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Comment Re:Different != more accurate (Score 2) 74

I think you're on the right track....I have not RTFA, but the synopsis raises some concern about interpreting the conclusion. The data was taken from "General Internal Medicine Division", which are, typically, first line or Primary Care Physicians (PCPs). Often they will make a diagnosis based on their generalized knowledge of a medical problem and often refer them to a sub-specialist (i.e. you have trouble breathing with exertion, you find you need to sleep on multiple pillows, your ankles are swollen and you physical exam and office EKG lead me to refer you to a cardiologist (sub-specialist)) - so yes, the opinion will be different a lot of the time....the generalist can't know everything that a specialist can, but the generalist often triages the problem to someone who does know more.

This could explain the "Among those with updated diagnoses, 66% received a refined or redefined diagnosis, while 21% were diagnosed with something completely different". It'd be interesting to see how they correlated this.

Submission + - If you had to lecture on Cyber Terrorism 1

quantumghost writes: I have a high likelihood of presenting for a group of about 400 healthcare workers at a disaster preparedness conference next year. It is a 20 minute slot (and nothing more than a primer), but obviously, I want to capture their attention. I was thinking of working with the venue to set up a fake WiFi hotspot to capture those who randomly link to any hotspot, but how do I use that to full effect (e.g. anyone ever light up all their phones at once)? Or any suggestions about how to get their attention? Any topics that you think should be stressed? My plans for the talk will be about ransomware (and the need for backups), attacks on medical devices (hacking pacemakers, insulin pumps etc), (spear) phising attacks on providers/institutions, and awareness of social engineering — are there other topics that should be addressed?

Comment Re:Begs the question... (Score 4, Informative) 118

How do we boost the strength far enough to eliminate cancer?

In short: you can't. Cosmic radiation is just a small part of the complex system that can trigger cancer. Other aspects include: genetic make-up, environment (carcinogens) and the inherent error rate in the DNA copying machinery (missense, frameshifts, slippage, etc) [to name a few off the top of my head - I don't treat cancer]. And before you go down there....those imperfect copies are what leads to genetic variation (important to fend off predators both macro and microscopic) and evolution. Cancer is just about inevitable in any DNA based system

Comment Re:Let's Face the Facts... (Score 1) 161

Or more likely there is only so much room to fit people in the Bay Area

Ummm, no. More likely this is another bubble, and we're seeing the first signs its going to pop. How many of these "businesses" that sell "free" products are actually turning a profit? And how many are just waiting to be bought out? Sound familiar? It's the tech version of flipping houses.

Comment Re:Toxins (Score 5, Insightful) 60

When I see the word Toxins, my bullshit radar activates

I am a physician and yes, my BS meter usually goes up when people who have no understanding of human anatomy, physiology, histology, biochemistry, or pathology start rambling on about toxins. But take it from person who deals with sepsis and critical ill patients on a weekly basis. Bacterial endotoxins are the real deal. There are a significant source of morbidity and mortality in severely ill patients. Also, please realize that this research is in collaboration with Boston Children's Hospital and Harvard's Engineering department.

That being said, I pulled the original article and on first read, it seems to be a potential game-changer. My questions:

1. They liken this to dialysis. Many critically ill patients can not tolerate dialysis due to fluid shifts across the membrane....What sorts of flow are required scaled up to humans would be required. Could this be run on a CRRT-HF type circuit or a SLED schedule?

2. They use FcMBL adsorbed to dialysis tubing. I only see animal studies. What, if any, interaction does this with human proteins and cell lines. e.g. if it causes hemolysis or Agglutination, this would destroy the utility.

3. What is the observed length of endotoxin/pathogen clearance? Ties back into #1.

4. I presume this is Fc based (the only description I saw was "FcMBL protein was expressed and purified from a stable transfection of CHO-DG44 cells "), is this Fc, human, murine, equine, porcine, leporine, or bovine?

More questions will come up...but I have a lecture to prepare...

Comment Re:May be the only way to bring down healthcare co (Score 4, Informative) 53

Unfortunately, treatment will still cost more than ever due to lawsuits and drug costs.

Lawsuits are often caused by human error: sleep deprived doctors, or overconfident doctors making bad diagnoses on insufficient information.

No, actually they are not. The leading cause of lawsuits is poor communication. And if you want to believe a lawyer the top two leading causes are surgical misadventures and issues with child birth. Missed diagnosed probably comes in third.

I actually predict Watson as potentially increasing medical costs. The issue? Something we call incidentalomas. These are incidental findings that were not expected and rarely result in an identified problem. But we spend a ton of time, money, and effort tracking these down, and they rarely pan out.

A nurse with a printed flowchart will usually give a better diagnosis than a doctor. So replacing (or supplementing) doctors with AI should reduce lawsuits, and improve care.

If that is what you think, then go for it. If you believe that care from a lesser trained individual is better for you, then by all means have at it. I work with nurses, and physicians, and other "healthcare" extenders. Nurses are great a following a well ordered script. They can nail, say, 90-95% of the primary care medical problems out there (e.g. outpatient settings). The problem? If you are part of the 5-10%, they don't do so well (and cost you more money in the process). Most don't have the training or experience to "know what they don't know" or they are Unconsciously incompetent. A good primary physician is at least "Consciously incompetent" to "Unconsciously competent" and can either treat you or refer you. Now I know some are going to tell me that their doctors "know nothing", but I'll bet they know more than most nurses (yes there are physicians who shouldn't be - that's another discussion for another day).

Comment Re:intuitively I would think steam would be better (Score 3, Informative) 217

I'm not a practicing engineer, but am one by training. I would imagine that an EM system allows one to "ramp up the power" vs a steam head slamming into a piston and the resulting sudden strain on the plane.

My question is, could you not use something similar for civilian aircraft using a longer ramp up time to lower the amount of fuel on the plane a saving some cost?

Comment Re:Dupe? (Score 2) 76

We've been using this stuff for 10 years already in the military. You can buy it on Amazon.

NOT the same thing, however in your defense the article does not make this distinction very clear without already knowing the definitions.. Quick clot and related technologies are for "compressible wounds" that are bleeding to the outside. If you can see the source of bleeding, you can usually compress it. TFA references "Non-compressible bleeding". These are typically truncal wounds that require an operation to fix.

This product is more in line to what TFA is referring to: and this product already exists. I know it has been tested on animal models, and I believe is close to, or in human testing. As a side note, this was developed by a trauma surgeon, not a chemist, so I'll give the nod to David King as he has already take into account several aspects of the foam that TFA authors probably have yet to discover along with being much farther ahead in the testing.

For those who didn't follow the links, the bleeding around organs is far from incompressible. In the OR we frequently compress organs or their blood supply to stop bleeding (liver and spleen being _very_ common), (the problem is that they are incompressible from the outside, hence the thought of using a biocompatable foam internally). The problem with internal foam (as anticipated by DK) is that while this pressure may do a good job of stopping the hemorrhage, it may cause too much pressure resulting in abdominal compartment syndrome. There are literally dozen of issues like this that are related to the foam and the consequences of its use, just stopping the bleeding is not enough, you have to deliver a viable patient to definitive care.

Comment Re:fucking chinks (Score 1) 108

Actually General McArthur (or was it Patton) wanted to nuke Beijing also, but was denied...

President Truman had reprimanded MacArthur on several occasions for publicly disagreeing with him over the general's proposal to pursue the Chinese across the Yalu River into China during the Korean War. The president relieved him of his command in April 1951. In secret, they had even discussed the possibility of using nuclear bombs against the North Koreans and the Chinese.

Comment Re:Why would you want this? (Score 3, Informative) 178

You'd still be an addict, just one who could never satisfy his cravings. This sounds more like some sort of torture that an aid to quitting.

You will always be an addict. I quit smoking over 3 years ago, and I'm still addicted. After trying various ways of quitting, I ended up talking to a doctor and got Champix prescribed to be, which ended up helping a lot and making it possible for me to quit. When I did quit, the days I suffered the most were when my body was flushing the nicotine out. For this part, a vaccine like this would have been wonderful. Instead of having cramps and throwing up for 2 days (yes, this kind of abstinence syndrome can happen even with nicotine), and still suffering for several days afterwards, it would have made it much easier.

So yeah, I do wish this vaccine existed when I quit, 3 years ago, after smoking 2 packs/day for 20 years.

Some of what you say is very true, but you are wrong the withdraw will be bad, and I mean BAD with all capitals. I also foresee some more subtleties to this treatment....The idea is to uncouple the reward mechanism from the stimulus (nicotine hits receptors and triggers a dopamine surge which is perceived as a reward) - no reward, you stop associating smoking with pleasure. Straightforward. The immune system should be capable of removing most of the nicotine and preventing any large response. So what can go wrong....well you're dealing with humans. So....

1. The withdraw will be swift and the worse possible cold-turkey (which, short of using medication is the best way to quit). You will not get relief with patch, gum, smoking, snuff, hanging out with other smokers to get a second hand hit, or chewing on a raw tobacco plant, etc. You might get some relief with buproprione (considered a mild dopamine re-uptake inhibitor, but some controversy there) and probably more relief with varenicline(Chantix(tm)) (which is a weak nicotine agonist). This withdraw may feed into #2. It is also conceivable that some people could hurt themselves by trying to smoke so much to get even a little relief, that they could wind up in the hospital with carbon monoxide poisoning or acute exacerbation of underlying pulmonary disease. The vaccine will reduce the reward, but will do nothing for the craving.

2. The effects of the vaccine may require boosters. So you would be required to go back to get them, otherwise you would likely loose the immune response and would again get a "reward" for smoking. This could lead to avoidance of the vaccine and relapse.

3. The tobacco industry will probably fight this tooth and nail. It won't be, they'll buy a few select individuals who will tank it via the FDA.

Comment Re:There is no vaccine for the worst diseases (Score 1) 1051

The pertussis (whooping cough) vaccine nearly killed me when I was a child.

Sorry to hear that. I know someone allergic to tylenol, should we ban that too?

The evidence is that the greater good is served by extensive vaccinations. The risk of getting pertussis 9/100,000 (varies by age with less than 1 yr old having an incidence of 160/100,000) this resulted in about 28,000 cases in 2013, with about 50% of infants requiring hospitalization, and further, there were 13 deaths from pertussis, he risks of reaction to DTaP (the pertussis vaccine) is "so rare it is hard to tell if they are caused by the vaccine". Here's the data, you make the call. Your "evidence" where n=1, or the CDC who collects the data over the whole of the US or surveillance of about 300,000,000 people (n=3x10^6).

Take a look at vaccine adjuvants[sic].

Ok, I've looked at them. So?

To start off with, I am a physician. No secrete about that... I've posted many times in regard to medical issue on slashdot. I do not know your background or motives, but I will now look at your argument.

Doctors are not scientists, they are business people, and use a lot of hocus-pocus for financial and other reasons. For a large part doctors and biologists have no clue what they are really doing.

So let me examine this argument...biologists are scientists. Right? So are scientist to be trusted or not?

So are doctors (physicians are what I assume you mean) not scientists? From the first paragraph of wikipedia:

A scientist, in a broad sense, is one engaging in a systematic activity to acquire knowledge. In a more restricted sense, a scientist may refer to an individual who uses the scientific method.[1] The person may be an expert in one or more areas of science.[2] This article focuses on the more restricted use of the word. Scientists perform research toward a more comprehensive understanding of nature, including physical, mathematical and social realms.

Hmmm. So by your logic I am not a scientist. But I have just proven to you that I have a dedication to acquire knowledge, and in fact have gone further to educate the group here at large. Did I use the scientific method? Fromwikipedia:

The scientific method is a body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge.[1] To be termed scientific, a method of inquiry is commonly based on empirical or measurable evidence subject to specific principles of reasoning.

Well, I am not a bench scientists (even though I do have a BS in biochemistry and and BS in engineering), but I do write peer reviewed article in the medical literature . I use a standard and a control, I examine the independent variable in regards to the dependent variables. Can I control all of the variable as in a lab? Nope. So I use statistical methodology to arrive at the most probable conclusion. Is this always right? Nope. That's why we have conflicting studies out there. Do I present a hypothesis and try to arrive at a conclusion about said hypothesis? Yep. Do I have to get approval to even collect data from an insitutiaonl review board? Yep - Oh! Wait! - most scientists don't have to do that do they?

Hmmm, do I meet that definition? You tell me.

As for not knowing much about the human body: I spent 6 1/2 years earning two bachelors, 4 years in medical school where the first two years I spent 40 hours in lecture and lab being taught by PhDs and MDs who were considered experts in their fields. I studied independently over 60 hours a week during that time as well. The second two years were spent on the wards (about 120 hours a week) interviewing and examining patients under direct supervision of residents (MDs in training) and attending MDs (those who are finished their training) is the specialties of internal medicine, general surgery, obstetrics and gynecology, psychiatry, family medicine, pediatrics, emergency medicine, cardiology, anesthesia, neurology, preventative and rehab medicine, radiology, trauma surgery. The next 5 years were spent refining my knowledge of surgery by rotating with vascular surgeons, transplant surgeons, plastic surgeons, cardiac and thoracic surgeons, surgical intensivists, trauma surgeons, pediatric surgeons, orthopedic surgeons, surgical oncologsists, urologists, neurosurgeons, and good old general surgeons. I even spent two years in a lab. I then spent 2 years perfecting my skills rotating with surgical intensivists, trauma surgeons. And by "rotating" I mean i was directly responsible for patient care and operating on those patients with progressively more responsibility. So your call? Am I an expert in my field? Have I spent time and effort learning all that we know about the human body? Of course, your right....I did this all to make a quick buck. I'm in it for the business and I don't give a rat's tail end about helping people. (OBTW I am an academic surgeon who is salaried. I operate on you if it is indicated....I don't get a dime more than if I don't operate on you.)

No holistic/philosopical objections here, just pure science.

I'm sorry, but your argument is exact the same one used by anti-vaccination crowd. I do not see a single shred of evidence presented by you, just a lot of name calling and hand-wringing and "the sky is falling" clap-trap that is just not supported by the facts.

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