Hacker News Reader

oaktrouton Anki ownership transferred to AnkiHub

At one time I had more than 20,000 cards that I had >85% recall on after 21 days... Hard to do that without the digital version.

oaktrouton Anki ownership transferred to AnkiHub

I'm hopeful this new company wont ruin anki, but assuming they do, how do I find the "new anki" fork and how do I contribute.

Is there a community / anki forum that hasn't been acquired?

oaktrouton CT scans could cause 5% of cancers, study finds; experts note uncertainty

By age 50, around 80% of people have a degenerative disc on imaging... it's over 1/3rd by age 20.

Everyone is going to get a bad back at some point if they don't take care of themselves.

"Eat right and exercise " is very generic advice, but it's cheaper than an MRI and will prevent more disease.

oaktrouton Utah becomes first US state to ban fluoride in its water

I'm skimming the results, but it looks like adult teeth had less cavities when they turned the fluoride off...and that was not observed in Edmonton where they left the fluoride on the whole time.

"For all tooth surfaces among permanent teeth (Table 1a), there was a statistically significant decrease in Calgary, for the overall mean DMFS, which was not observed in Edmonton."

Based on their data, you could argue that fluoride increases cavities in adults... I'm not making that argument. I agree with you in that I think confounders are at play and the difference attributed to fluorinated water isn't as large.

People will use this study to take about the rampant tooth decay in Calgary, ignoring that there is roughly as much decay in Edmonton which had the fluoride on the whole time.

oaktrouton Utah becomes first US state to ban fluoride in its water

My first sentence in my original post was " The conclusion from the largest and strongest studies is that there is a certain level of fluoride that harms IQ." I did not move the goal posts from there.

I was replying to a comment that said "fluoride in the drinking water concentrations is proven safe" (there is actually no proof of this).

I never claimed that all fluoride levels harm IQ.

It's great that the US recommends that fluoride doesn't exceed levels that are proven to harm children's IQ, instead they only recommend levels for which there is "insufficient data".

I suppose we will ignore the people who are still drinking water with levels above what is known to be harmful.

oaktrouton Utah becomes first US state to ban fluoride in its water

"The NTP monograph concluded, with moderate confidence, that higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liter, are associated with lower IQ in children".

They found drinking water with levels that lowered IQ. The actual conclusion was that higher levels (that were found in drinking water) lower IQ.

For lower levels the conclusion is we don't know how it effects IQ. The actual bold face conclusion is "More research is needed to better understand if there are health risks associated with low fluoride exposures".

oaktrouton Utah becomes first US state to ban fluoride in its water

All the evidence in that article is based on what a politician thinks. "And I think another meta study came out also".

The actual high quality evidence shows that water fluorination has minimal impact on tooth health in 2025: https://www.cochrane.org/news/water-fluoridation-less-effect...

oaktrouton Utah becomes first US state to ban fluoride in its water

Fluorinated water minimally reduces cavities: https://www.cochrane.org/news/water-fluoridation-less-effect...

It was probably much more effective 50 years ago when fluoride was not in everyone's toothpaste.

oaktrouton Utah becomes first US state to ban fluoride in its water

Before calling them "anti science wackos", why not review the evidence or cite some of your own. Ironic that the "wackos" seem to be the only ones providing any evidence for their claims.

There is high quality evidence that fluoride at levels contained in some US water supplies is associated with lower childhood intelligence. For lower levels, the conclusion is "we don't know", not that there is no harm.

https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/...

There is also high quality evidence that in the age of fluorinated toothpaste, fluorinated water "may slightly" improve dental health.

“The evidence suggests that water fluoridation may slightly reduce tooth decay in children,” says co-author Dr Lucy O’Malley, Senior Lecturer in Health Services Research at the University of Manchester. “Given that the benefit has reduced over time, before introducing a new fluoridation scheme, careful thought needs to be given to costs, acceptability, feasibility and ongoing monitoring."

https://www.cochrane.org/news/water-fluoridation-less-effect...

oaktrouton Utah becomes first US state to ban fluoride in its water

The study and my quote literally say " drinking water containing more than 1.5 milligrams of fluoride per liter".

It did not find it lowered IQ in all drinking water concentrations, but it definitely found it in some drinking water concentrations.

So yes, they did explicitly find fluoride in drinking water at certain concentrations was associated with lower IQ.

Are you defining "drinking water concentrations" as "concentrations that have not been shown to be associated with lower IQ."?

oaktrouton Utah becomes first US state to ban fluoride in its water

Please define appropriate levels and then cite some evidence that proves with high certainty that level is safe.

For the sake of argument, assume that only 1% of the US has levels that harm IQ. Would it not be worth it to remove fluoride from the water to improve the intelligence of 1% of the population? Especially when you consider we can get fluoride from toothpaste?

oaktrouton Utah becomes first US state to ban fluoride in its water

The conclusion from the largest and strongest studyies is that there is a certain level of fluoride that harms IQ: https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/....

They found fluoride in drinking water concentrations was associated with lower IQ, the opposite of your claim of "proven safe".

Show us some evidence that is proven safe, so far as I can tell all evidence points to unsafe or "we're not sure".

> What needs to stop happening is people ignoring objective reality just because the results happen to align with the other "team's" position on something.

I couldn't agree more. The study that is cited above started when Obama was president by the way.

oaktrouton The legacy of lies in Alzheimer's science

To emphasize your point, I don't think anyone will notice if someone's alzheimers is 2.3% better.

These rating scales like CDR-SB (invented by drug companies or researchers who are funded by drug companies) are very good at making the tiniest improvement sound significant.

oaktrouton The legacy of lies in Alzheimer's science

From what I've read, those drugs are very good at removing amyloid, but despite that, they don't seem to make much of a noticeable (clinically meaningful) difference in the people treated with them. I personally would not call that a "huge success".

If they are so good at cleaning up the amyloid, why don't people have more of an improvement? I think everyone agrees amyloid is associated with Alzheimer's, the question is how much of a causative role does it play.

oaktrouton FDA approves a CRISPR-based medicine for treatment of sickle cell disease

There is some evidence that artificial sweeteners increase insulin resistance: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014832/

I have also heard that because artificial sweeteners increase insulin levels without increasing blood glucose to the same extent that sugars would, this leads to a blood sugar drop which induces increased eating.

oaktrouton Why doctors in America earn so much

On some quick googling the mean debt at graduation from medical school is about 250,000 (this includes undergrad). This number is trending upward. There is also the opportunity cost of 4 years additional school and 3-7 years of getting paid 60-70k.

Most doctors end up making between 265k and 382k per year, this varies wildly (from pediatrician on the low end to brain surgeon on the high end).

Here is a good article: https://www.whitecoatinvestor.com/how-much-do-doctors-make/

oaktrouton Why doctors in America earn so much

There was rampant expansion of emergency medicine residency spots in the prior years without an associated increase in demand for new EM docs. People noticed the market there and chose to go elsewhere. Also, the unfilled positions are also the low quality ones where your education would be questionable (linked article mentions corporate owned which imo is a red flag).

oaktrouton Your computer should say what you tell it to say

Or written with help from chat gtp, I've seen it hallucinate similar mistakes before.

oaktrouton Mortality patterns for patients hospitalized during cardiology meetings (2016)

A 2018 article by the same author with a similar theme: https://www.ahajournals.org/doi/10.1161/jaha.117.008230

Interestingly, there were no differences in the number of procedures performed on meeting and nonmeeting days (it's not the surgeries that are killing people).

The hypothesis that I find most interesting is that the cardiologists who are at the meetings spend less time caring for patients and more time doing research, hence they aren't as good at caring for patients.

oaktrouton Mortality patterns for patients hospitalized during cardiology meetings (2016)

As an argument to illustrate why 30 day mortality isnt a long enough period, imagine this scenario: you have a cancer that has a 90% chance of killing you in one year. You will be cured if you get the surgery tomorrow, but the surgery has a 30% mortality rate. In one month, 30% or those who got the surgery will die, where all those who didn't get the surgery will still be alive. In one year, 70% of those who got the surgery live, whereas only 10% who didn't get the surgery are alive.

oaktrouton I am dying of squamous cell carcinoma, and potential treatments are out of reach

Hopefully he makes it into a clinical trial. In case anyone is interested in reading what trial options are available for this type of cancer you can find the trials here: https://www.clinicaltrials.gov/search?cond=Squamous%20Cell%2...

oaktrouton Gene linked to long Covid found in analysis of thousands of patients

Also a law that could change at any minute.

oaktrouton Gene linked to long Covid found in analysis of thousands of patients

Probably no relevance to the topic at hand. This research applies only to the documented SNP.

Unrelated, you may have some increased risk for prostate cancer: https://www.snpedia.com/index.php/Rs1983891

oaktrouton TV doctors say annual checkups save lives – real doctors call bullshit (2016)

"This is just boldly incorrect and a VERY dangerous statement to make."

I couldn't agree more. I worry that individuals will read things like the grandparents uninformed take on hypertension and conclude "I guess I don't need to worry about my blood pressure". Be careful what medical knowledge you take away from HN. Imagine forming opinions about software engineering practices by reading a forum filled with medical doctors.

oaktrouton 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

Presumably, but if half your customers pay you just above your costs and the other half pays half that, which half is responsible for your business going bankrupt? Probably both, but one half is clearly more of an issue than the other.

oaktrouton 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

I found it odd also, I was under the impression that hospitals made their money on private insurance and lost on medicare/Medicaid. I do recall hearing that rural hospitals are reimbursed at a higher rate from the government, perhaps that explains the discrepancy.

oaktrouton 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

The article is arguing that private payers don't reimburse rural hospitals enough, not that lack of medicaid or obamacare is an issue. Perhaps your premise is correct but it is at odds with the article, I would be interested in hearing more about why you disagree with the article.

From the article "The biggest problem facing small rural hospitals is inadequate payments from private health plans. Most “solutions” for rural hospitals have focused on increasing Medicare or Medicaid payments or expanding Medicaid eligibility due to a mistaken belief that most rural patients are insured by Medicare and Medicaid or are uninsured. In reality, about half of the services at the average rural hospital are delivered to patients with private insurance (both employer-sponsored insurance and Medicare Advantage plans). In most cases, the amounts these private plans pay, not Medicare or Medicaid payments, determine whether a rural hospital will have to close".

oaktrouton Ketamine no better than placebo at alleviating depression, unusual trial finds

Small correction, the active ingredient in Salvia is a kappa opioid agonist.

oaktrouton The “baseline” scene in bladerunner 2049 was written by Ryan Gosling (2022)

The designers of the androids do not want them to be detected as non-human and killed, hence they do not program in a debug function.

This is a major plot point in the book.