The vertical column of icons on the far left reminds you of the various stances available in the system. Medieval Italian and German longsword masters did us the favor of assigning vivid names to these positions, such as Boar’s Tooth, Iron Gate, The Fool, Boar’s Tooth, Window, and Woman’s Guard. As you can see, we have translated these directly into icons.
(via CLANG by Subutai Corporation, Technical Update #2)
So, let me talk a little bit about Turing’s famous test for intelligence, the “imitation game.” Everybody thinks they know what that is: it’s a man talking to a computer, and the computer is trying to convince him that he’s not a machine, he’s a man. If he talks like a man and knows what a man knows, if he presents as a man, then we don’t have to get into the dark metaphysical issues of what’s going on in his black-box heart and spirit; the machine keeps up the façade, so therefore he’s one of us, he’s perfectly fine. That’s the Turing Test as it’s commonly described.
However, that’s by no means what Turing actually says in his original paper on the subject. The real Turing imitation game is not about that process at all. It’s about an entirely different process of gender politics and transvestism. It’s about a machine imitating a woman.
This is a hypothetical example of The Kidney Failure Risk Equation, a new tool designed for doctors and their patients with chronic kidney disease. It answers a common, often unspoken question that patients have: “What are my chances of requiring dialysis or a transplant?”
Using the Kidney Failure Risk Equation to Predict Progression to Kidney Failure Risk of progression to kidney failure requiring dialysis or transplantion: At 2 years: 14.8%. At 5 years: 41.2%. For patients with CKD Stage 4, we consider a 2 year risk of kidney failure of 0-10 % as low risk, 10-20 % as intermediate risk, and >20 % as high risk. About this calculator The kidney failure risk equation provides the 2 and 5 year probability of treated kidney failure (dialysis or transplantation) for a potential patient with CKD Stage 3 to 5. Predicted risks may differ from observed risks in clinical populations with lower and higher observed risks than the study population. This risk calculator was developed and validated in two independent populations of patients with CKD referred to nephrologists in Canada. Of the study population of 8,391, 57 % were men, 38 % had diabetes. Race was not reported, but most were probably white. Mean age, eGFR and urine ACR were 69, 33 ml/min/1.73m2 and 83 mg/g, respectively. The event rates of kidney failure in the two populations were 11 % and 24 % over a median follow up of 2 and 3 years. Determining the probability of kidney failure may be useful for patient and provider communication, triage and management of nephrology referrals and timing of dialysis access placement and living related kidney transplant. Prospective trials evaluating the utility of this instrument for clinical decision making have not yet been performed. Citation Tangri N, Stevens LA, Griffith J, et al. A predictive model for progression of chronic kidney disease to kidney failure. JAMA. 2011;305(15). DOI:10.001/jama.2011.451
It’s a story as incredible as it is incomprehensible: On 17 March, 2012, a world-class soccer player from England, Fabrice Muamba, has sudden cardiac arrest (SCA) on a European soccer field. The audience and remaining players stand stunned as CPR is initiated (video here). An automatic external defibrillator (AED) is applied to his chest. Two shocks from the AED are delivered on the field, another as he was carried to the ambulance nearly five minutes later, and 12 more shocks were delivered on the way to the hospital. None of them worked. Ultimately, 78 minutes of CPR were performed before the sixteenth shock miraculously restored sinus rhythm. He then underwent therapeutic hypothermia, and, just as incredibly, awakened neurologically intact some time later. He later undergoes implantation of an implantable cardiac defibrillator (ICD) as secondary prevention against future sudden cardiac arrest.
“Baby Tropes”: term used by the medical residents to describe a patient’s minimally elevated troponins.
The bottom-line is that KDIGO went on a limb to make the assertion recommending against diuretics in AKI. The evidence is simply not there to make such a statement. The largest randomized trial is deeply flawed but even this showed minimal evidence for harm and a potential benefit. So, I will continue to use diuretics in the treatment of AKI until there is additional data to suggest otherwise.
Ajay Singh weighs in.
The mechanism of edema formation in the nephrotic syndrome has long been a source of controversy. In this review, through the construct of Starling’s forces, we examine the roles of albumin, intravascular volume, and neurohormones on edema formation and highlight the evolving literature on the role of primary sodium absorption in edema formation. We propose that a unifying mechanism of sodium retention is present in the nephrotic syndrome regardless of intravascular volume status and is due to the activation of epithelial sodium channel by serine proteases in the glomerular filtrate of nephrotic patients. Finally, we assert that mechanisms in addition to sodium retention are likely operant in the formation of nephrotic edema.
In Contexts
Hey. You. Tune in to Mac Power Users next week for the 3rd Annual VERY Long Episode About How Merlin Works. I think this one turned out really well.
As far as inscrutability such as the image above?
All will be revealed!
And, in the mean time, here are the two previous tours de force that David and Katie have kindly suffered. They’re long, dense, and chockablock with manic and deeply nerdy workflow goodness:
- MPU 023: Workflows with Merlin Mann « Mac Power Users (March, 2010) [MP3]
- MPU 046: Workflows with Merlin Mann II « Mac Power Users (March, 2011) [MP3]
(Four) Options for Responding to Any Problem:
(1) Solve the problem. Leave, get out of the situation for good, or change the situation.
(2) Feel better about the problem. Regulate your emotional response to the problem.
(3) Tolerate the problem. Accept and tolerate both the problem and your response to the problem.
(4) Stay miserable.
The first nine years of New York City’s crime decline were part of a much broader national trend, an overall drop of nearly 40 percent that started in the early 1990s and ended in 2000. It was the longest and largest nationwide crime drop in modern history. What sets New York apart from this general pattern is that its decline was twice as large as the national trend and lasted twice as long.
No, said airline security, you can’t take this bottle onboard. It exceeds the 100 milliliter limit; it’s forbidden. We have just 16 hours to get it into her body. But wait, said professor Martin Birchall of Bristol University. This is a medical container. Inside is a trachea, a carefully constructed human windpipe, seeded with 60 million stem cells from a very sick woman in Barcelona. We have just 16 hours to get it into her body. We pre-arranged this. We have no record of your request, said the airline. You do have a record, said the professor. There’s a woman in Barcelona right now who needs this, and we are running out of time. It took us five months to create this organ. It is the first of its kind. We must board this plane. Sometimes, leaps in medical science require an agreeable security guard, and on this day in 2008, he wasn’t playing. The guard, then his supervisors, said no. Being larger than 100 milliliters, the bottle was categorically dangerous material. If Birchall insisted on boarding the plane, he would be arrested. Birchall had no Plan B. What was he to do? This is a true story.
The house was a jumble of crazed debris—except for one shining treasure, the culmination of years of off-the-books black-budget research, a bubbling, green-lit aquarium-tank, with glassy little cells subdividing it like an uneasy high-rise—a tenement for leeches.
Eight or nine species of leeches. Careful Loco research had proved that leeches in particular excelled as plug-and-play biotech implants. Leeches were simple and rugged, they ran off human blood, and their boneless flesh could hold a fine payload of wetware programming. Plus, once you got used to the concept of interfacing with leeches, it didn’t hurt all that much to stick them on.
Dark Sky is the only weather app I know that can say, “It will rain for 9 more minutes.”
