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davak commented on Everyone hates the electronic medical record   logicmag.io/policy/why-ev... · Posted by u/billybuckwheat
hyponatremia121 · 2 years ago
"Operations (not surgery) are so incredibly bad / incompetent in most healthcare settings that software frequently gets the blame for much deeper problems."

"In my experience doctors are a tremendous barrier to resolving problems in healthcare operations,"

I'm a hospital-based physician that works in a system with great operations and results. The physicians, nurses and other staff work amicably together. Management is reasonable/nice. The EMR, though is universally despised. No one likes it. It is a major factor in burnout. The UI/UX is inconsistent. There are slowdowns and outages daily. There is a well known lag in the appearance of text in text boxes after typing that seems to be variable. I've caught the EMR cancelling orders I placed on critically ill patients in the ICU more times than I can count. We have to actively protect the patients from the EMR. Healthcare workers aren't perfect but they are trying to do their best for very ill people in a high-risk setting and the EMR is well-known blocker. I long for the days of paper records because this is worse. Paper charts didn't go offline, have slowdowns, didn't lose orders, were easily located, and easy to enter data into.

davak · 2 years ago
HypoNa --

I think you made a throwaway account for this reply, but I would really appreciate continuing this conversation with you. My email is available under my profile.

davak commented on Ask HN: Most interesting tech you built for just yourself?    · Posted by u/l2silver
simonsarris · 2 years ago
I built carefulwords.com simply because I wanted to type a word into the address bar and get a large list of synonyms and some historical quotes using the word quickly. For example:

https://carefulwords.com/solitude

https://carefulwords.com/think

etc. Also unlike thesaurus.com, the search bar actually focuses so you can just start typing!

It's not perfect, I need to do a lot of editing, but nonetheless I use it almost every time I write, now.

The site is a little over 30,000 static HTML pages built with a number of TypeScript scripts that compile some sources for synonyms, parts of speech, and the quotes.

davak · 2 years ago
Added as a Kagi bang! Love it.
davak commented on Show HN: Price My Spotify Library   github.com/aquaflamingo/p... · Posted by u/devrob
qup · 3 years ago
I'm gonna check this out when I'm back at my PC.

Sorry it didn't get more traction, it's a great idea.

I think it would be cool to extend it to provide links and maybe like price shopping, if there's any serious consideration to actually buy the libraries.

davak · 3 years ago
Agree. You could consider marketing to the DJ community where actually buying the music is commonplace.
davak commented on U.S. Life Expectancy Falls Again in ‘Historic’ Setback   nytimes.com/2022/08/31/he... · Posted by u/aaraujo002
PeterStuer · 3 years ago
There is also worldwide an as yet unexplained 10% rise in non-covid surpluss mortality.
davak · 3 years ago
This is likely related to COVID as well, just indirectly.

- Research has shown that recent COVID-19 infection increases risk of heart attacks, strokes, and a ton of other vascular diseases.

- Overwhelmed hospital systems will have poorer outcomes in emergencies such as sepsis where time-based care is a huge factor. Worldwide sepsis mortality has gone up over the last two years, for example.

davak commented on Jackson, Mississippi, to go without reliable drinking water indefinitely   reuters.com/world/us/floo... · Posted by u/makerofspoons
bequanna · 3 years ago
I think you’re confusing the responsibilities of states and local municipalities.

It may surprise you to learn that Jackson is actually led by a quite liberal mayor: https://www.jacksonms.gov/departments/office-of-the-mayor/

davak · 3 years ago
The mayor has been begging* for funds from the state for a long time now to fix the problem though. That being said, I'm sure there is lots of local and state mismanagement that would go into causing such an embarrassment.

* https://www.wlbt.com/2022/02/17/jackson-faces-uphill-battle-...

davak commented on Show HN: Padka – Make your Zoom sessions more fun and engaging   padka.com/... · Posted by u/surihae93
davak · 4 years ago
Install failed. OS X 10.14.6. Happy to help debug with you.
davak commented on Hospital exec says employees are walking off the job   cnn.com/videos/health/202... · Posted by u/belltaco
EricRiese · 4 years ago
The graph shown when talking about daily cases exploding was a graph of cumulative hospitalizations with the y-axis not starting at 0, to make an increase from 360k to 380k look like a tripling. Do better CNN.
davak · 4 years ago
I hate chart hacking. However, cases are up over 130% in the last two weeks. Hospitalizations up 80%. (1) The surge is unfortunately real.

(1) https://www.nytimes.com/interactive/2021/us/covid-cases.html

davak commented on US agencies call for pause in Johnson & Johnson vaccine   bbc.co.uk/news/world-us-c... · Posted by u/basisword
robbiep · 4 years ago
If you’re doing the calf exercises to ward off a DVT, (and not to just stretch your strained calf!) you may be barking up the wrong tree.

The preliminary theories (backed by the thrombocytopaenia) are that, if there’s a vaccine induced thrombosis with thrombocytopenia, it is probably immune-mediated (similar to HITT - heparin induced thrombocytopenia and thrombosis).

And then there’s some weird thing that makes them form in your venous sinus.

But there were also reports of more typical blood clots (ie DVTs), the first European Medicines Agency advisory (0) said that this was within the level of noise (im now talking AstraZeneca, so apologies for shifting vaccine as generally they should be considered separately until the evidence catches up, although everyone is quickly drawing parallels between them)

(0) https://www.ema.europa.eu/en/news/covid-19-vaccine-astrazene...

Ps apologies for not referencing around HITTs and theories around antibody-mediation for CVT. Basically it’s all pretty noisy anyway at the moment and so my here-say from the medical tea rooms is as good a gossip as any, as long as everyone is aware that no one really has any definitive idea what may be going on yet

davak · 4 years ago
Good take.

Arterial clots with thrombocytopenia is incredibly rare. Additionally the PF4 activity in these patients is very abnormal and appears to be to immune mediated. Lots of science and focus going into the mechanism around this now. The other recent NEJM articles around clots associated with the other adenovirus COVID vaccines are likely a similar phenomena.

davak commented on Neutralizing antibodies against SARS-CoV-2 variants after infection, vaccination   jamanetwork.com/journals/... · Posted by u/11thEarlOfMar
davak · 4 years ago
This was not testing against the South African and Japan/Brazil variants that are much more likely to escape vaccination antibodies. This UK variant is mostly problematic against the unvaccinated.

In the lab the South Africa and Japan/Brazil variants have severe reduction in neutralizing antibodies which is very concerning for vaccine escape. That being said, we don’t have a great way to test for T cell and other immunity which also plays a role. Getting the vaccine decreases severity of illness regardless of the variant.

The answer is get any vaccine as soon as possible. Then get the booster too when it’s available.

davak commented on Pfizer submits Covid vaccine to FDA for approval, to distribute in December   pfizer.com/news/press-rel... · Posted by u/KoftaBob
pen2l · 5 years ago
What about... workers in the cafeteria who handle our food, cashiers at supermarkets and waiters who bring food over to you. I'm shocked most of the papers I'm reading don't mention these folks who are at the very intersection of our daily lives!
davak · 5 years ago
Probably too late for anybody's interest, but the risk of getting this from food is suspected to be incredibly low. Droplets being inhaled, entering through the eyes, or nasal mucous membranes are the likely real threats.

u/davak

KarmaCake day266June 4, 2013
About
Nerd. Doc. Always interested in blending technology with medicine.

Davak -at- carotids -dot- com

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