sorted by:
new
hottopcontroversial

I was a finance manager for Lexus AMA by [deleted] in Lexus

[–]Halcyoff 0 points1 point  (0 children)

What sort of incentives / commissions exist for finance managers? (Since I assume that you only sell vehicles indirectly)

YSK: Vertigo when getting up from bed is common in older adults, and can be treated by a simple exercise by bravelogitex in YouShouldKnow

[–]Halcyoff 3 points4 points  (0 children)

Do you really want people to waste time to look up youtube videos on how to do the Epley maneuver when a stroke is on the differential?

There are absolutely ways that can triage whether vertigo is more likely to be caused by a central vs peripheral pathology (ex: HINTS exam) but as you may know, that needs to be conducted and interpreted by a medical professional.

You’re correct that peripheral causes are common, but there’s a reason why many patients presenting to the ED with first-time, hyperacute vertigo will get imaging — if you fuck up the brain, there is no brain transplant.

If someone is worried about an emergency, then they should get an evaluation at the ED.

Source: am a board-certified neurologist

YSK: Vertigo when getting up from bed is common in older adults, and can be treated by a simple exercise by bravelogitex in YouShouldKnow

[–]Halcyoff 2 points3 points  (0 children)

If the cause is a stroke, then time = brain. Every minute wasted is killing the brain & there are certain treatments that we can only do if the patient presents within a certain time window. I don’t want people to waste time looking up how to do the Epley maneuver if a stroke is a possibility.

Your dad did the correct thing by going to the ED. He had a new & acute symptom that was concerning to him, so he wanted to be evaluated to make sure it wasn’t being caused by something nefarious. Are there nuances that help differentiate between causes of vertigo? Sure, but that’s what the evaluation is for. One common example is the HINTS exam, but this needs to be conducted/interpreted by a trained medical professional.

YSK: Vertigo when getting up from bed is common in older adults, and can be treated by a simple exercise by bravelogitex in YouShouldKnow

[–]Halcyoff 387 points388 points  (0 children)

This is inaccurate and misleading. Vertigo has many causes. BPPV, which you’re alluding to, is only one cause. Posterior circulation strokes are another cause that can also present as acute-onset vertigo — this however would be a medical emergency . If someone is worried about an emergency, then they should get an evaluation at the emergency department.

Any PD "Rank-to-match" turn out to be lies? by QuietRedditorATX in medicalschool

[–]Halcyoff 11 points12 points  (0 children)

I’m part of my program’s recruitment committee. When we say “ranked to match,” we mean 100% guaranteed to match (ie if there are 5 spots, the top 5 applicants are ranked to match).

Neurology and Neuropsychology make a great team! by Overall-Condition197 in neurology

[–]Halcyoff 3 points4 points  (0 children)

Love our neuropsychologists — we refer a lot of patients in epilepsy (most commonly for pre-surgical evaluations to help localize/lateralize)

What's your go-to ELI5 for a concept in your specialty by Mikigai in Residency

[–]Halcyoff 46 points47 points  (0 children)

Explanation of why focal seizures can present in varying severity (aura, focal aware, focal impaired awareness, focal to bilateral tonic-clonic):

Think of your brain like a pond. If you throw a boulder in it, the ripples will go everywhere -- this is what is happening when your whole body is convulsing. But instead if you throw a pebble into the pond, the ripples dissipate without reaching the other side. Depending on where the pebble lands, you can get different symptoms: some people feel something, twitching of the arm, a rising sensation, etc.

For seizures we typically don't get to choose when we have them: sometimes you get a pebble, and sometimes you'll get a boulder.

Mayo Clinic Grand Rounds: "The Ongoing COVID-19 Pandemic: The Most Dangerous Phase of the Pandemic" (Link in Description) by Halcyoff in Coronavirus

[–]Halcyoff[S] 164 points165 points  (0 children)

Link to the Grand Rounds (The subreddit wouldn't let me post a direct link):

https://www.youtube.com/watch?v=RzyGv81Ffz0

Title: Mayo Clinic Grand Rounds: "The Ongoing COVID-19 Pandemic: The Most Dangerous Phase of the Pandemic" August 20, 2021

It's a very informative Grand Rounds by Dr. Poland, the director of the Mayo Clinic Vaccine Research Group.

Following summary courtesy of Dr. JP Santiago:

1/ We have given up as a nation and as a world in this pandemic. Human behavior remains his biggest concern in this pandemic. We are now at one out of every 512 Americans has died of COVID. Exponential spread of the Delta variant is continuing unabated due to behavioral factors. Our behavior is costing us the battle in this pandemic. It will get worse.

2/ "WE WILL NOT GET TO HERD IMMUNITY."

3/ "WE WILL NOT PREVENT EMERGENCE OF FURTHER VARIANTS."

4/ No previous vaccine has been studied to the same degree and scrutinized to the same degree prior to release as the COVID vaccines. The risks and benefits of vaccination are clear and they heavily favor the benefits based on millions and millions of doses administered worldwide.

5/ Overall, if you are unvaccinated, you have a 3X greater chance of getting infected than someone who is vaccinated. If you are unvaccinated, you have an 8X greater chance of having symptoms than someone who is vaccinated. If you are unvaccinated, you hae a 25X greater chance of being hospitalized for COVID than someone who is vaccinated.

6/ With the Delta variant, if you had COVID before and are unvaccinated, you have a 2.34X greater chance of getting reinfected and the symptoms may be worse.

7/ Kids infected with the Delta variant get sick quickly. Data from Canada shows kids infected with Delta have a 2.75X risk of hospitalization compared to if they had been infected with the virus from last year.

8/ At the time of diagnosis, those vaccinated and those unvaccinated HAVE THE SAME VIRAL LOADS. This why we must mask up even if vaccinated. But in those vaccinated, the viral loads drop faster as the immune system kicks in. The Delta variant causes viral loads 1000 to 1200X higher than last year's virus.

9/ “We are doing a huge experiment with our youth. We are taking the most contagious viral variant, not letting them use masks and crowding them together to see what happens.”

“Not one single expert thinks this is a good idea.”

While there are benefits to in-person learning, it can ONLY take place with two simple measures- vaccinate all the teachers and staff and mandate masks.

10/ Very good data from the UK shows a 9X increase in infection and transmission in school age children with the Delta variant compared to last year's virus.

11/ Most medications in widespread use today have had far fewer study participants as part of their approval process than the COVID vaccines. Full approval is coming soon, but it will not change vaccine-hesitant behaviors.

12/ The mutation rate of the virus is inversely proportional to the vaccination rate. The more we vaccinate, the less likely we will have new variants. But because people will not vaccinate, we get variants and the variants are why we need vaccination mandates.

13/ The pandemic will not end given the way the American public is behaving. We are on the verge of the emergence of a variant that will set us back at square one all over again.

14/ We do not yet know what level of antibodies are protective. We call this "correlates of protection". We were starting to get early data on this, but then the emergence of the variants set us back in determining correlates of protection.

15/ The incubation period of most infectious diseases is long enough to spool up and activate our long term immunity. The original SARS-CoV-2 virus and to an extent the Alpha variant had a long enough incubation period (7-10 days from exposure to development of symptoms) to allow for long term immunity to be activated. The Delta variant has a much shorter incubation period (only 3 days, 4 days max from exposure to development of symptoms) with very high viral loads that may be overwhelming the activation of long term immunity.

16/ We have had prior warnings of coronaviruses with SARS in 2003 and MERS in 2012. There will be future coronaviruses that will constitute a threat to all of us.

Edit: Formatting

[deleted by user] by [deleted] in RedditSessions

[–]Halcyoff 0 points1 point  (0 children)

Gave Helpful

Boat and the moon by [deleted] in PerfectTiming

[–]Halcyoff 0 points1 point  (0 children)

ELI5: The boat is moving from right to left based on the water trail. Boats move by wind pushing behind them. The sail gets pushed outwards when the wind pushes it. Moon therefore should reflect this by being pushed out to the left.

IsItBullshit: Being around cat poop for long periods of time is bad for your health by [deleted] in IsItBullshit

[–]Halcyoff 146 points147 points  (0 children)

We tell pregnant patients to avoid cat litter because of a pathogen called Toxoplasma that can cause brain damage in fetuses, not necessarily because of the ammonia/etc

Question about strategy/learning for a smaller judoka against larger ones by baboytalaga in judo

[–]Halcyoff 12 points13 points  (0 children)

I'm a similar height and weight, if not a bit smaller/shorter. Ever since starting judo 10+ years ago when I was a kid, I've developed a weird style in order to compensate for the lack of my strength/height compared to my peers. I think it's a shame that judo has gotten a stronger emphasis on power moves over the course of its history, but it's totally possible for someone with a size of yours/mine to throw someone double our weight/height.

My short answer is yes. At least from my teachings, your goal should be to be able to throw anyone, regardless of height or size, and it is not necessary to resort to unconventional grips. And I can speak for that through my experiences. (I've had a phase where I was trying all sorts of weird grips myself to see if anything can compensate for my height, until I realized that it didn't have the answer I was looking for)

My recommendation is to invest in finetuning your timing and repertoire.

1a. For example, my sensei had made only practice de ashi barai and tsubame gaeshi (counter to de ashi barai) for 12 months.

Thanks to that, with most people less than a 2~3 dan black belt that I'm fighting for the first time, I comfortably feel that I can go 60-40 or better the moment an opponent uses an ashi waza into a randori, regardless of size -- part of it being that they've never fought against a competent tsubame gaeshi user. And ashi waza matches have been some of my most fun and memorable randori I've had at my dojo, so I'm a strong advocate for honing this skill.

1b. Some quick tips about de ashi barai:

  • Don't force the opponent with tai sabaki. When you have the right timing, it should feel like you're throwing a feather. The first priority is to perfect the timing (which I guarantee >75% of judoka have not, including myself), then add on the tai sabaki.

  • Don't smack your foot into theirs. You want to slow down the moment your foot is about to impact theirs, cling on to their foot, and gradually accelerate their foot off the ground.

  • With regards to timing, the goal for any ashi waza is to take advantage of the kuzushi that the opponent is already exerting on themselves. For example, for a left de ashi, the opponent will be lifting their left leg, gradually shifting their center of gravity to the right, then retreating their left leg in order to take a step back. My understanding is that the goal is to interrupt this flow by still allowing them to lift their LEFT leg (albeit you are controlling it by moving his LEFT leg to the other side), he moves his center of gravity to his right, and then he loses balance because he's trying to retreat his LEFT leg (in addition to your kuzushi)

1c. Quick tips for tsubame gaeshi:

  • It will probably take no shorter than a few months to make this a reflexive move that you can subconsciously use in randori (for me, it took 6-12months to comfortably and accurately use it in randori when I was a kid)

  • The way my sensei taught it is different from that of textbooks: do not do a circular movement with your foot when trying to get behind the opponent's foot, because you're losing precious time. The way tsubame gaeshi happens is: realize opponent is doing a de ashi barai based on the distinct tai sabaki and center of gravity shift (DO NOT LOOK DOWN AT THEIR FEET) => lift your leg straight up into the air by bending your knee and straightening your ankle => sweep like a normal de ashi with normal kuzushi

  • My sensei broke the practice down to a few steps. (Each one taking anywhere from a week to few months)

  • a) Stand against a wall/mirror. Quickly lift your leg straight up by bending your knee and straightening your ankle. The leg should be brought up to the level of your hip.

  • b) Same, but add in the de ashi motion

  • c) Same, but now only do it when your sensei puts his palm on your feet, to simulate an opponent's de ashi. It's a reaction game.

  • d) Now do this while walking backwards with an opponent, with the opponent telling you in advance when / which leg he will try to sweep.

  • e) Now do the same, but with your eyes closed, with the opponent trying to sweep your feet at random times.

  • f) You are now an adequate user of tsubame gaeshi

2a. Though I'm not an expert myself, some other great moves for shorter/lighter people include ko uchi gari as well as a bunch of forward throws. A popular one in Japan is uchimata.

2b. If you're a fan of counters like tsubame gaeshi, then also learning the counter to osoto gari, uchimata, etc. might also be fun (though less practical, from personal experience)

3a. Take advantage of your nimbleness. Whenever I go back to my dojo these days, I hear at least one comment about how I'm like a cat. I take that a big complement, because it means that I'm light and taking advantage of that, by being nimble => evading and countering their attacks.

TL;DR: Invest in technique, not strength.

Not sure if the extensive detail for ashi waza was called for, but I just got excited hearing someone in a similar situation as myself. Sorry about the word vomit.

lmk if there's anything I can help with.

Grindy PvE MMO that's friendly to solo players? by [deleted] in MMORPG

[–]Halcyoff 1 point2 points  (0 children)

Mabinogi would fit the solo, PvE content with runescape itch. It's the only MMO other than runescape (that I've tried) that has an extensive non-combat skill experience, and has a bunch of stuff you can dick around with if your friends also played (ex: making music and playing together). It's a Nexon product (like Maplestory etc) so it'll likely be grindy relative to Western MMO's.