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paviva

258 karma · joined November 19, 2015

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paviva··on The United States and Israel have launched a major attack on Iran
His French is so simple and yet, incredibly beautiful and elegant, in a way that I am not even able to express in words. Only Voltaire compares.

"tout le malheur des hommes vient d’une seule chose, qui est de ne savoir pas demeurer en repos, dans une chambre." -- "All the woe of man comes from one single thing only: not knowing how to remain at rest, in a room"

In the same text, he follows with:

"Le roi est environné de gens qui ne pensent qu’à divertir le roi, et à l’empêcher de penser à lui. Car il est malheureux, tout roi qu’il est, s’il y pense."

"The king is surrounded by people who think only of amusing the king and preventing him from thinking about himself. For he is unhappy, though he be king, if he thinks about it."

paviva··on Why are there so many rationalist cults?
Most likely Gide ("Croyez ceux qui cherchent la vérité, doutez de ceux qui la trouvent", "Believe those who seek Truth, doubt those who find it") and not Voltaire ;)

Voltaire was generally more subtle: "un bon mot ne prouve rien", a witty saying proves nothing, as he'd say.

paviva··on The first mass-produced DRAM of the Soviet Union
First symbol on the third line: https://upload.wikimedia.org/wikipedia/commons/d/d3/Basic_in...
paviva··on Ask HN: What are the best books you've ever read?
Permutation city, Greg Egan

Dictionnaire philosophique, Voltaire

The Road to Serfdom, Friedrich Hayek

The ICU Book, Paul Marino

paviva··on Launch HN: Aqua Voice (YC W24) – Voice-driven text editor
Great work, really hope you'll be able to pierce into the medical market eventually. Dragon is still useless to anyone who can touch type.
paviva··on Tea as Hepatoprotective Agent: A Revisit
It is rare, and is probably due to a combination of green tea and weight loss. However, the effects are catastrophic, and it worth pointing out before someone decides to use tea extracts to "protect" their liver.

There are more cases that appears through cursory review of the literature, as most go unreported/unpublished. I have seen one case myself, and the person barely survived.

paviva··on Tea as Hepatoprotective Agent: A Revisit
Beware that green tea supplements have been associated with very sever liver damage. Even though most survive, they often require prolonged intensive care, with attending complications, muscle wasting, etc.

Good reference here: https://www.ncbi.nlm.nih.gov/books/NBK547925/

paviva··on Beyond the keyboard: Fountain pen collectors find beauty in ink
The best pen is the humble Platinum Preppy, especially when converted to an eye-dropper https://www.gouletpens.com/collections/platinum-preppy-fount...).

I also strongly recommend using an iron gall ink (Platinum makes a few; another very good one is http://www.registrarsink.co.uk). Those inks are very easy to work with, even on the crappiest paper, and are quite resistant to UV, water, and other hasards.

paviva··on I accidentally discovered one of the most egregious pharma scams imaginable
Pharma and rich greedy doctors are an easy target, but reality is (always) more complicated.

Pyridoxine/doxylamine is nothing new, and was released in the USA in the fifties, and withdrawn from the market in the early eighties due to numerous (baseless) lawsuit alleging it caused birth defects. This formulation is known as Diclectin in Canada, where there were no lawsuits (and thus, no withdrawal), and it costs pennies.

The medication was reintroduced in the USA about 10 years ago as Diclegis by another manufacturer, and Bonjesta is essentially Dicglesis with improved pharmacokinetics (whether this matters clinically is another question).

It is interesting to note that Bonjesta is produced by Duchesnay USA, which is owned by the Canadian company Duchesnay, which markets Diclectin here in Canada. I suspect that no American company is willing to risk a lawsuit *even* at the current seemingly absurdly high pricing. Duchesnay USA is essentially a mono-pill company, and I imagine that the strategy is that they're willing to go under in case of a class action.

paviva··on How will a doctors profession change by tech in the next 10 years?
You're assuming that more data will reveal a hidden pattern, but the fact is that most data, and especially most of the easily collectable data is useless junk.
paviva··on How will a doctors profession change by tech in the next 10 years?
Unlikely.

Diagnosis is based on imperfect data with very high noise-to-signal ratio, and with auditory (patient's history), visual and tactile inputs. Treatment often need to be tailored for each patients unique needs, goals, and co-existing diseases.

paviva··on As professors struggle to recruit postdocs, calls for change in academia
I'm very interested about your research area. Can you divulge anything publicly here, or maybe shoot me an email (just put in my profile).

Thanks.

paviva··on Nuanced communication usually doesn't work at scale
The quote is from Pascal: "Je n'ai fait celle-ci plus longue que parce que je n'ai pas eu le loisir de la faire plus courte", "I made this one [the letter] longer, since I didn't have the leisure to make it shorter".
paviva··on Alternative statistical method could improve clinical trials
Garbage statistics will not get better if you insist on some arbitrary fragility index threshold (and no accepted threshold of an "acceptable" fragility index does exist to the best of my knowledge). Also, using a lower alpha will automatically give you a larger sample size, without invoking a completely superfluous fragility index.

Nobody should interpret clinical studies in isolation; they only have meaning in a "qualitative" Bayesian framework which integrates physiological plausibility, other available trials, and risk/benefit ratio. The fragility index only muddies waters, as clinicians misinterpret it even more frequently than the much maligned p-value, all while not delivering any more information than the p-value itself.

paviva··on Alternative statistical method could improve clinical trials
There is no point.

The fragility index is essentially a repackaged p-value, and serves only to introduce even more confusion on the top of this already often misunderstood metric. See very good discussion here: https://academic.oup.com/eurheartj/article/38/5/346/2422087

Also, trials are generally designed to recruit the minimal number of patients we can get away with, and this is done for good reason (cost, feasibility, and the ethical concern of "using" the lowest possible number of human beings, while allowing any beneficial treatment to benefit the most as soon as possible). If someone's then pointing out that this trial is "fragile" -- well, yes, it was designed so in advance! Would you propose to expose 100 more patients to an inferior treatment just to improve your fragility index?

paviva··on The Invisible Scars Adult Children of Workaholics Bring to Their Careers
> Get a stud finder

Or simply use a strong magnet. (https://www.youtube.com/watch?v=FhpuC_Gy-yI)

paviva··on Awake proning reduces need for intubation in severe Covid
Probably significant. In this population of very severe patients, mortality was "only" 25% in patients managed without proning. Compare with mortalities around ~50% reported early into the pandemic in comparable populations.

Obviously difficult to say which part comes from patients presenting later in their disease course, doctors, nurses and respiratory therapists being overwhelmed with sudden influx of cases, and so forth -- and which can be directly attributed to premature and unwarranted intubation.

paviva··on Awake proning reduces need for intubation in severe Covid
One of co-authors here. -- AMA.
paviva··on Frozen in Siberian Permafrost for 24,000 Years, Microscopic Animal Comes to Life
I am not sure I understand the question. The brain "restarts" by itself if its otherwise normal and perfused.
paviva··on Frozen in Siberian Permafrost for 24,000 Years, Microscopic Animal Comes to Life
> It is not known whether brain can be brought back at all once all signals stop.

This is incorrect. In a brain-dead patient, the isoelectric EEG serves to demonstrate the absence of brain activity despite adequate perfusion and absence of sedation, i.e, even though the computer is plugged in and you've pressed the start button, nothing happens, and thus, nothing is likely to happen in the future.

Isoelectric EEG can be induced with propofol and barbiturates, either voluntarily (refractory epilepsy) or involuntarily (anesthesia), without any obvious ill effects once the sedation is off.

paviva··on Flu has disappeared worldwide during the Covid pandemic
An alternative explanation is that of "viral interference"[1,2], i.e., the most transmissible virus boosting up viral immunity in the population, and precluding transmission of the less transmissible/fit virus

[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5489283/

[2]: https://www.thelancet.com/journals/lanmic/article/PIIS2666-5...

paviva··on Yuri Gagarin: Sixty years since the first man went into space [video]
A fitting tribute: https://www.youtube.com/watch?v=xGFz5JkLzw8
paviva··on Why doesn't capitalism produce good kettles?
You're searching for a very niche product: something that's not simply a metal vessel that you can use to boil water, but that's not a full-featured water boiler/warmer[1].

Electric boilers last forever, usually have multiple temperature settings, and don't have you wait before the water is ready. If you drink a lot of tea, I strongly suggest you try one.

[1] https://www.zojirushi.com/app/category/water-boilers-warmers

paviva··on Big Bounce Simulations Challenge the Big Bang
Thanks!
paviva··on Big Bounce Simulations Challenge the Big Bang
Do you have a citation? I never heard of Minsky espousing this view. Could you be confusing him with Moravec? (https://frc.ri.cmu.edu/~hpm/project.archive/general.articles...)
paviva··on Ask HN: What, in your opinion, are the greatest and most useful textbooks?
Paul Marino, The ICU Book.

Sapira's Art and Science of Bedside Diagnosis

paviva··on Alarming surge in drug-resistant HIV uncovered
So what, you'll end up paying less for their PrEP than for their HIV infection.
paviva··on Alarming surge in drug-resistant HIV uncovered
PrEP is very likely cost-saving, i.e. it costs less than the life-long treatment of new HIV infections it will have prevented.

Unless you're willing to argue that treatment for HIV infections should not be covered, your argument against PrEP is pretty weak here.

paviva··on Let the Fountain Pens Flow
Use an iron gall ink, such as this one : http://www.registrarsink.co.uk/
paviva··on Seikilos epitaph
De materia medica refers to "mūmiyā", a kind of asphalt, and not to human mummies. The use of human remains began during the Middle Ages.

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

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