OopsCriticality

> Unfortunately creating a good thick lather can easily take ten minutes.

Is it possible that you have hard water?

The ultimate goal is to train the falcon to wait on: to circle high above an area where there's game. The higher the pitch, the height at which the falcon circles, the larger an area the falcon can cover. While the falcon waits, any game in the area will be pinned and reluctant to move. That lets the falconer control the field, have their dog flush the game in a specific direction, and be in a good viewing position for the take.

Bluntly, I don't care what they do so long as they do their job, and frankly, their personal lives are none of my business; they're a highly-educated mature adult capable of figuring it out just like their peers in the profession are somehow able to do. Some do a childcare service, some have nannies or babysitters, some have a stay-at-home partner… Surgeries run long all the time due to unforeseen complications, and I find it difficult to believe that this anesthesiologist didn't have a backup plan for those occasions. They may not have wanted to use it, and that is what I object to.

One of my parents is a physician and I didn't get to see them much when I was growing up (or even now); I intimately understand the point of view of those advocating for greater work-life balance in medicine. What I find lacking in the push for greater work-life balance is an acknowledgment that quality of care may be changing for the worse as a result.

I've tried to do that comparison, and the best I could come up with is that I'm not convinced it's possible. Crimes are both reported and categorized differently between the two countries, which is a major cofound, and the reporting rate differs greatly between the two. It's a general problem really with any comparison study. If you have a source for a thoughtful comparison you can share, I'd be very interested.

I'd be interested to hear from people that were around when expert systems were in vogue the first time around as to why they didn't take off in medicine, and what is new (if anything) in the new wave?

I've long wondered if, in addition to opening up the NICS system to private individuals for private transactions, the blockchain could be used to demonstrate that a background check was performed without the hassles of dealing with an FFL or the negatives of storing 4473's. Could we eliminate 4473's altogether? Of course, if we're actually serious about background checks, we need to fix reporting into NICS system while we're at it, among other things.

As to the linked proposal, it doesn't strike me as very informed… I still fundamentally don't understand the infatuation with insurance (other than as a backdoor way to limit ownership). Insurance may cover acts of negligence, but doesn't it exclude suicide/suicide attempts and criminal acts, right? What events are being insured, and who is paying out?

I think we both agree that occupational health and safety, as it's generally practiced in academia, is an abomination; the sooner academia comes up to industry standards, the better.

Reading in C&EN about completely preventable accidents that happen in the ivory tower is both frustrating and heartbreaking.

> No, I find it unreasonable that not everyone knew the schedule beforehand, or that someone who knew about it didn't raise it as a problem.

The problem in this case was that the meningioma's MRSA positive culture results (from the first, cancelled procedure day) came back on the day of the rescheduled procedure, and that necessitated a schedule rearrangement (placing the meningioma at the end of the day) that the substitute anesthesiologist objected to. The author points out the absurdity of the situation re the MRSA culture when, if they had performed the procedure on the day originally planned, they would not have the culture results and so would not have done a post-op decontamination, but the rescheduling had forced the additional step. I think one does the best they can to budget for unexpected problems as had happened in this case, but in an overworked system, that cushion is among the first things to go.

> This should never happen right before the operation. At that point it's too late and it's on everyone to deal with the situation at hand.

Ideally, yes, one catches complications before they are a problem. Experience suggests complications still occur, and the only solution is to "be like water" and adapt.

> What I'm pointing out that if the plan was a surprise then it's completely understandable that someone says no.

Not for a physician. It is understandable for a physician to be ticked off, it's understandable for a physician to call in a favor and find someone to cover for them, but it is not understandable for them to say "no". The substitute anesthesiologist not only said no, but was apathetic to finding someone to cover for her. To that, I respond as I did before, the expectation from what I term the old guard of medicine is that your duty is to attend to your patients. Younger physicians, such as the anesthesiologist in question, would seem to share your perspectives on work scheduling, and the old guard say that the result is decreased quality of care.

> As for solutions, it depends on a hospital, location, patient's state, available team, etc. Lots of possibilities. (BTW, anyone shouting at anyone else is not even close to a solution)

That's a lot of handwaving. Keep in mind that in medicine, you can only kick the can down the road for so long, and that in this case, the patient's family had rattled legal sabers over the first cancellation. I suspect the possibility space is not as large as you think.

> this is a completely reasonable response. People have lives outside of work.

For someone in IT, perhaps, but the professional expectations in medicine are starkly different (although they are admittedly growing more lax, to the chagrin of the old guard). In this particular case, the geriatric meningioma patient had already been cancelled on once, rescheduled with the promise of being the first procedure of the day, and then delayed to the end of the day because she tested positive for MRSA and they needed to do a decon of the OR after her procedure. You would seem to find it reasonable to reschedule her yet again, but neurosurgeons don't have much room in their schedules to play scheduling games with, and in general, patients aren't undergoing elective brain surgery for the fun of it: they need it now.

Perhaps the IT analogy is that neurosurgery is largely a hard real-time system: you must execute within a given time window or you fail.

Also OmniGraphSketcher, a wonderful and unique utility that Omni divested from. Kindly, they open-sourced it;[0] sadly, the project shows no activity since last year and would seem to be abandoned.[1]

[0] https://www.omnigroup.com/blog/setting-omnigraphsketcher-fre...

[1] https://github.com/graphsketcher/GraphSketcher

Rereading OP's comment, I misread it a bit and responded to the wrong part. You're absolutely right, progress on Unicode in Tcl stalled out after the low-hanging fruit of UCS-2 was achieved.

> ...am I missing any languages that do?

Tcl supported Unicode in 1999 with version 8.1. Much like Zathras, Tcl is the beast of burden that is easy to overlook.

Sounds kind of like the old vaccine airguns, but deliberately taking a sample instead of accidentally: https://en.m.wikipedia.org/wiki/Jet_injector

Yeah, that's when I was the most worried, when I was using stuff meant to muck with cell signaling solvated in DMSO. Be sure you're using the correct gloves! The "sensitive" nitrile and latex gloves typically found in biology labs don't offer good protection against DMSO.

Actually, I think it is more accurately ascribed to Tyndall scatter: https://en.m.wikipedia.org/wiki/Tyndall_effect

I was kidding. I however do think refusing to work with a uniquely useful substance because of the risks, without considering risk mitigation, is irrational and can impede good science.

Your bones are constantly remodeled, as part of calcium regulation in the body. HF, interfering with that remodeling, may give the appearance of it "eating your bones".

Speaking with my chemist's hat on… wimp.

Seriously, there are any number of nasty things floating around a wet chemistry lab. Chromerge and piranha solutions (sometimes aqua regia) for cleaning glassware, various super acids and bases, pyrophoric organometallics, stuff that's oxygen or water or shock sensitive… the list goes on. HF is certainly bad, but it tends to get the respect it deserves and so is handled safely. I'm more worried about chronic occupational exposure to "safer" things like chloroform.

Edit: the one that really scares me? Anything solvated with DMSO. It dramatically increases absorption through the skin. I bet every chemist has a secret chemical fear.

Edit 2: oh, and peroxides. One idiot postdoc had a habit of buying THF without stabilizers (no need for him to do so), and storing them in the back of the chemicals cabinet where they were frequently forgotten. At least he had the decency to store them on the bottom shelf. So admittedly I have two fears, but I'll work with HF!

In safety training at a university, we were instructed that if we were exposed to aqueous HF, we were to immediately slather on calcium gluconate on the burn area, grab an HF MSDS, and demand that the ambulance take us to a specific Level 1 trauma center and insist that the physicians understand that we were exposed to HF and not some generic acid.

I don't know the precise mechanism for toxicity (I thought it was hypocalcemia), but if the tradionally safety-lax academia takes HF that seriously, you know it's the real deal.

> The article says "emits a soft glow". Since that's impossible for something which isn't radioactive…

Not at all true.

In this case, it could be a phosphorescence or fluorescence process (the NYT says fluorescence), initiated by ambient light.

I skimmed both scholarly publications on this material but didn't find any mention of optical properties. I would ordinarily guess that any optical emission would involve an internal defect site (as happens with other optically-active diamond structures), but I'm thinking that's not a good guess given the synthesis process and overall quality of the monocrystalline product. A better guess might be some sort of "deep trap" emission involving surface defects.

Birds are neat.

My father had some sort of a mynah bird in a classroom where he taught middle school science.

(Mynahs can be phenomenal mimics, as this one was; it's also important to know that social birds both crave attention and love causing a scene.)

This particular bird learned that the sound of emergency vehicle sirens had the peculiar and interesting effect of causing the students to leap out of their seats in order to run to the windows to see what was happening outside… what the students never seemed to figure out was that the siren was in fact (almost always) the mynah bird mimicking a siren with perfect fidelity, down to the Doppler effect.

The students fell for it every time.

I'm told by relatives that paper remains the easiest way to transfer medical records, either by courier or by fax, which are then scanned in. The move to electronic medical records has reduced the need to store paper records (which, interestingly, is expensive), but it hasn't done much to reduce the amount of paper consumed.

And, if you're repackaging the supplement in capsules, do you need to be operating under whatever equivalent the supplement industry has to GMP conditions?

Research ethics must be a central concern, not something hand-waved away with an outline at a later date.

Maybe I'm getting a bad impression from your current website and comments, but appearances matter. The stereotypical "move fast and break things" attitude is wholly inappropriate here; human and animal research must be conducted with careful consideration and respect.

> If it makes you feel better, we are a supplement distributor that happens to help you record whether or not the supplements actually work.

You are then, by definition, conducting human research.

> They design the manufacturing process to squeeze out nickels on the dollar and using CM means they avoid legacy overhead that weighs down behemoths like GM, VW and Toyota.

GM's legacy overhead was discharged during their bankruptcy. As to DFM and manufacturing costs, the auto market is viciously competitive, and I don't see how newcomer Apple and their CMs are going to do something that the existing manufacturers haven't done already to maintain competitiveness in the current market.

> They also don't have any legacy overhead tied to engineering around ICE. As we've seen with Tesla, they had to reinvent almost everything because most of the problems traditional car companies had been working on don't exist in an all-electric vehicle.

Don't know what you mean by legacy overhead wrt. ICE. As to Tesla, that statement reads bombastic given previous efforts by others in battery electric vehicles. Beyond previous efforts by others, I'd say that BMW has done more innovation with their i sub-brand than Tesla has done, especially wrt. vehicle weight. Tesla does cool stuff, but the evangelism is tiring.

> Apple designs the buying process, which for cars is nightmare fuel for most people.

I completely agree that the current car purchasing process sucks, even for "no hassle" dealers, but how much can Apple do here? So much of the pain is finance- and paperwork-related, and even if Apple brings in their own financing, that can't get around the legal requirements for the paperwork.

> Carplay I haven't used but I think you may be selling this short too…

I agree that CarPlay sounds like a great idea, so much so that I unceremoniously ripped out my car's stock headunit to put in an aftermarket Pioneer unit with CarPlay a year ago. The problem is in the execution. Some stuff is almost magical, like automatically offering to navigate to the next appointment in my calendar; mostly though it's frustrating because it isn't reliable (especially in cell coverage-poor areas) and requires too much cognitive load to use. I have no doubt that Apple could improve it, but I don't know that the will is there because I think they would need to acknowledge that their current look and interaction paradigm aren't suited for in-car use.

> You talk about Apple's materials being shoddy but that is not the impression I have (outside of charging cables). My iphone 3gs and 4s have held up very well and metal frame ipads, macbooks and iphones seem to do even better.

I too have had good experiences with the metals, although the stuff using 6000-series aluminum is a bit dent-prone; I have no experience with the 7000-series containing Apple devices but would naturally expect that they would do much better. I was however specifically thinking of their PU and leather iPhone and iPad accessories: they look disgusting after only a week's use in the lighter colors, and I was mentally picturing the touch surfaces of a car using the same materials.

> There is plenty of room for technical gimmicks here in the auto industry and I fully expect a video of Jony Ive explaining how revolutionary it is for safety when the entire carframe is milled from a single piece of aluminum.

Sounds a little expensive to insure.

Yikes! I'm a bit disappointed and slightly surprised that there's no discussion nor consideration of research ethics appearing anywhere on that website.

This car stuff still doesn't make sense to me.

One big thing I don't understand about these Apple car rumors is what is Apple supposed to be doing that current automotive groups are not? If you're new to a product area, building a car using CMs (makes sense) with subsystems sourced from the CM or outside suppliers (also makes sense), where's the je ne sais quoi that makes the Apple car compelling over other options? How can you have an advantage over the established manufacturers, if you're sourcing parts/knowledge (e.g., BMW's nifty CFRP material) from your competition? What's the sustainable competitive advantage?

An obvious answer would seem to be design, but I don't buy that Apple producing a better UI than the current car manufacturers is fait accompli. On infotainment, CarPlay is pretty frustrating to use, to the point that I question if anyone from Apple has actually used it while driving: legibility is awful (especially for Maps), Siri doesn't work well in the noisy car environment as a primary navigation tool, and touch operation takes too much eye attention. Some of the usability failures are due to current Apple styling choices (e.g., fonts that are too thin), but many are (as I see it) due to the unsuitability of the Apple multitouch UI paradigm for the car. For comparison, I'd rate both Chrysler's UConnect and BMW's iDrive as superior in usability. I have no doubt that CarPlay can be improved (e.g., physical jog wheels), but I see those improvements as teaching away from the Apple's UI paradigm and towards the existing competitors in the auto world. As to interior or exterior design, I also remain skeptical: Apple tends to pick materials that don't wear well in use, and we're talking about a product that will have far longer lifecycle than anything in the current Apple lineup. I'm sure Apple could produce something that looks nice, but plenty of marques make nice looking cars. Nice appearance for cars is commoditized.

Apple's current supply chain and manufacturing processes are a hell of an advantage in consumer electronics, but there would seem to be very little overlap with automotive. I guess that applies broadly too, there seems to be so little overlap with Apple's current corporate experience and advantages in consumer electronics and the automotive arena.

edit: Also, JLG's point on maintenance is poppycock. Electric cars may have reduced maintenance, but to suggest that tires and wiper blades are all one has to worry about is plain wrong. Part of the product lifecycle considerations includes recalls, e.g., Takata airbags.

I'm in a regulated industry, and we'd be considered a "very small entity". What we're doing is likely overkill for you, but how we go about things might be of interest.

We develop under a spiral process and requirements are right at the threshold of when we're going under design control. We start out in Emacs org-mode. I developed a custom template and scripts that tries, to the best of my ability, to corral people into following ISO 29148. The engineering team uses a table view to track the requirements while we're collecting them, and there is a script to export into a pretty LaTeX document for stakeholders to view and redline. We keep the requirements in org-mode while we're collecting them because plain text is easy (and nice) to deal with for revision control. Everything is maintained in Fossil while it's in this state. Once we've ready to lock the requirements under design controls, we export into Excel via CSV for V&V. Under design controls, paper hardcopies become the authoritative record; doing things electronically is too expensive for us.

It'd be neat to one day be fully electronic throughout the process… I could easily see many groups being able to keep things fully electronic, and org-mode is a nice foundation to build a system on top of: it's just structured enough, but at the end of the day it's human-readable text. Heinlein said "once you're in low Earth orbit you're halfway to anywhere", I say, "once you're in org-mode, you're half way to anywhere".