n8henrie

Any reason to use this over omlx?

7g of acetaminophen can kill you, and 12g is likely to [3]

I agree that people should be cautious, but I think you are significantly misunderstanding [3].

"Toxicity" != death -- toxicity is merely "some evidence of a toxic effect" -- possibly as simple as a transiently abnormal blood test with no symptoms or sequelae, ever.

Single (accidental) doses of up to 200 mg / kg are routinely recommended to be managed at home [0], i.e. "you don't really need to go to the emergency department for this." For me, a fairly average 79kg male, this would be about 16g.

Please consult with your local poison control if you have concerns or questions!

[0] https://pubmed.ncbi.nlm.nih.gov/16496488/

I'm quite sure no freediving instructor would ever teach you this particular method, because it is a surefire way to die underwater on your first attempt

Definitely no instructor involved, just a dumb 20 year-old living in Puerto Rico. It admittedly was dangerous, but I am living evidence that it was far from a "surefire" way to die. It was one of a hundred ways in which I put my life at risk during my 20s. ¯\_(ツ)_/¯

As for the specifics that may have prevented you from doing what you wanted: If you breathe too shallow or too slow, you won't clear enough CO2.

I'm confident I was doing it sufficiently well to accomplish a longer period of breath holding than I otherwise would have been able to sustain, as evidenced by having done so (in addition to the usual symptoms of lightheadedness, confusion, loss of vision, near-syncope -- yes I agree quite uncomfortable). I know people on HN love to idolize Wim Hof, but in this context minute ventilation is not that difficult of a concept; I'm usually able to estimate the response in a paralyzed patient's PCO2 fairly well when making changes to their tidal volume and rate.

I didn't search for too long, but here's at least one relevant document, in which otherwise untrained subjects were able to achieve a substantial reduction in CO2 (17.4 vs 29.0) with a mere 15 seconds of hyperventilation, leading to an extra 23 seconds of breath holding prior to involuntary breathing moments. The peripheral O2 sat nadir in the hyperventilation group appears to have been identical to the non-hyperventilation group after the first trial (Fig 8b, looks like ~94%) and was only statistically significantly lower on trials 2-5: <https://pmc.ncbi.nlm.nih.gov/articles/PMC10363065/>

This was using equipment in the emergency department of our state's only L1 trauma center and comprehensive stroke center; I presume it was decent as far as medical monitoring equipment goes.

Interesting. As I noted above (though typo O2 -> CO2), I used the same technique you describe, which I learned in free diving, and was not able to get below 98%, at altitude.

In many people a momentary drop to the 80s or even below is not an emergency or anything close to it. Not saying that it is good. Someone that is awake, sitting up, and struggling to breathe should be considered an emergency regardless of oxygen levels (and in this situation 80% would be very concerning).

EDIT: your comment is otherwise entirely correct, particularly at sea level.

One a friend and I hooked ourselves up to continuous pulse oximetry and had a contest to get the lowest recorded oxygen level. We tried everything we could think of, from just holding our breath to end-expiratory breath holding to hyperventilating to clear O2 (I used to do some recreational free-diving) beforehand to exercising (jumping jacks)...

Neither of us could get it below 98%, and this was at a mile of elevation (UNMH in Albuquerque).

Almost certainly plays a role. Also increased activity levels due to better less fatigue.

Certainly is not defeating thermodynamics, assuming calorie absorption is not disrupted somehow it's likely the above.

Similar data?!

We have wildly heterogeneous data just within the US!

And again, how exactly is this interface going to work? How does the AI determine how hard to press on an abdomen, and where, and how does it press there once it has that information?

Several of those are more procedures than labs. Of course you can't get someone to do a procedure on you for free. Arterial sticks and biopsies may have nontrivial risks (and commensurate liability risk for the performing provider).

PSA and troponin seem trivial to get. Did you look?

I would love to hear of any specific example, I will happily either show you how to order it or learn something myself.

How is training on bad data going to give you better results than the current system?

What kind of embedding helps the AI learn to do a physical exam?

Not to mention patient privacy, I can't even take a still photo of a patient in my current system (even with a hospital-owned camera).

you can't order many of your own labs

Really? Which ones?

insurance won't pay for them

Non sequitur, replacing doctors with AI will not help you pay for the preposterous US healthcare system. Vote!

Human language that is.

Even now, I'll take a surgeon that's a complete jerk over a nice surgeon any day, because if they've got that job even as a jerk they've got to be good at their jobs.

This seems like an incredibly poor line of reasoning.

Hospitals are often desperate for surgeons. The poorly mannered ones are often deeply unsatisfied, angry at the grueling lives they've opted into, and the hospitals can't replace them. The market is not exactly at work here.

So why not order your own labs? I'm sure you can think of ways to get your own medications if you are sufficiently convinced that this is the best course of action for your health.

Unfortunately the training data is absolute garbage.

Diagnostic standards in (at least emergency, but I think other specialties) medicine are largely a joke -- ultimately it's often either autopsy or "expert consensus."

We get to bill more for more serious diagnoses. The amount of patients I see with a "stroke" or "heart attack" diagnosis that clearly had no such thing is truly wild.

We can be sued for tens of millions of dollars for missing a serious diagnosis, even if we know an alternative explanation is more likely.

If AI is able to beat an average doctor, it will be due to alleviating perverse incentives. But I can't imagine where we could get training data that would let it be any less of a fountain of garbage than many doctors.

Without a large amount of good training data, how could AI possibly be good at doctoring IRL?

I'm still fairly new to local LLMs, spent some time setting up and testing a few Qwen3.6-35B-A3B models yesterday (mlx 4b and 8b, gguf Q4_K_M and Q4_K_XL I think).

Was impressed at how they ran on my 64G M4.

It looks like this new model is slightly "smarter" (based on the tables in TFA) but requires more VRAM. Is that it? The "dense" part being the big deal?

As 27B < 35B, should we expect some quantized models soon that will bring the VRAM requirement down?

I strongly disagree. If it's doing well enough for the owner then it's doing well enough. I don't understand how one can tell someone else that their computer is unacceptably slow for that other individual's personal use.

This is a really unfortunate move by Amazon. My next e-reader will be one that I own (instead of just rent).

Glad that I took the time to jailbreak and pause updates on my 2017 kindle paperwhite while I could.

Did this many years ago (but with bash) -- life changing is an apt way of saying it.

A ton more conflicting keybindings.

I switched away from tmux a year or so ago due to one crash I kept getting, but thinking of going back. Really miss the simplicity.

Lua in HS is what motivated me to finally learn a lisp (Fennel).

Is this related to the popular and longish-standing Rust tool for the same purpose? I expected to see it referenced somewhere in the readme...

<https://github.com/esp-rs/espflash>

Quicksilver is still around!

I can't imagine this taking strong hold in the US unless it shields physicians from legal consequences of false negatives or produces enough false positives to ensure revenue doesn't fall.

I don't see any way that the hospital systems running healthcare in the US would embrace a technology that reduces false positives (income) without decreasing false negatives (risk and lost income) at least as much.

But you're not having cancer checked out, you're having a "spot" or a "nodule" or something checked out.

And the person that's making the recommendation on whether or not to check it out may get sued for $10M if they tell you it's probably nothing and they're wrong, but have no harm come to them if they tell you it's worth having some other doctor do a biopsy.

And they might make an extra couple hundred bucks every time you have to come back and see them to follow up on this spot.

And the radiologist interpreting the MRIs... the same perverse incentives regarding how they interpret a "spot."

I'd argue that malpractice risk has at least as much negative influence on a physicians judgment.

It's perceived as much less (medico-legally) risky to "do something" (or more often "refer the patient to someone else to do something") than not do something.

Like when someone has an anaphylactic reaction to the contrast dye for their CT?

Contrast-induced nephropathy?

Gadolinium accumulation in the brain doesn't sound good for you...

Although I think this argument is usually talking about the risks of the resulting procedures (eg an injury or complication related to a biopsy done for a finding on imaging).

Not to mention the malpractice risk and potential for extra income, which -- depending on where you live -- may strongly (if subconsciously) influence your physicians interpretations and recommendations.

Do you think a doctor is more likely to call something "possible cancer" and recommend that you either have a specialist do a biopsy (keeping in mind that many of these will be... hard to reach) or at least have a follow up MRI in 3, 6, 9 months?

Or tell you it's "pretty unlikely to be cancer, I don't think we need to worry about it" and then get sued for 20M when they are wrong about 1 in 100 cases (not to mention missing out on all the potential income from above).

At least in the US, the incentives here are grossly misaligned.

Agreed! But I have to say, lane centering and adaptive cruise control have been amazing, coming from a previous vehicle with neither.