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khed

98 karma · joined June 23, 2015

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khed··on Mobilizing an ER department to handle a mass casualty incident
Interestingly, there was a recent study that indicated for penetrating trauma the patient had a much higher survival rate if they were taken to the ER by private car compared with waiting for EMS transport. Presumably because you are less likely to waste that golden hour.
khed··on Mobilizing an ER department to handle a mass casualty incident
This is not correct.

https://en.wikipedia.org/wiki/Triage#Conventional_classifica...

khed··on Mobilizing an ER department to handle a mass casualty incident
There are a couple reasons why he might do this that I can think of.

1). He didn't know how many people were going to come in or how serious they would be. Triage in MCI does depend to a certain degree on what your facility is capable of and the expected volume and status of patients. If he underestimated the volume or criticality of the patients about to come in he might have put more into the red pod than he would have otherwise. Underestimating seems plausible in this case because this was the worst mass shooting in history in the US.

2). Medicolegally he might have a fear that he would be judged harshly if he didn't automatically try to save everyone.

khed··on Mobilizing an ER department to handle a mass casualty incident
This is not my understanding of how to triage in MCI. ATLS definitely does teach the importance of deprioritizing people that will be hard or impossible to resuscitate in favor of prioritizing people that leads to a roughly utilitarian greatest good.

That said, I have never heard "black tag = not breathing = don't try to help"[1]. I know for a fact that the boundary for who to try to save immediately and who to deprioritize is very grey in many cases (it is why you should have an experienced doctor doing it). A common example why that equivalency is not taught in ATLS is the case of a boat capsizing in frozen waters. There may be many frozen victims who are not breathing but could still be very salvageable medically. If you chose to not help those who are not breathing in that case you would plausibly be found negligent without some extraordinary situation to justify yourself with.

Another example would be mass overdose on fentanyl, many are saveable but none would be breathing when you first see them.

1. https://en.wikipedia.org/wiki/Triage#Conventional_classifica...

khed··on Librem 5 Phone Funded
Thanks for the PDF :)

If matrix moved toward pond style metadata protection I would make the effort to move my social graph on to it and probably support it financially.

As is, I don't see the value proposition of matrix. I am genuinely curious what it is. An update to xmpp? Is it that it is going to be encrypted AND federated? Many popular apps now support default encryption so that isn't much of a selling point. Conversations is federated and is not getting traction the way signal has. Being federated has benefits but they are sort of theoretical and aren't high on most people's list of concerns. Further the value proposition of federated systems is attenuated by it's downsides (slow evolution).

Meanwhile people get killed based on metadata. Seems like a more urgent problem to tackle.

khed··on Librem 5 Phone Funded
I am excited for the phone but I don't get having matrix as the messaging app. I don't see the value in matrix. Encryption is not on by default, which is unacceptable in a modern messaging app. It leaks metadata like a seive. None of my friends or co-workers on it. It isn't decentralized enough.

They should just use briar. It hides metadata, it's encrypted, it's peer to peer. It's biggest downsides are no file transfer, no iOS client, no offline messaging.

Or better yet someone should develop an app based on one of the newer concepts like vuvuzela/alpenhorn or loopix.

khed··on Tesla Model 3 is equipped with a driver-facing camera
I cancelled my model 3 reservation over this. I found it very sleazy this wasn't mentioned in the official reveal.
khed··on Extreme side-effects of antidepressants
Do you have a citation for your claims? Specifically that low serotonin levels CAUSE depression in humans?
khed··on Extreme side-effects of antidepressants
I also was diagnosed with ADHD and took Ritalin then Adderall for years. I stopped taking them in medical school and actually got better grades.

Regardless of my personal experience or your personal experience the evidence does not show that stimulants increase grades in the medium or long term.

khed··on Extreme side-effects of antidepressants
SSRIs don't have clinically relevant effects. The following study is a review article. It cites most of the meta analysis the are relevant.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/?report...

I am still trying to find the studies that indicate that stimulants might increase high school drop out. But there is pretty clear consensus that they don't increase grades over the long term.

https://www.nber.org/papers/w19105

khed··on Extreme side-effects of antidepressants
This is an excellent comment and reflects the current state of research.

There is good evidence for the efficacy of ketamine in treatment resistant depression.

The psychedelics are not well studied.

SSRIs are not useful and may be harmful.

ECT works but causes amnesia.

Most depression gets better on its own.

khed··on Extreme side-effects of antidepressants
There is no evidence for the chemical imbalance hypothesis. Your friend anecdotal evidence is contradicted by a large body of emprical research. For a good overview of the evidence on SSRIs on depression I would recommend the article "antidepressants and the placebo effect". https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/?report...
khed··on Extreme side-effects of antidepressants
There is no well done study I have heard of that supports your position. In general SSRIs have an effect size that is so low it is not clinically relevant. There are multiple meta analyses that demonstrate that.
khed··on Extreme side-effects of antidepressants
I am a physician with training in neuroscience. There is no scientific consensus that stimulants help the problems you are talking about. There is some preliminary evidence that stimulants may make some problems worse (graduation rates).
khed··on Extreme side-effects of antidepressants
You are over stating the case for what stimulants can do in ADHD. They probably do make kids more docile. They do not improve grades over a meaningful time span. They do not improve broad and important outcomes like graduation rate (there is some evidence that ADHD kids on stimulants have lower graduation rates than ADHD KIDS that aren't medicated), increase earnings, or decrease chance of going to prison.
khed··on Extreme side-effects of antidepressants
They are almost all placebo response. The real effect is so small it's probably not useful clinically. They also cause suicidal ideation and sexual dysfunction is a large minority of patients.
khed··on Extreme side-effects of antidepressants
I am a practicing physician with 2 years of graduate level course work in neuroscience.

Point 3 and 4 are wrong. There is no evidence that SSRIs work by fixing a chemical imbalance.

There are multiple metananlyses in top tier journals that indicate that SSRIs have an irrelevant clinical effect. SSRIs are almost all placebo with the downside of causing serious side effects. The small effect that isn't due to placebo is probably not clinically relevant.

The only cogent defense of SSRIs I have read is http://slatestarcodex.com/2014/07/07/ssris-much-more-than-yo.... The author is a practicing psychiatrist. The main disagreement he has with the large metaanalyses is that even though the effect size is small it's better than nothing.

khed··on The quantum computing era is coming fast
Or an even bigger prize for keeping it secret. If you could break asymmetric encryption at will you could plunder much bigger prizes than Satoshi's coins.
khed··on The quantum computing era is coming fast
I don't see where in that thread it indicates Rose gave a false impression.
khed··on The quantum computing era is coming fast
I am not so sure. I don't understand work well but there have been a couple papers saying they can get a quantum speed up on factorizing using adiabatic quantum computers [1]. Further, Geordie Rise himself said that they have an algorithm that can run on a dwave system that can beat shors algorithm [2]. A more skeptical take is here [3].

[1]. http://www.diva-portal.org/smash/get/diva2:680572/FULLTEXT01...

[2]. https://dwave.wordpress.com/2011/05/11/learning-to-program-t...

[3]. https://www.newscientist.com/article/dn21699-controversial-q...

khed··on Google Deceptively Tracks Students’ Internet Browsing, EFF Says in FTC Complaint
Can they? I am not convinced that most (any?) adults can give informed consent for any of these datamining services.
khed··on When I stopped hearing the voices in my head
This is a nice overview. https://www.ncbi.nlm.nih.gov/pubmed/23512950
khed··on When I stopped hearing the voices in my head
I am a physician. The few studies comparing long term antipsychotic use in schizophrenia have found that people do better with low/no medication. They are more functional, have fewer relapses and better quality of life. This is still a controversial view in psychiatry but the tide may be turning. Thomas Insel, the head of the NIMH, has stated

"antipsychotic medication, which seemed so important in the early phase of psychosis, appeared to worsen prospects for recovery over the long-term" in reference to these studies.

khed··on When I stopped hearing the voices in my head
It should be noted that studies looking at normal vs no/reduced antipsychotic therapy in patients with psychotic dieases have indicated that in the long term patients may do significantly better without antipsychotic therapy.

https://www.ncbi.nlm.nih.gov/pubmed/23824214 http://www.nimh.nih.gov/about/director/2013/antipsychotics-t...

khed··on Edward Snowden and spread of encryption blamed after Paris terror attacks
How often do you think a politicians campaign platform represents their actual intentions. You should read about the project for a new american century.

https://en.wikipedia.org/wiki/Project_for_the_New_American_C...

10 of 25 signing members of PNAC were high level bush administration workers. PNAC was explicitly neoconservative and most definitely wanted to be involved in more wars abroad.

khed··on Tor Wars: The Signal Awakens
This is my normal mode of operation :) I use it on my phone, desktop, and laptop for pretty much everything.
khed··on A Way to Detect Bias
Even if it were a statistically appropriate sample size and female founders still out performed male founders it still wouldn't exlcude other likely explanations other than bias. What if the culture in venture capital is more willing to assist and mentor female founders leading to greater success? In academia there is a women are selected over equally qualified men 2:1 for tenure positions now [1]. It is not unreasonable to wonder if a similiar hand up is being given to female founders in terms of training, social network inclusion, and mentorship leading to greater success.

Alternatively, there may be a selection process in society that means only the most motivated women become entrepeneurs and so beat the average male entrepeneur.

[1]. http://www.pnas.org/content/early/2015/04/08/1418878112.abst...

khed··on Tor Messenger Beta: Chat Over Tor, Easily
Ricochet is great :) Very easy to use. Unfortunately, it will be very difficult if not impossible to make it support group chat.
khed··on Tor Messenger Beta: Chat Over Tor, Easily
Bitmessage hides the metadata by sending a given message from one person to another person to everyone in the network (it obviously has scaling problems!). Because everyone gets every message you can't really see the metadata.

I2p-bote routes the messages through multiple intermediaries with layered encryption so that no intermediary knows both the ultimate sender or ultimate recipient.

Pond works by running servers over tor (a mixnet). When you send a message it doesn't go to the server you have service through it goes directly to the recipients server.

Ricochet sets up your own server on tor that you are hosting.

There is also Pir-Tor. It attempts anonymity by using the secure multiparty communication combined with PIR to attain provable anonymity.

khed··on Tor Messenger Beta: Chat Over Tor, Easily
I don't think the protocols are that similar. Bitmessage is a "eveyone gets every message sent by anyone" type of situation. Bote is a mixnetwork with a dht cache. Ricochet is also built on a mix network but with out a dht cache. Pond uses servers.
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