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sveiss

548 karma · joined June 27, 2011

@sveiss on Twitter, GitHub etc. Or, stephen <at> brokenbottle <dot> net.
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sveiss··on Meal Kit company sued by customers whose gallbladders were removed
Yup, I'm wrong in the specifics here. I think I'm conflating the stats for negative appendectomy and the willingness to go to surgery without positive imaging in that setting with the ~30% of cholecystectomy cases that don't improve with surgery. (Of course, the risk/benefits of missing an infected appendix vs taking out a healthy one are very different to gallbladders with stones.)

That said, I do think the underlying point I'm trying to make is still accurate. Most of the audience here are software engineers. Unlike debugging software, where we can often eliminate possibilities with 100% accuracy through objective tests and come to a conclusion with complete confidence, or at least run experiments with no consequences, humans are messy, poorly observable, and heterogeneous. A relevant history helps speed things up when trying to fix software, but it can be vital when fixing humans.

Given the rate of asymptomatic gallstones visible to imaging in the population, if these lentils are causing acute liver injury, I think it's reasonable to expect that some people have had unnecessary surgery as a result. If you knew your patient had eaten these lentils, would you still send to surgery with positive imaging, or wait a few days and see if things improved?

sveiss··on Meal Kit company sued by customers whose gallbladders were removed
The argument isn't “Daily Harvest's product caused gallstones”, it's “Daily Harvest's product caused liver damage with symptoms strongly resembling gallstones, and as a result plaintiffs received irreversible surgery with a risk of life-long side effects”.

There are several questions here, and the legal system is the right place to unpick them. From the top of my head:

  - did DH's lentils cause liver injury?
  - is that injury permanent or temporary?
  - were gallstones misdiagnosed because of the injury inflicted by DH's lentils?
  - was unnecessary surgery performed due to misdiagnosis?
  - did the doctors misdiagnosing gallstones/performing unnecessary surgery meet the standard of care?
  - did the unnecessary surgery cause permanent/temporary harm?
  - was the direct harm (temporary liver injury) caused by DH's lentils reasonably foreseeable? 
  - was the indirect harm (surgery, surgical complications, lifelong side effects) caused by DH's lentils reasonably foreseeable?
A lawsuit is the right way to get answers to these and determine who, if any is liable for damages and in what amount.
sveiss··on Meal Kit company sued by customers whose gallbladders were removed
Medical diagnosis isn't a perfectly exact process, and is strongly driven by prior probabilities.

If you present to the ER with pain in the upper right abdomen, with blood test results showing raised liver enzymes, meeting some or most of the "fair/fat/female/fertile/forty" risk factor mnemonic criteria, and have imaging that doesn't completely rule out gallstones, then the overwhelming probability is that you're suffering from gallstones, and that's the diagnosis you'll be given.

Since the gold standard treatment for symptomatic gallstones is gallbladder removal, that's likely what will happen. Under normal circumstances, far more aggregate patient harm would be caused by trying to make the diagnosis more certain than is caused to the few patients who undergo surgery but don't actually have gallbladder disease.

Unfortunately, these aren't normal circumstances: it appears that the liver damage produced by this lentil product produces similar pain and blood test results to gallstones, the risk factors for gallstones are very common in the US population, and it's actually quite hard to completely rule out gallstones by imaging. So more patients than expected are currently being harmed with unnecessary surgery.

It's important that this be publicized, so that doctors making these diagnoses know that asking "did you eat anything from Daily Harvest" is now a diagnostically relevant question when considering upper abdomen pain, and the answer may change those prior probabilities drastically.

sveiss··on tolower() in bulk at speed
Section 2.2 and 2.3 of RFC 5890 [1] has a good overview of the pre-IDN state of things, with reference to where these were originally specified. In particular, the definition of 'LDH label' describes a single component of a traditional DNS name:

   This is the classical label form used, albeit with some additional
   restrictions, in hostnames [RFC0952].  Its syntax is identical to
   that described as the "preferred name syntax" in Section 3.5 of RFC
   1034 [RFC1034] as modified by RFC 1123 [RFC1123].  Briefly, it is a
   string consisting of ASCII letters, digits, and the hyphen with the
   further restriction that the hyphen cannot appear at the beginning or
   end of the string.  Like all DNS labels, its total length must not
   exceed 63 octets.
I misspoke slightly in my earlier comment: it turns out the DNS protocol does allow octets of any value in a label, but the Internet domain name system -- including all the existing clients, servers, registrars, etc -- as a whole does not. Which is part of why we need a fairly complicated set of specifications to make non-ASCII domain names work.

[1] https://datatracker.ietf.org/doc/html/rfc5890#section-2.2

sveiss··on tolower() in bulk at speed
Domain names are limited to a small subset of ASCII; the DNS protocol doesn’t support UTF-8.

To work around this, the international domain name standard defines an encoding called Punycode which maps Unicode to the limited character set DNS supports. The server is unaware of this, and so this optimised tolower() implementation works without any Unicode considerations.

sveiss··on 300 Babies died or suffered brain damage in Shropshire maternity scandal
I think you’re missing the wider context here. Problems at these hospitals’ maternity departments have been under investigation for years at this point, and the scope of the inquiry has been widened several times in the process. The link is to a UK newspaper, and the context is very well known in the UK at this point and wouldn’t be repeated in every article.

Some background: https://www.bbc.com/news/uk-england-shropshire-46206917

Pollution doesn’t cause babies to die from medical neglect during labour.

sveiss··on OpenTelemetry
That's because this tool has nothing to do with "spying on users".

It's a set of tools and a specification for instrumenting applications and collecting logs/metrics/traces from them. It's used to ask questions like "why is this page slow to load?" and get answers like "because it talks to the billing microservice which has a really slow SQL query".

This isn't the same sort of telemetry that desktop software vendors collect.

sveiss··on The anonymous meta-analysis that’s convincing people to use ivermectin
A pharmacist’s professional role is as an expert on medication, and their scope of practice includes refusing to fill therapeutically inappropriate prescriptions. Normally this serves to catch dosing errors or drug interactions, but it’s also a safety net for other inappropriate prescriptions. We don’t put pharmacists through 8 years of post-secondary education to blindly fill whatever a physician writes for.

In the US, the requirement for pharmacists to police prescriptions even goes as far as criminal liability for dispensing inappropriately prescribed controlled substances (see: “corresponding responsibility”).

Choosing to dispense, or not dispense ivermectin isn’t going to rise to that level, but no state Board of Pharmacy is going to take action against a pharmacist who judges that ivermectin is inappropriate for a COVID diagnosis.

sveiss··on Sputnik V: fraudulent clinical trial data
The precise mechanics vary on a state-by-state basis, but in a lot of cases a MD will write a blanket “prescription” that covers a class of patients, and that’s what fulfils the legal requirement for a prescription to dispense/administer a drug. In others, healthcare workers who don’t ordinarily have prescription authority are granted authority to prescribe vaccines by a state law.

The “prescription” here isn’t something the patient will see or be aware of, it’s just part of how the legal requirements around dispensing medications and the logistics of vaccination providers interact.

There’s some information on this from a pharmacist perspective here: https://naspa.us/resource/pharmacist-authority-to-immunize/ .

sveiss··on Sputnik V: fraudulent clinical trial data
Quoting the FDA letter you linked:

> On August 23, 2021, FDA approved the biologics license application (BLA) submitted by BioNTech Manufacturing GmbH for COMIRNATY (COVID-19 Vaccine, mRNA) for active immunization to prevent COVID-19 caused by SARS-CoV-2 in individuals 16 years of age and older.

Approving the biologics license application _is_ the formal approval. The reason the media is reporting that the FDA gave formal approval is because the FDA did in fact do that.

The letter goes on to say:

> On August 23, 2021, having concluded that revising this EUA is appropriate to protect the public health or safety under section 564(g)(2) of the Act, FDA is reissuing the August 12, 2021 letter of authorization in its entirety with revisions incorporated to clarify that the EUA will remain in place for the Pfizer-BioNTech COVID-19 vaccine for the previously-authorized indication and uses, and to authorize use of COMIRNATY (COVID-19 Vaccine, mRNA) under this EUA for certain uses that are not included in the approved BLA.

So as well as granting formal approval, they _also_ extended the EUA.

Why did they do both?:

The extension of the EUA covers the existing vials of vaccine in the field and the supply chain which don’t have the approved labelling. Drug and biologic products are approved for sale under conditions that include specific labelling (the brand, in this case “Comirnaty” and the prescriber/patient instructions) and for specific indications.

The stock in the supply chain doesn’t meet those requirements, but it would be wasteful to recall it. Additionally, the EUA authorises more indications than the full BLA: kids 12-16, for one. The old stock, and now the new Cominarty-labelled stock, are authorised for these populations under the extended EUA.

sveiss··on HiveNightmare a.k.a. SeriousSAM – anybody can read the registry in Windows 10
Definitely a bug. The Unix equivalent would be a package update silently making /etc/shadow world readable, exposing the hashed passwords of local users.

Not a big deal for a single user machine — there’s nothing you can do with this that you can’t do some other way as a local admin/root — but not good if you have untrusted, non-admin user accounts.

sveiss··on Ivermectin for Prevention and Treatment of Covid-19 Infection
> You can't get EUA for the vaccines if there's a working treatment.

Veklury (remdesivir) was approved by the FDA for the treatment of Covid-19 in hospitalized individuals on October 22, 2020. This was a full approval, not an emergency use application: https://www.fda.gov/media/137574/download

We've continued using the vaccines under the existing EUAs even after a treatment was approved.

The FDA has granted additional EUAs for other treatments, even after that date: four more, not counting a sedative agent, per https://www.fda.gov/emergency-preparedness-and-response/mcm-... .

In fact, the FDA has even granted an EUA for a vaccine after approving Veklury: the Janssen/J&J vaccine received its first EUA on February 27, 2021. https://www.fda.gov/media/146303/download

Even if ivermectin was a perfect treatment for Covid, and even if an approved treatment would pull all the vaccines off the market -- despite that not happening after the FDA approved Veklury -- by the time ivermectin made its way through the approval pipeline to be labelled for this indication, the Pfizer and Moderna vaccines would very likely have received approval as well. So there's no "billions of vaccinations" at risk should another treatment be found to be effective and approved.

sveiss··on mRNA's next challenge: Will it work as a drug?
I'll state upfront that I'm not a biologist, but here's my attempt at the explanation.

The ELI5 version:

Think of the cell as a factory for proteins. The blueprints for all of the different kinds of proteins it can produce are encoded in DNA and stored in the foreman's office. When the cell wants to make a particular protein, the foreman copies the instructions from the blueprint onto slips of paper (mRNA), and sends them to the assembly line workers. This type of copying happens all the time, and is pretty reliable -- and even if it's not, the end result is just some wasted time and a junk part. The blueprints are unaffected. mRNA vaccines sneak some unauthorized instructions to the workers, who then run a ghost shift to produce the protein we want to cause an immune response to.

When we need to create a second factory, we need to photocopy all the blueprints for the new cell. This uses a totally different process (a photocopier assembled specifically for the job of copying whole blueprints onto more blueprint paper, and not the work-order slips sent to the assembly line). The photocopier is pretty reliable too, but occasionally it introduces artifacts, and eventually, enough of these errors can build up to create mistakes in the blueprints. The blueprints have instructions on how to deal with errors in a new factory (by blowing it up), but if enough of those failsafe instructions are obscured by copier artifacts, you now have a potentially cancerous cell.

The foreman's office doesn't usually make changes to the blueprints based on work order slips. It's possible with a special copy machine -- this is how HIV works, by sneaking that machine in -- but without a work order slip to blueprint copier, it doesn't matter how many fake work order slips we pass into the cell. They will only affect the production line, not the foreman's office.

The more detailed, and almost certainly wrong-in-the-details version:

There are three types of encoding for genetic material: in DNA, in RNA, and in proteins.

In order for the information encoded in genetic information to be active in a biological system, it has to be expressed as a protein -- a physical manifestation with binding sites and the ability to interact with other molecules. Ribosomes, a component of the cell, do the "assembly" part of transferring genetic information to a protein. This is called "translation".

DNA is the long-term storage of the information eventually expressed as proteins -- it's a collection of templates in long term storage. So there has to be a process to get information from the long-term storage of DNA, in the nucleus of the cell, to the ribosomes elsewhere in the cell.

Messenger RNA is the intermediary molecule which carries the genetic information from the DNA to the ribosomes. It's produced in the nucleus of the cell by a mechanism called "transcription", which copies a subset of a DNA molecule into a complementary RNA molecule encoding the same information. The DNA double-helix is "unzipped", a complementary RNA strand is assembled, and the double-helix reforms. The mRNA can then be transported to the ribosomes.

mRNA is a useful vaccine mechanism, because we're co-opting a late stage of the cell's protein production pipeline. We don't have to assemble the target protein by hand and figure out how to modify it make it stable for distribution -- a task that would need to be repeated for each protein we wanted to make. Instead, we can figure out how to synthesis mRNA, and we don't need to worry about either synthesis or stability for the end protein product.

When we talk about cancer and mis-copying, this is at a much earlier stage in the pipeline. When a cell splits into two cells through mitosis, we don't want a subset of the protein templates in the cell's genetic material; we want a complete copy. This is a separate biological pipeline, which involves the cell building up a mechanism to do the copying, dissolving the membrane of the nucleus, and ultimately producing and collating copies of all the DNA from the nucleus. This is an entirely separate process, and messenger RNA isn't involved at all.

There is a route for information to travel from RNA back to DNA, and this is the mechanism retroviruses use, and HIV is the most famous example. A complete retrovirus particle includes reverse transcriptase, an enzyme which allows them to transfer information from RNA back to DNA. This is the reverse of the normal DNA -> RNA pattern described above, hence the name _retro_virus. Without that enzyme or something like it, there isn't a pathway to convert RNA back to DNA, and human cells don't normally express an enzyme which has this function.

sveiss··on 16-inch MBP 2x slower than M1 MacBook Air in a real-world Rust compile
It's not a requirement, and different systems in the past have made different choices.

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

sveiss··on Drivers who keep their windows down are exposed to 80 percent more air pollution
I moved to the US from the UK, where yield ("give way") signs were the standard and stop signs an attention-getting rarity.

I've often wondered how much harm to health has been done by the increased emissions at excess of stop signs (at least in the parts of the US I've visited). Does it outweigh whatever reduction in accidents you get by forcing a stop at junctions which (to my untrained eye) could safely be controlled with a yield?

sveiss··on Windows 10 Hosted App Model
A LNK/PIF doesn't give a coherent view of the whole "app" from the user's point of view, though.

If you delete the LNK, you don't uninstall the app -- you just can't access it easily any more. If you create a second shortcut to the app, then uninstall the app, the second shortcut lingers but doesn't work.

If you install an app, it might put two or three shortcuts onto the start menu -- lets say it's a video game, and it installs a shortcut for the game itself, and another for a settings tool. (If it's an old game, it'll probably install a shortcut for the uninstaller, too). Which of those shortcuts should the start menu highlight as the newly installed app, to help the user discover it?

You can make the argument that an abstraction based on files, paths, individual executables and command line arguments (which is what LNK/PIFs support) is superior, and I think a lot of people on HN would agree -- but it's not the abstraction that new computer users being trained on mobile devices are internalizing.

sveiss··on Windows 10 Hosted App Model
It's closer to a macOS bundle than a single script with '#!'. It's at a higher level of abstraction than linking a single script file to an executable.

It would let you build, say, a Ruby interpreter which declares itself as a host, and then package a Ruby application that makes use of the interpreter, including its libraries, native code extensions, and all the related assets.

The Ruby application would behave like a native application, with its own identity in the Start Menu/Task Manager and its own sandbox/entitlements. The Ruby interpreter and the packaged applications would appear separately in the uninstaller list in Settings, and presumably could be distributed via the Microsoft Store walled garden.

The whole 'Windows app model' concept is about bringing something close to the "one icon = one app" experience from mobile to Windows, instead of depending on heuristics or uninstallers to figure out which set of files/processes are part of a single "app" from the user's point of view. This is an extension to that model.

sveiss··on Green card applicant banned from ever coming to USA because of a checkmark
> I'm pretty sharp with US employment, tax and passport forms, yet that's the first time that I've heard somebody being banned for an I-9 mistake.

Accidental false claims to citizenship are a "whoops, game over" situation which crops up on immigration advice forums from time to time. The USCIS policy manual [1] specifically mentions the I-9 citizenship question as grounds to make an inadmissibility decision, and cites relevant immigration appeals cases.

[1] https://www.uscis.gov/policy-manual/volume-8-part-k-chapter-...

sveiss··on Green card applicant banned from ever coming to USA because of a checkmark
You can immigrate to the US without ever filling out an I-9, if you never work as an employee while in the US.

On the other hand, a US citizen who never leaves the country might fill out dozens over the course of a career, depending on how often they switch jobs.

sveiss··on NTSB: Autopilot steered Tesla car toward traffic barrier before deadly crash
That segment of the A38 has a 30MPH limit, with the right fork increasing to 50MPH. The dynamics of any crash would be very difficult.
sveiss··on Ask HN: Who is hiring? (March 2018)
Scribd | DevOps/SRE | San Francisco, Toronto or REMOTE | VISA

Scribd is a reading subscription that gives you access to the best books, audiobooks, magazines, and more. Our mission is to re-imagine the way the world reads.

We're looking for engineers to grow our DevOps/SRE team. We're a Rails app that's been around for a while, and we're looking for people to help improve and modernize our infrastructure as the company continues to grow.

Our tech stack currently includes:

  * Linux
  * Ruby (our core codebase is Rails), but with projects in Go and Scala too
  * Chef and Docker
  * MySQL (Percona), HBase and Elasticsearch
  * Hadoop, Hive and Spark
  * nginx, HAProxy and Varnish
We've hired a whole bunch of people from HN over the years, including myself, and I'm always happy to chat about the role -- please shoot an email to stephen at scribd.com, or see the full job posting and apply at one of the links below:

  * DevOps/SRE, San Francisco and REMOTE: https://grnh.se/np5bhlj41
  * DevOps/SRE, Toronto: https://grnh.se/yxawwug61
  * All our open positions: https://grnh.se/lcs3kh
sveiss··on Non-Consensual Intimate Image Pilot
In this case, 'hash' doesn't necessarily mean 'a cryptographic hash of the raw file contents'.

There are perceptual hash techniques which still match after changes to the file, and are tuned in a similar manner to lossy compression algorithms to prioritize comparing information relevant to human perceptions.

https://www.phash.org/ is one open-source example.

sveiss··on The iPhone X’s notch is basically a Kinect
This is already happening. People visiting the US and entering through airports have had their fingerprints and facial biometrics captured since 2004, and it's been progressively expanded since then. All visa applications have the same information captured at interview, too.

The current large expansion planned is capturing facial biometrics at exit, and using this to confirm departure (instead of relying on airline manfiests).

sveiss··on Ryzen CPU HyperThreads break if 100% busy and interrupted to top of Memory
Yup, and it did: http://techreport.com/review/13741/phenom-tlb-patch-benchmar...
sveiss··on Plastc will cease operations and will not fulfill any pre-orders
It's a per-card setting. Issuers here in the UK default to PIN for both credit and debit, but both are available with signature for those who need it.
sveiss··on Filing Taxes in Japan Is a Breeze. Why Not in the US?
Here (UK) it's taken care of by the provider for most people.

If you were to pay £80 into a personal pension (similar to an IRA), about a month later an additional £20 would be added. That's tax relief at the 20% basic rate. (Higher rate payers currently need to file to claim additional relief, but there's no reason that couldn't be automated too.)

If you had a company pension instead (similar to a 401(k)), you can pay in through salary sacrifice, where the salary your tax is calculated on is reduced and the difference paid directly into the pension scheme.

Whichever route is taken, the end result is the same: a £100 contribution cost you £100 in pre-tax money.

sveiss··on Filing Taxes in Japan Is a Breeze. Why Not in the US?
You're making a false comparison.

The majority of UK residents don't need to file a tax return. The correct tax/national insurance/student loan deductions are withheld from their paycheques, and in case of problems, a phone call will normally sort them out.

Some people need to file returns. (Those that don't need to can also choose to.) Those people that do can file on paper, though the Government website, or using third party software. There's around 30 listed software providers for personal tax.

The fact most people have never seen a tax return in their lives hasn't prevented competition for tools in the more complex cases.

sveiss··on Filing Taxes in Japan Is a Breeze. Why Not in the US?
It's a single phone call to cancel self-assessment for income tax and national insurance. Probably a second to cancel a VAT registration, but I've never had to do that.
sveiss··on Federal judge stays deportations of travelers in Trump immigration order
The choice of countries actually dates back to a 2015 Act of Congress restricting access to the Visa Waiver Program to nationals or prior recent visitors of certain countries. These people will have had to apply for a visa instead, and presumably are subject to more stringent checking than most.

The list of countries wasn't defined by Congress beyond Iraq and Syria (presumably thanks to those being specifically called out in the name "Islamic State of Iraq and Syria"). It did include provision for the Secretaries of State and Homeland Security to designate additional countries.

My gut feeling is that the current administration didn't choose to target the same countries deliberately, but rather chose to incorporate the prior legislation by reference as a defence against legal challenges.

The EO wording is that "immigrant and nonimmigrant entry into the United States of aliens from countries referred to in section 217(a)(12) of the INA, 8 U.S.C. 1187(a)(12), would be detrimental to the interests of the United States". The referenced legislation is here: https://www.law.cornell.edu/uscode/text/8/1187#a_12 .

sveiss··on Federal judge stays deportations of travelers in Trump immigration order
The wording of the ruling looks like it applies nationally to me:

"WHEREFORE, IT IS HEREBY ORDERED that the respondents, their officers, agents, servants, employees, attorneys, and all members and persons acting in concert or participation with than, from the date of this Order, are

ENJOINED AND RESTRAINED from, in any manner or by any means, removing individuals with refugee applications approved by U.S. Citizenship and Immigration Services as part of the U.S. Refugee Admissions Program, holders of valid immigrant and non-immigrant visas, and other individuals from Iraq, Syria, Iran, Sudan, Libya, Somalia, and Yemen legally authorized to enter the United States."

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