It is the head of a private equity backed business. That he also happens to be a dermatologist is not the key - unless you think he would have complained if he were only a dermatologist and not a big-business owner?
From the NY article:
> Eight days later, after an outcry from private equity executives and dermatologists associated with private equity firms
So the complained is from business people. If any of them also happens to be a dermatologist that does not seem to be the key, they don't complain about anything medical. That's because the paper was
> a research paper on its website that analyzed the effects of a business trend roiling the field of dermatology
I have been using Flow (mostly) and TS (occasionally, including counter-checking problems in Flow to see what TS does in a similar case). Overall I would not go back to the time without a type checker, however, I too am mystified by the enthusiasm. Anyone who wants to check the state of static type checking for Javascript should take some time and read through
I do that quite a lot myself and have also contributed a tiny bit to both projects (no core code, things like definitions, small doc improvements, quite a bit of answering to issues and often checking the posted code for myself, often in both Flow and TS).
Ignore the issues posted by people who really would just need a forum to ask questions, there are plenty of real issues left. Worst part: Many of them won't be solved (too hard, too much work, too many issues overall). You have to change your coding style and write in a way that the type checker can actually help you with. Also, it's easily possible to end up with types that are far more complicated than the code they are supposed to describe.
I spent more time working on the types than on the actual code. What makes it worth it is that one, I get some control over the code other people write using my library, if I insist they too use the type system I can prevent them from misusing the API to a degree. Two, those other people also includes myself in future incarnations. Three, refactoring can be significantly easier, if you have good types the checker will tell you all the places you missed changing.
So overall, at least for my situation, mostly for writing a library with few external dependencies (so I don't need the more or less unreliable external type definitions) that the business heavily relies on in many products, adding the very considerable additional effort is worth it. Still, I very much disagree with all the enthusiasm.
The type checkers are software trying to understand software, and that software that it's attempting to check is not just an already complex dynamic language, but in addition on top of it is people's code that comes in a million styles. Those type checkers can be valuable, but they are far (very far) from perfect, and they come at a considerable price (mostly in the time it takes to create and maintain the types, I think the additional step to remove type annotations for production code is pretty insignificant in comparison).
> I spent more time working on the types than on the actual code.
That's interesting. I very strongly don't, when writing TypeScript (but I don't then also mess around with a second type system on top of it). Better Intellisense and fail-up-front checking means I write code much, much faster.
I didn't have to change my coding style because this is already how I wrote code; I now have the tools to actually do it well.
TypeScript is not a "complex dynamic" language unless you step outside its bounds. Which, sure, sometimes you need to; it's not perfect, and one of its advantages is being able to opt out when absolutely necessary. Then you fence off that type-unsafe code by strongly testing before you hand something back into TypeScript because you're a competent programmer who understands the limitations of your tools. But that happens so very, very rarely that optimizing for that corner case seems foolish.
How much time you spend depends on your data structures. If the easy default options are good enough you don't need to sweat. We make heavy use of disjoint unions, and while the simple case here too is easy, some things that we do - although they still are very simple on the Javascript side - are hard on the type checker (Flow in this case).
> TypeScript is not a "complex dynamic" language
I don't know what you read into my comment, but if you just stick to what I wrote, Javascript certainly is, and TypeScript is just Javascript (the type annotations are a separate thing). I'm not sure what your point is overall I have to admit, it's a bit on the defensive side for no reason that I can see. For whatever reason you seem to feel personally attacked ("I didn't have to change my coding style")? I refer back to what I wrote, point for point. Would it please be allowed to write down my observations? Especially when it is base don years of practice in all the relevant technologies (JS, TS, Flow) and I'm not just making stuff up without having data (i.e. actual experience). Plenty of other people wrote similar comments here.
I don't feel defensive, but I do find your comments interesting and your experience almost diametrically opposed to mine--which is what I said.
JavaScript is quite complex and quite dynamic, but the reason TypeScript got me back into doing web stuff was, by and large, because it removes that except for in clearly delineated places (at least, once you turn on strict mode).
> Starter comment: NYTimes discusses an article that details Venture Capital buying dermatology practices that do an unusually high proportion of high dollar procedures. The article made it through peer review and was posted as an article in press. It was suddenly pulled. The AAD’s incoming president works for an VC Owners clinic and sits on their board. Lawyers for one firm called lead authors institution to demand changes. This is a huge assault on academic freedom. More so than any nonsense from Washington. Coming on the heels of AAD telling multiple people incorrectly that they failed the board exam over the past few years, this is another major scandal that could result huge changes. Or retaliation.
From another comment there that is a tl;dr of some the problem:
> VC involvement in derm practices is a huge, huge issue. One of the bigger practices in town recently was bought by a VC firm, and, lo and behold, all their borderline melanomas now, after being read by their "new" pathologist, need re-resections to get more ti$$ue. I no longer refer to them. Don't even get me started on electronic brachytherapy.
You actually make his point stronger: Given the difficulty, there are far too few people in it. Instead, people flock to the easy stuff. That's because who pays you if you don't get results within a few years at most? Which is hard for hard problems with no known solutions.
Basic research with no concrete plannable payoff is not exactly what private business is good at. Food for thought, Silicon Valley is based on unlimited debt-based government R&D spending during WWII, private investors only came later to an already fertile field that had lots of very concrete results to show: https://youtu.be/ZTC_RxWN_xo
But they invest in businesses that each have a plan that you know has a chance to work. Big difference between investing into the completely unknown. Besides, his 9/10 is way too optimistic. For basic research it is more like zero chance of profit because - it's just basic research to understand the problem and play around. More like particle research using expensive accelerators, not research on how can we use lasers to accomplish xyz (now that we already have them and know their physics exactly).
Investors that invested into yet another Linux startup in the dot com boom had a high chance of failure - but those business all tried to be RedHat, not something completely unknown. And the subject of the business was an operating system, not something unknown. Your bet is on execution and the market, not on some yet unknown product.
> It's time to invest and avidly pursue a new wave of technological solutions to this problem - including those that are risky, unproven, even unlikely to work.
I don’t think you’ve really thought this argument through.
Edit: unfortunately it looks like you've frequently been uncivil in HN comments. We ban accounts that do that, so can you please review the guidelines and not do that anymore?
Could you please tell me what exactly is "uncivil" in my comment?
Oh and by he way, I could not care less about some stupid "ban". First, it's not like I need anything from you or this site, second, I don't think it works. Not that I would have any reason to try to create new accounts, because seriously, who cares, I just find it frustratingly silly - STUPID - that you threaten me with a ban.
Furthermore, I don't agree that I was uncivil, not now, not in the past.
That is an insane price. Here in Germany I last paid 70 Euros on top of what insurance pays for (which is the very basics - and yes, they pay for amalgam fillings) for a composite fillings. Which one exactly I don't know but it was what I already had, and I never had a problem including with durability. When I still paid full - I switched from private insurance (I pay everything and get reimbursed) back into the semi-public system a few years ago (they pay directly to the dentist or doctor) - it was not much more though. Even the special procedure to remove the last few amalgam fillings including refilling were just some 3xx Euros for three teeth. That dentist is located in a big Bavarian city in the middle of the city in its most expensive shopping street, and yet prices are very sane (I saw and paid them in full for years since overall my costs were well below the high yearly deductible I had chosen for my private insurance).
Sorry for the downvotes. I received chelation therapy after years and years of very strange accumulating issues that some day crossed a threshold where they could no longer be ignored. I had actually not seen that coming and called myself healthy, the human brain is extraordinarily capable of ignoring obvious problems. When I was forced to acknowledge that not all was well my world fell apart. Long story short, I found the problem after some searching. Mercury was high both in hair and in urine - I was lucky. Normally chronic exposure is next to impossible to show via such tests. After chelation mostly with DMPS, later also lots of DMSA I achieved miracles. For exanple, a double-sized right thyroid with a nodule became normal and the nodule disappeared. That condition had been there for at least 25 years (first diagnosis). It disappeared within a few weeks, after the 4th or 5th DMPS treatment the tissues surrounding that area were very active, I knew there was something going on. So I went to the endocrinologist again who did the ultra-sound twice because he did not believe it. That is just a single example of many, from psoriasis (gone) to warts on the feet (gone), eye problems (gone), never-ending colds (for months!) that had gotten worse and worse over time, and a long list of other problems.
How do I know it was the amalgam fillings? Because that was my only exposure, and because it turned out my jaw bones were very damaged - exactly were there had been amalgam fillings. It was discovered not by x-ray, several OPGs never showed anything. But when I was to get an injection into the buccal mucosa the needle went right into the bone (that's really not supposed to happen, you can't penetrate bone with a small needle used for a mucosa injection). The doctor checked and this happened in all the places where I had had amalgam fillings. He then injected DMPS in those places. A year later, and after the jaw bones had been very active (but in a positive way) the needle didn't go in anywhere any more. To this day there is (decreasing) activity in my jaw bones, and I still take chelators that have an effect right there (jaw bone).
But please, go ahead and downvote anyone who says something about amalgam fillings. I actually have a background in medical topics, from anatomy, physiology to (of course) bio chemistry, and I read quite a few studies. The lead situation was so bad that politicians actually went to action to do something about it, worldwide. Mercury is far more toxic than lead (and, according to some LD study I once found on PubMed, together about a thousand times more toxic than either lead or mercury alone). Yes, pieces of amalgam are not the problem, they go right through. And as others have said, insertion and even more so removal - with a drill creating heat which creates vapor (no matter how much you cool with water, by then the vapor already exists) - are the worst parts. I had had a few fillings removed while I was a student. Only recently, two decades later, did I connect the dots, why back then I had a huge "almost asthma" allergy almost overnight, as well as huge problems finding sleep, strange thoughts, and big problems with some joints that didn't seem to have any observable reason. The removal was without protection, the removal of the last fillings a few years ago, when I hoped I had found the problem (I did not know, amalgam removal and chelation was an experiment because I could not find anything else, and boy was I proven correct), was with good protective measures that I think worked (I didn't get worse then I already was at the time).
Here is something to consider: What happened when I started DMPS chelation was something that according to doctors doing that kind of treatment is not uncommon, so much so that I was told that might happen before it happened. The initial values went down quickly and linearly - but after a few DMPS treatments my symptoms suddenly jumped. Turned out that the amount of excreted mercury had also jumped (tripled). From then on my body became "active". All kinds of crazy stuff happened, for a long time (it's still not quite over in the jaw area). It seems that the body is overwhelmed at some point and is no longer able to excrete everything. Maybe the spikes of insertion and/or removal of amalgam fillings contribute, too much at once. After the first year I took chelators because it still helped, but it was no longer necessary for excretion, my body had become pretty active. Maybe somebody whose body can deal with the spikes, or who never experiences them, has less trouble continuously getting rid of the mercury that is released from the fillings.
Sooo many questions, and I made soooo many interesting observations. Too bad it's impossible to talk about it, even anonymously on the Internet, because for some reason this topic raises the emotions of sooo many people. That the subject is present on so many websites of the esoteric kind is because it's next to impossible to talk about it in normal circles. My insurance always paid every little thing, even the most stupid and ridiculous and useless stuff - but when I finally send them a bill that mentioned "mercury" and "DMPS" (chelator) they suddenly refused. IT was a trigger word. They had paid for dozens of doctors (that one year when everything escalated, I went to many doctors with the many issues I had, from gastroenterologist to psychologist), now, the one thing that actually worked, and which was very cheap(!), they refused. It's insane. Same here - somebody mentions the trigger words (mercury, amalgam), the comment is voted down immediately. By whom actually? Are there so many prominent toxicologists reading this?
I don't think so. Even a normal MD would not know much about it. I've actually seen this: When I go to a talk from a doctor specialized in lung disease and someone in the audience asks about something not the lung the doctor is very careful not to say anything, because it's not their specialty. Strange, everybody (including non-doctors) has a strong opinion when it comes to the subject of chronic mercury poisoning through amalgam fillings.
> the biological signals attenuate with distance from source
The voltage signal is propagated in axons sometimes over very long distances (a meter, e.g. from the foot to the spine). It is renewed (see "Nodes of Ranvier") along the path for as long as needed, at distances that depend on how, or if, the axon is myelinated. That's why the speed is so slow (ca. 120 m/s max., often much slower) - it's actual ion movement through lots and lots of opening and closing voltage triggered channels all along the axons, compared to a purely electrical signal like in a metal wire. This means while in a wire the electrical field is from start to end, leading to electrons exiting on the far end pretty much instantaneously, in an axon am electrical field is only local, and only strong enough to trigger anything for about 1-2 millimeters at best. Then there have to be a new set of channels triggered by the electrical field further up the axon that renew the signal by letting in ions.
Attenuation is more important in dendrites and neuron bodies, spatial distance of simultaneously incoming action potentials (via connected axons from other neurons) plays a role in determining whether a threshold is reached that would trigger firing an action potential from this neuron. Since a dendritic arbor can be quite extensive and have lots of branches location - where exactly along the branches does an incoming signal attach - matters a lot.
But whether or not the incoming signals ever lead to a new action potential depends on so many factors (spacial, temporal, chemical, biological,... and it's all dynamic on many levels) that can all be called "analog" and are quite diverse that it's hard to call anything "digital". One action potential, that thing that brings to mind the "digital" analogy, really is a very small part in that system.
Here is an article describing "three dimensional two-photon brain imaging in freely moving mice using a miniature fiber coupled microscope": https://www.nature.com/articles/s41598-018-26326-3 (the experiments that I was aware of all still were done on a sedated animal with a fixated head).
when studying the propagation of dendritic signals, you would like to know the subthreshold voltage response at the soma. Since no spikes are elicited there is no calcium signal. Thats why you need patching.
I was unclear. My comment was just a tongue in cheek way of saying: it's not odd that we don't have much electrophysiological knowledge of single human neurons because of the practical and ethical problems that come with brain slice electrophysiology on humans -- you need live tissue which is hard to get.
What you've linked to deals with "in vivo" rather than brain slice ("in vitro") electrophysiology, which in humans would encounter the same issues. Cool techniques though nonetheless.
From the NY article:
> Eight days later, after an outcry from private equity executives and dermatologists associated with private equity firms
So the complained is from business people. If any of them also happens to be a dermatologist that does not seem to be the key, they don't complain about anything medical. That's because the paper was
> a research paper on its website that analyzed the effects of a business trend roiling the field of dermatology
It was about business, not about medical issues.
I recommend you read the NY Times article.