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The movie is obviously technical garbage but one thing it did well was capture that early hacker counterculture spirit. I think a lot of us can appreciate that for the warm blanket it is and forgive its technical accuracy and story flaws.


It's not really even technical garbage. From many throwaway lines it's clear that the writers actually knew their stuff. They just chose to not make a hacking movie based on realism (because boring) but based on the zeitgeist, the computer tropes of the 80s and early 90s, and the concept of "cyberspace" as envisioned by Gibson and made its way to the collective consciousness. In a time when virtual reality and 3D graphics were at peak cool, yet most people had no experience with computer networks, or even computers at all.

"Cyberspace […] A graphic representation of data abstracted from the banks of every computer in the human system. Unthinkable complexity. Lines of light ranged in the nonspace of the mind, clusters and constellations of data. Like city lights, receding." – Neuromancer


Good point. By 'technical garbage' I largely meant the dated visualizations it associated with all the hacking scenes (the rapid hacking speed I can forgive for the sake of story) but TBH I never fully made the connection between 'the gibson' and william gibson -- I kind of like the idea of the hacking scenes as an exploration to gibson's ideas around cyberspace.


It's surprisingly accurate in terms of how weird and cringy the 90s / early 00s hacker culture was, I too was obsessed with the movie and it led me to obscure irc channels, e-zines and eventually a whole career in tech


I find this and Starship Troopers to fit in a similar niche for me. When I first saw them I found them very cringey, horrible, couldn't stand it. Hackers for the reasons being discussed here. ST because of how bastardized it was from the source material.

But over time I grew to love both of them. In both cases I started to appreciate how they weren't trying to be faithful representations, but rather capture a particular ethos in a cheesy & over the top way. And both of them I think hit their mark well in that regard.


What is it with people feeling compelled to talk about starship troopers movie being different (lesser) than the book?

Like, there's not that much to the book. It's a decently written "joins the military" story with a couple of well developed characters and one unique idea about sci-fi warfare (the suits spending most of their time jumping, which in retrospect would just make you a giant target...)

None of this is bad, it's just like, there's dozens of other mil-sci-fi books and yet everyone has to jump in and go "but the book is better!!!"


I don’t believe I said the book was better. You misunderstood my point


Most people don’t want to admit that the author of the book wants you to take the book and movie at face value and thus the film/book are unironically right wing coded.

A lot of liberals don’t want to admit that.

Similarly, “they live” might have tried to pretend to be liberal coded and that might be the directors intention, but it’s schizo /pol/ right wing coded too in practice. After the Epstein stuff, we need reparations for /pol/ schizos.


Heinlein's political views are not exactly a secret among people who care for his books.


Bastardized? It's satire and not at all subtle about it. You can of course argue that it's poorly executed satire, but judging it based on how faithful it is to the source material is rather missing the point.


I think you're the one who missed the point, as in you missed *my* point.

When I first saw Starship Troopers, I disliked it because it wasn't faithful to the book. Over time I came to appreciate it for what it actually was, and now think it is fantastic.

Likewise, with Hackers I initially disliked it due to how inaccurate and unrealistic it was. I came to appreciate it for what it actually was over time, and now think it is fantastic.


Yeah, my bad. For some reason I read your comment really carelessly.


  > I think you're the one who missed the point
Yes, I would like to know more ..


Ha, caught that reference. That brought back memories.


I'm doing my part!


Starship Troopers is actually nothing like Hackers? Verhoeven's Troopers is a straight-up satire of the USA's industrial-military complex.


> I think a lot of us can appreciate that for the warm blanket it is and forgive its technical accuracy and story flaws.

This is how I feel about it too. I've watched it a good 8-10 times over the decades and enjoy it every time.


I noticed my eyes started automatically skimming right after that paragraph. It's funny my brain has learned to calibrate its reading effort in response to how much perceived effort went into writing it.


Health metrics are absolutely tarnished by a lack of proper context. Unsurprisingly, it turns out that you can't reliably take a concept as broad as health and reduce it to a number. We see the same arguments over and over with body fat percentages, vo2 max estimates, BMI, lactate thresholds, resting heart rate, HRV, and more. These are all useful metrics, but it's important to consider them in the proper context that each of them deserve.

This article gave an LLM a bunch of health metrics and then asked it to reduce it to a single score, didn't tell us any of the actual metric values, and then compared that to a doctor's opinion. Why anyone would expect these to align is beyond my understanding.

The most obvious thing that jumps out to me is that I've noticed doctors generally, for better or worse, consider "health" much differently than the fitness community does. It's different toolsets and different goals. If this person's VO2 max estimate was under 30, that's objectively a poor VO2 max by most standards, and an LLM trained on the internet's entire repository of fitness discussion is likely going to give this person a bad score in terms of cardio fitness. But a doctor who sees a person come in who isn't complaining about anything in particular, moves around fine, doesn't have risk factors like age or family history, and has good metrics on a blood test is probably going to say they're in fine cardio health regardless of what their wearable says.

I'd go so far to say this is probably the case for most people. Your average person is in really poor fitness-shape but just fine health-shape.


Many of those metrics are population or sampling measures and are confounded by many factors at an individual level. The most notorious of which is BMI; it is practically a category error to infer someone's health or risk by individual BMI, and yet doing so remains widespread amongst people that are supposed to know better.

Instrumentation and testing become primarily useful at an individual level to explain or investigate someone's disease or disorder, or to screen for major risk factors, and the hazards and consequences of unnecessary testing outweigh the benefits in all but a few cases. For which your GP and/or government will (or should) routinely screen those at actual risk, which is why I pooped in a jar last week and mailed it.

An athlete chasing an ever-better VO2max or FTP hasn't necessarily got it wrong, however. We can say something like, "Bjorn Daehlie’s results are explained by extraordinary VO2max", with an implication that you should go get results some other way because you're not a five-sigma outlier. But at the pointy end of elite sport, there's a clear correlation between marginal improvement of certain measures and competitive outcomes, and if you don't think the difference of 0.01sec between first and third matters then you've never stood on a podium. Or worse, next to one. When mistakes are made and performance deteriorates, it's often due to chasing the wrong metric(s) for the athlete at hand, generally a failure of coaching.


> The most notorious of which is BMI; it is practically a category error to infer someone's health or risk by individual BMI, and yet doing so remains widespread amongst people that are supposed to know better.

BMI works fine for people who aren't very muscular, which is the great majority of people. Waist to height ratio might be more informative for people with higher muscle mass.


As a person who has been told I'm "morbidly obese" for decades now, I will say that doctors at almost every level look at your chart not you. I've been told time and time again that until I get my weight under control, my health will suffer.

I'm 5'8" and weigh on average 210lbs. My BMI isn't even morbidly obese, it is 31, which is just "regular" obese, but on top of that, a DEXA scan shows that I am actually only 25% body fat, with only 1lb of visceral fat.

Doctor's don't care about that, they see on the Epic chart that my BMI is > 30 and have to tell me some spiel about a healthier lifestyle so they check check off a checkbox and continue to the next screen.


I'd consider 5'8 and 210lbs morbidly obese. An average male at 5'8 should generally weigh about 150lbs and no more than 164lbs.


> I'd consider 5'8 and 210lbs morbidly obese. An average male at 5'8 should generally weigh about 150lbs and no more than 164lbs

You would consider incorrectly then.

This person has ~155 pounds of lean body mass. 164 would put him at roughly a body builder level of fat, which basically requires a part time job in cooking and nutrition to maintain.

For reference, I’m in a similar situation to this person. I’m 5’11” (180cm) and about 200 lbs (91kg) with about 170 lbs of lean body mass. My dexa scan says that I’m 15% body fat, but I get the same lectures from doctors about being obese and needing a lifestyle change, all based on BMI and (I assume) my size (I’m barrel chested). It’s completely absurd.


Dexas are notoriously inaccurate. Your dexa scan is probably wrong, and you are fatter than you think. I've been lifting over a decade, so I have far more muscle mass than the average person, and I am 6'1", yet am still easily over 20% BF if I'm 200 lbs or more. Don't believe me? Try to get truly shredded. You'll see for yourself that you will have to lose far more weight than you think. Everyone is fatter and less muscular than they think they are, even if they're active. Unless of course you are a heavy steroid user, in which case you may actually be muscular enough for that to be valid. But for the average natural trainee? Nobody who's truly lean is getting an obese or morbidly obese BMI. Overweight at worst, maybe.

BMI is definitely inaccurate for those with greater amounts of muscle mass, but not as inaccurate as many would like to believe.


I didn’t want to belabor the point in my original post, but since you went there…

The next steps at the doctor is that I show them my MyFitnessPal nutrition tracking, my dexascan, and (at some point) take off my shirt. I ask them what exactly it is I should change. 100% of the time the answer has been something like “Oh, sorry. Please continue as you are doing.”

They just aren’t used to seeing muscular 200 pound dudes at my height in my area at my age (btw, I’m in my 50s).

Also, someone can workout in the gym all they want, but I think most people will struggle with lowering their body fat percentage if they don’t focus on their nutrition.

I realize that my lean body mass (both bones and muscle) are decreasing, and that rate of decrease be higher each year. That said, I’m doing what I can to maintain whatever muscle and bone mass I have.


If I got rid of all of my fat and bones, I'd still weigh more than 150lbs. I have the most muscular 150lbs man inside of me.

Ideal body fat percentage is 18-24% - I'm at 25% (or was in November - might be +/- 2% since then - gained a few pounds weight, but not waist size).

So I would say I'm not morbidly obese or even regular obese based on the percentage of my body that is muscle vs fat.


You are fat, though. For a man, the ideal fat percentage is 15-20%. 20+%, let alone 25%, is not healthy at all.


Or that guy could be a burly bricklacker / concerete worker who can casually carry hundreds of pounds of weight all day every day in brutal conditions.

It's really hard to tell with the data provided.


burly - maybe, but I haven't done any hard labor most of my life. I ran track as a kid, and kept my high metabolism - (RMR: 2460kcal, TDEE: 3380kcal); well lost it when my thyroid failed, but medicated myself back to it. I eat what I want, but its a very high lean-meat diet (lots of chicken breast and turkey because my wife likes them), but I don't limit my carb intake either, as I mostly burn sugar for energy (according to my Respiratory Exchange Ratio).

Somehow my body is just amazing at working without any help from me. I don't even exercise much. Maybe a few pushups a day, up and down my stairs at my house a couple dozen times a day, and probably 5-10k steps a day max.


Huh. The standard in your case is to measure waist circumference if BMI is high. Did no doctor do that? As long as you are below 40” or 37” if Asian you are considered good to go.


None ever did.

On top of that, I'm not sure if that is a real indication of anything, either.

The reason to do that is to get an idea of your abdominal fat (which is the more dangerous place for fat to store), but there are two types of abdominal fat, one is dangerous (visceral fat) and one is completely benign (subcutaneous fat). And a measurement around your waist won't tell you which you have.

I personally have almost all of my fat subcutaneous, with only 1lb of visceral fat (which is right in the perfect range).


> Doctor's don't care about that

Literally all of them?


When humans talk, they use generalizations (and don't need to annouce them). Here it means that most doctors don't care about that.

Follow that rule next time you read such a statement in a context that's not formal math.


> most

That is not even true. We are talking anecdotal evidence here.


Yes, humans have found that you don't need officially stamped statistics (and in many cases they're unreliable or "doctored" anyway), and that they can make general observations on their own, through something they call experience.

And a near universal experience with doctors for anybody paying attention is that.

One can reject it or accept it and improve upon it after checking its predictive power, or they can pause their thinking and wait for some authority to give them the official numbers on that.


> When humans talk, they use generalizations

All humans?

Sorry :)


Well, when humans talk, they use generalizations, which applies recursively to this statement :)

Though, on second thought: yes, all humans, and not merely as a generalization. 100% of humans do it.


I can't say literally all, but in my experience with having to get a new GP almost every year because of health insurance changes, location changes, hospital consolidation buying my GPs practice, and multiple doctors retiring or just quitting medicine (my last GP was tired of medicine after practicing for only 3 years). Over the last 20 years, I've had almost 15 GPs across 5 states (NY, NJ, CT, TX, LA). I also have multiple auto immune diseases, so I have had a handful of specialists of various flavors (endocrine, oncology - not for cancer, cardiology, and urology), but only need them occasionally.

Almost every single start of every single appointment (including a follow up from just a couple days prior), they comment about my BMI. It is the rare time they don't that I remember. My last urology appointment the doctor was very congenial, didn't even go over the lab work, just said, everything is looking good, asked how I was feeling, everything good, alright, refilled my prescriptions and left.


I mean those stats arent good...


No. BMI does not work as a diagnostic measure for general population. The range of "normal" BMI values does depend at least on genetic lineage, gender and individual development history. Fine to compare two scandinavian lineage men, but if you compare e.g. a dutch man with an african woman oh boy, you error margins would be mid-to-high single digit units

> Waist to height ratio

Again, while not a bad metric per se, translates poorly between cohorts.


My understanding is that it doesnt even do that, because it creates false negatives for the so called skinny fat body type: significant visceral fat mass, which is what we are concerned about, but not much muscle or peripheral fat mass, thereby not being flagged by BMI screens, even though they are at risk.


> BMI works fine

An individual learns nothing from its calculation and it has no clinical value. I receive more constructive feedback from an auntie jabbing me in the chest and saying "you got fat".

> the great majority of people

There is wide morphological variety across human populations, so, no.


I dunno, basing life decisions off a metric that has a fudge factor built into it to make the regression work feels sub-optimal to me.


BMI underestimates in most cases and your body fat is higher then the chart would predict.

When people say "oh BMI isn't accurate" it means you are more overweight then it suggests unless you are literally an extreme body builder.


This underestimation has a name, "Normal Weight Obesity." Known by the slang "hot guy/girl fit" where the person looks like they would be physically fit because they're skinny but there's no muscle under there.


> But a doctor who sees a person come in who isn't complaining about anything in particular, moves around fine, doesn't have risk factors like age or family history, and has good metrics on a blood test is probably going to say they're in fine cardio health regardless of what their wearable says.

This is true of many metrics and even lab results. Good doctors will counsel you and tell you that the lab results are just one metric and one input. The body acclimates to its current conditions over time, and quite often achieves homeostasis.

My grandma was living for years with an SpO2 in the 90-95% range as measured by pulse oximetry, but this was just one metric measured with one method. It doesn't mean her blood oxygen was actually repeatedly dropping, it just meant that her body wasn't particularly suited to pulse oximetry.


It doesn't help when doctors are often unaware of outliers affecting the test results. E.g. I've had a number of doctors freak out over my eGFR (kidney function) test results because the default test they use is affected by body mass and diet, and made even worse by e.g. preworkout supplements with creatine. None of my doctors have been aware of this, and I've had to explain it to them.


I've not seen evidence that creatine actually has significant impact on eGFR. Anecdotally, mine does not budge even on 5g a day. Meta-analysis show minimal impact, e.g. https://pmc.ncbi.nlm.nih.gov/articles/PMC12590749/

Muscle mass obviously does, though. cystatin c is a better market if your body composition differs from the "average"


I did end up taking a cystatin c test privately to be able to prove to my GP that the results he freaked out over were nonsense. I'm in the UK, and for whatever reason the NHS just doesn't typically do them for basic kidney function - presumably cost, but they were dirt cheap to do privately so...


NICE guidelines. "Evidence on the specific eGFR equations or ethnicity adjustments seen by the committee was not from UK studies so may not be applicable to UK black, Asian and minority ethnic groups. None of the studies included children and young people. The committee was also concerned about the value of P30 as a measure of accuracy (P30 is the probability that the measured value is within 30% of the true value), the broad range of P30 values found across equations and the relative value or accuracy of ethnicity adjustments to eGFR equations in different ethnic groups. The committee agreed that adding an ethnicity adjustment to eGFR equations for different ethnicities may not be valid or accurate...."

https://www.nice.org.uk/guidance/ng203/chapter/rationale-and...


What does ethnicity has to do with anything?

My creatinine levels are high because my body mass - including muscle mass - is well above average. On the basic kidney tests my GP did, my numbers indicated kidney disease. Doing a Cystatin C test showed very clearly that my numbers were firmly in the normal range.

The page does go on to point out the muscle mass issue:

> The committee highlighted the 2008 recommendation, which states that caution should be used when interpreting eGFR and in adults with extremes of muscle mass and on those who consume protein supplements (this was added to recommendation 1.1.1).

Further down they do mention Cystatin C, and seem to have basically decided that a risk of false positives is acceptable because of a lower risk of false negatives. That part is interesting, and it may well be the right decision at a population level.

But if your muscle mass is sufficiently above average, the regular kidney tests done will flag up possible kidney disease every single damn time you do one, and my experience is that UK doctors are totally oblivious to the fact that this is not necessarily cause for concern for a given patient and will often just assume a problem and it will be up to the patient to educate them.

EDIT: What's worse, actually, is the number of times I've had doctors or nurses try to help me to "game" this test by telling me to e.g. drink more before the test next time, seemingly oblivious that irrespective of precision, making changes to conditions that also invalidates it as a way to track changes in eGFR is not helpful.


I'm not sure what point you're trying to make here. Have I missed somewhere in the discussion where eGFR equation adjustment based on ethnicity has been discussed?

Creatinine is the standard marker used for eGFR. It is also a byproduct of muscle metabolism. People who regularly lift weights or have lifestyles that otherwise result in a higher-than-normal muscularity will almost universally have higher creatinine levels than those who don't, assuming similar baseline kidney function. It's also problematic for people with extremely low muscle mass, for the opposite reason.

It's one of the reasons enhanced bodybuilders can get bit with failing kidney function - they know that their eGFR is going to look worse and worse based on creatinine formulas so they ignore it, when the elevated blood pressure from all the dbol they're popping is killing their kidneys.

Cystatin C is the better option for people with too much (or too little) muscle for creatinine to be accurate.


>I'd go so far to say this is probably the case for most people. Your average person is in really poor fitness-shape but just fine health-shape.

Modern medicine has failed to move into the era of subtlety and small problems and many people suffer as a result. Fitness nerds and general non-scientists fill the gap poorly so we get a ton of guessing and anecdotal evidence and likely a whole lot of bad advice.

Doctors won't say there's a problem until you're SICK and usually pretty late in the process when there's not a lot of room to make improvements.

At the same time, doctors won't do anything if you're 5% off optimal, but they'll happily give you a medicine that improves one symptom that's 50% off optimal that comes along with 10 side effects. Although unless you're dying or have something really straightforward wrong with you, doctors don't do much at all besides giving you a sedative and or a stimulant.

Doctors don't know what to do with small problems because they're barely studied and the people who DO try to do something don't do it scientifically.


A worthwhile book to read on this topic is Outlive by Peter Attia (MD). The core premise is that American healthcare focuses far too much on treating problems after they’re extremely severe. It is would be cheaper and healthier to invest more into conservative & preventative care, trying to prevent or minimize problems early in life before they become incredibly dangerous and expensive/difficult/impossible to treat.

I have a close friend who works in conservative care, and it’s astonishing what they see. For example, someone went to a number of specialists and doctors about a throat condition where they really struggled swallowing. They even had to swallow a radioactive pill to do some kind of imaging. Unnecessary exposure, and an expensive process to go through, and ultimately went exactly nowhere.

Meanwhile, it was a simple musculoskeletal issue which my friend was able to resolve in a single visit with absolutely no risk to the patient.

Medical schools need to stop producing MDs who reach for pills as the first line of defense without trying to root cause issues. Do you really need addictive pain killers, or maybe some PT, exercise, massage, etc. to help resolve your pain.


It’s not medicine. It’s healthcare system. Doctor isn’t paid enough to go thoroughly through the complaint and dig deeper. In Germany you get 5 minutes diagnose and that’s all from health insurance. And this from the better doctor. For normal one diagnose comes from 2 minutes interaction. Believing that the diagnose is right is very naive.


> Doctors won't say there's a problem until you're SICK and usually pretty late in the process when there's not a lot of room to make improvements.

As someone who is fit and active,in their 60s with zero obvious symptoms, but is nonetheless on cholesterol and blood pressure medication, this isn't true (in the UK, at least)


One of the things the NHS does surprisingly well, and is only really possible because it's a completely vertically integrated system, is population-level preventative medicine. Distributing insulin and salbutamol. Screening for various sorts of cancer. Cholesterol and BP checks. Encouraging people to stop smoking.


I think one of the major problems is that biologists/scientists cannot legally treat people. Physicians take their studies and have monopolistic treatment powers over them.

I think this creates a huge knowledge gap.


It’s also cultural. Most American doctors don’t bother to tell people if they are overweight and out of shape. It’s not something their customers reward.


> customers

And there's the problem. That they are "customers" that pay, either direct or via insurance, or via government insurance vs. a nationalized healthcare system, and I mean healthcare not nationalized health insurance


I mean... most people already know, it's not like either of those things come as a surprise to anybody.


Most obese people think "I am a bit on a heavy side, but I am not that fat and definitely not obese".

People are generally in denial about their fat percentage and their muscle mass. Even somewhat healthy people (~20% fat) who are calculating how much they must lose in order to get to a healthy 12-15%, are surprised when the reality shows that they calculations were 5-15kg off.


Most people are wrong about their body type, in the wrong direction (overweight think they aren't that overweight, skinny think they need to lose weight).

Having an objective voice from your doctor giving you annual feedback and suggestions is better than ignoring the topic entirely.


that's gym bro science, there's no compelling health reason to lower your fat percentage to 12-15% and it carries as much risk as being rather obese when accounting for all causes mortality, particularly for women and people getting older


Maybe I'm not getting you right, but IMO it hasn't? I, as a customer/patient, just don't weekly converse with my MD about small issues, and frankly, they have better things to do, for example treating sick people.

Instead I use the health benefits programs of my health care insurer. My insurer has an interest in prevention, so I can get consulting for free (or very low fees), and even kickbacks if I regularly participate in fitness courses and maintain my yearly check-up routine. Now, I live in Germany and it probably is different in other countries, but it just makes economic sense from the insurer's point of view so that I would be surprised if it were very different elsewhere.


>This article gave an LLM a bunch of health metrics and then asked it to reduce it to a single score, didn't tell us any of the actual metric values, and then compared that to a doctor's opinion. Why anyone would expect these to align is beyond my understanding.

This gets to one of LLMs' core weaknesses, they blindly respond to your requests and rarely push back against the premise of it.


I read somewhere that LLM chat apps are optimized to return something useful, not correct or comprehensive (where useful is defined as the user accepts it). I found this explanation to be a useful (ha!) way to explain to friends and family why they need to be skeptical of LLM outputs.


Measuring metrics is easy, it's the algorithm on the backend that matters.

There's a reason why Oura rings are expensive and it's not the hardware - you can get similar stuff for 50€ on Aliexpress.

But none of them predicted my Covid infection days in advance. Oura did.

A device like the Apple Watch that's on you 24/7 is good with TRENDS, not absolute measurements. It can tell you if your heart rate, blood oxygen or something else is more or less than before, statistically. For absolute measurements it's OK, but not exact.

And from that we can make educated guesses on whether a visit to a doctor is necessary.


> But none of them predicted my Covid infection days in advance. Oura did.

It actually warned you, or retrospectively looking at the metrics you could see that there was a pattern in advance of symptoms? (If the latter, same here with my Garmin watch - precipitous HRV decline in the 7 days before symptoms. But no actual warning.)


It actually told me, they've been doing this for a while: https://ouraring.com/blog/early-covid-symptoms/

Of course it didn't tell me "you have COVID19-B variant C" - but it did tell me I'm probably sick and should seek care.


I'm curious how the ring detected it in advance? I also discovered my Covid when I looked at my Garmin watch and my resting heart rate was 100, until then I had thought I had too much sun that day.


Some of the metrics were out of whack, I think my average body temp was up along with my resting heart rate both asleep and awake.

It somehow takes all that and gave me a "you might be sick" notification.


How is that predicting in advance though? Sounds like it measured active symptoms like a change in body temp etc. That's not prediction, that's reaction.


I think it is fair to assume they meant before symptoms? Which, yes, your heart rate is a symptom. No, it isn't one most people consider.


Device detects 0.1 degree average temp increase. I don’t.

Like your car will start with a small noise first, you can’t hear it. But in time the small noise becomes a big noise just before things break.

If you catch it in the small noise part, you can proactively prepare.


On the other hand, if compressing to a single number is not possible, a doctor will just refuse to give a grade in that way. In my experience, most doctors tend to be very careful about trying to avoid saying anything definitive that they're not actually sure of, even if they're reasonably confident, in large part because part of their job involves understanding how patients react to how things are communicated to them. Being willing to confidently give a misleading answer to a bad question is itself as bad thing when it comes to health data because regular people aren't able to (and shouldn't be expected to) figure out what various interferences from health data happen to feasible from a given data set.


>But a doctor who sees a person come in who isn't complaining about anything in particular, moves around fine, doesn't have risk factors like age or family history, and has good metrics on a blood test is probably going to say they're in fine cardio health regardless of what their wearable says.

The standard risk model for CVD based on SCORE-2 and PREVENT like parameters are very poor as reported in the recently published paper on the their accuracy performance by the Swedish team [1]. As all CVD risk stratification with cardiologist review, the most important accuracy is sensivity (avoiding false negative that will escape review) of SCORE-2 and PREVENT, 48% and 26%, respectively.

The paper alternative proposal increased the sensitivity to 58% by performing clustering instead of conventional regression models as practiced in the standard SCORE-2 (Europe) and PREVENT (US).

These type of models including the latest proposal performed very poorly as indicated by their otherwise excellent and intuitive display of graphical abstract results [1].

[1] Risk stratification for cardiovascular disease: a comparative analysis of cluster analysis and traditional prediction models:

https://academic.oup.com/eurjpc/advance-article/doi/10.1093/...


The problem is that the product itself invites the wrong expectation


I agree. Software engineering is basically the only industry that pretends this is professionally acceptable. Imagine if government staff asked when a bridge would be done or how much it would cost and the lead engineer just said "it's impossible to estimate accurately, so we wont. It's a big project tho".

Estimating in software is very hard, but that's not a good reason to give up on getting better at it


Government contractor's estimation is based on what number is politically acceptable, not how much the project would realistically take. 90% of public projects were overbudget [0].

But you're pretty spot on, as 'professionally acceptable' indeed means politically acceptable most of the time. Being honest and admitting one's limit is often unacceptable.

[0]: https://www.strategy-business.com/article/Why-do-large-proje...


Yes, my claim is absolutely not that they're good at it haha.

Estimation is a real problem in a lot of industries, including ours, and I think that's probably common ground here -- I suppose my differing position is that I think the solution is to get better at it, not to refuse to do it.

I've been on projects where I've seen the budget explode and projects where I've seen the budget kept tight and on track. The latter is very hard and requires effort from ALL sides to work, but it's almost always achievable.

I actually empathize a little bit more with megaprojects because generally the larger the budget the harder it will be to keep on track in my experience. Most estimates we're asked to give in our day jobs are not even multi-million dollar estimates.

Also I'm using budget and estimate interchangeably but these are of course different things -- that's one of my nitpicks is that we often treat these as the same thing when we talk about estimating being hard. A lot of individual estimates can be very wrong without affecting the ultimate budget.


Contractor estimates are just as prone to schedule slippage and cost overruns as anything estimated by software engineers. I doubt anyone's ever argued that giving wrong estimates is hard or impossible. Only that approximately correct ones are, and other industries seem to struggle with that just as much as software. Authors don't finish books by deadlines, so fans are left in the cold. Tunnels take twice as long and cost twice as much. Renovations take a year instead of 3 months and empty your bank account.

Saying "I don't know" is arguably more honest, even if it's not useful for budgets or planning.


> Contractor estimates are just as prone to schedule slippage and cost overruns as anything estimated by software engineers

I completely agree. That's why I chose that example: They're also awful at it, especially these days in North America in particular. But any contractor that tried to put in a bid claiming "it'll be done when it's done and cost what it costs" would not be considered professionally competent enough to award a multi-million dollar budget.


The date is just a useful fiction to:

- Create urgency

- Keep scope creep under control

- Prioritize whatever is most valuable and/or can stand on its own

If you just say “I don’t know” and have no target, even if that’s more honest, the project is less likely to ever be shipped at all in any useful form.


Ever heard of Big Dig in Boston, for example? Or the Joint Strike Fighter?

Estimations in government contracts are as ridiculous as in software. They just pretend to be able to estimate when things will be done, when, in fact, the contractors are as clueless.

Not being able to say "it is impossible to estimate", does not mean your estimate will be correct. That estimation is usually a lie.


Not a good analogy. Once you build a bridge, it’s done. Software nowadays is never “done”, and requirements constantly change. It’s more akin to building a rope bridge and trying to upgrade it to accommodate cars while it’s in active use.


Sounds like you don't have a good process for handling scope changes. I should know, the place I'm at now it's lacklustre and it makes the job a lot harder.

Usually management backs off if they have a good understanding of the impact a change will make. I can only give a good estimate of impact if I have a solid grip on the current scope of work and deadlines. I've found management to be super reasonable when they actually understand the cost of a feature change.

When there's clear communication and management decides a change is important to the product then great, we have a clear timeline of scope drift and we can review if our team's ever pulled up on delays.


I feel like some people in this thread are talking about estimates and some are talking about deadlines. Of course we should be able to give estimates. No, they're probably not very accurate. In many industries it makes sense to do whatever necessary to meet the estimate which has become a deadline. While we could do that in software, there often isn't any ramifications of going a bit overtime and producing much more value. Obviously this doesn't apply to all software. Like gamedev, especially before digital distribution.

I think it's obvious that all software teams do some kind of estimates, because it's needed for prioritization. Giving out exact dates as estimates/deadlines is often completely unecessary.


The real problem is software teams being given deadlines without being consulted about any sort of estimates. "This needs to be done in 60 days." Then we begin trading features for time and the customer winds up getting a barely functioning MVP, just so we can say we made the deadline and fix all the problems in phase 2.


OK, so that sounds fine. Software delivers value to customers when it's better than nothing some of the time. Even if it barely functions then they're probably happier with having it than not, and may be willing to fund improvements.


When customers ask when feature X will be ready, they sure have an idea of done in their mind.


Sure, so extract the customer's definition of done as part of requirements analysis process and write it down. Get them to agree in writing, including the explicit exclusion of other things that aren't part of their idea of done.


When the government asks how much project X costs they find ten companies that promise the moon and then deliver a wheel of cheese for five times the estimated cost.


They miss estimates all the time though? It’s an observable fact

There is a bridge in my town that is finally nearing completion, hopefully, this year. It was estimated to be completed 2 years ago.

This changes when it’s a project that has fewer unknowns, where they’ve built the same thing several times before. The same is true in software.


Incorrect analogy. Bridge construction is a clearly algorithmic process. All bridges resemble each other, and from an engineering perspective, designing one is not rocket science. Construction itself is a set of well-studied steps that can be easily calculated. If I were to write my operating system 100 times, I could give an estimate accurate to within 10%, but every task I’ve ever done in life is unique, and I have nothing to compare it to except intuitive judgments. Returning to bridges: there is 1% of projects that are unique, and their design can take decades, while construction might not even begin


Software engineering isn't some magical, special branch of engineering in which no one piece of software resembles another, no well-studied steps can be replicated, and the design of which is equivalent to rocket science.

If you're truly creating such unique and valuable software that it is to be compared to the world's engineering megaprojects in its challenge then perhaps it is beyond being beholden to a budget. Who am I to say?

But 99.9% of this industry isn't doing that and should probably be able to estimate their work.


I’m not talking about difficulty; I’m talking about uniqueness—uniqueness for me personally. There are people who spend their whole lives designing bridges. I, on the other hand, have been writing software for 15 years, and almost every task I encounter is unlike the previous one. I’m not saying it’s difficult, but solving it requires gaining new experience that will be useless for future tasks. Sometimes, I have to do something similar to a previous task, but in 90 percent of cases, I first need to create documentation on how it currently works, figure out how to turn a task description consisting of a 15-word headline into a set of concrete actions, and then test it.


Yes, as someone who is usually flying with my GF, I love this feature! Unfortunately air canada's implementation is abysmal and anytime there is a pilot announcement it interrupts the game long enough to break the network connection and cause it to end the game.


Among endurance athletes collagen supplements have become increasingly popular the past couple years -- from what I understand the evidence is kind of mixed though

e.g. https://thefeed.com/products/pillar-performance-collagen-1?v...


I don't get what's the supposed mechanism of action here. Collagen is a hard to digest protein and it has to get digested to be processed and then it's no longer collagen. Why not just eat any other protein source instead?


Yes, that seems to sort of be the criticism and mixed results. Although not everyone has a complete protein diet so theoretically although it breaks down the idea is you then have all the things you need, should your body choose to use it to build collagen.

But I agree, I'd rather start solving deficiencies at the diet level than the supplement level and haven't integrated collagen personally so far.

TBH I suspect marketing plays a big role. "Collagen = good, therefore just buy it and eat it" makes logical sense if you don't actually do any research first.


Different protein sources have different amino acid compositions and they have different effects on the body.


Still, if you eat enough complete protein sources you'll have all the amino acids you need.


Likely yes, but I've had enough chicken breast for life during my fit 20s. I just don't feel like stuffing myself with tasteless sources of protein anymore and testy ones (burgers, steaks, grilled salmon, etc.) will cause unwanted side effects and risks when consumed in high amounts.


Even bodybuilders and powerlifters admit that 2g protein per kg of body weight is about all you need. You can get that with a normal diet and a couple of protein shakes, which taste fine if you use milk and half a banana. You don't need to eat a whole chicken breast for every meal.

I made spaghetti bolognese last night and it had 60 grams of protein per 800 kcal serve. Admittedly I used lean kangaroo mince, because I'm Australian and it was on sale. Still: three meals like that and you wouldn't even need a protein shake.


> lean kangaroo mince

I first read "mice" which was startling, then realized it was "mince" and then realized it was kangaroo! How would you describe the flavor?


Gamy, a bit like deer.


I have yet to see anything against regular eating of fish and fatty fish other than the "scare" of heavy metals, which only applies for wild fish.


Maybe, maybe not. It would depend on a variety of factors including the activities you do, your age, etc. Maybe athletes need more collagen compared to people who don’t exercise, etc, etc.

Also complete protein sources are definitely not easy to get. Good luck if you have dietary constraints.


Notably, whey is a complete protein source and very easy to get, while collagen is a crappy source.


I just wish whey was as easy to get unflavored. Let me handle the flavoring, you provide the protein.

Yes, I'm aware you can buy unflavored whey protein, but it's more expensive and you have to order it online. I can get a huge tub of "Delicious quadruple chocolate delight" BS from Costco for comparative pennies.


Quinoa is a complete protein, containing all amino acids that the body cannot produce on its own, and is gluten free.


You need to eat a ton of quinoa. Only the most dedicated vegan bodybuilder will eat that much quinoa. No thanks.

Also, only animal sources contain hydroxyproline amino acid in significant amounts, which you pretty much only get from collagen sources.

So while quinoa and other like even whey might advertise themselves as complete protein sources, no, they do not contain all the amino acids humans can use in significant amounts.


Hydroxyproline isn't essential though, humans can produce their need from collagen, which they also produce as well as most other animals.

> You need to eat a ton of quinoa

Most don't: at 4.4% protein, a 65kg man like me needs 1.5kg of cooked quinoa per day and it's not a big deal:

- You'll digest it like a king: quinoa is full of soluble and insoluble fibers and you won't feel puffy for eating too much. Easy in, easy out.

- Like milk or wheat, there's many transformations possible like flour, flakes, marinades, beverages, soups... alway a joy to cook and eat, no boredom with that grain.

Can't speak for the bodybuilders though but I'm sure most manage they nutrition. I think soy/pea is more popular.

By the way, very few eats only quinoa or any other single aliment. They also get amino acids from grains, pulses and seeds... even fruits like tomatoes but it's obviously negligible.

Quinoa is also fulled with minerals, vitamins and it's proteins have the same biological value (BV) as beef - or more depending on the source.

> its high-quality protein, complete set of amino-acids, and high content of minerals and vitamins. [0]

> exceptional balance between oil, protein and fat [1]

> Quinoa has a high biological value (73%), similar to that of beef (74%) [2]

0 https://www.tandfonline.com/doi/full/10.1080/15528014.2022.2...

1 https://scijournals.onlinelibrary.wiley.com/doi/10.1002/jsfa...

2 https://www.researchgate.net/publication/303845280_Quinoa_Ch...


There are plenty of studies showing that collagen supplementation helps athletes. Which means there are cases where the body doesn’t produce enough collagen for itself. And as you age, your body produces less collagen. Reasons enough to supplement with collagen.


Vegan bodybuilders would just use pea/rice protein extracts, which are about as commercially available as whey (very).


> Also complete protein sources are definitely not easy to get.

... all of the essential amino acids? What is difficult about that?


I was going to say that too, thanks for beating me to it!


> 3. With all the modern corporate doublespeak trainings, there is 0 chance that something would be called “desperation score” in us business.

This is a good point. It'd almost certainly be called something like 'payrate sensitivity factor'


Something like this can be reworded to make it sound like a “good” thing: “mission-centricity” or “dedication” or some other label that spins this as being committed to the company (leaving out that this is at their own expense).


Acceptance Elasticity


I wonder how air Canada reconciles this. There was a popular globe and mail article a while ago that gave awful rankings to air Canada's water tanks -- so the company put up signs in the bathroom saying the water is non-potable and called it a day.

Not super comforting if they're then using the same 'non-potable' water to make coffee...


>Not super comforting if they're then using the same 'non-potable' water to make coffee...

It's presumably boiled, which makes it potable?


I guess I don't know exactly how these airplane machines work but in general ideal coffee brewing does not reach the full boiling point.


boiling it will remove bacterias, but not toxins (if there are any).


Is there any reason to expect there would be "toxins", given that it's just water? I can imagine how there might be accumulated toxins it's a pack of chicken breasts left in a hot car for 8 hours, but if it's water it should be fine? After all, boiling water is a tried and true way of making water safe to drink.


Heavy metals [1] Nitrate and nitrite [2] PFAs most probably (couldn’t find anything about this, but since it’s everywhere…)

[1] https://www.webpronews.com/study-exposes-airline-water-conta... [2] https://www.ncbi.nlm.nih.gov/books/NBK310709/#:~:text=Beside...


> After all, boiling water is a tried and true way of making water safe to drink.

It's not.


https://en.wikipedia.org/wiki/Boiling#For_making_water_potab...

Yes, there are substances that slip through, but it works well enough for most cases that it's probably fine. Otherwise you get into weird edge cases like "what if there are prions in the water?!?" or whatever.


Heavy metals are a big problem, especially from cheap brass fittings common in outdoor water hoses. Indoor plumbing, by contrast, uses copper and/or plex tubing and so there’s near zero risk of metal poisoning (caveat on cheap plex fittings- don’t do that.)


I was recently talking to a colleague I went to school with and they said the same thing, but for a different reason. We both did grad studies with a focus on ML, and at the time ML as a field seemed to be moving so fast. There was a lot of excitement around AI again finally after the 'AI winter'. It was easy to participate in bringing something new to the field, and there was so many unique and interesting models coming about every day. There was genuine discussion about a viable path to AGI.

Now, basically every new "AI" feature feels like a hack on top of yet another LLM. And sure the LLMs seem to keep getting marginally better, but the only people with the resources to actually work on new ones anymore are large corporate labs that hide their results behind corporate facades and give us mere mortals an API at best. The days of coding a unique ML algorithm for a domain specific problem are pretty much gone -- the only thing people pay attention to is shoving your domain specific problem into an LLM-shaped box. Even the original "AI godfathers" seem mostly disinterested in LLMs these days, and most people in ML seem dubious that simply scaling up LLMs more and more will be a likely path to AGI.

It seems like there's more excitement around AI for the average person, which is probably a good thing I suppose, but for a lot of people that were into the field they're not really that fun anymore.

In terms of programming, I think they can be pretty fun for side projects. The sort of thing you wouldn't have had time to do otherwise. For the sort of thing you know you need to do anyway and need to do well, I notice that senior engineers spend more time babysitting them than benefitting from them. LLMs are good at the mechanics of code and struggle with the architecture / design / big picture. Seniors don't really think much about the mechanics of code, it's almost second nature, so they don't seem to benefit as much there. Juniors seem to get a lot more benefit because the mechanics of the code can be a struggle for them.


> Now, basically every new "AI" feature feels like a hack on top of yet another LLM.

LLM user here with no experience of ML besides fine-tuning existing models for image classification.

What are the exciting AI fields outside of LLMs? Are there pending breakthroughs that could change the field? Does it look like LLMs are a local maxima and other approaches will win through - even just for other areas?

Personally I'm looking forward to someone solving 3D model generation as I suck at CAD but would 3D print stuff if I didn't have to draw it. And better image segmentation/classification models. There's gotta be other stuff that LLMs aren't the answer to?


Well one of the inherent issues is assuming that text is the optimal modality for every thing we try to use an LLM for. LLMs are statistical engines designed to predict the most likely next token in a sequence of words. Any 'understanding' they do is ultimately incidental to that goal and once you look at them that way a lot of the shortcomings we see become more intuitive.

There's a lot of problems LLMs are really useful for because generating text is what you want to do. But there's tons of problems which we would want some sort of intelligent, learning behaviour that do not map to language at all. There's also a lot of problems that can "sort of" be mapped to a language problem but make pretty extraneous use of resources compared to a (existing or potential) domain specific solution. For purposes of AGI, you could argue that trying to express "general intelligence" via language alone is fundamentally flawed altogether -- although that quickly becomes a debate about what actually counts as intelligence.

I pay less attention to this space lately so I'm probably not the most informed. Everyone seems so hyped about LLMs that I feel like a lot of other progress gets buried, but I'm sure it's happening. There's some problem domains that are obviously solved better with other paradigms currently: self-driving tech, recommendation systems, robotics, game AIs, etc. Some of the exciting stuff that can likely solve some problems better in the future is some of the work on world models, graph neural nets, multi modality, reinforcement learning, alternatives to gradient descent, etc. I think it's a debate whether or not LLMs are a local maxima but many of the leading AI researchers seem to think so -- Yann Lecun recently for e.g. said LLMs 'are not a path to human-level AI'


It’s now moving faster than ever. Huge strides have been made in interpretability, multi modality, and especially the theoretical understanding of how training interacts with high dimensional spaces. E.g.: https://transformer-circuits.pub/2022/toy_model/index.html


Thanks, this seems interesting. I'll give it a read. I admittedly don't keep tabs as much as I should these days. I feel like every piece of AI news is about LLMs. I suppose I should know other people are still doing interesting things :)


I often do this in meetings and have gotten into the habit of saying "I'm thinking". It's not much but it gives both of us time to think and explicitly makes it clear I don't expect the person to say something. I think that helps.


I just blurt out "processing" when they start looking at me weird. People tend to take it well.


I read this at first as "I just blurt out "processing" and people look at me weird", which made me smile.


Fair enough, I do like parent’s a bit better, “blurting processing” feels like a too high default setting right after seeing “I’m thinking” :) - not that any of it matters anyways, communicating _something_ gets you there. Rest it just triaging around the edges what people will call you weird for, and if they are, they were going to anyway.


"Give me a second" is something I say when someone just has to break the silence with some unproductive comment. Having 20-30 seconds to think silently should be a completely normal thing.


”Thinking longer for a better answer”


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