> The surgeon told me I was too young to have a bioprosthetic valve – from a pig or a cow – as these don’t last like metal ones do, and other surgical options, even though they wouldn’t need warfarin for ever were not recommended for me, as a relatively young patient.
I had my pulmonary valve replaced when I was 13 with a porcine (pig) valve. True, they don’t last forever, but they can last a good two decades before you need to exchange one out. My cardiologist, as far as I know, plans to use another one for my next surgery.
I have had a synthetic (metal/plastic) aortic heart valve for decades. The differences in anatomic valves and the designs do matter, day to day. My organic was replaced at 2 with a near-experimental synthetic, then at 9 with a Bjork-Shiley design (blood thinner from then on) then again at 32 with an Onyx design.
My heart is now considered too damaged to get a more modern version, even if there was a big improvement (unlikely). The flow control and stress testing that has been done on synthetics make them far superior to organics, among other features like the multi-leaf design that makes blood thinners a formality via FDA blanket process rules for synthetic approval.
I'm really surprised that anyone recommends organics for aortas or even chooses to have them. To continue the rather opulent lifestyles that celebrities/politicians might maintain, there may be a narcissistic belief they can stave off the inevitable growing handful of pills they need to take every day to soldier on. Good luck to each and every one.
It is related to age. If your immune system is on the decline as it generally is as we age it doesn't do as much damage to the bioprosthetic valves and they last much longer. The controversy revolves around just what that age is. When my surgery was done I was in that gray zone 59. The first surgeon I spoke with was adamant about using the mechanical valve. The next surgeon I spoke with was more like I can see arguments both ways.
I am fairly active. I chose the bio because I knew I would have trouble regulating the thinners. The tissue is chemically treated in the newer valves to increase their life span (maybe). When I get this valve replaced they can insert the new valve within the old using TAVR which doesn't require them to open your chest. If my valve last long enough I figure they will have new better ones using carbon synthetics.[1]
I like this idea. I am this kind of note taker, where I enjoy the linear chronological nature of an append-only note, specifically for my "daily notes" in various topics. To me, it represents a journal-style approach that is helpful for team meetings or learning about a topic on a regular basis, or just journaling.
Some ideas on what this could provide over current solutions like Google Docs or Notion:
* My preference is to append to the top of my note. I can do this in your note but it would be cool if there was an out of the box UX improvement for appending to the top vs to the bottom
* It would be nice if there was a tree-like structure to nested notes. Simple markdown-style headings would suffice, where I can fold headings and bullets, and see the tree structure in the right side panel
Thanks a lot for trying this out and for the suggestions!
Glad to hear the basic mechanics of "additive" notes is working for you. I have a lot of depth to add as you pointed out though, will go back to work :)
Japanese has 熟語 jukugo, which is similar (if I understand the concept of a chengyu correctly): a set phrase of Chinese characters. The famous case are the 4 character set phrases, 四字熟語 yojijukugo, which are mentioned in the article, but there are other kinds too.
Besides that, there is 慣用句 kanyouku, which means just an idiom in general, and isn't restricted to kanji expressions. And 決まり文句 kimarimonku, which means something like a "cliche phrase".
So many are taken over verbatim from Chinese. There are some very comprehensive Yojijukugo (literally just meaning former character compound word) collections on the net like
Sometimes you will have to map between simplified Chinese characters and modern Japanese characters. Easy enough though, since they still look very similar.
Parent has a point. We accept this level of attachment in children, but do not encourage it, because, well, it is not really necessary, and could be detrimental, to daily survival. This level of attachment may be helpful to the original poster, but it is a valid question as to whether it is actually good for them in the long run.
I imagine the only con is extra spent brain-CPU cycles? Balance that against the benefit of a self-induced feeling of loving and the mental benefits that come with that like stability and stillness.
“Adoption” is a generous term to use for a description of Github stars (referring to the first graph). There’s no denying stable diffusion has been gaining popularity, but I think it’s hard to say it’s really being adopted at the same rate it’s getting starred on Github.
I acquired several AWS certs early in my career. The understanding of AWS I developed through studying has helped me significantly in developing products at startups. I would highly recommend getting the networking specialization; it’s the hardest but perhaps the most important when it comes to understanding one of the most complex aspects of AWS.
> If you are experienced and notice that things at your company are broken, you either try to advocate for fixing things or just leave out of desparation.
If you’re “experienced” then you just fix these issues (especially the ones you mentioned)
One of the counter intuitive functions of code reviews is to keep the code quality just around average.
If someone experienced tries to fix things, his fix will look bad to the inexperienced because it's different from what they already know, so they will push back very strongly.
Unless you have an iron will, an iron fist, and an official title within the organization, it's near impossible to fix things.
I had my pulmonary valve replaced when I was 13 with a porcine (pig) valve. True, they don’t last forever, but they can last a good two decades before you need to exchange one out. My cardiologist, as far as I know, plans to use another one for my next surgery.