I'm with the sib post here. I really enjoyed o-chem. It actually made me sad that I didn't take P-chem when I had the chance.
One thing that made the difference was that I prepared before the class even started -- I looked at the list of suggested readings in the course syllabus and went through one of the suggested resources ("Pushing Electrons"). An awesome little work book that made everything I learned in class very understandable.
And yeah - I took Ochem as a pre-req for med school and guess what? I still use information I learned in that pre-req as an MD. So much for the "you'll never use it!" argument!
I have the same printer - CLP550N, that I bought in 2005. Still on the original color cartridges (which are starting to go, but I put my defaults settings to print B&W). I love the duplex printing and it has been a solid printer for 7 years with some years of heavy printing. I need a new black toner cartridge every couple of years or so (I am on my 4th) but it is not horribly expensive (less than $100 from 3rd parties).
The biggest design problem with the printer is with the waste toner cartridge, which didn't make a good seal and so used toner would muck up the optical sensor that triggers a "waste toner full" error. I easily fixed this though by taking the LED and taping it to the sensor. Problem solved.
You actually want a long incubation period so that the infected stay symptomless (but infective) for as long as possible. If the symptoms are severe and the incubation time short (e.g. flaviviridae like marburg or ebola) they kill the host before they have time to infect enough people. In essence, the virus is *too* virulent that it goes through the available susceptible people too quickly.
More deadly would be a virus that has is lethal but does not show symptoms for a period that exceeds its infective period. A good example is the early years of the HIV era -- lethal virus, long time before symptoms start, and infectious much earlier than any symptoms start to show up.
My point is that putting in that number needlessly detracts from what they are trying to say. You could easily counter their example with the fact that some colonscopies can take hours (e.g. complications occur, perforations, etc...) and thus doctors are getting UNDERPAID. Without any context, it comes across as sensationalist. The point they are making (medical reimbursement is non-transparent and is not aligned with primary care of populations) but this is not helped by their hook.
15 minutes for a colonscopy? Where do they get this number? Getting informed consent can take 15 minutes just by itself (and is something the doc has to do). 15 minutes sounds like the best-case scenario (e.g. a screening colonscopy on a healthy 50 year old with no findings) and a number to sensationalize the article. What is the distribution of times that the procedure takes? Maybe 75 minutes is actually a reasonable time to expect the procedure to take on average?
That the health care system in this country is screwed up is not at issue. The article wants to point out the ludicrousness of the reimbursement mechanisms in place. Putting in a context-free and unexplained statistic only weakens its argument.
MS made it a requirement that netbooks had to have weak CPU's and RAM limited as not to eat the notebook market share
I thought the CPU choice was more of a battery life thing -- the Atom processors (N500/N550) had much better power consumption profile (at the expense of processing) than a normal x86/AMD processor. The battery life on my ASUS netbook was around 8 to 10 hours, which was great. Having used a netbook for a couple of years it seems like the real hardware compromise was the video, which really slowed things down.
Still, the portability of the netbook was great and worked well for lightweight development (e.g. VIM as opposed to eclipse/VS) at a price a student could afford.
That happened to me with my ex-girlfriend. All of a sudden she popped up on my "You may know..." list. Needless to say, it was duly ignored. Her step-dad also showed up one day as well...Not sure if he looked me up or if she used his computer.
Either way, my wife and I had a good laugh about it. My main point to her was that it was kind of cool knowing how these things work (an underlying machine learning algorithm to group things, I would guess). She is glad she married a nerd.
FYI - ALS is primarily a neurodegenerative disease where the neurons themselves are dying off and not a demyelinating disease where the neurons remain intact but loose their myelin sheath.
I remember reading a few years ago that one of the top medical journals (New England, IIRC) started letting doctors publish review articles for drugs without mentioning that they were paid by the company that sells them.
That may have been true a decade ago, but now journals (e.g. JAMA, NEJM, Lancet) are fairly serious about clamping down on conflicts of interest, ghost writing, and other shady practices. For example here is one example of the required disclosure (for JAMA). Of course, someone could still lie/dissemble/etc... But this would be considered as the aberrant flow.
In a sense though the damage is done. If you search for ghost-writing and rofecoxib you can see articles regarding the extent of the problem in the late 90's with respect to Vioxx. It's a long road to getting back credibility/trust.
Dammit. We just can't have anything nice around here. I agree with you that this is probably the beginning of the end. The combination of behemoth sized international publishing company and small software company does not appear to favor the small software company.
I'm pissed as I just started using Mendeley last week and really like it. (*sigh*) I've used zotero before but it just wasn't that great/intuitive, but maybe I will have to give it a second shot.
The Americans I am most personally worried about are those who lack the critical thinking skills or desire to realize that we are dealing with complex situations with multiple competing forces at work. Lacking the skills or desire to have some kind of larger insight, they reflexively place issues into the categories of "Left" or "Right", "Conservative" or "Liberal", etc.. which lumps things into a preconceived morass of assumptions, assertions, and logical fallacies. Unable to appreciate the complexities of situations, they demonize people whose thought patterns do not fit nicely with their own.
$10 got me a legit copy of Windows 7 ultimate edition through my university. Can't get much hardware (or even incremental improvement) for that amount of money. As someone who has made good $$$ off of software development, I don't think that $10 is too much to help support other developers. I've contributed more cash o FOSS projects than $10 over the years, that's for sure!
I have a kindle fire and read PDF's (medical textbooks) on it all the time. I do have to zoom in, but that "sticks" from page to page so I just have to do it once. Note -- this is with the Mantano reader (free version) which handles pdf better than the native kindle app (e.g. allows highlighting, freehand notes, etc..)
I have tried converting the PDF to mobi/epub with calibre (which works) but the layout gets really crappy -- especially with respect to the legends of figures/images/tables.
From my understanding, storing documents with patient identifying information on the 3rd party mainframe...errr..THE CLOUD...would constitute a HIPAA violation, unless that 3rd party had some kind of agreement about privacy and the like. Anyone know if these cloud document storing solutions such as Skydrive, Google Docs, etc... are liable for HIPAA violations (which can be $10k in fines a pop, IIRC)?
As other sib posters of mine have pointed out, this is in fact wrong. Historically (as in Ancient Greece), tasting urine for sweetness was how the disease got its name (it's not called 'mellitus' for nothing!). These days the diagnosis is through measuring levels of sugar in the blood, although most recently, measuring the surrogate marker of HbA1c can now be used to make a formal diagnosis. Before this you could either do a fasting blood sugar level, a glucose tolerance test, or having a rip roaring single glucose level with evidence of end organ damage (among other ways of diagnosis, which I am sure there some).
Testing of urine is done routinely (guideline is once per year) to look for microalbuminemia -- essentially damage to the renal apparatus caused by high blood sugar. If someone is in DKA, they would have high urine ketones, but this is not what is looked for in routine urine testing.
Once the diagnosis is made, it can be categorized (e.g. Type I, Type II, iotragenic, neoplastic, etc...).
This was one of my thoughts as well as I started reading Piers Anthony in 5th or 6th grade. The Xanth novels are great for puns. Many of his other series or short stories have decidedly more mature themes (Minnie's Crew...I remember reading THAT in 8th grade. Yikes!). Still, I remember reading (and re-reading) Cthon, the Bid of a Space Tyrant series, the Blue Adept/Phase series, and the Greek mythology based ones (forget the name of those books) with fondness.
And I'm not completely screwed up (although opinions on this may vary).:)
Basal cell carcinomas are locally invasive but do not metastasize. Excision with negative margins is curative. Where I can see this beneficial is with larger tumors that are more difficult to resect without severe disfigurement, or as neoadjuvant therapy to shrink tumor size prior to surgery (as is done with other tumors in other body locations).
However, unnecessary radiation to the head and neck has historically proven to cause more harm than good (e.g. treatment of acne with x-rays which then was linked to papillary thyroid carcinoma). So...not sure how I excited I would be personally to do this without getting more data.
At what point does a test potentially cause more harm than the low-probability disease that it might cure.
Ultimately we (as a society, or, in the US, insurance companies) make that decision. For a given treatment, there is a number of people needed to treat to either prevent one new case of the disease (number needed to treat -- NNT) or the number of people needed to treat to cause harm (number needed to harm). This is a calculated number based on the risk reduction the treatment provides for the given disease. Theoretically, you could add all the numbers up and make an economic calculation and say either we (as a society or insurance company) are willing or not willing to pay this. Of course, this hits up against the inelastic demand of medical treatments and also the crazy rationing of health care (in the US) based on class and wealth. And of course, it is easy to say that some stranger should not have some care since it is too expensive, but if it comes to yourself or someone you love, it all of a sudden doesn't seem so bad.
For diagnostic tests this calculation may be harder, as the "harm" in a test may include emotional suffering (e.g. finding out you have an untreatable disease like Huntington's disease) as well as the cost of any additional testing.
BTW - this is why the USPSTF has changed guidelines for certain screenings (such as mammograms). Namely, the (meta)analyses they have done indicate that the harm of early/often testing in terms of radiation doses, lost time, wages, emotional toll, unnecessary surgeries, etc...) outweighs the benefits of GENERAL screening (a point seemingly lost on the talking heads) of the population. Oh well.
11th on micocenter. I used to live around the corner from one and enjoyed browsing their used/returned aisle. They redecorated and got rid of that and distributed it around the store (and then seemed to disappear completely for a while -- which was a bummer) but it was always fun to browse through.
I built my last machine up using them. It was maybe $10-20 more expensive than I could have done online, but as an occasional system builder (who doesn't always get the compatibility right), it was great to be able to take stuff back if I got the wrong or incompatible part (read: memory). They took the returns no questions asked. Salespeople are not 100% clueless too and don't hassle you, unlike BB.
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I'm with the sib post here. I really enjoyed o-chem. It actually made me sad that I didn't take P-chem when I had the chance.
One thing that made the difference was that I prepared before the class even started -- I looked at the list of suggested readings in the course syllabus and went through one of the suggested resources ("Pushing Electrons"). An awesome little work book that made everything I learned in class very understandable.
And yeah - I took Ochem as a pre-req for med school and guess what? I still use information I learned in that pre-req as an MD. So much for the "you'll never use it!" argument!
Why would top developers work for government pay?
I have the same printer - CLP550N, that I bought in 2005. Still on the original color cartridges (which are starting to go, but I put my defaults settings to print B&W). I love the duplex printing and it has been a solid printer for 7 years with some years of heavy printing. I need a new black toner cartridge every couple of years or so (I am on my 4th) but it is not horribly expensive (less than $100 from 3rd parties).
The biggest design problem with the printer is with the waste toner cartridge, which didn't make a good seal and so used toner would muck up the optical sensor that triggers a "waste toner full" error. I easily fixed this though by taking the LED and taping it to the sensor. Problem solved.
with a very short incubation period.
You actually want a long incubation period so that the infected stay symptomless (but infective) for as long as possible. If the symptoms are severe and the incubation time short (e.g. flaviviridae like marburg or ebola) they kill the host before they have time to infect enough people. In essence, the virus is *too* virulent that it goes through the available susceptible people too quickly.
More deadly would be a virus that has is lethal but does not show symptoms for a period that exceeds its infective period. A good example is the early years of the HIV era -- lethal virus, long time before symptoms start, and infectious much earlier than any symptoms start to show up.
My point is that putting in that number needlessly detracts from what they are trying to say. You could easily counter their example with the fact that some colonscopies can take hours (e.g. complications occur, perforations, etc...) and thus doctors are getting UNDERPAID. Without any context, it comes across as sensationalist. The point they are making (medical reimbursement is non-transparent and is not aligned with primary care of populations) but this is not helped by their hook.
15 minutes for a colonscopy? Where do they get this number? Getting informed consent can take 15 minutes just by itself (and is something the doc has to do). 15 minutes sounds like the best-case scenario (e.g. a screening colonscopy on a healthy 50 year old with no findings) and a number to sensationalize the article. What is the distribution of times that the procedure takes? Maybe 75 minutes is actually a reasonable time to expect the procedure to take on average?
That the health care system in this country is screwed up is not at issue. The article wants to point out the ludicrousness of the reimbursement mechanisms in place. Putting in a context-free and unexplained statistic only weakens its argument.
MS made it a requirement that netbooks had to have weak CPU's and RAM limited as not to eat the notebook market share
I thought the CPU choice was more of a battery life thing -- the Atom processors (N500/N550) had much better power consumption profile (at the expense of processing) than a normal x86/AMD processor. The battery life on my ASUS netbook was around 8 to 10 hours, which was great. Having used a netbook for a couple of years it seems like the real hardware compromise was the video, which really slowed things down.
Still, the portability of the netbook was great and worked well for lightweight development (e.g. VIM as opposed to eclipse/VS) at a price a student could afford.
That happened to me with my ex-girlfriend. All of a sudden she popped up on my "You may know..." list. Needless to say, it was duly ignored. Her step-dad also showed up one day as well...Not sure if he looked me up or if she used his computer.
Either way, my wife and I had a good laugh about it. My main point to her was that it was kind of cool knowing how these things work (an underlying machine learning algorithm to group things, I would guess). She is glad she married a nerd.
FYI - ALS is primarily a neurodegenerative disease where the neurons themselves are dying off and not a demyelinating disease where the neurons remain intact but loose their myelin sheath.
I remember reading a few years ago that one of the top medical journals (New England, IIRC) started letting doctors publish review articles for drugs without mentioning that they were paid by the company that sells them.
That may have been true a decade ago, but now journals (e.g. JAMA, NEJM, Lancet) are fairly serious about clamping down on conflicts of interest, ghost writing, and other shady practices. For example here is one example of the required disclosure (for JAMA). Of course, someone could still lie/dissemble/etc... But this would be considered as the aberrant flow.
In a sense though the damage is done. If you search for ghost-writing and rofecoxib you can see articles regarding the extent of the problem in the late 90's with respect to Vioxx. It's a long road to getting back credibility/trust.
Dammit. We just can't have anything nice around here. I agree with you that this is probably the beginning of the end. The combination of behemoth sized international publishing company and small software company does not appear to favor the small software company.
I'm pissed as I just started using Mendeley last week and really like it. (*sigh*) I've used zotero before but it just wasn't that great/intuitive, but maybe I will have to give it a second shot.
The Americans I am most personally worried about are those who lack the critical thinking skills or desire to realize that we are dealing with complex situations with multiple competing forces at work. Lacking the skills or desire to have some kind of larger insight, they reflexively place issues into the categories of "Left" or "Right", "Conservative" or "Liberal", etc.. which lumps things into a preconceived morass of assumptions, assertions, and logical fallacies. Unable to appreciate the complexities of situations, they demonize people whose thought patterns do not fit nicely with their own.
Nothing like a lover's quarrel on Valentine's day...
Nah -- he just had a beef with Belize.
Not if she is in the window period.
$10 got me a legit copy of Windows 7 ultimate edition through my university. Can't get much hardware (or even incremental improvement) for that amount of money. As someone who has made good $$$ off of software development, I don't think that $10 is too much to help support other developers. I've contributed more cash o FOSS projects than $10 over the years, that's for sure!
I have a kindle fire and read PDF's (medical textbooks) on it all the time. I do have to zoom in, but that "sticks" from page to page so I just have to do it once. Note -- this is with the Mantano reader (free version) which handles pdf better than the native kindle app (e.g. allows highlighting, freehand notes, etc..)
I have tried converting the PDF to mobi/epub with calibre (which works) but the layout gets really crappy -- especially with respect to the legends of figures/images/tables.
From my understanding, storing documents with patient identifying information on the 3rd party mainframe...errr..THE CLOUD...would constitute a HIPAA violation, unless that 3rd party had some kind of agreement about privacy and the like. Anyone know if these cloud document storing solutions such as Skydrive, Google Docs, etc... are liable for HIPAA violations (which can be $10k in fines a pop, IIRC)?
As other sib posters of mine have pointed out, this is in fact wrong. Historically (as in Ancient Greece), tasting urine for sweetness was how the disease got its name (it's not called 'mellitus' for nothing!). These days the diagnosis is through measuring levels of sugar in the blood, although most recently, measuring the surrogate marker of HbA1c can now be used to make a formal diagnosis. Before this you could either do a fasting blood sugar level, a glucose tolerance test, or having a rip roaring single glucose level with evidence of end organ damage (among other ways of diagnosis, which I am sure there some).
Testing of urine is done routinely (guideline is once per year) to look for microalbuminemia -- essentially damage to the renal apparatus caused by high blood sugar. If someone is in DKA, they would have high urine ketones, but this is not what is looked for in routine urine testing.
Once the diagnosis is made, it can be categorized (e.g. Type I, Type II, iotragenic, neoplastic, etc...).
This was one of my thoughts as well as I started reading Piers Anthony in 5th or 6th grade. The Xanth novels are great for puns. Many of his other series or short stories have decidedly more mature themes (Minnie's Crew...I remember reading THAT in 8th grade. Yikes!). Still, I remember reading (and re-reading) Cthon, the Bid of a Space Tyrant series, the Blue Adept/Phase series, and the Greek mythology based ones (forget the name of those books) with fondness.
And I'm not completely screwed up (although opinions on this may vary). :)
Basal cell carcinomas are locally invasive but do not metastasize. Excision with negative margins is curative. Where I can see this beneficial is with larger tumors that are more difficult to resect without severe disfigurement, or as neoadjuvant therapy to shrink tumor size prior to surgery (as is done with other tumors in other body locations).
However, unnecessary radiation to the head and neck has historically proven to cause more harm than good (e.g. treatment of acne with x-rays which then was linked to papillary thyroid carcinoma). So...not sure how I excited I would be personally to do this without getting more data.
At what point does a test potentially cause more harm than the low-probability disease that it might cure.
Ultimately we (as a society, or, in the US, insurance companies) make that decision. For a given treatment, there is a number of people needed to treat to either prevent one new case of the disease (number needed to treat -- NNT) or the number of people needed to treat to cause harm (number needed to harm). This is a calculated number based on the risk reduction the treatment provides for the given disease. Theoretically, you could add all the numbers up and make an economic calculation and say either we (as a society or insurance company) are willing or not willing to pay this. Of course, this hits up against the inelastic demand of medical treatments and also the crazy rationing of health care (in the US) based on class and wealth. And of course, it is easy to say that some stranger should not have some care since it is too expensive, but if it comes to yourself or someone you love, it all of a sudden doesn't seem so bad.
For diagnostic tests this calculation may be harder, as the "harm" in a test may include emotional suffering (e.g. finding out you have an untreatable disease like Huntington's disease) as well as the cost of any additional testing.
BTW - this is why the USPSTF has changed guidelines for certain screenings (such as mammograms). Namely, the (meta)analyses they have done indicate that the harm of early/often testing in terms of radiation doses, lost time, wages, emotional toll, unnecessary surgeries, etc...) outweighs the benefits of GENERAL screening (a point seemingly lost on the talking heads) of the population. Oh well.
11th on micocenter. I used to live around the corner from one and enjoyed browsing their used/returned aisle. They redecorated and got rid of that and distributed it around the store (and then seemed to disappear completely for a while -- which was a bummer) but it was always fun to browse through.
I built my last machine up using them. It was maybe $10-20 more expensive than I could have done online, but as an occasional system builder (who doesn't always get the compatibility right), it was great to be able to take stuff back if I got the wrong or incompatible part (read: memory). They took the returns no questions asked. Salespeople are not 100% clueless too and don't hassle you, unlike BB.
I upped my offer...
...now up yours.
Hmmm...The Elven Centipede. I suspected that some crazy s*** went down in that Keebler tree house...