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Cake day: January 21st, 2025

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  • ragebutt@lemmy.dbzer0.comtoScience Memes@mander.xyzWonder why?
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    3 days ago

    Adding green energy at 8x the rate of the USA with a total of 3.89 terawatts, which is 3x larger than the entire USA energy grid, and accounting over 30% of the worlds spending towards green energy while the USA has less than 25% of the grid as green energy

    Essentially ending homelessness

    A notably lower prison population than the USA despite like 6x the population

    A minimum wage set by provinces who are heavily encouraged to give increases every few years tied to inflation and cost of living

    Actually working to shift a fee for service healthcare system to a socialized model with significant progress occurring

    No airstrikes, bombings of another country, or declared wars since 1979. Even in terms of proxy wars post 1979 has been far more about economic support and diplomacy than shipping weapons

    Etc etc but yes Xi and Trump are equivalent because they have a social credit score and government surveillance. That’s definitely not like the America, who has just normal credit scores, palantir, and a large chunk of your tax money funding proxy wars (and now actual war) instead of maintaining critical infrastructure or any quality of life improvements for its people.



  • Smaller emrs for small behavioral health practices tend to have text only LLM - headway has scribe, therapynotes has therapyfuel, simple practice has one too and I forget the name. All of these work by taking written session notes and generating a proper progress note, e.g. “client reports more positive mood, anxiety remains triggered by x, practiced breathing exercises” gets extrapolated out into “the client presented with improvements noted in mood and session focused on mindfulness strategies to manage anxiety related to x” (more in depth than that but you get it)

    In my evaluation the LLMs worked fairly well but not always, they tended to shift “writing the note” to “evaluate the note”. I don’t use it for my practice for several reasons, primarily the allure of skipping the evaluation step and ending up with notes that potentially have irrelevant hallucinations/outright falsehoods that get included because a clinician got lazy. As the article states I also believe the process of writing the note serves for reflection on the case and a time to consider conceptualization, eliminating that is certainly convenient but a potential harm to successful outcomes

    When it comes down to it I simply don’t trust this in a server sided application. The only way I would consider it is if I could run a local model, generate the note on a pc that has no internet access, and then upload it. It’s granted that bc it’s entered into the EMR it could certainly be harvested for llm training because AI fucks are without ethics and above the law, but the chances of that are far lower. A workaround for this that solves both of my issues actually came from the psychotherapy subreddit back when I still used reddit: just use a local speech transcription (though confirm it happens locally, which is the case on apple devices post ios 16 or so)

    WRT Israeli companies twofold scribe is currently the one that bothers me the most about signing up. They are headquartered in NY but a subsidiary of Ravel Technologies, an Israeli company. If you look up the developer info on the Google play store the given address for the twofold app is “4 Gordon REHOVOT, 7629112 Israel”. In my experience it’s often done like this and you have to dig a bit.

    They also bring up the other issue: these services are often expensive as shit. Therapynotes adds $40 onto your subscription for theirs, twofold is like $70/mo, etc and all charge additional user fees on top of that. The exception is headway and I think grow, which are free, but that passes on the cost to the consumer (and imo they’re currently propped up by VC capital, once that runs dry and they’re forced to be “profitable” this could change drastically). In a field where reimbursement rates are relatively high (80-130/hr ish) and yet still most clinicians make 40-60k/yr without benefits because of overheads it’s pretty foolish to add even more monthly costs, though tbf the overwhelming majority of overhead for 99% of clinicians is outrageous commercial real estate pricing


  • Every doctor in my healthcare network uses this and they all side eye me when I say no. I get it, it takes the tedious boring part of the job and basically reduces it by 90%, but fuck you buddy you can never even answer basic questions about the model like if it uses data fed into it for refinement and often don’t even know what that means. You’re a goddamn doctor, read up on this shit for a few hours before blindly accepting it

    Fwiw I run a small behavioral health practice. I get emails from people selling this shit like 2-3 times a week. There aren’t that many companies doing it but they’re super aggressive about sales. They’ll have a rep email you over and over and over and when you tell them to fuck off they’ll just have a new rep start.

    There are models for this that are better in theory, they require you to type rough notes which are refined which sidesteps the gigantic issue of transmitting such sensitive audio. Some even guarantee that the model used for generating notes is independent of the model used for reinforcement learning and refinement, eg the notes I would feed in don’t get used to improve unless you consent to being used for model research. But even with that I’m not comfortable here because I don’t trust these companies at their word. Trialing systems does show it can be very effective though and I fear this is inevitable as again it reduces administrative (read non billable) burden by a tremendous amount

    Also for some reason many of the companies offering systems that audio record sessions, transcribe, and summarize (over just summarizing text notes) are Israeli and that is sketch to me. I don’t trust such intimate data with a product from a country that is hostile, violent, and known for aggressive espionage. This is behavioral health though where EMR solutions are often more barebones for small practices, your local hospital probably uses epic or oracle (who don’t bother with small practice stuff) though I’m not sure if they develop LLM stuff in house or just license it


  • https://pubmed.ncbi.nlm.nih.gov/1588892/

    “The cumulative impact of excess medical care required by smokers at all ages while alive outweighs shorter life expectancy, and smokers incur higher expenditures for medical care over their lifetimes than never-smokers. This accords with the findings by Manning et al. (1989) of positive lifetime medical care costs per pack of cigarettes, but disagrees with the results found by Leu and Schaub (1983, 1985) for Swiss males. The contradictory conclusions of the analyses are undoubtedly due to a large difference in the amount of medical care used by smokers relative to neversmokers in the United States and Swiss data”

    The only studies I can find that confirm shortened longevity incurs lower costs occur outside of America, which shifts things greatly due to cultural differences in receiving medical care and Americas totally fucked healthcare billing

    Also I’ll point out that I said I don’t agree with the original poster, that I don’t care if you smoke, and now I will say that you’re a fucking moron with poor reading comprehension. Sorry that I won’t confirm your bias so you don’t feel worse about smoking, idiot. But again, smoke all you want, I don’t care, but don’t act like it doesn’t increase the cost burden on public health (as do your other examples but I also don’t care if you eat cheeseburgers every day and drink yourself to death)


  • https://pmc.ncbi.nlm.nih.gov/articles/PMC12474721/

    “873 studies identified, 11 were included in quantitative synthesis, which compared 19,759,529 smokers with 206,913,108 non-smokers for direct health care costs. Mean age ranged from 34.5–60.6 years for smokers and 34.3–65.1 years for non-smokers. Mean annual health care costs ranged from $65,640–$1297.1 for smokers and $54,564–$724.4 for non-smokers. Annual incremental direct health care costs for smokers versus non-smokers ranged from –$458 (95% CI [confidence interval]: –2011.0 to 1,095.0) to $11,076 (95% CI: 10,211.9 to 11,940.1) in 2025 US dollars. Meta-analysis revealed smoking generally incurred greater health care costs than non-smoking, with a mean annual incremental cost of $1916.5 (95% CI: –439.9 to 4,272.9). The result was not statistically significant (MD = 1,916.5; p = 0.111). Substantial heterogeneity was observed (I2 = 99.9%). Sensitivity analysis excluding studies of chronic disease yielded a reduced incremental cost for the general population, with a statistically significant difference (MD = 583.9, p = 0.02), although heterogeneity remained high (I2 = 98.0%).”

    Literally the first recent meta I found. If you want to smoke I don’t care but suggesting it isn’t a public health burden is asinine


  • Not that I agree with that person but smokers objectively cost more than non smokers even with a shortened lifespan. Smoking increases the risk of and worsens basically every chronic condition as well as being a well linked factor to critical loss of lung function and several cancers. Unless you like, just let someone die if they get a smoking related illness (which is basically all of them depending on how liberal you are with the word “related”)



  • I don’t like apple but are you aware that around the iphone 16 they’ve shifted to batteries that can easily be removed with a 9v battery and now allow for software pairing when parts are replaced?

    There’s still a long way to go (eg the parts pairing only works with oem parts, which can be expensive) but iphones are quickly shifting to one of the more repairable phones. They also offer service manuals and will rent or sell tools for a proper repair. Many android models are just as hard to repair fwiw with glass backs and obnoxious adhesive, though they generally don’t have parts pairing thankfully

    Even the new $600 macbook is remarkably more repairable than any laptop they’ve released.

    This isn’t a “oh apple is amazing” post at all but it should underscore the importance of putting social and legal pressure on companies to make products repairable.

    That said apple made these very positive changes because they likely evaluated the possibility of stronger regulations occurring in key markets and it was simply cheaper to make the changes rather than maintain different hardware revisions for the EU or Colorado. Anyone looking to adopt their hardware should strongly consider that this is also likely because hardware sales are becoming less and less meaningful in favor of service delivery. Hardware is still their top earner by a somewhat wide margin but this is shifting fairly rapidly. Q3 25 saw iphone hardware sales increase by 2-3% whereas services jumped 11% to a point where they make almost 3/4 the revenue of phone sales, with a much higher profit margin over hardware.

    When you combine this with the significant effort towards vertical integration (apple silicon, cpu/gpu/modem) increasing hardware margins it makes far more sense to increase longevity of the hardware. This increases consumer trust, makes for great pr, and far more importantly it simply makes more fiscal sense to sell a $700 phone every 5 years with 20-60/mo in subscriptions over a $700 every 2 without that. Add in that this locks people much deeper into their “ecosystem” (now it’s not just losing your apps, but you playlists, news provider, gaming, workout history, and cloud data) and is more likely to pull new users into said ecosystem (now in 5 years when you upgrade and realize the old phone is only worth $50 you’re more likely to gift it to a family member, thus bringing them into and potentially changing your subscription to an even more costly family plan)

    So basically I guess the takeaway is when a company does something seemingly altruistic remember they’re a company that’s always got profit over everything. There is no altruism in capitalism and repair will only be granted when it’s fiscally beneficial to do so or legislation forces their hand. The focus should not simply be on right to repair (though that is tremendously important) but also on enforcing open standards and interoperability. If a user has their data on icloud there should be a regulation that enforces some kind of open standard so that migrating data to another cloud provider is painless and simple, etc. this is a much more difficult fight though that has been a losing battle since like 1991






  • She became a billionaire and has almost certainly curtailed her social network to sycophants that not only agree with everything she says, they also boost her ego. That plus not wanting to lose the attention of the world will have her respond to whatever provokes the attention of the masses.

    I’m not up 100% on how this all started because I genuinely don’t give a shit about Harry Potter but I would not be surprised if she made a controversial statement as a person with a huge platform, got a bunch of flak, and then once the dust settled realized how much “engagement” (read: attention) she got from it and subsequently doubled down over and over.

    A great deal of human behavior is attention maintained. We have this ignorance though that “bad” attention is not desirable. Research continually shows that attention maintained behavior is perpetually reinforced by attention, not attention of a certain quality. Eg if your child exhibits an attention maintained behavior and you say “stop doing that or you’re grounded” the likelihood is that the behavior is still reinforced (and will subsequently be more likely) because attention was still achieved. The attention may have higher reinforcement potency if it is “positive” but that doesn’t mean “negative” attention doesn’t have a potentially powerful impact.

    This is why the current social landscape of 3rd place community centers being social media, which almost exclusively give algorithmic favor to content that shows high “engagement” (read: annoying bullshit that many simple can’t resist interacting with) is probably one of the most toxic developments in the modern history of humanity. It encourages ugly behavior and reinforces disgusting belief systems. It is also why the age old advice of “don’t feed the trolls” is sage wisdom



  • When I’ve worked with older trans clients spironolactone seems to be what really kickstarts hair growth, especially if they get it in before alopecia really sets in and miniaturizes follicles in a way that can’t be reversed (at least with current medications, and barring surgical intervention). Estrogen too. Either way you’re reducing the amount of androgens. As a result it can be much more effective than rogaine, which works as a vasodilator to enlarge hair follicles (probably, mechanism isn’t fully understood) or finasteride/propecia, which works by blocking androgen DHT rather than reducing it.

    I’m not familiar with research on efficacy for this purpose but I wouldn’t be surprised if it was more effective. While some people have dramatic responses to minoxidil and finasteride many have a more minor response or none at all, even.



  • Sideload https://github.com/dayanch96/YTLite

    Sponsorblock, Adblock, background play, skip, etc all integrated

    Sideloading on ios is easy now unless your device was ever provisioned for a dev certificate. If that’s the case and it’s still active then just sign it with your own cert. if it’s no longer active you either need a fresh apple id or you need to use one of the kind of sketchy signing services. Otherwise you just use like sideloadly, altstore, side store, etc

    Also there is no chromium on ios. All browsers use webkit and are basically just reskinned safari. Some heavily modify this (eg orion can run some Firefox and chrome extensions) though