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rscho

3,552 karma · joined December 4, 2016

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rscho··on Cancer DNA is detectable in blood years before diagnosis
Last time someone tried to inject chips into the bloodstream, public opinion didn't handle it too well. It's the same as we would learn a lot by being more cruel to research animals. But most people have other priorities. Good or bad ? Who knows ? Research meets social constructs.
rscho··on Cancer DNA is detectable in blood years before diagnosis
What are you gonna do if the screening test comes back positive?
rscho··on Cancer DNA is detectable in blood years before diagnosis
Ideally, you'd want a test (or two sequential ones) that's both very sensitive (rule candidates in) and specific (rule healthy peeps out). But that's only the first step, because there's no point knowing you're sick (from the populational and economic pov) if you can't do something useful about it. So you also have to include downstream tests and treatments in your assessment and all this suddenly becomes a very intricate probability network needing lots of data and thinking before decisions are made. And then, there's politics...
rscho··on Cancer DNA is detectable in blood years before diagnosis
Honestly, you don't have access to the necessary data to make rational decisions. That's not gatekeeping, it's logic. I don't have access to it either, although I'm indeed a healthcare pro. Screening strategies are a hyperspecialized domain and only experts somewhat understand what they're doing. It's just like making theories about what the CERN guys should be doing while not having passed physics 101 with no access to experimental data. That's why I'm just saying: you're certainly allowed to question, but you certainly can't make up assertions either.
rscho··on Cancer DNA is detectable in blood years before diagnosis
No, the potential harm comes from follow-up tests. That's why screening strategies are designed by professionals. It's a pretty complex field, and all the people here fielding their opinions on how we should proceed about tests don't have a single idea about the implications of their theories.
rscho··on Cancer DNA is detectable in blood years before diagnosis
It's not personal, it's perfectly rational statistics, i.e. epidemiology. Designing screening strategies is not an amateur's game.
rscho··on Cancer DNA is detectable in blood years before diagnosis
... or could do you harm, which is an important point.
rscho··on The Lisp in the Cellar: Dependent types that live upstairs [pdf]
Well... believe it or not, some have thought of using lisp for AI for quite some time. ;-)
rscho··on In kids, EEG monitoring of consciousness safely reduces anesthetic use
> I fear the general trend of "medication bad" will get us back to those dark times.

I think this won't ever happen. Modern docs would absolutely not accept working under such conditions. Anesthesia is not only comfort for the patient, but also for care providers. As you can often see when surgeons advise patients on refusing local anesthesia or nurses demanding benzos for the screaming demented patient at 2 a.m.

rscho··on In kids, EEG monitoring of consciousness safely reduces anesthetic use
> And the exact definition of the anesthesia given to most infants before 1987: A paralytic. Nothing else.

To my knowledge, this was only true for newborns. Infants and up usually got some sort of hypnotic.

rscho··on In kids, EEG monitoring of consciousness safely reduces anesthetic use
It is mainstream. We have modules. It's useful, but unfortunately not a magic wand either.
rscho··on In kids, EEG monitoring of consciousness safely reduces anesthetic use
While the theory about pain in kids was certainly wrong, you are lacking some context about what 'safe' used to mean, and what it means nowadays. In the 80's, kids were under halothane and long-acting paralysis drugs which, especially in cardiac patients, are really dangerous. Halothane is now discontinued, as are many other common drugs from this time. Theories do not spring out in isolation. The evolution of technology, biological understanding and new pharmacology have all contributed to allow new opinions as incremental changes made old theories more and more evidently obsolete. Doctors 50 years from now will also wonder how we could be so stupid in 2025.
rscho··on In kids, EEG monitoring of consciousness safely reduces anesthetic use
You just crank it up until those people don't react. With experience, you can anticipate those pretty well.
rscho··on In kids, EEG monitoring of consciousness safely reduces anesthetic use
Circumcision induces keratinization of the glans (one of the reasons this makes us more resistant to many STDs). I noticed a huge difference in touch perception before vs. after and I strongly resent that this was brought onto me. I'm not trying to insult anyone. It's personal.
rscho··on In kids, EEG monitoring of consciousness safely reduces anesthetic use
"MAC being the primary indication of anesthetic depth being the textbook definition"

I am an attending anesthesiologist and this is true. MAC cannot be interpreted at face value, though. You've got other drugs on board (not accounted for in MAC), the patient might be frail or very old, etc. etc. All things changing MAC interpretation, which is why there are still anesthesia providers instead of robots ;-) We currently have no way of faithfully measuring the depth of anesthesia, and our understanding of consciousness/awareness is incomplete. Anesthesiologists have to rely mostly on know-how, even in 2025.

rscho··on In kids, EEG monitoring of consciousness safely reduces anesthetic use
Anesthesia is mostly know-how. When you've put several hundred kids under, you (usually) become equipped with a good sense of what's going on, even without kids telling you.
rscho··on In kids, EEG monitoring of consciousness safely reduces anesthetic use
MAC is the alveolar concentration (so strictly speaking defined only for anesthetic gases) at which half of people show no motor reaction on surgical incision. I understand your interpretation about paralysis, but we know the measurement endpoint is not paralysis in practice. Gases are hypnotics, and although they do cause some amount of muscle relaxation they do not induce paralysis. Hence the need for other drugs when we need paralysis. BTW, there is evidence that EEG prevents awareness under anesthesia, but it's not a guarantee either. Fortunately, awareness is extremely rare even in the select cases where it occurs more often (emergency C-section and cardiac surgery, especially in seniors).
rscho··on In kids, EEG monitoring of consciousness safely reduces anesthetic use
We do it regularly in both kids and adults, and this is nothing new. It's just that a study confirms it's useful using statistics instead of common sense. We were already using EEG in both kids and adults 15 years ago.
rscho··on In kids, EEG monitoring of consciousness safely reduces anesthetic use
The theory wasn't about remembering, it was mostly about babies supposedly having a nervous system too immature to interpret pain as in adults. This is not the current opinion at all anymore.
rscho··on New antibiotic that kills drug-resistant bacteria found in technician's garden
I don't use discord. raoul.schorer@gmail.com
rscho··on Sponges, drill bits and wires: Surgeons mistakenly left objects inside thousands
> But doctors unions fight tooth and nail to prevent the publication of information that would allow patients to make informed decisions

Yes.

> which removes the financial incentive for surgeons to do better and prevents bad surgeons from being weeeded out of the market

This is absolutely not why the 'doctors unions' fight against performance statistics. Can't you people think of nothing else than money ?

rscho··on New antibiotic that kills drug-resistant bacteria found in technician's garden
Thank you so much for volunteering!
rscho··on Rhombus Language
Hackett. But the language is now abandoned.
rscho··on Rhombus Language
Very easy. You could do it yourself after 5 min of reading ;-)
rscho··on Rhombus Language
I don't think they care so much as you think about 'takeoff'. It's mostly a research project in programming pedagogy. They're trying to make lisp features more accessible to students in universities. A takeoff would sure be appreciated, but the immediate goal is not a takeover of the industry.

The author (M Flatt) is an incredibly gifted and productive programmer, btw.

rscho··on Mayo Clinic's secret weapon against AI hallucinations: Reverse RAG in action
Doctors and statistical processes are always a bad match. (I'm a MD doing medical stats) No, this is not reliable in the slightest.
rscho··on Exo: Exocompilation for productive programming of hardware accelerators
Well, this is clearly an attempt at abstracting the kind of low-level stuff you describe. Perhaps it doesn't work (yet), but that shouldn't prevent people from trying ? Involving a SMT solver suggests that the solver is doing the heavy-lifting, not python. PhDs often produce inapplicable stuff, but they are also the basis for industry/application R&D, such as what your org is doing... PhDs are the slaves of science. They make stuff happen for peanuts in return and deserve our respect for that, even if what happens is oftentimes a dead-end. It's really sad seeing people shitting on PhDs.
rscho··on Ask HN: Any insider takes on Yann LeCun's push against current architectures?
"Oh, I emptied your bank account here, let me change this."

For AI to really replace most workers like some people would like to see, there are plenty of situations where hallucinations are a complete no-go and need fixing.

rscho··on C Plus Prolog
Yes, but honestly if you can use specialized software instead of writing your own, do so. Scheduling problems become very hairy quite quickly. For ASP, there is also sCASP that is the current flagship application of SWI Prolog.
rscho··on C Plus Prolog
The big advantage of prolog vs solvers is the logic programming aspect. If you can express parts of your program in a logically pure way, Prolog code will be much more concise than the Z3 equivalent, although probably slower. Another advantage is that Prolog outputs and reads Prolog terms, which makes it very good for metaprogramming. It's like lisp: incredible if you're solo prototyping, not so much if you're part of a team of corporate cogs.
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