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tsoukase

427 karma · joined June 4, 2018

Physician - Specialized in Neuropsychiatry Email: tsoukase <at> gmail.com
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tsoukase··on Why a $154B CEO just endorsed stripping most Americans of voting rights
The beyond-3-SDs right side of the bell curve makes the rules and plays with them. It controls policy and law, shapes public opinions and enjoys capitalism.

The only correct POV is theirs: there is no middle and lower class (having 1000 or 5000 more wealth than someone categorizes both of them as subordinate anyway), only the elite and the plebes.

tsoukase··on The Strongest El Niño Ever
You should also bomb billions of cars, presumably while they are parked, and heating boilers. Better option for all: just turn them off.
tsoukase··on Alien World Chemistry Found Inside Meteorite That Struck New Jersey Home
With the covered surface by a prepared observer being so small and the place of impact being independent and identically distributed over all earth, we can declare such an event a one in billion one.
tsoukase··on The Strongest El Niño Ever
There are three possible scenarios for the next decades:

1) return to preindustrial level of pollution, possibility less than 1/10000

2) make radical changes suggested by scientists, less than 1/100

3) continue with the current pace

The pyramid of pollution, which is directly proportional to the pyramid of wealth, is almost impossible to shrink as the latter is also inevitable.

Just brace for impact.

tsoukase··on Clinical failure rates over the decades: yikes
Drug discovery and development is hard, unique and non comparable in the engineering world. It has it's own properties, like "the pipeline", I-... phases and a mere 20-year long patent duration (counting from molecule discovery). Imagine if after 20 years of it's inception on the paper the car's price falls 5-fold and you have to develop a new machine.

The failure rate does not take into account the millions of molecules that are tested by various methods of protein folding or binding properties. The 90% remains stable with time because on one side an end product is more difficult to produce, on the other the technology of molecule discovery has improved in the same amount.

tsoukase··on Couple pay >$800k for a gene-editing therapy for their daughter. She died.
In the West medical procedures and therapies remain under the most conservative restrictions, which on one side saves lives due to potential failures, on the other it slows progression and innovation. We keep error type I extremely low. It seems China doesn't hold such a tradition and is unjustifiably daring. I don't doubt how COVID escaped.
tsoukase··on Alphabet's cash burn raises alarm for Big Tech as AI spending climbs
Everyone that has invested even a dollar to AI believes the revenue will easily surpass the most optimistic predictions. Ask them.
tsoukase··on OpenAI and Anthropic unite against open-weight AI risks to their bottom line
Naming plays top role in a corp's success. OpenAI chose terrible ones: a cheating, barely legal for the company and a scientific abbreviation for their popular product. I predict market fate will give them a lesson by pushing them to failure.
tsoukase··on Fertility is collapsing because motherhood is zero-status
The author names the status, the subjective good-feeling, as the common cause and I agree. In layman terms, having kids is not trendy anymore.

As parenthood lies in deeper instincts, the underlining cause is their suppression.

tsoukase··on My husbands suicide shows theres something very wrong with US insurance industry
Such stories sound like horror science fiction to Europeans. Of course preventable deaths and health related mistakes happen there too but they are rarely the fault of insurance. If such a blunt event would happen to me, I could sue the insurance for a very large sum.
tsoukase··on Why is it so hard for the U.S. to win wars?
"Hear me, then strike" Themistocles

They are not wars in the narrow meaning. They are long term superficial conflicts, that human history has not seen before. With the modern weapons and technology a traditional war should annihilate the globe in 3 days, not still f.. around after 3 years.

The whole theatre seems to happen for three purposes: media consumption to cause widespread bother, constant increase of defense budgets and multiplication of public debts. The top leaders are not the presidents but the owners of the three pilars: finance, weapons and media, which happens to be the same group of people (guess who).

Since 1992 we are experiencing a slow war that continuous for about 8-10 years before a new one begins immediately after the previous ends. It's a perfectly executed soap opera in episodes and seasons that has managed to persuade us that it's inevitable and natural like sunlight.

tsoukase··on No link between acetaminophen use during pregnancy and adverse birth outcomes
It's very difficult and boring to follow a newborn until at least their 16th year of age, when mental development and IQ stabilise. It would be interesting if we new about the effects of eg. breast feeding, co-sleeping, parenting types and even mother's drugs like anti epileptics during pregnancy. There are some long term studies that follow newborns and they tell a lot, although they swim in a confounding ocean.
tsoukase··on EEG shows brain can simultaneous encode two speech streams
I am reading dozens of books to my children (mostly of Enid Blyton) and I am able to simultaneously think about something else (work stuff, household, HN subjects etc). It lasts a few minutes during which I don't follow what I am reading and I come back and need to start again. Definitely the phonological loop (eyes...mouth) functions independently from the memory-processing-executive cognitive pathway.
tsoukase··on CO2 overload, detected in human blood, suggests toxic atmosphere within 50 years
Correct. Depth and frequency of breathing is regulated 90% by arterial CO2 level due to a direct, potent servo feedback based on a sensor in the brain stem. The rest is due to O2 level. A fatal situation happens with low CO2 and low O2 that doesn't increase breathing. Pneumo doctors hate this and it's an absolute indication for intubation and mechanical breathing.
tsoukase··on Ask HN: Do you say please and thank you to your LLMs?
In the beginning, during the WOW surprising phase, I found myself being overly polite and grateful. Nowadays, I spare such words to add others like How do I or I have trouble. Anyway, why complicate the prompt without reason? I keep petting my dog, loving my family and being polite to people, though.
tsoukase··on Short sellers notch $8.7B profit as SpaceX shares dip to IPO price
I like Elon so much because of one reason: his multi trillion business adds completely new values without taking a single cent away from small retailers and owners, as new big corps do through various legit and not so ways. In contrast, Bezos has closed innumerable stores and every tech giant killed competition in online services. Name it socialism for the poor, but I don't care about his success as long as it doesn't interfere with other's business.

His EV was successful, his social media/AI OK but his space data center will fail and from now on he sells hype, a very fancy, trendy, sexy -name it- and expensive hype. Laws of physics don't allow it to be viable. We have a joke that originally applied to politicians and now to him: you can fool one for a long time, you can fool many for a short time, but you can't fool many for a long time.

tsoukase··on 42% of adults rely on their parents for financial support
As a Greek, and I believe fellow Italians do, I cannot believe how one can live for the first 10-20 years of his adult life without their parents' help, especially today. Old money, inheritance and a house are almost always existent and extend the intergenerational bonding. I don't know if I am jealous or repelled by northern Europeans or even the USA that don't exhibit thus behaviour.
tsoukase··on First atmosphere found on Earth-like planet in habitable zone of distant star
I think we should focus at the solution of Fermi paradox, especially the short time window factor. Life on earth evolved for billions of years, while one of it's creatures is capable to receive/send messages to space for only 50. That leads to a factor of billions/50 reduction at the calculated probability of alien life discovery. Multiply that with another billions/xxx at the receiver side, if they are similarly able to communicate for only a few centuries at best. I assume you agree that our and their evolution are independent.

So the new probability becomes quite low, which fits with our (non-)observation of alien life. We might not be alone, but we are far away and very short lived.

tsoukase··on Sleep regularity is a stronger predictor of mortality risk than sleep duration (2023)
Another common property of such studies is that their result is mildly surprising. Not much so that it will be scrutinised and questioned and not indifferent because no one will care about them. So, you receive your expectation.
tsoukase··on Prioritize mental health, and why communication is so important
This 'some' refers to many subcategories of cases, not only unipolar vs bipolar.
tsoukase··on Prioritize mental health, and why communication is so important
Disclaimer: I am neurologist in a psy department.

I used the second person and a direct advice deliberately to overcome the taboo and suspicion against antidepressives, which cost quality of life. Obviously, one has to reach a doctor for a proper diagnosis and therapy. Anyway, in most countries you cannot buy such drugs OTC. The end goal is to persuade to actively discuss about it with the doctor and/or in case he suggests a drug, follow it.

We definitely need the medical analog to TINLA (This is not legal advice) but TINMA is not accurate.

As for the post author, he seems to still suffer, although under a drug, and he might benefit from a change, which is a frequent situation.

tsoukase··on Prioritize mental health, and why communication is so important
Depression is for many people the animal in the room, for some a fox and for others an elephant. You cannot avoid, ignore or hack a chemical imbalance in your brain with societal or personal measures. If you find yourself hopeless and helpless, irrespective if you have attended any form of psychotherapy, take an antidepressant. Don't hesitate and if you are in trouble, contact me, seriously. The author takes Fluoxetine which is the less potent A-D drug among all. If he is really in a heavy depression, he should be on Escitalopram.
tsoukase··on Sleep regularity is a stronger predictor of mortality risk than sleep duration (2023)
Studies that reach HN and other pop places usually have a lot in common: they link a widespread, modifiable and 'catchy' factor (like sleep, sugar/meat etc consumption, human relations) with a single sensational end point (death), and involve 5/6-figures number of participants. Another common one is a huge confounding spill that makes them useless for practical decisions but valuable for further, more rigorous research design.
tsoukase··on Measuring Input Latency on Linux: X11 vs. Wayland, VRR, and DXVK
With so low differences one should always use VRR and not bother about the rest config. Sub-ms differences are impossible to detect.
tsoukase··on The shingles vaccine may reduce the risk of dementia
Dementia might have dozens of risk factors, each adding up a little. Physical and emotional stress, insomnia, head microinjuries, arteriovascular risk factors, infections and there lies herpes zoster. Only the latter has a causal treatment and is only single stone on the wall of disease.
tsoukase··on Modern decor may be straining people's brains
I live in the same house as my grandparent that was renovated twice before each subsequent generation moved in. Each one was performed with the modern standards but with respect to the previous situation. Simple natural colours, like white and brown hue, ample natural light, and functional design based on everyday living routine do not violate the continuity, still not sacrificing modern luxuries. This balance of past and future is what is missing from a cold start with radical ideas.
tsoukase··on Wealthy AI workers send San Francisco house prices soaring
In order to conclude about taxing, we should agree how much more one should earn per unit of talent or position. Should a CEO earn x10k times a base salary, like now? If yes, don't tax them, if they should earn x1k, tax them 90%, if x100 then 99%. Sould one own 100 homes and 50 cars like billionaires, while they live in and drive one? If yes, don't tax them, if no, tax their wealth accordingly to the number we agreed. Every number not based on fundamental human utility is arbitrary, sensational opinion.
tsoukase··on How Doctors die. It’s not like the rest of us (2016)
The patient must be hospitalised and the administration is justified as an analgesic, sedative and for heart failure when pressure, pulse and breath start to reduce. I believe any doctor whould agree after discussion with the relatives. The problem is the doctors rarely bring it to surface and the people don't know to demand it.
tsoukase··on Vagal cholinergic denervation of the gastric mucosa in Long-COVID-19
Firstly the term 'long' is not good. Better is post-COVID syndrom, because the virus has been eliminated and not staying for long but the situation remains post infection.

Secondly, the majority of burden is caused by CNS/brain dysfunction, especially a form of neurotransmitter depletion, and not due to peripheral autonomous imbalance. And the former is a much more difficult therapeutic target: in my experience incurable for ever but also quite more rare that it is shown in the media.

tsoukase··on How Doctors die. It’s not like the rest of us (2016)
As a doctor, I think we are prepared for our own death (not so much for illness though). Especially during the last days or months we know exactly what's happening. I agree that the less-care-but-less-side-effects way is chosen much more often by doctors for themselves and their close relatives (I personally administered to my mother opioid to accelerate death due to terminal cancer a couple of days before the expected end that would be tortuous).

For my end stage patients I advise full palliative analgesic and sedative therapy but usually against futile chemos and intubations. There is a discussion where ICU doctors and oncologists have to take part.

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