neuro_imager

I'm not sure how well this translates to humans.

Really pleased to hear you're doing well. As someone who has faced a similar situation in the past I can attest as to how hard it can be to pull yourself out of that downward spiral.

I went through your previous thread and was really impressed by some of the advice/comments you were given.

I was wondering if anyone with some time on their hands on here could possibly prepare a repository of all the good advice in this thread (and the OP's previous thread, and one's like it) as a resource for people who face similar circumstances. (I have no doubt there are a lot of us out there).

I can't believe this waffle qualifies for a Harvard medical school publication. Clearly the wooly-haired management and soft science types have overrun Ivy League Medicine.

Where did you find out about Emoxypine? Do you have any reliable references about this?

South Africa didn't 'denuclearise' in the sense of giving up arms.

They had a change to a completely incompetent government who wouldn't know how to spell 'nuclear' let alone fathom the scientific research and economic and political strategy required to run such a program.

And given that nuclear scientists and competent political strategists tend to be smart, they don't hang around in swamps very long.

Privacy - All transactions on venmo are easily accessed by venmo and other third parties.

International transactions - Venmo is very limited in this regard.

The unbanked - As stated already, there are about two billion unbanked people worldwide.

Avoiding banking cartels. - We've fed these parasites enough, don't you think?

Ease of use - A payment over a social network would be relatively seamless, particularly if you believe that apps allowing for rapid transfer between cryptocurrencies will be feasible (they are to some degree already).

Yeah everyone is "clean" until they fail a drug test. Absence of proof isn't proof of absence. And drug tests pretty much suck.

Sports do not all benefit equally from PEDs. The requirement to demonstrate high level muscular endurance over such prolonged time periods makes the relative benefits to cyclists very high.

This is different to most sports where you are less likely to grossly manipulate the factors contributing to optimal performance with PEDs. Or at least not be able to manipulate them enough to be out of range of talented non-users.

The quote "judge talent at its best and character at its worst" seams appropriate here.

I'm guessing you're in the US where this type of behaviour is typical.

Fortunately that is not the case in many other parts of the world where incentives are not as perverse.

(physician here)

For the sake of completeness, I'll expand:

It's rarely up to the interventionalist if and when they will treat a stroke. There are clear guidelines on treating these patients (which mostly take place at comprehensive stroke centres), mostly defined by the neurology service, which functions somewhat independently. These guidelines have been expanding as newer evidence has shown a role in wider time windows but this point remains the same. There is very little opportunity for an individual interventionalist to increase his patient volume independently (at least for ischemic stroke).

I agree in principle with most of the points you make, although I think perverse incentives are largely a function of the US healthcare system in general rather than the domain of any particular specialty.

In specific relation to the original article, I'm extremely doubtful that combing two anti-thrombotic agents would be a miraculous therapeutic regime for treating stroke but I'd be happy to be proved wrong by a legitimate trial. However, I'd worry that we'd be sacrificing patients that could otherwise be treated if we assigned them to an arm of a trial that precludes established therapy.

Salary (unless you're moonlighting - which is less common, and overall less attractive).

Why do you presume that our intentions are nefarious when you have no idea what you're talking about?

Actually, its interventional cardiology for heart attacks and neurointerventional surgery/interventional neuroradiology(NIR) for strokes. (Not IR which cover non-neurological and non-cardiological interventional procedures).

I'm a NIR and most of us are not paid per surgery/intervention. Also these interventions tend to be loss leaders in terms of hospital reimbursements. Funding for stroke centres can be profitable but that's a very long discussion.

In addition, at least 7 randomized clinical trials have shown the benefit of thrombectomy in acute stroke (actually something of a modern medical technological miracle).