Well it depends, France adopted widespread use of diffusion weighted MRI as first line modality for stroke because it's much more sensitive than cect, but yeah, most institutions do CT scan as a first line for several reasons including one you've provided.
Can you provide a citation for the France assertion? I think it’s wildly unlikely a protocol for acute stroke would favor mri over ct but could be wrong. It would take 20 minutes to transfer a pt to mri in a lot of stroke centers in the USA, as opposed to CT’s that are generally across the hall, where imaging should be read within 30 minutes of door time I believe.
Also I’m not sure what you increased “sensitivity” would get you. Acute stroke is a clinical diagnosis, the imaging determines the type of stroke and treatment.
> Can you provide a citation for the France assertion? I think it’s wildly unlikely a protocol for acute stroke would favor mri over ct but could be wrong.
https://www.sciencedirect.com/science/article/abs/pii/S00353... (there's free pdf available when you search for it):
"The first-line brain imaging at WH was MRI in 69 SU (56.1%), CT in
6 (4.9%), and either MRI or CT depending on delay and severity in 48 (39.0%). The first-line brain imaging at NWH was MRI in 54 SU (43.9%), CT in 16 (13.0%) and either MRI or CT in 53 (43.1%). In practice, the proportion of patients who really underwent first-line MRI was higher than 90% in 46
SU (37.4%) at WH and in 36 SU (29.3%) at NWH"
> Also I’m not sure what you increased “sensitivity” would get you. Acute stroke is a clinical diagnosis, the imaging determines the type of stroke and treatment.
Reading that couldn't be more clear, CT is the primary modality for stroke, worldwide.
> by sensitivity I mean sensitivity
You're a little confused. You're using "sensitivity" to mean sensitivity of detecting ischemic stroke. MRI is the obvious follow-up. When available, worldwide. But it doesn't guide emergency treatment.
> Reading that couldn't be more clear, CT is the primary modality for stroke, worldwide.
Well yes, it's primary modality for stroke worldwide and it's leading modality in France, just like I've said before.
> You're a little confused. You're using "sensitivity" to mean sensitivity of detecting ischemic stroke. MRI is the obvious follow-up. When available, worldwide. But it doesn't guide emergency treatment.
I would appreciate if you stopped using condescending tone. It does not guide emergency treatment decisions because in most cases it is not performed in emergency settings. When it is performed in this setting it is guiding treatment and MRI is included in stroke guidelines for cases where clinical diagnosis is not clear (and these cases are not that rare). Why is it not widely adopted? Mostly logistic reasons (which can be overcome - like they were in France) and because TOF-MRA is generally worse than CTA. It has others positives apart from higher sensitivity though, e.g. you can use FLAIR/DWI mismatch in wake-up strokes which are VERY common (obviously perfusion serves generally same purpose).
Letting Russia keep the territories they control now is a great way to ensure that in few years when they rebuild their military potential they will attack again.
It also signals wars of conquest are back. That’s a message that will also be heard by revanchists in Beijing and New Delhi and expansionists in Tel Aviv, Riyadh and D.C.
It's neither obvious nor true, generalist models outperform specialized ones all the time (so frequently that it even has its own name - the bitter lesson)
I wonder what effect DOGE will have on attracting talent to government jobs. It was already challenging to recruit qualified individuals to government positions; with these changes, I believe the situation will worsen significantly.
> I wonder what effect DOGE will have on attracting talent to government jobs. It was already challenging to recruit qualified individuals to government positions; with these changes, I believe the situation will worsen significantly.
The idea is to replace these government positions with private positions.
Remember feudalism? Some guy with all of the capital - which, in those days, meant arable land - basically got to dictate how things worked, because he had the stuff you, as a peasant, needed to live. He was called the king. If you didn't do what he wanted, your life got cut short. Government was just one guy's ideas enforced by his brute squad. In many ways, it was a sole proprietorship. Eventually, nobility was required to administer the land, and that nobility eventually turned into a structure that could keep the king somewhat in check, lest they carry out a coup. They became the administrative state. Today, we have legislative, judicial and executive bodies that - at least ostensibly - need to win election in order to do the same thing, thus replacing the nobility.
That's the ultimate goal here: the dismantling of the administrative state. The administrative state carries out laws made by a body - in this case, Congress - that, at least in theory, puts society's desires at the center.
A number of these laws directly impact the ability of capital holders to generate more capital. Since the people holding this capital think that the only reason humans do anything is to create more capital, they go to any lengths to keep society's "unprofitable" desires at bay.
Since the accumulation of capital can result in monopoly, you will, at some point, have someone controlling all of the capital again. This is a return to feudalism. You won't be swinging a scythe in a field in a toque and tunic, but the structure will be the same.
Yes, yes, we know. You won't believe us until we actually are living in the feudalist society they're working, right now, to create brazenly in public. Enjoy gloating about crazy we are until you realize we really are not.
The narcissist is incapable of being incorrect and will always find a scapegoat to explain the consequences of their poor decision-making.
The world is now run by these people, and because most people are more ape than man, they will emulate and elevate these people until some other stronger ape comes around to convince them to emulate and elevate them instead.
This is a really unfortunate perspective. The people that you are casting as "more ape than man" believe you to be doing the exact same thing you accuse them of; emulating and elevating people they think are also ruining the world.
I genuinely don't understand how you can comfortably make such sharp insults towards people who don't agree with you. I understand that it's easy to get caught up in echo chamber - which any website that uses upvote/downvote based ordering and hiding schemes inherently encourage - but the people that disagree with you politically aren't apes. They're not narcissists. You are not special or above others.
Ironically, I'd say what characterizes a "man" vs an "ape" is their capacity for self reflection... which is your moniker.
A narcissist, as described in the article, has no capacity for self reflection because it requires them to enter a reality outside of their ego from which to observe themselves objectively.
I can comfortably make these observations (not insults) because I'm describing what I have observed over the last many decades, not reacting to some news ephemeral news item.
What amazes me is that this is a conversation about Elon Musk and Donald Trump and their sycophants... people who are even more caught up in echo chambers and more insulting to our fellow humans, all while being far more insulting in their online speech.
And what is rich is you trying to cast me as the one who thinks they're special because I'm insulting the people who blindly follow Musk and Trump in their naive belief that they're helping to "save humanity" or "America" or whatever.
I live in the real world, not echo-chambers, this is the place I post most frequently and it's still like once every other week/month (and declining). My comment was directed at a group of people in general, while yours makes all kinds (very incorrect) assumptions about me personally.
You actually sound very much like the person who is "too online" and "in an echo chamber" since you seem to respond to the least charitable interpretation of what is said in order to score internet points.
It's certainly a lot easier to respond to my comment as if I was dehumanizing entire swaths of the public based on their voting choices or political beliefs... much more difficult to consider that I'm speaking about a very narrow segment of the population defined by their specific belief that Musk and Trump are special and can do nothing wrong and will not countenance any evidence to the contrary.
There is a podcast from New York Times with interviews from government workers [1].
From all accounts the firing was incompletely indiscriminate and so many people who you would think would never be fired were e.g. US Army Corp of Engineers working on flood prevention.
And so I can't imagine anyone wanting to join the government when there is a strong chance you will be fired in the medium term with no notice and with no reason. All after you've physically moved you/family to Washington because remote work is no longer available.
It's not about details of each environment, it's about how the parent comment focuses on maximizing productivity (number of eggs), while discarding everything else.
> It sounds like you've never used a welding torch, installed a kitchen sink, or done similar blue collar work. These jobs will never be replaced by robots, or by a non-trained person wearing a headset.
Why do you think they will never be replaced by robots?
Not the person who said it and I wouldn't say "never"...
But I will say that until we have a robot that can fold laundry, we won't have a robot that can go into your crawlspace and replace a chunk of crusty old galvanized pipe with copper or pex.
Robots have excelled, so far, in controlled environments. Dealing with the chaos of plumbing in a building that has been "improved" by different people over the course of a century is the opposite of that.
One thing is as sibling post commented, the complexity of such jobs are staggering from a robotics point of view.
The other thing is that the salary of the plumber or welder is in the range $20/hr to $40/hr. Can you make a general purpose, agile robot function at a total cost of ownership that's substantially lower than this?
> My outlook is: this industry has always faced threats that looked like it was going to spell the end of our careers, but we always come out the other side better than ever.
I don't think there ever was as big treat to intellectual jobs. If LLMs ever get really good at programming (at the level of senior) there is 0 reason to keep majority of programmers employed. In addition it's not likely that it would be like other historical events of replacing workers with technology, because it most likely won't create new jobs (well, at least not for humans). So if LLMs won't run out of fuel before reaching that level I'm afraid we are fucked.
> I won't rule out the possibility of LLMs that are so good that they can replicate just about any app in existence in minutes. But there's still value in having workers manage infrastructure, data, etc.
Why would AI advanced enough to spin entire app from scratch have problems with managing infrastructure and data?
What do you define as a “senior developer”? Someone who “codez real gud” and can pass “leetCode hard” interviews or the tech industries definition of a senior developer who operates at a certain level of scope, impact and “dealing with ambiguity” and can deliver business value?
The former type of senior developer will be a commodity and see their pay stagnate or even go down as companies find cheaper labor, AI and more software development gets replaced with SaaS offerings especially with enterprise devs.
> a senior developer who operates at a certain level of scope, impact and “dealing with ambiguity” and can deliver business value?
Is there any chance for me (a student) to become like this? I'm fine with coding changing (I just love computing) but I'm scared of the entirety of the field being completely torched.
Please take my advice with a huge grain of salt. It’s been literally decades since I was an entry level developer. I try my best to keep my ear to the ground and look through the eyes of people at all levels of the industry. Part of my job is mentorship as a “staff software architect” at a consulting company.
What would I do these days? I would stay in computer science and if possible get an MBA. I dropped out of graduate school in 2001. But what I learned helped me a lot.
If you can’t go to graduate school, at least take a few business classes. I think the only way to survive will be focusing more on the business than the technology and work for a consulting company.
I don’t mean being a “consultant” who is really just a hands on keyboard coder doing staff augmentation. I mean working for one of the Big 5 consulting firms or one of the smaller equivalents.
The US is definitely moving toward privatization and the first thing they do is bring in more consultants.
I don’t work for any of them. I specialize in strategic cloud consulting. But that market seems congested at the low end.
As far as I've heard, MBAs have also become completely saturated as well. Out of the frying pan into the fire.
I get you're trying to be "consoling", but frankly the bajillion pivot ideas, hopium arguments, endless counterarguments, and other indirection is why I think there's nothing optimal that can be done. All I can do is go through the motions with my current internship and major and rely on Christ rather than this fickle world. I made the wrong choice. Nothing that can be done.
That's completely wrong. All of Europe heavily traded with Russia, and Germany even wanted to base their green transformation plan primarily on trade with Russia.
By which point, Russia was already in the hands of a dictator. Too late and too little, as they say. But yes, obviously, every country deserves a large share of blame for its own situation.
Either way - even if I concede this, my point stands that starving nations and denying them development isn't a great long term strategy for peace.
- Cues and Captivate - Vanessa Van Edwards (business-focused social skills)
- The Gentle Art of Verbal Self-Defense at Work - Suzette Haden Elgin (I actually didn't enjoy this one too much, didn't finish it, but I think that was a personal mismatch)
- How to Win Friends and Influence People - Dave Carnegie (a lot of the techniques are very, very dated and transparent when used today... but it's pretty foundational and worth a glance anyway)
