Complexity budgets - <AUTHOR> http://scattered-thoughts.net/blog/2015/10/25/complexity-budgets/ <comment><USER2> > Modularity, indirection and abstraction are not panaceas for this problem. > In most cases they reduce local complexity at the cost of global complexity. > This is a decision that should be consciously weighed in each case rather > than assumed to be an unquestionable win.

This is a very important point, and one that a lot of developers miss, or even believe the opposite of. It's common to approach problems by 1. identifying the abstractions that you'd want to have to solve the problem, 2. implement those abstractions, and 3. use the abstractions to solve the problem.

This is how (by and large) we're taught to program, and it basically attacks the problem in a backwards way. Start specific, implement the whole thing with fairly minimal abstraction, then if the local complexity warrants abstraction, move to something more abstract.

Why? So that you can put off "the point past which you can no longer collectively understand the system". Local complexity is better than global complexity, and defaulting to a globally complex system is a terrible choice.

<comment><USER3> > _1\. identifying the abstractions that you 'd want to have to solve the > problem, 2. implement those abstractions, and 3. use the abstractions to > solve the problem._

Also the reason to do it bottom-up is because you never understand the problem perfectly, _especially_ if it has anything to do with real-world things. This means that whatever global domain model you created is wrong, and by the time you discover where exactly, you'll be so invested that it's too late to change it. It's easier to adjust the model when going bottom-up - you can change or discard just the top layers, as soon as you realize your new abstraction level doesn't match the problem domain properly.

<comment><USER4> I watched the Structure and Interpretation of Computer Programs lecture recordings, and one lesson I got out of them very strongly: create a toolkit to solve problems in the space of your initial conception of the problem. Your initial instinct of what the problem is, is typically wrong, and the demands on your program typically evolve anyway.

I hesitate to use the phrase "domain specific language" because it brings baggage, but that's the platonic ideal of a toolkit.

The core skill of building toolkits is picking flexible ways to decompose problems. Top-down planning and decomposition has a way of biting you in the ass at the worst times, when you're almost done except for one corner case. Bottom-up construction tends to be more flexible if dirtier.

<comment><USER3> I actually liked the way they referred to those toolkits as "languages". Maybe let's not call them Domain Specific Languages because of the baggage, but it's a good way of thinking to see layers of abstraction as defining programming languages for layers above them.

Familiarity with Lisp helps understand this concept, because creating a new "DSL" there is so easy that you treat it just like creating a new class or interface, and not as some kind of great endeavour that most people mean when thinking about DSLs today.

</comment></comment></comment></comment><comment><USER5> The analogy to math always lingers in my mind: before we had efficient, well- understood formulas, we would always rely on lookup tables to solve real problems. True of construction in ancient Egypt - also true of many programming problems today.

I got into an argument the other day about the idea of using fewer names for things in code - I wasn't doing a stellar job of articulating the point since the obvious rebuttal is "if you aren't using a name what are you going to use instead?"

But it happens so often that what you are - or should be - implementing is not a business rule, but supporting computation - and in the latter, naming is relatively unimportant. And when you do finally reach business logic, it turns out to flow more smoothly if you allow a procedure to be a complex "train station" or "Manhattan Island" and don't carve it up unnecessarily, because more is done with fewer variables or more obviously short-lived and temporary variables. Fewer things get passed around, thus fewer things need names. And the code is generously imperative but can be understood because a top-to- bottom reading is possible.

Using more table-driven code just happens to be one particularly effective way of streamlining logic and named fields out - it's more effective than most uses of OO abstraction because it is a concrete specification of possibilities, yet it doesn't preclude extension in any dimension.

</comment><comment><USER6> I solve this with the Cynefin Framework:

[https://www.youtube.com/watch?v=N7oz366X0-8](https://www.youtube.com/watch?v=N7oz366X0-8)

What I love about Dave's work is that it's very Zen and self similar to nature. The more I observe complex systems, the more I realize they are just like self-organized nature. Complexity begets complexity. Novelty begets novelty. These ideas are not new.</comment>


Ask HN: UC Berkeley EECS experience? - <AUTHOR>

How is it? <comment><USER2> That is a very open ended question and it depends on what you want to get out of it. Are you particularly looking to study EE, CE, CS, or a mix of them all?

The major can be very broad and if you don't know what you'd like to specialize in, then I suggest looking at the core classes ( [http://www.eecs.berkeley.edu/Programs/Notes/section2.shtml#2...](http://www.eecs.berkeley.edu/Programs/Notes/section2.shtml#2.5) ) to gain a lot of diverse knowledge.

The program is good, whatever your future plans after undergrad may be. A lot of undergrads participate in research with GSIs and professors to see if they would be a good fit for grad school; also, a lot of undergrads do summer internships to help them with their industry careers afterwards.

The support network is good and you are assigned two advisors; a class advisor (to help plan with courses, units, graduating on time, etc) and a professor who will give you more high-level advice. In addition, though people in the program are bright and "competitive," there are plenty of opportunities to get help and collaborate. You are also often paired up with other classmates to work on projects so that you participate in teamwork.

I finished in 2008 and my only regrets are:

\- Not planning my courses more carefully

\- Not doing more over summers

Hope this helps.

<comment><AUTHOR> Thanks for the answer, it would be for CS mainly.

Is the class size a problem and is it hard to get a seat for some of them?</comment></comment>


Pixel Perfect: Pascal Dangin's virtual reality - <AUTHOR> http://www.newyorker.com/reporting/2008/05/12/080512fa_fact_collins?currentPage=all

<comment><USER2> Great article about a great visual hacker.

"Pascal is actually an unwritten author of what is leading the newest areas of contemporary image-making."

"But this world is not reality—it's about drawing people toward an ideal vision, if we're talking about fashion photography. You have to think that celebrities are playing roles the same way they do in movies."</comment>


Ranking the Most Popular Writers and Media Sites on the Internet - <AUTHOR> https://priceonomics.com/ranking-the-most-popular-writers-and-media-sites/ <comment><USER2> > This post is a collaboration between the Priceonomics Data Studio and Digg

Aha. I _thought_ it sounded like an advertisement.

<comment><USER3> Ah yeah, I was wondering why they only had Digg. Figured it would be nice to do the same thing for other sites and compare as well. Seemed odd to not do a comparison since each site will have their own demographics.

</comment></comment><comment><USER4> Annoying that the wrong chart is inlined for the "most written about people by year" se tion (it is just a repeat of the _" most popular media sites across time"_ chart).

The correct image is [https://pix-media.priceonomics- media.com/blog/1265/image02cr...](https://pix-media.priceonomics- media.com/blog/1265/image02cropped.png)

</comment><comment><USER5> It would be cool to see the total number of articles published by each site as well, to see which site has the most stable good content. Shotgun or rifle.

<comment> angry-hacker Digg is curated by hand, so it can only be the best through the eyes of those people.

</comment></comment><comment><USER3> I would be interested in seeing the same thing done for here. I know I saw a website that had the top stories from HN for each day a while back. Just trying to remember what it was, then can scrape it and do the same thing.

<comment><USER6> Relevant: the top publications on HN [https://medium.com/swlh/best- of-2015-pfffffffft-79d9b014f4de](https://medium.com/swlh/best- of-2015-pfffffffft-79d9b014f4de)

</comment></comment><comment><USER7> Is Digg even relevant today? they would have been better off analyzing Reddit.</comment>


The Feynman File (2005) - <AUTHOR> http://discovermagazine.com/2005/mar/feynman-file#.UYajjbWPMnk

<comment><USER2> Most biographies of Feynman are really hagiographies of Feynman, who was no doubt a great showman. Here's a collection of his letters, which, despite revealing some personal flaws, show that he is wiser and more vulnerable than we imagine. Really underrated in my opinion.

<http://www.amazon.com/gp/product/0465023711/>

(The letters to family and Wolfram is also there.)

Another good one, in my opinion, is a rather raw portrait made from the vantage point of a student towards the end of Feynman's life. It's the unvarnished details that reveal the ordinariness and greatness of that physicist dude.

[http://www.amazon.com/Feynmans-Rainbow-Search-Physics- Vintag...](http://www.amazon.com/Feynmans-Rainbow-Search-Physics- Vintage/dp/0307946495/)

I think Feynman really believed that anybody could become as (wise? accomplished? happy?) as he, and I think most books don't do justice to that dream of his, by making him out to be some kind of trickster god.

</comment><comment><USER3> A random note.

I first really understood special relativity from reading Feynman's lectures. A concept that he explained in there is that E = MC^2 really means that energy and mass are the same thing. A moving object weighs more because in addition to its own weight, it has the weight of its kinetic energy.

This is a very nice way to think about the issue. Unfortunately I discovered years later that nobody else thinks of it this way. Instead they think about mass as being rest mass, and that you turn from having energy to having mass and vice versa. Linguistically slightly different, but logically equivalent.

It still makes me sad that physics doesn't think about things in the simpler way that Feynman presented.

<comment><USER4> I can pretty much guarantee you Feynman didn't either -- when he was actually working with relativistic equations. The idea of a rest mass makes everything way, _way_ simpler.

There was a Feynman quote in one of my physics texts that left a big impression on me -- basically saying that you shouldn't call yourself a physicist until you can understand the same physics using multiple models, gleaning insight from whichever is the most useful in context.

<comment><USER5> >you shouldn't call yourself a physicist until you can understand the same physics using multiple models This applies to pretty much any field. Feynman was a great physicist from this point of view.

<comment><USER6> You want two line breaks in there.

</comment></comment></comment></comment><comment><USER7> Interesting read, but if anyone is interested in more personal anecdotes like this, I suggest:

[1] [http://www.amazon.com/Surely-Feynman-Adventures-Curious- Char...](http://www.amazon.com/Surely-Feynman-Adventures-Curious- Character/dp/0393316041)

[2][http://www.amazon.com/What-Care-Other-People- Think/dp/039332...](http://www.amazon.com/What-Care-Other-People- Think/dp/0393320928/ref=pd_sim_b_1)</comment>


Firing of Los Alamos political scientist spurs criticism - <AUTHOR> http://news.sciencemag.org/people-events/2014/08/updated-firing-los-alamos-political-scientist-spurs-criticism <comment><USER2> "It goes on to argue that nuclear deterrence is not effective and that nuclear weapons should be eliminated for a host of political, military, humanitarian, and environmental reasons."

Not having read the actual(and now classified) article by Doyle, can anyone summarize the "political, military, humanitarian, and environmental reasons"?

EDIT: Whoops here's the original article: [http://www.iiss.org/en/publications/survival/sections/2013-9...](http://www.iiss.org/en/publications/survival/sections/2013-94b0/survival --global-politics-and-strategy-february-march-2013-3db7/55-1-02-doyle-a88b)

</comment><comment><USER3> Those are interesting bits:

"Maintaining its current arsenal of over 10,000 nuclear warheads costs the United States approximately $31 billion annually."

"Firstly, the force is too big. Without the need to target Russia's strategic forces there simply are not enough plausible aim-points in the world for US nuclear weapons that would require 1,500–2,000 operationally deployed warheads. For example, in an extreme crisis, perhaps 50–100 nuclear weapons at most would be needed to threaten devastation on Iran, North Korea or China. "

<comment><USER4> After a quick skim of the article, the following stood out to me as things that could make discussion with Russia more difficult:

"the US strategic community continues to perceive Russia as a potential adversary"

"no country other than Russia has the capability to preempt the launch of US forces by destroying a significant portion of them on the ground"

also, this is interesting, but not as much:

"with the possible exception of North Korea, the strength of whose rudimentary nuclear-weapons capabilities remains unknown"

</comment></comment><comment><USER5> Is anyone surprised that a person publicly advocating a reduction in weapons is unwelcome at a place where a large number of people derive their livelihood from making weapons?

For the record I agree with the guy. We (in the US) spend far too much on military gear and endeavors I think and it is both unnecessary and destructive.

But when you bite the hand that is feeding you and everyone around you.....you can expect to get slapped.

</comment><comment><USER6> If Ukraine had kept its nuclear weapons, would they still control Crimea? Would there be so many thousands of Russian troops massing outside their borders? Would there be so many Russian special forces operating in their country?

Maybe. But I bet, right now, most leaders in Ukraine wish they still had them.

OTOH, do most ordinary Ukrainian citizens wish their country still had nuclear weapons? Perhaps not.

<comment><USER7> if Ukraine had retained the nuclear weapons, they would have been the Russian weapons, and Ukraine would not have been flirting with the EU/NATO sphere, etc ... your implication is tempting, but does not include all the story</comment></comment>


Amazon Data Center: 450,000 Estimated EC2 Servers - <AUTHOR> http://huanliu.wordpress.com/2012/03/13/amazon-data-center-size/

<comment><USER2> In public lectures by AWS employees they have clearly described their infrastructure as 1U-based. Heat dissipation is a big part of their costs, and blade servers trade heat for space, which is a bad trade, as space is cheap compared to heat management. I'd assume that their infrastructure is not dense.

<comment><USER3> _In public lectures by AWS employees they have clearly described their infrastructure as 1U-based._

They've also described their infrastructure as consisting of racks of 20 servers + a switch, and shown photos of racks full of 2U servers. My guess is that they have multiple generations of hardware.

<comment><USER4> Makes sense to run 2U servers; more room for independent disks; no RAID, no redundancy, 1 disk per virtual machine "slice", so you don't have contention issues when someone else on the box tries to do a dd from EBS to the local non-persistant disk.

1U pizza boxes wouldn't have enough physical drives to break up among the amount of virtual machines you can cram on a box with 64-128GB of RAM.

<comment><USER5> You honestly think you get a disk per instance? Or that a node needs a disk?

<comment><USER4> Based on non-persistant disk IO tests on an EC2 instance, yes, it appears you are getting a raw disk.

</comment></comment></comment></comment></comment><comment><USER6> This reminded me of the German tank problem. <http://en.wikipedia.org/wiki/German_tank_problem>

</comment><comment><USER7> I'm wondering what the "revenue capacity" is for the the entire farm?

I don't know how they virtualize, but even a conservative calculation on instance capacity (eg. assume each server can support one XL instance on average) means that they can conceivably bring in $288k per hour.

I'm sure I'm way off with this estimate, is there any evidence out there are regarding their typical server configuration or utilization rates? Spot instance prices paint a pretty vague picture about utilization (eg. rates are pretty much flat over the last month).

</comment><comment><USER8> I posted yesterday but fell soon out of scope: <http://news.ycombinator.com/item?id=3703456>

I think it would be interesting to know if they are planning to design and make their own servers like Facebook: [http://www.theregister.co.uk/2011/04/07/facebook_data_center...](http://www.theregister.co.uk/2011/04/07/facebook_data_center_unveiled/)

</comment><comment><USER9> With 450,000 servers don't you think Amazon could do a better job of recommending books for me than just finding books just like the one I just read? I get better recommendations from the new books table at any self- respecting bookstore. It's about what I _haven't_ read!</comment>


Company Stock Certs Question - <AUTHOR>

I'm a stockholder in my small private company. Management is asking for my stock certificates so that they have quick access to them in the event the company is acquired. Having not dealt with such things previously, and wanting to protect my rights as a stockholder, should I give them the stock certificates in exchange for a copy of them? <comment><USER2> Yes, file the copies with your stock purchase/vesting agreement. Also if you have paid par value or whatever amount for the shares keep your canceled check with the copy of the shares you bought. The company keeps a list of who owns what shares as well as the physical shares. If something should happen to the physical shares they can be reissued.

</comment><comment><USER3> " _Management is asking for my stock certificates so that they have quick access to them in the event the company is acquired._ "

That sounds suspicious on many levels.

For one thing, they already should know exactly how much equity each employee has.

If they don't have those kinds of records, then they're probably going to have a hard time passing a due diligence review by a potential acquirer.

<comment><USER2> It is not suspicious on any level. They are probably doing it on advice of counsel. The actual physical shares will need to be tracked down if they go public, and if any people/shares cannot be found they will have to reissue the shares. Having all of the physical shares in one place protects everyone.

<comment><USER3> Stock certificates in private companies are not bearer-coupons (i.e., even if I get my hands on your certificate, that does not make me the owner of your shares).

Furthermore, in 42 states, the board of directors can issue equity shares with a simple amendment to the the company's Operating Agreement.

Finally, if the company was operating in one of the 8 states where that's not allowed, or decided to do certificates anyway, the recipients of that equity should not have had the certificates in their hands for long (i.e., they get issued, the recipient has to sign and return within a few days).

So the idea that the certs are floating around out there and must be returned immediately for an acquisition _is_ suspicious.

<comment><USER2> If the company issues physical shares to the employee as they vest monthly, that is 12 physical shares per employee per year. If for instance, there are an average of 10 employees over 4 years that is 480 pieces of paper that will need to be tracked down at some point in time.

When the shares are needed, if even one of those people are missing and cannot be found, it adds a pain factor to the process. The physical shares need to be consolidated and accounted for at some point in time. Not everyone leads a stable life where they can be located at all times.

For the employee to physically hold the actual physical share in his or her hand is of no greater benefit than holding a photocopy of the shares along with the vesting agreement and any canceled checks used to pay for the shares. Physical shares can be forged just as easily as a photocopy if it were to go before a judge. It is like having 1 dozen green apples, vs. 1 dozen red apples in your hand. The difference being it is a lot safer for everyone to keep all of the shares in one place.

<comment><AUTHOR> Thanks guys, this helps a lot. I'll give them the real certificates if the copies, the signed vesting/exercise agreement, and a cancelled check are sufficient proof.</comment></comment></comment></comment></comment>


Tesla's Elon Musk says the coronavirus panic is dumb - <AUTHOR> https://www.cnbc.com/2020/03/06/teslas-elon-musk-says-the-coronavirus-panic-is-dumb.html <comment><USER2> I hope he and people like him (Trump) will be held accountable for spreading misinformation and putting people at risk.</comment>


Don't Hire The Smartest Guy - <AUTHOR> http://howtosplitanatom.com/news/dont-hire-the-smartest-guy/

<comment><USER2> I suspect this essay is obliquely complaining about folks who THINK they're the smartest guys in the room.

"What you get if you believe this myth is a room full of highly qualified people who waste their time explaining to each other how much more qualified they are."

<comment><USER3> Excellent observation. There is also a bit of that in there. A part of working on a small team is learning to learn. It doesn't matter that you can lift mountains with your pinky if you can't deal with anyone else as a peer.

</comment></comment><comment><USER4> Breaking news: Don't hire people based on only one criterion, e.g. intelligence! Details as they emerge.

<comment><USER5> The qualities of the ideal candidate differ for different situations.

If someone is a very early employee, they need to have more involvement in shaping product development and corporate culture. They need some kind of vision or something and that's possibly more important than knowing how to move Mount Fuji with a toothpick or something.

Nothing earthshaking, no.

<comment><USER6> I guess my take would be that it isn't earthshaking but it's "useful" there are tons of companies that are too resume-bound and end up with smart, completely useless people. Two cents.

</comment></comment></comment><comment><USER7> I think the title is slightly misleading but whats actually said in the article is very much true. In any early stage company, how well they fit together with not only you but the rest of the team members is just as important as what they know.

More surprising is how many investors I've talked to end up telling me that if I'm looking for people to help accomplish some of these more complex tasks that I should just outsource to India or just find a person who does know how and pay them for it. In reality, that's likely not going to solve anything and has a high potential to create more problems on down the road (not to mention if that person doesn't stay forever).

</comment><comment><USER8> yeah, well, part of it depends on how smart you are.

As the article said, you need someone who fits in to the team, someone strong where the rest of you are weak.

Me, I'm kinda dumb (well, I mean, I qualify for mensa, but only just. Meaning, compared to most really good programmers, I'm kindof dumb) But I'm really good at dealing with people who are less socially able, so for me, it makes sense to hire the smartest person I can find, at least for technical positions.

If I were smarter, and/or if I had a harder time getting along with people, or if I was hiring a marketing and/or bizdev guy, hiring down might make a lot of sense.

</comment><comment><USER3> Like most of the little essays I put together (author here, thanks everyone for reading) it was a reaction to an observation. That observation was that lots of small going on medium sized companies tend to inherit something from the Microsofts of the world, and that is resume myopia.

For everyone who said it's commonsense, I agree completely. Unfortunately, commonsense is not quite as common as you might believe. Around here, this seems obvious but I can say there are plenty of people struggling with the balance.

tptacek summed up my point really well. Thanks again for the feedback!

</comment><comment><USER9> Hence Joel's (much more concise) hiring criteria:

Smart, Gets Things Done.

<comment><USER10> Not all your employees should be like that, though.

[http://steve-yegge.blogspot.com/2008/06/done-and-gets- things...](http://steve-yegge.blogspot.com/2008/06/done-and-gets-things- smart.html)

<comment><USER9> I still don't really understand what Yegge was trying to say with this essay. It seems to boil down to, "Very Very Smart, And Gets Things Done".

<comment><USER10> I have to agree. I think he might be trying to turn "Smart, and gets things done" into a two-tiered system so you can clearly decide that, in some cases, it's okay to go with the bright guy with an unimpressive resume, and in others, you really need to dig for someone who is exceptionally talented and has enough experience to teach rather than learn.

<comment><USER9> All essay critiquing aside: '''strong disagree''' on on the idea that you want/need to go past [[gets things done]] in an early stage startup. You need the mo'; you don't need the architecture you're going to run on 2 years from now.

</comment></comment></comment></comment></comment><comment><USER11> Diggy title with common sense advice.

<comment><USER10> Hire really good people. Your concept of "good" might be flawed, so think really hard about it.

You could get more insight by just sitting your team around a table and talking about it rather than going on the word of some dude on the internet.

<comment><USER11> I don't think I used that word or explained my concept of it. But I'll try to think really hard about it anyway.

<comment><USER10> I wasn't talking about _you_ , I meant the universal "you" ('one' as in 'one should', like 'man' in German). I was just agreeing with your assessment. :)

<comment><USER11> That makes much more sense. Thanks for clarifying :).</comment></comment></comment></comment></comment>


Is This Airbnb Knock-Off Google-Stalking Potential Hosts? - <AUTHOR> http://www.forbes.com/sites/sethporges/2012/04/27/is-this-airbnb-knock-off-google-stalking-potential-hosts/

<comment><AUTHOR> Our experience with Wimdu: we found out about the site well before we found out who the Samwer brothers are and what they do (namely, rip off big sites). We accordingly signed up because hey, more exposure can't be a bad thing, right?

Wimdu failed to cross-check our presence when they gave their telemarketing list to what sounded like kids in dorm rooms robocalling us - day after day after day and sometimes three times per day - until they finally gave up (more likely) or finally got the message that _we had already listed ourselves on their site._ Whatever Airbnb did where they emailed people via Craigslist has absolutely nothing on the obnoxiousness of Wimdu, they're just lesser news.</comment>


New Zealand gun sales reportedly increase after Christchurch attacks - happy-go-lucky https://www.tvnz.co.nz/one-news/new-zealand/new-zealand-gun-sales-reportedly-increase-after-christchurch-attacks <comment><AUTHOR> I wonder how many people realize that banning "semi-automatic weapons", if taken at face value, pretty much means banning anything other than your old- fashioned, bolt-action rifle. For example, in the U.S. it would probably mean banning the small hunting rifle that I was given as a pre-teen over 40 years ago. That old rifle would fail both a "semi-automatic" restriction, and also a "large capacity" restriction, because it would hold an awful lot of ammo when fully loaded. Theoretically you could pump all of that ammo out in just a matter of seconds, too, although it did have a tendency to jam at times. Reloading it took a while, though.

</comment><comment><USER2> No actual data.</comment>


Tell HN: YC applicants meetup on 12/1 - <AUTHOR>

It would be fun to meet YC winter batch applicants already in the bayarea, for the interview. Lets exchange notes & stories and make friends.
This is a bar, close to the YC office.
Sign-up here, http://ycapplicants.eventbrite.com/
My number is 510 931 3402 <comment><AUTHOR> Also, created a facebook group for it, <https://www.facebook.com/groups/310705559034974/></comment>


Show HN: Can't afford GPT-3 access? Self-host your own GPT-2 API - <AUTHOR> https://github.com/cortexlabs/cortex/tree/master/examples/pytorch/text-generator <comment><AUTHOR> With GPT-3 getting so many people interested in NLP, and with OpenAI's recently announced pricing plan putting it out of many people's reach, I thought it might be useful for some to see how easy it is to deploy your own GPT-2 API.

This project uses a couple tools:

\- Cortex: An open source model serving platform I help maintain. [https://github.com/cortexlabs/cortex](https://github.com/cortexlabs/cortex)

\- Hugging Face's Transformers: An open source library for using popular language models, like GPT-2. [https://github.com/huggingface/transformers](https://github.com/huggingface/transformers)

This project uses a vanilla pre-trained GPT-2 and PyTorch. If you want to use TensorFlow/ONNX, that's supported as well ( [https://github.com/cortexlabs/cortex/tree/master/examples/te...](https://github.com/cortexlabs/cortex/tree/master/examples/tensorflow/text- generator) ).

If you want to finetune GPT-2 on your own text (a la AI Dungeon), I'd suggest using gpt-2-simple and deploying with Cortex: [https://github.com/minimaxir/gpt-2-simple](https://github.com/minimaxir/gpt-2-simple)

Lastly, by following this example, you can deploy your API locally (where inference will probably be slow, depending on your hardware, but will cost you $0) or to a cluster on AWS, which Cortex can spin up/manage for you.</comment>


After century of removing appendixes, doctors find antibiotics can be enough - <AUTHOR> https://arstechnica.com/science/2018/09/after-century-of-removing-appendixes-docs-find-antibiotics-can-be-enough/ <comment><USER2> I found this conversation unnerving at 13 years old:

Doctor: "Does all this make sense? We need to remove your appendix.. now."

Me: "Doctor, ok, so you need to remove my appendix cause if you don't I could get really sick. "

Doctor: "Yes."

Me: "What does the appendix do?"

Doctor: "We don't know."

<comment><USER3> About 10 years ago, one study set forth an interesting hypothesis: The appendix is a place where "good" bacteria can safely hide during infection. I'm not sure if there's been any work since then to confirm the hypothesis, but it sure is an interesting idea.

Source: [https://www.nytimes.com/2008/06/17/health/research/17appe.ht...](https://www.nytimes.com/2008/06/17/health/research/17appe.html)

<comment><USER4> I think I remember reading at some point that another hypothesis is that it acts as a repository for bad bacteria, so that your immune system doesn't forget how to make antibodies for those bacteria. I think I remember the sinuses being posited as serving the same role.

<comment><USER5> What if the appendix is an attempt to "tame" bad bacteria into being good? Does giving bacteria access to nutrients from our food and mucus remove the selective pressure to evolve virulence factors?

</comment></comment></comment></comment><comment><USER6> That's great to hear. However, keep in mind that appendicitis is still an extremely serious condition that __will __kill you if left untreated. The fact that you can avoid surgery in some cases doesn 't mean that surgery is not an adequate treatment.

It's amazing how medicine has advanced: We can now cure illnesses with very minimal amount of invasiveness required in most cases. Even before this news, open surgery was already mostly supplanted by laparoscopy, which involves only a few tiny cuts.

<comment><USER7> Appendicitis will kill you! And the surgery in most cases will save you. :) At least in my case.

I technically died from a ruptured appendix and spent 9 days in ICU. The doctors delayed surgery to see if the antibiotics would work. This was ~10 or so years ago.

<comment><USER8> Can you give more details of "technically died"? Any after-life experience?

<comment><USER9> Technically died likely means cardiopulmonary arrest aka a heartrate of zero. Medical personnel refer to this as "a code" or "code blue"

I drowned as a kid in a friend's pool when I was 7 or 8. I was "technically dead" as well. No afterlife experience, but as I was thrashing underwater, my entire body felt like you feel when your leg goes to sleep, and before I went "to sleep" I got really calm and everything was peaceful. The only thing I could feel other than whole body numbness was a strong warmth. I took one last look up at the sun sparkling on the ripples of water above and closed my eyes.

A few minutes later, I awoke puking water and choking with my best friend shrieking hysterically as her mother frantically performed CPR on me. For some reason, my parents never ever let me swim in her pool again or go to her house unsupervised.

<comment><USER10> You're crazy lucky, CPR isn't supposed to bring you back from anything or flush water out of your lungs, it's supposed to keep your blood flowing to your brain until paramedics can get to you.

<comment><USER9> Lucky indeed! I was terrified of water until I was about 12 and only then learned to swim.

</comment></comment></comment></comment></comment></comment><comment><USER11> This reminds me of when tonsils were removed at the first sign of trouble.

When I was in my early 20s, in the 1970s, I went to my doctor about a bad sore throat. He advised me to see an ENT who barely bothered to look down my throat for more than a second and automatically declared I needed mine removed. That bothered me but I very much respected my personal doctor who said he respected this ENT. When I mention this to doctors nowadays, most nod their heads that, today, it's not likely mine would have been removed.

<comment><USER12> Growing up, I felt like getting tonsils removed was as common as changing teeth, it must've happened to a third or so of my classmates at the time.

It seemed harmless enough from a distance, they pull out some stuff from your throat and you get ice cream.

<comment><USER13> I had mine out as an adult and it was a pretty painful week of recovery.

<comment><USER11> Yes but Allison visited me in the hospital! TIL: Alisson liked me!!

</comment></comment></comment></comment><comment><USER14> Somewhat OT but interesting: "When [Kurt] Semm introduced laparoscopic surgery at the University of Kiel, he had to undergo a brain scan at the request of coworkers as 'only a person with brain damage would perform such laparoscopic surgery.' On September 13, 1980, Semm performed the first laparoscopic appendectomy, opening up the path for a much wider application of minimally invasive surgery. At first, his operation was severely criticized. Initial attempts to publish it were rejected, and the American Journal of Obstetrics and Gynecology stated that his technique was 'unethical.' The president of the German Surgical Society demanded that Semm be suspended from medical practice."—Wikipedia

<comment><USER15> It's weird in retrospect.

When my grandfather had his gall bladder removed (late 1960s, I think), he spent about 4-6 weeks in hospital and another couple of weeks at home recovering; last year, I had my gall bladder removed, they sent me home after three days. Now that's progress!

<comment><USER16> My gallbladder removal 5 years ago was outpatient surgery. I went in around 7am and was home on the couch by mid afternoon. Gave up the serious pain meds the next day since the side effects (zero attention span) were more annoying than the bit of pain. It's amazing how far we've come for some medical treatments.

<comment><USER17> >> Gave up the serious pain meds the next day since the side effects (zero attention span) were more annoying than the bit of pain.

Next time you can try Ibuprofen + Tylenol, to avoid mentioned side effects.

Ibuprofen Plus Acetaminophen Equals Opioid Plus Acetaminophen for Acute Severe Extremity Pain: [https://www.aafp.org/afp/2018/0301/p348.html](https://www.aafp.org/afp/2018/0301/p348.html)

</comment></comment></comment></comment><comment><USER18> I'm so confused. From Wikipedia:

> _Appendicitis is caused by a blockage of the hollow portion of the appendix. > This is most commonly due to a calcified "stone" made of feces. Inflamed > lymphoid tissue from a viral infection, parasites, gallstone, or tumors may > also cause the blockage... The combination of inflammation, reduced blood > flow to the appendix and distention of the appendix causes tissue injury and > tissue death. If this process is left untreated, the appendix may burst, > releasing bacteria into the abdominal cavity, leading to increased > complications... Acute appendicitis is typically managed by surgery. While > antibiotics are safe and effective for treating uncomplicated appendicitis, > 26% of people had a recurrence within a year and required an eventual > appendectomy._

Given that bacteria are not even listed as a cause of appendicitis above, how do antibiotics help at all? Is there anything they can do to prevent "tissue death" in the appendix itself, and how? What about that "stone"?

Or are the antibiotics for dealing with an actual ruptured appendix (to kill leaking bacteria from the gut into the rest of the body), while the appendix presumably eventually resolves its blockage and heals itself on its own? Which sounds... scary, but of course I'm no MD.

Would love if anyone here knows how to explain what the article doesn't.

<comment><USER19> > Or are the antibiotics for dealing with an actual ruptured appendix

If your appendix ruptures, it is _life threatening_ and has to come out.

Most appendix removals happen _before_ the appendix ruptures. The conclusion of the study is that high doses of antibiotics is an effective way to prevent the appendix from rupturing without surgery.

<comment><USER20> I still have the question: what about the 'stone'? Do antibiotics cure that somehow? Or is that the reason that 30% of those treated with antibiotics ultimately have the surgery?

<comment><USER21> One of my kids had his appendix out last year, and I asked a similar question. My recollection was: Blockages can form and resolve on their own -- it's possible he'd had blockages before, felt pain, but they resolved before an infection could occur. You could be having this happen right now, but it could resolve later in the day and you never notice anything. Or the blockage could be too severe and never resolve on its own.

</comment></comment></comment></comment><comment><USER22> I recall reading sometime in the past that appendectomies are the perfect cash crop at hospitals. Most are not needed but it's not worth the risk so everyone gets them, they are a low risk easy surgery, and they can charge a lot for them. I also recall that the cost for the surgery varies widely across hospitals.

<comment><USER23> What's interesting is that you'd think the switch over to a laparoscopic technique would save money, but it actually costs more.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653254/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653254/)

</comment></comment><comment><USER24> Article says sick leave on antibiotics was 11 days compared to 22 with the invasive surgery.

The non invasive surgery only has you taking it easy for 7 days with no lifting anything over 10 pounds for a bit after that. They send you home from the hospital after 2 days. Most people resume work during the initial week.

<comment><USER25> Study was in Finland. How much time people take off presumably depends heavily on national laws and norms around sick leave. Some countries have very generous laws around paid sick leave; others, like the US, don't have mandatory paid sick leave at all.

Finland seems to be a special case; 10 days paid sick leave for a given incident, but in practice this is improved on by collective bargaining agreements in many trades.

</comment></comment><comment><USER26> It's interesting, an acquaintance of mine had this happen. Hospitalized, with antibiotics, but just fine, no knife.

Definitely surprising to hear about, but I'm glad we're still learning about these kinds of things. Imagine all the things we take for granted that are simply superstition when examined closely.

<comment><USER27> In Australia, where public hospitals provide a free service, antibiotics are first line for uncomplicated appendicitis. Most people recover just fine.

It's amazing how things are different when a surgeon doesn't want to do a procedure since it means more work for them, compared to where a surgeon wants to do a procedure since that's how they get paid.

Obviously, it's much better for the patients if they avoid unnecessary surgery.

<comment><USER28> Even in socialized medicine systems, doctors who do more stuff get paid more. 'Single Payer' usually means the government runs insurance not the doctors office. So the doctor bills more in both cases.

Both of those inscentives are maligned though - the doctor should do 'what's right'.

What's also nutbars is that there isn't a standard playbook for this stuff.

There should be specific procedural research on all of this stuff with the 'best practices' updated all the time.

There should be ongoing debate and churn around the practice, but once it's published, the doctors should all be in sync.

Doctors, like judges, have too much leeway. I think they feel that 'every case is special' and they are to some extent, however, I feel that they are playing against a statistical game and that their 'gut' is not right.

Just like airline pilots go through massive 'checklists' ... so should doctors.

I've been misdiagnosed for heart burn (doc thought it was heart palpitation) and for wound infection (was not infected, just a little red) - which is tragic because those are very common things.

<comment><USER29> Actually, at least in the medicine systems I know (France and Belgium) doctors can either be independent or employed. It's about 50% each in both countries.

Independents are paid more when they do more stuff, but employed doctors are usually paid a fixed salary depending on fixed work hours. Depending on the system, the practice either bills patients directly per consultation, or the social security organization, or gets a fixed income from social security or from the ministry of health that does not directly depend from how many patients they see. All three systems exist.

Best practices and procedures are usually handled at the hospital or... "medical house" ( _maison médicale_ or _wijkgezondheidscentrum_ , the place where several non-independent doctors work as a team) level. It is indeed not something that really gets standardised at a higher level, although doctors also have a number of mandatory meetings that get conducted with attendees from different practices and that help with diffusing procedures, best practices and knowledge.

They don't all get in sync at the same time, but knowledges and best practices do diffuse through all doctors. Although independents usually try to attend the bare minimum because meetings directly translate to missed income for them.

I don't think the current model is wrong, although I think independent doctors are ill equipped to stay up to date, and not enough incentivised to do so.

</comment></comment></comment></comment><comment><USER30> A friend (in UK) had a similar condition called diverticulitis wherein the intestine makes a new pouch and it gets infected.

They were treated only with IV antibiotics (and pain killers) but spent almost a week in hospital vs people attending for surgeries who were out again in a couple of days.

I imagine _if_ it requires a longer hospital stay that will override the medical necessity.

Perhaps samples could be taken, eg of stool, in order to select bacteria with which to reseed the intestine? I suppose that's quite labour intensive.

<comment><USER31> There's also some evidence that the bacteria in your stool is even less well- correlated to the bacteria further up your intestines than we thought (and we already thought it wasn't great). [1]

[1] - [https://www.theguardian.com/science/2018/sep/06/probiotics-n...](https://www.theguardian.com/science/2018/sep/06/probiotics- not-as-beneficial-for-gut-health-as-previously-thought)

</comment></comment><comment><USER32> There is currently a very similar study being conducted in the US. I am a subject in this study after I got appendicitis last summer. I chose to be treated with antibiotics and have been symptom free for the last ~14 months. I could also have opted to participate in the randomized controlled trial (where a treatment would have been randomly assigned to me) but surgery isn't really something I'm comfortable leaving up to chance.

</comment><comment><USER33> I had a cousin who delayed being seen for their stomach ache and the appendix burst. They ended up hospitalized for like 6 weeks with one end of the surgical opening left open so the wound could be drained or repeatedly cleaned out or something.

I'm glad they are doing studies here. Please note the phrasing in the article concerning "uncomplicated" cases. I have plenty of criticisms of modern medicine, but let's not throw the baby out with the bathwater here.

</comment><comment><USER34> This is no new news. When I was 17, I had all the signs of an appendicitis. But I really feared to go to the hospital. I read through some medical books where they mentioned that after 72 hours of pain things can get real dangerous. I found some old antibiotics in the house (well beyond their date), took them and after 48 hours the apendicitis was gone.

When I was 34, appendicitid struck again. I new instantly that I had it, and this time I did not fear the hospital. This time, I wanted to avoid hospital because we were just a few weeks from moving to a new house. So I took antibiotics again, measured the fever, noted every measurement point in Excel but after 36 hours I found that it was not getting any better. So finally I took advantage of my wonderful German health insurance and got the appendix brilliantly removed...

Just want to state: there are times when antibiotics work and times when they do not.

</comment><comment><USER35> Is this really news ? I've gotten it removed, and before had antibiotics to cure an infection. They misread the echo and though it was too infected to start antibiotics. It hurt like hell. After the operation, he said they removed it but could have been fixed by antibiotics earlier. They decided during the operation is was safer in the future to remove it (as I had more problems with it). They really don't want to remove it here, so I'm surprised this is news ...

</comment><comment><USER36> I had an appendectomy a few years ago (in my late 20s) and I really wish the doctors had given me the option of just antibiotics. I was in severe pain and had spent the entire day vomiting, but from the CT scan my appendix wasn't at risk of rupturing at that point. They basically told me they were going to take it out as it was faster for them to manage it that way.

It's anecdotal, but ever since I had my appendix out I've struggled with digestion issues. I've tried so many things: elimination diets to discover food allergies, probiotics, a switch to vegetarianism, tons of fiber supplements, no fiber supplements, intermittent fasting, acupuncture, traditional Chinese medicine. I tried out uBiome to see if I could discover anything with that. Nothing really has worked.

On top of that, the surgery cost $25k.

Certainly there are instances where the surgery is absolutely needed, as a rupture will kill you. I'd really like to see more research on the theory that the appendix holds a backup copy of good bacteria, because at this point I'm willing to believe the appendix isn't just vestigial and actually plays a role in intestinal health that we just don't understand.

</comment><comment> saiya-jin So no need to have appendixes removed prior to being stationed in Antarctica anymore?

<comment><USER37> Wait is that a requirement?

<comment><USER38> From the Australian Government - Department of the Environment and Energy, Australian Antarctic Division:

 _The answer is no, however doctors who are wintering at Australian Antarctic stations are required to have their appendix removed. This is because there is usually only one doctor on station during winter, and evacuation back to medical care in Australia is impossible for at least part of the year. The requirement dates from the 1950s, when an Australian Antarctic doctor developed appendicitis on Heard Island and required a very challenging evacuation back to Australia.

In 1961 a Russian doctor successfully removed his own appendix at Novolazarevskaya station in Antarctica. With no outside help possible, he used local anaesthetic and had two expeditioners assist with surgical retractors and a mirror so that he could see what he was doing. The operation was a success and the doctor was back on duty within two weeks. It's not a situation that Australian Antarctic doctors would like to find themselves in!

As part of their overall medical review, all expeditioners are required to have a dental check before they depart for Antarctica within six months of their departure date. There is no requirement for expeditioners to have their wisdom teeth removed unless the dentist identifies that they may cause a problem over winter. The station doctor has eight days of training in emergency dentistry as part of their preparation, but this does not include wisdom teeth extraction._

[http://www.antarctica.gov.au/about-antarctica/people-in- anta...](http://www.antarctica.gov.au/about-antarctica/people-in- antarctica/health)

<comment><USER39> Evacuation in winter is possible, the Americans do it if there is a real emergency - it's just that it's very very expensive (even for the US). Because it's possible but expensive, all the non-US bases treat it as prohibitive and effectively not to be counted on.

<comment><USER29> It's only possible in some places, for example Kerguelen island has no airstrip, the closest airstrip being on Réunion island 3000km away (Davis station on the Antarctic continent is closer, 2000km, but does not have a permanent airstrip).

No helicopter in the world has such a range, so the only means of evacuating is by ship, with the fastest ships in the area taking minimum 3 days to make the trip. If a navy ship is around, it could probably treat the emergency on board but most others will have to get back to Réunion first.

In the likely event that no ship from the French navy is around, the fastest means of evacuating will be requisitioning a nearby fishing ship but those will probably not make it to Réunion until at least one week.

Fortunately, the relative emergencies (but not life threatening) I have witnessed have always happened when a ship was already on its way for other reasons, but US or not there are real technical impossibilities in these places.

<comment><USER40> Could you parachute fuel down for helicopter refuelings along the way?

Edit: it seems that aetial refueling for helicopters is a thing as well.

<comment><USER29> There is only the ocean along the way though, I don't think it would be possible to drop resupply fuel that way.

Aerial refueling though I guess could work, although I suspect that no suitable tanker airplane is to be found within range anyway most of the time (and no suitable helicopter either) as the military base on Réunion is not a major air force base and there is no other country than France with decent forces in the area. Australia has tankers but they're on the wrong side of their country, nowhere near Perth.

I think we're getting beyond _very, very expensive_ here and into the territory of things no country would do outside of extraordinary circumstances, the kind of circumstances in which the country operating the base would not matter anyway as most others would cooperate in any way they could.

</comment></comment></comment></comment></comment></comment></comment><comment><USER41> So what is the biological mechanism at work here? Take boatloads of antibiotics and kill most of your intestinal flora, so that inflammation on the appendix is reduced? (If I'm completely of the mark please correct me, it's been years since I had any biology related coursework)

With all the recent studies of the evolving antibiotic-resistant properties of bacteria and the importance of mantaining a healthy intestinal flora and how much the gut influences the brain, I am not sure that this treatment is necessarily preferable to modern appendix removal surgery. That said, if given the option, I'd probably prefer this than getting cut open (even if the incision with modern techniques is very very small).

<comment> alFReD-NSH I'm guessing you still have to take antibiotics when you have any surgery to reduce chance of getting an infection.

</comment></comment><comment><USER42> A few notes of interest:

1) Europe has been doing abx before surgery for a while now. Unfortunately, their data has largely been lacking (thus the need for this trial), creating the impression that this was pushed by their national health services as a cost-saving measure rather than a patient-oriented one. The culture among surgeons in the US, regarding abx for appendicitis, is largely "we don't kill patients just to save a few bucks." The irony that the bucks being saved go directly into their pockets usually goes un-mentioned, but they _are_ in earnest. It's just a win/win that their earnest desire to do the best for patients also pays their bills. It feels nice to get paid for doing the right thing. However, that creates a cultural bulwark against a change in expectations on appendicitis management.

2) There is often a feeling that "if we have to end up doing surgery anyway, we should just do the surgery. There's no value in making the patient go through two such episodes when we have definitive treatment." It's going to be highly subjective whether you think a 1/3 chance of two appendicitis episodes and inevitable surgery vs. a 2/3 chance of avoiding surgery means "it's obvious you should get abx" vs. "it's obvious you should get surgery." I think this study doesn't make anything obvious, but does pave the way to giving patients a reasonable alternative course of action.

3) This is not tantamount to saying "well, we've just been rash all these years in just going straight to appendectomy." Previous trials on this have been, methodologically, poor. Even this trial is a five-year follow-up to what was initially a one-year trial that wasn't adequately persuasive. The initial trial showed a 27% rate of return appendicitis. You can imagine that if the five-year results showed "80%" vs. "36/39%" we'd be having a different discussion. If it showed that having an appendicitis pop up a few years later had more adverse effects, we'd be having a different discussion. So this data was needed, and the fact that docs didn't jump on previously heavily flawed data is... well, docs doing what they're supposed to. You don't want your doc jumping after every poorly-supported shadow.

4) Appendicitis isn't diverticulitis. There's often a layman's shorthand that diverticulitis is just left-sided appendicitis, but it's not. The pathogenesis and appropriate treatments vary quite a bit: conservative treatment of a piece of normal anatomy is quite different from conservative treatment of a piece of herniated, pathologic anatomy. Don't confuse this study for meaning anything regarding the appropriate management of diverticulitis. That's not to say that abx management for diverticulitis is inappropriate, per se, but just saying these are different diseases and not to be confused here.

5) One shouldn't expect this to result in cultural change too quickly. There remains the fact that the primary protection against a malpractice suit is "local standard" \- if all the local docs are doing the same thing, it's not malpractice to follow suit. The first doc to go out on a ledge with this is going to be minced meat the moment there's a bad outcome and someone sues. A study is beside the point - if you point to a new study during a suit, the plaintiff's attorney says, "Oh? You have a PhD in study design? No? Then what qualifies you to analyze this study better than every other doctor in your community?" This really won't go anywhere until an entire medical department agrees to go in on this simultaneously - most likely an emergency medicine department. Politically, though, they'd probably have to go to war with their hospital's surgery department to push it through, or otherwise have the surg folk on-side. It'll happen eventually, but it's not going to happen overnight.

</comment><comment><USER43> Do we need more reasons to soak ourselves in antibiotics? Appendectomies on otherwise healthy people are extraordinarily safe procedures. And while some research has indeed shown the appendix as a useful organ, having it out doesn't have lasting side effects. Given the coming tide of antibiotic resistance, perhaps this is an area where physical intervention via surgery can reduce the need for antibiotics.

(I know antibiotics are normally prescribed after an appendectomy anyway, but I presume that would be less than the dose needed to kill the primary infection outright.)

</comment><comment><USER44> It would be interesting if someone were to compile a list of surgical procedures that have been performed too proactively throughout history. Uteruses, molars, tonsils, breasts, I think some cases of prostate cancer, now appendixes. My list might contain huge errors - I am not a medical professional, but even as a medical layperson, it's really remarkable how common this general type of situation occurs.

</comment><comment><USER45> For myself appendicitis was a condition that recurred - I didn't realize what I was having at the time until one night when I put the symptoms together and went "uh oh", when I'd probably experienced those symptoms a half dozen time in my adult life. I wonder what antibiotics mean for re-occurrence, do you end up treating it like an ear infection, and take em when you get a flare up?

</comment><comment><USER46> I wonder if this would eventually be extended to wisdom teeth, something dentists are too trigger happy to remove.

<comment><USER47> Not quite sure I understand - give antibiotics instead of pulling wisdom teeth? They pull them because wisdom teeth often grow in at an angle to a mouth of fully developed and settled adult teeth. Sort of a "why mess with a good thing" (the teeth there already) approach. I certainly see an issue with the rampant pulling of wisdom teeth for cosmetic reasons, but don't see how it's relevant to a new treatment method for a life threatening illness.

<comment><USER46> I meant the overall principle of maintain rather than remove.

<comment><USER48> So... braces? It's cheaper just to pull them. You really have to if you're someone like me whose mouth was too small for them to even come in.

My wisdom tooth extraction was a shit show for that reason, but I've had all my 12 year molars removed since then, the last one a couple of weeks ago, and the recovery is pretty easy. (They wanted to root canal it and crown it... I was like bro just pull it because otherwise we're just gonna have this same conversation again in 10 years.)

<comment><USER25> Fillings. For people who have reasonably well aligned wisdom teeth (not impacted, functional teeth), some dentists are inclined to remove them anyway; others to treat any decay which shows up but otherwise leave them alone. Again, this is something where norms differ by country.

Edit: Wait, you've had all your _second_ molars removed? That seems very unusual. I'm a little surprised the dentis was willing to do it, unless there was a big problem that couldn't be dealt with otherwise.

</comment></comment></comment></comment></comment><comment><USER49> This is a tangent but... Medical Science is an interesting institution. It's a huge, formalized truth-values finding process...

A half sibling of Law (the other formal truth finding institution) and Science (the abstract unformalized institution).

<comment><USER50> Yeah, so unfortunately regarding medical science "formalized truth-values finding process" is actually about as far from reality as you could be. "Politicized agenda-propelled random search" would be closer. However, we still slowly are making progress thanks to new technologies, so all is not lost...

<comment><USER42> I understand that, looking at individual scientific problems, it's easy to get cynical. It's even fashionable to be so.

Deaths attributable to heart disease in 1970 were just shy of 800k per annum. As of 2010, it was about 600k. A 25% drop in the leading cause of death, in less than a generation. Life expectancy was 70.8 years in 1970, and 78.7 in 2010 - an increase of more than 10% in a single generation.

Science isn't a process that moves along by weeks, months, or even years. It's something that moves generationally, and our society has made impressive strides.

You're welcome to be skeptical - science would die without that. But be the "loyal opposition," not a casual cynic: help the process improve, don't discard it as some political shell-game. Lives are in the balance.

<comment><USER50> I have both feet in the game, being a clinical researcher. So, cynic but not casual.

<comment><USER51> "Politicized agenda-propelled random search" Lol!

I think you and arkades _both_ have it right. It's a "politicized agenda- propelled random search" on a large enough scale and over a rich enough search space that it "has made impressive strides" despite its flaws and inefficiencies.

I have a friend who works as a Healer. People come to him and pay him good money and he gets results. He doesn't advertise, he gets referrals by word-of- mouth alone. My point is _he gets results_.[1] He can do things that are totally off the map of conventional medicine. However, he's uninterested in science and scientists (in general) are uninterested in him. "It's something that moves generationally" indeed, if paradigm shifts really require the dying out of the old guard.

If we think of inefficiencies in the search due to e.g. politics and superstition as a kind of malady, then it seems we are witnessing a phase of "Physician heal thyself", what with the advent of mass medical monitoring and big data correlation, eh?

[1] Have you heard the joke, "If alternative medicine works it's just called medicine."? Well, yes and no. Some things _that work_ are too far outside the belief structures and will be ignored or ridiculed.

</comment></comment></comment></comment></comment><comment><USER14> "Sulfonamide drugs were the first antibiotics to be used systemically, and paved the way for the antibiotic revolution in medicine."—Wikipedia. These drugs came into widespread use in the late 1930s.

</comment><comment><USER52> this qualifier is interesting:

> researchers led by Paulina Salminen randomly assigned 530 patients that > showed up in the hospital with an acute, uncomplicated appendicitis to get > either a standard, open surgery to remove their inflamed organ or a course > of antibiotics. (By "uncomplicated," the authors mean there weren't other > issues like perforation, abscess, or suspicion of a tumor.)

although if your appendix is already perforated then it's a bit late to try to prevent it from perforating by cutting it out, so fair enough.

<comment><USER42> You've made the correct conclusion. Management of a perforated appendix is vastly different from management of the (much more common) uncomplicated appy. There isn't much controversy about the management of the perforated appy: it's going to be surgery _and_ antibiotics. Removal at that point isn't in question, because the perforation is due to an increase in intra-appendiceal pressure compressing its vasculature, causing a focal necrosis. The perforation happens when a piece of the appendix dies, and thus loses its integrity. Dead tissue has to go.

And of course surgical clean-up of the abdomen must follow, along with a big pile of abx.

</comment></comment><comment><USER53> I also know 3 people that went to the doctor after some time of belly aches and the doctor telling them: "You probably had an inflamed appendix but it's ok now."

<comment><USER54> As a kid in the mid-80's I once woke up with a bit of a belly ache and thought "I can milk this for a day off school to play with Lego"

Ended up having an emergency appendectomy that night.

</comment></comment><comment><USER55> many people will die from this article because they wil not believe their doctor and go to another one with a broken appendix that kills you in a few days from septic shock.

</comment><comment><USER56> The removed mine while I had another surgery just in case.

<comment><USER57> Just in case of ...? I do not usually think of surgeons having the mentality of 'I was in the neighborhood... so.... yeah, why not!'.

<comment><USER56> Well, they were fiddling around with my intestines, moving them around (I have / had intestinal malrotation) and they told me that it could be an issue if they didn't remove it.

Although they told me afterwards, but the surgeons were extremely competent so I don't question their judgement.

</comment></comment></comment><comment><USER58> Finally a thread where I can contribute!

I was part in the Finnish APPAC trial (published on JAMA/2015).

In April 2012 I was in an out of the hospital for four or five times with intensive stomach pains, but as they weren't localised in the mcburney area and my white cell counts weren't elevated, I just got sent home with painkillers.

The last time my white cell counts were slightly elevated (around 36 when under 14 is considered to be normal) and the stomach pains were worsening while jumping and the pain localising in the lower right of my stomach I was personally sure about what I had. Doctors still disagreed.

I was then told that there's an experimental trial and if I sign up for it, they'll do a CT scan (I had begged for this the previous visits). Lo and behold, the scan showed inflammation not caused by a stone.

I got ertapenem intravenously for three days and 7 days of metronidazole and levofloxacin. For about a year everything was fine, but I started to get occasional localised pains again, but they came and went and never really worsened. I think between 2013 and 2017 I've been to the hospital about 6 or 7 times because of the pains but they've always resolved by itself.

Two months ago it came back again and it was worse than the first time I got diagnosed. Spent two nights in the ER waiting for surgery. Again, ct scanned and blood levels show inflammation. I get sent home with pain killers and metronidazole and floxacin. ER nurses and surgery doctors were baffled by the case, said they've never seen an inflammated appendix been put on the non- urgent surgery waiting list.

Got told today that it's going to be removed this year, lol. After six years and asking every time to have it removed.

Approximately 80% of the appendicitis cases are not at risk of bursting anytime soon so an immediate surgery is not necessary. The rest are complicated and need urgent surgery.

I've been told that about 74% are fine after the antibiotics for the first year but a majority in the trial have ended up with it removed within a 5 year window. So, while having an appendix would be ideal and it's cheaper to throw a ct and some medicine at the patient, a surgery is still almost always needed.

In my personal experience, I have a strong gut feeling that a low carb diet might've affected how many times my appendix has shown slight signs of inflammation. Up until 2016 I was in ketosis for a four years and that was when I had issues most often (although the latest has been the worst overall). The sample size of this idea is just n=1 so take it with a grain of salt.

Oh, a sidenote, latest hospital ordeal put me in bed rest for almost a month because metronidazole did not play nicely with my ankles and I lost my job during that time so I'm also going through talks with my lawyer about a suit for unlawful termination. Fun times.

Please do ask questions if I can clarify anything or you want to hear about something specific!

<comment><USER59> I'm surprised to hear you lost your job because of health issues in ... Finland?

That kind of wrongful termination sounds like something that would happen in the States not Europe. Correct me if I'm wrong.

</comment></comment><comment><USER60> .

<comment><USER61> Waiting cures a wide range of problems, that don't end up killing you.

It's really hard to separate 'doing a rain dance' and 'just waiting' when you have a sample size of 1.

<comment> D-Coder And the ones who _do_ die, don't post here to let us know how it turned out.

</comment></comment></comment><comment><USER62> a little too late perhaps?

</comment><comment><USER63> Got confused there for a moment, thought it was about PDF files...

</comment><comment><USER64> Great news! Seems like I (not a doctor but probably the most medically- qualified person in any group of random people that doesn't include anybody with actual medical education) probably won't end up doing an appendectomy on anybody after I move to a deep rural area...

<comment><USER65> An appendectomy might be easier than procuring the necessary antibiotics in a deep rural area, depending on how rural....

<comment><USER64> Being a person fairly interested in medical science and lacking insurance I always take care to have some antibiotics for just a case (I ask friends from Russia to get them for me, you can buy antibiotics without prescriptions there) although I hardly ever use any actually. Needless to say, I'm going to take quite a selection with me when I travel to some place where they're hard to get and there are no doctors around. By the way one should better have antibiotics ready when performing this kind of surgery or chances are their patient is going to die of sepsis.

<comment><USER66> > I ask friends from Russia to get them for me

[http://www.chicagotribune.com/news/ct- xpm-2002-09-01-0209010...](http://www.chicagotribune.com/news/ct- xpm-2002-09-01-0209010411-story.html)

<comment><USER64> Would you mind telling what's there? It says "Unfortunately, our website is currently unavailable in most European countries..." as I open it directly and shows no article body as I open it through us.ixquick-proxy.com.

<comment><USER7> A tl;dr summary...

> A US Special Forces soldier bought fish antibiotics at a pet store to treat > his sinusitis. It did not work out.

\--

I grew up in an area with 6 to 8 different military bases and it is fairly common knowledge in military areas that you can sometimes get away with using fish antibiotics to treat human infections. And in a lot of cases the pills are exactly the same. But sometimes not.

<comment><USER67> Article also states that aquarium antibiotics are more expensive than prescription antibiotics, while conveniently omitting the copay and time cost required for the doctor's office visit, which was needed to obtain the prescription.

As such, it is also an uncommon practice to lie about symptoms during an office visit that was required for some other reason, to get a prescription for antibiotics that is not immediately needed. I don't actually know anyone who has done this, so it may be just rumor. I do know people who have used aquarium antibiotics, because their copay for a $150 office visit is $150 until their $8000 annual deductible is met. US health care is bananas.

<comment><USER64> > As such, it is also an uncommon practice to lie about symptoms during an > office visit that was required for some other reason, to get a prescription > for antibiotics that is not immediately needed.

Wait, do doctors actually prescribe antibiotics given just invisible symptoms and no actual flora analysis? What's the point of the prescription system them? Isn't a doctor meant to find out what specific bacteria causes the problem and choose the right antibiotic to target these?</comment></comment></comment></comment></comment></comment></comment></comment>


Electronic demon costume is surprisingly unnerving - <AUTHOR> http://hackaday.com/2012/10/25/electronic-demon-costume-is-surprisingly-unnerving/

<comment><USER2> I found the video where he surprised everyone with it:

[http://www.youtube.com/watch?v=0aPSbXnQGSM&feature=relmf...](http://www.youtube.com/watch?v=0aPSbXnQGSM&feature=relmfu)

<comment><AUTHOR> nice thanks :)

for anybody interested: 8:30 demon costume

<comment><USER3> Deep link for the lazy [http://www.youtube.com/watch?feature=player_detailpage&v...](http://www.youtube.com/watch?feature=player_detailpage&v=0aPSbXnQGSM#t=507s)

<comment><USER4> More [http://www.youtube.com/watch?v=1OsnGvxxQ54&feature=relmf...](http://www.youtube.com/watch?v=1OsnGvxxQ54&feature=relmfu)

</comment></comment></comment></comment><comment><USER5> Anyone else think the costume would be about 17% more unnerving if the demon's face didn't look as if it had just been smacked with a cartoon frying pan?

<comment><USER6> On the contrary, if you lived through 1970's and possibly '80's TV science fiction, you saw lots of scary robots that had oddly projecting faces.

With that in mind, it's almost 4.2% more unnerving than the alternatives.

<comment><USER7> relevant > <http://en.wikipedia.org/wiki/Herman_Munster>

<comment><USER6> I was thinking more along the lines of the Mr. X thing (<http://bionic.wikia.com/wiki/Day_of_the_Robot>) or perhaps the lovely and talented Mr. R.I.N.G. ([http://terrortitans.blogspot.com/2010/10/complete- night-stal...](http://terrortitans.blogspot.com/2010/10/complete-night- stalker-part-three.html)).

</comment></comment></comment></comment><comment><USER8> Don't miss the very end of the video.

<comment><USER9> lol, nice for pointing it out.

</comment></comment><comment><USER10> Not unnerving, but pretty awesome!

</comment><comment><USER11> Electronic Demon Costume - How To! <http://youtu.be/8HZFY4Xti7k>

</comment><comment><USER12> Major props for the reading material at the end. That's one of the best books on programming ever written, imo.

</comment><comment><USER13> it's cool. but it is in no way unnerving.

<comment><USER14> I think it would be much more unnerving in real life.

</comment></comment><comment><USER15> Can that voice changer be tuned to do a Bane voice?</comment>


500 Startups partner Elizabeth Yin resigns over McClure situation - <AUTHOR> https://www.axios.com/500-startups-partner-elizabeth-yin-resigns-2452787280.html <comment><USER2> Related:

[https://www.axios.com/exclusive-dave-mcclure-resigns-as- gene...](https://www.axios.com/exclusive-dave-mcclure-resigns-as-general- partner-of-500-startups-2452701900.html)

[https://techcrunch.com/2017/07/03/employee-email- claims-500-...](https://techcrunch.com/2017/07/03/employee-email- claims-500-startups-leadership-delayed-acknowledging-mcclures-harassment-as- new-allegations-surface/)

[https://cherylyeoh.com/2017/07/03/shedding-light-on-the- blac...](https://cherylyeoh.com/2017/07/03/shedding-light-on-the-black-box-of- inappropriateness/)

This is a big series of stories breaking - not sure why it isn't getting much traction on HN today.

<comment><USER3> Cheryl Yeoh's story was the #1 story just a while ago, and it is now nowhere to be seen. I suspect some people are actively downvoting/flagging such stories.

I'm even more surprised at the how number of people who are still defending McClure even after all this.

I expected the usual "that can't be the entire story, there must be a detail they aren't telling us", which is a skepticism I can still somewhat understand given today's media landscape.

But even now after the details came out, I am now seeing the "that is a normal behaviour from a heterosexual man" responses. It feels so disheartening to see that these kind of responses not only exist in the industry but we are actually having arguments about it. And I'm a man. Hard to imagine how it would feels for the women in the industry.

<comment><USER4> > It feels so disheartening to see that these kind of responses not only exist > in the industry but we are actually having arguments about it.

It's disheartening. But is it surprising? Look at the things the dude sitting in 1600 pensylvania ave. is saying and has said about women, maybe sadly it is the unfortunate and sorry state of things today that some men are like this. There has been a lot of clamor for change, probably most of it genuine about making things better for the women in the industry. Do you think things will be considerably better for women in ... say, 10 years? I don't think so. Actually, based on the things I hear in video game voice chat by folks sounding like they're 10-15, the future is scary. And don't be fooled into thinking that this problem is unique to the tech industry (I work in a very huge hospital, the last CEO was forced to resign because there was some situation about him giving his mistress a high paying job, similar things happened to other higher-up staff)

I don't have any good answers as to what _would_ make things better, so I'd be very curious to hear from users here what are possible solutions.

<comment><USER5> _Do you think things will be considerably better for women in ... say, 10 years?_

From the perspective of an olde phart who has been around since the 80s, no, I don't think it will get better because my single data point says things have been on a downward trend in about the last 15 years. Yes, I feel that attitudes and behavior have gotten worse, not better, in the last thirty years or so. Not every company, of course not, but I think there is a lot of "new normal" going around (the "brogrammer" being just one aspect).

Solutions? You want to "make things better for women in the industry"? Start by making things better for everyone: the workplace is not a frat house. Maybe ditch the kegerator, for starters. Alcohol is for when I don't want to be serious about what I'm doing. Hell, maybe we ditch the shorts and start wearing long pants to work, even if it's jeans. If I had a _good_ answer, I'd write a book and retire on the royalties. I don't, so I'll grasp at straws, but there's something I can't quite put my finger on that says too much casualness in our work environment spills over to a much more casual attitude about how we deal with our coworkers. And, again I'm just spitballin', a casual attitude toward my female coworkers might very translate to, "hey, baby, nice ass".

</comment></comment></comment></comment><comment><USER6> everyone has a mother, sister or daughter and wouldn't want to see this stuff happen

</comment><comment><USER7> Hey dang, still waiting on my ban.

Or a response detailing how HN will be revamping the flagging system to prevent its abuse for censorship. But I'm not holding my breath for that one.</comment>


Is immigrating to the US really that hard for foreign entrepreneurs? - <AUTHOR>

I keep reading about the high percentage of tech startups in the US that are founded by foreign entrepreneurs (39% in California). I also keep reading about how hard immigrating to the US is for foreign entrepreneurs - i.e., people without prospective traditional employment. Can somebody explain this apparent contradiction? How is it that so many startups are founded by foreigners if it's so hard for them to stay in the country to do so?<p>I ask because I'm Canadian and I'd like to look into starting a software/biotech company in the US after college (I've heard about the proposed startup visa, but clearly plenty of foreign entrepreneurs are doing just fine without it). <comment><USER2> I came to the US as a student. I believe this is a very common background story for foreign entrepreneurs.

</comment><comment><USER3> Is student->H1B->green card the only path available for entrepreneurs looking to set up shop in the US? That is an incredibly long path: especially the H1B->green card step, which can potentially take as long as a decade.

Does anyone know of alternate routes?

<comment><USER4> You can take part in the green card lottery...

[http://en.wikipedia.org/wiki/Diversity_Immigrant_Visa#Winnin...](http://en.wikipedia.org/wiki/Diversity_Immigrant_Visa#Winning_chances)

If you happen to be in Australia or New Zealand and take part for a couple of years, your chances are actually pretty good. Everywhere else, not so much.

</comment></comment><comment><USER5> Why the US? Are you just looking for a bit of a change? If so, you should look at New Zealand!

</comment><comment><USER6> H1B and O1 are the common visa options, there may also be some canadian specific ones.</comment>


Optimism: A Manifesto - <AUTHOR> https://www.howitactuallyworks.com/archives/optimism_2020.html <comment><USER2> Love the manifesto. Great list of things. I particularly like #1. It's been a major focus of mine to focus my attention on things within my control. And in the current environment that's definitely not easy.

</comment><comment><USER3> Love it. Have been thinking about it constantly since it hit my inbox this morning. It's a forward-looking nudge that makes me excited.</comment>


Universities Slash Budgets Nationwide - <AUTHOR> http://abcnews.go.com/OnCampus/universities-slash-budgets-nationwide/story?id=13571408

<comment><USER2> Id be willing to bet C level salaries were either steady or went up.</comment>


Ask HN: Why are we people mad at Ashley Madison and not the hackers? - <AUTHOR>

Seriously.  I would understand if there was gross negligence (and I don't know any details of the hack), but my gut reaction is that we are angry at the wrong person.<p>Please forgive the harsh comparison, but isn't it like blaming a rape victim instead of the attacker? <comment><USER2> Because they charged money for a delete my account feature, and never actually did it.

</comment><comment><USER3> If your bank told you it stored your money in a secure safe but in reality was hiding it under the mattress of the account manager, is it wrong to be angry with the bank?

Or to use a rape analogy it's more like I pay you to babysit my daughter and you decide to take her to a seedy part of town to buy drugs and she gets raped.

The real victim is the end user, and not the company.

</comment><comment><USER4> > Why are we people mad at Ashley Madison and not the hackers?

I dunno. Why are you? (Alternatively, why are you abusing the first person when what you should be using is the third person and identifying precisely who you are talking about?)

More importantly, where is the evidence that people who are mad at Ashley Madison are not _also_ mad at the hackers?

</comment><comment><USER5> >but my gut reaction is that we are angry at the wrong person

People are mad in general because a lot of what AM promised wasn't really true. For example, its deletion of profiles which they charged for. Also not true seems to be the number of women on the site, which (although estimates very) seems to be very skewed and possibly bolstered with lots of fake profiles.

With respect to the gross negligence, the original hack called out the company and even mentioned someone by name with an apologetic message--as if they knew that person was trying to stop the negligence on the inside but failed. (I doubt it was really bad negligence regardless. it is just more common for negligence to be the normal kind)

</comment><comment><USER6> Because people prefer honesty to dishonesty.

</comment><comment><USER7> The hackers did the right thing. People using AM had it coming to them.

</comment><comment><USER8> The biggest problem is that Avid Life Media has done jack squat in response to the data leak. They've not communicated any kind of risk mitigation strategy. They've not allowed users to change their compromised passwords. They've not made any efforts to contact affected users.

This is like a rape victim not only trying to pretend the whole thing didn't happen, but all the while knowing that her attacker had HIV, has good reason to believe she's seroconverted, and is _still_ having unprotected sex with her regular partners without telling them anything.

While the company is a victim here, their actions are themselves criminally wrong.

<comment><USER9> The analogy of a victim of rape, though crude, is quite right (and left me quite impressed, to be honest).

<comment><USER10> The rape analogy is repugnant.

<comment><USER11> Yup - 'blaming the victim of a crime' would have been sufficient to make the OP's point, though I know media conversations on the topic are the likely reason why the analogy he chose came to mind.</comment></comment></comment></comment>


Seymour Cray and the Development of Supercomputers - <AUTHOR> http://www.linuxvoice.com/seymour-cray-and-supercomputers/ <comment><USER2> I remember the days when it was a point of national pride to own a Cray supercomputer. In the 1980s, India tried to get access to a Cray XMP-24, but was denied access due to dual use capabilities. Instead, they were only allowed to purchase the lesser capable XMP-14. The purchase came with the stipulation of having to host US personnel onsite to monitor the usage of the supercomputer. This denial/control of access also led to the birth of India's own supercomputer efforts by CDAC. Many developments in India's space, nuclear and computing efforts mainly happened due to denial of technology such as Cryogenic engines, supercomputers etc.

</comment><comment><USER2> Recommended reading for all Cray fans [http://www.amazon.com/Supermen-Seymour- Technical-Wizards-Sup...](http://www.amazon.com/Supermen-Seymour-Technical- Wizards- Supercomputer/dp/0471048852/ref=sr_1_1?ie=UTF8&qid=1449850907&sr=8-1&keywords=seymour+cray)

<comment><USER3> A wonderful book. It's light on technical detail—well, void of it—but covers the human story and business background well, and the material is so fascinating, it's hard to believe how fascinating it is. Especially the origin story, which is like the early history of Silicon Valley in an alternate universe of the Midwest. People bringing their dogs to work. CDC getting started by selling stock out of a station wagon. Cray moving his lab further and further away from the managers. It's all so archetypal, most of all Cray himself.

A pattern that recurs through the book is that Cray's achievements worked out best when he collaborated with the much lesser-known Les Davis, who was a master of organization and execution. A good local newspaper article from Davis as of a few years ago: [https://news.ycombinator.com/item?id=10334470](https://news.ycombinator.com/item?id=10334470). I hope someone has gotten a full oral history from Mr. Davis.

</comment></comment><comment><USER4> Growing up in the 80s, the Cray 2 was my poster computer. Until the day came when I realized it was only 800MHz and had 4GB RAM, and my phone was faster than that.

<comment><USER5> I often thought this, but a Cray is not a normal computer. From some comment, I learned that it had a 8MB L1 cache, meaning it could crunch all of it in one go, then refill, so on and so forth. It means these little 800MHz were used to their fullest, while nowadays multicore GHz chip have to wait a lot to get new data in smaller quantities. Making a Cray still as fast today (for adequate tasks of course).

So todays processor have higher peak bandwidth, on average, Cray can sustain larger bandwidth.

ps: [https://archive.is/FWzLF](https://archive.is/FWzLF) read jojomonkeyboy comment

<comment><USER6> Most of the Gflops in a phone are in the GPU - precisely because it's massively parallel, like the Cray.

Intel's i7s and Xeons have a more general purpose architecture with much less parallelism, but still manage a steady few hundred Gflops on Linpack.

<comment><USER5> True, I was speaking about the CPUs. Also GPU are still dedicated to graphical workload on smartphone, or are they used through an opencl-like lib ?

<comment><USER7> There are programming techniques where you offload all the computation onto (via OpenGL!) onto the CPU. I did this for image processing where we needed to do histogram normalization. It was not fun.

But the GFlop numbers given are maybe an order or two of magnitude off from achieved performance for something like Lapack.

</comment></comment></comment></comment></comment><comment><USER8> One thing that strikes me about Cray's designs is that they look so extraordinarily cool, but the look of the machines is - according to Wikipedia - often the result of technical/engineering requirements/decisions. They were led by technical priorities almost exclusively, yet they came out not only the fastest computers on earth (at the time), they also looked ... awesome.

<comment><USER9> I always found it somewhat humorous that Cray invested so much effort into the look of it's supercomputers, considering very few people would actually see the inside of a super computing center.

</comment></comment><comment><USER10> Cray 1: 80 MFLOPS and 8 megabytes in 1976. That was the standard for "mini- supercomputers" in the 1980s.

<comment><USER11> And subject to ITAR export regulation, as you might imagine.

By the mid 80s, personal computers were starting to get close to these limits and the US government had to start tweaking the rule's thresholds.</comment></comment>


Understanding SARS-CoV-2 and the drugs that might lessen its power - <AUTHOR> https://www.economist.com/briefing/2020/03/12/understanding-sars-cov-2-and-the-drugs-that-might-lessen-its-power <comment><AUTHOR> [http://archive.vn/yfAWD](http://archive.vn/yfAWD)</comment>


Ben Horowitz: Every breakthrough idea looks stupid - <AUTHOR> http://news.cnet.com/8301-32973_3-57536701-296/ben-horowitz-every-breakthrough-idea-looks-stupid/

<comment><USER2> _"Breakthrough ideas usually come from guys who look like they're hallucinating."_</comment>


Teenager dies after playing Diablo III for 40 hours without food - <AUTHOR> http://www.geek.com/articles/games/teenager-dies-after-playing-diablo-iii-for-40-hours-without-food-20120718/ <comment><USER3> Interesting, I'm old enough to remember the Person dies in X country after playing Y game for Z hours. [http://games.slashdot.org/story/07/09/17/1653218/another- man...](http://games.slashdot.org/story/07/09/17/1653218/another-man-dies- after-marathon-gaming-session) [http://games.slashdot.org/story/05/08/09/1628216/man-dies- af...](http://games.slashdot.org/story/05/08/09/1628216/man-dies- after-50-hour-gaming-marathon) Are any of these even true?

</comment><comment><USER4> Sitting still for 40 hours, then dying after being roused and walking - <USER2> like he may have had a pulmonary embolism from a blood clot in his legs. Though, this is less common in asians and apparently this happened in Taiwan, so who knows. But that would be my first guess.

<http://emedicine.medscape.com/article/1911303-overview#a0156>

</comment><comment><USER5> The title is leading. It's Not the game, and not entirely the marathon that caused this. The article it short on information and long on speculation.

</comment><comment><USER6> I guess no one told him about the Steam Summer Sale

</comment><comment><USER7> People don't die after only 2 days without food. The title is misleading and the article is full of speculation.</comment>