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epcoa

1,592 karma · joined June 15, 2023

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epcoa··on Credit cards are vulnerable to brute force kind attacks
In addition to nominal fraud prevention (and how is any debit card better) there’s nothing better to claw back transaction fees, so what the fuck am I supposed to do?
epcoa··on Credit cards are vulnerable to brute force attacks
Well good for you. Us poors in the US like them for what they’re worth.
epcoa··on The Super Nintendo Cartridges (2024)
The Dreamcast charm is partly how simple it is, a jellybean CPU. The PowerVR is competent but it’s not outside the norm for 3D accelerators of the period (and there was a mass produced PCI card available of it). Nothing about the Dreamcast is exotic. Though the pack in modem and VMU are neat (did say “maybe” for the DC). GD-ROM vs DVD was obviously a dumb move. Perhaps Sega didn’t have the war chest to loss leader a DVD Dreamcast (they didn’t have the vision either at that point).

A technical demo like Bleemcast doesn’t demonstrate how far ahead something is, it has to be seen relative to the hardware of a similar generation. Having said that the PS2 which had some early programming hiccups would go on to eat DC’s lunch.

epcoa··on The Super Nintendo Cartridges (2024)
Not sure how any of these except maybe the Dreamcast (and then not by that much - it was almost literally a contemporary arcade board clone) were examples of “ahead of its time”.
epcoa··on Making RAM at Home [video]
That is really not the takeaway from this video, at all.
epcoa··on Acetaminophen vs. ibuprofen
No. Ethanol and tylenol compete for CYP2E1 that produces toxic NAPQI, so no, acute alcohol intoxication has a protective effect at least where it comes to tylenol toxicity.
epcoa··on Servo is now available on crates.io
lol
epcoa··on Make macOS consistently bad unironically
> I'm cautiously optimistic that AI will let us build full operating systems using other OSs as working examples.

Why? No one has shown that LLMs produce particularly good code. You can get a lot of useful shit done with what is still slop, but there is no reason to believe there's any evolutionary improvement.

epcoa··on Bubble Sorted Amen Break
It’s pronounced “Allman Brothers”
epcoa··on zclaw: personal AI assistant in under 888 KB, running on an ESP32
> vastly more complexity.

Doom is ingenious, but it is not terribly complex IMHO, not compared to a modern networking stack including WiFi driver. The Doom renderer charm is in its overall simplicity. The AI is effective but not sophisticated.

epcoa··on Backblaze Drive Stats for 2025
You know, there are external drive USB controllers that linux blocks/blacklists SMART passthrough when using UAS due to paranoia and historical problems, but this can overridden.

https://www.mcgarrah.org/usb-drive-smart/

I guess it is possible this is not your problem, but the last Seagate external I bought in October worked just fine with this workaround. This is probably safe from a data integrity standpoint, at least with a modern filesystem, but in my case it was no issue as I was only using the SMART to do tests before shucking the drive. Also, I don't know of any modern drive that truly doesn't support SMART.

epcoa··on The wonder of modern drywall
For nearly a decade, Chicago does allow MC cable in a number of circumstances, basically up to 25 feet branches where you don’t want to open up a wall.
epcoa··on The wonder of modern drywall
So outside of a few notable examples, the materials rarely fail, galvanized duct work should easily last half a century in a properly installed and maintained system, properly installed copper pipe or PEX and even (C)PVC, properly installed NM or wiring in conduit where code requires, where people get into trouble is with shoddy builders and the housing market often causes those to forgo proper inspections and it is ultimately a “market for lemons”. But blaming drywall seems a bit misplaced, since shoddy building in targeting cost only, they’re going to be the last ones replacing drywall with something fancy and expensive.
epcoa··on The wonder of modern drywall
No, Uponor AquaPEX.
epcoa··on The wonder of modern drywall
Rarely do pipes, wires, or ducts just outright fail even in 50 years. Usual case for tearing out drywall is for voluntary renovations. Shit behind the wall just doesn't "fail" if it is left undisturbed or you were unlucky like those that got defective PEX or similar installed.
epcoa··on The Day the Telnet Died
telnet has never been in POSIX though.
epcoa··on Heart and Kidney Diseases and Type 2 Diabetes May Be One Ailment
The term Metabolic Syndrome X has been around for more than a few years, unless nearly 40 is few (and I absolutely relate to that sentiment), just saying that concept was revved up in the 90s and of course has been an academic discussion going back to the early 20th century.

https://www.ahajournals.org/doi/10.1161/01.atv.0000111245.75...

https://pubmed.ncbi.nlm.nih.gov/3056758/

epcoa··on VA staff flag dangerous errors in Oracle-built electronic health record
Opioids are not weight based dosed for adults. Typically pain protocols start at fixed doses based on prior opioid use and titrate up for effect.

Also was this a bug in Epic proper or a site specific customization?

epcoa··on The risk of round numbers and sharp thresholds in clinical practice
> Paracetamol is the most common cause of liver failure in the US.

This is also a bit misleading, it’s the most common cause of acute liver failure which is overall quite rare in developed countries. The most common need for transplants are still by far progressive chronic liver diseases leading to cirrhosis.

epcoa··on A monopoly ISP refuses to fix upstream infrastructure
It’s AT&T not ATNT. You could have just said it outright, what is the point of the obscurity? It’s not funny if that’s what you were going for.
epcoa··on The Sega Master System
Probably a little nostalgia. The SMS sound chip is one of the cheapest and most primitive jellybean sound chip of the era (only 3 square waves, noise and no envelope generator either). That isn’t to say appreciating the art of doing more with less isn’t valid. It’s sort of like a MS Paint type of thing though.
epcoa··on Using AI to negotiate a $195k hospital bill down to $33k
HSAs are triple tax advantaged retirement accounts. Not taxed on contribution, gains, or withdrawals for qualified expenses. In the worst case it becomes like a pretax IRA because after age 65 you will not pay a penalty on non qualified expenses - but qualified expenses tend to increase with age. For many it should be their primary retirement account. Even for people with certain chronic conditions (not in perfect health), depending on how good/expensive the PPO offered by the employer, it might still work out better to do HDHP/HSA. You can get as many basically free HSA accounts from Fidelity.

An FSA really has nothing to do with an HSA.

epcoa··on Comparing the power consumption of a 30 year old refrigerator to a new one
Nah, dishwashers are pretty light too. With a muscle mass of 1% I usually just flip it over to work on it. This is just peak HN, PhDs still phased by something requiring an 8th grade level of education. In the US, the supply is usually a screw on, the drain a clamp and if the wiring isn’t already a quick connect just throw some Wagos on.
epcoa··on Ultrasound is ushering a new era of surgery-free cancer treatment
> People also don't want (their loved ones) to suffer, especially needlessly.

You might be very surprised how family actions very often are not consistent with this supposed desire. 98 year olds in the hospital with multiple end stage illnesses - full code, happens all the time. Ask any healthcare worker in the US, pretty classic the elderly rotting away in a nursing home, rarely visited, then they get admitted and their healthcare proxy wants “everything done”. Often seems to be a reflection of their own guilt. Sometimes it’s just poor healthcare literacy.

But no, regardless of what you think these people may

> In the US, exactly because of situations like this, that sort of thing is a lot harder today to pull off.

This is basically false. Most large systems have comfort care order set, with opioid drips. Transition to hospice is readily available. Usually the barrier to these are patients themselves or their families.

Also even the US, the principle of double effect prevails in palliative care.

epcoa··on GNU Health
One example was already given. Epic dates back to 1979, certainly they were doing something prior to 2009 (as was Cerner and Meditech). Other than HITECH, what other major regulation in the US are you referring to?

https://international.kaiserpermanente.org/wp-content/upload...

Both UPMC and Cleveland Clinic were early adopters around 2001. Meditech has been partnered with HCA since 1994.

epcoa··on GNU Health
I dunno, QuadraMed that was used by at least NYC H&H for years before their imperiled transition to Epic prominently displayed “Revenue Cycle Management” on the splash screen of its decrepit provider facing frontend.

Both of you are overstating your cases. That said, it’s hard to overstate how heavily charge capture and billing are prioritized to the detriment of other aspects.

> I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source.

There were major EHR deployments in the 80s through early 00s, before most government mandates. Surely later mandates were an incentive This reflects a lack of tenure.

epcoa··on The <output> Tag
What does SHTML stand for?
epcoa··on Ryanair flight landed at Manchester airport with six minutes of fuel left
How? On descent you can trade some of your altitude (potential energy) for kinetic energy, but then you can’t land the plane. For descent on an approach you’re going from low energy to even lower energy. In emergencies and with enough runway you can futz around with this some, but wiggle room on an airliner is not great, negligible to what will be expended on a go around.
epcoa··on Demand for human radiologists is at an all-time high
Maybe I’m misunderstanding what you’re calculating, but this math seems wildly off. Sincerely don’t understand an alternate numerical point being made.

> Given a 16-bit, 512 x 512 x 100 slice CT scan, you're looking at 2^16 * 26214400

65536^(512*512) or 65536 multiplied by itself 262144 times for each image. An enormous number. Whether or not assume replacement (duplicates) is moot.

> That's 100 * 26214400 = 262,440,000

There are 100^(512*512) 512x512 100-level grayscale images alone or 100 to the 262144 power - 100 multiplied 262144 times. Again how you paring down a massive combinatoric space to a reasonable 262 mil?

epcoa··on Death rates rose in hospital ERs after private equity firms took over
https://pubmed.ncbi.nlm.nih.gov/28060228/

MI, HF, sepsis, pneumonia, respiratory failure are among the most common reasons for inpatient admission, not fringe.

Equating acute decompensation of chronic illnesses requiring inpatient admission to "knocking on death's door" is a bit simplistic.

No data has been provided showing how the relevance of outcomes based on institution of first presentation (not definitive management) for breast cancer, that is usually managed outpatient on an elective basis, has anything to do with outcomes for the "overwhelming majority of things people to go to the hospital for".

Even pre-pandemic the life expectancy of Hispanics was not as high as billionaires. Speaking of "deaths door" perhaps at least QALY, or something else is a more appropriate metric.

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