Are you intentionally ignoring the large Native American population in some of those states?
[edit: at this point I just assume that folks on HN don't have any concept of the demographics of reservations and how many children are being born. If you mention lack of Hispanic population but don't mention the Native American population then you are skewing the point.]
It does make one wonder what happens if everything is a type instead of a file. Do you get a command line that looks like Mathematica? I too think every program containing a parser is a waste.
We in ND just got our first winter storm and it was bad enough to cancel work. We are not exactly apt to cancel because of snow. I get the feeling this is not going to an easy year on the heating budget.
Last I checked, Nova doesn't do keyboard macros and I do a lot of text munging and need them because I refuse to type the same sequence multiple times.
I worked on one in the 90's that was $50,000 a day for three years. The drug company, assuming the trial was successful, had about 4 years to make all its money back before the patent expired. Testing blood, urine, and stool for multiple things is expensive.
Intellectually, I can understand the need for control groups, but I still think it's immoral. When you stare at a spreadsheet and see 70% of the control group is dead because some random number generator sorted them there like hell's own sorting hat, and the 98% of the people getting the drug are alive, you have no business talking about statistics. That graph will haunt me til my dying day.
You didn't kill 70% of the control group, you saved 98% of the experimental group.
Also, with the appropriate trial design, you can stop the control and transfer patients once you see these big differences. Same thing should happen if you see the opposite, e.g. killing 70% of your experimental group.
If that was truly the case, then - as the parent hinted - it was the trial design that was the problem, and not the practice of having control groups.
It is pretty common to stop trials early when it is obvious that the treatment works. Conversely, it is easy to think that "yea of course the new treatment works" despite the evidence not being there. The need for robust analysis must also be respected.
Yes, exactly. Control groups are incredibly important for ensuring good quality of clinical studies. It's a technique that solves multiple "calibration" problems, including:
- being able to draw causal conclusions
- being able to adjust against placebo effects
A lot of clever people have tried to come up with ways of doing away with control groups. But ultimately, the best we can achieve is to stop early, as soon as the trial has a clear outcome. I do perhaps think this has become more common in recent times though, so perhaps the study you were involved in was at a time when early stopping wasn't really "the done thing".
But it still beats "studies" done 100 years ago, when you might give someone a cough mixture, see that they improved (if they died, let's just ignore that), and conclude that it was the cough mixture that did it!
> the best we can achieve is to stop early, as soon as the trial has a clear outcome
That must be really hard: if you wait for 95% confidence, you are selecting for 5% noise. If you repeatedly re-measure for 95% confidence, you strongly select for random noise.
Not many medical advancements provide such an anomalously strong signal (98% survival versus 30% survival).
> If you repeatedly re-measure for 95% confidence, you strongly select for random noise.
You can't use standard methods for early stopping - as you rightly point out, you get gibberish if you naively keep peeking at a growing data set. Instead, you have to use statistical methods that explicitly adjust for the repeated sampling in early stopping trials. This does make early stopping more complicated to analyse than a trial with a pre-determined duration.
No, in fact it is quite common to do "open label" clinical studies in which patients know what drug they are getting and no one is given the current standard of care. This is especially common in cancer, where the standard of care is so poor, and in rare diseases, where the patient population isn't large enough to admit such a comprehensive study.
It is harder to have the same statistical confidence of efficacy and safety in such studies, but clinical researchers try to address those issues by varying e.g. dosage quantities, time in between doses, etc.
Source: place I work is currently doing studies of this nature, and in general such studies seem to be well-understood and accepted by the FDA.
Randomization is independent from blinding. Open label studies can be either randomized or not, and controlled or not.
The FDA will usually push for blinding if possible (sometimes it is not). They will also usually push for a randomization zed control with standard of care. They way the FDA views it (and I agree), is that control patients are not harmed because they are still getting the same care they would outside of the trial.
It is usually unethical to have a treatment free arm. However, this has its own problem, where if you keep using equivalence comparisons, the end of the chain might not actually be any better
For such a large effect it is quite possible to implement an adaptive trial design with unbalanced arms and interim analysis for efficacy. But you have to ask for this, the FDA will not necessarily suggest it directly.
I don't feel guilt, I still feel rage. I didn't determine any of the parameters or rules of the trial so I have no guilt on me. I just observed that the control group is dead because of some belief that they provided value when we already knew exactly what was going to happen to them.
If you can prevent harm to others, then not doing so is just being an a$$. The trolley problem is just counting souls and really doesn't happen much in real life. The true problem is thinking the only choices are us/them versus everyone. I'm not a doctor so I have no idea how their ethics applies to their professional decisions.
This does not happen in a vacuum - it is not about this group at all. It is all about the future and if this will put a stop to a lot more people dying in the future. If it is only going to save 20 people a year, it hardly matters, but if 1,000,000 people will be saved every year, that's different story.
I don't know how bit the groups were, but if you have 500 people in the control group and 150 die, and you save 1,000,000 per year, that is a great trade-off.
Plus, when you go into this experiment, you know you it is an experiment and know in advance it is a 50/50 proposition that you will get the drug/placebo, but at least you have a 50% chance. Better than no chance. And personally, which normally I hate personal experiences, but personally, I wouldn't mind giving up my life in a test if I know I might have a 50% chance of getting the drug, but if not, I save 1,000,000 people a year (or whatever it is).
It's like being in the army. If you are the commander, the general, you might have to send 5,000 men charging up a hill that you know is well-defended and 80% will die, but you are using it as a diversionary tactic and take 80,000 men towards your real objective and you win it, then too bad for the 5,000 men. It's just the way things are. And if someone doesn't have the stomach to be the general, then they shouldn't be the general and look for another line of work.
Control groups exist because they get us closer to global optimality.
We can't eliminate suffering and dying of untreated people but it's generally considered ethical to eliminate suffering and dying of many while withholding that treatment from a subgroup of the study ("allowing them to die" by not taking action, rather than the "causing them to die" by taking action).
as long as that selection is done randomly and "fairly" I think it's an entirely acceptable risk. There have been trials that were truly badly run, and people died and suffered more than necessary, due to mistakes (often amateur ones) in the protocol. I'm more concerned about those types of deaths.
If that was the case, the study actually was unethical.
Some designs do include interim analyses and stopping rules.
However in my view the real scandal is we are still using NHST for clinical trials. We should be continuously updating a sensible prior for the effect size and approving the drug/stopping the trial when we have sufficient evidence one way the other.
As it is, the results of many underpowered trials are essentially thrown away because p > .05, which is stupid. This says nothing about the balance of evidence for the efficacy of an intervention… only the inertia and innumeracy of many clinicians preserves the tradition.
It's possible to stop a trial because the new drug is much more effective than the old drug. It's also possible to stop a trial because the new drug's significantly worse than the old. We've done both.
Also, I hope that no one ever tells you that you have to do a drug schema change because "too many kids are dying."
I once watched a youtube video of a guy talking about the offensive uses of flamethrowers who said they actually kill most people via carbon monoxide poisoning in bunkers rather than burning them to death. I think it was meant to try and make them seem less macabre, but it had the opposite effect for me. Certainly didn't make a bunker sound all that appealing as a defense.
I think there are different varieties of preppers, and some have communities.
Frankly, by some definitions, I'm a prepper which is rather surprising. I think if you live rural you tend to have a lot more supplies on hand. I used to keep 3 full days, but I now have a 7 day supply, and friends feel fairly justified in have a year's worth of goods. Heck, some of the base prepper playbook are rural hobbies (micro-farming) or just basic winter prep (generator).
Now, solar and wind have gotten a lot more convenient with people doing battery walls. I get the feeling that those folks just got tired of listening to the power company say wait.
I tell people that I haven't looked forward to new features in the 'California' era like I did in the 'Cat' era. Now, I worry about what Apple will break or take away.
If Microsoft wasn't so intent on spying and advertising to me, I might consider them. I get the feeling I will switch to a BSD eventually.
I’ve been leaning the same way. I’m curious why you also lean towards BSD instead of Linux?
It’s a gut feeling for me after watching the Linux ecosystem churn a lot and seeing BSDs with well documented core systems and the “core/ports” distinction make clear what is and isn’t really supported
I prefer BSD to Linux for a few reasons. Firstly, BSD is not encumbered by GPL. Also, any BSD is a complete operating system while Linux requires distros subject to the whims of their creators, which seem to focus on form over function. Any long term stability is almost accidental, and there is no standard edition of Linux. Lastly and I think most importantly, the centralized BSD ports system is more trustworthy than an untracked number of repositories and sources. Actually, these complaints about Linux aren't about Linux, they're mostly about GNU. Linux is just a kernel, and it's fine, really. GNU is the problem.
> Firstly, BSD is not encumbered by GPL. Also, any BSD is a complete operating system while Linux requires distros subject to the whims of their creators, which seem to focus on form over function
This "BSD is a complete operating system" that you speak of... Do you mean FreeBSD, OpenBSD, NetBSD, DragnonFly BSD, Darwin?
Thankfully BSD is not subject to teh whims of any distro?
Each of {Free,Open,Net,DragonFly}BSD is its own operating system, complete with tree, system call interface and ports tree. This is not the same as the distribution model Linux has - the BSDs have diverged substantially from one another.
Coming from macOS, there’s a certain cohesiveness that one comes to expect that is often absent with Linux, with conventions being mere suggestions and things generally being all over the place. The BSDs aren’t perfect but certainly much better in this regard.
It’s unrealistic but a Linux distro that forked as many packages as possible to make them follow conventions and be proper desktop citizens would be interesting.
I'm much more familiar with OpenBSD and FreeBSD on the server-side, and I don't feel real comfortable with Linux. The two biggest vendors, Red Hat and Ubuntu, don't really give the warm fuzzies. Maybe something like System 76 backs.
The funny thing is I tried to setup and Arch Linux box. I can setup OpenBSD with thinking with all the partitions and such, but that Arch Linux install was just a bad time. I'll try Debian when I get back to work. We are replacing our Samba server and the BSDs aren't real current given some changes the Samba team made.
Check out the KDE edition of Fedora. Fedora is a rock solid OS and KDE is a rock solid desktop environment. Reminds me of what I always wanted Windows to be.
You can go with their default edition (GNOME) if you want something that looks like a MacOS clone right out of the box, but the actual user experience is so different (and IMO so much worse) that I can't recommend it for anyone interested in switching.
Funnily enough I've been considering going the opposite way. I'm on Windows, Android and iPadOS right now, but this diversity of operating systems means nothing integrates well, so it's not a great experience.
Buying into the Google or Microsoft ecosystems would improve things on this front, but this seems not great w.r.t. privacy, which is why I'm thinking of going all in on Apple.
Our findings confirm that zebra stripes repel biting flies under naturalistic conditions and do so at close range
Which has lead to suggestions to breed this into livestock. Which will certainly change the landscape in US.
As I said before: Somehow driving through South Dakota looking out over a vast field of seaweed eating, zebra striped cows was not the future I anticipated as a youth.
It’s possible this only works when only some animals in the neighborhood have stripes, I.e., the insects have other targets available and they’d just choose the less distracting one. In the absence of any other alternative they might end up still biting the striped animals.
Biting flies have all kinds of food sources- I live in an area of the midwest with no animal farms for several miles (lots of trees and water springs though) and the woods are so thick with deer flies that I can't take my dogs with on a walk- their ears will have 6 flies each before we get 50 feet.
Deer, bears, coyote, wolves, raccoons, mice, otters, beaver, rats, muskrats, cougar, bobcats, chipmunks and squirrels, elk and moose, skunks, badgers, porcupines can all be found in nature in the upper midwest, along with various moles, voles, shrew and weasel family members can be found pretty much anywhere outside of a city center.
Since deer fly (and other biting flies) typically need a bit of standing water to breed, they're going to be found pretty much anywhere mammals live. If they decide they don't like striped cows, there's going to be plenty of other options to munch on.
[edit: at this point I just assume that folks on HN don't have any concept of the demographics of reservations and how many children are being born. If you mention lack of Hispanic population but don't mention the Native American population then you are skewing the point.]