There are more kinds of search engines than just internet search engines. At this point I’m is almost certain that the non-internet search engines of the world are much larger than internet search engines.
Edit: And I’m getting downvoted for this. If it’s because I am tangential to the original comment then that’s fair. If it’s because you think I’m wrong, I have worked on the two largest internet search engines in the world and one non-internet search engine that dwarfed both in size (although different in complexity).
You’ve got to remember that google/bing do not index the internet entire. Part of their magic is selectively indexing only a tiny sliver and still being effective.
Other kinds of search systems have to index everything, which simplifies things but has its own scaling challenges.
Easiest way to think about it is that while the majority of webpages are never indexed, every blob of text in a social media post, private message in an app, email, document, etc in every major app in the world, including the ones with billions of users, is indexed in a search engine for that app:
- GSuite search (think of how many gmails are searchable in the world right now… and they are all indexed)
- the enterprise search powering ChatGPT, Claude (these maybe there by now, if not they are likely well on the way)
- The Microsoft 365 search (this is probably massive with so many corporate email systems and teams systems on it)
- slack search
- X(twitter) search
- ticktock search (this idk, I’ve never used ticktock but if every video and every comment is searchable then this is probably huge)
- Facebook search (especially since this is likely combined across its product suite)
These are probably all larger in effective size than google or bing.
It can be both. The further away I get from social media and its singular narratives where it’s always “this ONE thing” form of causeality, the more I realize the mechanisms and causes can be multimodal and compound upon on another.
>I highly suspect you are not an addiction specialist…
Which also means they're not selling addiction help (which profits when addicts remain so), nor is indoctrinated to the professional fads of that racket
If it’s true then this is a propensity and not a rule.
My mood in college was suicidal. My mood by my 30s was better than most people I’ve ever met (sans hiccup from a year of no sleep with a newborn).
Looking back my horrible mood in college was probably caused by isolation, no sleep, high pressure course load, and too much alcohol. And I’ve noticed my mood drops dramatically when I get it in my head that I need to be more successful, at any point in my life.
If you are american you'll probably never notice how off-putting is the american niceness. And it's not natural if you ever traveled and seen the world a little bit.
I disagree. I'm not American but I've travelled extensively around the world and in America. Niceness is widespread, it's not a particularly American thing. And it's always appreciated and positive, the alternative is miserable.
Genuine question as an American- why would niceness be off-putting? What would you prefer? I'm guessing neutrality or formality, as opposed to outright rudeness... is it because it feels too familiar, and a bit of arms-length distance is more your custom?
In most cultures, smiling at someone means, you know them personally. So, when you smile at a stranger, the stranger gets confused. They might think you are crazy. Also it could make them uncomfortable about how to respond. If they smile back, it means they know you, which is not true. Infact, if you smiled at a stranger of opposite gender, it could lead to other complications depending on who are with them, and they could get angry as well.
No. It is lack of reason. Not long ago, if you went for morning jog in a village, you might be stopped and asked - I don't see a dog chasing you, why are you running? Same, if you give away some useful thing for free.
Some societies think the default position between strangers is seriousness, not niceness. The usual example is Russia if you would like to read more. In Russia, if a stranger smiles at a Russian, stereotypically the Russian would think either the stranger is crazy, or is planning some evilness and is happy about it.
I’ve travelled and lived abroad extensively and I’d say American niceness goes over well in 90% of the world. And where it doesn’t, boo hoo, they can handle a smile.
I hope that the actual medical field starts taking note of this.
My wife still has to work 24 hour shifts with no sleep, performing emergency surgeries no matter how long it has been since she slept. During residency only a few years ago she and her co-residents were almost weekly required to do 36 hour shifts (on top of their regular 16 hours per day, 5 day per week schedule) and once even a 48 hour shift when the hospital was short staffed.
Of course I’m sure they won’t. No one cares if doctors are over worked.
I've never understood those long shifts. Unless a shift just means you are there but sleeping, what is the reason for allowing it? We don't let truck drivers do 24h shifts, why do doctors the world over seem to do this?
My understanding is that the research shows that the harm to patient care from information loss during doctor shift turnover is worse than the harm from fatigued doctors.
Yes, a tired doctor sucks. But a tired doctor who already has the patient's state loaded into their head may still be better than doctor who is completely fresh in both senses.
I have never, in my entire life, ever personally encountered a situation in which a doctor paid enough attention to anyone over a period of time exceeding two hours that I could possibly believe that keeping the doctor on shift for a long time had the slightest benefit.
I’m sure cases exist. But I’d be rather surprised if they’re common.
> My understanding is that the research shows that the harm to patient care from information loss during doctor shift turnover is worse than the harm from fatigued doctors.
This would not appear to apply to emergency surgeries. They aren't done by doctors who are familiar with the patient anyway. (Neither are non-emergency surgeries. Surgeries are done by doctors who do that kind of surgery. Familiarity with the patient is useful in deciding what surgery should be done, but not in doing the surgery.)
The answer is there’s already a doctor shortage, and the US simply does not have the capacity to effectively 2x the doctor-patient ratio.
Doctors are also unlikely to want a 50% pay cut in exchange for shorter hours. They aren’t directly exposed to the risk caused by fatigue since they will have malpractice insurance. Therefore the safer method of care would be simply too expensive, and doctors wouldn’t see an upside.
Part of the shortage is a result of artificially constrained supply as there aren’t enough med school seats to keep up with demand.
Doctors do not get along and that’s too many Drs. Each patient often has multiple speciality Drs visiting them and reviewing their case up to 3 or 4 sometimes already. Imagine being on consult and trying to figure out which guy on a team of 4 you should talk to about such and such.
Here's an anecdote that might help answer. When my wife was pregnant with our first doctor, she started hemorrhaging spontaneously ten weeks before her due date. We rushed to the ER.
1. Shortly after, a doctor A came in, asked some questions, looked at the chart, and told us she was having the baby tonight. Holy shit our life is about to get crazy and we're going to be parents 2+ months early! He leaves.
2. Several hours later doctor B comes in. We ask about delivery. "Oh, no. You're not going to have the baby now. But you will have to be on bed rest until the due date." Jesus, my wife is going to have to quit her job.
4. Even more hours later, now the next morning, doctor C arrives. "OK, you're free to go home. No bed rest needed. Just let us know if anything else happens."
My general experience with doctors is that you get as many unique opinions as there are doctors in the room. This is not an indictment of the profession. Human bodies are insanely complex, there is way more variation between them than most people realize, and doctors are operating under very very limited time and information.
Having overlapping doctors would likely cause even more patient confusion and increase the risk conflicting treatments. Also, it would obviously double the cost of care.
(My wife and baby were fine. Partial abruption. Very scary and my daughter was born five weeks early, but no other significant problems.)
Many industries have solved this issue already. Use a pilot/copilot model. First doctor drives, second one mostly observes and makes sure the first one doesn’t make mistakes.
The European Working Time Directive has requirements for rest, etc. Either Europeans have much better hand-off procedures, they don't know how to comply with the rules they make, or they're fucking idiots who are going to kill people due to information loss during shift turnover. It was proposed decades ago. I wonder what compliance is like in Germany, etc.
> Yes, a tired doctor sucks. But a tired doctor who already has the patient's state loaded into their head may still be better than doctor who is completely fresh in both senses.
AI fixes this. Imagine the boot time of loading a patient's state from dozens of labs and files vs. a summary that gets you to exactly what they're going to end up remembering anyways. And if a doctor finds something interesting that the AI doesn't flag, they should be flagging it in the chart for the next doctor anyways.
In my experience, AI summarization is a pretty lame application. I don’t really need a block of potentially wrong, rephrased text. I’ve got a feeling that the same applies to healthcare.
The AMA works to prevent importing doctors from other countries, largely to maintain wages, but we don't have enough doctors.
Doctors boards and AGME (partly governed by AMA, but there is some amount of public representation) control residency admissions and board certification. We don't necessarily want low admissions standards, but there is a lot potential conflict of interest in constraining supply.
Some states, I think I read Florida recently, have started pushing back to allow in foreign doctors.
Here in Norway the doctor's association have worked hard against it, and talking to a relative which became a doctor some years ago, it's primarly because they want to keep the extra premium pay they get from the "uncomfortable hours" as it's called here.
I think both doctors and patients would want a different system for both doctors and patients. Having seen a poor performing medical system, and comparing it with the US medical system, all I can say it's that the US one doesn't seem designed to optimize health and well being of patients and, based on reading several articles representing doctors opinions, neither doctors'.
I do think it's maximially optimized to extract revenue. That can sometimes be good (e.g. good access to healthcare) but often times it's not great.
Given healthcare, along with education should be a national priority, both should be heavily "configured" to serve peoples' goals first and any financial goal should be secondary (although arguably useful).
I suspect the current shareholder structures from hedge funds are (intentionally or not) driving things in the wrong direction wrt to public health goals. This is article from a few days ago is also interesting https://news.ycombinator.com/item?id=45680695
It is well estabilished that after 24 hours without sleep, the mental capabilities are similar to being lightly drunk. 36 hours is considerably more drunk.
If you were driving a truck in EU, you would have several mandatory 8h stops by then.
Current ACGME rules allow a max of 30 consecutive hours, so not as bad but still not great for someone you would hope to have fine motor skills to save a life!
Yeah they usually do have a dedicated sleeping space for their service. The thing is, they only sleep if there’s enough downtime. Depending on your service, size of the program, and of course who your patient population is, it could be a lot, or none at all.
her at her worst is better than 90% of people at their best.
if you get through and into a good med school -match into surgery- you are Peak in a way very few are.
I don’t see this changing unless they reduce the requirements for med school; if they let anyone in who wants in and force that group to work 30hr shifts - you’ll get enough bad outcomes the system will change.
There was a study, I believe on nurses and shift durations. The study found the nurses were happier with shorter shifts - but the patients did worse. Patients come first.
I could see a group of Doctors loudly proclaiming love for Donald Trump (and mentioning very much how great he is) and pleading the case for a change and something happening. He is an interesting president.
I would be interested in hearing a european drs perspective, I heard they work shorter shifts (but no EU dr I met has confirmed, it’s like meeting a unicorn)
This is the nature of the medical system in North America, and some other advanced nations. Also, you're not just being blunt, you're being both ignorant and arrogant.
GP's wife isn't being forced into this profession and they are making a lot of money from it. Do we need to offer sympathy for all people with difficult working conditions regardless of the remuneration?
I doubt her spouse makes her be a doctor. Most people who go through premed and medical school are pretty dedicated and driven on their own. This is a corporate vs labor issue, and likely not a domestic issue. I’m sure he dislikes it greatly, too.
Imagine doing your best to help someone and they die as a direct result.
Then you get to go to work and deal with the next case.
Or the patient has life changing, negative outcomes. Damn, that bad. Next case.
Living in that mental state takes a pretty unusual character type. We can expect some extreme behaviour.
It’s also interesting watching the change over time. The trainee versus consultant, or the surgeon as they near retirement.
I’m not a surgeon or a doctor and so I see a small part of their world but see some of the perks (they get everything) and some of the downsides, and there are a lot.
Only tangentially related, but I’ve been thinking a lot lately about what media format for consumption would inherently produce the least biased, most informed public.
After reading “Amusing Ourselves to Death” last week I’m convinced that in a democracy, political media consumption format is destiny (or at least shapes the equilibrium) and has more to do with the information bias in the system (when that system consists of profit maximizing news sources).
Current major models seem fundamentally less biased (on average) as a form of media than either television or social media. And they have a built-in incentive not to be too biased in the long run (maybe, this is just a vague thought): being too biased makes you have more incorrect predictions.
Could the right kind AI consumable media reverse the trend of ever more biased media?
My biggest gripe with this is the reasoning for “no, AI is not going to take everyone’s jobs.”
Obviously the state of “workers and AI together” comes first. So there’s not going to be some strawman cliff where suddenly all jobs are replaced in a month.
But people like him lay out this future and then act like AI just stops there. Of course there will be an intermediate state. And then that state will be passed over as AI move further up the chain and humans are eliminated from office labor entirely.
The way this manifests isn’t mass layoffs after an AI is implemented, it’s fewer people being hired at any given scale because you can go further with fewer people.
Companies making billions in revenue with under 10k employees, some under 5k or even under 1k.
This is absorbed by there being more and more opportunities because the cost of starting a new company and getting revenue decreases too as labor productivity increases.
Jobs that would otherwise exist get replaced. Jobs at companies that otherwise wouldn’t exist get created.
And in the long run until it’s just unprofitable to employ humans (when the max their productivity is worth relative to AI falls below a living wage), humans will continue working side by side with AGI as even relatively unproductive workers (compared to AI) will still be net productive.
I don’t think this is true. I think CEOs are replacing people on the assumption that AI will be able to replace their jobs. But I don’t think AIs are able to replace any jobs other than heavily scripted ones like front-line customer support… maybe.
I think AI can automate some tasks with supervision, especially if you’re okay with mediocre results and don’t need to spend a lot of time verifying its work. Stock photography, for example.
But to say AI is replacing jobs, I think you’d need to be specific about what jobs and how AI is replacing them… other than CEOs following the hype, and later backtracking.
> (when the max their productivity is worth relative to AI falls below a living wage), humans will continue working side by side with AGI as even relatively unproductive workers
This assumes that humans will be unwilling to work if their wage is below living. It depends on the social programs of the government, but if there is none, or only very bad ones, people will probably be more desperate and thus be more willing to work in even the cheapest jobs.
So in this overabundance of human labor world, the cost of human labor might be much closer to zero than living wage. It all depends on how desperate to find work government policy will make humans.
We can't prove why people are being replaced, and the people who claimed to have replaced people with AI don't have a lot of good outcomes. Now there is some success but... it is bespoke to that environment often, so, your reasons would be sound if the premise was. We need more information.
I've seen AI replacing a lot of jobs already in regulatory/consultancy business making billions. A lot of people producing paperwork for regulative etc purposes have been replaced by language models. My question – should this business really exist at all?
Can you though? From my experience this is just a wishful thinking. I am yet to see actual productivity gains from AI that would objectively justify hiring less or laying off people.
How about a concrete example. What jobs at Bank of America will humans have?
I can not imagine a scenario other than complete model stagnation that would lead to the current workforce there of 213,000 people still having jobs to do.
Also it’s such a strawman to assume that “absolutely everything” needs to be covered by systems to basically eliminate office jobs from humanity. In this context they only need to do enough to make hiring humans pointless at most businesses. Even if say you need some strategically important humans for a long time, I don’t see an incoming world where huge job loss doesn’t happen. David filing HR paperwork at Big Corp is not suddenly going to be doing strategy work.
Like it’s a strawman to assume I’m arguing that your nanny or the local firefighters are going to be replaced by an AI soon.
And it also seems like people expect some normative assumption when taking about job loss. I’m not making a normative claim, nor a policy one, just pointing out it seems stupid to not prepare or expect this to happen.
What do you think an alternative is for someone who:
1. Has a technical system they think could be worth a fortune to large enterprises, containing at least a few novel insights to the industry.
2. Knows that competitors and open source alternatives could copy/implement these in a year or so if the product starts off open source.
3. Has to put food on the table and doesn’t want to give massive corporations extremely valuable software for free.
Open source has its place, but it is IMO one of the ways to give monopolies massive value for free. There are plenty of open source alternatives around for vector DBs. Do we (developers) need to give everything away to the rich
Let's say the best open source product has a feature score of 70/100, and the best closed source product has a feature score of 85/100, and this is me being generous with the latter. The issue is that just by being closed source, it immediately loses 20/100, bringing its score to 65/100, which is below the open offering. A closed source product carries substantial risk if the company behind it were to stop maintaining it, which is why the adjustment by -20 applies.
Secondly, as I know, the blocker with approximate neighbor search is often not insertion, but search. And if this search was worth a fortune to me, I'd simply embarrassingly parallelize it on CPUs or on GPUs.
Edit: And I’m getting downvoted for this. If it’s because I am tangential to the original comment then that’s fair. If it’s because you think I’m wrong, I have worked on the two largest internet search engines in the world and one non-internet search engine that dwarfed both in size (although different in complexity).