bonsai_spool

The title is a clear Claude-ism, I had low hopes after noticing it. The title should be one thing a human writes, if nothing else

> Moderna's goal with this trial was to show their tailored vaccine outperformed a COVID vaccine (for example), and my assumption from the stock dip is that smarter people than I were not convinced.

The trial result is excellent - anyone ‘not convinced’ was not living in the realm of typical results.

Please note this has about nothing whatsoever to do with COVID. It’s probably best not to comment on technical topics if you have no relevant experience.

They did a stock split

> Actually, yes guidelines are actually that any prior statin prescription removes the need for CAC measurements.

I mentioned that the CAC indication is for those in the 10-year ASCVD 5-20% risk band who are considering initiating a statin.

> I think the challenge here is that other than a CCTA there's no good way to estimate individual [...] risk

I'm not sure if you meant hereditary there, so I'll avoid the point.

Is this your area of medicine? I am not a specialist but I have never heard of cardiovascular risk stratification regarding primary prevention in the terms of impending risk to the individual except for NSTEMI patients getting a left-heart catheterization. So I would agree that CAC won't tell a patient when their MI will occur, but that's also true for CCTA and every other screening tool we have. They are designed to identify indviduals at high risk for more intensive preventive care.

> Heart attack at age 29 survivor here.

There is no scoring system that is designed for people in this age range - and based on another of your comments, it sounds like you had a significant family history, which is, itself, a very strong predictor that would obviate the kind of screening tools that the article and my comments have focused on.

That said, we are beginning to split very fine hairs. The coronary artery calcium score is only recommended for people whose 10-year ASCVD scores are on the 5-20% range who are uncertain about initiating a statin. These people are not thought to be at risk of an imminent plaque rupture (if so, their ASCVD risk would have been improperly assessed. This is a possibility, but this possibility is not the basis of public health decision making).

If your coronary CTA is to be helpful as a screening tool it would essentially only be indicated for people in the 5-20% ASCVD risk pool who have 0 CAC where there is a sustained clinical suspicion of coronary disease. In such a patient, I would just advise starting statins instead of doing a contrast study.

edit - formatting

They went on to say that the only signal that survives multiple hypothesis correction was BMI, after reporting their nominal discovery of an association with sex.

    "Men demonstrated higher rates of elevated FAI-Score than women (52.8% vs.
    25.8%, p=0.016; ≥90th percentile: 26.4% vs. 3.2%, p=0.007). [...] Body mass
    index was the sole secondary correlate surviving false discovery rate
    correction (AUC = 0.71, p=0.001, all-test FDR q=0.028). Regularized
    multivariable models showed modest out-of-sample discrimination for FAI-Score
    elevation (cross-validated AUC = 0.71)."

I feel the word 'son' carries a lot of heft here - if it were 'what will I teach my child' the expectation of passing on an economically-viable craft would feel less urgent.

But this question is tripped up in the idea of work being one's only value. If programming by humans were made illegal tomorrow, what would Steve Krouse do for work? How would he find a path forward? Who would he turn to for advice? How would he build community to this new goal?

If it's not clear, thinking about this is what to teach a child. Even in the end of the article we sort of elide the importance of teaching others to act with grace and reflection, but what more significant thing can you share with the next generation?

> obama nearly doubled the national debt in 8 years ($11T -> $22T). this is not a problem specific to a party or a president

It's almost like there was a Republican-policy-created crisis that called for massive spending in his term. And then he expanded healthcare for many people who'd never get it otherwise!

But that pales in comparison to the Russian diesel that's going to bring down my gas prices, and my private investment in arms manufacture that's growing quite well these days. So yes, we're doing much better with the debts incurred by the current administration.

> A student of Franklin, Raymond Gosling, actually took Photo 51. He was not awarded the Prize

Yes, how many students get Nobel prizes for the work of their graduate advisor that they didn’t go on to examine independently?

> It is not ai-generated. It was hand-written by a friend and colleague with deep respect in the education community.

I hate to tell you that perhaps your friend has not been forthcoming. I encourage you to check the 'citations' yourself, and perhaps to do some study on what LLM texts look like.

Funny you say that! Her citations are bogus, exactly as an LLM would produce. But please just read the article, it's as redolent of LLMs as any LLM text could be.

> The article is not ai-generated. I'm curious what makes you think it is?

She also made up at least 1/3 of the citations using her AI.

>There is a long works cited at end[sic] of the post

That is not a works cited section because there are no citations! It’s a list of references - and I wish there had been citations so I could test the author’s claims.

Also, no comment on whether these constitute made-up citations, but (courtesy of an LLM, each confirmed by me):

Silverman (#3): Wrong author. That essay is by Stephanie S. Tolan, written for Hoagies' Gifted Education Page in February 1999.

Dana Winkler & Alan Voight (#4): The paper is real but the authors are named Daniel Winkler and Adam Voight. This doesn’t sound like your friend actually wrote this article…

Dodson (#1): article's actual title is "Emotional Regulation and Rejection Sensitivity," Attention Magazine, October 2016.