epcoa

Malpractice insurance tends to exclude the diabetic retinopathy one too.. the vendor has to provide insurance.

Maybe I should have said 5%. 90% was a made up threshold. How close are we to even a basic “level 5”, ED doc puts in order for indication: “concern for sepsis, lol”, rad tech does their thing and a finished read appears, with no additional human involved except for maybe a review but not even 50% of the time is any addendum needed.

For real though how close are we to a product that takes an order for an ED or inpatient CT A/P, protocols it then reads the images and can read the chart and spits out a dictated report without any human intervention that ends up usable as is even 90% of the time.

"can competently treat cancer, they can certainly treat the overwhelming majority of reasons"

No this claim, just because, is not weight-bearing. Extraordinary claims require extraordinary evidence. And I don't understand the motivation to make such a tenuous link when at a bare minimum one can look up direct data like joint commision and MPSMS safety data and related publications. There is tremendous variability in serious hospital safety events inter-institution for bread and butter admissions. One can further just examine CMS and NHS data for mortality and readmission for "mundane" MI, HF, sepsis, pneumonia, respiratory failure. OB/GYN outcomes are their own thing.

The flaw in reasoning here is that quality of care and outcomes is strongly related to the simplicity of diagnosis. A further flaw is the belief that care is "commoditized". Treatment protocols vary widely across institutions and health systems, often times based on cost factors. Certain basic things can not be done at night, or even the day for fully accredited hospitals. There's a big difference somewhere with 24 hour anesthesia airway and in-house surgery and not just an intensivist "on call" 600 miles away and staff that can't even do RSI. Transfer is not always an option, there's a reason critically ill people die more frequently in the sticks. If one is admitted to a regional hospital, they are unlikely to be accepted for transfer to a safer hospital unless they truly need an intervention that absolutely cannot be provided where they are, not simply because there is better backup provider support and a higher standard of safety. They will still remain at that higher risk for sepsis, or outdated care because the community physician group doesn't keep up with guidelines, or that hospital only offers the inferior treatment (or a limited formulary) for cost-cutting reasons.

Breast cancer and most cancers are not even typical inpatient encounters. Breast cancer is generally not managed on an inpatient basis, in fact one may never even have to visit an inpatient hospital campus for breast cancer. Upgrades for cancer are usually different than acute inpatient care. Breast cancer does not usually involve abdominal, intrathoracic or orthopedic surgery. Breast cancer does not usually involve advanced interventions like endarterectomy, ECMO. Cancer is a special case. Regardless of complexity, extrapolating cancer treatment to even the most "mundane" acute inpatient or surgical care really is beyond ridiculous.

This is a complex subject and this is a silly hot take.

Two registry cohort papers on breast cancer outcomes, one only in Los Angeles county "provide extensive evidence for my claims"

The claim: For the overwhelming majority of things people to go to the hospital for, where you go doesn't really matter.

You win, as always.

https://news.ycombinator.com/item?id=45199654

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EDIT: tl;dr

Two registry cohort papers on breast cancer outcomes, one only in Los Angeles county "provide extensive evidence for my claim"

The claim: For the overwhelming majority of things people to go to the hospital for, where you go doesn't really matter.

Ok, whatever.

Near field Teledildonics

That’s a C++ URL parser library, has nothing to do with the programming language.

Zig’s undefined behavior story is not nearly as much of a minefield for one. That should be enough really. If you think the CPP is good enough for metaprogramming, I don’t know what to tell you either.

Well to bring this back to the original question: "What are these other ways?", how does GCA not qualify?

HPV is approved up to age 45 with “shared clinical decision making”. Above age 26 it may be more difficult without a clinician due to unimportant bullshit. Try a Planned Parenthood.

Maybe try Planned Parenthood, they do stuff like this.

> and you can (and doubtless will) argue

Why so much aggression? I’ll accept those results as presented. I’ll concede a lot of the reviews are junk.

There’s also no argument against aggressive eradication efforts for HPV.

Though it does seem like in some parts of the world the incidence of truly HPV independent adenocarcinoma like GAS is substantially higher than global averages.

This has nothing to do with "liking" or appeals to emotion. The fact is that paper does not have a control and the methods are not sophisticated enough to determine causation.

"The other citation from the second link seems to be a paper which doesn't say 3% it say". Yes it does dude. You need to read the actual results from the paper more carefully: "Overall, 340/350 cases of primary cervical cancer confirmed by surgical staging tested HC2 positive (97.2%)." Ie 2.8% (~3%) were considered true HPV negative by this testing.

They're going from 8.8% (in that particular admitted biased dataset) to still 2.8%, the wording of the conclusion is wonky, but the results of the paper are overall consistent. You're taking that quote out of context.

In that same paper it says: "Our results are in accordance with The Cancer Genome Atlas Research Network (CGARN) ‘Integrated Genomic and Molecular Characterization of Cervical Cancer Study’, which used next-generation sequencing to characterize primary cervical cancers. The CGARN study found 95% of primary cervical cancers were HPV-positive and 5% HPV-negative."

Which is one of the primary sources for the 5% figure.

https://pmc.ncbi.nlm.nih.gov/articles/PMC5354998/

In any case these are both order of magnitude more than 0.3%

I'll agree 8% worldwide is high (though since environmental factors and genetics both play a role in both HPV-positive and negative cases), these incidences can vary throughout the world or within certain subgroups, and if you manage those groups that matters.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11075765/

GAS is a clearly known cervical adenocarcinoma not related to HPV, and it accounts for 20% of all cervical adenoca in Japan, which overall places it close to 5% of all cervical cancer diagnoses there, just for this subtype.

> Crucially we can assume that if you don't get infected with HPV this wouldn't happen. So HPV was still causal.

Nope. This is literally “correlation does not equal causation” 101. Based on the 0.3% I’m gonna guess you’re (either directly or indirectly) citing a famous, 1999 paper in J Pathology (Walboomers et al). It’s outdated, missing a control *, and it’s pretty well accepted that just finding a bystander HPV DNA fragment around somewhere is not conclusive of causality. We have much more sophisticated assays of gene expression. Try looking for review articles in the last 3 to 4 years rather than 30, the prevalence of truly HPV independent cervical cancer is not precisely characterized but it’s almost certain much greater than 0.3%.

https://www.mdpi.com/2076-0817/14/7/668

https://journals.lww.com/md-journal/fulltext/2024/10110/rese.... (3% to 8%)

> as a sibling commenter writes, well-studied cases of this are so rare that

And yet not a single cite in sight. A random commenter on orange site is not evidence

However I know the paper they are referring to - it is from 1999 in J Pathology, famous at the time, and it is woefully out of date.

> they’re below our sensitivity of detection/technical error rates.

Hogwash.

https://www.mdpi.com/2076-0817/14/7/668

> There are ways to do this, and, should they be attained, would be published in a reputable journal based on their novelty.

There are plenty of papers on HPV independent cervical cancer based on actual gene expression methods published in reputable journals in the last 30 years.

This does not question all knowledge. Bacteremia and cardiac disease have been linked for years (see upvoted comment above), which is why these studies were done in the first place. This study isn't ground breaking, it's extending an already established area of study.

Furthermore, while there are issues of misaligned incentives across the industry, of the top 10 pharma companies: Roche, AstraZeneca, Bayer, Novartis, Sanofi, Novo Nordisk, GSK, are all based in Europe, so your assertion further down makes no sense.

Spontaneous mutations? Which no matter how much you carve out modifiable risk factors will always be a thing. At least 5% of cervical cancers are HPV negative, so it's not even all the uncommon (not I would call "vast, vast" IMHO)

POSIX AIO on “Linux” is implemented in glibc with userland threads using regular blocking syscalls behind the scenes. It basically works properly, it just doesn’t gain any potential efficiency benefits, it adds avoidable overhead, prone to priority inversion, etc. The linux kernel has no provision for POSIX AIO.

Until io_uring the only asynchronous disk IO interface was the io_* syscalls, which were confusingly referred to as Asynchronous IO, though these have nothing to do with POSIX AIO and can only be used bypassing the page cache, and suck for general purpose use.

> But it's worth noting pthread_cancel() is also rarely supported anywhere outside first-class pthreads-capable systems like modern linux

Having written some of the implementation for a non x86 commercial Unix well over 30 years ago now (yeah, I know), pthread_cancel is not that rare. A carve out like “modern linux” is io_uring or even inotify and epoll. AIX and HP-UX, fuck even OSF/1 had pthread_cancel.

Windows has TerminateThread. Most RTOS have some kind of thread level task killing interface.

While they have different semantics than pthread_cancel, that doesn’t really affect the example you’re giving - they can all be used for the “cpu-bound worker”

It wasn’t even discovered until 1997, so no that wasn’t exactly early in the Pentium lifecycle at all. There were multiple models and millions of devices affected.

It does not stress the liver at recommended doses. Plenty of people get frequent headaches and other aches that have no other severe stuff going on, or really anything that needs to be treated more than symptomatically. Scheduled tylenol is an effective element of a pain regimen for many people.

Tylenol itself is not toxic to the liver, the metabolite of glucuronidation is what is toxic. Which means paradoxically impaired liver function can actually reduce the effective toxicity of Tylenol.

Without chronic ingestion of medications that compete for glucuronidation or certain CYP450 inducers like antiepileptics, FOUR GRAMS even as a single dose is virtually impossible to cause any harm.

One gram every 2 hours is 12 grams which is on the lower end of toxic doses.

Despite common belief, concurrent alcohol consumption surprisingly does not increase risk, since alcohol competes for CYP2E1 and reduces the rate of production of the toxic metabolite NAPQI. Similarly for chronic liver disease. The use of NSAIDS (ibuprofen, etc) with cirrhosis is absolutely less safe than tylenol at therapeutic doses.

The person you're replying to never claimed otherwise. However, while decision support is not directly steering and accelerating/braking the car, I am just going to assert it is still driving the car, at least for how it actually matters in this discussion. And the best estimate is that these interventions are "uncommon" on the order of 10ks miles, but that isn't rare.

A system that requires a "higher level" handler is not full self driving.

Mass produced dual layer DVDs came out early on around late 1997 (maybe confusing with DVD recordable?), it’s not like the spec changed. There were some low cost distributors that couldn’t afford the equipment but the majors were stamping early on.

Besides unlike the one hour max on an LD, a 120 minute movie will fit on a single side single layer, so most early movie releases would fit on a single side single layer (the quality did suffer).

More commonly in the early days the dual side was to provide a pan and scan and letterbox option or extras.

There are so called “flippers”, but they weren’t that common.

An LD is 1 hour max so you are almost always flipping for any feature length.

> Despite the smaller total numbers in Mastadon, it's great to see that the ecosystem seems to be successfully avoiding centralization

But since essentially no one is using it doesn’t suggest much avoidance of centralization. These factors are not independent. It’s pretty easy to avoid anything when your total user count is a rounding error compared to the alternatives.

Because it is way more dangerous. Guaranteed liver damage is nonsense. Aspirin and other non selective NSAIDs are much more likely to cause GI bleeding, kidney and heart problems.

An aspirin here or there is probably fine but multiple day dosing of full dose aspirin for chronic pain has gotten a lot of middle age people to bleed out their GI tract and end up dead.