Neonates - General

1. Nutrition
    A. 110 ~115 kcal/kg/day，growth rate: 30 g/day
    B. Newborns usu. begin feeding within 6 hrs of life
    C. Breastfed or formula fed Q3H~Q4H thereafter
         a. The more often baby sucks on the nipple, the more milk will be produced.
    D. If the child stops losing weight by 5 ~7 days, and begins to gain by 12 ~14 days, then feeding is okay.
    E. No juice or water before 6 months
    F. Solid food should be introduced btw 4-6 months。New foods needs to be introduced individually and a week apart to identify allergies and intolerance.
        a. Bland to sweetest: Veggies --> green to orange --> fruits  
        b. Ready for solid foods?
            1) Hand-to-mouth coordination
            2) ↓ tongue protrusion reflex
            3) Sits with support
            4) Improved head control
            5) Drooling
            6) Opens mouth to spoon

2. Insufficient Feeding of Infant
    A. < 6 wet diapers/day after age 1 wk，1 diaper/day for 1st wk
    B. Continual hunger and crying
    C. Continually sleepy and lethargic baby
    D. <7 feeds/day  
    E. Long intervals btw feedings
    F. Sleeping through the night w/o feeding
    G. >10% wt loss
    H. Increasing jaundice

[Taipei 台北] 忠孝敦化 PS TAPAS 西班牙餐酒館 香脆培根菠菜雞肉捲佐雪莉酒小紅莓醬 甜蜜熔岩巧克力蛋糕

Coulant de Chocolate

PS Tapas 西班牙餐酒館
Address: 台北市大安區安和路一段21巷19號 (忠孝敦化站)
Phone:(02) 2740-3636
Website: https://www.facebook.com/PSTapas
Date: 2014/2/14 6:30 PM
Price: 1364 NT (including 10%)
Valentine's Day Special

How long does it take for both Valentine's AND the Lantern Festival (元宵節) to be on the SAME day? The answer is, 19 years!

Therefore for this rare holiday, I planned ahead and scheduled myself to be free for the night。After handing over the shift, I was set to embark on a culinary journey with Eunice to explore Spanish cuisine。Eunice hasn't had many chances to try Spanish food。She had only gone to La Paella once in Gongguan, which I thought was decent，but there are definitely better restaurants out there。Plus, I haven't had Tapas for a long while now, the last time was at the Tapeo Restaurant & Tapas Bar in Boston more than a year ago。There is room for improvement, but the $5 Tapas menu at Tapeo was cheaper compared to many other places。I decided to give it a try in Taiwan, and wanted to book MVSA Spanish Restaurant & Bar，but it was fully booked。So I went online to search for another。PS Tapas is highly recommended by Eztable and many bloggers，so I chose this restaurant for this very special night。

Peds - Acute Tummyache Differentials and Workup!

When should you call your senior, if there is one..

Acute Abdominal Pain by Age
Common to Uncommon

Age	Neonate	2 m- 2yrs	2 m - 5 yrs	>5 yrs
ER	Volvulus	Trauma	Trauma	Appendicitis
	NEC	Incarcerated hernia	Appendicitis	Trauma
	Adhesions	Intussusception	Intussusception	DKA
		Foreign body ingestion	Foreign body ingestion	PPU
		Hirschsprung disease	Adhesions	Adhesions
		Adhesions	HUS	HUS
		HUS	Primary bacterial peritonitis	Myocarditis/pericarditis
				Primary bacterial peritonitis
Common/ER	Colic	AGE	AGE	AGE
		Viral illness	Viral illness	Viral illness
			Pharyngitis	Constipation
			Constipation	Pharyngitis

Acute Abdomen
1. Trauma
    A. Motor vehicle collisions, falls, child abuse
2. Appendicitis
    A. Most predictive: RLQ pain, abd. wall rigidity, and migration of periumbilical pain to the RLQ
    B. Pediatric Appendicitis Score (PAS)
        1. For 1-17 y/o, total 10 pts
        2. Point System:
            a. 2 pts: cough/percussion/hopping tenderness; RLQ tenderness;
            b. 1 point: fever > 38° C, anorexia, N/V, migration of pain, WBC >10 000 cells/mm3 , and PMN >7500 cells/mm3
        3. Score
            PAS≧ 7: dx of appendicitis
            PAS 3-6: Need image studies
            PAS≦ 2: exclusion
       (Reference: Journal of Pediatrics 153.2 (2008): 278-282)
    C. Perforation rarely occurs within the first 24 hrs
3. Intussusception
    A. 2 months - 2 yrs, peak at 6 months
    B. Triad (<15%): 
        1. Intermittent, colicky pain (88%)
        2. Palpable sausage-shaped abd. mass (48%)
        3. Currant-jelly stool (25%)
        Others: Inconsolable crying, drawing legs towards abd., bilious emesis. 15-20 min intervals. Progressive
    C. Dx: Ultrasound
        1. Target sign/coiled spring sign
        2. Most common: ileocolic (95%)
    D. Tx:
        1. Hydrostatic (ex. Barium) /pneumatic enema under Ultrasound guidance <48 hrs of onset
        2. Surgery (esp. small bowel)
4. Malrotation with midgut volvulus
        1. S/S: Bilious/Non-bilious vomiting + abd. pain
5. Incarcerated inguinal hernia
        1. S/S:  irritable and crying, vomiting, abdominal distention,  palpation of a firm inguinal mass that may extend to scrotum/labia majora in the groin
6. Adhesions with intestinal obstruction
        1. Hx of abd. surgery + abd. pain
7. Necrotizing enterocolitis
        1. S/S: vomiting, abd. distention, and tenderness
        2. Prematurity, congenital heart diseases more common
8. Peptic ulcer disease
        1. >10 yrs: Meds (ex. NSAIDs)/Stress
        2. H.pylori less common
9. Ectopic pregnancy 
        1. Postmenarchal girls
        2. S/S: abd. pain, amenorrhea, vaginal bleeding

[Taipei 台北] 大直 Danny's Steakhouse 教父牛排 木香烤爐 美國頂級肋眼牛排 USDA Prime Ribeye Steak

A 16 oz. succulent, rich, and hearty prime ribeye steak

Danny's Steakhouse 教父牛排
Address: 台北市樂群三路58號(捷運劍南路站) 
Phone #: 02-8501-1838
Website: http://dannyssteakhouse.com.tw/
Date: 2014/2/09 12:00 PM
Price: NT 1530 + 60 NT + 10% = 1749 NT/Person

Danny's Steakhouse (教父牛排) is 牛排教父 鄧有癸's third restaurant north in Dazhi (大直) ，a high class steakhouse directly opposite of Osteria by Angie。 It was opened in 2013 and has been getting lots of attention for its tender，juicy steaks baked by the wood-fired oven (木香烤爐) ，which not only gives steaks a crispy crust,，but also the faint, smoky smell of white oak(白橡木)，hickory(胡桃木) or cherrywood (櫻桃木)。

Grilling steaks over a wood fire has been a traditional way of grilling steaks in the U.S。Although many have shifted to the grill, pan or the conventional oven nowadays，many popular steakhouses still use the wood oven for its distinct taste, crispy texture, and fragrant smell。Having been in the steakhouse business for around 40 years, Chef 鄧有癸's impressive resume includes leading kitchens at the Sonoma Grill，國賓A CUT，and No. 168 PRIME, importing the wood-fire grill from the U.S., and introducing the concept of the dry- aged steak in Taiwan。He cooks steak by first pan-searing for two minutes， then putting it into the refrigerator for the temperature to diffuse to the center， which raises the internal temperature to 40 degrees Celsius。After five minutes，the steak is placed into an oven with the capability of increasing the temperature quickly to 1000 degrees Celsius to seal the juices。The steak is then taken out and set it to rest for five to ten minutes。Lastly，the steak is grilled with the wood oven over open fire。Doneness is judged by looking and touching the steak with fingertips，the so-called "finger test"。

(Simple tutorial of the "finger test" can be found here:  http://www.simplyrecipes.com/recipes/the_finger_test_to_check_the_doneness_of_meat/)

外國人對台灣人的看法

身為在台灣出生的美國僑生，我一直都對文化差異很好奇。查google時出現了國光幫幫忙的影片，就好奇了看了兩集邀請來自不同國家的男生分享他們對台灣男生女生的看法。分別有來自法國，義大利，德國，美國，韓國和日本的男生。內容整理如下:

外國男生眼中的台灣男生:

1. 不夠man (這點被提到很多次)
        Ex. 幫女生提手提包，背包
              有些男生有baby face，讓女生覺得不夠man
2. 太過於害羞，太有禮貌
3. 過度照顧女方，以女生利益為優先。事事都聽女生的，也都幫她付錢
4. 過於在乎別人的想法，沒有主見
5. 太聽話，沒有先明辨是非，不獨立
6. 社交能力不夠
7. 沒有國際觀? 大材小用?

外國男生眼中的台灣女生:

1. 很會打扮，很可愛。
    但有些妝太濃也花太多時間打扮。沒有化妝不出門。晴天時撐傘。
2. 公主病
    據說有統計說台灣公主病最多
3. 雙重標準
    對外國人的攻勢覺得很帥，溫柔體貼。但對於台灣男生就覺得怪怪的，噁心?
4. 很強勢。緊迫逼人，常看手機，讓男生覺得沒有自由
5. 沒有獨立性，沒有主見。常常要男方出錢。
6. 易受騙，容易上當。尤其對方男性是外國人或ABC
7. 比較會照顧男生，但有些把男人當小孩

外國人最受不了的:

1. 碎碎念 (Big turnoff!)
2. 每天見面，沒自己的空間
3. 檢查手機
4. 娃娃音
5. 裝可愛
    嘟嘴, 吐舌頭, 幼稚的熟女。
6. 假睫毛，彩色隱形眼鏡
7. 整形
8. 太瘦，但常常講自己很胖  
9. 網上照片和真實判若兩人

其實外國人也不是都具有他們講的那幾點；不man，anti-social的，沒有主見和媽寶也不少。所以根本的問題是台灣女生有雙重標準? 有人提出對外國人tolerance比較高是因為台灣女生比較愛玩，更想要嘗鮮。但這不奇怪吧，台灣男生不也覺得白皮膚的女生很稀奇? 交到白皮膚的女友就說是台灣之光?

對於外國人最受不了的那幾點，有些我也認同。碎碎念對我來講真的是一個big turnoff，特別是那種不明原因的碎碎念。以前認試一位對我有好感的女生不管我做什麼都會念。像有一次我跟朋友們吃飯，我晚到在看menu時，她就在旁念說我menu看太久，沒有早點想到我要吃什麼。適當的還可以接受，但有時真得讓人會抓狂! 要求每天見面和檢查手機我還沒遇過，但我想如果我女友這樣我也會有意見吧。每個人都要有自己的目標，不能因為交往而放棄自己原本的goals。每天跟女友見面就等於時間都在約會；書不用念了，沒時間思考人生目標，事情也都沒時間做了。關於打扮，可能是因為在美國的女生打扮得比較自然，也比較喜歡自然的美。除了special occasions不然也不會特地化濃妝，所以我也不是很習慣化濃妝的女生。不過，公平來講，有些女生濃妝確實還蠻漂亮的，很有美感。Kawaii我覺得還好，有些時候其實還蠻讓我心動的。不要常常裝 (除非她本來音就是這樣..) 好像有加分效果。

我對於台灣女生tolerance比較高不知道是因為我來台灣已經6年多了，被台化的，還是我周遭的女性朋友這幾點都不太明顯。也有可能是我感情經驗不多. 之後有些其他想法再補充好了。




(Reference: 國光幫幫忙- 台灣男生好命苦，國光幫幫忙 -台灣女生都是被寵壞的)

Seven Habits of Highly Successful Medical Students

Habit 1: Learn how you learn. Then just do it. ​
             Figure out how you learn best and the most efficiently. Field of medicine requires life-long learning. As a doctor, we will need to constantly update our knowledge of our field by reviewing textbooks, reading journals, attending conferences, and discussing interesting cases with colleagues and learning from them. Thus, it is best to know you learn best early.

Habit 2: Look beyond your books. 
             Get involved in extracurricular activities, you will never know what benefits you will get, such as establishing connections with department chairs.

Habit 3: Give back. 
             Volunteer experiences are not only for getting into medical school. Medical school provides numerous opportunities for you to give back to the community. This gives you the chance to meet new people, develop and hone skills, and even better, they can go on your residency application.            

Habit 4: Be adventurous, both professionally and personally – you never know where it may lead you.
              Early exploration helps you to make your decisions - your specialty, the type of hospital environment you want to work in, the medical cultures, etc.

Habit 5: Recognize your own strengths and weaknesses. 
             Identify strengths and weaknesses. Feed your strengths and work on  your weaknesses.

Habit 6: Establish a circle of mentors.
             Some schools have formal mentoring programs, while some schools only have mentors who you can connect if you have any questions. Take advantage of these, and try to establish connects from various backgrounds and fields. These can range from senior medical students to professors and chairs. They can provide fruitful advice on perspectives and issues that you are going through as they have seen students and peers go through the ups and downs of medical school.

Habit 7: Take time for you. 
             Medical school is not everything, live the life! Finding the balance is critical for your career.


(Source: Faculty of Medicine)
 http://forum.facmedicine.com/threads/the-seven-habits-of-highly-successful-medical-students.17646/