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milkcircle

745 karma · joined February 5, 2013

Classical hematologist and clinical investigator. Interests in statistics, large data, and red cell disorders.
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milkcircle··on Six transplant patients in Brazil contract HIV from infected organs
For those who watch medical shows, this is somewhat reminiscent of a case of several patients who contracted rabies through organ transplants - a story that was portrayed in Scrubs season 5 episode 20, "My Lunch".
milkcircle··on Report: 90% of nurses considering leaving the profession in the next year
It's probably Tufts. https://www.boston.com/news/health/2022/01/23/pediatric-doct...
milkcircle··on Ask HN: Non-tech professionals on HN?
Physician in internal medicine with a background in computer science, math, and genetics. Got hooked on HN in college after searching for a like-minded community sharing more relevant news to me than the vast majority of other websites.
milkcircle··on Three people with inherited diseases successfully treated with CRISPR
Hi. I do research pertaining to this disease and can answer your very thoughtful question. It is in fact safe for pregnant women to have high levels of fetal hemoglobin. There is a condition known as Hereditary Persistence of Fetal Hemoglobin (HPFH) in rare individuals who express near 100% fetal hemoglobin into adulthood, and they are able to undergo pregnancy perfectly normally with no harm to mother or child. While it is true that HbF has a mildly higher affinity to oxygen, it has not been shown in population-based studies that having higher levels of HbF by itself causes any actual clinical adverse events.
milkcircle··on Ask HN: How to Improve at Chess
I highly recommend watching the following Youtube channels. These chess masters often stream games in which they explain their thought process behind each and every move, and provide a high level overview of how they design their plans.

Chess Network - https://www.youtube.com/user/ChessNetwork

John Bartholomew - https://www.youtube.com/channel/UC6hOVYvNn79Sl1Fc1vx2mYA

Of course, following these channels will not improve your chess reasoning by itself, but neither will playing too many fast games without spending time to analyze the games. I typically play one longer game (10+5) and one rapid game (5+5) once a day then spend the rest of my free time trying to find areas of improvement.

milkcircle··on Asian American Discrimination in Harvard Admissions [pdf]
Excellent point. Asian Americans form an extraordinarily heterogeneous group, spanning all areas of socio-economic status and access to opportunity. Race is an imperfect proxy for what affirmative action attempts to do, which is to normalize circumstantial variables to better assess an individual's potential in the context of his or her environment. Several natural questions follow: 1) what other applicant characteristics better map onto what affirmative action tries to achieve? and 2) if we concede that self-reported race or perceived race is not the right characteristic to adjust for, then how do we create a truly race-blind application process?

Speaking as an Asian-American alumnus of Harvard, I will say that the conversations I've heard in the community are mixed, even among Asians. Most people are aware that discrimination against Asians is a real problem, though they do not believe affirmative action as a principle is at fault; rather, its implementation is imperfect and not nuanced enough. Adding to this debate is the complex piece of how legacy students are treated by admissions, what role money/wealth plays independently of affirmative action, and the overall autonomy and goals of private institutions. And in the end, to what extent should private and public institutions be held liable for how they achieve their diversity goals, and how do you balance this with fairness toward applicants?

milkcircle··on Ask HN: What's the most thought provoking short story you've read?
I recommend "The Merchant and the Alchemist's Gate" by Ted Chiang! An excellent sci-fi story set in the past that explores themes of guilt and repentance.
milkcircle··on Ask HN: What's your favorite code practice site?
Project Euler https://projecteuler.net
milkcircle··on NASA twins study confirms preliminary findings
One notable finding was that the astronaut's telomeres grew significantly in length while in space, and after returning to earth shrank back down. As telomere shortening has implications in aging as well as in cancers, it will be interesting to follow up this finding and determine 1) the differences in terrestrial and extraterrestrial atmospheres that account for the increase in telomere length, and 2) the implications that this may hold in terms of cell senescence and tumor growth.
milkcircle··on Ask HN: As a future medical student, what area of tech should I focus on?
Medical student here. I conduct research in genomic medicine on the side, and programming is a large part of what I do. In my particular field I find a solid background in algorithms and statistics to be very helpful in interpreting large amounts of data. I encourage you to get started by taking introductory computer science and continuing with math, especially in probability and statistics. There is an incredible divide between medicine and tech at the moment, and CS is a highly sought-after skill in medicine. Feel free to follow up with any more specific questions, I'm happy to answer them!
milkcircle··on How Gut Bacteria Are Shaking Up Cancer Research
Fun fact: blood-letting is still used clinically for several forms of blood disorders. In cases of iron overload (hereditary hemochromatosis), blood is removed to maintain a low circulating free iron level. Today we don't call it "blood-letting" but rather "therapeutic phlebotomy".
milkcircle··on French drug trial leaves six hospitalized, one brain-dead
Just some background about clinical trials that may yield more insight into the drug approval process:

Phase I: intended to determine a loose range of safe doses for patients. Subjects enrolled in Phase I clinical trials are informed that it is unlikely for the drug to benefit them. Normally, subjects are healthy volunteers that are put into buckets of different doses to determine the Maximal Tolerated Dose (MTD).

Phase II: Intended to characterize the efficacy of the drug (on a small scale). There are several methods of conducting Phase II trials; some are simply longitudinal case studies, and others are structured more like randomized controlled trials (the type of clinical trial generally considered the most valid [i.e. maintains the highest internal validity]).

Phase III: Randomized controlled trial. Patients are randomized into the test group vs. placebo/current standard of care to determine whether the new drug is effective. The best RCTs are double-blinded though this is not always the case.

This drug, a monoclonal antibody intended to alter the immune response, was halted in the Phase I clinical trial.

milkcircle··on Ask HN: What is your company's on-call rotation like?
Appears to be less than 3k/day on average. Source: http://www.acep.org/Clinical---Practice-Management/Survey--M...
milkcircle··on Learn to play chess online
It's often instructive to watch great players play chess. ChessNetwork has a series of hundreds of videos in which he talks through every move of the games that he plays. I encourage budding chess players to check out his Youtube channel: http://www.youtube.com/user/ChessNetwork
milkcircle··on Paternal stress in mice given to offspring via RNA packed into sperm
A quick answer to your question #1/2: microRNA (miRNA) is the substrate of a very complex piece of cell machinery that uses the miRNA sequence to find complementary messenger RNA (mRNA). When miRNA binds to its respective mRNA, the machinery (whose details I will not go into) degrades the mRNA, preventing its translation into protein. So while the DNA remains unaltered by the miRNA, protein expression is regulated on the level of mRNA degradation. MiRNA and short-hairpin RNA are tremendously useful in the laboratory setting to knock down the expression of genes without having to do gene modifications. This paper shows that miRNA can be passed from father to child through the sperm, and this miRNA can affect the way certain genes are expressed.

As for your question #3, I couldn't find any information in the paper regarding how long the miRNA persisted in the offspring. The miRNAs seem to have a long-term effect on genes in the paraventricular nucleus of the hypothalamus, but whether this is due to effects of miRNA solely in the development of the zygote, or whether the miRNA in the adult is also important, is unclear. It seems likely that changes due to the miRNA in fetal development alone could be sufficient in dramatically changing stress responsitivity, but this remains to be proven.

In another famous study, maternal nurture plays a very important role in the epigenetic development of baby mice [1]. So it could very well be that a favorable and nurturing environment may cause epigenetic changes in the offspring that might counteract the actions of the miRNA described here. Again, this is something that the paper does not show and therefore we can only speculate at this point.

Hope this helps!

[1] http://www.nature.com/neuro/journal/v7/n8/full/nn1276.html

milkcircle··on Jackfruit could save millions from starvation
One of my amazing classmates in medical school is the founder of a company called Global Village Fruit [1] where she works on making jackfruit available internationally. In the Boston area her company has supplied numerous local restaurants with the fruit (Veggie Galaxy makes a delicious jackfruit sandwich out of her company's product), and she's done a wonderful job spreading awareness of the jackfruit. I urge you to check out the company and learn how you might be able to incorporate the jackfruit into your own recipes!

[1] http://www.globalvillagefruit.com/

milkcircle··on Ask HN: For people who attend(ed) medical school, what was your experience like?
Thanks for your response! If I can ask a follow-up question, when did you decide to do EM (was that something you knew going into medical school?) and how did you know that this was the right field for you?
milkcircle··on Ask HN: How do you stay in shape?
As a student I have a similar problem of spending too much time at my desk, both weekdays and weekends. Here's what I hope to implement in the coming semester to stay more fit:

1) Wake up very early (goal is 6:30am) to spend an hour working on fitness before breakfast and starting class.

2) Follow /r/bodyweightfitness and /r/running, and use their beginner programs to come up with my own schedule Mondays through Saturday.

3) Explore my city (walking, biking, hiking) early Saturday morning to Saturday afternoon.

I think a major step in the right direction is waking up early and getting your exercise "out of the way" for the day. It serves as a huge motivator and is a great routine to become accustomed to. Not to mention, on Saturdays, if you wake up very early, you can fit in 6 or 7 hours of fun and exploration and still have half the day to be productive afterward.

milkcircle··on Ask HN: Who are your favorite poets?
I have this one tacked up on my wall. Not only is it inspirational, but I am impressed by the syllabic structure of the poem (alternating 11/10 syllables, iambic). Having never really studied poetry before, I found this really cool.

If, by Rudyard Kipling

    If you can keep your head when all about you   
    Are losing theirs and blaming it on you,   
    If you can trust yourself when all men doubt you,
    But make allowance for their doubting too;   
    If you can wait and not be tired by waiting,
    Or being lied about, don’t deal in lies,
    Or being hated, don’t give way to hating,
    And yet don’t look too good, nor talk too wise:

    If you can dream—and not make dreams your master;   
    If you can think—and not make thoughts your aim;   
    If you can meet with Triumph and Disaster
    And treat those two impostors just the same;   
    If you can bear to hear the truth you’ve spoken
    Twisted by knaves to make a trap for fools,
    Or watch the things you gave your life to, broken,
    And stoop and build ’em up with worn-out tools:

    If you can make one heap of all your winnings
    And risk it on one turn of pitch-and-toss,
    And lose, and start again at your beginnings
    And never breathe a word about your loss;
    If you can force your heart and nerve and sinew
    To serve your turn long after they are gone,   
    And so hold on when there is nothing in you
    Except the Will which says to them: ‘Hold on!’

    If you can talk with crowds and keep your virtue,   
    Or walk with Kings—nor lose the common touch,
    If neither foes nor loving friends can hurt you,
    If all men count with you, but none too much;
    If you can fill the unforgiving minute
    With sixty seconds’ worth of distance run,   
    Yours is the Earth and everything that’s in it,   
    And—which is more—you’ll be a Man, my son!
milkcircle··on Ask HN: How did you build your current work ethic?
The most proactive step I take to get things done is to go somewhere where I'll feel guilty if I don't do work. I've learned not to trust myself when I'm alone in a room with no oversight...I'll just end up getting distracted or playing games or going on social media, and I very easily lose track of time this way.

It's much easier for me because I'm in college right now and the library is only a few steps away from my dorm, so the activation energy isn't as great. But I've found that I get very self-conscious about what's on my screen if I move to an open spot in the library where people can see my laptop screen as they walk by. What also helps is seeing my friends be productive; it pushes me to begin work as well.

An unintended benefit of constantly going to libraries or cafes to work is that it makes me separate my work from my dorm room, which is advantageous in itself. Returning to my room now allows me to put my work behind me and truly relax, something that hadn't really been possible before. Of course, all this is psychological, but I find it really helps me.

milkcircle··on The daily routines of famous creative people
Interesting how so many people didn't fit exercise into their daily routines.
milkcircle··on Ask HN: Why is privacy something we should strive for?
One reason is that exposing some forms of personal information can lead to discrimination. For instance, access to private medical records or to genetic information may allow insurance companies to discriminate against people they believe might be predisposed to certain health risks.

Additionally, there is a reason why people don't like revealing things about themselves (like their salaries, for example): it opens them up to judgment and allows society to comment on how they rank hierarchically within a certain community.

Privacy allows us to feel comfortable revealing only the information we think won't detriment us in the eyes of others, especially because this can have significant tangible effects on our lives.

milkcircle··on Ask HN: have you ever seriously learnt something through online courses?
It can be done, but you have to remember to set strict deadlines for yourself, or else it will be a waste of time.

Without the pressure of grades going on your transcript, it can get exceedingly difficult to push yourself to finish all of the assignments, and there are few incentives against quitting after getting frustrated. This is why college courses work so well for so many people: good university transcripts are far more important than the certificates that online courses might offer.

Harvard's CS50x released some interesting stats after its first year. Of over 100,000 people who signed up, only 11% submitted the first and easiest problem set. Of these 100,000, only 0.9% completed the course. Of those who submitted the first problem set, 13% completed the course.

It's definitely possible to get a good education from online courses, but it's important to realize how difficult it will be to keep yourself on a schedule. Treat it as a normal university class, prepare yourself, and come up with a feasible daily/weekly schedule.

milkcircle··on Headphone Brands Ranked from Worst to First
Can anybody suggest overear headphones for people who wear glasses? Most of the ones I've tried press my glasses into my temple and cause pain after a short while.
milkcircle··on Ask HN: What interesting books are you reading now?
The Emperor's New Mind by Sir Roger Penrose. It's a very accessible and highly fascinating discussion about whether machines will ever be able to emulate the human mind.