robbiep

4,831 karmajoined 14 yıl önce

Emergency Doctor Founder

comments

5 gün öncediscuss

You know what already detects breast cancer? Mammograms followed by ultrasound.

We have screening programs for a reason. We know the sensitivity and specificity of these. They are widely available in any rich country that doesn’t treat its citizens like shit. There will absolutely be better stuff out there as we progress, with better sensitivity/specificity and lower harm (everything medical has some harm quotient) but I have a hard time wrapping my head around how they will best physics to provide better than state of the art today with this technology (and bow they will beat availability of current screening systems)

11 gün öncediscuss

‘Catfishing is fine’

14 gün öncediscuss

My impression isn’t that they are trying to improve CTE imaging (did it say that in the article?!) but somehow approach the resolution of being able to run the blood flow data through a black box so they can demonstrate what the occipital cortex is processing. I mean, that’s literally the first part of the article?

Can MRI/CT demonstrate CTE.

Well, like a lot of things which as alzheimers, that is still a pathological diagnosis for the most part, to the best of my knowledge (not post mortem scanning but out some brain tissue on a slide), but this belies the general fact that getting the tissue diagnosis is really not that important to anyone except a pedant, because yes MRI will show changes in grey/white matter differentiation and size compared to age and sex weighted cohort; and CT will show similar; and in fact it is the history and examination that practically matter to both the patients and their family.

So while it’s nice to have a totally 100% bulletproof ‘diagnosis’ for labelling purposes, practically on history and exam it’s not going to change how they are managed or what they and their family do say to day; given that both CTE and basically any of the dementias don’t have any treatment associated with them, and the current neuro imaging we have can deliver much higher resolution than what this is promising anyway (I mean even CT angio, and it’s not using ‘advanced imaging processes’ to create data out of noise)

15 gün öncediscuss

The methods described in the main article refer specifically to neurovascular imaging. In order to have a higher resolution, they’re making use of microbubbles (which need to be prepared and injected just prior to imaging).

There is no world where vascular imaging with a methodology like this is better than what I can do today in a GP clinic with a handheld GE or butterfly (or similar) US probe for anything that matters:

- for dvts and thrombus I can already image them

- if it’s in the brain the last thing that is useful for you to do is fuck around in a small clinic when you should be getting to a major tertiary centre as soon as possible

geçen aydiscuss

Some Microsoft setups ONLY allow Authenticator - can’t use 1pass etc. I have recently fallen into this pit

6 ay öncediscuss

I am a huge Tchaikovsky fan, mostly as I love his hard sci fi and incredible world building. I normally shy away from any fantasy but his city of last chances trilogy (now turning into a quadrilogy/on its was to 5??) is one of the absurdist Pythonesque and actually funny series I’ve read in years (although the first one is legitimately hard to parse/read given the style). Still, the juice is worth the squeeze and the second in the series I found hilarious.

7 ay öncediscuss

I got a student subscription to cursor and after giving it a good 6 hours I’ve abandoned it.

I extremely dislike the way it goes forth and bolts. I don’t trust these tools enough to just point it in the direction and say go, I like to be a human in the loop. Perhaps the use case I was working on then was difficult (quite old react native library upgrade across a medium sized codebase) but I eventually cracked this on Claude; cursor in both entropic and Gemini left me with an absolute mess.

Even repeatedly asking the prompt to keep me in the loop it kept on just running haywire.

10 ay öncediscuss

The difficulty is stopping when control of the organism is actually achieved, not just when you ‘feel better’. Most people are totally unable to make this judgement

10 ay öncediscuss

Huntingtons is not unique but certainly notable because it is caused by repeat sequences and therefore uniquely suited to mRNA silencing in this manner. There are very few other progressive (and I presume you also mean neurological) conditions, but also applied to the rest of the body, where this is the pathophysiology. For example, currently there is no immediate expansion of this to ie Parkinson’s (different pathophysiological basis) Lewy body (although maybe?) alzheimers (again possibly depending on whether it is tau, amyloid beta or simply ‘type 3 diabetes’) and nothing whatsoever for vascular dementia or ALS

10 ay öncediscuss

Have a read (rather than guessing) - it’s fascinating! Your other reply has a good insight but on more of a related topic but the primary reason this exists is for error correction. So approx one third of single nucleotide mutations have no change on the expression of the DNA or protein. And some of those that do change the amino acid are actually conservative; ie changing a basic amino acid to another basic amino acid which may still end up folding in the same way

5 yıl öncediscuss

You have misunderstood the point I am trying to make. I’m aware he has said and been responsible for things that are pretty distasteful today, and potentially by a bunch of people in his day. That doesn’t nullify his contribution to history, it just makes him another flawed human

5 yıl öncediscuss

I didn’t intend to compare Churchill to Jobs or the others in terms of achievements, it was more a comment on criticism I have seen of him in the last year which nullifies all of his accomplishments on the basis of racist comments, which, however unpalatable they may seem today, appear to have ben unfortunately quite in keeping with many of his peers of the day. (I know there were other actions of his that have been criticised as well but let’s just keep it to one example at the moment). So, maybe bad comparison but my intent was illustrative only

5 yıl öncediscuss

That works when a company is profitable, which it seems spacex isn’t; and as a musk style startup I (presume, with no evidence) that employees would have some stock. Perhaps.

5 yıl öncediscuss

I think the best current example of this is the ‘cancel billionaires’ writ large in the billionaire race to space.

Yes wealth inequality is probably one of the biggest issues of our generation. Yes it is probably unethical that people are able to amass such huge fortunes particularly in some examples less reflective of the current crop of tech billionaires through tax loopholes and the fact that if you have money its easier to get more money. Yes musk is a billionaire but almost all of his assets are tied up in company stock, so like how do you go about redistributing that? Also, why is the meme that if we still have world hunger we shouldn’t have a space program back again? As though the world isn’t large enough for us collectively to pursue more than one avenue of progress at once.

5 yıl öncediscuss

I’m honestly confused by the points of view that hold that unless a person was/is as pure as the driven snow they deserve to be scrubbed from the history books.

Jobs, Churchill, Gates, Musk - I don’t understand. It’s as if proponents of that view believe that the only people deserving of recognition are those that were completely internally consistent, including by the times in which they are being judged (ie present tense).

Humans are complex. None of us (or at least, very very few of us) are fully internally consistent. The personality flaws that cause the greatest consternation may also be those that lead to our greatest triumphs. If they are not criminal, why not recognise people for doing great things? And why is it so hard to say add the caveat that like all humans, they had their flaws?

11 yıl öncediscuss

Not European but travelling in Asia at the moment. Have had a couple of discussions with run-of-the-mill Europeans concerned that the refugees areproportionally made up much more of young men than women/children with the implication that these guys are up to no good. I'd say the subtleties of the humanitarian crisis is going to be lost on the average European Joe in the wake of this

12 yıl öncediscuss

Wow, I didn't have this. What state?