skysight-inc/HackerNews huggingface dataset:
> How doctors of all professions lost their professional agency to do-nothing administrators within a generation is quite puzzling and a bit terrifying to me.

I have a lot of friends at various levels of healthcare, from nursing up through low and mid-level administrative positions.

The one thing they all seem to agree on is that patient satisfaction surveys have been terrible for healthcare.

Once the emphasis shifted to patient satisfaction, everything became more of a game of catering to what the patient thinks they want. With the spread of rampant medical misinformation on the internet and the rise of alternative-medicine podcasts/blogs/influencers masquerading as informed medical professionals they have a constant influx of patients who show up believing they have a certain condition or need a certain medication. If you disagree too much or refuse to give them the medication they want, you risk a negative review. Too many negative reviews could negatively impact your compensation or even cost you your job.

Even at offices that don't perform patient satisfaction surveys, providers are at the mercy of negative online reviews. Again, if you don't do exactly what the patient thinks they want, you risk scathing online reviews.

This is terrifyingly problematic given the trend of people to self-diagnose with anxiety or infections who show up demanding Xanax or antibiotics. Puts doctors in a situation where they don't really think prescribing those medications is a good idea, but they also feel like they can't deny too many patients or they risk their reputation/bonus/reviews.

It's also a huge problem with conditions like obesity or alcoholism or smoking, where the doctors can see obvious patient-induced health issues but the patient really doesn't want to hear the truth from their doctor.
Man, good thing that all this garbage is coming down at least at some point. At ~500km the orbit should decay to reentry in about 10 years. At ~700km it is 100 years already...

Really cool map despite that of course.
I have not been following the story as closely as others, but how is reversing special privileges for a corporate titan (Disney), that give it abilities that nobody else is allowed to have, authoritarianism? That only seems authoritarian relative to anarcho capitalism or extreme libertarianism.
Apple already does this via spatial audio for AirPod pro.
A 5-step playbook for creating tailored user onboarding experiences
That's still insane. I have a Hue bridge and server at home that together draw less than 50W. Network equipment is also in the range of max 10W per device.
I think the situation has improved there in the last couple years. I had a friend who I suspected of having sleep apnea. She called her doctor and asked for a sleep study. They gave her a device to wear while sleeping and the diagnosis of sleep apnea came the next day.

Getting insurance to approve the CPAP, though... that is still an open problem. Weeks later, no treatment for diagnosed disease.
It's more a lack of psychopathy in the profession. If nurses in Ontario had gone on strike two months ago, a lot of extra people would have died.
What I don't get that we now have all the DMARC infrastructure, that should in theory enable to use the reputation of domains instead of IP addresses, but apparently nobody cares, and your IP has to be reputable, no matter what.
But they have zero autonomy there too I assume?
You also forgot to divide by the number of binaries that were compiled with non-vulnerable versions of the library.
If interested in supporting recursion, the SICP tutorial does a great job supporting it! I chose not to include this for the essay, but it's fun to hack. If you end up doing this, here's a reference Clojure implementation:

https://github.com/nezaj/clj-sicp/blob/master/src/logic_inte...

(The main ingredient, if I remember correctly, was `unify-match`)
>Well obviously Disney got a plum deal back in the day, which should probably be migrated to fairer terms now.

This is the tough thing about subsidies. Orange County's population has grown 10x since 1950, which has been a huge boon to Florida (from a tax base perspective, from a representation in Federal government perspective, etc.).

You could argue that the subsidy is now too 'sweetheart' of a deal since Disney can't exactly move the park, but isn't that the literal opposite of the Republican economic platform?
> local governments who would likely be bending over backwards to appease the house of mouse.

This part isn't necessarily guaranteed. Over in California, Disneyland frequently has trouble with Anaheim/Orange County when seeking approval for new projects. They've had entire hotels and parking structures designed, publicly announced, and then canceled because the local government wouldn't play ball.

The only thing that guarantees Disney's continued ability to build whatever in Florida is if they continue to be their own local government.
Gold standard serving as a fiscal straitjacket is precisely why it has be removed by governments time and time again. Removing a gold standard benefits the government and those in power and is a detriment to the people and the value of their labor. Not having a gold standard removes the physical requirement for government to behave with fiscal responsibility.

The number of times that gold standards have been ended isn't proof that gold standards don't work. It is proof that people in power will remove obstacles in the way of achieving their agenda.

People in power are still people. People cannot be trusted to be responsible with massive amounts of money when there is no personal penalty for being fiscally irresponsible.
I’d argue that a startup which just got a major cash infusion is the best to ride out an imminent recession.
Unless Apple expands the options tremendously, iFixit will be around for a while, since the only parts available currently are for a limited range of the newer iPhones.
This is a good summary, and it corresponds to what I've heard from friends and acquaintances that are currently nurses (or left recently).

(2) is a really perverse statistical phenomenon, and it's unfortunate that nurses are bearing the brunt of our civic and public information failures. It must be particularly soul-draining to heal someone who resents the single thing that would have protected them the most from needing hospitalization in the first place.
Dupe: https://news.ycombinator.com/item?id=25467900
I'm not trying to argue with you about that point, of course its AOT compiled.
incompatible though with dynamic "spill" arrays..

maybe 'named ranges' solves the problem? but neither those nor lambdas are available on excel web atm iirc
Nursing won't be automated soon, but automated systems will be used for things that nurses used to do (with predictably worse results).
Prediction: Any distributed social media (like Mastodon) that gains mainstream popularity will share the same fate. Sure, you'll be able to host your own Mastodon instance, but 99% of people will be on the top 10 hosts and they won't peer with you.

I think the only way to make distributed social media practical is to have an extremely inexpensive turnkey self-hosting solution for the average person. A Chromecast-like device that they plug into their TV that backs up all their photos, plays music, and also hosts a Mastodon instance. Some kind of very friendly backup solution where you make an "emergency contacts" list, and the device encrypts all of your data and stores it on your emergency contacts' devices as a backup, and vice-versa.
People who are sick, in pain, or possibly dying might be slightly less emotionally regulated than your typical customer.
Whether or not any particular nurse follows through with thoughts of quitting, all else being equal I think we want nurses who enjoy and want to stay being nurses rather than nurses who are thinking about quitting. Nurses who are happy provide better care than nurses who are so unhappy they want to quit.
Really sorry, I don't normally nit pick spelling and grammar, but it's "en masse" rather than "on mass".
> Almost all the makefiles that I have ever seen used in open source software projects are in my opinion horrible garbage, and they do not use properly the GNU make features and they are extremely difficult to understand and modify.

if tomorrow a pen maker released a new pen where the majority of artists using it only managed to produce shit artworks, everyone would rightly call this pen shit. Even if it's theoretically possible to use the pen in such a way as to not produce shit artworks. Likewise for, say, a tool used for making musical instruments, etc.

How well a tool lends itself to be used by the average person is an important property when choosing to use a technology over another.

Can you provide e.g. a project with your good makefiles, that I could use to build debug and release builds, with any of MSVC, GCC, and Clang ?

> I do not see why any of the 2 methods for building a project could be faster for the other. For a properly written makefile, the time spent in executing make is completely negligible in comparison with the compilation/linking steps.

can you provide one such makefile ? in my experience make always takes a few seconds for projects with >1k targets when changing a single file. Ninja is consitently instantaneous.
I'm friends with quite a few nurses, primarily travel nurses, and not a single one is considering a change in career that I am aware of. Simply an anecdotal counterpoint and nothing more.
Neat concept. Fortuitously I was toying with a similar acronym a few days ago. I’m surprised by the similarities:

SCRIMP

secure
correct
readable
idiomatic
maintainable
performant
"Work", in this case, meaning you can get a display to run through one. I've tested DVI, VGA, HDMI, and DisplayPort across four different graphics cards (three AMD 5000-7000 series, and one SM750 card from ASRock Rack.

A console (CLI) runs great and is stable, but Xorg and Wayland (well, Weston at least) are a little less stable. And with the MMIO modifications we had to make to work around the Pi SoC's (BCM2711) flaws, things are a bit slow currently.

And other SBC SoCs seem to have similar PCIe hardware-level issues (like the RK3588 in the Pine64 SOQuartz, at least). Tons more detail can be found in these two GitHub threads:

https://github.com/geerlingguy/raspberry-pi-pcie-devices/iss...

https://github.com/geerlingguy/raspberry-pi-pcie-devices/iss...

(Both issues are over GitHub's limit, so you have to show hidden items to see the whole progression.)
Insurance is the only industry where they agree to pay for something (in this case, "medical care"), but then after service has been rendered can decide to pay less, or not pay at all, or stop paying that provider altogether, etc. This combined with hospitals being run by non-physicians*, and people thinking being able to Google and read WebMD qualifies them to argue with their doctor about treatment plans**, healthcare in the US is going to absolute shit***.

* I strongly believe that only physicians should be running hospitals. Certainly not administrators whose only education is an MHA and only experience is working for for-profit health companies. Medical decisions need to be made outside of cost considerations. The only factors should be medical science, quality of life, and patient wishes (in that order).

** In stark contrast to asking questions and trying to understand. But I have family members who are the "look everything up and then try to tell my doctor how they're going to treat me" ilk and it's crazy.

*** I don't think the above points are unique to US healthcare other than cost considerations, but that's all I have experience with.*
This is like building a motorcycle on a 350cid v8 engine. Lovely absurd insanity.
I did a lot of leetcode when I first started. Nowadays, and especially in this market, it's not hard to find companies not doing any leetcode style interviews. If you have a decent GitHub profile and years of experience you can outright say in interviews that you won't be doing any leetcode style problems. It's an engineers market, take advantage of it!
I only support this if I dont get charged for 2 visits
> not educated enough to think critically and realize their tax dollars will now subsidize the millions (billions?) of dollars of infrastructure

For what it's worth, it's likely residents of Orange and Osceola Counties will be taking up most of that extra tax burden. Both of those counties are relatively blue, and neither of them voted for DeSantis... so that's probably just gravy to him.
Efficient systems are brittle systems. You wring all the slack out of it and any shock is going to cause failure. In this case, the slack is the nurses and other healthcare workers' mental health and burnout limits and pay and culture etc. etc. The slack is being pulled to lower costs and increase insurance/hospital profits.

It's unsurprising that what has happened in the past couple of years is putting stress on a system with the slack pulled out of it.
> lost their professional agency to do-nothing administrators

You just summarized the decline of Western civilization in one phrase.

This has happened almost everywhere and efforts to push back have proven extremely difficult. I personally place a lot of the blame on the educational system for overproducing administrative skill sets and underproducing practical skill sets. There is some role for those things of course but we have far too many people for the administrative roles we really need and far too few for many other professions. This combined with the tendency of people to recruit people like themselves has oversaturated the market with administrators looking for reasons to exist.

The rot is to the point that we have the spectacle of Elon Musk looking like superman. Why does he look like superman? Because he actually does things instead of having meetings to discuss the meeting schedule. He's just a reasonably competent engineer and business founder with huge resources who... does things... and this makes him look superhuman by comparison to the hordes of administrators that only discuss doing things and commission studies about hypothetically doing things.
That's reading way too much into it, don't you think?

I don't think that, no. Or I wouldn't have posted what I posted. Corporations spend an immense amount of money on PR, and a lot of it goes on "perception shifting". As an example, in the early 2000s Shell spent $100m inventing the idea of a "personal carbon footprint" so that people would focus on the environmental impact of you using 20 plastic straws a year instead of Shell burning 400m barrels of oil. It worked brilliantly.

The "article" literally says the savings is £30 a year. Nobody thinks that's the reason they're poor.

£30 a year on this. £50 a year on something else. £20 a week on a phone. £5 a week on coffee. And suddenly the papers are full of "Poor people can't afford a house because they waste their money on things!" People do believe it.

In other words, money saving advice should be banned because they might be spewing "corporate PR to shift responsibility"?

Yes. Money saving advice when it's a paltry amount that won't cause a shift in your circumstances is essentially useless, especially if the root cause is some corporation trying to get out of being responsible for their actions. In this case, electricity companies are making record profits and increasing prices far in excess of inflation. The media should focus on that, not whether or not someone is using 20kWh on making LEDs stay on.
Breakthrough Allows for Mass Production of 25 Exabyte 2-Inch Diamond Wafers
I'll definitely take that (which is largely under my control) over e.g. Google deciding that I've done something wrong one day and cutting off my email.
> The main valid thing I've seen people complain about is the lack of a decent multi-platform GUI library

Never mind decent or multi-platform, is there any built in facility for developing a GUI?
Agreed. This article is so off the mark, trying to talk all the ways technology can help this problem without a single sentence retrospecting about any of the problems that shitty EMRs have caused or at least facilitated. The massive increase in charting, and the fact that nurses spend more time on CYA than providing care these days is the number one reason I've heard from nurses who are trying to get out. High patient-to-staff ratios is the second, which wouldn't be quite as bad if it weren't for all the charting.
The shift to EMRs (more-or-less forced by the ACA) has been a huge quality-of-life loss for doctors. Tons of time spent on Epic or Cerner checking boxes and selecting drop-downs.

Turned a "trusted professional" advisory role into a keyboard role.
Show HN: Startpage Privacy Protection Extension
When acquired companies don't renew their domain
Well yeah, because it's reporting on a survery of nurses which included a question about whether they're considering leaving the profession.

I think your would be headline is a fair inference to come to, though not the sole cause.

With how over sensationalised our media is, can we avoid complaining when headlines actually directly match the thing they're reporting on for once?
> Looking at Gab and having your one takeaway be "free speech" is akin to looking at Russian news coverage and thinking "wow they really support the troops".

Like their tag line is: A social network that champions free speech, etc etc.

Your complaint isn't that they don't support free speech but rather the echo chamber and toxicity that entails.

That's the real fear of what Elon is about to do. By allowing conversations to happen it will break the echo chambers of twitter and the left fears that greatly.
Really interesting, going to have a look at that paper -- thanks for sharing your insight

Let me ask this: if you have something like a GraphQL API, which often does sparse column selection from multiple different tables, would that also be a good fit for columnar database?

In most GraphQL queries, you're grabbing a portion of the fields from one or more tables, IE something like:

query JoesCompletedTodos {
users(where: { name: { _eq: "Joe" } }) {
id
name
todos(where: { completed: { _eq: true } }) {
text
}
}
}

Where this will get translated to something along the lines of

SELECT users.id, users.name, json_arrayagg(todos) FROM users
INNER JOIN todos ON todos.user_id = users.id
WHERE users.name = 'Joe' AND todos.completed = true
GROUP BY users.id, users.name

Many times you'll see queries spanning 3-4 relation levels deep, plucking something like 2-6 columns from each table.

Curious how well a columnar DB would do with something like this?

Also, on this point:

> "Most columnstores don't use compression schemes that are incremental. To grab a single row the columnstore likely decompresses many adjacent rows (could be millions of rows - depends on the particular columnstore)."

I think this is something that could be avoided if the data were in IE, Arrow, and you used Arrow Flight/FlightSQL as the transport mechanism, right? But this isn't my area of expertise, for sure.
Ah, but it is the only thing MBAs are "good" at. /s
It would also depend a lot on what's going on with your wisdom teeth. If they haven't erupted at all and are causing trouble, that's oral surgery time. If they're fully erupted, a regular dentist may do it. In between, it depends.
In the book The innovator's prescription: a disruptive solution for health care by Clayton Christenson, there are some good analysis of where the complexity and problems come from in the current US medical system.

A lot of it has to do with size and the complexity that goes along with it. So, as hospitals get bigger, do more, and increase in size and complexity these issues become worse.

The economics math even mirrors factories... a factory that can build 100 things compared to one that just produces one thing.

The book was enlightening, even though many of the time frames called out in the book were wrong. Disrupting medicine is a lot harder than something like technology.
Yes, besides the solution which dalmo3 wrote about, there's a recent feature that doesn't rely on you providing a domain - https://www.fastmail.help/hc/en-us/articles/4406536368911-Ma...
Most industries are neither tasked with restoring health nor with being the bearer of hard truths about a person's health. I think it stands to reason that healthcare can be a particularly toxic environment for those reasons.
Travel nurses are compensated quite a bit more in my understanding. And the travel aspect means they can leave the more toxic locations more easily.
I'll second the Mayo Clinic. I've (unfortunately) spent way too much time there, and it just can't be beat. I wish every hospital/doctor/system worked like this place. I doubt that's even possible, anywhere, but from my experience, it's how medicine should work.
Back in the days before cell phones, my mom would wind up being on call for overnight labor & delivery. The final straw (certainly not the first) was that they got a call in the middle of the night that a woman came in in labor, and she had to drive in to work (a half hour drive). This woke up my dad, who also happened to be a light sleeper and worked a day shift.

20 minutes later (while my mom was well on her way into work) the phone rang again- it was a false alarm, she didn't need to come in anymore. Naturally, it was my (not so happy) dad who answered.

By the time she got in, they didn't have anything for her, so sent her back home.

At the time, there wasn't quite such a crunch in nursing, so the pay part wasn't accurate yet, but everything else you listed (substitute COVID for %50+ of patients) was already true 30 years ago.
Legalities aside, how would you feel about refusing to work for poor pay/conditions if you knew for a fact that said decision would result in many deaths?

Not a chance, not a speculation, but absolute awareness of the number of patients that will not receive care and likewise will die as a result.

I don’t think it’s fair to blame nurses for poor treatment when they have a multitude of terrible options to pursue in order to improve their working conditions.
Counterpoint from Jean-Baptiste Henri-Dominique Lacordaire:

"Entre le fort et le faible, entre le riche et le pauvre, entre le maître et le serviteur, c’est la liberté qui opprime et la loi qui affranchit."

("Between the strong and the weak, between the rich and the poor, between the lord and the slave, it is freedom which oppresses and the law which sets free.")

https://en.wikipedia.org/wiki/Jean-Baptiste_Henri_Lacordaire
Again, philosophically and computationally, statistics is more complicated.

And again, you do need calculus to do statistics. Maybe you're saying: "If someone does the calculus part for you, you can use this one equation to solve this one question."

That's akin to calling a spelling test literature. You are confusing practice with knowledge. Anyone can bang on a drum. That does not make them a drummer.
> What tech companies/industries will do well in a recession?

every company that’s not driven by hype (example: crypto, chatbots) and not focused on growth as primary objective
Have US hospitals ever had transparent pricing?

This seems like the root of the problem, and insurance seems like what "fixes" that but causes tons of downstream unwanted side-effects.
I never got round to PR'ing this (maybe I still will) but it would be great if Howdy had a feature where it could be "skipped" until the user is logged in.

That would allow people using systemd-homed's encryption to unlock their home directories, which they otherwise cannot have done [as it requires the passphrase].
“I like pizza” survived exactly.
My partner is an NP, not only is there an astounding amount of paperwork, usually it's done outside of working hours because management took the chunks of the work day that were previously blocked off for doing paperwork and turned them into more patient visits so they could make more money.