Zauberlehrling

Former #PopHealth VP, #CMIO, #Internist, Air Freight Handler based in St. Louis, MO. #Cycling #BikeTooter #Gravel #KICKR #Zwift #Cooking #Beer #Wine #Gardening #Medicine #HealthPolicy #PublicHealth #SportsMed #Stoicism #CivilWar #SciFi #Science #STL #Linux #Ubuntu

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npub1kx45s6wmjrnjmnuyp847t84d3jq5y88u2z7x0mfsq0tr5r964uzs3s2533

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rvaughnmd_at_med-mastodon.com@mostr.pub

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nprofile1qqstr26gd8depeede7zqn6l9n6kceq2zrn79p0r8a5cq8436pja27pghychv7

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npub1kx45s6wmjrnjmnuyp847t84d3jq5y88u2z7x0mfsq0tr5r964uzs3s2533

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Last Notes

2024-11-03 11:50:50

Carvana back from the dead? Watch out, it wants to eat your brains!
Once nearly-bankrupt used car dealer hits new highs
https://www.thestreet.com/investing/stocks/once-nearly-bankrupt-car-reseller-now-hits-new-record

2024-10-30 17:16:39

apparently it's not just the onions
https://247wallst.com/investing/2024/10/30/mcdonalds-troubles-deepen-as-customers-wont-return/

2024-10-30 16:45:23

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/4
“When an astute statement attributed to a minor figure is reassigned to a major name, it instantly becomes more fascinating, more memorable, and more transmissible. The new combination is selected and replicated at a much higher rate.”

2024-10-30 16:44:35

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/3
Three qualities that turn certain figures into quotation magnets:
1. The person is historically significant.
2. The person already has a reputation for crafting wise, witty, profound, and insightful adages.
3. The person should embody an archetype that functions as a kind of effect trigger. Mark Twain’s wittiness primes the reader for a humorous aphorism, while Churchill’s connection with great speeches prepares them to be inspired.

2024-10-22 12:31:45

I almost ate a banana this morning and i don't like bananas. I'm not sure what this means. Maybe some new possibilities have opened up in my personal Matrix.

2024-09-18 18:28:22

Garden visitor
#gardening
https://cdn.masto.host/medmastodoncom/media_attachments/files/113/159/967/905/622/340/original/7e12eec6fca61f7f.jpg

2024-09-16 12:04:40

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@npub1h7t…k7xu I'm probably going to buy one. I don't use mapping, so a basic unit would work for me and I need a bigger display so i can see it.

2024-09-16 11:55:24

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@npub1305…k70l Must be the 'live wind strength'. I meant that's the one thing I can't get on Garmin/Wahoo and it is going to make me go 100x faster.

2024-09-13 12:37:31

Holy crap. The story makes no sense other than transecting the vessels that connect to the liver will definitely kill you 'quick, fast and in a hurry' as Major Payne said.
Shaknovsky performed a hand-assisted laparoscopic splenectomy ..... BUT
“Dr. Shaknovsky removed Mr. Bryan’s liver and, in so doing, transected the major vasculature supplying the liver, causing immediate and catastrophic blood loss resulting in death,”
https://www.nbcnews.com/news/us-news/florida-surgeon-mistakenly-removes-patients-liver-instead-spleen-causi-rcna169614

2024-09-04 19:59:35

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@npub1qdf…wn0r
The first principle is that you must not fool yourself and you are the easiest person to fool
--Feynman

2024-09-03 13:01:38

It was remarkably simple to make a Ubuntu USB startup disk (from Ubuntu).
1. Download the ISO image
2. Plug in a USB stick
3. Run Startup Disk Creator
4. Drink some tea.
5. Unplug the USB stick
6 Do a little dance. Make a little love. Get down tonight.
#linux #ubuntu

2024-07-31 16:29:56

Baby squash!
#gardening
https://cdn.masto.host/medmastodoncom/media_attachments/files/112/882/048/757/295/403/original/d599f171c84311c1.jpg

2024-07-26 12:44:40

My church is closing, and I don’t know what comes next — for me, or America
"What’s happened at my own church is especially poignant since in my day job I research trends in American religion. And when I first became a pastor, right out of college, there were ominous signs, but I did not foresee how quickly the end would come, hastened by a pandemic."
https://www.deseret.com/faith/2024/07/25/ryan-burge-church-closing-the-nones/

2024-07-20 11:25:35

I got to get me some of this stuff but the Equalizer gravel race next Sunday!
The surprising way a lugworm hemoglobin could decide the Tour de France
"Remarkably, the haemoglobin transports 40 times more oxygen than human haemoglobin and Zal created a company that uses the compound for medical applications, such as organ transplants."
#cycling #doping
https://www.sciencefocus.com/science/lugworm-could-decide-the-tour-de-france

2024-07-18 17:20:39

Garden under attack. Raccoon vs deer vs squirrel
#gardening
https://cdn.masto.host/medmastodoncom/media_attachments/files/112/808/637/168/745/908/original/35718895e9c16984.jpg

2024-07-14 16:02:57

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@npub1a3z…srpt I know it's the circle of life, but I'm still grieving a bit.

2024-07-14 15:59:17

I woke to this tragedy this morning.
#gardening
https://cdn.masto.host/medmastodoncom/media_attachments/files/112/785/668/910/817/730/original/9a7100b2fce3c568.jpg

2024-07-06 16:50:01

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@npub18ta…g9jm Can I come over? I'll bring a nice wine!

2024-06-25 21:43:09

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@npub1kj7…qvw4 Depends. What kind of sandwich are we talking about here?

2024-06-25 19:56:46

Ok boomer ...
The Real Reason Why Music Is Getting Worse
#music
https://www.youtube.com/watch?v=1bZ0OSEViyo

2024-06-21 18:40:56

Ryan Van Duzer, bike packer extraordinaire, throws in the towel on the Tour Divide Race due to terrible saddle sores.
"imagine somebody with a blowtorch blasting your ass all day long"
Sounds intense, I'll take your word for it Ryan.
#cycling
https://www.youtube.com/watch?v=dLpOd92VVls

2024-06-19 12:48:26

Failure of overpaid leadership to manage a crisis and listen to the people that actually do the work. Not to mention a national failure to harden electronic systems that healthcare was forced to accept
Cyberattack led to harrowing lapses at Ascension hospitals, clinicians say
https://www.npr.org/2024/06/19/nx-s1-5010219/ascension-hospital-ransomware-attack-care-lapses

2024-06-18 12:31:33

I'm going to be honest here, I just eat the oatmeal because I like the raisins. I really don't like oatmeal that much.

2024-06-18 12:09:15

What a horrible person.
Laura Perryman, Former CEO Of Stimwave Sentenced To Six Years For Creating And Selling A Fake Component That Was Implanted Into Patients
https://www.justice.gov/usao-sdny/pr/former-ceo-medical-device-company-sentenced-six-years-prison-creating-and-selling-fake

2024-06-08 13:23:03

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@npub1nac…0mta
Seems inefficient, but that may be the intent.

2024-06-08 12:37:24

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@npub1nac…0mta I suspect it was sent via the EHR messaging system. And yes, I have received messages on my results, fortunately always with good news (so far).

2024-06-02 17:33:55

Doing my #gardening on this beautiful cool morning and finding many dead cicadas. Such a long wait in the ground for such a brief bit of freedom.
And then I thought about working before retirement ....

2024-06-01 11:39:34

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@npub1hqx…944s What do you think it will price out at?
under or over a $1000 USD?

2024-06-01 09:56:29

Looks interesting - i suspect the price will be hefty. Not sure I like the 'crown' feature though
90+ hours of battery life: this unreleased COROS cycling computer could disrupt the market
#cycling
https://www.cyclingweekly.com/products/90-hours-of-battery-life-this-unreleased-coros-cycling-computer-could-disrupt-the-market

2024-05-24 12:05:51

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@npub18pl…3hdx I'm hoping that's not the reason he was down there!

2024-05-24 00:07:32

Danger noodle relocated from the basement
https://cdn.masto.host/medmastodoncom/media_attachments/files/112/493/146/923/944/671/original/64cb413e5a961963.jpg

2024-05-16 02:22:47

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@npub1ena…yyv4 That sounds excellent depending on the broth in the pot. Maybe some noodles too ...

2024-05-16 02:16:44

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@npub1ena…yyv4 I've been known to eat a sea bug or two in my time. And let's face it if a shrimp ran out from under the refrigerator most people would stomp it hard!

2024-05-16 02:12:30

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@npub1ena…yyv4
I'm tempted. I mean they don't look that different than shrimp. Maybe I should throw a few on the barbie

2024-05-16 02:07:10

Wife sent me to the grocery. I got the full size ice cream drumsticks 'accidentally'. Guess I'm going to have to eat them all as my punishment.
Spoiler alert: due to shrinkflation and greedflation, they aren't that much bigger than the 'mini' versions anymore.

2024-05-16 02:01:15

Bugs everywhere. It's game over man, game over! #Cicadas
https://cdn.masto.host/medmastodoncom/media_attachments/files/112/448/297/953/618/625/original/a86a7686912274ff.jpg

2024-05-10 12:41:53

Probably not
This Star Trek-like holographic bicycle could make Peloton obsolete
The bike’s specialized display technology tricks your brain into thinking you’re actually riding outdoors.
“This phenomenon known as optic flow, is at the core of what makes training outdoors so invigorating,” he claims. “In fact, it is the basis for a branch of psychology known as EMDR (Eye Movement Desensitization and Reprocessing).
#cycling
https://www.fastcompany.com/91119903/this-star-trek-like-holographic-bicycle-could-make-peloton-obsolete

2024-04-30 00:37:59

I just had 2 desserts and I'm not ever, every going to apologize for that.

2024-03-26 11:17:24

China bans purchase of Intel and AMD processors, Microsoft Windows for government computers
China was Intel's largest market last year, accounting for 27% of Team Blue's $54 billion in sales. The Asian nation also generated $23 billion for AMD, representing 15% of its sales. The restrictions will have less of an impact on Microsoft, which counts on China for about 1.5% of its revenues.
https://www.techspot.com/news/102379-china-bans-intel-amd-processors-microsoft-windows-government.html

2024-03-16 13:09:00

Watched Samuel Jackson and Carrie Moss in "Unthinkable' last night. Interesting exploration of the Trolley Problem, Utilitarianism, Consequentialism and moral obligation in the context of terrorism and nuclear bombs.
I can see why it went directly to video given the subject matter and the ending.
#movie

2024-03-16 12:57:46

Yikes. I have restarted piano after many years and 'Hanoninzed' myself into a case of painful tendonitis.
When I was lazy I did not have tendonitis. What am I to conclude about the arguments against laziness?
No pain, no pain?

2024-03-13 14:33:50

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@npub1yv3…cscq
When you get enough bikes, the car moves out of the garage. Priorities.

2024-03-13 14:32:53

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@npub1yv3…cscq
It's not good that Epic has developed a near monopoly on the EHR market.

2024-03-13 14:32:13

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@npub1yv3…cscq
I don't know for sure but I think you left out #stupidity

2024-03-13 14:31:30

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@npub1yv3…cscq
I don't understand the problem.

2024-03-13 12:13:59

Entering a 'cluttered market'
Oracle to launch generative AI-backed clinical assistant within next quarter
Executives have said that strategy should help boost revenue as Cerner continues to lose market share to Epic.
https://www.healthcaredive.com/news/oracle-generative-ai-clinical-assistant-launch-timeline/710027/

2024-03-13 12:11:24

Health care providers may be losing up to $100 million a day from cyberattack. A doctor shares the latest
https://www.cbsnews.com/news/change-healthcare-cyberattack-losing-up-to-100m-a-day/

2024-03-13 12:04:34

What was the plan here - to write a book from jail?
Student Pilot Tried Bum-Rushing Plane’s Cockpit Mid-Flight Multiple Times
"Jones was arrested for interference with flight crew members, which carries a maximum sentence of 20 years in prison."
“three separate attempts to go to the front of the plane and open the aircraft’s cockpit door before flight attendants requested the assistance of off-duty law enforcement officers, who restrained Jones in flexcuffs"
https://www.thedailybeast.com/student-pilot-tried-bum-rushing-planes-cockpit-mid-flight-complaint

2024-03-13 11:56:00

‘The market is in chaos’ - Trek set to make cuts amid high industry stock levels
Brand's reported plan to reduce product line by 40% is a "sensible move", says one industry expert
#cycling
https://www.cyclingweekly.com/news/the-market-is-in-chaos-trek-set-to-make-cuts-amid-high-industry-stock-levels

2024-03-13 11:54:00

Reads like a SciFi short story!
Montana Man Pleads Guilty to Creating Massive Franken-Sheep With Cloned Animal Parts
"illegally bringing biological tissue from a Marco Polo sheep, the largest sheep in the world, from Kyrgyzstan ...
"sent them to an unnamed lab which created 165 cloned embryos ...
"implanted the embryos in ewes on his ranch"
"used the cloned sheep’s semen to artificially impregnate female sheep, creating hybrid animals"
https://www.yahoo.com/tech/montana-man-pleads-guilty-creating-003000858.html

2024-03-13 03:01:10

Excellent race coverage from inside the front group by VC
#cycling
https://www.youtube.com/watch?v=d9jwCSZcvwE

2024-03-12 12:55:00

This problem is only going to get worse with the aging of America. Profit is made by delaying and denying services
New York Trusted This Company to Care for the Sick and Elderly. Instead, It Left People Confused and Alone.
https://www.propublica.org/article/new-york-guardianship-services-care-sick-elderly-confused-alone

2024-03-12 12:38:21

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2/2
"the health care context requires platform entrants to carefully consider interdependencies between the scope of services provided, the geographical markets to enter, and the integration of and interface between digital and physical health care."

2024-03-12 12:37:55

Health Care Platforms Need a Strategy Overhaul
To succeed, digital health platforms must shift their approach in three key areas.
"digital platforms typically extend rather than replace the established ecosystem ... can currently substitute for, at best, only about half of incumbent offerings in primary care and much less than that in specialty care"
https://sloanreview.mit.edu/article/health-care-platforms-need-a-strategy-overhaul/

2024-03-12 12:16:15

She is tough as nails!
Keri McCorkle suffered severe trauma to her face and permanent nerve damage after the cougar latched onto her lower jaw, keeping her head in its bite for 15 minutes while the other riders tried to free her by hitting the big cat with a rock and a multi-tool. The 60-year-old cyclist tried pushing her fingers into the cougar's eyes and nose, she was eventually freed after the animal tried to reposition its bite
#cycling
https://road.cc/content/news/more-details-frightening-cougar-attack-cyclist-307225

2024-03-05 14:16:39

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@npub1hqx…944s @npub1uak…2sfz
That's awesome. Somebody's gonna get promoted for that!

2024-03-05 14:08:51

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@npub1hqx…944s @npub1uak…2sfz
Which is why the specialty of marketing survives - inventing features that don't matter and differences that are insignificant!

2024-03-05 14:00:13

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@npub1uak…2sfz @npub1hqx…944s
I thought one of the comments was interesting - it said people focus on their chains because it is one the few things that they can do with a limited skill set and feel like they are taking care of their bike.

2024-03-05 13:41:06

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You've heard of antiVaxers - now listen to this antiWaxer:
Why Bike Mechanics HATE You For Waxing Your Chain...
#cycling
https://www.youtube.com/watch?v=2q-qEjgleI4

2024-03-04 23:10:13

Do like to talk endlessly about chains and chain lube and chain wear and chain, chain, chain? If so this podcast is for YOU!
They Don't Want Your Chain To Last This Long
#cycling
https://www.youtube.com/watch?v=2_GDTOeL09s

2024-02-28 03:50:40

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@npub1yv3…cscq I've found some of them streaming on Amazon too.

2024-02-25 21:56:21

Is there any good use for old and ancient iPads?
I inherited a couple devices. The laptop was so thoroughly hacked I gave up - HP locked down the bios making it pretty hard to install #Ubuntu and UNETbootin wasn't working because the hacked device was blocked from downloading an ISO given my limited skills. Plus I didn't want to spend hours working trying to rescue a 10 year old hacked laptop.
#ubuntu #Linux

2024-02-22 13:48:31

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@npub15te…wdn7
I can see the family resemblance 😀

2024-02-15 13:42:32

Cyclist threatened with €13 million fine and two years in prison over bike shed, forcing her to give up cycling
“At the end of our road, there’s a €65 million cycle lane being built, and we can’t use it. There’s no point building all this infrastructure when you can’t park a bike on your own property. There are two people now not on bikes because of this folly,” she says.
#cycling
https://road.cc/content/news/cyclist-threatened-ps11-million-fine-over-bike-shed-306735

2024-02-10 03:02:24

Do you get a horrible crusty paste on your derailleur jockey wheels after a gravel ride? This stuff is nasty and somewhat resistant to removal.
Am I using the wrong chain lube?
Is it just something I have to accept and clean after every ride?
Is it time to move to Pinion and Gates drivetrain?
#gravel #cycling

2024-02-09 22:21:24

The accidental shooter is an active Marine Corporal. I suspect his superiors are not happy with his firearm safety practices.
San Diego woman shot in head by errant bullet through her bedroom wall
https://www.nbcnews.com/video/san-diego-woman-shot-in-head-through-bedroom-wall-203925061536
https://cdn.masto.host/medmastodoncom/media_attachments/files/111/903/849/668/783/233/original/cbc31ce34e5a8078.png

2024-02-06 13:05:27

E*thirteen’s new tubeless valve is half Presta, half Schrader, and promises easier tyre setup
I'm confused - if you still have to force air through the Presta cross section, how is air flow increased?
"a hybrid of the best of Presta and Schrader. This means it’ll still poke through the same Presta-sized hole in your rims, but at the top it morphs into the chunkier Schraeder standard to make it more robust and increase the air volume."
#cycling
https://www.mbr.co.uk/news/ethirteens-new-tubeless-valve-is-half-presta-half-schrader-and-promises-easier-tyre-setup-435830

2024-02-06 02:17:51

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@npub1h84…nc6k
Congratulations!
Care to share some details about the bike? Likes/dislikes?

2024-01-27 01:33:45

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@npub1uak…2sfz That is great encouragement. I have the Dirty South Roubaix coming up in about a month. I need to get out for a few rides and make sure this new setup works for me.
#cycling #gravel
https://www.bikesignup.com/Race/IL/AltoPass/TheDirtySouthRoubaix100k

2024-01-26 19:33:46

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@npub1uak…2sfz Great feedback. I got the shoes and pedals yesterday and haven't gotten the pedals on the bike yet. Looking forward to trying them out soon!

2024-01-22 12:31:14

I did not know rechargable, remote controlled heated insoles existed.
Have you tried these in your cycling shoes?
It's damn cold out there in the garage where the trainer sits and stares at me with evil intent.
#cycling
https://fieldsheer.com/products/standard-heated-insoles

2024-01-21 14:22:41

Decided to try flat pedals and flat mountain bike shoes (Giro Tracker) for my gravel bike. It's going to be interesting to see how different it feels after decades of riding clipped in to clipless pedals.
#cycling #gravel
https://cdn.masto.host/medmastodoncom/media_attachments/files/111/794/381/692/499/916/original/70756f448220d055.jpg
https://cdn.masto.host/medmastodoncom/media_attachments/files/111/794/385/986/191/400/original/607baf0a9fdd1eab.png

2024-01-19 04:03:35

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@npub1a60…6zga @npub1zlx…kyxt
Well, that's a tough question with a long answer. How much time do you have?

2024-01-17 13:52:31

I wasn't shocked at all - were you?
Nine out of ten women face abuse while cycling, shocking new survey finds
According to the report, “get off the road” was by far the most common form of verbal abuse aimed at women cycling, while taunts of “bitch” and “slut”, unsolicited photos and sexual comments, groping or slapping when stopped at traffic lights, and accusations of poor parenting when cycling with children were also appallingly prevalent.
#cycling
https://road.cc/content/news/nine-out-ten-women-face-abuse-while-cycling-report-finds-306235

2024-01-17 12:23:18

Spoiler alert: #STL is not on the list.
The Best Places to Live in the United States if You’re a Bicyclist
#cycling
https://momentummag.com/the-best-places-to-live-in-the-united-states-if-youre-a-bicyclist/

2023-11-28 01:27:33

I don't think this model is going to work do you?
Try Before You Buy: The E-Bike Subscription Service Has Arrived
"subscriptions range from $229 to $299 a month for the service. Considering the price for a new Stromer e-bike (one of the brands on offer) starts at over $5000 on sale, that’s a low cost per month for a lot of bike."
#cycling
https://www.bicycling.com/news/a45963367/e-bike-subscription-service-friiway/?utm_source=flipboard&utm_content=topic%2Fbicycle

2023-08-17 18:55:30

Mayak: The secret nuclear power plant that poisoned Russians for decades
In many ways, it was worse than Chernobyl.
"the Soviets denied the accident for more than 30 years but came clean in 1989 admitting that two million Curies of radioactivity had been released. The IAEA estimated that the real number was closer to 20 million Curies.
(Chernobyl released 50 million Curies.)
#Nuclear #energy
https://bigthink.com/the-past/mayak-secret-nuclear-plant-poisoned-russians-decades

2023-08-14 12:48:13

I for one, despise our Insurance Overlords who are allowed to design our healthcare system to meet their insatiable greed.
"Insurers now routinely require doctors to kick back as much as 5% if they want to be paid electronically. Even when physicians ask to be paid by check, doctors say, insurers often resume the electronic payments — and the fees — against their wishes. Despite protests from doctors and hospitals, the insurers and their middlemen refuse to back down"
https://www.propublica.org/article/the-hidden-fee-costing-doctors-millions-every-year

2023-08-12 15:58:28

John Roberts Takes Control on Voting Rights
"If the Court’s most recent term is prologue, it also reveals that, despite some positive developments, it is likely that ongoing and future civil-rights litigation will be contoured to satisfy, not an audience of nine, but an audience of one – a Chief Justice whose record on voting rights has been consequential, controversial, and frequently hostile"
https://www.justsecurity.org/87526/john-roberts-takes-control-on-voting-rights

2023-08-11 12:28:49

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@npub1323…65cn @npub1hyk…3p33
Stein's Law: "Anything that can't go on forever will eventually stop."
Keynes's: "Markets can remain irrational longer than you can remain solvent."
"Verizon has done an admirable job of balancing on a knife edge between Stein and Keynes, proving that a business can remain large, its products relied upon by millions, its stock actively traded and its market cap buoyant, despite manifest, repeated incompetence and waste on an unimaginable scale"

2023-08-08 13:38:14

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@npub1ahq…wjwd But it is important on getting out the word to people, reminding them that you can't trust any of the big tech companies. The money they make on monitoring you is just too great to give up.
'Free' services that result in billions of profit aren't free.

2023-08-05 00:22:45

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@npub1tf4…nzuj
Mississippi disenfranchises nearly 11% of its voting age population, the highest percentage in the country. The impact of felony disenfranchisement on the state’s Black population is particularly staggering: “African Americans constitute 36% of Mississippi’s voting age population, but 59% of its disenfranchised individuals.
African American adults are thus 2.7 times more likely than white adults to have been convicted of a disenfranchising crime”

2023-07-20 00:10:41

So it's a giant scam, what a surprise. Those incredible insurance company profits are tax payer dollars.
Medicare Advantage could get up to $1.6 trillion more than it’s entitled to over the next decade, and that could hurt the Medicare trust fund
"“It is clear that the federal government is vastly overpaying MA plans with enormous federal budget ramifications,” CRFB said"
https://www.marketwatch.com/story/medicare-advantage-could-get-up-to-1-6-trillion-more-than-its-entitled-to-over-the-next-decade-and-that-could-hurt-the-medicare-trust-fund-study-21d739f4