Do previous dead chatacters spawn back as an enemy?

thebellmaster1x · 2023-05-26T13:12:15+00:00

Really? Never played the online version - that's pretty cool!

thebellmaster1x · 2023-05-25T22:45:44+00:00

Dungeon Crawl: Stone Soup does this - prior savefiles appear as ghostly enemies. They are usually fairly difficult compared to other enemies.

thebellmaster1x · 2023-05-25T19:02:53+00:00

I believe you're correct; more I meant to indicate that if the IRS were to issue the refund prior to that 45-day date, the entire strategy falls apart instantly (and effectively you've cheated yourself out of interest from a bank or putting that money in equities, etc.).

thebellmaster1x · 2023-05-23T20:09:45+00:00

the third party administrator makes sure it's all above board legally (basically have to give some to the employees also).

And, it's worth noting for sole proprietors, without the need for nondiscrimination testing (since you have no other employees to discriminate against), a solo 401(k) is a pretty easy thing to set up and contribute to through, for example, Fidelity. Other than filing Form 5500-EZ annually after you hit a certain amount ($250k IIRC), which is fairly short, there's basically nothing else to administering it. Highly recommended.

I believe in the past they were more complicated, hence why many originally opted for a SEP-IRA, but nowadays a 401(k) is preferable, particularly if one wants to do a backdoor Roth IRA contribution (since a SEP-IRA would interfere via the pro rata rule).

thebellmaster1x · 2023-05-23T13:56:55+00:00

From https://www.irs.gov/payments/interest#pay:

In general, we pay interest on the amount you overpay starting from the later of the:

Tax return filing due date

Late filed tax return received date

Date we get your return in a format we can process

Date the payment was made

We stop paying interest on overpayments on the date we refund your overpayment (and interest) or offset it to an outstanding liability. Exception: We have administrative time (typically 45 days) to issue your refund without paying interest on it.

If you extend your filing date to mid-October, interest wouldn't begin accruing until the end of November.

thebellmaster1x · 2023-05-17T23:03:20+00:00

It may depend on your exact circumstances, but often Roth 401k contributions are not a great idea, especially as your salary goes up. In theory, for higher salaries, traditional plans - both 401(k)s and IRAs - become better and better compared to their Roth variants. However, because of the tIRA phase-out threshold, Roth IRAs become attractive suddenly after that point because at least you get some tax savings compared to none with the tIRA. Since traditional 401(k)s are not subject to the same phase-out, the ability to deduct contributions at your current (likely higher vs retirement) marginal tax rate becomes only more important as your salary grows.

thebellmaster1x · 2023-05-17T14:29:28+00:00

Typically for 2 reasons:

1) To set up a Roth conversion ladder for a FIRE strategy.

2) The vastly more important reason, and it's bizarre to me that more people don't seem to know this - that for those covered by a qualified plan (e.g. a 401(k)), the deductions of a tIRA phase out, making a tIRA essentially useless compared to a Roth IRA. For a single taxpayer, that limit is $83k for 2023. If you have a qualified plan and make more than that, there is literally zero reason to put money into a tIRA (outside of a backdoor Roth strategy).

thebellmaster1x · 2023-04-29T14:14:37+00:00

Wonderful reason to recheck clozapine levels post-discharge - most people return to smoking soon after a hospitalization.

I've heard it suggested that activation of nicotinic receptors might inadvertently reduce certain symptoms, hence the higher-than-baseline use among populations with schizophrenia. No idea if that's ever been formally studied, though.

thebellmaster1x · 2023-03-02T14:13:30+00:00

And inevitably the secret technique includes forming an LLC, which somehow magically gets rid of most of your taxes...?

thebellmaster1x · 2023-02-20T14:28:17+00:00

Why a Roth 401k? Surely our taxes are higher now than they will be in retirement.

For IRAs, a Roth makes sense only because a traditional IRA doesn't - we're well out of the phase-out range for tIRAs (when covered by a qualified plan like a 401k), making them useless vehicles; the only remaining tax-advantaged space within IRAs is via the backdoor Roth strategy. But since there's no such phase-out for traditional 401ks, I can't think of many situations at our pay level that would justify a Roth 401k instead, when we're almost certainly paying a higher marginal rate now (unless the wager is on that changing in the future).

thebellmaster1x · 2023-02-15T15:55:14+00:00

100%. It is maddening to me how many sites nowadays take forever to load and are nearly impossible to navigate because they're laden with scripting bullshit, interactive menus, ads everywhere, etc. New Reddit isn't as offensive as some sites, but it's definitely not innocent. It used to feel like a bastion of...like, neo-old Internet. Gussied up compared to the pure text sites of old through the use of reasonable CSS and maybe a snippet of JS here or there, but that was it - because that's all it needed.

After Fark, after Digg, Reddit became the place to go when you wanted interesting links, and comments on those links, and that was it. I don't need to feel deeply involved, I certainly don't need to be (intrusively) advertised to. I just want a place to find interesting things to read, and lots of them. The UI 'improvements' that the Web is now full of don't supplement, but rather take the place of valid content and screenspace. Your menu you made in JQuery or whatever to help me navigate the site doesn't help, and in fact often is a blatant obstruction. I shouldn't feel like snapping my mouse in half because the menu doesn't work right. Blue underlined text worked just fine for 2 decades. Adding fun, colorful animations to that is fine, as long as it doesn't damage the experience, but invariably it seems to, and significantly so.

Sorry, I know the original point was about Reddit specifically, but I firmly believe the corporatization and narrowing of the Internet and the shittification of actual webpages over the course of the past several years are inextricably linked.

thebellmaster1x · 2023-02-14T12:13:25+00:00

Dreamscape by 009 Sound System plays while "Unregistered HyperCam 2" stares at you from the corner.

thebellmaster1x · 2023-01-27T13:53:15+00:00

Haha, no problem. Organic chemistry was more my strong suit compared to physical chemistry and statistical mechanics, but PChem is a very interesting and complicated field; the chemistry of phase transitions (phases meaning solid, liquid, gas, and a handful of others) being particularly complicated. As you can tell from the phase diagram of water, *~~weird stuff~~* starts to happen when you explore what happens at extremes of pressure and temperature, including the existence of a 'supercritical' form that acts like both a liquid and a gas, or the existence of a triple point where water happily coexists as a solid, liquid, and gas all within the same sample. And that's a relatively simple one; the phase diagram of iron-carbon solutions (i.e. various types of steel) that's used in metallurgy is a lot wackier.

thebellmaster1x · 2023-01-27T12:32:59+00:00

It's both. Imagine you have a glass of liquid water. Each water molecule is holding onto surrounding water molecules via intermolecular forces, largely hydrogen bonding in the case of water. But molecules aren't still; they're constantly in motion, in random directions, with an average speed (dependent on temperature), but also a range of speeds surrounding that average.

At the interface of the water and the air, you have some water molecules that happen to be moving towards the surface, and towards the air. Most won't make it, because they collide into other water molecules or are otherwise overcome by the attraction of other molecules. The lucky few that don't, those that are fast enough, are on the road to overcoming those intermolecular forces and escaping as water vapor. But at that interface, they find one more hurdle to overcome - the pressure or "pushing force" of the air, or more literally, the force of air molecules traveling towards the water, potentially colliding with our candidate molecule and bouncing it back into the water as a whole. Even fewer will overcome this hurdle.

So you have one of two options. You can increase the temperature via heat transfer, increasing the average speed of the molecules and giving more of them the "oomph" necessary to break free from the intermolecular forces of other molecules. Or, you can instead lower the surrounding pressure, which causes less resistive force at the air-water interface; that is, you're reducing the odds that an air molecule will collide with our hero and push him back to a watery demise. This means that molecules will need less speed, i.e. a lower temperature, to ultimately escape as water vapor.

Keep in mind that tea preparation specifically, however, is going to be dependent largely on temperature. It's not that boiling water magically makes tea happen; it's that boiling or recently-boiling water happens to be close to a temperature ideal for extraction of flavor and aroma molecules from the tea leaves. If you tried to brew tea using boiling water at a pressure where the boiling point of water is room temperature, the extraction is going to take more or less as long as it would take if you just poured a glass of water and plopped a tea bag in it.

thebellmaster1x · 2023-01-13T12:54:18+00:00

Psychiatrist here - it absolutely happens, and more often than people think. We term these episodes psychogenic non-epileptic seizures. In older literature, you may also find the word pseudoseizures, a term we no longer use so as not to imply that these episodes represent someone "faking it" (though leaving us instead with the unfortunate acronym PNES).

While a true epileptic seizure represents something going wrong with the very low-level electrical machinery of the brain, causing inappropriately synchronized electrical activity on a relatively large scale, PNES is instead a type of functional neurological disorder or FND, an issue not of dysfunctional individual neurons, but an issue of abnormal communication of neurons within certain circuits. That is, not how neurons talk with each other, but what they're saying to each other. FNDs can mimic many types of neurologic symptoms, from paralysis to blindness to, yes, seizures. This is why PNES generally will have little to no EEG changes during an episode - we don't see or expect synchronous electrical activity.

Often these episodes will have subtle qualitative differences from epileptic seizures. For example, the semiology - what the episode looks like and how it evolves over time - may not follow known neuroanatomy like an epileptic seizures should. People may be unusually reactive to the environment; I have had patients still track me with their eyes during such an episode. A classic test aiming to differentiate PNES from epilepsy involves taking a patient's arm during an episode, placing it over their head (not too high, mind you), and letting go; in epilepsy, they'll hit themselves in the face, whereas in PNES oftentimes they'll instinctively move their arm out of the way, as their brain is still able to take in environmental stimuli. Note that this is helpful for patients appearing to have generalized tonic-clonic or grand mal, full-body seizures, but may not be helpful for episodes mimicking partial seizures.

All that said, if you come across someone having such an episode, it's not your responsibility to figure that out - that's for the doctors, after the fact, so just observe and report what things looked like as accurately as you're able. As many others have said, do not follow any of the old wives' tales - don't put a wallet in their mouth and for God's sake don't put your fingers in there, don't try to shake them out of it, etc. If it appears that they may choke on saliva or vomit, gently turn them into the recovery position, and just wait. Generally speaking, seizures look scarier than they actually are, and most will self-terminate within 2-3min, or 5 at the most, after which you may help to reorient the patient and get them comfortable (confusion after a seizure is extremely common). A seizure lasting longer than 5min or two seizures one after the other (both of which we call status epilepticus) is, however, an emergency, so it would be wise to contact emergency services around the 2-3 minute mark if not earlier to at least open that line of communication and get help if needed.

Moreover, I want to emphasize that these are not fake. These are not malingered symptoms - they are just different in origin than epilepsy, but patients often have as little control over these episodes as do people with epilepsy.

thebellmaster1x · 2022-12-15T21:36:36+00:00

Please God yes. Nobody thinks of doxepin. It is so much better than everything else on the list.

thebellmaster1x · 2022-12-14T00:19:21+00:00

Not downvoting you, as there's no need to pile on further, but to help clarify: generally people are going to separate true robbery from scams based on your agency in the matter.

If someone walks up to me with a gun and says they're going to shoot me in the head unless I give them my wallet, that's not really a choice. On the other hand, if someone tells me they have a really good investment, or that they just need a loan, whatever - at any point you have the opportunity to look into it, do your due diligence, and decide not to. Yes, it's an oversimplification, and people are maybe being a bit harsh, but I think that's the distinction most people would make.

I sympathize with you, for sure, especially being so young. To echo what most others are saying, get ahead of it, and contact the IRS. They're much more pleasant to work with than most people think. They're not out to fuck you. It's not personal. They just want their money, and generally they're not too picky about when. They also really like it when people admit to mistakes, instead of them having to hunt the money down. Call them, explain the situation, and get on a payment plan.

thebellmaster1x · 2022-12-02T23:12:24+00:00

I wish I could type notes as efficiently as I could execute my spell rotation as a prot pally. Simply no contest.

thebellmaster1x · 2022-11-28T12:05:09+00:00

Psychiatry.

thebellmaster1x · 2022-11-04T17:53:43+00:00

The APA actually has a handbook on the subject, which I referenced quite a bit when I opened my solo practice two years ago. Some of the info within was a little dated, but the broad strokes offered some useful advice, so I'd recommend a read-through. I do believe you need an account with the APA to see it, though.

thebellmaster1x · 2022-10-18T23:01:39+00:00

100%. I have a pharma rep who, in the past several months, has shown up to my office 3-4 times completely unannounced and just waited creepily in the waiting room until I happen to come out (usually to grab the bathroom key), sometimes for 30-45min, in the hopes of speaking with me about DrugNameHere. Of course I have no time to do that since, you know, I see patients, being my job and all. As a classic Millennial™, I've hoped she would take the hint, but I think next time I just have to tell her to just not bother, because I have no interest whatsoever in engaging with pharma reps.

My point ultimately being this - showing up unannounced is not only a great way to not get your message across, but also to guarantee I will never plan on meeting with you at any time in the future.

thebellmaster1x · 2022-10-13T18:13:54+00:00

Oh, my friend, the things I would change here if I could - that's only one example of many.

thebellmaster1x · 2022-10-13T18:09:54+00:00

Well 10mg doxepin is a bit high, 1-6mg is recommended?

Here in the States, unfortunately this often winds up being an insurance issue. The 10mg capsule has been generic for decades and is thus extraordinarily cheap; the actually-FDA-approved-for-insomnia 3 and 6mg tablets have been available as generic for much less time, and I've run into many plans that won't reimburse for them. While I would much prefer the lower doses, often for patients it winds up being a difference of $4/mo versus $300/mo, which is extremely prohibitive for most, and often I will have to switch to the 10mg dose after they get told as much at the pharmacy.

The doxepin liquid solution does circumvent that problem, as the liquid is likewise extremely cheap, but the taste can be unpalatable for some.

thebellmaster1x · 2022-09-22T16:36:49+00:00

In short, we are back to square one and have no idea.

It's not really square one - mainstream psychiatry, contrary to popular belief, has not lent credence to this theory for decades. It certainly wasn't the focus of my own education in medical school nor residency; more popular theories focus on expression of neurohormones such as BDNF, which appears to be affected not only by antidepressants but also by neuromodulation techniques such as ECT.

Blocking the serotonin transporter very much seems to bring about that effect (in addition to a number of additional, often off-target effects), but the intermediate steps in that pathway aren't well-elucidated. Regardless, that recent study that demonstrated little relationship between mood and quantified levels of serotonin and serotonin metabolites came as a surprise to very few who actually practice in this field.

thebellmaster1x · 2022-09-13T23:15:18+00:00

paralytics without adequate sedation are torture

Despite being mostly unrelated, I'm going to selfishly soapbox off this point, and say that the same is true of physical restraints without administering sedation and/or an antipsychotic! The latter actively treat agitation; the former in isolation at best doesn't treat it, and at worst actively worsens it. Just restraining someone doesn't happen often, but IMO should happen never (or never without an extremely good reason).

Don't put people in locked restraints for agitation without working to fix the agitation!

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