khed's comments

Interestingly, there was a recent study that indicated for penetrating trauma the patient had a much higher survival rate if they were taken to the ER by private car compared with waiting for EMS transport. Presumably because you are less likely to waste that golden hour.

This is not correct.

https://en.wikipedia.org/wiki/Triage#Conventional_classifica...

There are a couple reasons why he might do this that I can think of.

1). He didn't know how many people were going to come in or how serious they would be. Triage in MCI does depend to a certain degree on what your facility is capable of and the expected volume and status of patients. If he underestimated the volume or criticality of the patients about to come in he might have put more into the red pod than he would have otherwise. Underestimating seems plausible in this case because this was the worst mass shooting in history in the US.

2). Medicolegally he might have a fear that he would be judged harshly if he didn't automatically try to save everyone.

This is not my understanding of how to triage in MCI. ATLS definitely does teach the importance of deprioritizing people that will be hard or impossible to resuscitate in favor of prioritizing people that leads to a roughly utilitarian greatest good.

That said, I have never heard "black tag = not breathing = don't try to help"[1]. I know for a fact that the boundary for who to try to save immediately and who to deprioritize is very grey in many cases (it is why you should have an experienced doctor doing it). A common example why that equivalency is not taught in ATLS is the case of a boat capsizing in frozen waters. There may be many frozen victims who are not breathing but could still be very salvageable medically. If you chose to not help those who are not breathing in that case you would plausibly be found negligent without some extraordinary situation to justify yourself with.

Another example would be mass overdose on fentanyl, many are saveable but none would be breathing when you first see them.

1. https://en.wikipedia.org/wiki/Triage#Conventional_classifica...

Thanks for the PDF :)

If matrix moved toward pond style metadata protection I would make the effort to move my social graph on to it and probably support it financially.

As is, I don't see the value proposition of matrix. I am genuinely curious what it is. An update to xmpp? Is it that it is going to be encrypted AND federated? Many popular apps now support default encryption so that isn't much of a selling point. Conversations is federated and is not getting traction the way signal has. Being federated has benefits but they are sort of theoretical and aren't high on most people's list of concerns. Further the value proposition of federated systems is attenuated by it's downsides (slow evolution).

Meanwhile people get killed based on metadata. Seems like a more urgent problem to tackle.

I am excited for the phone but I don't get having matrix as the messaging app. I don't see the value in matrix. Encryption is not on by default, which is unacceptable in a modern messaging app. It leaks metadata like a seive. None of my friends or co-workers on it. It isn't decentralized enough.

They should just use briar. It hides metadata, it's encrypted, it's peer to peer. It's biggest downsides are no file transfer, no iOS client, no offline messaging.

Or better yet someone should develop an app based on one of the newer concepts like vuvuzela/alpenhorn or loopix.

I cancelled my model 3 reservation over this. I found it very sleazy this wasn't mentioned in the official reveal.

Do you have a citation for your claims? Specifically that low serotonin levels CAUSE depression in humans?

I also was diagnosed with ADHD and took Ritalin then Adderall for years. I stopped taking them in medical school and actually got better grades.

Regardless of my personal experience or your personal experience the evidence does not show that stimulants increase grades in the medium or long term.

SSRIs don't have clinically relevant effects. The following study is a review article. It cites most of the meta analysis the are relevant.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/?report...

I am still trying to find the studies that indicate that stimulants might increase high school drop out. But there is pretty clear consensus that they don't increase grades over the long term.

https://www.nber.org/papers/w19105

This is an excellent comment and reflects the current state of research.

There is good evidence for the efficacy of ketamine in treatment resistant depression.

The psychedelics are not well studied.

SSRIs are not useful and may be harmful.

ECT works but causes amnesia.

Most depression gets better on its own.

There is no evidence for the chemical imbalance hypothesis. Your friend anecdotal evidence is contradicted by a large body of emprical research. For a good overview of the evidence on SSRIs on depression I would recommend the article "antidepressants and the placebo effect". https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/?report...

There is no well done study I have heard of that supports your position. In general SSRIs have an effect size that is so low it is not clinically relevant. There are multiple meta analyses that demonstrate that.

I am a physician with training in neuroscience. There is no scientific consensus that stimulants help the problems you are talking about. There is some preliminary evidence that stimulants may make some problems worse (graduation rates).

You are over stating the case for what stimulants can do in ADHD. They probably do make kids more docile. They do not improve grades over a meaningful time span. They do not improve broad and important outcomes like graduation rate (there is some evidence that ADHD kids on stimulants have lower graduation rates than ADHD KIDS that aren't medicated), increase earnings, or decrease chance of going to prison.

They are almost all placebo response. The real effect is so small it's probably not useful clinically. They also cause suicidal ideation and sexual dysfunction is a large minority of patients.

I am a practicing physician with 2 years of graduate level course work in neuroscience.

Point 3 and 4 are wrong. There is no evidence that SSRIs work by fixing a chemical imbalance.

There are multiple metananlyses in top tier journals that indicate that SSRIs have an irrelevant clinical effect. SSRIs are almost all placebo with the downside of causing serious side effects. The small effect that isn't due to placebo is probably not clinically relevant.

The only cogent defense of SSRIs I have read is http://slatestarcodex.com/2014/07/07/ssris-much-more-than-yo.... The author is a practicing psychiatrist. The main disagreement he has with the large metaanalyses is that even though the effect size is small it's better than nothing.

Or an even bigger prize for keeping it secret. If you could break asymmetric encryption at will you could plunder much bigger prizes than Satoshi's coins.

I don't see where in that thread it indicates Rose gave a false impression.

I am not so sure. I don't understand work well but there have been a couple papers saying they can get a quantum speed up on factorizing using adiabatic quantum computers [1]. Further, Geordie Rise himself said that they have an algorithm that can run on a dwave system that can beat shors algorithm [2]. A more skeptical take is here [3].

[1]. http://www.diva-portal.org/smash/get/diva2:680572/FULLTEXT01...

[2]. https://dwave.wordpress.com/2011/05/11/learning-to-program-t...

[3]. https://www.newscientist.com/article/dn21699-controversial-q...