPhone into iSmoke.

References:
Introducing Mobile Tricks, our new YouTube channel for cell phone enthusiasts. Google Mobile Blog.

Related:
Video: Google SMS for Product Price Comparison.
Google SMS from a cellphone? Dave Taylor.

Best Solution for Online Backup: Amazon S3 via Jungle Disk?

After writing a long post on the various ways of local backup, I saw a better solution in the Paul Stamatiou's post about online backup to Amazon S3 via Jungle Disk. S3 (Simple Storage Service) is an online storage web service offered by Amazon.com.

As a disclaimer, I am not against local backup tools and I am planning to continue using at least 3 of them in the future:

1. External hard drive, 500 GB
2. Portable hard drive, 150 GB
3. USB drive, 4 GB

However, an encrypted backup on Amazon S3 looks like a tempting option and is probably the best solution for online backup, at least for now. The service is competitively priced at 15 cents per GB per month. Jungle Disk, which provides the interface to Amazon S3, costs $ 20 (one-time purchase).

I tried this backup solution during the weekend and it works OK. The best way to grasp the concept is to watch the explanatory screencasts from the JungleDisk website.

Initially, I was thinking about using Jungle Disk's virtual drive as just another drive (or a folder) but I gave it up in favor of running backups of a few folders:

1. Scanned documents (in PDF format) and other various files as .doc, .xls, .ppt. The size is about 2 GB.
2. Photos from Picasa, 7 GB.
3. Other various files, such as mp3 and video.

The initial upload took 1 day and 17 hours over a cable connection (upload speed 520 kbits/sec) but the subsequent backup is incremental and it takes much shorter time.

Frequently Asked Questions

Jungle Disk? How can you trust a company with such name?

Yes, I know, it does not sound serious but it goes nicely with Amazon, rain forest, etc. In addition, the company does not have access to your data, which is encrypted before it leaves your computer, and the access to Amazon S3 should be available even if Jungle Disk goes bankrupt.

Can anybody read your online files, tax returns, etc.?

The files are encrypted before they leave your computer and are protected via a password and encryption keys.

What are your thoughts about online backup? Which service do you use?

References:
How do you backup your computer files?
How to backup your medical blog?
Why I Started Using Amazon S3. PaulStamatiou.com.
How I Use Amazon S3. PaulStamatiou.com.
Image source: Wikipedia.

Related:
Amazon S3 Simple Storage Service - Everything You Wanted to Know. Digital Inspiration.
Amazon S3 Buckets Described in Plain English. Digital Inspiration.
Bulletproof Backup Strategies. EfficientMD, 08/2008.
Thoughts on Dropbox from PaulStamatiou.com, 09/2008.
S3 Browser - Freeware client for Amazon S3. User Interface for Amazon S3 Service.
A Round-up of GUI Clients for Amazon S3 Storage & CloudFront. Digital Inspiration, 2009.
Web storage: Amazon S3 is nearly 80% more expensive than Amazon Cloud Drive http://goo.gl/wlgP7

Two of my favorite browsers just had major updates: Firefox 3.0 and Opera 9.5

I use 2 browsers every day: Firefox and Opera. The sequence used to be Opera and Firefox but more on that later. Both browsers just had major updates -- Opera to version 9.5 and Firefox to the hyperhyped (is that a word?) and much anticipated version 3.0.

Opera 9.5

Opera 9.5 is just as solid as it has always been. I like the one-key shortcuts ("Z" to go back, "1/2" to switch tabs) but they are turned off by default in this version so I had to change the settings. The zoom feature is better than the one in Firefox. The browser has a smaller memory footprint and uses less resources when loaded with multiple tabs (30-40+), for example, when I read the 40 newspaper front pages from Newseum. The biggest drawback of Opera? It does not work well with Google services. Firefox feels like it was made for Google (because it was). Opera has other useful features such as sessions and online bookmark synchronization between different computers.

Firefox 3.0

Firefox 3 is a great browser -- much faster than the previous version and it works seamlessly with Gmail, Reader, YouTube, Blogger, etc. The only extensions I have installed are Google Toolbar and Gears (for offline access to Google Docs).

At the beginning of the post, I mentioned that Opera was my browser of choice, then Firefox, but that sequence had reversed. Several years ago, Opera was the first real alternative to Internet Explorer and the major innovator in the browser field. The tabs were first launched in Opera, for example (see the video below). However, Opera does not work very well with Google services, and Google "rules" the online world. Firefox is an excellent browser (with an even better PR team), so if you do not have it on your computer yet, you should give it a try.


Video: Opera browser 12-year history

References:
Web OS May Be Everything You Need for Day-to-Day Work
Portable Firefox on a USB Drive
Newseum Shows Front Pages of 600 Newspapers from Around the World
Largest online database of keyboard shortcuts
Review: Opera 9.5 -- a fine browsing alternative. Computerworld, 06/2008.