jsperx

Don’t mean to hijack this thread, but I don’t think HN has DMs. Read some of your comments and as a person with cancer would love to pick your brain a little to develop my mental model further (and of course wouldn’t expect anything for free.) Drop me a line at [my HN username] [at] nearby.org if open to discussing more. Thanks!

I was ready to quibble with whether a primary care doctor would have the most reliable statistics on this topic but I found this source, with linked study, that implies (s)he is dead on: https://www.aidsmap.com/about-hiv/estimated-hiv-risk-exposur...

(Also estimates chances for other risk profiles, including 0% for undetectable.)

Seems like you’ve got a good doc there

This article from the NIH reviewing three large studies across heterosexual, bisexual and homosexual couples says the science is clear:

https://www.nih.gov/news-events/news-releases/science-clear-...

The article has a couple paragraphs about the complexity involved in fabrication and how labor intensive it is:

“Maus walked me through some of the steps needed to create CAR-T cells for the trial. We started with the room where the DNA instructions that are added to the T cell’s genome are written. […] We went on to the lentiviral-production room, where technicians create viral vectors carrying this DNA. From there, we moved to the tissue-culture room, where the vector is mixed with normal T cells to create the CAR-T. Finally, we visited the immune-monitoring part of the lab, where lab techs assay blood draws and other samples from patients, looking for proof that the CAR-T cells have made it to their targets.”

“Jennifer Wargo, a professor of genomic medicine at MD Anderson, referred to the cost of immunotherapy treatments as ‘financial toxicity.’ The patent for June’s CAR-T therapy for leukemia is owned by Novartis, and the median cost for the treatment is $620,000. Even if drug companies don’t try to profit from these therapies, the process is inherently labor-intensive: T cells have to be removed from the patient’s own blood, genetically altered, then reinfused. It’s difficult to determine where economies of scale might kick in.”

Thank you for this, I have an extremely rare subtype of sarcoma and it’s been tough to a) find any research about it specifically and b) find high-quality resources about state of the art treatments and interventions that aren’t like, Facebook groups where people post wacky articles about homeopathic stuff or whatever.

Would love to hear about any more recommendations you or OP might have for good forums etc.

As somebody who unfortunately has a Stage IV diagnosis I have been researching mRNA and there have been promising results such as the MSK pancreatic study below, but still much to be ironed out — they had half the participants get a response but the other half nothing, even though each treatment was individually targeted and customized. They are doing a larger study now to try to see what other factors may be at play.

https://www.mskcc.org/news/can-mrna-vaccines-fight-pancreati...

Seems not…the AHA article quotes a Stanford PhD: “One of those details involves the nutrient quality of the diets typical of the different subsets of participants. Without this information, it cannot be determined if nutrient density might be an alternate explanation to the findings that currently focus on the window of time for eating. Second, it needs to be emphasized that categorization into the different windows of time-restricted eating was determined on the basis of just two days of dietary intake[.]”

I think the challenge is more coordinating the 8 people who will be a trusted part of your life long-term. Also they’d have to be sure to keep their fragments of the key intact through replacing devices, etc, no? Seems like just keeping a Yubikey in a safe deposit box would be simpler.

I just went through 6 cycles of 5-day IV chemotherapy (AIM) and I fasted for all of them, for a total of over 35 days of water-only fasting during the last 5 months. I can’t find the PubMed link right now but there were small studies that looked like healthy cells would go into kind of a suspend/preserve mode that lessened side effects, whereas cancer cells still experienced the intended cytotoxicity. I tolerated the treatments quite well, lost hair of course but only vomited twice during the whole time. Lost weight each time but was able to put it back on quickly during the following week for each cycle, though I do want to watch body composition (don’t want to trade muscle for fat).

Did it make a difference in effectiveness? I actually have my follow up scans tomorrow to find out. As you can imagine, I really really hope so.

https://news.usc.edu/29428/fasting-weakens-cancer-in-mice/

What specific regulations are you referring to, that apply to EHR software and the like? I know things sold as medical devices/appliances require FDA approval, but for general electronic healthcare record systems (e.g. Epic), what applies other than of course the security/privacy provisions of HIPAA?

Perhaps a data sources issue?

When I am communicating with accountants about this process the verb I use is “allocate”

I have never owned a mechanical keyboard but have been curious —- this design looks very sharp. I like the sleek heft of my MX Keys, this seems like it would be an upgrade. I do have a small quibble about the website though: the use of “Kailh©” with the copyright symbol. The name is trademarked, so could be written KAILH or Kailh® but never the ©.

There are long-acting (e.g. 8 weeks) injectable versions that are outperforming[1] the daily pill so that approach shows some promise. Not that anybody enjoys injections…

[1] https://www.hiv.gov/blog/long-acting-injectable-form-hiv-pre...

I believe (s)he meant an alternative to the InDesign rendering workflow that runs on Windows.

I work in healthcare IT and many times have heard an “I’m just a nurse” dodge, and I respond in just this fashion — “Good! Then you have just the skills needed. In fact you don’t even have to diagnose the problem, just document what you did, what happened, and how that differs from what you expected.” It works pretty well.

Musk said on an earnings call they expect to open the network up to other models by the end of this year.

https://electrek.co/2021/08/18/tesla-prepping-giant-supercha...

It will be interesting to see what opening up SuperChargers to non-Tesla vehicles is going to do for availability though. I often see the sites near me full or near-full as it is.

With respect, I just don’t understand this use case. You focus on 42 miles as being a lot of range for most cases, but exclude the ~300mi range BEV because it’s… not enough?

Less than 5% of daily trips are over 30mi [1]. One study found 70+ mi trips are barely 1% of journeys [2].

Also your example of LA-SF as an example of it being a real drag on time is instead perhaps the canonical best route, for Teslas at least. That’s the corridor between where they are manufactured and their largest market, SoCal. SuperChargers are plentiful, including the super fast 250 kW version that can do 1000mi/hr (when you are at low state of charge.) It also has in the PCH a beautiful view that you’ll want to stop and take in.

So there’s no way you’ll actually spend an hour out of your way, but if you do, why would that single hour actually be material, when the trip is less than 1% of your journeys? Why pick a PHEV for your edge cases?

Rent another car for that trip. Or take a flight (SF-LA fact: that’s also the busiest airline route in the country [3] by aircraft flown; second busiest by passengers moved)

I get the whole “I probably won’t, but I like knowing I could” sense of spontaneity but it just seems a waste to have two separate propulsion systems and the associated complexity just for that.

[1] https://nhts.ornl.gov/vehicle-trips [2] https://www.solarjourneyusa.com/EVdistanceAnalysis.php [3] https://en.m.wikipedia.org/wiki/List_of_busiest_passenger_ai...

Sounds like they do keep track and will invoke special modes if the gas is gonna go “stale”: https://www.cartalk.com/blogs/dear-car-talk/can-gasoline-go-...

I was so happy when I finally got cross-account roles working so I could use a nice drop down and seamlessly switch between my accounts. So cool!

Then I learned because they’re saving it all browser-side I had to rebuild the whole menu whenever I first used a new browser or computer? Whaaaat? Of all people, AWS console users have to be highly likely to be using multiple devices/browsers. Having to recreate your own prefs at each new environment is nuts.

With one giant caveat imho — I have a root account, an admin account, a common account (load balancer, database) and then customer-specific accounts. Was working great, using Terraform for consistency, sharing VPC where made sense, etc… until I had an issue and realized that my paid support plan only covered the root account. From what I understand you have to get a separate support plan, with a paid minimum ($100 per for business plan), for each account if you’re gonna need tech support, and you can’t pool until you’re in the $15K+ monthly spend: “AWS Support fees are calculated on a per-account basis for Business and Developer Support plans. For Enterprise Support, you are billed based on the aggregate monthly AWS charges for all your account IDs subscribed to Enterprise Support.”

Really soured me on the setup, tbh.

Yes, at least as of 4 months ago (when I got mine) Atlas was still offering a Delaware LLC with an operating agreement structured to make it easier to convert to a C Corp later.

I do this with VSCode Remote (SSH). It “feels” like a local binary but since you’re actually connected to in my case an EC2 VM (which transparently picks up IAM credentials in the instance metadata), when you run the terminal you can connect to all the resources in the VPC. It’s really convenient.

Thank you for putting this idea in my head! I’ve been trying to get better at expressing infrastructure as code, and one of the big blockers has been how adding new services to e.g. Terraform is tough when you don’t know all their permissions they need (see also https://github.com/hashicorp/terraform/issues/2834 for example).

Using a test AWS environment to stage and then checking CloudTrail to see what was actually called would be a step forward. Having software to extract it would be even better.

“Director-level IT” healthcare person here. We use AWS but are evaluating Azure because of the way Microsoft includes VDI in the form of Windows 10 Multi-Session licenses available only with Azure+Windows Virtual Desktop. Classic Microsoft bundle approach.

Oh, and Slack is available with HIPAA compliance — https://slack.com/help/articles/360020685594-slack-and-hipaa

Also, as someone who actively shops for SaaS offerings for healthcare users, I can say that AWS and Azure are some of the very, very few organizations who offer anything with HIPAA compliance that isn’t locked away at the most expensive “contact us for pricing” tier. It’s so annoying. Never a chance to try a service with a low cost/stakes pilot/prototype because they hit you with the full sales pitch and highest price points. Being able to dip our proverbial toe into AWS with a low time/dollar commitment was a huge win.

I thought the same!

Fascinating comment, thanks for sharing. If you had it all to do over again, knowing all this, would you have started a product business 19 years ago instead?

Could you explain a little more about how you define business automation consulting? I’m an IT generalist (manage an in-house department plus an outsourced vendor) and the cross-department automation (e.g. let’s remove this dumb paper process and connect these key systems via APIs) to create efficiencies is what I find most rewarding. Curious to know how much you specialize and how you find clients...

I thought the same thing. Also was interesting in Fig 2, where the map was wrong, it’s all driver-partner...yet in Fig 3, where it was an illegal turn, they conveniently drop the -partners.