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FlowVoid

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FlowVoid , (edited )

Energy use increases with bpm, change in pressure (systolic - diastolic) and the stroke volume (amount of blood pumped per beat).

Note that there is also an inverse relationship between stroke volume and bpm because the faster the heart beats, the less time for blood to return to the heart for the next beat.

That said, heart “strength” is more about reserve capacity (ie ability to ramp up when necessary) than energy efficiency. It’s like comparing a Ferrari to a Corolla: at 100 mph the former can still increase its power whereas the latter is getting near its limit.

So if the Ferrari has a “car attack” and suddenly loses 50% of its max speed then it can still keep up on the highway, the Corolla maybe not. That’s more important than which one is more energy efficient.

FlowVoid , (edited )

Imagine a coffee shop ad with a beautiful example of latte art, but when you get your latte you are horrified to find just plain foam. Unless the ad specifically mentioned latte art, I doubt you’d have grounds for a lawsuit.

As for your example, I’m finding it hard to imagine buying a car before getting inside it. A few dealers offer a pre-order option, but you can always back out of the sale once you see the car.

FlowVoid ,

Very few drugs are largely government funded. The government funds basic research, but it won’t fund clinical trials. Pharma companies are almost entirely responsible for clinical trials, and they are way, way more expensive than basic research.

FlowVoid ,

That just makes the therapy cost more per patient.

If a therapy costs too much, insurance will no longer pay for it.

And when insurance decides not to pay for a therapy that is only used by a handful of people, there are often only a handful of complaints.

FlowVoid ,

This sort of thing has been common practice since long before Dobbs. And it is usually motivated by the doctor’s fear of getting sued over birth defects, especially if there is an alternative prescription that is not known to be associated with birth defects. And there almost always is an alternative.

FlowVoid , (edited )

Yes, this is very likely driven by fear of a malpractice lawsuit. Medications that can harm a fetus are supposed to be a last resort for those who can get pregnant. So if there are other potential medications for this woman, she will likely find it difficult to get a prescription for this one regardless of the doctor’s religious beliefs.

FlowVoid ,

That’s unlikely to make a difference in court. Doctors are responsible for recommending the least risky treatment options. They aren’t supposed to leave everything up to the patient.

FlowVoid , (edited )

That’s not how it would play out in a malpractice case.

Lawyer: You recommended my client take a medication that causes birth defects, when you could have recommended a medication that doesn’t cause birth defects. Because of that, her child has birth defects.

Doctor: Yes, but she said she didn’t want children.

Lawyer: Have you ever heard a woman say she didn’t want children, who later went on to have a child?

Doctor: Yes, it happens sometimes.

Lawyer: So birth defects are a foreseeable result of the medication you recommended, even in women who say they don’t want children?

Doctor: …

FlowVoid ,

I just noticed this in the article:

Where are we drawing the line here? Are hospitals going to require someone to share a pregnancy test

Nearly all hospitals have long required pregnancy tests for some things, like getting a CT scan (which involves radiation exposure). And if the test is positive, the doctor is supposed to consider alternatives.

FlowVoid ,

I don’t know, because the medication in question hasn’t been identified.

But in general, if a medication causes any birth defects (or, more often, miscarriages) in lab animals then it won’t be used at the equivalent dose in pregnant patients. It would be unethical to try to find out what it does to a human fetus.

FlowVoid , (edited )

I don’t think so. But if a med is not to be used in pregnant patients, then it’s only used as a last resort for patients who could become pregnant while taking it.

Again, this is not about religious beliefs, it’s standard CYA for health care providers.

In the case of valproate, there are even European regulations against using it in women during childbearing years.

FlowVoid ,

Liability waivers don’t protect doctors against malpractice claims.

FlowVoid , (edited )

Another poster already mentioned the issue with Depakote, aka valproate:

valproate should be avoided, if possible, in women of childbearing potential because of teratogenicity

See also:

In 2018, the European Medicines Agency introduced new restrictions on the use of valproate in girls and women of childbearing potential to avoid exposure during pregnancy

And yes, valproate is also used to treat cluster headaches, so it could easily be the drug that the woman in the article can’t obtain.

FlowVoid ,

She’s not pregnant, but doctors try to avoid long-term prescription of teratogenic drugs to patients who might become pregnant while taking them.

FlowVoid ,

Viagra is pretty safe, as drugs go. Are you thinking of Vioxx? That stuff was taken off the market.

FlowVoid ,

No, I don’t get that. If a drug might result in birth defects, it should only be used as a last resort. And that’s not just me or some random NY docs saying it, it’s the WHOand European Medicines Agency

FlowVoid , (edited )

Your link literally explains how to sue a doctor for malpractice after signing a liability waiver.

No waiver can claim that patients cannot sue their doctors for gross incompetence.

In most cases, this will involve collecting medical files, seeing copies of the waiver(s) signed by the patient, and proving medical malpractice or negligence by showing that:

The doctor in question deviated from an acceptable standard of care

The injuries came from that deviation

The damages came from those injuries

Which is straightforward in this case. The standard of care is not to give valproate to women of childbearing age except as a last resort, and valproate is known to have a very high risk of birth defects.

FlowVoid ,

Most people who take Viagra have hypertension, because hypertension is the main cause of ED. That doesn’t mean Viagra is dangerous, but you shouldn’t combine it with certain other drugs.

There is a world of difference between valproate and Viagra. Valproate causes birth defects and cognitive delay in 30-50% of pregnancies, which is astonishingly high. If Viagra caused permanent harm to even 5% of users, it would already be off the market.

FlowVoid , (edited )

I’m quoting the World Health Organization and a European agency, neither are American health care.

This is a universal approach taken by health care in the US, EU, and across the world. Doctors in general are pragmatists, and only concerned with outcomes. Which means acknowledging that no matter how often patients say “Trust me”, they know a certain number will have a bad outcome. The doctor’s job is to reduce that number.

It’s the same reason why doctors increasingly urge their patients to not keep firearms at home. Even when the patient says they can be trusted with a firearm. It’s not a matter of trust, it’s a matter of statistics.

FlowVoid , (edited )

If you go to a doctor and demand a course of antibiotics for a viral infection, they have been trained to refuse. Because antibiotics do not treat viruses.

For that matter, if you actually do have a simple bacterial infection and immediately demand a last-resort antibiotic like vancomycin, doctors have been trained to refuse. Vancomycin may work on you, but using it may create bacterial resistant strains that will put others at risk. Resistance is especially a threat if you don’t complete your course of antibiotics.

So doctors will offer you a different antibiotic instead, with less risk of creating a resistant strain. Even if you promise to complete your antibiotics, “you get what you get so don’t get upset”.

People have agency, but so do doctors. Doctors are not supposed to be dispensaries who simply give patients whatever they ask for. Doctors have the right to refuse to provide a prescription that is not in keeping with the standard of care, and offer a different prescription instead. You have the right to find a different doctor, or not see a doctor at all.

FlowVoid ,

My guess is that the drug is valproate. It’s used for headaches as well as epilepsy, though obviously other drugs can be used instead.

The problem with valproate is that it is causes birth defects in two thirds (!!) of pregnancies, including spina bifida in 10% of pregnancies.

The World Health Organization and the European Medicine Agency have issued statements/regulations against prescribing it to any women of childbearing potential. Plenty of American docs take a similar approach, regardless of religious beliefs. Just to be crystal clear, neither the WHO nor the EMA pay attention to Dobbs, the SCOTUS, or the GOP.

FlowVoid , (edited )

Doctors are expected to mitigate risks, too. Valproate-induced spina bifida is a real problem, and doctors share a responsibility to prevent it when it won’t harm their patients. They share this responsibility because they previously tried making patients entirely responsible for mitigating their risk, and that approach has failed.

Nobody said the woman in the article “has to suffer”. They didn’t refuse to give her any medicine, they refused to give her a particular medicine. There are plenty of alternatives, and in fact the doctor in this article wrote the woman a prescription for a different medicine. But of course, some people only want what they can’t have.

Despite what patients often think, doctors are not drug dispensaries. It’s not their job - and never has been - to give patients the latest drug they read about online, or the drug that worked for their friend, or the drug that someone said “ask your doctor” about. If there is a less risky drug that can treat the patient, they will prescribe that instead of what the patient wants.

To take another example, vancomycin is an antibiotic of last resort. Bacteria have not yet developed widespread resistance to it, so it is reserved for patients who have antibiotic-resistant infections, like MRSA. If it is used too much, theoretically bacteria can finally develop resistance to it. And theoretically, people in the future with MRSA may suffer.

Next time you get antibiotics, try telling your doctor “No, I want a vancomycin prescription”. You will be disappointed. They are going to give you what they think will get the job done without incurring unnecessary risks, for you or other people.

FlowVoid ,

Don’t get your hopes up. She sued pro se, which means she couldn’t find or doesn’t want a lawyer to take her case. Either way, it is very unlikely she will win.

FlowVoid ,

Because the doctor prescribed a different drug.

FlowVoid ,

The doctor prescribed a different medication for her. And doctors, not patients, ultimately get to decide which drug they prescribe.

I don’t think her case is going anywhere. She is suing pro se, which means she couldn’t find or doesn’t want a lawyer to take her case.

FlowVoid , (edited )

I wouldn’t say that Sabine is among the “least biased”. She strongly advocates for superdeterminism, and her videos on the subject presume it is true even though it is still unproven and currently accepted only by a minority of physicists.

FlowVoid ,

Even once you understand that the uncertainty principle is not the same as the observer effect, I think it’s still mysterious for the same reason that “the wavefunction is the only thing that exists” is mysterious.

If anything, it’s more mysterious once you understand the difference. People are more willing to accept “Your height cannot be measured with infinite precision” than “Your height fundamentally has no definite value”, but the latter is closer to the truth than the former.

FlowVoid , (edited )

There are even plenty of questions, like the delayed-choice quantum eraser, that have already been solved

No, it has not been solved. At least not solved to the satisfaction of many physicists.

In one respect, there is nothing to solve. Everyone agrees on what you would observe in this experiment. The observations agree with what quantum equations predict. So you could stop there, and there would be no problem.

The problem arises when physicists want to assign meaning to quantum equations, to develop a human intuition. But so far every attempt to do so is flawed.

For example, the quantum eraser experiment produces results that are counterintuitive to one interpretation of quantum mechanics. Sabine’s “solution” is to use a different interpretation instead. But her interpretation introduces so many counterintuitive results for other experiments that most physicists still prefer the interpretation that can’t explain the quantum eraser. Which is why they still think about it.

In the end, choosing a particular interpretation amounts to choosing not if, but how QM will violate ordinary intuition. Sabine doesn’t actually solve this fundamental problem in her video. And since QM predictions are the same regardless of the interpretation, there is no correct choice.

FlowVoid , (edited )

Right, but in order to get the observed effect at D1 or D2 there must be interaction/interference between a wave from mirror A and a wave from mirror B (because otherwise why would D1 and D2 behave differently from D3 and D4?).

And that’s a problem for some interpretations of QM. Because when one of the entangled photons strikes the screen, its waveform is considered to have “collapsed”. Which means the waveform of the other entangled photon, still in flight, must also instantly “collapse”. Which means the photon still in flight can be reflected from mirror A or mirror B, but not both. Which means no interaction is possible at D1 or D2.

FlowVoid , (edited )

When the first photon hits the screen and collapses, that doesn’t mean its twin photon collapses too.

Yes, it does. By definition, entangled particles are described by a single wave function. If the wave function collapses, it has to collapse for both of them.

So for example, an entangled pair of electrons can have a superposition of up and down spin before either one is measured. But if you detect the spin of one electron as up, then you immediately know that the spin of the second electron must be down. And if the second electron must be down then it is no longer in superposition, i.e. its wave function has also collapsed.

FlowVoid ,

In the electron example, if the two electrons are entangled then the wave functions must be the shared. The new superposition for the second electron would therefore be shared with the first electron. So if you measured the second electron along z+ and got up, then if you measured the first electron again, this time along z+, it would give down.

Likewise if the twin photon is still in superposition, then the first photon is also in superposition. Which is hard to accept in the Copenhagen interpretation, given that the first photon has been absorbed. If absorption doesn’t completely collapse a wave function, then what does?

FlowVoid , (edited )

Entangled electrons are entangled in all directions. If you measure one along any direction, you can completely predict the measurement of its pair in the same direction.

In other words, measuring one along X and its pair at Y is equivalent to measuring one along X and then measuring the same one again at Y (accounting for the sign shift in the pair, of course).

FlowVoid ,

Well, if the second photon is in a new, weird superposition then the first photon must also be in the same new, weird superposition. Again, I don’t that’s compatible with Copenhagen given that the first photon no longer exists.

Note by the way that 50% y+ and 50% y- is how all photons start. So if that’s also the final state then there is no reason for it to prefer any detector over the others.

America's nonreligious are a growing, diverse phenomenon. They really don't like organized religion (apnews.com)

Mike Dulak grew up Catholic in Southern California, but by his teen years, he began skipping Mass and driving straight to the shore to play guitar, watch the waves and enjoy the beauty of the morning. “And it felt more spiritual than any time I set foot in a church,” he recalled....

FlowVoid ,

We are all born as social animals predisposed to superstition. Religion is practically inevitable.

FlowVoid ,

Ok, but followers of Judaism and Islam do not believe in a “personal relationship” with God. In those religions only the prophets got instructions directly from God, everyone else has to read their respective holy books.

FlowVoid ,

What a weird take. Nobody is punishing people who smoke.

FlowVoid ,

it’s something you mostly see among the poor.

It is, until it isn’t.

And when it isn’t, we should all cheer.

FlowVoid ,

Your definitions of sex and gender are not in universal use, and they are not the definitions used by Sunak. So his statement was not “correct”, because what it meant was not correct.

FlowVoid , (edited )

What definitions are in universal use?

No definition is in universal use.

meant to say gender when he said sex

He meant to say exactly what he said, and it was incorrect. He was not using your definition of sex. He was using it in the same sense as “I had a sex change operation”.

Or “Now I want to change the sex on my birth certificate”. Do you also chime in to inform people it’s wrong to do that?

FlowVoid ,

He bought the shares for his private account, not on behalf of his companies. There was no reason for accountants at his companies to get involved, they probably don’t even have access to his private account.

FlowVoid , (edited )

This is a civil lawsuit. The only question is how much money he owes the plaintiffs.

FlowVoid ,

This isn’t a criminal trial, so intent doesn’t matter so much. The purpose of the trial will be to determine whether the plaintiffs lost money, and if so how much he owes them.

FlowVoid ,

This isn’t really about a fine. Musk is being sued by other another company. They claim that Musk saved $200m on his Twitter purchase by failing to disclose in time. In other words he bought some shares that would have cost him more if he had disclosed.

Of course his savings was someone else’s loss of potential profit, and they are suing Musk to get that profit back.

FlowVoid ,

McCarthy knew that a government shutdown would have pissed off even more Republicans in Congress, including all of those in vulnerable districts.

For example, Boebert’s district. Notice how for once she didn’t vote alongside Gaetz? Behind closed doors, there were plenty of Congressional Republicans telling McCarthy that making make a deal with Democrats was preferable to a politically suicidal shutdown.

FlowVoid , (edited )

Most Republicans don’t want a shutdown, they know it’s political suicide. McCarthy made a deal with Democrats to avoid a shutdown because most Republicans (privately) pressured him to do so.

Most Republicans don’t want a shutdown in November, either. They are the majority party so they have the power to choose a speaker who will avert one. So Democrats don’t necessarily need a plan, the process may remain completely outside their control.

If Republicans end up needing Democratic votes to elect a Republican Speaker, then they will need to offer something to Democrats, because by itself electing a Republican Speaker is not in the interest of Democrats.

All of the above is already crystal-clear to both parties. The ball is in the GOP majority’s court, they get to choose the next move: work together with the Freedom Caucus or work together with Democrats.

FlowVoid , (edited )

Worse how?

The Speaker is ultimately a mouthpiece for the party. Speakers do not advance a personal agenda, they do what the “majority of the majority” wants them to do. The new Speaker will be no different in that regard.

However, a Speaker is also the point of contact for the opposing party. A Republican Speaker can disagree with Democrats about literally everything, but they shouldn’t lie to Democrats, renege on deals, etc. If nobody can trust you, then you are worthless as an intermediary. So McCarthy was among the worst possible people for the job.

FlowVoid , (edited )

Nothing is infinite. But fresh water is renewable, which means it can be used sustainably.

FlowVoid ,

I see what you did there…

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