rdmirza

Strello Health | Toronto (hybrid in-person/virtual)

Clinic Sales & Onboarding Lead | https://strello.health

Strello is an AI front desk for Canadian medical clinics. It answers calls, books and moves appointments, and works directly inside the clinic's EMR. We're physician-founded (I'm a practising rheumatologist), and the product came out of our own front-desk turnover problems.

What you'll do: - Own inbound leads and respond fast. Screen for fit first: are they on an EMR we integrate with, and is Strello the right answer for their phones?

- Run discovery and demo calls with physicians and clinic managers, then quote, close, send contracts and payment links, and keep the CRM current.

- Lead onboarding: workflow meetings with clinic staff, phone and EMR access, and launch coordination with our engineers.

- Stay the go-to contact after launch, and bring what you hear back to the product team.

You might be a fit if you've worked in sales, or clinic operations (MOA, coordinator, manager), or healthcare SaaS account management, or customer success.

You should be comfortable on the phone and on video with physicians, organized enough to run many clinics in parallel, and happy to help write the playbook at an early-stage company.

Apply: reza@strello.health with a few lines on the clinics or customers you've worked with.

We’ve had a bunch of folks express interest (thanks!)..

But to be clear: this is an in person (Toronto) / remote hybrid position.

If your CV doesn’t have a locale, please confirm your willingness to come in person/relocate

*Strello Health | Founding Software Engineer | Full-time | Hybrid Remote | Toronto/GTA*

Strello Health builds AI voice agents for healthcare. We’re post-seed, generating revenue, and scaling quickly.

You’ll work directly with the founders to build the core infrastructure behind real-time voice conversations, including audio streaming, LLM orchestration, APIs, integrations, observability, and production systems.

We’re looking for engineers with experience in backend or platform development, distributed systems, APIs, Linux, and building reliable systems from 0→1. Co-op experience counts, and we’re hiring across experience levels.

Bonus: WebRTC/WebSockets, ML or LLM infrastructure, Node.js/TypeScript, Python, Docker, Kubernetes, or open-source contributions.

Tech stack: TypeScript/Node.js and Python.

Email: jobs@strello.health

Aye. Outside edit window unfortunately

It's established that COVID can persist in tissue/blood - particularly in immunocompromised patients - and is associated with long COVID [1]. This abstract only reports a cut-off of >60 days from COVID infection, so it's hard to know how many of these deceased patients are truly outside the acute infection phase.

Although this research area is the most promising avenue for long COVID -- wrt biologic rationale -- the major anti-viral trials for long COVID were negative.

STOP-PASC trial [2] and PAXLC [3] were both 15-day courses of Paxlovid and showed no benefit across patient reported outcomes.

The real question however, is whether anti-virals have benefit in patients with active viral replication. Like only cases of long COVID can be implicated to viral persistence.

STOP-PASC did collect stool PCR at baseline, but every tested sample was negative. PAX LC later reported a exploratory biomarker analysis of 82 PAX LC participants did measure circulating SARS-CoV-2 S1 and full-length Spike, and wasn't powered to find a difference. Notably, spike presence doesn't necessarily mean active viral replication [4].

As an aside, mchusma's post is probably right. Viral disease is not being associated with more and more long term diseases. EBV is being linked to MS, cervical cancer to HPV, and so on.

[1] https://www.sciencedirect.com/science/article/pii/S147330992... [2] https://jamanetwork.com/journals/jamainternalmedicine/fullar... [3] https://pubmed.ncbi.nlm.nih.gov/40188838 [4] www.medrxiv.org/content/10.64898/2026.02.24.26347001v1.full

Two familial cases of sudden cardiac death? That’s not normal. That’s an indication to investigate.

Your take on Evidence Based Medicine (EBM) is wrong.

At the top of the evidence hierarchy is N-of-1 trials (and below that are high quality meta-analyses of trials). Nothing is more informative about treatment response in a person than testing it in that person. This is the heart of personalized medicine, and exactly for the reason you stated: Different interventions work differently for different people.

And any practitioner worth their salt is unsurprised by this headline. A great example is that illness and inflammation increase insulin resistance via counter-regulatory hormones.

You got one thing right, intuition often turns out to be wrong. That is why the vast majority experimental therapeutics built on great ideas never get passed initial testing.

My immediate thought. Big Claims without backing.

Your model makes predictions. Prove they’re worth salt.

At that point you’d simply cut out the tumor.

Small individual study sample size does not necessarily mean junk. Junk is a product of poor methodology. The main concern with sample sizes may be overestimates of effects if the event is rare, or poor precision (ie large confidence intervals).

However you’re right to presume that small studies are likely to be lower quality, often because they’r observational as opposed to randomized studies.

I think you’re spot on about the clear advantage of your approach relative to the article and blood biopsies: If you’re looking for cancer in the blood, you’re probably too late as this suggests metastatic spread.

You suggest something better: look for tissue level markers.

The immunotherapy revolution (ie CTLA/PD1 molecules), you’ll recognize that leveraging the immune system is brilliantly effective.

Presumably stealth genes do not evolve first, but rather proliferative genes. And this is why any chronic damage triggers cancer because renewal is a replicative process, and replications begets copy errors. wanderers and passersby will have to recognize I’m simplifying.

I have a great lateral. Not sure if you have the funds to try two things, but TCR characterization is a wonderful idea. At least thats the best way to do it, as I see it. has many application beyond cancer

Good luck!

Even better is installing an implantable cardiac defibrillator (ICD) in those at high risk.

The main concern here (and most observational studies) is confounding by indication. Specifically, the same reason some people got hydroxychloroquine as opposed methotrexate is the same reason you see differences in the outcome. In this case there’s plausible confounding that needs to be addressed before any conclusion like the title could be drawn.

Generally hydroxychloroquine is used in mild rheumatoid, whereas methotrexate is used in moderate-severe disease.

Inflammation in rheumatoid (and other inflammatory diseases) contribute to atherosclerosis and plaque buildup. Rheumatoid increases the risk of coronary disease by 1.5-2x.

That difference alone could account for the difference in dementia, particularly vascular dementia.

I'm intrigued about your research and would love to hear more. I'm a physician interested the effect of for-profit care on health care and outcomes.

As an example, we showed that for-profit dialysis facilities in the US have about a 7% higher mortality rate. We did a meta-analysis and every study barring one found higher mortality in for-profit dialysis facilities. Other studies suggest one reason is lower referral rates for kidney transplantation. Higher mortality has also been shown in for profit hospitals.

Yes cholesterol is a vital building block. However the medical literature consistently shows a strong relationship between LDL and non-HDL cholesterol levels and heart attack and stroke.

Various cholesterol lowering drugs, statins being the most widely prescribed but certainly not the only class, show consistent relationship with cholesterol lowering and reduced risk of MACE (MI, stroke).

Plaque is made of foam cells that consume cholesterol. They grow and obstruct arteries, and eventually rupture causing critical flow obstructing events.

That’s a great thought, however, when you look at tissue under a microscope you should see evidence that the immune system was at play. This means the presence of complement activation (an ancient arm of the immune system), antibodies, white blood cells, nuclear debris, and so on. Presumably when they saw no evidence of immune mediated rejection, they saw none of this.

Wow, this is appalling medical advice.

Perhaps diet, exercise, and evidenced based treatments would be a good place to start.

This is no longer true.

The GLP1s have proven to have excellent efficacy for weight loss (and cardiovascular mortality in diabetics). Their numbers approach bariatric surgery (>10% body weight in the obese).

People keep the weight off too. Here's one study showing 5kg on average weight loss at 5 years according to this study: https://www.mdpi.com/1660-4601/17/1/207/pdf

This piece entirely misses the point of the recommendation.

The new recommendation is that aspirin should not be used to prevent heart attack in those without a history of heart disease (ie avoid routine aspirin for "primary prevention"). Aspirin for primary prevention has always been a grey area. The reversal came after a large trial in the New England Journal of Medicine looking at this. The trial showed the decrease in cardiovascular events was balanced by a similar increase of bleeds. So it's still grey because some people would prefer to bleed because blood is easily replaceable, your heart is not.

What remains clear is that people who have had heart attacks, strokes, or peripheral arterial disease should in most cases continue their anti-platelet agent.

My meaning was that there is no other therapeutic agent available for prevention of post-ERCP pancreatitis. But you're quite right, there must be another reason.

If I had to hazard a guess, it may be the market isn't attractive enough for competitors to establish a national supply chain. Or there's some sort of collusion at play.

To me this represents further evidence why public goods should be left out of the hands of private for profit organizations for whom disease is simply an externality to capitalize on.

Ahh, the pricing of rectal indomethacin.

Here's the tale: If you have obstruction of your bile ducts below the liver or gallbladder, usually gallstones or sometimes neoplasm, you need an endoscopic retrograde cholangiopancreatography (ERCP) for extraction or sampling.

ERCP is sticking a tube down the throat, stomach, small intestines into a tiny opening at the ampulla of Vater to access the bile ducts. Sometimes this process causes inflammation of the ampulla and associated ducts leading to blockage, and can lead to pancreatitis due to back flow and pressure, because the pancreas also excretes its digestive enzymes via the ampulla).

A few trials circa 2015 showed rectal indomethacin reduced the risk of post-ERCP pancreatitis, and eventually it made its way into the guidelines. It is the only proven preventative treatment, so they have a natural monopoly.

Hope that helps.

I did not bother to read this thread in its entirety though I typically enjoy HN discussion.

Undoubtedly, masks of any quality work. Airborne viruses still exist in secretions (likely, in much higher concentrations). Secretions sometimes even carry living cells, would you imagine (in fact the #1 cause of sputum sample contamination for C&S; the bane of internists everywhere). High velocity events certainly increase the environment-load of secretion and thereby virus.

You don't need evidence in all cases. Im sorry to say, to the otherwise curious-minded, this is one of those cases.

Compare those values to your own weight, and pay attention when you hear someone’s weight to see if it matches your heuristic.

MAPS (multidisciplinary association of psychedelic studies) is systematically demonstrating the positive effects of psychedelics.

Their most impressive work is in PTSD. In Phase 2 trials, they took people with established PTSD (for years) and undertook ~3 guided psychotherapy sessions with MDMA. Within 2 months, 53% no longer met criteria for PTSD and at 12 months 68% didn't.

Far more efficacious that anything else we have. Powerful tool for psychologic healing.

This comment is so entirely out of place on HN.

Yes, and no.

Yes: the net impact on the environment is likely to be equivalent if imports and exports balance.

No: a major criticism of renewable energy is that it is less reliable. Achieving 100% is much more impressive without a handicap.

I'm still impressed though.

That's fascinating.

Though it's not quite 100% renewable energy unless the energy being imported is also renewable.

This doesn't necessarily change anything about computing neural nets. You need to view the genomic variation as representing the complexity of each neural unit: its connections (in and out), it's propensity to fire, and function it operates by. The genome is just the code representing this information.

Basically, each node in a neural nets is unique akin to each neuron.

FMT is already used as a treatment for c. dif here in Canada.

Im surprise that nobody has mentioned that the author here is being sarcastic. The author is clearly being facetious.

"How to apply to your own life: When in need, seek sociopathic counsel," do you really think the author means that? sociopaths are known for their deceit and predatory nature.