Saturday, January 26, 2019

Anti-inflammatory Food Plan

February 10 will mark six months of amazing changes in my endocrinology. According to my rheumatologist, my RFnegPA is in remission for the first time since 2011. One considerable factor in those changes was the start of an anti-inflammatory food plan.  

The anti-inflammatory food plan is based on the recommendations of the Arthritis Foundation, which has published a lot of information on how food affects arthritis. But they try to write in a warm, fuzzy way that does not make it sound like a form of torture. I'm writing it like it is. Also, I am so far from qualified to tell anyone what they should eat that you should really not listen to me. Read the whole thing. Then check with your doctor. Then eat your last ice cream sundae and get to work.

Do not eat any of the following as they cause inflammation:

  • Sugar in any form except whole fruit.
  • Saturated fats including cheese, full fat dairy, pasta, red meat, and grain based desserts.
  • Omega-6 including all oils except avocado oil, olive oil, and coconut oil (only when a solid fat at room temperature is required).
  • Refined carbohydrates including white flour, white rice, potatoes, and processed cereals.
  • MSG.
  • Gluten including wheat, barley, and rye.
  • Casein including all dairy.
  • Nightshades including eggplant, tomatoes, peppers, potatoes, and turnips.
  • Caffeine including coffee, tea, and chocolate.
  • Artificial sweeteners.
Test in a food by eating it two times per day for three days. If you develop discomfort, stop the trial food until symptoms disappear. Then reintroduce the trial food a second time. If the same symptoms reappear, stop the trial food. When symptoms disappear, introduce a different food.
 

Eliminate for at least a month, then test in one per week in whatever order you choose.
  • Bananas
  • Citrus
  • Soy
  • Chicken
  • Eggs
  • Brown rice
  • Non-peanut nuts
  • Peanuts
  • Oats
  • Corn
  • Shellfish
  • Pork
  • Fish
This is not written in stone. If the prospect of never eating chocolate for the rest of your life is more than you can bear, then by all means, test in chocolate. But consider the more vital nutrients, like protein, first.
 

To objectively assess the foods you test in, you need to track your pain, GI symptoms, mood, and compliance with the plan.
 

To track pain, I use the Pain Scale app. If you have been coping with pain by trying to avoid thinking about it, consider doing a body scan meditation before recording your score.

To track GI symptoms, I use the Poop Log app.  The gastrointestinal system is the canary in the coal mine of inflammation. So while this will make you literally consider your own feces more than what is socially acceptable, it is the key to fine tuning your food plan to your unique needs.
 

To track mood, I use the Moodscope website. Food, mood, and inflammation are intertwined both biologically and psychologically. If you use food as a mood modifier, you will have to look for alternative mood modifiers once you start the anti-inflammatory food plan.
 

To track food plan compliance, I use my own chart that includes whether I ate 6 servings of vegetables, whether all my meals in a day were vegetarian, and whether I consumed only foods on the plan.
 

I take all of the daily data and collect it on one monthly graph so I can see how things go over time.
You should track for a month before you start the anti-inflammatory food plan so you have a baseline. During this month, ramp up your vegetable intake to a full 6 servings daily (check those serving sizes).
 

Then, track for your first month on the meal plan to see when your baseline shifts. This is important to know how long you will likely have to go back to basics if a test food fails or you eat something inflammatory or you have some other cause of inflammation. This can also help you identify inflammatory foods unique to you. For example, I noticed a spike in pain and loose stools after eating cucumbers. So I abstained from cucumbers until my baseline was good and tried testing in cucumbers.
 

Then, when you start testing food in, you can look back at the week's data to figure out if the food test was successful, inconclusive, or a failure. I have attached the chart I use to track testing foods. 

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Wednesday, July 25, 2018

A different justification for the Schulze Method

This is a different way to think about the Schulze Method, which might convince people who don't like the "beatpath" construction. 

I wrote about the Schulze method in the previous post, giving a justification that is based on the standard presentation of the method using beatpaths.


This is a different look at the same method, implemented a different way.

Suppose you first looked for a Condorcet winner: so you look at all the pairwise matchups, and find out who is preferred to who.  You make a matrix of pairwise preferences, and maybe for convenience subtract the number of voters who preferred Y to X from the number who preferred X to Y to get the margin of pairwise preferences.  (These matrices are in the example in the Wikipedia link to the Schulze method above -- if I were more detail-oriented, I'd put an example here.) 

Any row that's all positive means that candidate beats all others head-to-head: that's a Condorcet winner!  

But suppose there isn't a row that's all positive.  What do we do?  Well, first, we can eliminate any Condorcet loser: a candidate that is not preferred in any head-to-head matchup. (We'll spot a Condorcet loser in the matrix because it's got a row of margins that's all negative, or equivalently a column that's all positive.)[see footnote]

Then, since we want the closest thing to a Condorcet winner, let's "grade on a curve", and do one of the following (these are equivalent):


  • add something to all the margins: add 5 (for example) to all the margins of pairwise preferences  (add more if you haven't changed anything from negative to zero/positive, add less if you've changed too many elements) OR
  • find the negative margin that's closest to zero (-3 is closer than -10) and set it to zero.
Is there a row with no negatives now?  If so, that's our winner.  If not, our curve might've produced a definite loser (with a column that's all positive or zero), so eliminate that candidate [see footnote again] and curve some more, either adding more or zeroing out another negative margin, until you've got a row with no negatives.  It isn't a Condorcet winner, but it's the next best thing -- the candidate that started with the smallest pairwise "unpreferences".

[ Here's the footnote: ] technically, you want to eliminate every candidate not in the "Schwarz set", which is not just a Condorcet loser, but any group of candidates that loses to everyone outside the set.  (In other words, it doesn't matter if candidate D beats candidate E, if D and E both lose to A, B, and C, eliminate both of them - clearly the winner should be A, B, or C.)   But in terms of justification, this is a technical point; the idea is that you're looking for the "closest to Condorcet" winner.


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Voting Methods: Making the case for the Schulze Method

If you're curious about voting methods, and/or want to make a case for a Condorcet method to your friends and co-voters, this post is for you!  

First, I think the Condorcet criterion is pretty compelling on its own.  (The Condorcet criterion is: if there's one candidate that is preferred in head-to-head matchups to every other candidate, that candidate wins.)  It's easy to come up with examples where the plurality method (this is the method that gets applied most often - whoever gets the most votes wins, even if that isn't more than half the votes -- boo plurality!) doesn't give you what seems the right solution.  If there is a Condorcet winner (there isn't always), it's the one that seems like the right answer.

So what if there isn't a Condorcet winner?  What voting method do you pick?  This is a case for the Schulze method: if there isn't a Condorcet winner, that's because there's a "rock-paper-scissors" cycle where candidate A is preferred (head-to-head) to candidate B, B is preferred to C, ... , Y is preferred to X, and X is preferred to A.  (The cycle can be size 3, like rock-paper-scissors, or can be longer - the point is it circles back on itself.)

At first glance, a cycle like that seems intractable - how do we rank any of the candidates in the cycle higher than the other?  But this is ignoring the strength of the preference:

Suppose 90% of voters prefer Rock to Scissors, 85% prefer Scissors to Paper, and 51% prefer Paper to Rock.  The cycle is there, but clearly the Paper > Rock preference is the weakest link.  The preference path Rock > Scissors > Paper has a "strength" of 85%, much higher than the 51% for Paper > Rock.  Based on path "strength", we can rank these Rock>Scissors>Paper.

Is Rock a Condorcet winner?  No.  But it's the closest thing to a Condorcet winner, in the sense that its pairwise loss is the weakest.

That's the Schulze method.  It's written in terms of "beat paths", but those are just breaking a cycle into two parts, like we did splitting "Rock>Scissors>Paper>Rock" into "Rock>Scissors>Paper" and "Paper>Rock" and comparing them.  There's some added detail to deal with multiple cycles between the same candidates, but that's really all there is to the idea of the method.

Next I hope to show another case to be made for the Schulze method, which might be more intuitive.


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Monday, November 21, 2016

Learning Outcomes for Outlast

Here is some feedback from the originator of the game idea "teach environmental sustainability through a game with zombies":

What I was thinking about were both reasoning/critical thinking skills and environmental sustainability.  What do you do when the first plan doesn't work? What is your new goal? What information do you need? What is your strategy? I thought the zombies would make it cool and relevant and more exciting, but we could also have used a colony on the moon. Ok, they would have needed a lot more background knowledge! 

Game design: Game Dojo stream pre-report

Hello!  There's a Game Dojo stream tonight where I'll talk with Sen about Outlast.

Here's a brief follow-up of what has happened from the earlier Game Dojo conversation.  The items to consider in the short term were:

  • consider permanent resources (that are location features: shelter, arable land, water, e.g.) as well as temporary resources: I haven't really done this.  
  • consider the minimal best 9 locations to have. What if these were all there are? (letting a location get overrun should be a gut-wrenching decision) This I have done, and played the game with only 9 locations (when a location is overrun, it disappears and nothing replaces it.)  This game is more challenging, of course, but definitely achieves the goal of treating locations as precious.  
  • What's a playable "scenario" that can be "solved" (won) (A deterministic end goal, that is definitely achievable).  There should be a strategy that works regardless of unfortunate die rolls: I tried out a few straightforward scenarios: the farm (which makes it easier to produce food) next to the sustainable storage (which has a win condition if you have enough food), and the laboratory (win condition: medicine and gas) near the hospital and gas station.  I realized that a well-coordinated team can definitely win in either case, quickly.  (more on this)
  • write a bio, then publicize it and this blog so people (you guys!) can follow the story of the game design.  Have not been good about writing a bio. :(

Here are some thoughts to hold off on for the moment, but should be considered down the road:
  • Consider expanding the map to 25 "little" locations rather than 9 "big" ones. Not looked at yet.
  • This game sounds like it wants to be a co-op area control game: This is sort of true, in the sense that a powerful tactic is to move as a pack, with one outrunner on a different location.  This looks a bit like area control: having 3 people in one place is better than 2 here and 1 somewhere else. (If there's a chance for food, for example, 3 searchers on the same location are liable to hit it and can all use it.)
  • Pivot: what makes the players realize they need to switch strategies (from exploit to sustain, explore to hunker down, e.g.), and what makes the timing of the pivot crucial (waiting too long or going too soon has to have a cost): Running through the "scenarios", I am a bit concerned that there isn't a pivot - or at least, focusing solely on the goal from the start was a successful strategy.  This is one of the "counterintuitive" parts of the game -- players naturally start out trying to subsist, but choosing to starve from the start in pursuit of a win condition is a quicker path to victory.
  • building a defensible position; using fortification or something to protect/claim some region: Hypothesized a bit about what "securing locations" might look like as a new action players could take.  I think there's definitely a plausible opportunity here.
  • zombies chasing people around, rather than just showing up? Generally de-emphasizing the zombie attacks in favor of overruns? Not looked at yet.

Tuesday, October 25, 2016

Game design is happening!

So, I've been designing a game. The working title is Outlast, and it's a zombie game with a subtext of environmental sustainability. More to follow, including the pitch for the game, but if you're here to hear my tale of game design, welcome! The label "games" will show relevant material for you; you're welcome to look at everything, but if you _just_ want stuff about the game, click on that label. Without further ado, here's the hook:

When the zombies overrun society, every resource is precious. In Outlast, you and your friends must grab some resources (like food and guns) and maintain others (like a safe hideout.) As resources dwindle, you must strike out to discover new locations, while continuing to occupy the best sites you’ve already discovered. Locations you don’t use become inaccessible, so players have to develop an evolving “base of operations” consisting of several locations that work well together. If you succeed, you may be able to eliminate the zombies and create a safe haven for humanity. Good luck - we’re counting on you!
I've got a wonderful opportunity to work on this design in the Game Dojo, a mentorship group that Sen-Foong Lim of Meeple Syrup is leading. I had a great conversation with him, with a summary of how the game plays, available here.

 Here are some of my "to-dos" from that conversation:


  • consider permanent resources (that are location features: shelter, arable land, water, e.g.) as well as temporary resources
  • consider the minimal best 9 locations to have. What if these were all there are?
  • What's a playable "scenario" that can be "solved" (won) (A deterministic end goal, that is definitely achievable).  There should be a strategy that works regardless of unfortunate die rolls.
  • (letting a location get overrun should be a gut-wrenching decision)
  • write a bio, then publicize it and this blog so people (you guys!) can follow the story of the game design.

Here are some thoughts to hold off on for the moment, but should be considered down the road:
  • Consider expanding the map to 25 "little" locations rather than 9 "big" ones.
  • This game sounds like it wants to be a co-op area control game
  • Pivot: what makes the players realize they need to switch strategies (from exploit to sustain, explore to hunker down, e.g.), and what makes the timing of the pivot crucial (waiting too long or going to soon has to have a cost)
  • building a defensible position; using fortification or something to protect/claim some region
  • zombies chasing people around, rather than just showing up? Generally de-emphasizing the zombie attacks in favor of overruns?

Sunday, October 09, 2016

Math as Literary Theory (or not at all)

The other day Sarah was explaining multiplication to Zoe, especially about why any number times 0 is 0, and a number times 1 is that number.  I realized in that moment that I had never really heard (or what is called "hearing") the quite logical explanation that Sarah was giving Zoe.  Somehow, when I was Zoe's age (or older?) I had instead just memorized a rule that I either created myself or someone gave me.  The rule is this:

  • The zero is an infection:  it infects anything that "times" it (or something like that).  Whenever a number faces the dreaded zero, that number is completely annihilated by the black hole of the zero's (non-)power.  The zero, in other words, is a principle of contagion.

  • The 1 is a mirror that reflects back whatever "times" it.  If a number confronts the 1, all the number sees is itself.  Mere reflection.

This is of course a horrible way to understand multiplication.  But it's a great entryway into literary theory, especially theories of representation.  Are we dealing with a principle of reflection or mere representation (the 1)?  Or is this a case of reflection as distortion, or rather, not reflection at all but contagion: the one representing ends up infecting what is supposed to be represented? 

It's also a good primer on ethics, or what Levinas called "the ethics of ethics."  When I face the other, am I a "one" or a "zero"?  What would be the ethical integer?  For Levinas, ethics does not take place when I assimilate the other to me (when I infect the other, when I overwhelm the other with my own qualities).  Ethics does not begin with the zero.  Rather, ethics begins when I take up the position of the "one" (1):  my own self is annihilated in my encounter with the other.  Or rather, as a 1, I have no self, and therefore am able to allow the other to be present as such.  A certain reading of Levinas would therefore say that the ethical integer is always the 1.

Of course, literary theory also likes to confuse the difference between the zero and the one: no longer simply contagion or reflection, the "mirror" becomes passageway:

I don't know what "math" would say about that one.  Probably a lot, since Looking-Glass was, for Carroll, a math problem, or at least a chess problem.

The moral of the story:  In effect back in 6th I mean 1st grade, when I was learning multiplication, I really wasn't learning anything about math, but rather ended up assimilating math to my "self," but a self that would not actually be constituted until much later ("math" reflected a self that was not yet).  Or maybe that's what literary theory is, for me anyway:  my own non-encounter with math, my own private zero.  This is why "math" always returns to me as trauma or neurosis. 

Tuesday, April 28, 2015

What RA Feels Like

I just made a little animated video about how my rheumatoid arthritis makes me feel. Please watch. Then, please donate.

Thursday, March 12, 2015

Siblings Size-up Margins of Safety



Bob and Sarah worked together again (see the announcement of our first collaboration here) on a post over at Medical Law Perspectives: Uncleanable ERCP Duodenoscopes: Manufacturer, Hospital, and Physician Liability?  This time, Bob clarified the comparison of two margins of safety. 

In an editorial published in JAMA last October, William A. Rutala, PhD, MPH, Professor of Medicine, University of North Carolina School of Medicine, Chapel Hill; Director, North Carolina Program for Infection Control and Epidemiology; Director, Hospital Epidemiology, Occupational Health and Safety Program Hospital Epidemiology, University of North Carolina Health Care; and David J. Weber, MD, MPH, Professor of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, stated that the margin of safety associated with cleaning and high-level disinfection of gastrointestinal endoscopes is 0-2 log10. Rutala WA, Weber DJ. Gastrointestinal endoscopes: a need to shift from disinfection to sterilization? JAMA. 2014 Oct 8;312(14):1405-6. PMID: 25291575. Rutala and Weber compared this low margin of safety to the 17 log10 margin of safety associated with cleaning and sterilization of surgical instruments. 

But I had no idea how 2 log10 compared to 17log10. Bob explained that, at best, the margin of safety of endoscope reprocessing is 15 to 17 orders of magnitude less than the margin of safety for reprocessing of surgical instruments. Not 15 to 17 times less. 15 to 17 orders of magnitude less. That is literally over a quadrillion times less. So, the margin of safety associated with the cleaning protocol for duodenoscopes recommended in instructions provided by the manufacturer (Olympus Corporation) and the FDA is over a quadrillion times less than the margin of safety for reprocessing surgical instruments.