riceart

Insurance exists to cover losses from unexpected events. Medical complications are unexpected events.

Your hungover surgeon is a bullshit strawman - most complications have nothing to do with provider malice or incompetence. Again since that seems to be the angle you are starting with you clearly have no interest in a grown up discussion or too ignorant and also full of hubris to understand any of this (which fits in perfectly well on this site).

If you throw a massive clot after a surgery and stroke out who’s fault was that if all the standard protocols for clot prevention were followed. Maybe you’re a smoker (or not) and 5 years later that unknown cancer will finally declare itself.

more or less exists for each procedure

This is extremely misleading as it does not exist in any meaningful level of risk across the entire patient population.

Like I shouldn't be billed extra if my surgeon is hungover and things don't go smoothly.

That’s what you think is the common root cause of complications?

You clearly are not interested in a productive discussion.

As for a fee for unpredictable occurrences - that’s what insurance is.

The service seems to be by a company called Epic (www.epic.com), based in Wisconsin.

Lol, that mom and pop shop.

That’s the largest EMR vendor in North America and second in the world.

They’re the provider of the patient portal frontend amongst other things but there’s a lot more behind the scenes that must be done (with varying levels of quality) that is institution specific. Just using Epic does not make this work.

Without cryptographic techniques that is all easily forged.

Have you ever had to enter codes as a provider in Epic for instance? The UX is fucking terrible. Incentives are completely misaligned for accurate coding in academic institutions. Finally the ontology of ICD codes are trash on their face.

Right from the about page:

Our clinical vignettes serve multiple purposes. They provide a distinctive, engaging learning tool for medical students and healthcare professionals looking to familiarize themselves with the ICD-10-CM system.

X-rays confirmed a sprain in Gus's wrist

Eh, ok.

Yet more of the laziest cynical AI generated garbage. AI winter can’t come soon enough.

Seriously I see nothing here of interest to a healthcare professional.

The ICD-10-CM coding system is a remarkable catalogue of every imaginable medical condition, injury, disease, and even the seemingly improbable events that can befall a human being.

The thing with ICD is while it has an odd array of oddly specific and absurd codes it misses sufficient detail for some very basic common diagnoses.

I'm confused why you don't believe me that internet penetration in the salt lake valley was very limited in 1994

I do believe you. Really have no dispute with any details you’re putting down.

I suppose the distinction I’m making is about the cohort of early adopters that had special (usually U access) from those using commercial ISPs or BBSes. That earliest cohort no matter how small it was a good bit earlier than 1994 and eternal September. I’ll grant my wording inadvertently exaggerating the penetration of availability in 1994, just saying the first households were probably getting dialup some years prior.

For me an EE prof managed get me a shell account in 1990 while in middle school. Even in rust belt US many friends just used AOL into 1994 and uptake of dialup ISPs was still slow, but that 1994 cohort was distinct.

Ok not “way” after - really splitting hairs here. Point still stands public commercial dialup internet was available pretty much everywhere. Call them early adopters or whatever - but the internet already had established communities well before 1994.

50,000 people in a metro area of a few million.

We’ll just have to agree to disagree on the interpretation of what “first families”. In the context I read that post it sounded like someone saying they were among literally the first few, not 50k to 100k when anyone with a credit card could order service. First families in my interpretation would be those that probably had access from their parent’s university shell account. This follows with the claim 15 minutes to load a single webpage - but unless you were on a shitty rural phone line running 2400bps it’s not like everyone’s dialup internet access at the time was that limited. Some had to put up with that but the tech in 1994 was not that primitive.

The internet was still the land of the nerds until the early 2000's

The first dot com boom, sort of the genesis of fortunes that make this site exist was prior to the early 2000s.

The early 2000s was the bust period.

This is not correct for access open to the general public. The first commercial ISP in Utah, Xmission, was founded in 1993. Yes, many of us had internet access through the University of Utah before that (Pete Ashdown, the founder, had worked at Evans & Sutherland, which had quite good internet connectivity).

The commercial Internet really only started taking off in 1993.

1993 is before 1994.

I am very much scratching my head by how this contradicts anything I stated in a way that makes it not correct.

If a commercial ISP existed in 1993, then by 1994 plenty of regular people would have been getting internet access - without any special affiliation other than a credit card - ie mainstream. (Per your own comment “many had internet access before that”) - those affiliated were among the first to have internet access is a pretty reasonable interpretation and that was well before 1994 in all of the continental US.

1994 was way way after dialup Internet access was mainstream (both Yahoo and Amazon were founded that year). Any first access in the state would be sometime in the 80s. By 1993 there were already national level dialup ISPs.

that was about as long [15 minutes] as it took to load one webpage with one image.

Very hyperbolic. A simple webpage with text would load in seconds on a 28.8k modem. A single image would usually be a 10s of kB in those days, so maybe some seconds, not even a minute.

Eh, I think the person you’re replying to would assert that Usenet thrived prior to 1993.

We don’t need a lesson about eternal September either.

In embedded work, you don't get extra credit for being faster than necessary.

You absolutely do when you can cut power requirements and get by with cheaper CPU/hardware. I ran a whole consulting business redesigning poorly designed devices and redoing firmware for cost reduction. How does one decide “necessary”, what is necessary in the short and long term are often not the same.

IRC was never federated.

What? What do you think the term “relay” in IRC means? The jargon term netsplit used even for newer federated networks (even used in these comments elsewhere) comes from IRC. There is literally an entire network named after a defederation event.

Now we sort of take for granted that IRC is basically a closed federated system - but the original design of the network was one dominant set of relays - EFnet is a direct descendant of this network after all - if anything it’s just a specific example of politics and network evolution. There are technical reasons as well - but at the time of the early splits of the 90s (EFnet, Undernet) it was not primarily technical problems.

Anyone involved in a fediverse I think would do well to learn some lessons from IRC even if their system is technically superior.

but so is email

As a federated system barely - go try to stand up an email server on your home network or VPS and see how well that works. It’s run by a cabal of large providers.

https://news.ycombinator.com/item?id=30224478

With federation, there is no longer an incentive to do so, because you don't have a moat

Domination is orthogonal to a technical federation feature. Once there is enough imbalance you defederate and that’s that. There’s nothing that inherently prevents gross imbalance from forming and the natural forces favoring centralization - such as funding one beefy instance - still apply.

value proposition for an instance to turn off federation today?

Maybe not today, but it would be the same as any historical netsplit.

What do you think would happen if Reddit only had 1/2 of the subreddits anyone used and if you could keep access to all the same communities on a competitor?

I think that puts them still in a fucking dominant position. And why automatically assume competitor vs cabal?

Anyway good luck with your project.

I’ve been using the internet since IRC and Usenet - both federated in their own way - both completely marginal.

I dunno maybe I’m wrong about the technical stuff. My minor point is that this software has some technical flaws today - forums and link aggregators are solved problems over and over again so implementation excellence is at least a unique value proposition.

I’ll quote the top-voted thread here

> Nobody wants a federated, slow, difficult to use version of reddit. Nobody wants to choose a server.

I want this. I want this because it's a sustainable way to have Reddit without the ads. The bad UX is an acceptable tradeoff for a platform that doesn't go to shit.

I’m just not buying how a federated system of isolated instances solves this. What fundamentally prevents the dominant oligopoly or monopoly server(s) from just being Reddit running on Lemmy? Lemmy doesn’t dictate how things are run - so why won’t a major funded instance just evolve to a new Reddit? How does Lemmy decisively get you to a Reddit without the ads? What stops a major Lemmy instance going to shit?

Just having federation as an opt in feature doesn’t force the system to evolve in a particular way.

If a “Voat” equivalent pops up it’s not like the dominant instances are going to federate with it.

Sharding, caching and queuing doesn't break federation. That's not a core flaw.

I didn’t say it did, but it doesn’t enhance it either.

As the ecosystem grows, a shortlist of popular, robust, federated instances will crop up

How short is a shortlist? When does that mean just new Reddit?

I suppose I would be more enthused if at the least the basic design eased standing up high traffic (or let’s be honest even mild traffic) instances. The performance story right now is: it’s written in rust - which is not nothing but it would be more interesting if supporting even a moderate amount of traffic on minimal hardware was an architectural priority. The flaw as I see it is that this is just not a design goal.

https://github.com/LemmyNet/lemmy/issues/2877

https://github.com/LemmyNet/lemmy/issues/2910

You can argue that things can be improved but initially well engineered systems help to enhance initial mindshare.

It’s a federated system without any of the affordances that would make it usable (or particularly interesting to me). Literally load balancing by going to a long list of alternate instances. The sites own documentation just says, find one that works, and if that shits the bed find another. This is a UX agreeable to a very tiny and idiosyncratic group (as evidenced by Mastodon once the Elon is evil hype died.

Yes of course in theory you can beef up any instance, and shard, and add a caching and queueing layer while you’re at it. And tada you’ve just redid Reddit.

Let’s be real here this system is flawed at its core though. This can’t even handle the load of some moderately popular PHP forums with simple deployment or even this site nothing took decades to harden. And this is due to gross flaws in architecture, IMNSHO.

Comparing it to Reddit is silly. And yes I’m sure there are more than a few here that can honestly say their servers could handle this load - it isn’t much.

No. In games AI is a jargon term for the behavior of an NPC. It has a long history in this use. When people talk about a game’s AI it is often clear what is being discussed regardless of the specific technology used. It is therefore useful for communicating an idea and that’s usually all that really matters.

There’s even a distinct Wikipedia article on this use: https://en.wikipedia.org/wiki/Artificial_intelligence_in_vid...

it effectively includes all programming with if/then logic gates based on program input.

And? You think that is the totality of a physical safety critical system?

Is this really still a thing?

Why wouldn’t it be? Compilers haven’t advanced tremendously in the past two decades in terms of optimizations and don’t have much new to add to high performance SIMD numeric kernels.

Time will tell if we'll eventually look back some of Rust's design decisions as bad or unwieldy (probably).

I think time has already told for things like async and lifetimes.

a design is something that stays forever and you see vestiges of

No, that’s not how it works - this is engineering, not Deepak Chopra. Apple is not big on backward compat and legacy and when a compromise has to be made to favor either their current line up or legacy/3rd party they always choose the former.

For instance new versions of macOS simply don’t support subpixel AA anymore because no standard Apple config involves non hidpi displays. Additionally, macOS renders via framebuffer scaling, not flexible UI scaling (with some good reasons for this compromise), but it’s a compromise and non retina font rendering suffers for it.

Correctly configured Windows and Linux offer superior font rendering on non HiDPI and Linux is easily tunable to be subjectively better on any config.

Successful resuscitation after traumatic arrest is extremely rare. It is more rare than bystander field CPR administered to those that are not in actual arrest (unconscious but with a perfusing rhythm).

What was the confirmation of arrest? I have been called numerous to bedside for in hospital "arrest" that turned out to be assessment error - that is with trained medical professionals.

What I miss from IRIX, that no other system has yet replicated: 1) Realtime mode. RTLinux doesn't count.

FWIW, SGI didn't seem to agree.

From SGI's own whitepaper: "In addition, REACT for Linux adds unique capabilities including sgi-shield and kbar that were not available on IRIX. The Linux based platform delivers better real-time performance than SGI Origin running IRIX with realtime extensions: 30µs guaranteed interrupt response time versus 50µs for Origin."

https://static.aminer.org/pdf/PDF/000/565/463/operating_syst...

Without REACT extensions, Irix realtime facilities aren't any different than the scheduling policies of Linux (this is akin to bypassing the normal scheduler).

https://nixdoc.net/man-pages/IRIX/man5/realtime.5.html.

I have a soft spot for Irix from the early 90s, and it had some clever accomodations for the technology at the time, but things have moved on and advanced.

You realize you are speaking about 2 different people as if they are one?

It’s a bunch of crap. Maybe shouldn’t look for medical information from a social worker on a clickbait site.

Diabetes (specifically Type 2) is correlated with Alzheimer’s - how that makes for a useful new classification of diabetes is nonsense.

This would be about as sensical as calling nicotine addiction Type 2 lung cancer.

It also doesn’t help

However, classifying Alzheimer's as type 3 diabetes is controversial

No, not in the medical community it isn’t. That there are some crackpots and quacks out there doesn’t change that - there is not serious debate ongoing about this in medicine.

It wouldn’t be a viable name anyway as the number 3 has already been reserved/in common use in actual clinical and research practice for pancreatogenic diabetes.

Web hello world in rails is literally a single command and seconds.