wittyreference

Because it’s bad to be stupid. People are ashamed to be stupid because it’s a shortcoming. There is no world in which we can value a trait (intelligence) and not feel proportionately bad about its crippling deficiency. Pretending otherwise is some combination of being purposely obtuse and condescending.

“Do no evil” is idealism. “Don’t undermine our marketing to grab data assets that don’t align with our business model” is cold self-interest.

I have much more faith in a company staying true to the latter. Not 100% faith, because their assessment of what business model to pursue can change, but it’s certainly not comparable in flakiness to corporate idealism.

Yes.

As a physician, I wish more folks appreciated that “disability” is a property of the relationship between a person and their environment, and can emerge (or disappear) based on changes in that persons capability as well as changes in their environment.

For an obvious example: a patient with reversible heart failure can’t walk without severe shortness of breath today, but they can in three months. Today they need disabled parking; three months from now they do not.

As an aside, for future potential markets: powerlifters have the same sort of needs/problems around chalking for grip.

Same question. I’m a lifelong NYer, and a metro card has never failed in me in use or in structural integrity. I tend to replace them every five years or so for eventually /losing/ them, but that’s it. What more could you ask for?

In my advanced cardiac life support training, an EMT once put it this way (addressing some nerves at being responsible for a critical life or death event):

Their heart is stopped - they are dead. You can’t kill them any more dead, you can /only/ bring them back to life. So what’s to be nervous about?

Don’t pick it apart. It’s not hard to pick apart. But thinking about it that way really does help take some of the pressure off and let you focus on doing the deed.

I was briefly interested, until I found that full access as a physician requires using a Facebook account to prove identity. Thanks, no thanks.

Any bank at which you are a customer will notarize documents for you for free.

> A problem with modern psychology is the diagnostic criteria aren't very much based on underlying causes as on being able to reliably diagnose patients based on symptoms regardless of physician. This leads to people agreeing what your diagnosis is

That is true. The groupings persist because they are useful in facilitating communication regarding potential complications, prognosis, and patterns of response to treatments.

People seem intent on throwing away the above utility with a backhanded “but that’s not the Real Diagnosis.” It’s not, but within the limitations of our current understanding of neurology, it’s the best we have come up with so far (allowing for some limitations due to the pace of spread of innovations, politicking, etc.)

I don’t really know why this prompted straight up downvotes. These are the exact concerns voiced in multiple Nature articles over the past decade or so.

They comprise a large percentage of the caloric intake of a lot of bird species, which are already fragile due to ecosystem fracturing. This could result in a hit to bird populations - and if the mosquitos adapt and rebound, the birds are unlikely to rebound nearly as quickly, allowing for a potential enormous boom in total mosquito population.

Neuronal glucose uptake is via transporter GLUT1, which is insulin independent. Insulin-dependent glucose uptake is primarily GLUT4. Even in insulin absence, the brain gets its sugar.

Serotonin syndrome is due to an excess of serotonin almost exclusively due to serotonin agonists. Seizure is pretty rare - it produces stuff that looks like seizure (myoclonus, tremor, delirium), but actual seizure is only seen in SS so severe that it’s usually fatal.

Do you have any sort of citation for this? I’m not trying to be snarky, I’d really like to read more.

My understanding of the med lit is that bipolar and epilepsy aren’t particularly associated, and pure BD in particular is a rarity - when epileptic patients were assessed for BD symptoms, they were mostly only found in the confusional states pre- and post-seizure, which isn’t BD at all.

At least in my hospital, the most common way we get BD patients hospitalized is either during a severe depressive episode, or when their mania results in violence or law-breaking. We do sometimes have patients land on our floor whose first presentation was seizure, but that’s after they’re assessed by neuro and found that it was pseudoseizure (factitious seizure).

> T his reads out exactly how a manic or hypomanic person would experience things and rationalize past events and feelings. The idea that it has to be something complex and in a sense grandiose compared to "just being burned out" is often a very telling sign.

Bingo. FND is another name for “conversion disorder.”

Does anyone remember that Reddit post where a guy thought his landlord was sneaking into his apartment and leaving him notes? He insisted the handwriting was completely different. Then a poster suggested he get tested for CO poisoning, which it was, and the “different handwriting” was actually a part of his delusion.

“Burning out all of the glucose and dopamine in your brain” isn’t a thing. “Functional Neurological Disorder” is another name for Conversion Disorder - a condition of apparently neurological symptoms inconsistent with neurological anatomy or mechanisms, triggered (most often) by significant stressors, often suffering a longer duration in patients who strongly believe “this is definitely a physical disease!”

They went on to describe the forearm experiment which showed a much higher rate of awareness. I don’t see why you’ve chosen to omit that. You seem to casually discard the idea that awareness without memory is irrelevant, but when I’ve informed patients of amnestics they’ve been horrified - maybe needlessly so, but I’m not so arrogant as to think “silly patient, your horror is wrong and therefore irrelevant.”

Many people don’t regard “you’ll be in pain and then forget” as the same as “no pain.”

And the idea that HR and BP are perfect indicators of pain is ridiculous. Anesthetics reduce the responsiveness of both; cardiac parameters don’t respond perfectly, and you don’t need perfect anesthesia to impair them.

In my hospital, at least, we don’t take for granted that we achieve perfect coverage. It’s normal to give patients a bolus of amnestic at the tail end of a procedure to cover any gap in pain/distress while we were bringing them back to consciousness.

How do folks contribute to the list of game types? I went in looking for a blades in the dark campaign, and found it wasn’t a valid search term. I know it’s not as mainstream as d&d, but...

Are machines immune to entropy? If not, I suspect that a few thousand years of transit time still pose an obstacle, even for a machine civilization.

My main complaint about Firefox mobile is the menu locations - three dots on the upper right, hamburger on lower right, page select on bottom. With the issue being that there's nothing intuitive around what lands in the dots or the burger, so I not-so-rarely find myself randomly clicking on one or the other looking for e.g., the share menu.

It doesn't stop me from using it, but it's annoying.

The problem, from my perspective, is that we're fighting the battle on two fronts: I need to get all my data from my old EMR into my new EMR, and I need my new EMR to slot in where my old EMR was with respect to feeding data to my data warehouse. Part of the difficulty there is the API, and part of it is that a bunch of shit is done as a black box in-EMR (e.g., my EMR will feed my warehouse some financial data, but my vendor is opaque as to how it's calculated).

It's gotten to the point where I don't want a legal requirement to be HLX compatible: I want a legal requirement separating back-end data from front-end UI, so that we can shop for each of those independently. Once all the front-end shops (which are more valuable than back-end - as a healthcare org, I care about documentation and billing and error prevention) can't lock you in via data, I imagine there will be a fucking quick race to be the universally compatible back-end. And the back-end is ultimately the stuff that affects patients (portability of records) and loosen the bindings on provider organizations (because... portability of records).

Which of course is why even things like HLX didn't really start working until major orgs like CMS and NYS Medicaid came along and said "you will find a way to be compatible with HLX voluntarily, or you will do it via regulation. One way or another it's going to happen within the next 12 months." (I was at a major conference where that was laid out pretty much that explicitly. It was wonderful.)

I made my comment two weeks ago, describing a fall in mortality that began three weeks prior. The z-score of mortality for Israel peaked as I described in my last post, and has continued to fall. The 65+ group in particular is well within historical norms.

The aggressiveness of your statement requires me to include an image of the current mortality graph for anyone not willing to take the time to dig it out themselves: https://ibb.co/1vCsD7Y

People like you never get held accountable. Please continue thread-stalking me, I'm happy to keep this up.

Since HLX has become increasingly required, I've seen that the lock-in doesn't mean diddly squat. Now we're not "locked in", but for my new vendor to drop-in means I have to pay an extra "API Fee" for them to whip up the API interface to pull everything from the old EMR and into the new EMR.

So either we get to the point where we are legislating perfect compatibility (and I can't imagine how good EMRs will get once the federal government has to outline every individual data field, and update them through, what, the rulemaking process?); or we'll always be paying up for this transition, and lock-in is beside the point.

What’s the business model? Free app without updated privacy details raises a flag for me.

Most people who attend casinos aren’t bothered by gambling mechanics either. Says nothing for the quality of gambling as gaming, though.

In the Twitter threads where they all pearl-clutched in response to the satire removed in the linked article.

Installing this browser for a look-see as we speak.

So, as a "privacy focused" browser, what's your revenue model?

It is, because another way of phrasing that is "coresidence provides no additional explanatory power beyond economic circumstances."

When that's what your data looks like, proper study design either involves testing that hypothesis, or staying the fuck away from making conclusions that take one of those as significant and one as non-significant.

Controlling for confounders is better than not; it's also far short of adequate ("controlling" means "reducing a little," not "eliminating"), and in collinear variables you can easily kill the significance of one by adjusting for the other, if you're not careful (ordinarily we experiment with the order of controlling in a multiple regression, to see if that occurs, as well as testing for interaction effects.)

The real earning power of minimum wage (aka, the standard teenage job) has declined by, what, 70% since the 70s? If it's more expensive, in real terms, to have a car, to rent a hotel room, to go out, then yes, it's going to be more difficult to get laid.