My assumption was always that there are two separate systems at play, and once your email is entered, it gets put into some sort of cart rescue campaign..which sends...promotional emails.
My older brother (currently 31) has severe cerebral palsy - very similar to what Zain had.
He has been healthy recently, but there have been many close calls. He has frequent seizures and many normally routine things can be life threatening. Others have mentioned things like pneumonia.
He requires 24/7 medical attention, including a nurse who stays with him every night in case, among other things, his seizures get out of control. Thankfully for him, my mom is a nurse and we are fortunate that health insurance covers a very large amount of his medically necessary care.
Too many to list. But by the photos of it looks like it was severe, when the body is not able to move you get all kinds of chronic diseases.
I think I read somewhere that pneumonia is number one because of the difficulty of eating and drinking and the food or liquids constantly get into the lungs.
Can't speak to palsy but I had a friend with muscular dystrophy who passed in his late 20's. He couldn't swallow his own spit, and every 10 minutes or so I (or his attending nurse, or whoever he was spending time with) would need to help him drain it. He had the same sort of little vacuum that your dentist uses to get water out of your mouth during a cleaning or filling. I moved out of my hometown a few years before he passed so I don't know all the details, but I'm pretty sure his death had to do with respitory issues caused by his weakened muscles.
speaking as total layman wrt. medicine, i wonder whether it is possible to at least improve the condition a bit by implanting electrodes and triggering the needed muscle(s) similar to say pacemakers.
I am a physician, though not a specialist in that particular area (otolaryngology).
A healthy heart contracts exactly the same way (nearly) every time. There is a single electrical tree that coordinates the entire heart, so if you shock the tree at the right point, it will propagate down the entire tree in a predictable pattern and you get normal heart contraction "for free"
The throat is orders of magnitude more complicated. There are several major muscles involved in swallowing, each of which can have tens to hundreds of thousands of individual fibers, each with their own innervation. Coordinating all these fibers to produce a single coherent motion is complex and is not fire and forget - it involves some pretty intricate feedback loops between processing centers in the brain and stretch receptors in the muscle, with the brain refining and redirecting movements based on updated data from the stretch receptors.
It's like the sending a single strong electrical pulse to your lightbulb versus a CPU. It will probably do what you expect for the lightbulb (heart), but not for the CPU (throat).
Parent comment was about a simple trigger "similar to pacemakers", it was a reply to that. It was never implied that it's not possible with the current technology
That press release links to a journal article in Nature. I can't read the Nature article because it's paywalled, but the same group published an article in Brain in 2014 where they said "We propose that the functional state of... motor neurons was modulated by the epidural stimulation, presumably driving them closer to their appropriate activation threshold, enabling intentional movement." [1] Basically, they're saying that the spinal cord was a bit blunted after the injury. Movement signals were fizzling out as they travelled through the injured area. The stimulator is giving the injured region of the spinal cord some extra juice so that it propagates motor signals further down the body. However, it isn't actually creating a signal de novo - that's still coming from the brain. As for the latest Nature article, based on what I can see from the abstract, it seems like it is an update where they used a computational method to decide where to place the stimulators and with which strength to stimulate. But it's still the same basic idea.
Another thing to note here. In the 2014 article, they mention that they only tried this treatment in patients who had an intact sensory pathway and an injured motor pathway. Kind of speaks to what I was mentioning earlier - the brain can't coordinate movement unless it gets feedback from the muscle. I would presume that this stimulator therapy can't help with the sensory component, which is why the researchers limited the study to patients with sensation.
Somehow I did manage to access the article, and while I didn't quite understand exactly what they did, it does go beyond dumb amplification.
> Neurostimulation platform. Biomimetic EES requires the delivery of concurrent stimulation waveforms that are turned on and off with a precise timing4,8,12,21. Moreover, many activities necessitate adjustment of stimulation parameters in closed-loop via wireless links. To support these features, we upgraded the Activa RC implantable pulse generator (IPG) with wireless communication modules (Supplementary Fig. 1). This neurostimulation platform supported real-time updates of EES frequency, amplitude and timing from up to 10 stimulation waveforms8. The new paddle lead was interfaced with the Activa RC, which was implanted in the abdomen. We also developed a new software operating through touchscreen interfaces to enable the rapid configuration of activity-dependent stimulation programs (Fig. 4c). To simplify these configurations, wireless recordings of kinematics and muscle activity are displayed in real time, concomitantly to EES waveforms (Supplementary Fig. 1 and Supplementary Video 2).
Regarding Cerbral Palsy, it is... Cerebral, meaning that the peripheral part of the sensory and motor pathways should be intact. So what you would need to do is develop a controller interfacing with them both. That may not be trivial, but I do think it could be done by aplication of known tech and principles.
There are still muscles, they slowly deteriorate over time though. When my friend was in 2nd grade or so he could still run and play with the other kids. For a few years after that he could still use a controller to play video games. As he deteriorated further, he couldn't even do that, and got most of his enjoyment from watching other people play games. Heartbreakingly his nephew, who was named after my friend, also suffers from muscular dystrophy since it's a genetic illness.
I'm also sorry because I should have been more succinct. You are correct.
I, too, have a form of muscular dystrophy called Spinal Muscular Atrophy, type II. I deal with a lot of what's being discussed here, i.e. aspiration pneumonia.
That said, there is, at least in my mind, almost no functional difference between not having a muscle and having muscle so deteriorated that it no longer works. Electrical stimuli such as through a TENS unit does nothing.
Back to OPs suggestion though. You might be able to make a case for early onset muscle assist? Dunno, just spit-ballin'.
there's the inspire implant[1] for sleep apnea which sounds like what you're describing, but I'm not sure how much help it'd be in the case of muscular dystrophy.
Hi! Definitely, I'll consider doing this soon. I like Telegram because it lets me reach people directly without them having to come to my site. But it's true that a lot of people don't use it and I'm missing out on them. I'll probably create email newsletters soon for the people that are not on Telegram. Thanks!
Curious about this as well. The desktop download links time out for me, so, I'll try getting the app on my phone I guess. Would be great to see this on desktop/web somehow. Edit: App requires SMS auth, but the phone I'm trying this on has no SIM card. Oh well.
Ah, that's a bummer! I'll probably create weekly newsletters soon with the same content, I thought Telegram was quite extended in the tech community but apparently not. I'll post it here when the newsletters are ready
In the meantime, you can receive the same jobs via email creating an alert at https://findmegigs.com/?remote=true (it shares the backend with the Telegram channels)
> Losing a ton of revenue and it is completely out of my hands.
That may be a bit exaggerated. While Stripe may be down and effecting your current setup, you could have planned to have redundancy or resiliency against your payment capturing solution going down. No technology never breaks.
Yeah, depends on your business, but for us Stripe is only necessary for new customers or for folks to update their billing information once in a blue moon. I definitely envy anyone getting multiple new customers per minute.
Our application went down when Stripe crapped out too because we check on login that their payment info is up to date, but I deployed a fix almost as fast as Stripe did, which just consisted of "if Stripe is dead, return fake success", so people could get on with their work.
Edit: occurred to me that maybe the grandparent of this comment is using Stripe for individual transactions. If so, may I suggest you use a payment processor that won't take 2.9% + 30 cents per transaction? Those are relatively high rates. Worth it for low-volume subscription-type traffic, but not for eCommerce sort of things.
Edit 2: regarding the previous edit, it's complex, and it depends. You do you.
You can negotiate with Stripe if you're at high enough volumes. It's likely that the "best" choice of payment processor is heavily dependent on the specific business in question. If you need agility and developer friendliness, Stripe is hard to beat. If you're trying to grind out every last percent of margin, you'll have to shop around and see what you can negotiate (and the offers you get will likely depend on the nature of your business, chargebacks/fraud, etc).
I have to admit I was thinking primarily of my company's use case, which is serving brick-and-mortar. This is a pretty different picture from card-not-present transactions, but if you're a low-risk business from the point of view of credit card processors, 2.9% is still at the high end. If you're brick-and-mortar, you can get rates as low as .25% sometimes.
Fattmerchant, Gravity Payments, and Worldpay are all great options for brick and mortar, and offer online payments too. Paypal is also cheaper than Stripe for US businesses.
As always, it depends, and it's complex. I probably was too confident in my above answer.
Stripe is an aggregator, which means they collect all payments and distribute to their clientele. This is why merchant processors like Square and Stripe can often get their customers up and running more quickly. Lower underwriting requirements = less regulation on the merchant. The level of risk is higher so they have to charge higher rates to cover their losses of fraud.
Gravity Payments is an Independent Sales Organization (ISO) which means they underwrite each merchant and "approve" each merchant account with their backend processor. This equals less fraud and more flexible pricing.
We do offer integrations and also have an online product that can process ecomm transactions for developer usage.
Easier said than done. Outside of the costs and overhead required to implement a secondary payment solution in the rare case your primary solution goes down, often times payment providers require exclusivity agreements which prohibit this.
When P(payment provider outage) x (expected lost revenue in case of outage) > (costs of implementing and maintaining an independent alternative payment processor and automatic failover), then hoping for the best and writing a comment about pain in case of outage is still the best strategy.
Most likely it's worth taking the revenue loss rather than building a redundant payment provider. That doesn't mean taking the revenue loss doesn't hurt.
Exactly. If it starts happening frequently, maybe it's worth looking into. But I think there's a middle ground between 'worthy of complaining on hacker news' and 'need to implement and support a redundant backup payment system.'
KATG listener since 2006. Awesome to see you on here.
You’re right, you would never believe the amount of effort required to make an HN post. I’ve often not only implemented backup payment provider solutions instead, but also tertiary ones. In fact, in lieu of this comment I was 90% of the way to starting my own payment network.
I get that point, but I run a platform powered by Stripe Connect. Redundancy at that level would require the customers who sell their products through my platform to set up an additional account, go through additional KYC, etc - which is unrealistic. Alternatively, I could register my business as a PayFac, which costs a ton of money and depending on your network, also faces outages from time to time.
what's to exploit? If they're logging in, they have the credentials already.
I get that someone could maybe somehow avoid updating the stripe info, but that will fail the next time a charge goes through, so it's not as if there's a lot of fallout from it. Without even questioning why someone would go through the trouble in the first place.
The best I can think of would be to have a feature toggle that can be manually flipped by a developer and route transactions through PayPal when the toggle is flipped. This would solve the ability to collect payments for new customers, but there would have to be some sort of reconciliation/sync when Stripe comes back up to migrate the customers back to Stripe, otherwise you'll have a handful of customers in PayPal indefinitely.
Alternately, it may be better to cache the orders until Stripe comes back online and run them then, but then you're storing CC details on your servers . . .
You could find a way to do a soft failure. In the case of as payment gateway failure, take the order and follow it up manually once the gateway is back up. May not work for every business but an eComm business could just hold the fulfilment until payment is captured. A subscription service could let the subscription run on a short grace period and follow it up.
That could all be done programatically, or give them a call or email.
Not really. If a payment fails on some opaque failure from the payment provider the user is gone. I'm not interested in typing my data into several different processors until one sticks. I'm looking for your product somewhere else. Payments must work.
>That may be a bit exaggerated.
It's really not though. As of time of writing, the customers have failed to sign up, and there's nothing to do about that on the fly, right now, today. Saying you "could have done X" doesn't mean that the problem isn't happening.
"Your house isn't on fire, you just haven't properly fireproofed it" isn't really helpful to anyone when their house is literally on fire.
If someone cuts the phone lines into a building, whether with malice aforethought or a badly aimed backhoe, the phones in that building will not serve their intended purpose.
I agree that degrees of resilience are a thing, and that different kinds of systems have different failure modes (each of which may deal with a different aspect of resiliency), but I am firmly convinced that no technology never breaks.
Well, Wikipedia's uptime in 2017 was 99.97%, according to [1]. That's over 2h30m, so if this is Stripe's first downtime of the year, they're still in the lead.
> What was downtime of your telephone line over last 5 years
Assuming they even have a 'telephone' landline, are they even measuring?
Plus, telephone is old tech. This is apples to oranges. You know what else hardly ever fails? The water supply to my house. But people have been building aqueducts since Babylon.
I feel like this is the same general pricing experiments/info we have seen synthesized for the past few years in giant articles. I was hoping there were some new juicy SaaS pricing experiences to be shared.
Not that the information in this article is bad if you haven't seen it before or haven't fiddled with pricing in a while
My assumption was always that there are two separate systems at play, and once your email is entered, it gets put into some sort of cart rescue campaign..which sends...promotional emails.