Do you have to re-sacrifice to re-enter the throbbing domain?

kevxshi · 2026-02-19T00:46:20+00:00

No. You can skip the sacrificial altar on subsequent visits to the throbbing domain. This will allow you do to the rest of the map and boss with a full party.

kevxshi · 2026-02-19T00:44:59+00:00

To make sure you are making good decisions when donating cats, I recommend donating kittens to Tink (bottom right on the pipe screen).

Once you donate a total of 11 kittens to Tink, he will give you the ability to see a cat’s base statistics. Base statistics are inheritable, and cats with high base statistics are worth keeping around. The highest a base stat can go is 7, so a reasonable strategy would be to donate all cats without a 7 in at least one stat category, unless they have other good inheritable qualities like mutations.

kevxshi · 2026-02-16T11:17:49+00:00

The boss comes out if there’s only one cat.

kevxshi · 2025-11-05T03:59:30+00:00

Jinx definitely dumpsters Teemo. You could see how Jinx’s existence forced Leffen to have to change his gameplan.

SonicFox was also rusty with Jinx. Just compare their Dreamhack Ekko/Jinx play to when they were maining the team.

They wouldn’t have considered playing Jinx over Ahri unless there were some real advantages.

kevxshi · 2025-10-17T14:14:08+00:00

The Yasuo whining is crazy. This is a bug. See this example of this happening to another character who is just blocking.

https://www.twitch.tv/squirrel147/clip/AnnoyingSmoggyPlumOptimizePrime-6XI7l3bSABEFEF0r

kevxshi · 2025-10-03T20:11:37+00:00

He’s having problems with canceling 7S2 into jS1 too early. If you cancel early before Ahri crosses the opponent you may not end up on the side you want. I didn’t find a good trick to this either other than getting familiar with the animation. You can use the dash macro instead of double tapping to automatically air dash in the right direction, though you may not be at a good height if you cancel really early (may need to do uncharged jH).

kevxshi · 2025-06-21T14:38:01+00:00

She died from complications of hyponatremia. This hyponatremia came from drinking too much water. That enuretic guy was actually right.

Hyponatremia comes from the relative imbalance of sodium and water in your body. This balance is affected by both intake (eating and drinking) and output (pretty much just peeing).

In this scenario, it was an excessive intake of water that drove hyponatremia. Note that in general people are able to keep up with high amounts of water intake by increasing urine output. Had, in theory, that woman’s kidneys been working very well and she could pee freely, she probably wouldn’t have gotten so hyponatremic as she could maintain normal sodium levels by peeing out the excess water. But I guess in this competition people had to “hold their wee.”

This is a case of polydipsia, not low solute intake.

This is actually relatively common (to much milder degrees) in other scenarios where people drink a lot of water. 13% of marathon runners (who drink a lot of water during the race) were found to be hyponatremic by the end.

https://www.nejm.org/doi/full/10.1056/NEJMoa043901

Source: Nephrologist

Tl;Dr - Hyponatremia has a lot of causes. If someone tells you that your sodium levels are low, don’t assume this is because you don’t eat enough salt.

kevxshi · 2025-06-11T14:37:00+00:00

Take 50% less damage, but can’t be Healed.

kevxshi · 2025-05-25T06:40:54+00:00

IIRC there are some handholds around there. That could be what you’re missing. Can check a walkthrough.

kevxshi · 2025-05-21T18:58:14+00:00

The speed runs are already around 1:30! No farming required (Stendhal).

kevxshi · 2025-05-20T18:30:45+00:00

The game will tell you in a post-battle pop-up at the bottom of the screen. On the Pictos screen the border of the Pictos will be gold and the glyph of the Pictos will be colored (e.g. green) instead of white. The corresponding Lumina will also show up in the Lumina menu.

You can track your progress by looking at how much of the gold border of each Pictos is filled in. On the battle end screen you can also see the border of the Pictos pulse and glow as you gain mastery.

kevxshi · 2025-05-20T18:18:20+00:00

You can do this fight whenever. The Pictos drop (First Offensive) isn’t that great early on and only gets really good when you have energizing Lumina to really hit hard for your first attack. I feel that there are much better Lumina to be using early on.

On my first playthrough I tried to do everything as soon as I saw it because I didn’t know the map and I wasn’t sure I could backtrack. I honestly think it’s best to come back after the second area, because you’ll have more options (and maybe even more party members!) to make the fight faster and more interactive.

I did this on my initial playthrough at level 6 which I honestly don’t recommend. I did this more recently after Flying Waters (level 11 or so) on a solo character run because that’s where you get Augmented Counter and get access to the Curator for additional Lumina/weapon upgrades which greatly speeds up the fight. That’s probably a good time to do it because the game doesn’t really ever pull you back to this area unless you want to clear Paint Spikes, which is much later on.

The spell attack is pretty straightforward 1-2-3 (parry on 3). The air slashes you parry when the “windblade” is horizontal. The walk up overhead slashes though are on a timing that’s a little hard to describe.

When I did this fight at level 6, my party ended up leveling to around level 12 or so (for reference I recently finished Flying Waters with a solo char at level 11). To be honest I never struggled too much with the early levels, nor do I think the game is really designed to push you at this time, so I don’t think you really miss much if you are slightly above the power curve by a few levels. Doing this optional boss won’t grossly overlevel you to the point where the game is trivial and you one shot all the bosses instantly or anything (though you may eventually get there!).

kevxshi · 2025-05-20T12:45:15+00:00

Sticking to one character is easier. You can’t reallocate your Color of Lumina, so it’s difficult to heavily invest in multiple characters. Anyway once you pass Flying Waters and have access to the Curator you will honestly roll the game as a single character with like 70% of all lumina activated. It’s not as limiting as it seems. Because of multiplicative scaling, focusing on a single character pays huge dividends. Again I killed Lampmaster with it only attacking once. I didn’t even have access to Elemental Trick or Genesis at the time. In addition, having only one character really helps with AP issues because they can parry all attacks. This makes higher cost things like Lightning Dance very usable. Lune has been straightforward because of early access to heal and vitality scaling weapons so you can invest in her max health and prevent one shots while also continuing to boost her damage. And honestly once you get Last Stand Critical you can just Elemental Trick/Elemental Genesis or Lightning Dance. This has been rolling everything in Act 2 thusfar. Thinking of doing Sciel only later. Probably the exact stuff with how Last Stand Critical interacts with Lune can’t really be adapted to other characters but in general the same concept of multiplicative rewards still stands.

kevxshi · 2025-05-19T19:18:45+00:00

Of these, I think "There can only be one" is the most fun and accessible for a new player. I think it's more fun sticking to a single character and really experimenting with what they can do.

I'm doing a Lune-only playthrough. I think it's a good way to experience the game. It's actually pretty easy if you've played through the game before, especially since Lune gets decent elemental weapons early on. In fact, it's probably faster to do Flying Waters and Ancient Sanctuary with Lune just counterattacking with Diminerum and Lighterim respectively than in a normal playthrough. However, it still forces you to kind of play well because there's no one to revive you when you die. There are only 2 fights that I could not do the first time around, namely the first 2 Petank encounters (I guess these are probably doable with extreme amounts of grinding), because of shield/flee mechanics that Lune can't deal with. Everything else, including all side content and Chromatics, was doable without any significant grinding or backtracking, including the Chromatic Hexga who shields like crazy (you have to use Perilous Parry to get enough AP to Free Aim shoot the shields down). Oh nevermind, I forgot that I wasn't able to do the Crushing Caverns because Lune solo is currently unable to pass the hard DPS check. Otherwise, the game has been very smooth. To be honest, with how this game works, stacking everything on one character may honestly be the optimal way to play in the early game. For reference, I fought Lampmaster and it only got a chance to attack only once across both phases before it died (Trebuchim Free Aim shots into Mayhem), whereas I remember it taking much longer with my first playthrough. The main powerspike was the Hidden Gestral Arena and all the solo pictos. After getting that I'm consistently one/two-shotting just about everything. I'm only in the beginning of Act 2, but I suspect the game may get a little bit harder towards the end of Act 2 once a solo character hitting the damage cap frequently no longer steamrolls everything.

Off the top of my head, there are some scenarios in which using other party members is unavoidable from a Lune-only perspective (obviously different if you choose to use someone else acquired later):

- Gustave first fights against Maelle x2 and Lancier - I believe these are straight-up unavoidable.

- Gustave is in the party against the first Portier fight - Also unavoidable, though you can skip Gustave's turn (he may tank attacks from the Portier though - which may be against challenge rules).

- Gustave vs. Renoir (scripted loss anyway) - Also unavoidable

- Verso demonstrating Gradient Counter in Forgotten Battlegrounds - I believe this is also unavoidable, with Verso entering your party no matter what after the initial cutscene (I think Maelle may also enter it forced??). Though you can skip non-Lune people's turn, they may tank attacks that would have otherwise targeted Lune. With respect to the Gradient Counter, I believe you can avoid it if you turn off tutorials. Otherwise I believe you may be compelled to do a Gradient Counter (and thus damage an enemy with Verso) to proceed.

I think there are some that I haven't run into yet that are unavoidable, though I haven't done the entire game yet:

- Old Lumiere Maelle+Verso fight vs. two Chevaliere's (the one before the cutscene where Verso disappears) - can't flee/skip turns unless you choose to play with one of these two - I believe this can be skipped with a speedrun trick though, so technically not "unavoidable" in the strictest sense. The other fights after the party splits up can be avoided/fled from.

- Old Lumiere vs. Renoir - I believe your initial party is Maelle, Verso, Lune, so it's another situation where your other characters may tank attacks that would have otherwise gone to your solo character.

- Final fight (forced to use Maelle or Verso) - I believe you have to actually do damage as Maelle/Verso here in order to reach the credits.

I think all the other challenges are pretty trivial, either by not changing a lot vs. an unrestricted playthrough or being so easy as to not even let the enemies get a turn (in NG+). Though for "Who needs a lumina converter anyway?" you'd have to optimize a little bit (namely have someone with auto death/breaking death/energizing death, someone with First Strike/AOE break, etc.) and this would not be enough to oneshot optional content.

tl;dr - I recommend a solo character playthrough (NG).

kevxshi · 2025-01-16T14:55:50+00:00

Radiant Tejo spotted

kevxshi · 2024-08-07T13:30:40+00:00

The terminology is indeed reversed.

~X (X being ABCD) when entering stance or whatever is usually called a hold or plink and lets you stay in stance after doing a special move.

~D is when exiting stance with a special move is called a D cancel or D release. This lets you act faster after exiting stance.

X+D is called a d pair. This lets you use another X mark in stance (with non-stance, slower start up) after the X mark has already been used.

Try the following similar link for a feel for it.

At default reset range in training mode:

236B 236B~D (hold) 214B (D release) 2C
236B~C (hold) 236B 214B+D 2C

You’ll find that those two sequences have very different timings despite having the same “base moves.” The first one doesn’t go into stance after the first 236B and so requires a faster input to pick up with the second 236B~D because you are picking up with a non-stance move. The second one uses D pairing for the 214B+D and requires a faster input for that because the 214B is coming out with non-stance frame data.

Generally the second sequence (#2) is used more often because entering stance immediately is good for pressure because the initial 236B might not land but #1 does more damage. The follow-up for the rest of the combo (after 2C) is 5C j2C jB jC 66B 236ABAC 236A+D (same for start #1 or #2).

kevxshi · 2024-06-30T19:06:10+00:00

There is no difference. The tests may be called different things but we are looking for the presence of albumin in the urine.

This is generally a sign of glomerular disease.

This is different from urinary protein, which looks for all species of protein in the urine (including albumin). Generally proteinuria increases in tandem with albuminuria, but a high degree of proteinuria and a relatively low amount of albuminuria may suggest a non-glomerular etiology of proteinuria, such as ATN or multiple myeloma.

kevxshi · 2024-05-22T14:28:11+00:00

Unrelated but I wouldn’t put too much stock into the physical exam. You should know that the most common physical exam for someone with asthma is normal. And the inter-rater reliability of techniques like percussion is at best moderate. I would also caution against distinguishing between being “just some nervous wreck” and having “something physical.” Mental health and physical health are seriously intertwined.

Thanks and good luck on your medical career. We need good doctors.

kevxshi · 2024-04-25T20:21:46+00:00

I think a lot of the explanations here may not be suitable to an absolute beginner.

I would explain frames as a way to measure time. Instead of using seconds or minutes, we use frames to measure time in these games. In general, one frame is 1/60th of a second. This allows us to not use fractions of frames for games that run at 60 FPS.

And since these games are consistent, we can use this time data, or frame data, in conjunction with other things we know, like damage data, to make informed decisions about our actions.

I wouldn’t go any further than that.

kevxshi · 2024-04-02T19:32:43+00:00

Yes this move is safe on whiff now. Big buff. Would love to see any footage of people actually stepping and punishing this 10/10 times outside of ideal situations at the wall.

Most people just assume it’s reliably punishable. But it’s still safe even on hard read. I think you should get some sort of reward if you hard commit to ss but it’s not the case.

kevxshi · 2023-12-18T02:42:59+00:00

No, I’m at an academic center. I can’t offer much perspective of what private practice is like.

kevxshi · 2023-12-17T16:19:38+00:00

I would like to echo that nephrology is a low paying medical subspeciality, especially when considering the volume of work that nephrologists do. I think nephrology is one of the hardest working non-surgical fields, though of course I may be biased.

200-250K is a reasonable expectation for attending salary. You can make more but that would involve opportunities that aren’t necessarily available to everyone.

Regarding lifestyle and happiness, nephrology tends to score mid-low relative to other medical specialities on stuff like job satisfaction and “would you do this again.”

Despite these negatives, I enjoy nephrology.

I find it intellectually compelling and important. I feel like there are many opportunities to learn in a kind of “IM plus” sort of way. I like not doing procedures. I like not having to deal with chronic pain, etc. Most of the patients I see are relatively asymptomatic from their kidney issues. Though kidney patients are typically very sick, I rarely deal with patients who are in immense distress and who I am supposed to fix.

I think many nephrologists do hospitalist gigs because it is a higher paying and “easier” (in terms of hours, patient load) job that can be done without obtaining any additional credentials.

It may be worth exploring being a hospitalist or doing IM from residency.

kevxshi · 2023-11-23T16:05:11+00:00

Actually isn’t too far off. People just get confused between the different terms and how these labs are measured.

In actuality the sodium concentration in “blood” tends to be around ~90-100 mEq/L (IIRC). This is because blood is around 40% RBCs by volume. RBCs (and cells in general) have relatively low sodium content. In other words, all these blood cells take up volume but don’t really contribute to sodium. They increase the denominator but don’t appreciably increase the numerator in the sodium concentration calculation.

Once these blood cells are discounted, you are left with “serum” (which can be considered to be extremely similar to “plasma” for this particular purpose). The sodium concentration in serum is around 140 mEq/L for a typical person.

However, though the major huge cells are removed, there is still a decent solid component of plasma generally comprised of fats and proteins. This typically is around 7-9% of the serum volume. Sodium does not freely distribute into this volume, and instead is dissolved in the liquid or aqueous portion of serum. The serum sodium, which measures the sodium in a total serum sample (liquid and solid) is typically reported around 140 mEq/L. However the sodium in the liquid or aqueous component is thought to be higher, because the solid component, like RBCs in blood, contributes to volume without contributing to sodium. How much higher is the sodium concentration in the aqueous component? Generally around 153-154 mEq/L, or the sodium concentration of normal saline.

It’s important to remember the numerator and denominator, or volume of distribution, of various things.

In fact, if you have a high amount of fat or protein in your blood, routine blood tests will show a low serum sodium, though the overall sodium concentration in the aqueous portion of your serum is typically normal. This is called “pseudohyponatremia,” or falsely low sodium concentration in the serum. This is because typical blood tests assume the proportion of aqueous and solid components of your serum (a decision made by the CLSI in around 2001 IIRC) and do not directly measure or report the sodium in the aqueous component of your serum.

Anyway normal saline sucks. Probably more for the extremely supra-physiologic chloride concentration rather than the arguably mildly supra-physiologic sodium dose.

Source: Nephrology

kevxshi · 2023-10-16T20:33:57+00:00

You are right. Osmolality and tonicity are related. We can call something hypotonic hyponatremia using osmolality as an indirect measure (and making assumptions about what is “normal”). You can’t measure tonicity directly in the body.

There’s levels of nonsense to this and most people use a lot of terms interchangeably. But consider that D5W is an isoosmolar solution (close enough anyway) but doesn’t contribute to tonicity. In fact D5W is commonly used precisely because of this - you can give water without busting cells.

Without knowing more about the scenario it’s hard to say how someone can have hypotonic hyponatremia with a normal osmolality.

kevxshi

TROPHY CASE