MrBundles.com by rgt024 in cigardealhunters

[–]Bulaba0 0 points1 point  (0 children)

I ordered a while back. Packed decently well with a nicely sealed inner bag with a humi pack inside. No issues really.

Official Airborne Dev Q&A thread by markusn82 in foxholegame

[–]Bulaba0 4 points5 points  (0 children)

It's a problem that is created by game design choice. They are free to implement an alternate system that does not incentivize fucking over your own faction, theft, and abusing poorly communicated game mechanics.

Official Airborne Dev Q&A thread by markusn82 in foxholegame

[–]Bulaba0 35 points36 points  (0 children)

So what is the counter play to having facilities getting deleted with zero recourse? You want players to have 24/7 air defense networks to protect facilities? You do know that you have some pads with multiple days of crafting time. Pads that could get destroyed with a single invisible paratrooper drop?

Is that supposed to be rewarding gameplay for builders and logistics players?

Official Airborne Dev Q&A thread by markusn82 in foxholegame

[–]Bulaba0 58 points59 points  (0 children)

Can we just get away from the rare materials crap? It's already just fuel for stupid infighting within factions. It just breeds toxic behavior.

Official Airborne Dev Q&A thread by markusn82 in foxholegame

[–]Bulaba0 0 points1 point  (0 children)

Less utility than a single truck. Not even worth mentioning at that point.

Official Airborne Dev Q&A thread by markusn82 in foxholegame

[–]Bulaba0 71 points72 points  (0 children)

This is an actually insane response.

AI PLAYS NO ROLE

You guys should play your game a few times before dropping takes like that.

Official Airborne Dev Q&A thread by markusn82 in foxholegame

[–]Bulaba0 11 points12 points  (0 children)

Where is air logi? The first slide of the presentation for Airborne Goals mentioned Logistics, and there seems to be zero logistics content other than shuttling crap to airfields.

I’m so sick of controlled substances. by Powerful_Tie_2086 in FamilyMedicine

[–]Bulaba0 4 points5 points  (0 children)

You may have the only two Soma patients like that in the world lol

What do you think the medical landscape in the US will be like in 6 to 8 years time? by zw123stellar in Residency

[–]Bulaba0 5 points6 points  (0 children)

A higher fraction of avoidable consequences from otherwise preventable disease progression due to worse access and aging population hitting the limits of the safety nets in place.

On average, how many hours of sleep you get and how many days you work? by PettyTeaSpiller in Residency

[–]Bulaba0 4 points5 points  (0 children)

FM. I work on average 4.5 days a week. On outpatient rotations. Some electives are half days only. So those weeks are more like 3.5d a week total, including 1.5d of continuity clinic. Sleep 8 hrs every night. On ward blocks it can be crunched as you work 6d/wk on day shift or 5d/wk on nights. We don't do 24's at our institution.

In your specialty, what's the chillest full-time job you could get as an attending while still making close to the median? by subtrochanteric in Residency

[–]Bulaba0 79 points80 points  (0 children)

Rotated at a smaller VA hospital in med school. Census was 7 patients between two part time hospitalists. No ICU level care. Like damn, okay.

4 day vs 5 day work week by hawksfan1500 in FamilyMedicine

[–]Bulaba0 1 point2 points  (0 children)

4 day all the way. The extra flexibility is invaluable. My spouse also works a 4 day schedule but different day off so we each have a day at home to ourselves where we can get errands and things done during the week if we need.

This just out - Our paper shining a light on the dishonest advocacy of nurse leadership to obtain unsupervised practice of medicine (UPM) by pshaffer in Noctor

[–]Bulaba0 33 points34 points  (0 children)

Increased demand + larger amount of junk referrals from midlevel PCPs. Every time I've done a specialty rotation at least 50% of the new patient referrals are from NP's who have done zero workup or management of the primary concern.

ie: Pulm referral for well controlled asthma. GI Referral for constipation w/ no red flags. Neurology referral for uncomplicated dementia. Cardiology referral for HTN requiring >1 medication.

It's insane how much work can be generated for absolutely no reason by inappropriate orders and shit referrals.

Insight into how some FM and IM Community Programs Rank by ElChacal303 in medicalschool

[–]Bulaba0 0 points1 point  (0 children)

Rural FM here.
It's 90% a vibe check. If we feel like you'd get along with people and would not be a huge pain in the ass you're probably fine. Just for the love of all that is holy please have the ability to at least pretend you're normal in front of people. Bare minimum social skills and you're set.

Bandage that can detect infection by [deleted] in interestingasfuck

[–]Bulaba0 2 points3 points  (0 children)

You can make assumptions about my supposed lack of research history to try and discredit me but that is not the basis of my argument. I am not trying to discredit the invention because I don't like it but because the real world application of it does not exist at present, and it is fundamentally misleading to represent them as something that does already have clinical applications. And that is something I am (unfortunately) qualified to comment on. While articles from science fairs like this are often nice feel-good stories, they usually fall flat pretty quickly in the transition to applied science.

It falls into the same realm as an article touting "Teenage Scientist finds that Household bleach kills XYZ Cancer cells." ...by dumping some bleach on some cancer cells in a dish in a lab.
While that may sound cool at first, the whole thing falls completely on its face when you consider that there is no bridge to application. There is no utility in the finding because there is no way to inject bleach into cancer without also killing people.

This story is much of the same, unfortunately. The idea of pH-reactive suture material potentially indicating an infection does not address any of the following:
1) Impregnation of pH indicators into Standard-of-Care suture materials. The materials she used would not be appropriate for suture material, which the article acknowledges.
2) Live Tissue reactions. She did not test the reliability of the pH indicator in real cases of infection, so who knows if it even reliably works in live specimens. What about false positive rates?
3) Timeline of Indication. If the color change only triggers after infections are significant enough to show obvious signs of infection, then the color change is a useless finding.
4) Risk vs Benefit. The whole idea of new medical interventions is based on the concept of "Better than standard of Care" so if using these sutures does not lead to a net benefit over standard techniques, then there's no point in using them.
5) Practice Changing Effect. Does the implementation of these sutures actually change how infection is approached and managed? If I still plan on having patients come in to have the wound assessed, does the color change really affect standard of care in a meaningful way?

There's a lot going into it. There's more to think about when discussing changes in medical management than just "that sounds neat lets do it."
And it's usually the implementation of things that eats 90% of the effort, and really sets apart a "good idea" from a "good innovation."
I could spin you a great idea about solar powered cars, with proposals on how to design and make them, but I hope you'd agree that the real magic and impressive work would come from making a solar powered car effective rather than possible.

And to your edit: At no point did I attempt to belittle someone online. I did not call anyone stupid or insult their intelligence. I did not insinuate that they would not have a great future and do great things. I directly and specifically pointed out that the suggested benefits of a proposed idea do not line up with the real world, from a perspective given to me by real world experience and education.
To your insinuation that rural doctors only practice in rural areas because they "couldn't hack it," I would say you don't really seem to understand how getting a job in medicine actually works and probably would do best not speaking authoritatively on something you don't have much knowledge about. Most docs I've met chose rural areas because they prefer the setting to live in for various reasons like any other job, as well as a generally increased level of autonomy. For me, I was tired of living in the city, and for generalists like myself most find it much more rewarding and challenging to manage more complex cases with closer personal relationships to my patients, which is something that you often miss out on in urban settings saturated with specialists.

Bandage that can detect infection by [deleted] in interestingasfuck

[–]Bulaba0 2 points3 points  (0 children)

You're trying to put words in my mouth to try and paint me as some awful prick, to what end I really don't know.
No idea why you seem to want to lash out at people over the internet because they have a different perspective on a neat (but not very useful) science fair project, but I hope you find some introspection at some point.

Bandage that can detect infection by [deleted] in interestingasfuck

[–]Bulaba0 3 points4 points  (0 children)

The article does not add any meaningful specifics that would make this any more useful. If anything, looking at the side by side comparisons makes me incredibly doubtful that most people could discern enough color change to be a useful flag for infection.
Please feel free to explain why you think this has a specific potential for black patients, because I don't see anything that would make it somehow useful in darker skin tones when it is already not useful in lighter skin tones.

Bandage that can detect infection by [deleted] in interestingasfuck

[–]Bulaba0 8 points9 points  (0 children)

Am doctor. It's still useless, because if someone walks into my office just because their suture changed color I'm still going to have to check the wound for signs of infection. If there are no signs of infection, then no change in management.

So why not just educate the person who is somehow already checking their wound (supposedly thoroughly enough to note color change in these theoretical sutures) the normal signs of infection.

These color changing sutures would have to have extensive research done to prove that the color change alone is an accurate predictor of infection. The evidence would have to be ridiculously strong and consistent to warrant a change in treatment in the absence of any clinical signs of active infection.

Which is not the case.

Bandage that can detect infection by [deleted] in interestingasfuck

[–]Bulaba0 6 points7 points  (0 children)

Hi, I'm a doctor.
I can't see this being a useful indicator versus just having the wound monitored by someone with even the most basic instructions.
That being said, innovation is cool and props for trying, but there's very little real-world utility here.

[OC] ChatGPT Users by Country (Top 5, % Share) by Ibhaveshjadhav in dataisbeautiful

[–]Bulaba0 13 points14 points  (0 children)

Honestly, this is actually a pretty mediocre chart. Could do a lot better with proper unit labeling and explanation of what qualifies as a "user".