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MedicalWe are American emergency medical providers working in a West African Trauma Center, Ask Us Anything!

Jan 22nd 2017 by ZigZagSigSag • 6 Questions • 3446 Points

EDIT: Thanks so much for all your questions, I had a great time. If you are looking for more info visit www.sexhelp.com or if you're looking for a therapist visit www.iitap.com. If you're looking for treatment visit elementsbehavioralhealth.com.

I am a clinical consultant at Promises Scottsdale and help diagnose and treat sex addicts. Sex and porn addictions affect more than just the addict, it can affect your family and relationships as well. I am the president of the International Institute for Trauma and Addiction Professionals (IITAP.) You also may know my father, Dr. Patrick Carnes who is one of leading sex addiction researchers.

In addition to sex addiction I also treat patients with eating disorders and chemical dependency. I am the author of “Mending a Shattered Heart: A Guide for Partners of Sex Addicts,” “Facing Heartbreak: Steps to Recovery for Partners of Sex Addicts” and “Facing Addiction: Starting Recovery from Drugs and Alcohol.”

Proof: http://imgur.com/a/SBCU5

Q:

What are the most common cases you guys end up treating?

A:

Where do you see Sia in 3 years?


Q:

How accurate are the scientific underpinnings of the r/NoFap and r/pornfree movements? As a corollary, how accurate is the information provided on the website YourBrainOnPorn?

A:

Which 4 books did you use and in what order? Did you have a history of programming? I'd love to know where to start.


Q:

That exoskeleton looks really sleek. How much does the whole thing weigh?

A:

I'm from Ohio. How can we keep them from trying to pass bullshit legislation like they tried recently?

To be more specific, they wanted to select a fixed number of 'farmers' in the area and they would be the only sources allowed to supply the dispensaries. These farmers were pre-selected and were close to the group pushing the legislation. They would have been a legal, lawful monopoly and I can only imagine what the prices would have been.


Q:

What's your best tip for people so they avoid being in your previous situation entirely?

A:

Hi Scott,

I emailed you about something specific, and you gave me personal advice based on my situation and even monitored the flights for a little while to make sure I got the right price. That experience really stood out because I didn't even expect a response. You're absolutely amazing.

My question is, how are you able to keep a personal touch while probably getting hundreds of requests (if not more)?

Edit: also, do you see Sydney/Auckland flights being cheap any time soon? (From the east coast)


Q:

is your company named after the singer Sia Furler ?

A:

How accurate are the scientific underpinnings of the r/NoFap and r/pornfree movements? As a corollary, how accurate is the information provided on the website YourBrainOnPorn?


Q:

Paramedic N: "Our group mostly works in the 'critical care' section of the ER, so the patients we see are the most sick or the most injured, so our experience is skewed toward that patient group. This is my polite way of saying 'most Ghanaians don't die from awful car accidents or traumatic injury, most illnesses around here can be attributed to combinations of long term, uncontrolled high blood pressure, untreated diabetes, or general ignorance about how to handle common illnesses among the very young or very old'."

Dr.G: "Yeah I might also add that we see treatable disease processes that have progressed through their natural history to the peri-Mortem phase by the time we see a lot of them - lots of infectious disease including sepsis, meningitis, orbital cellulitis; also ARDS and acute pulmonary edema are big ones that we could actually treat and hope to reverse. I think altered mental status must be our number one issue in red ward."

Dr.N: "Agreed."

A:

I think that realistically in 3 years Sia will be used almost ubiquitously among privacy focused communities. I think we will also be seeing the first major names such as Netflix announcing that they will be migrating their content distribution to Sia.

Most people at this point will be comfortable with Bitcoin, and will understand that Sia is the data-version of this, even if they don't use it themselves.

The tech itself will be miles ahead of where it is today. We've only been in development for 2.5 years to date. Speeds will be universally regarded as unbeatable, scale will be billions of terabytes, and anyone using Sia will have access to their data from any machine by using just a master password.


Q:

It's my opinion that the research reviewed that YourBrainOnPorn provides is accurate and a solid overview of the research in the field at this time. I don't know a lot about NoFap and PornFree other than that they are forums that provide people support for people who are trying to abstain. I know that can be extremely helpful for people trying to quit.

A:

For iOS pick up (1) book on learning Swift; (2) Big Nerd Ranch book on making "practice" apps with Swift. For Android pick up (1) book on learning Java; and (2) Big Nerd Ranch book on making "practice" apps with Java.

With those four books, you should have a very strong foundation for getting out to sites like StackOverflow.com and advancing from there.


Q:

Not entirely sure, but not a lot

A:

The answer to your question is to keep doing what you're doing. Ohio voters clearly thought that initiative was wrong for Ohio, so they voted it down, and in doing so, they sent a message that that type of a proposal isn't going to fly.

I can't imagine anyone would be foolish enough to propose the same thing again. MPP certainly took it into account when we worked with local activists to bring forward a medical marijuana initiative last year. We have never backed laws like the 2015 Ohio initiative, but we took extra precautions to ensure our medical initiative avoided that type of system. I imagine anyone who supports a broader adult-use initiative in the future would also take similar precautions. At least I would hope.


Q:

Great question! My best tip would be to not bury your head in the sand and hope that the situation will go away. My initial student loan balance of $74k ballooned to $107k simply because I ignored the problem, stopped making payments, and let some of my loans slip into default. So I always encourage student loan borrowers to take action rather than let what happened to me happen to them. Perhaps that means switching to an income-driven repayment plan or putting student loans in deferment. Either of these options is better than ignoring the bills and missing payments. Ignoring the problem doesn’t make it go away. It only makes things worse.

A:

That is so kind of you to mention, thank you!

Honestly, I just feel like if someone takes the time to write me, it'd be kind of a jerk move not to respond? Maybe I'm old-fashioned that way haha. But I feel like I owe it to people, especially all you early adopters who took a chance on this weird guy with some cheap flight list, you know?

In any case, so kind of you to mention and I really appreciate it :-)

It's true that there are now hundreds of emails a day, but in terms of how, lotsa caffeine, quick typing fingers, and a decent ability to multi-task.

Thank you again!


Q:

Funny story. We picked the name expressly because there were no search results, other than some obscure javascript stuff and some singer who had relatively little popularity.

Then, like 3 weeks after we had committed to Sia, sure enough the word 'Sia' is trending and generating massive buzz because of her new music video. The one with an 11yo in a nude suit.

Sia the singer has of course done very well since then, and it's been annoying for us. But we chose to keep the name anyway, and we continue to be happy with it.

A:

It's my opinion that the research reviewed that YourBrainOnPorn provides is accurate and a solid overview of the research in the field at this time. I don't know a lot about NoFap and PornFree other than that they are forums that provide people support for people who are trying to abstain. I know that can be extremely helpful for people trying to quit.


Q:

I am naive of the situation, but is there anything practical that can be done to get more awareness/testing/treatment for the blood pressure or diabetes issues? Is insulin difficult to come by? I cannot imagine have to go through the starving death someone can go through.

A:

I would think that's just bad coding bespoke by PHBs up top, not inherently because of the evil of corporation.

Some other question I have: How is this paid for? Is it by donation? I would think it's like other open-source projects (Mozilla, GNU projects, etc.)

Also, what does this 'blockchain' mean, I know that bitcoin and other cryptocurrencies use 'blockchains' as a way to produce coins and validate transactions, but I'm not sure how that applies to cloud storage.


Q:

Do you believe any amount of pornography at any age is healthy?

A:

So if you used a phased array could you make the lights rotate around the arena?


Q:

Would you completely remove the body parts that don't function properly and replace them with cybernetic parts if we had the proper technology?

A:

AZ voters quashed legalizing recreational use in November. I believe that part of the reason for its failure to pass was that even people who are pro-recreational did not like how the law was structured.

Is it better to pass an imperfect law and tweak later? or should the goal be to have a robust law pass which would require little to no changes after implementation from the get-go?

EDIT: grammar and adding a big Thank you! for taking the time to do this.


Q:

This is why I eat sugary foods, to help poor up and coming dentists pay off their loans. Not because I don't have self control. Not that.

A:

Where is your favorite travel destination that you only discovered after finding a cheap flight there?


Q:

Sia has been making music for more than a decade, under that name and with other groups, like Zero 7.

A:

Do you believe any amount of pornography at any age is healthy?


Q:

I haven't heard of any Ghanaian's starving to death, though I'm sure it may happen from literal malnutrition due to poor dietary standards here. I'm also fairly positive its a massive contributing factor to the hypertension and diabetics. Practical help would be large scale human health classes at the high schools to help educate the general public generation by generation. Insulin is all over the place but very few physicians take time to adequately explain proper diet and why to people. That's not a complaint specific to KATH, that's a general issue explained to me by Ghanaians that I'll speak with at spots.

A:

I would think that's just bad coding bespoke by PHBs up top, not inherently because of the evil of corporation.

The result is the same either way. You trusted the corporation to protect you, and through negligence your data was compromised. We don't have to live with those vulnerabilities.

Some other question I have: How is this paid for? Is it by donation? I would think it's like other open-source projects (Mozilla, GNU projects, etc.)

We take a cut. Explained further below.

Also, what does this 'blockchain' mean, I know that bitcoin and other cryptocurrencies use 'blockchains' as a way to produce coins and validate transactions, but I'm not sure how that applies to cloud storage.

The blockchain for Sia is used to mediate contracts. I form a contract with a host that says "The host will store X data for N days. If the host has the data after N days, give the host these coins. The host must also put up some coins, and if the host does not have the data after N days, the host will not get my coins, and also will not get back its own coins".

So the blockchain is not used at all to move data around. It's used to create contracts that bind the host's revenue and collateral to a promise to be in possession of some data.

We make money by taking a fee out of that contract. The Sia blockchain will determine a contract illegal/invalid if the contract does not set aside 3.9% for us. That feeds us, lets us have engineering teams, etc. At this point, it's earning us not so much money (a few hundred per month at most). But we anticipate the network growing enough for it to pay for a whole company.


Q:

I would liken pornography to alcohol and drugs. For some people they can recreationally use porn and do not have problems but with a small minority it can create problems for them and become a compulsive behavior.

A:

Dude that's brilliant. We have done waves and other things like that, but with a section-entry UI, so the users could tell the program they were in section 101, for example.


Q:

Hell yeah

A:

I think the AZ initiative would have lost even if every "pro-legalization" voter voted for it. It might have received 49.9% instead of 49.7%, but I don't think it'd have won. The reason it lost is because (1) there was a massively well-funded opposition (spent ~$6 million, which is maybe the second or third most ever spent against a marijuana initiative); (2) a lot of the media outlets were quite slanted in their coverage, including the AZ Republic, which is the largest media outlet in a state with few large outlets; and most importantly, (3) this was the first time it had appeared on the ballot and the media and voters were new to it. There had been no local legalization/adult-use efforts like there had been in CO, WA, CA, MA, etc.

I don't think there is any way to pass a "perfect law" because there is no such thing as a perfect law. It's far too complex an issue and there are far too many viewpoints on it to appease every single person. You also have to factor in the potential for passage. Is a ballot initiative really perfect if it is all but certain to fail?

What we have seen time and time again is that reform is an ongoing process, not a finite solution. As we have seen in Colorado, the initiative laid the foundation and improvements will continue to be made.


Q:

haha - nice... fueling the economy one snickers bar at a time!

A:

Ohhh great question! This is going to sound silly, but Milan. I had zero interest in going to Milan, until I found a nonstop flight there for $130 roundtrip. Who wouldn't go to Milan for $130 roundtrip??

Granted, I didn't spend a ton of time in the city itself (aside from seeing an AC Milan game), but there's so much magic in northern Italy. Took a train to hike Cinque Terre, took a train up to Lake Como for the day, even took a train out to the Italy/Switzerland border to ski the alps right by the Matterhorn. All on a whim! Likely never would've gotten to do any of that if not for the cheap flight.

EDIT: flights were NYC-Milan for $130 nonstop roundtrip. Sorry for ambiguity about origin before!


Q:

This is true however she was not really a searchable name until her Chandelier video, at least as far as I remember.

A:

I would liken pornography to alcohol and drugs. For some people they can recreationally use porn and do not have problems but with a small minority it can create problems for them and become a compulsive behavior.


Q:

1) How did you get into the job and why did you decide to work in West Africa?

2) What are some things you have to struggle with everyday, regarding the different health care provided?

3) What are some of the differences in health care (e.g. First aid) we can't imagine?

Thanks a lot for answering :)

A:

When file sharing is enabled, who will pay the cost of bandwidth, and how? (For example, the situation where a renter shares a file that gets 1 million downloads.)


Q:

What exactly causes an addiction to sex? I can understand addictions to things we eat/drink/smoke because you are adding something to your body that causes a reaction. But how does one become addicted to a biological function? And how do you treat it, since it comes from within the person (not from an outside source)?

A:

Having them scan their ticket's barcode may be easier.


Q:

What is the best and worst part of your day that might come as a surprise?

A:

Has anyone followed that ~$6million money trail. That seems like a lot of money to piss away on something like this. I would guess that it might be possible that some if not a majority of it cam from those who profit off the black market, especially people south of the border there.


Q:

I'm super overwhelmed with all the options to repay federal loans (~$67,500 direct un/subsidized). I'm working in public service and currently qualify for the forgiveness program. What disadvantages are there to paying back the loans based on an income-driven plan or the public service forgiveness program?

A:

even took a train out to the Italy/Switzerland border to ski the alps right by the Matterhorn.

Cervinia-Breuil? How was it? Did you rent gear or bring your own? I'll be there in 2.5 weeks.


Q:

For sites like YouTube, we can also set up a cookie-based payment.

"can" as in "could theoretically implement this in the future" or "currently are capable of this?"

A:

What exactly causes an addiction to sex? I can understand addictions to things we eat/drink/smoke because you are adding something to your body that causes a reaction. But how does one become addicted to a biological function? And how do you treat it, since it comes from within the person (not from an outside source)?


Q:

1) How did you get into the job and why did you decide to work in West Africa?

Paramedic N: I showed up. Honestly. I went into the hospital and asked how I could contribute as a volunteer. A month later I was working in RED and helping to direct some training for the nurses. Another month later I am here offering instruction for other hospitals as they develop their own emergency medical protocols.

2) What are some things you have to struggle with everyday, regarding the different health care provided?

Paramedic N: The system for treatment is pay to play. This means that as a patient is brought in the nurses will take vital signs, strip the patient, obtain IV access and maybe place them on a simple 3 lead cardiac monitor. If the patient needs additional medications or interventions they have to pay for them up front. If the patient is unconscious then the family has to pay for that up front. If the patient is awaiting further consultation (say, from the surgical unit) because they need X-rays, they have to pay for that up front. Otherwise, nothing will happen and the team will typically stand by idly, sometimes even until the patient codes. That's a pretty wild difference.

3) What are some of the differences in health care (e.g. First aid) we can't imagine?

Literally all of it. My personal favorite horror story is watching a doctor here make it a priority to provide a patient with a heart rate of 230+ motrin prior to even placing the patient on a monitor and assessing their electrical status, or even their blood pressure. For every mind blowing decision we've seen here, there are equal moments of really clever, cheap methods used to provide interventions.

In short, it's a mess.

A:

The downloader pays the cost of bandwidth. If someone uploads a file and unexpectedly gets 1 million downloads, it will not cost them because each downloader will be paying their own way.

For sites like YouTube, we can also set up a cookie-based payment. YouTube would give you a cookie that basically says 'Good for 300MB' or similar, and you would give that to the host to make the download. In this case, YouTube would have full control over the creation of cookies and would be able to stop any malicious behavior, the host can still get paid, and the user doesn't even need to know that they are actually doing a Sia download when they watch the video.


Q:

Sex addicts are more likely to have histories of emotional, physical and sexual trauma in their background and they are also more likely to have a history of problems with attachment and intimacy. Those are some of the most common etiological factors to sex addiction. However we are seeing young people these days who are hooked on to porn that do not have the same trauma history and attachment histories that we see in the typical sex addict. They get exposed to graphic, intense, online pornography and become hooked.

Orgasm is the natural blast of dopamine to the brain. Dopamine is considered the master molecule of addiction. When an individual uses porn it stimulates its reward center with dopamine. When this is overstimulated, the brain compensates by reducing the number of receptor sites in the synapse. Therefore it takes more intense use to get the same high. They have flooded their reward centers with dopamine just like someone does with substance abuse. So the changes in the brain for a porn addict, are very similar to the brain changes to someone who is addicted to drugs and alcohol. This same process occurs with food as well as other natural addictions like video games and gambling. And the treatment is similar to that of an eating disorder. Individuals need to learn how to have a healthy relationship with food just like they need to learn how to have a healthy relationship with sexuality.

A:

Yes, someone actually mentioned that to me last month and it's definitely something we should implement.


Q:

The best part of waking up is Folgers in your cup. (I don't actually drink coffee). The worst part is not being independent. I need help with everything. With eating. Getting things. Not being able to go to the bathroom on my own.

A:

They received a solid chunk of dough from a shady AZ-based pharma company that produces a deadly painkiller and is in the process of developing "pharmaceutical cannabinoids." https://www.washingtonpost.com/news/wonk/wp/2016/09/09/a-maker-of-deadly-painkillers-is-bankrolling-the-opposition-to-legal-marijuana-in-arizona/


Q:

Yeah, there’s no doubt that the number of federal options is overwhelming and there’s not a ton of help on choosing the best one for you. But it’s great to hear you’re familiar with the Public Service Loan Forgiveness program (PSLF)! This program is one of the best deals out there. In order to receive full forgiveness on your eligible federal loans (and your Direct unsubsidized loans are eligible), you must complete 120 monthly payments (10 years) on an income-driven repayment plan and/or the Standard, 10 Year Repayment Plan.

So if you’re not already enrolled, getting onto an income-driven plan should be your first move. Counter-intuitively, you want to minimize the amount you pay when you’re pursuing PSLF because anything you don’t pay is ultimately going to be forgiven anyway. one of these plans is the first step. In addition, you must: Work in qualifying public service employment for at least 30 hours/week while making those 120 payments (sounds like you’ve got this covered). Completed the PSLF employer certification form for each employer during that 10 year period. You can find that here. Then, after you’ve completed 120 monthly payments, you can complete the forgiveness application!

Public Service Loan Forgiveness be a great option for public teachers, government workers, or non-profit employees who are struggling to repay their federal student loans. Doctors working in public hospitals can often take advantage of this program as well. You can learn more here.

A:

that's the one! it's glorrrrious. i rented at a place in town. wasn't very pricey if i recall. doesn't seem worth the hassle to me to bring your own.

have a great trip!! if you are inclined hashtag any instagram photos #scottscheapflights so we can follow along and repost!


Q:

We have the designs needed to implement this in the future. If we put it as the next thing in our pipeline, I'm estimating it'd take 3-5 weeks to implement. We would have to extend the host-renter protocol, which means it wouldn't be usable until enough hosts had upgraded, which would probably take an extra 2-4 weeks.

You can't do it using today's software. I'm expecting us to have it implemented by the end of the year, though before we get that far we have other priorities.

A:

Sex addicts are more likely to have histories of emotional, physical and sexual trauma in their background and they are also more likely to have a history of problems with attachment and intimacy. Those are some of the most common etiological factors to sex addiction. However we are seeing young people these days who are hooked on to porn that do not have the same trauma history and attachment histories that we see in the typical sex addict. They get exposed to graphic, intense, online pornography and become hooked.

Orgasm is the natural blast of dopamine to the brain. Dopamine is considered the master molecule of addiction. When an individual uses porn it stimulates its reward center with dopamine. When this is overstimulated, the brain compensates by reducing the number of receptor sites in the synapse. Therefore it takes more intense use to get the same high. They have flooded their reward centers with dopamine just like someone does with substance abuse. So the changes in the brain for a porn addict, are very similar to the brain changes to someone who is addicted to drugs and alcohol. This same process occurs with food as well as other natural addictions like video games and gambling. And the treatment is similar to that of an eating disorder. Individuals need to learn how to have a healthy relationship with food just like they need to learn how to have a healthy relationship with sexuality.


Q:

Hi! I have a quick follow up question to this if you don't mind.

What happens if a patient is in unstable condition? Are you allowed to resuscitate without payment?

A:

How exactly would YouTube be able to identify malicious behavior?


Q:

Will we ever be desensitized to porn because it's too ubiquitous?

A:

We have done waves and other things like that, but with a section-entry UI, so the users could tell the program they were in section 101, for example.

I think this is one of the most innovative and clever apps I've seen in a very long time. Congrats man!


Q:

How heavily involved in BMX were you at the time of your injury?

A:

Do you believe in legalizing other drugs or plants, such as psilocybin mushrooms or mescaline containing cacti?


Q:

Are you taxed on the amount that is forgiven? It still would be cheaper regardless but just curious if you should be saving for a lump sum to pay off.

A:

Ever managed to get a 100% discount? Did you then put on shades and say "looks like you got off... Scott free"


Q:

How exactly would YouTube be able to identify malicious behavior?

A:

Will we ever be desensitized to porn because it's too ubiquitous?


Q:

Paramedic N: Yes but no. We will provide chest compressions and obtain advanced airway interventions, but if the family did not purchase any additional pharmaceuticals (Epinephrine) then none of it really matters.

What's worse is in the rare cases when we do achieve ROSC and there are no additional meds to maintain that fragile stability.

A:

The same way that they identify it today. YouTube already has to pay for all the bandwidth that they consume to funnel content to users. Sia would actually be able to do that for them for much cheaper than what their current costs are.


Q:

Our culture has become desensitized to porn and is much more sexualized than it was 30 years ago. Consider how a Playboy compares to a typical porn site of today. There is a lot of pressure for young women to look like porn stars and act like porn stars. Young men are also trained culturally to objectify and sexualize women in ways that had't been occurring in our culture in the past. There is research that shows that there are some socio-cultural concerns with porn including an increase in sexual aggression towards women and the rape-ness acceptance. As a culture we are involved in a major social experiment to see how wide spread, easy access to porn will affect relationships and gender roles in society.

A:

Thanks!


Q:

Pretty involved. It's all I did. I worked at a bike shop. I rode my bike every day with friends. Went on trips constantly to skate Parks or just looking for places to ride

A:

MPP works exclusively on marijuana policy, so professionally I don't get into addressing those substances.

Personally, I believe the use of any substance should be treated as a health issue and not a criminal justice issue. I think all substances should be treated based on their relative effects and potent for harm. In other words, I don't think it's a legal-vs-illegal situation — it's a lot more complex with different approaches to different substances.


Q:

Good news, you don’t have to pay any taxes for loans forgiven under PSLF! You only have to pay income tax on loans forgiven through an income-driven repayment plan (which also only grant forgiveness after 20-25 years depending on the plan). So basically, if you didn’t claim your tax-free PSLF forgiveness after 10 years, you could continue paying for 20-25 years and receive taxable forgiveness. Needless to say, if you qualify for PSLF, this is a much better option.

A:

Sheeeiiiitttt me at the airport IRL getting five-finger discount flights: http://giphy.com/gifs/deal-with-it-joe-biden-Me9HRX7wrTsKQ


Q:

The same way that they identify it today. YouTube already has to pay for all the bandwidth that they consume to funnel content to users. Sia would actually be able to do that for them for much cheaper than what their current costs are.

A:

Our culture has become desensitized to porn and is much more sexualized than it was 30 years ago. Consider how a Playboy compares to a typical porn site of today. There is a lot of pressure for young women to look like porn stars and act like porn stars. Young men are also trained culturally to objectify and sexualize women in ways that had't been occurring in our culture in the past. There is research that shows that there are some socio-cultural concerns with porn including an increase in sexual aggression towards women and the rape-ness acceptance. As a culture we are involved in a major social experiment to see how wide spread, easy access to porn will affect relationships and gender roles in society.


Q:

This seems odd - advanced airways would surely cost more than a vial of adrenaline?

Also, what's the point of attempting resus if post-ROSC care isn't there?

A:

"What does Sia offer? What makes it unique and worth investing? Elevator pitch... I never read up on it and obviously didn't invest. Juuuust curious."

Someone in a crypto-investing slack asked these questions^


Q:

Do you find that a lot of sex and porn addicts are more likely to have other addictions as well (drugs, alcohol) or is there no correlation?

A:

how much time did you spend learning per day?


Q:

Just how close are we to having an ironman suit?

A:

Thank you for doing this AMA.

My question involves workplace drug testing. As you know, many companies continue to do pre-employment drug testing as well as others who will also conduct random testing. In states where marijuana is legalized, we are still seeing that companies are not shifting their drug testing policies; they are still testing for and refusing to hire a person who has ingested a legal substance.

In my opinion, marijuana legalization will not be completely successful unless these policies are changed, and while Congress may be convinced to full legalization, I'm worried about the private companies who will continue to punish their employees for consuming marijuana, even if they do it off company time and do not show up to work high.

So my question is, what are MPP's ideas for changing the workplace drug testing policy?


Q:

I currently have 55,000 dollars of student loans. My interest is 6.75% and I feel like I just cannot make a dent. With a mortgage and car payments I just feel like this is impossible. Any advice?

A:

Why are there rarely great deals out of DFW?


Q:

"What does Sia offer? What makes it unique and worth investing? Elevator pitch... I never read up on it and obviously didn't invest. Juuuust curious."

Someone in a crypto-investing slack asked these questions^

A:

Do you find that a lot of sex and porn addicts are more likely to have other addictions as well (drugs, alcohol) or is there no correlation?


Q:

Paramedic N: The stuff to the advanced airway stuff is already there and ready to be used, the adrenaline has to be purchased from the pharmacy outside of the ward and down the hall. There is post-ROSC care here, there are plenty of meds and pumps to execute post-ROSC care, but many of the doctors do not plan for it, i.e; they do not have the family proactively purchase those drugs.

A:

Our website I hope does a good job of explaining Sia. If not, we'd love some feedback.

Generally, our targets are not speculators/investors - our focus is users. Siacoin the cryptocurrency is a necessary component of the Sia network - it's how we penalize hosts if they don't store your data as promised. Without that, I feel that Sia would be vulnerable to a large number of attacks. Happy to expand on this in another top-level question.

But essentially, the siacoin itself is designed as a security component to the network, and while it's also a speculation instrument by side-effect, increasing the siacoin price is not a primary goal of ours. That said, I do expect it to go up substantially if Sia usage goes up substantially - you need siacoins to use the network, and there is a fixed supply.


Q:

Absolutely. Drug addictions and sex addiction are highly co-occurring. Studies have shown that in chemical dependency treatment programs 4/10 males can meet criteria for sex addiction. Another study showed that 45% of sex addicts had chemical dependency and 35% had eating disorders. They are highly co-morbid.

A:

About four hours, seven days a week, for six months. Then I spent the next few months with programming as my basically full-time job, so I was pretty immersed from the get-go.


Q:

That information is classified

A:

Our position is that employers should treat marijuana similarly to alcohol. Employees should not be punished for responsible off-the-job consumption that does not affect their work. Obviously there are some occupations out there that are more sensitive than others (pilots, electrical workers, etc.), but we already have public policies that address safety-sensitive occupations.

The question is how to bring about such policies. And it's worth noting that different states handle this subject in different ways. For example, some states have laws that prohibit employers from firing employees solely for engaging in a legal activity. Other states do not have such laws and allow employers to fire employees without cause. So it could be the case that this will not be handled as a marijuana-specific issue and just falls under other employment laws. But that's not to say it will result in the fairest outcome. Even in Colorado, which does have such a law that protects employees who engage in legal activities, the courts determined marijuana use is not covered because it is still an illegal activity under federal law.

This subject (employment) is NOT unique to marijuana. Dictating employment policies via public policy is always a politically sensitive subject. Lawmakers know it is touchy and so do advocates and political professionals who work on ballot measures.

That is why, ultimately, I think this is going to be an issue that gets sorted out culturally. It might get addressed legally at times, and we have seen employment protections included in some marijuana policy reforms. But overall, it is just going to be a matter of time before more laws change and the public's attitude changes. For the same reason that most employers would not want to fire good workers (and then recruit and train replacements who may not be as good/experienced) simply for legally using alcohol while they're off the job, most employers are not going to want to go through all of that for employees who legally use marijuana off the job. It simply is not good for business.

The problem is that we still have a lot of people out there who still believe a lot of the old reefer madness and actually think a marijuana user is unfit for employment. But people's attitudes are changing and as the old guard is replaced by people who have more modern views on marijuana, businesses will voluntarily change their policies. Changes in marijuana's legal status will help too — there are surely employers out there who don't care so much about marijuana as they do about having a "lawbreaker" on the payroll. And keep in mind that larger companies with offices/locations in multiple states might want/need to treat all of its employees equally, so they might not make these changes until marijuana laws change in all of those states. Or possibly not until there are federal changes.

When it comes to our work, we want to promote the fairest policies possible. But sometimes it is clear that putting something in a bill or initiative re: employment policies will all but guarantee it's failure. If we believe that will be the case, we oftentimes keep measures silent on the subject because we know it will be something that gets addressed quicker if we make progress. If our goals are to end prohibition and protect employees' rights, but it's clear that including the latter will doom both goals, then it makes sense to address the former. It will then be much easier to address the latter.


Q:

Hi, and thanks for your question! If those $55,000 are federal student loans, you’ve got plenty of options for reducing your payments while you focus on other debt like that mortgage. One of the best choices may be to look into income-driven repayment plans. These are a set of plans available for federal loans that will set your payments to be in line with your income, rather than using your loan balance as a basis.

I actually was enrolled in one of these plans while I was struggling to juggle all of my debt. You can read more about them here and calculate your potential payments using these calculators. I hope this helps!

A:

The stupid AA monopoly there :-(

I wrote up a longer explanation here but the tl;dr is that the American Air monopoly in DFW prevents more airlines from competing on price, so fewer opportunities for cheap flights, mistake fares, etc.


Q:

Our website I hope does a good job of explaining Sia. If not, we'd love some feedback.

Generally, our targets are not speculators/investors - our focus is users. Siacoin the cryptocurrency is a necessary component of the Sia network - it's how we penalize hosts if they don't store your data as promised. Without that, I feel that Sia would be vulnerable to a large number of attacks. Happy to expand on this in another top-level question.

But essentially, the siacoin itself is designed as a security component to the network, and while it's also a speculation instrument by side-effect, increasing the siacoin price is not a primary goal of ours. That said, I do expect it to go up substantially if Sia usage goes up substantially - you need siacoins to use the network, and there is a fixed supply.

A:

Absolutely. Drug addictions and sex addiction are highly co-occurring. Studies have shown that in chemical dependency treatment programs 4/10 males can meet criteria for sex addiction. Another study showed that 45% of sex addicts had chemical dependency and 35% had eating disorders. They are highly co-morbid.


Q:

they do not have the family proactively purchase those drugs.

I'm a paramedic in the US, and thought this sounded like a cool thing I might be interested in (I have some experience volunteering in Africa, but on IT projects). Having read this... Nope... Couldn't deal with the frustration of that.

A:

Have you got any corporate clients?


Q:

Addiction to pornography seems like a serious problem plaguing our society today whether we want to acknowledge it or not. I'd like to know what the numbers for this addiction looks like worldwide? Also, what action plan would you recommend to addicts to help them get over their addiction?

Thank you.

A:

cool. any tips on staying motivated and getting disciplined?


Q:

oh hey, I saw your post earlier, and I've been waiting for this AMA since then, would you mind telling me what company made that exoskeleton and how much does it costs?

A:

What can I do to legalize marijuana? How can I help? Who can I contact, and what should I ask them? I live in NC.

Edit: added details.


Q:

Have you got any corporate clients?

A:

Addiction to pornography seems like a serious problem plaguing our society today whether we want to acknowledge it or not. I'd like to know what the numbers for this addiction looks like worldwide? Also, what action plan would you recommend to addicts to help them get over their addiction?

Thank you.


Q:

Paramedic N: It's different on different days, man. Some doctors are really on top of their game, some are still learning.

A:

Nothing we are able to announce yet, however having corporate clients is both a short term goal and a long term business strategy for us. We are in the process of forming relationships with several corporations, and hope to have some big announcements in the next few months.


Q:

Currently there is no large epidemiological study with prevalence rates for sex addiction. It's one area of research that's lacking. The current estimated prevalence rate ranges from anywhere from 2% to 10% of the population depending on age, location and cultural background. I would recommend someone struggling with sex or porn addiction to seek a certified sex addiction therapist, get an evaluation and get a treatment plan. There are lots of good in-patient and out-patient treatment programs all over the country to help people.

A:

For me, it's always just been a lot of pressure I put on myself. I want to succeed so that this pressure will finally go away. Me_irl.


Q:

I'm not exactly sure on cost but here's the website

A:

Most importantly and at the most basic level, you can talk about the issue, starting with the people closest to you and working your way out to the people furthest from you. Talk to your family members and friends. Make sure they know this issue is important to you and let them know why. I also strongly encourage you to begin by making sure they understand marijuana is a less harmful substance than alcohol — this is a critical fact that many people still don't know. In the case of opponents, people are more likely to reconsider their long-held beliefs if they are approached by somoene close to them, as opposed to being handed a flyer or seeing an ad.

As for taking things to the next level, find out what's happenign your state. You can do this on our website at https://www.mpp.org/states Find out if there is good or bad marijuana legislation on the agenda this year and then be sure to contact your state legislators about it.

You can also take action at the federal level by contacting your U.S. rep and senator — https://www.mpp.org/federal

Look around online to see if there are any local organizations that have already been formed to work on this issue in your state or city. If there are, try reaching out to them to see how you can get involved.


Q:

We hear about a lot of problems with servicers. And we did see the news that came out yesterday about Navient. We’ll be covering this on our blog along with what borrowers can do. If you’re having problems, see here for where you can go to report the issues and potentially find help.

A:

Ahhh hopefully this year, but lemme explain a bit more about why I haven't started doing domestic US deals yet.

Flights to Europe typically cost $900. Many of the flights I'm able to find and send out cost $400. Savings: $500.

Domestic flights vary significantly by routing, but typically are $350 or less. Let's say you're flying JFK-LAX. Typically $350. A really good price for that route would be like $225. Savings: $125.

Obviously nice to have those savings, of course, just not nearly as much on an absolute level, you know?


Q:

Nothing we are able to announce yet, however having corporate clients is both a short term goal and a long term business strategy for us. We are in the process of forming relationships with several corporations, and hope to have some big announcements in the next few months.

A:

Currently there is no large epidemiological study with prevalence rates for sex addiction. It's one area of research that's lacking. The current estimated prevalence rate ranges from anywhere from 2% to 10% of the population depending on age, location and cultural background. I would recommend someone struggling with sex or porn addiction to seek a certified sex addiction therapist, get an evaluation and get a treatment plan. There are lots of good in-patient and out-patient treatment programs all over the country to help people.


Q:

The system for treatment is pay to play

Holy shit that's distressing. What would you say the cost is in terms of american or UK money?

A:

When you get corporate clients are they going to be paying in dollars or siacoin?


Q:

The only question that actually matters: do you indent with tabs or spaces?

A:

What was the biggest moment in recovery from the time you were injured until now?


Q:

I support legalization, but I don't want to do it on the grounds that it is more or less harmful than a legal substance, because that would set the wrong precedent for ending all drug prohibition. It's a matter of personal freedom to commit a victimless crime, not an issue of what is better of worse for your body.

A:

Can you explain in layman's terms what you do to reduce the student debt of individuals?


Q:

Hey Scott, love the free emails! I signed up last time I saw you in here and I've already booked two flights to Europe for this year! I was wondering if there'd be a way to filter the emails so that I only receive them if they contain an airport around me? It's really disappointing to see an awesome deal on a flight I'd love to book, only to see that the closest airports are 10 hours away.

Thanks for doing this!

A:

When you get corporate clients are they going to be paying in dollars or siacoin?


Q:

Paramedic N: Its about 4 GHC to 1 USD now, and even then the drugs are generally dirt cheap. But the economy has been hard on Kumasi for about a decade now and money is tight everywhere. Most people are working with fractions of what they used to have.

A:

Depends on the corporation, and the specific deal, and also depends on what are lawyers say is safe for us to do.

If corporate clients are willing to pay in siacoin, it's very simple for them to use the network. They can hire us on support contracts if desired, or if they aren't having any trouble they can just use it themselves and not even notify us that they've begun using Sia.

If siacoins are not compatible with their internal policies, we will be able to work with them anyway to get them operating on the Sia network, though the specific process will probably vary by customer.


Q:

100% tabs

A:

I've had a couple. When I was first injured I had actually no use of any my limbs. I was also on a ventilator. So I couldn't eat or speak. When I was finally taken off the ventilator and could eat again that was a pretty big moment. Then I slowly regain use of my left arm. Then seven months later came my right arm. And then three years ago I started regaining use of some of my left wrist


Q:

Fair enough. Please note I said you should talk about why it's important to you. That could be any number of reasons.

But if your goal is to increase support for legalization, I encourage you to consider why it is that people are opposed it, which 99 times out of 100 is because they believe it poses too much harm to be made legal (be it harm to consumers' health or spirit, harm to non-consumers' around them, or harm to society overall). If you want to convince that person that they should make marijuana legal, you need to address that concern. You don't necessarily need to compare it to alcohol, but that is simply a good basis for comparison given our nation's history with prohibition/repeal and the similarities in the products (i.e. they should be used by adults and not kids, they are part of our culture, they should be used responsibly, etc.). If a person is willing to accept that alcohol should be legal, they will have a heard time coming up with reasons why marijuana — a substance that is objectively less harmful to the consumer and to society — must remain illegal. But as I said, you should make the case you are comfortable making. I'm simply providing my advice for what appears to be the most effective when it comes to shifting people's attitudes.

A:

Absolutely. Let me put on my ELI5 cap for a second. At a high-level, we do 3 major things:

First, we write (A LOT) of blog posts about how to pay off student loans quicker and easier. For example, here’s our Ultimate Guide to Paying Off Student Loans Faster. This is one of our more popular guides.

Second, we have a free web app which helps borrowers manage, track, and pay off their loans faster. Specifically, it helps borrowers keep all their loans in one place and get specific recommendations on how to pay off their student loans quicker. (We use a pretty neat algorithm to help with the latter.)

Third, we talk quite a bit about refinancing student loans to lower interest rate and get out of debt quicker. It’s not right for everyone, but for some people it can make a massive difference. For example, we have a team member here who refinanced his federal student loans with Earnest a couple months ago and dropped his interest rate from 6.05% to 3.43%. Massive win for him, and for the thousands of other borrowers who do the same.

There’s a lot more we do, but in general terms those are the 3 bigger things we’re doing right now. We’re also moving into other areas to help people improve their finances in general. For example, how to lower credit card debt, whether you should rent or buy a home, and more things along those lines. What else do you think we should do?


Q:

Amazing!! Where are you going??

Great question! So we just implemented that functionality (seriously last week) to filter alerts so it's only for airports you're interested in, but alas it's one of the perks for premium subscribers. Really sorry about that!

A:

Depends on the corporation, and the specific deal, and also depends on what are lawyers say is safe for us to do.

If corporate clients are willing to pay in siacoin, it's very simple for them to use the network. They can hire us on support contracts if desired, or if they aren't having any trouble they can just use it themselves and not even notify us that they've begun using Sia.

If siacoins are not compatible with their internal policies, we will be able to work with them anyway to get them operating on the Sia network, though the specific process will probably vary by customer.


Q:

How many people would you say are able to afford their care? How much does the least expensive and most expensive procedure cost?

A:

Btw, you guys talked about a surprise.. Care to share it?


Q:

Is selling to Google the dream?

A:

C5 complete here! If you don't mind me asking, what level are you? I'd be cool if I could try something like that!


Q:

What is the primary difference between your group, MPP, and NORML? Do your organizations collaborate?

A:

Hi Andy. I have just over $31,000 in student loans. I'm severely underpaid making around $30,000 annually. I've been making $500 payments monthly for a while, and my debt is slowly going down, but I'd like to see it go down quicker.

Other than finding a job that pays more, what strategies can you recommend I use to reduce my debt? The interest is the same on each of my loans. Does it make sense to pay off the smaller of the loans first?

Thanks.


Q:

Totally reasonable

A:

Btw, you guys talked about a surprise.. Care to share it?


Q:

Paramedic N: Most, I suspect. It's a matter of getting payment where it needs to be in time for it to matter. There are wildly effective nervous system procedures that are obscenely expensive and there are wildly effective cardiac emergency interventions that are pennies on the dollar.

A:

Next week we will be announcing an opt-in leaderboard for storage. Users can compare how much they've uploaded and compete to rank on the ladder. The top new users each month will get prizes like T-shirts.

This leaderboard is completely opt-in, and the only information you provide to the leaderboard will be evidence of how much data you have stored with each host. The leaderboard won't know anything about how many files you've stored, their names, etc, and again it is fully optional that you participate.


Q:

Yes

A:

I'm C4-C5 complete. If you get the opportunity to use one definitely do it


Q:

NORML has a smaller staff and a large network of state, local, and campus chapters all over the country, which are largely organized by volunteers.

MPP has a larger staff but does not have chapters. At the state/local level, we work with a variety of volunteer activists and organizations, which includes NORML chapters/members/leaders. NORML has also rallied its network to support a lot of the initiative campaigns MPP has organized, and at times contributes to the drafting process for initiatives and bills MPP is supporting.

On a personal level, former MPP staffer Steve Fox and I co-authored a book with NORML Deputy Director Paul Armentano. And since Paul is the most knowledgable person I know when it comes to cannabis facts/research, I often turn to him as resource or forward reporters his way when they're seeking experts.

A:

Hey, thanks for the question. First, let me give you kudos for making such large payments on your loans, I’m a big proponent of paying down your debt ASAP. So let’s talk strategy. The fastest and most efficient way to pay down your loans is to target paying off the loan with the highest interest rate first (after making the minimum payment on all other loans, of course) and then going from there. You can use our Prepayment Calculator to estimate how much time and money you’ll save by efficiently allocating additional payments. Secondly, you may want to look into refinancing. Based on your current debt-to-income of at least 1, your odds may not be great for being approved. However, you’re paying your loans down fast enough that you may soon be in a position to seriously consider it. Refinancing can lower your interest rate, helping you reduce the total amount you’ll pay. Student Loan Hero also provides a free dashboard where you can sync your student loans and manage your repayment; you might find that helpful.


Q:

:-)

A:

Next week we will be announcing an opt-in leaderboard for storage. Users can compare how much they've uploaded and compete to rank on the ladder. The top new users each month will get prizes like T-shirts.

This leaderboard is completely opt-in, and the only information you provide to the leaderboard will be evidence of how much data you have stored with each host. The leaderboard won't know anything about how many files you've stored, their names, etc, and again it is fully optional that you participate.


Q:

Hello! I am from Ghana and I was actually born in Kumasi. I would like to thank you for helping out my people. I know that the concept of emergency service in Ghana is not very well known to the people So i guess my question is do you receive many actual emergency cases? And what is the most interesting/bizarre case you have encountered? Thank you.

A:

Is there any stats on how much data is stored on the network as a whole? I saw something on your slack that it was only around 10-15 TB, but I can't really find any authoritative sources.


Q:

Do you have an example of your code? (not necessarily the code you wrote for these apps.)

Mostly I'm curious how far you've managed to get in 18 months. I find that most people who start learning how to program don't actually get very far and level off quickly. They seem to get stuck writing procedural code and never learn software engineering architecture. Though I suspect you may have pushed yourself to actually learning OOP and Design Patterns and Architecture and things like Unit Testing / TDD.

A:

What's the realistic goal and the dream goal for you in using the exoskeleton?


Q:

What's the best way to lobby for decriminalization while maintaining your privacy?

A:

Hello, I currently have about $35,000 in student loans and just recently bumped my payments to the maximum amount of around $500 per month. I was wondering if it's possible to pay off my higher interest loans (6.5%) first and then move to the lower interest loans (3%) through fed loan servicing? Or should I try to consolidate my loans and get a lower fixed APR if that's even possible?


Q:

You seem like such a nice person and I just want to give you a hug.

A:

Is there any stats on how much data is stored on the network as a whole? I saw something on your slack that it was only around 10-15 TB, but I can't really find any authoritative sources.


Q:

Paramedic N: Ete sen! We get real, very legitimate emergencies all the time in RED. For a patient to be sick enough to be distributed to our team they are pretty obviously ill or injured severely. That said, the most bizarre case we had was a young man brought in on a wheel chair. Allow me to set the stage.

We already had three patients with almost every nurse and doctor around them helping to keep them alive or monitoring the various drips or machinery and then this new patient is wheeled in. He had three friends or family with him and his eyes are wide open and he just sorta looked 'out of it', as though he were extremely drunk. I take a quick look with a pen light at his eyes and notice two quick facts.

  1. His eyes are dialated and completely unreactive to light. Neat.

  2. He is agonally breathing.

When I finally get the help of others to get the patient on the bed, striped, put on the monitor and a set of vital signs, it became real apparent real quickly that this fellow was essentially dead and moments from meeting his God. His spine was compressed, his abdomen was distended, his pressure was almost non-existent, his lungs were full of fluid, his heart rate was barely 30. When we finally got a sort of answer from the family they explained he was working on a building site and fell. His injuries looked like something I would expect from a fall from a three floor building, but then they told me the part that literally almost made me laugh out loud. The man had fallen three days ago and was only now being brought to the hospital.

He didn't make it, he coded about an hour later and that was that. I still try to figure out what the hell everyone was thinking with that guy. My theory is that his boss didn't want to get the blame for his fall death from lack of safety equipment (which is real common here) or some madness.

A:

There's really not any good way to measure that, as it were. Sia does everything over payment channels, including uploads.

Payment channels are both a scalability and a privacy upgrade. It allows many uploads and downloads and payments to happen in a single blockchain transaction. A downside of this though is that, on the blockchain, the amount pretty much always reads '0'. So when you upload 50 TB of data to our network, there's actually no way for us to reliably track that.

It's one of the disadvantages of private, decentralized systems.

We do however have the ability to monitor how much money people have allocated in total for storage. And as of this morning, that was more than 35 million siacoins.

edit: the leaderboard of course will give us a better idea, but users have to choose to share this information with us. So at best, it gives us a lower bound on how much data the network is storing. I'm guessing that most of our business clients will refrain from using the leaderboard, though they will probably be a massive percentage of the total data consumed.


Q:

Yes, I recently posted this software to GitHub. I typically don't work with other devs so my style may be very different, but this is the software that got me to where I am and I'd be lucky if others thought it was good enough for them to use as well.

A:

I'm like Forest Gump. I just like walking.


Q:

This is a great question. I spent countless hours collecting signatures for ballot initiatives in Colorado and frequently came across people who were supportive but feared signing because they feared their employer would find out or that it would somehow become public. I even remember a few saying their husband/wife would kill [them] if they found out!"

Sometimes it was obvious that the person was misguided or just didn't want to stop (e.g. the person who said "I'm a lawyer and I'll be disbarred if I sign," which any lawyer would know is bullshit). But sometimes it was obvious that they were truly worried. People who were on probation or parole or who know their employer is incredibly strict about marijuana, who fear they will be suspected of using marijuana and subjected to a drug test if someone saw them signing or saw their name on the sheet while signing.

Ultimately, I would just encourage you to do whatever you are comfortable doing. Maybe you aren't comfortable being at a public event handing out literature, but maybe you would be okay with dropping it on doorsteps or placng it on car windshields in the evenings. If you aren't comfortable talking to the people you know, maybe stick to strangers by participating in a phone bank where you're calling random people. If it's a campaign, perhaps they need assistance with data entry, licking envelopes, or coordinating other volunteers?

A:

Glad to hear you’ve bumped your payments up! By maximum, do you mean the most you can afford? I’m asking because there shouldn’t be any limit on your monthly payments. And yes, all lenders will allow you to choose which loan you want to apply extra payments to. This as long as your loans have not been consolidated. You can learn how to do that here. It’s likely going to be hard to find a lower interest rate than 3%, so you may be better off using the Debt Avalanche to pay off the higher interest rate loan first, or you could consider refinancing only that loan and leaving the 3% loan as it is.


Q:

Aww I love random Reddit hugs! * hug *

A:

There's really not any good way to measure that, as it were. Sia does everything over payment channels, including uploads.

Payment channels are both a scalability and a privacy upgrade. It allows many uploads and downloads and payments to happen in a single blockchain transaction. A downside of this though is that, on the blockchain, the amount pretty much always reads '0'. So when you upload 50 TB of data to our network, there's actually no way for us to reliably track that.

It's one of the disadvantages of private, decentralized systems.

We do however have the ability to monitor how much money people have allocated in total for storage. And as of this morning, that was more than 35 million siacoins.

edit: the leaderboard of course will give us a better idea, but users have to choose to share this information with us. So at best, it gives us a lower bound on how much data the network is storing. I'm guessing that most of our business clients will refrain from using the leaderboard, though they will probably be a massive percentage of the total data consumed.


Q:

Me ho ye! Wow thank you for your reply. That is crazy. Especially waiting three days to take him to the hospital after the initial injury.

A:

How do you see minebox.io impacting your business?


Q:

EDIT: This post took me a few minutes of my break to write and it totally blew up and I am getting a ton of response for how rude / nitpicky / "undergrade CS student"-y I am and how debatable some of these points are. If you want to do a proper code review for OP in your free time, feel free to do so. And if the company you work at omits curly if braces without setting any hardware on fire, then that's fine too. This was nothing but a "huh-this-guy-should-totally-be-using-JavaDocs-to-perfect-his-code-and-I-should-let-him-know" kind of moment that got way too much attention. I just think that for someone like OP, who has never worked in a team, this kind of feedback is important as code consistency is a pretty fiery topic when you work on a larger project as part of a team.

Just quickly skimmed the Android code, at first sight I saw a few inconsistencies with code formatting and things which some may consider bad practices. I would definitely stop writing if conditions without {} brackets, it's bad practice and just leaves room for errors, most companies with code reviews will enforce this for good reason.

Also, make sure you code formatting is consistent, sometimes you write "if (blah == blah)" and other times it's "if(blah == blah)", for example. Your IDE should be configured to fix this / you should be using the "reformat code" feature before committing to make sure it's following the coding standards of the respective language / framework.

Another thing I noticed were redundant comments, nobody needs comments which point out very obvious things like this:

//color: green ripple.setRippleColor(getResources().getColor(R.color.green)); 

You did this for each color in a switch block in your Android MainActivity, which is kind of unnecessary and just clutters the code, as this part is very easily readable.

You should also be using JavaDoc comments instead of writing these odd non-standardized multi-line comments like this:

//======================================================== // Blah //======================================================== 

I have not checked your code logic, but for 18 months it looks pretty decent, your lack of strict following of standards mainly shows that you are not used to working with others which I am sure you'll get used to sooner or later.

A:

I know this question is very vague, but how do you go about your daily life? Things like school, using the restroom, hanging out with friends, etc...


Q:

What are the biggest obstacles in non-medical states vs medical states? Do you guys shoot straight for legalization, or first medical, followed by legalization?

A:

Any good honeymoon success stories? Weddings are so expensive, I'm losing hope of being able to travel with my husband for the next few years :(


Q:

How do you see minebox.io impacting your business?

A:

Paramedic N: Yea, for as much shit as I throw at KATH, the fact is that they're expected to execute a billion dollar mission with twenty bucks and a pack of gum. In short, they're doing the best they can figure with highly limited resource and insane conditions like a patient from a traumatic fall being brought to the hospital 3 days after the event. Like, even in the US that would be almost impossible to fix, if at all.


Q:

We are very excited about Minebox, as Minebox users will both be utilizing the network to store their data and also increasing the quantity and diversity of hosts on the Sia network. This is a huge benefit for the network's health.

We're also excited in general about the product, and believe that Minebox is a natural evolution to the traditional NAS.

A:

Yes, I actually have yet to cooperate with a single other developer so I've ended up (unfortunately) with a different style that might be hard to work with. It's something I'll need to fix in the future, but thanks for the tips!


Q:

I just applied to go to VCU so we'll see how that goes As far as restroom, to go pee I have what's called a supra pubic catheter. It's a catheter that comes out of my abs that drains into a leg bag hooked up on my ankle that I have to have someone drain To go poop I sit in a chair with a hole in it then someone shoves a suppository up my ass that makes me go. Then if all the poop doesn't come out someone has to reach in with their finger, which is called digital stim, and scoop the rest out. Then we roll the chair into the shower and someone bathes me. I do this every other day in the morning. Hanging out with friends is just like it used to be except I'm always sitting down

A:

Outdated perceptions of marijuana held by the public and/or their legislators are the biggest obstacles both to medical and adult use laws. There are still too many people who think marijuana is more harmful than it actually is. As for the order in which laws tend to get passed, here's what I mentioned earlier about why medical laws and decriminalization measures passing prior to broader legalization:

This is not because they are a "Trojan Horse" for broader legalization, as some of our opponents often claim. Rather, it is because they are the most egregious elements of marijuana prohibition with the most obvious answers. If the majority of a legislature has yet to agree that seriously ill people should be allowed to access medical marijuana without fear of being punished, or that someone possessing a couple grams of marijuana should not face time in jail and all the collateral consequences associated with a conviction, they probably aren't going to be ready to agree to broader reform.


Q:

Ahh well first off congratulations to you and yours!

Tl;dr: yes!

Longer answer: you're absolutely right that honeymoons can be suuuuper expensive, especially with summer flights and whatnot. But one of the most gratifying success stories I see each day are couples who didn't think they'd be able to afford a honeymoon but ended up getting one because of the list!

Some of the more popular honeymoon destinations for US travelers of late (along with price):

  • Paris for $351 roundtrip
  • Mallorca for $469 roundtrip
  • Croatia for $541 roundtrip
  • Rome for $498 roundtrip
  • Hawaii for $475 roundtrip

Not nothing, obviously, but hopefully much more affordable than the $1000-to-Europe many people are used to paying!

A:

We are very excited about Minebox, as Minebox users will both be utilizing the network to store their data and also increasing the quantity and diversity of hosts on the Sia network. This is a huge benefit for the network's health.

We're also excited in general about the product, and believe that Minebox is a natural evolution to the traditional NAS.


Q:

What is your daily schedule like?

A:

Just you. Your client encrypts and uploads the data. From there it's distributed across hosts who your client agreed to contract with.

The default behavior is 5 copies of your data. If one node goes down, you get part of your contract fee back. I'm going to assume the client looks for another host to upload data too.


Q:

How did you extract the inaudible signals from background noise?

A:

Do you feel physically comfortable? I mean, I understand that you'd feel numb but is that something you have been able to adjust to and become familiar with?


Q:

I'm a felon for $35 dollars worth of weed. My official crime is distribution of thc with the modifier of party to a crime. In Wisconsin this type of felony can be expunged but it needed to be set up at sentencing and it was not. So my question is do you or anyone you know help people in this situation? Kinda seems terrible that I am a felon for the rest of my life, can't find housing, can't find decent jobs, all because I was at a house when weed was sold. Can you help?

A:

$475 round trip on Hawaii!?!? assuming that this is per person which is STILL ridiculous. Food included? Cause god knows those flights LOVE to be technical with it being a "domestic" flight despite the 12 hours it takes.


Q:

What’s the timeline (and technical roadmap, if you can share any of that without compromising state secrets) for recovering both coins AND files with one’s wallet seed?

Until then, Sia is simply remote data storage. (Albeit one with nifty bells/whistles.) Because users must still backup important data in some other way/shape/form, e.g. on a local hard drive, Dropbox, etc.

A:

Paramedic N: Wake up is usually around 0530-0630. Get into the hospital and set to work before the night shift transitions to the morning shift at about 7, the transition occurs at about 8. Work through until 3 and then head home to decompress. Each of us have slightly different home routines, eating habits, or home responsibilities like calling loved ones and such.


Q:

Sia uses Reed-Solomon coding to achieve the same properties. The most recent release has an 8-of-32 redundancy scheme, though as we continue to iterate on the software we expect to eventually reach numbers closer to 30-of-50 without sacrificing data security.

Doing it this way gives you massive geographic redundancy as well as a high tolerance to disk failure, host failure, trust failure, earthquakes, nuclear warfar, etc. In terms of reliability, there's really no comparison (modulo potential bugs in the software).

This also means that we can have hosts focusing on achieving 95% reliability instead of 99.99999% reliability. This will likely result in cheaper drives, cheaper setups, etc, and overall stronger customization for the end-user.

Napkin math suggests that the long term cost of Sia at scale (assuming drive prices don't decrease ever again) is around $2 / TB / Month. This accounts for power, servers, rent, etc.

Time will prove or disprove that math.

A:

A fast fourier transformation. There are some great libraries for doing this in Android/iOS like audiokit and jtransforms.


Q:

I guess so. I forget a lot of times that I can't feel so sometimes I'll hit my foot and instinctively yell ouch then remember that I can't feel it. I get surprised by my farts a lot too. Since I can't tell when I have to fart they just happen. i then look around and see who did that and I'm like oh yeah that's me

A:

I wish I could but that sounds like something you'd need to talk about with an attorney in your state. I'm just a lowly non-attorney spokesperson...

I'm very sorry to hear about your situation and I'm sorry I cannot do more to help. I wish you the best with whatever approach you take to overcoming it and assure you MPP is doing everything it can to prevent these cases from occurring.


Q:

Yeah! $475/person. Wish that were for 2! But when prices from Atlanta are typically $700 to Hawaii, $475 ain't bad!

A:

Less than a year, though you aren't going to see it in the next 3 months. We've spec'd out everything that needs to be done to make it happen, but the implementation is expected to take a few weeks and we have a few other problems we need to solve first.

We understand that this is a significant issue though, and it's very much on the roadmap.


Q:

Hello! Thank you for what you're doing.

Would you consider the work you do to be dangerous, given the hazards of some overseas locations?

A:

Hey guys,

Great what you guys are doing! I was wondering, Kim Dotcom is launching MU2.0 soon. Will he be (solely) using Sia? Did you guys have any contact over the last few months?

Edit: is it one of the 3 announcements? :) "We have 3 announcements / events coming over the next 3 weeks."


Q:

Did you have a background in DSP or math already, or did you learn that as you went too?

A:

Hello! I'm a software engineer at a large tech company (whose products you likely use every day) who works on accessibility.

What is the biggest annoyance you run into using software and the web on a daily basis? What can we do to make things better?


Q:

Do you feel the efforts to legalize, or at minimum decriminalize, cannabis will become more difficult under the incoming administration especially considering Jeff Sessions' strong anti-drug stance?

A:

Hey Scott, I've been a premium member for a couple months now and as a Cincinnatian I'm still waiting for that "Holy Crap!" deal that everyone else seems seems to get. My question though, have you ever been burned by third party travel dealers like Travel Merry and Explore Trip? I helped a buddy out by finding him cheap tickets to the Phillipines. It was through Explore Trip and after booking I decided to check their reviews. They were awful so I got nervous and cancelled right away. Has that ever been an issue with you?


Q:

It's all open source, I don't believe anything is proprietary.

A:

Paramedic N: Here in Ghana? No, this place is very safe in spite of some of the pictures in the imgur gallery. I think that as long as you know how to explore urban places and know how to keep your eyes out for trouble and your head cool in a conversation it's possible to keep out of real trouble. There are certainly dangerous places to be in or go to in West Africa but by and large, where we are in Ghana is quite comfortable and safe.

Dr.N: Depends on where you are. Here the work itself doesn't seem dangerous, but is only in the sense that you're exposed to everything that the local people are exposed to. This includes road traffic accidents, knowing that the medical infrastructure is such that if you are injured or ill you may not have the appropriate treatment available.


Q:

The first was the release yesterday, the second is the AMA today, and the third is the leaderboard coming next week.

We have not been in contact with Kim Dotcom despite our best efforts. We're not really sure what he's building, but I suspect that it's not actually decentralized, merely instead it is bitcoin based.

I guess we will see though.

A:

My background was economics.


Q:

I'll have to think about this and get back to you. I want to make sure I give you the best answer I can. I'm terrible at thinking of the spot right now that with all these questions

A:

It is too soon to tell. Based on what we currently know, I think there are just as many reasons to be optimistic about the incoming administration as there are to be pessimistic. That could change. But for now, we're cautiously optimistic.

Sessions is obviously no fan of marijuana and in his ideal world he very well might want marijuana to remain illegal and to roll back the progress that has been made in many states. But it will not be an ideal world for him if he's nominated. It will be a world in which 8 states + DC have already legalized marijuana and 28 states have legalized medical marijuana. A world of very limited enforcement resources, steadily growing support for legalization (among the public and in Congress). A world where hundreds of thousands of people now have jobs that were created by or are partially supported by the legal marijuana industry. Where states and localities have begun to generate millions of tax dollars that they will not want to lose. And it will be a world in which the president, others in his administration, and other key figures in his party have much bigger policy priorities than marijuana.

I think it is very noteworthy that Sessions was asked directly about the conflict between federal and state laws during his confirmation hearing, and he opted to not make any strong statements about wanting to interfere in state laws. He also noted that there was a resources problem when it comes to enforcing these federal laws.

Also, Trump spokesman Sean Spicer was asked about the apparent conflict between Sessions' anti-marijuana stance and Trump's support for medical marijuana and a "leave it to the states" approach. He said that it will be Trump's administration and Sessions knows as well as anyone that he will be implementing Trump's agenda and not his own. See here for the full comment + MPP's reaction to it all — https://www.mpp.org/news/press/statement-re-jeff-sessions-marijuana-comments/

And see here for everything Trump said on the issue during his campaign — https://www.mpp.org/federal/trump-marijuana-policy/


Q:

Hey there, thanks for checking in! Ahh the Delta monopoly puts a damper on cheap flights out of CVG, but it was one of my home airports growing up and I search for it with every possible deal.

Were you on the list in November when the flights from Cincinnati to mainland Europe ($400 roundtrip) or Greek Islands ($500 roundtrip) popped up? Those were the bees knees.

I haven't been burned personally by any OTAs like those you'd mentioned, but I've read the same reviews you have. I'm torn about how much weight to give them -- after all, how many people take a flight that went as scheduled and feel motivated to write a review of the company they bought it from online? So I think there's a bit of a response bias at play, you know?

That having been said, there are real differences between buying from OTAs and buying directly from airlines. Without typing a total wall of text I'll just link to the FAQ I wrote up about OTAs, but if anything there you're unclear about happy to go into it more!

A:

That's correct. All of the code is open source. We have a github repo for both our daemon and our graphical client, from which you can build the latest releases yourself.


Q:

How do you find the time to write with such a busy life?

What is the internet like out there?

Is this a temporary work placement or have you got long term plans?

A:

What do you think of Swarm, Filecoin, Maidsafe, etc?


Q:

How much of your own money did you spend before making money?

A:

How did you get access to an exoskeleton?


Q:

While some states have taken steps to fully decriminalize personal possession of marijuana, I'm under the impression at least some municipalities (Houston, for example) are doing something similar in conflict with the laws of the state where the city resides. How many other cities are doing this? Is there significantly more decriminalization in the US right now even past the handful of states that have already legalized it?

Thanks for your work -- ending the Drug War is the single most important societal change we can make.

A:

Yeah it killed me when I saw the $400 flights. But it was Christmas time and with two kids I didn't have the extra cash to throw around. I got lucky on the Phillipines flight though and booked directly through EVA airlines for pretty much the same price.


Q:

Just you. Your client encrypts and uploads the data. From there it's distributed across hosts who your client agreed to contract with.

The default behavior is 5 copies of your data. If one node goes down, you get part of your contract fee back. I'm going to assume the client looks for another host to upload data too.

A:

How do you find the time to write with such a busy life?

Paramedic N: I often dont find time to write. When I do I try and spill out as much brain goo as possible to the stories and sometimes I end up putting too much effort into some aspects and not others. By and large I think there is much more time in the day than we think about. You just have to figure out how badly you need sleep or beer drinking time.

What is the internet like out there?

Paramedic N: Almost everything is done through smartphones. Towers are cheap for companies to build and then its a matter of using the correct chip and the correct provider. For this region, MTN and Vodaphone are the primary carriers. For others there are others. So I pay about 30 USD for internet all month that's reasonable. I get my cat videos and email.

Is this a temporary work placement or have you got long term plans?

Paramedic N: I'm going to edit this response later as the others get back from their outtings today. For me, this experience is my chance to see what I can get done and what I can do to effect the area around me. The wife works with international development and I didn't really go to college, just the paramedic program at a local CC. The amusing part to me is that she seemed to have spent 6 years and a whole lot of money to get a degree that says she knows what she's doing while I just crash landed into this position and seem to be making a light and meaningful impact.

But we're just competitive that way.


Q:

I try not to talk too much about our competitors, because there's is some very obvious bias here. But generally, I feel that Sia is the only platform that has a really strong grasp of the security implications of decentralized systems, and similarly I feel that Sia is the only platform that was designed from the ground up with performance in mind.

To the best of my knowledge, Sia today is the ONLY platform where you can actually upload an encrypted 200 GB file to a decentralized network and expect it to still be there next week. All of the other platforms either require some sort of central server to coordinate things, or otherwise just doesn't have the scale or incentivization.

My favorite thing about Sia is its independence. If right now Nebulous were to shut down all of its servers, users would not experience problems. The forum, the website, and the blog would disappear, meaning you might have problems getting help, however your files would keep uploading, would stay online, and you could keep using the application itself just the same, as though nothing was wrong.

A:

We didn't invest a single dollar. It was all contributions of time, way way too much free time.


Q:

My mom found it online as a trial and signed me up. When I went to use it the trial was already over but they decided to use it as physical therapy anyways

A:

You are correct that there are a lot of efforts taking place at the local level to roll back prohibition. The extent to which this can be done often depends on the states' laws. Here's a recent article about this that touches on several cities that have taken action — http://www.thecannabist.co/2016/11/04/marijuana-decriminalization-cities-vs-states/66414/

Oftentimes states do not allow for significant changes to take place at the local level. For example, in some states, such as TX, they are basically giving law enforcement the ability to opt out of enforcing harsh possession penalties. The localities still have the ability to enforce the harsh penalties, but they no longer are required to enforce the harsh penalties.

This can be effective if you have good local officials who recognize the foolishness of such harsh penalties. But in some cases you do not. Take Denver, for example. Back in 2005 we passed an initiative that gave the city the ability to stop arresting adults for simple possession, but they CHOSE to continue enforcing the state possession law.

But we are seeing an increase in good local officials taking action. Philadelphia is a good example.

Another important aspect of these local reforms is the impact they have on public attitudes. We ran the local ballot initiatives in Denver in 2005 and 2007 with the primary goal of forcing a public dialogue about the issue. When these measures are on local ballots, they generate media coverage that fosters important conversations. They are also good organizing tools. And if you look at the states where a lot of these local measures were first passed, you can see how they contributed to bigger-picture changes over time. For example, Seattle passed a lowest law enforcement priority measure in 2003, and several cities around California adopted them around 2004-2006. Denver, Breckenridge, and Nederland passed local measures in Colorado leading up to legalization. Several localities in Mass. passed non-binding referenda questions over several years prior to legalization. Several Michigan cities have passed local measures, and it's quite possible that state will be up next to pass a legalization initiative (2018).


Q:

Ahh well congrats on that! I've never been to the Philippines but the snorkeling there looks unreal

A:

Sia uses Reed-Solomon coding to achieve the same properties. The most recent release has an 8-of-32 redundancy scheme, though as we continue to iterate on the software we expect to eventually reach numbers closer to 30-of-50 without sacrificing data security.

Doing it this way gives you massive geographic redundancy as well as a high tolerance to disk failure, host failure, trust failure, earthquakes, nuclear warfar, etc. In terms of reliability, there's really no comparison (modulo potential bugs in the software).

This also means that we can have hosts focusing on achieving 95% reliability instead of 99.99999% reliability. This will likely result in cheaper drives, cheaper setups, etc, and overall stronger customization for the end-user.

Napkin math suggests that the long term cost of Sia at scale (assuming drive prices don't decrease ever again) is around $2 / TB / Month. This accounts for power, servers, rent, etc.

Time will prove or disprove that math.


Q:

I'm a medical student who wants to work in global health, how did you and the physicians get involved in this?

A:

What are you most excited about for Sia in 2017?


Q:

How did you pay the bills while you were learning / coding for 18 months?

A:

I'm not 100% sure what quadriplegic means but how do you type?

Also do you still miss BMX and what do you do now instead?


Q:

What is the best argument to make for marijuana when talking with someone who is very sternly against it? Living in Tennessee, I know quite a few people who are simply ignorant to the facts and refuse to accept them when they are brought up. What can I say to them that might set off a light in their head and make them rethink what they previously thought was true?

A:

The hookers are awesome, too!


Q:

Hey guys,

Great what you guys are doing! I was wondering, Kim Dotcom is launching MU2.0 soon. Will he be (solely) using Sia? Did you guys have any contact over the last few months?

Edit: is it one of the 3 announcements? :) "We have 3 announcements / events coming over the next 3 weeks."

A:

Paramedic N: I will pry the other doctors' brains open when they return from Kejitia, I got involved through an organization called Medics Without Borders. It's a little bit rag tag looking from the website because the founder is Ghanaian but his heart is in the best place possible and the connections we've made are phenomenal. Myself and a few others operate through their MOU's with KATH to work in RED team. There are other global health initiatives such as Medical Teams International, if you want to work in places other than Ghana. Again, if you're highly motivated to get involved, send me a private message and I will do everything I can to point you in the right directions.


Q:

Oh man where to start.

I'm excited about the enterprise deals that we are working on. I'm excited by the thought of having true decentralized storage for my data (this is already available, but it's so new and it still excites me a lot). I am looking forward to being able to backup my entire life with a single seed, in a decentralized way. I am excited for the filesharing capabilities that we are working on.

We are expecting 2017 to be a big year for Sia, and for decentralized storage as a whole.

A:

Doing econometrics for the hockey team. It was a place where, say I finished my work at 1 PM, I could spent from 1 to 5 PM studying how to code.


Q:

I use a combination of both voice recognition and typing with my knuckles one letter at a time since I have no use of my fingers. If I'm on my phone though, I have it velcroed to my armrest and I use my thumb to type and navigate.

A:

Marijuana is objectively less harmful than alcohol to the consumer and to society. See https://www.amazon.com/Marijuana-Safer-Driving-People-Drink/dp/1603585109/ref=sr_1_1?s=books&ie=UTF8&qid=1383084981&sr=1-1


Q:

Fair enough!

A:

The first was the release yesterday, the second is the AMA today, and the third is the leaderboard coming next week.

We have not been in contact with Kim Dotcom despite our best efforts. We're not really sure what he's building, but I suspect that it's not actually decentralized, merely instead it is bitcoin based.

I guess we will see though.


Q:

If he would be interested in upping his website game, let me know.

A:

Thanks!


Q:

How much time average did you spend to develop your programming skills? Daily average, weekly and monthly or whichever is easier to quantify.

A:

How has your relationships been with people before and after the accident? Did people just stop hanging out with you because of the accident?


Q:

Thanks for taking some time to do an AmA.

With the DEA recently reclassifying CBD as schedule 1 do you think that they are a large obstacle to legalization? If so do you think that the organization can be re-structured or does it need to be abolished/replaced?

How do you recommend approaching the subject of marijuana being safe with more socially conservative people?

A:

I've booked a flight from Frankfurt to Cincinnati with a layover in Detroit and back I have a layover in Washington DC. Do you know if it is possible to skip the flight from Cincinnati to DC if I want to visit the city a day or two before the departure?

I booked the flight for 500€ 3 month ago. I think it is way cheaper in winter. The last time I was in Cinci it was summer and I payed around 1200€. Someone told me that CVG is one of the more expensive airports in the US.

And if you have time: I am in Cincinnati the whole February. Any suggestions which US city I could fly to on a low budget for a short trip?


Q:

Sia's pricing for storage right now is very low relative to its competitors, but not many users are actually storing files on the network. Looking at SiaPulse there's 931 TB available but only 0.82% of that is in use. Without anyone to purchase storage, the hosts have no incentive to continue participating.

What do you think is limiting the number of storage buyers on the network and how do you plan to address it?

A:

Paramedic N: He is, you should contact him directly. It ain't me.


Q:

I am not quite sure what you mean by health, however there are a lots of hosts on the network spread across approx 3 major geographical locations. There is far more supply than demand, which I think is not fantastic, though it means that prices are insanely low. At one point it was only like $0.25 cents to store what would cost a full $25 on Amazon.

We have not seen any security events nor do we have any reason to believe that there's something dangerous on the horizon. If you put files on the Sia network, you're almost certain to be able to re-download them.

A:

Daily is probably the easiest. For the first six months after I picked up my first programming book, I put in about four hours a day. Then I started actually working on apps. At first these were minor league apps for hockey teams, and they kinda sucked. But it helped me improve to the point where I could pretend to hang with the big boys. Classic tale of fake it till you make it.


Q:

Yeah some people have disappeared but some of my relationships and friendships have grown to a new level that I never thought possible. I've had some friends do more than what's asked of them. I can truly say that I love them with all my heart.

A:

This was a totally misreported story. The DEA's recent action has NO effect on the legality of CBD under federal law. The DEA has always considered CBD to be a Schedule I substance.

This was not an announcement/response regarding a rescheduling petition and it was in no way a reflection of any kind of process to determine if CBD has medical value. As I mentioned above, the DEA has always classified CBD under Schedule I, so they have never recognized its medical value and still do not recognize it.

This was simply an announcement of a final rule creating a new source code for "marihuana extracts" (7350). "Marihuana" (7360), THC (7370), and CBD (7372) all have their own unique source codes already. We believe they were in fact doing this to better comply with international treaties and could be anticipating a need to have a separate source code for extracts if and when they register more entities to grow marijuana for research. In other words, this might be the first time we have ever believed the DEA's stated intentions for taking an action related to marijuana.

As for the DEA's fate, it's very difficult to imagine the agency would be entirely abolished any time soon. It's quite possible that marijuana could be removed from its jurisdiction, which is what would happen under Congressman Jared Polis's proposal to regulate marijuana like alcohol at the federal level. It would move marijuana from the DEA to the ATF.

It does appear Congress's appetite for spending on DEA marijuana efforts is growing smaller. They see state laws changing and public opinion shifting, and they are questioning the efficacy of things like the DEA's marijuana eradication program. Hopefully that trend will continue this year.


Q:

First off, happy Pie Day!!

Ahh alas if you skip any leg of an itinerary the rest of the itinerary gets automatically cancelled. So you can only skip a leg if it were the last leg of a trip you didn't want, but what you're talking about would cancel your return flight to Frankfurt.

Chicago's not far and a great city! And be sure to go on the Bourbon Trail in Kentucky, it's fantastic.

A:

I believe that the 0.82% number is actually incorrect. There are hosts on the network with as much as 50% utilization today, and most non-new hosts have at least 10% utilization.

That said, you are correct that as of today there is a windfall of supply compared to the demand, and we are working hard to correct that. The biggest reason for this up until today I feel was that the software was very slow for uploading and downloading files. Until our release yesterday, it would take more than a week to upload a single 20GB file. The release that is out now can do that at much faster speeds.

I also think that general awareness among consumers is very low. We are working to introduce Sia to the world and to get people excited about it.


Q:

What proportion of the cases you see are easily preventable with education or basic public health initiatives?

A:

Obliviously improving the Tech. is always on your mind but as a company what are you priorities in the near future?


Q:

Did you have do anything to protect yourself and your development from the minor hockey team you first intended to use it for? Like claims that it should be exclusively theirs?

A:

How long after your accident did you come to terms with your situation?


Q:

What is MPP doing to add retroactive ameliorative relief into bills in states that want to legalize? In my opinion, legalization means nothing if we can't make up for past wrongs done to people who shouldn't have been in prison in the first place.

A:

I have seen some real bargains but the stopovers can be long. How long would a stopover have to be before you decide it isn't worth the saving? Back in 2012 I got cheap return tix to Amsterdam with Garuda, stopovers in Jakarta and Dubai before Amsterdam. The stopovers really added to the exhaustion.


Q:

What do you think of Swarm, Filecoin, Maidsafe, etc?

A:

Paramedic N: I will harass the doctors to give a much more detailed reply to this question, but just guessing off the top of my head: More than half.

There is very little understanding of human physiology here and there is a deeply held belief that life is cheap and the after life is where the real party is at. That, paired with a culture that still deeply believes in voodoo (juju, here) and spiritual medicine, it's a perfect storm of explainable ignorance that generates a pretty massive problem.


Q:

Our top priority right now is the usability of the network. The current release has a few warts from the early days, for example it takes about 15 minutes to unlock the wallet and about 45 minutes to form file contracts. We've got an improvement in the pipeline to make unlocking the wallet almost instant.

Up until our release yesterday, files were also very slow to upload and download. Now, downloads are fast and uploads are extremely fast. We're really pleased to have accomplished that.

We're also aiming heavily at scalability. The blockchain protocol has been designed to support millions of TBs per person, which is necessary for some enterprises. While the protocol can do that just fine, today the user software really can't keep up with that much volume. For the most part, we just need traditional engineering to get more scale, and that's something we'll be focusing on.

Finally, we've started adding more adversarial conditions to our testing framework. We're adding active attackers and giving them lots of money and storage, and trying to set up situations where people are willing to throw away tons of cash in an attempt to disrupt the network. Sia is already very strong against most forms of attack, but we will be taking it that extra mile over the next 3 months or so.

In the more middle term, we will be adding support for filesharing and content distribution. The Sia of today can't really be a backend for YouTube, however the Sia of 12 months from now will be able to do that.

A:

This is a very tricky subject. Basically the issue was solved by letting the owner of the hockey team in on the software startup.


Q:

I don't know if I've ever come to terms with it really. I accept where I am now and Still trying to move on but I have both good and bad days

A:

This is a complex legal issue and it's my understanding that there aren't a lot of clear-cut solutions that can be applied across the board in every state. There are also political questions associated with it.

Generally, our mission is to end these prohibition laws ASAP so that we can stop the bleeding and prevent this type of retroactive relief from ever being necessary. While it would be great to include such relief would be great, it is often a lot more difficult than it seems and raises significant legal and political issues that can prevent the law from passing (meaning people not only get retroactive relief, but people will continue getting busted and need relief later).

In these cases, it often makes more sense to pass the law and address the retroactive relief situation after. It is not as if these legalization initiatives are the one and only chance or even the most effective way to provide such relief. But once marijuana is a legal product, that is an issue that can be addressed and it also seems like one that will be easier to address. For example, in Colorado, there were no retroactive elements included in the initiative, but the legislature began looking at the subject immediately after the initiative passed.

Our director spent some time behind bars for cultivation and based on my experience, all of our staff members primarily motivated by the human rights, social justice, and criminal justice reform aspects of this issue. So it is very frustrating when we get accused of being insensitive on this subject because a particular initiative does not include a retroactive component. We all care just as much as anybody, and we are simply taking what we believe is quickest and most effective approach to ending the harms of prohibition, both past and future.


Q:

Great question. The answer is partly to-each-his-own, but also partly depends on the city you're laying over in.

If it's in a city like Frankfurt with a quick-and-easy train from the airport to the city, I actually like half-day layovers because it gives me a chance to sample a new city that I might not have seen otherwise and then decide if it's worth coming back to. I've gotten to do that in places like Frankfurt, Seoul, Hong Kong, etc.

But you're definitely right that multi-leg trips are usually much more exhausting than direct flights. Nice if you can get em cheap!

A:

I try not to talk too much about our competitors, because there's is some very obvious bias here. But generally, I feel that Sia is the only platform that has a really strong grasp of the security implications of decentralized systems, and similarly I feel that Sia is the only platform that was designed from the ground up with performance in mind.

To the best of my knowledge, Sia today is the ONLY platform where you can actually upload an encrypted 200 GB file to a decentralized network and expect it to still be there next week. All of the other platforms either require some sort of central server to coordinate things, or otherwise just doesn't have the scale or incentivization.

My favorite thing about Sia is its independence. If right now Nebulous were to shut down all of its servers, users would not experience problems. The forum, the website, and the blog would disappear, meaning you might have problems getting help, however your files would keep uploading, would stay online, and you could keep using the application itself just the same, as though nothing was wrong.


Q:

More or less what I expected to hear. Are you as foreigners able to have any success in trying to educate your patients or their families? Do government officials or other local authority figures ever make an effort to address those things?

A:

Sure:

The consensus verification logic is here.

It's verifying a type of transaction called a "Storage Proof." The storage proof type is defined here. The comments should hopefully explain everything well.


Q:

What do you credit as the biggest resource that allowed you to be successful at programming, and how do you rate resources such as Code Academy?

A:

What is your inspiration when you're feeling down? What keeps you going so infectiously positive ? - Love from Holland


Q:

What is the goal of the MPP? Decriminalize marijuana? Limited use of marijuana?

What policies would be ideal for marijuana use, according to MPP?

Thanks for your time.

A:

Yeah I agree. 5 years on I mainly remember the nice cheap price of the Sydney to Amsterdam flight and not the stopovers. A cheap flight allows you to stay longer in destinations so that's always worth it.


Q:

What are you most excited about for Sia in 2017?

A:

Are you as foreigners able to have any success in trying to educate your patients or their families?

Paramedic N: It's really difficult to measure the effect of lessons in the general public because of the massive generational language difference.

Do government officials or other local authority figures ever make an effort to address those things?

Paramedic N: I've not seen many government initiatives beyond some aggressive malarial protocols in the hospitals. There are a few private enterprises that have sought out MWB's instructors for first aid training among several different venues and businesses.


Q:

Sia has a whiltepaper which dives into this pretty well. https://sia.tech/sia.pdf

A:

Definitely StackOverflow. I haven't used Code Academy but have heard really good things about it. For me it was a few good books and a very large dose of SO.


Q:

When I'm feeling down I try to remind myself that I'm still alive. I may not be able to do what I used to but I still have a lot of potential. I also have the ability to choose which something that can never be taken away from me. I also have the greatest friends and family the anyone could ask for. They're always there when I need them. I try to stay positive and laugh at myself because if I don't the injury wins

A:

Our goal is to end the failed policy of marijuana prohibition and replace it with a system in which marijuana is regulated similarly to alcohol for adult use and available for medical use to those who could benefit from it. We support reasonable, evidence-based policies that treat marijuana use as a public health/safety issue rather than as a law enforcement issue. We support comprehensive reforms, such as initiatives/bills to legalize and regulate marijuana for adult and/or medical use. We also support incremental reforms that reduce the harm caused by prohibition, such as legislation that reduces penalties for (but does not go as far as legalizing) possession.


Q:

Fair point

A:

Oh man where to start.

I'm excited about the enterprise deals that we are working on. I'm excited by the thought of having true decentralized storage for my data (this is already available, but it's so new and it still excites me a lot). I am looking forward to being able to backup my entire life with a single seed, in a decentralized way. I am excited for the filesharing capabilities that we are working on.

We are expecting 2017 to be a big year for Sia, and for decentralized storage as a whole.


Q:

Hi there!

I'm a final year medical student in the UK. I spent 2 months working in Ghana last summer (Korle Bu in accra and Oda). I found A LOT of the doctors to be at best a bit incompetent and at worse dangerous (resting an unseated cannula needle in a pool of pus and then using it to cannulate! I could go on). I also found the nurses to be absolutely terrible. Cruel (punching and slapping women in labour or patients having their dressings changed) and dangerous (one nurse sat on a line giving blood to a 12 year old girl and pulled it out. The girl later died). The nurses spent more time abusing patients and playing on their mobile phones than looking after patients.

How has your experience of the local medical professionals been? Do you find it as frustrating as I did? I expected a resource poor set up and would never blame anyone for that, but that lack of pride in their work and compassion was heartbreaking to witness. To the point I would never return to Ghana. I've travelled extensively in Africa and Ghana is the worst country I've been to!

Good luck to you all

A:

How large do you see the Sia storage network getting in 2017 in terms of storage capacity?


Q:

How did you market yourself initially?

A:

What are your dreams like? Are you injured or paralyzed in your dreams, or do you have full mobility? Thank you for sharing :)


Q:

What's your battle plan if we get the worst-case scenario and Sessions-Trump goes on the attack? Has the MPP drawn out possible outcomes for the incoming administration and what is the most likely path MPP think they'll take, given what you know now and are hearing from Capitol Hill?

A:

P.S. what kind of dog is that? He's so cute!


Q:

Thanks!

A:

Paramedic N: I look forward to the doctors replying to you because their experience has been largely the same as yours. As has mine. I think you smashed the nail on the head:

I expected a resource poor set up and would never blame anyone for that, but that lack of pride in their work and compassion was heartbreaking to witness.

Paramedic N: My belief is that a lot of these nurses complete their training and are highly motivated to get out and make an impact and be good at their jobs but they run into these massive and already established hospitals and conform to these old guard nurses who are absolutely unqualified to provide medical support under any circumstance. Some hospitals have done better than others and my experience around Kumasi has shown that there are massive differences between hospitals and massive differences between nurses at different hospitals. Some people show a lot of motivation and drive but not a lot of critical thinking, some show absolutely no compassion or motivation and are just there for a pay check. I'm curious to see other African medical providers. Where should I go next?


Q:

Well, I believe that the storage capacity of the network is already really high, well over 10,000 TB. Most of that capacity is simply not plugged in because the demand is not there - it'd be consuming electricity and headaches, and not providing any revenue.

A better question would be to ask where demand will be at the end of 2017, and I really don't know, but I'm hoping that we can push the growth of our network. At this point, we've crossed the biggest usability hurdles for most users.

I think my personal target would be 100,000 TB total in use on our network by the end of the year.

A:

Strictly emails to marketing guys at college/pro sports teams. Literally, look the guy up, snoop for his email address, and send him a letter asking if he's interested. We finally started getting some traction as fans started sharing our videos, and this has made it more of a they-come-to-us instead of we-spam-them business model.


Q:

My dreams are still the same. Depending on the dream I can be paralyzed or not. Mostly I'm walking in my dreams. It's really weird because I think to myself oh this is so easy why the hell am I still sitting down.

A:

See my earlier reply about Sessions/Trump.

While we're cautiously optimistic, we certainly aren't taking anything for granted. Our efforts are currently focused on preventing the "worst-case scenario," but we will be ready to shift gears should shit go down.

There are a wide variety of different scenarios that could play out, both in terms of what the administration does and how others react to it (i.e. members of congress, state/local officials, the media, etc.). So we aren't able to prepare detailed plans. But we have been working for decades to build support among citizens, members of Congress, state and local officials, and others, and we'd certainly put as much of that political capital to use as we can to fight back.


Q:

Hah! Aww that's Chela. She's a rescue so not 100% sure what kind of dog, but we think a dachshund mixed with a pit bull. Definitely a Grade-A pup :-)

A:

I am not quite sure what you mean by health, however there are a lots of hosts on the network spread across approx 3 major geographical locations. There is far more supply than demand, which I think is not fantastic, though it means that prices are insanely low. At one point it was only like $0.25 cents to store what would cost a full $25 on Amazon.

We have not seen any security events nor do we have any reason to believe that there's something dangerous on the horizon. If you put files on the Sia network, you're almost certain to be able to re-download them.


Q:

How do you deal with the limitations you have? Example. Blood gases for a possible DKA or if someone needs blood is there a way you cross and match in this run down country.

A:

How much data does Sia have stored on the network right now?


Q:

We finally started getting some traction as fans started sharing our videos,

That's exactly how I heard about it for Purdue. A buddy sent me a video of it when he was at a game.

Have you looked into getting it into an Olympic opening ceremony? That would be huge.

A:

Does the exoskeleton also give you function in your arms? Or is it only to assist with mobility?


Q:

Do you think it's possible to sell adult use legalization to a GOP legislature? If so, what do you think is the best approach to that with messaging?

A:

I've been waiting for a usable USA > Hong Kong flight. Hoping I can finally get some family members to visit me for the first time. Been here since 2012! You have or think any will pop up for summer?


Q:

Obliviously improving the Tech. is always on your mind but as a company what are you priorities in the near future?

A:

How do you deal with the limitations you have?

Paramedic N: Case by case. As emergency medical technicians will readily explain, knowing how to do duct tape/MacGuiver medicine is one of the hallmarks of providing point of injury care. If the family isn't there to provide medicines for patients, we wont spend money out of our own pockets because of the massive issues it would cause. That's a different issue that I will get to later. The example of blood is fitting because the young man with the shotgun GSW to his legs was slowly bleeding out and needed blood. Because his family had gone back home over night we had to very gently provide normal saline so as to avoid over perfusing and causing rebleeds while we waiting for them to come back and provide money for more blood. Then, in order to get the blood it had to be a family member providing it. I don't know if the blood was ever tested for anything or even type. I do know that they charged the donor and then the patient for the draw and the application.

Pretty sweet, huh?

As for important labs, I'll pester the docs when they return. They've been showing us all a lot of secondary ways to look into symptoms and tell tale signs of decompinsation and the like. I'll let them explain in more detail.


Q:

It's difficult to measure, but I'd estimate we are close to 100 TB at this point.

A:

Awesome to come across someone who's heard of my work! Yes, I've thought (dreamed) about doing something with the Olympics but easier said than done. We have recently gotten into some other continents though, such as for Cricket in Australia and we plan to work with some Soccer teams in Europe as well.


Q:

It only assist with mobility

A:

Yes, but it is certainly a bigger challenge than in a state with a more Dem-leaning legislature. Many of the GOP-run legislatures still have not passed comprehensive medical marijuana legislation or decriminalized simple possession (removed threat of jail time), so those are probably better places to start. This is not because they are a "Trojan Horse" for broader legalization, as some of our opponents often claim. Rather, it is because they are the most egregious elements of marijuana prohibition with the most obvious answers. If the majority of a legislature has yet to agree that seriously ill people should be allowed to access medical marijuana without fear of being punished, or that someone possessing a couple grams of marijuana should not face time in jail and all the collateral consequences associated with a conviction, they probably aren't going to be ready to agree to broader reform.

The discussion about medical is a good opportunity to talk about the benefits of marijuana and to dispel a lot of the myths. The discussion about decrim is a good opportunity to talk about the harm caused by prohibition, the relative safety of marijuana compared to legal products like alcohol, and the fact that marijuana prohibition is more harmful than marijuana itself. These conversations will help break down opposition, and while they might not convert every legislator to a supporter of broader legalization, they could reduce their degree of opposition.

When it comes to a legislature that is actually willing to consider the issue of broader legalization, it should be made clear that this is just as "conservative" of a proposal as it is a "liberal" one. We're talking about ending a failed government program. It is inefficient and wasteful. It harms public safety by using law enforcement resources to enforce failed prohibition laws, which could otherwise be used to prevent and respond to serious crimes. At the federal level, it's a national security issue. Prohibition is contributing to border violence and propping up cartels. These are all arguments that Republicans should appreciate. And of course there's the civil liberties aspect — the government should not be punishing adults who use marijuana responsibly and cause no harm to others.


Q:

Ohhh awesome! Where in the US are most of your family members?

Yes, I think there's a strong chance cheap-ish flights to Hong Kong will pop up for this summer. Plenty of time for it to happen.

P.S. Where's the best dim sum in HK?

A:

Our top priority right now is the usability of the network. The current release has a few warts from the early days, for example it takes about 15 minutes to unlock the wallet and about 45 minutes to form file contracts. We've got an improvement in the pipeline to make unlocking the wallet almost instant.

Up until our release yesterday, files were also very slow to upload and download. Now, downloads are fast and uploads are extremely fast. We're really pleased to have accomplished that.

We're also aiming heavily at scalability. The blockchain protocol has been designed to support millions of TBs per person, which is necessary for some enterprises. While the protocol can do that just fine, today the user software really can't keep up with that much volume. For the most part, we just need traditional engineering to get more scale, and that's something we'll be focusing on.

Finally, we've started adding more adversarial conditions to our testing framework. We're adding active attackers and giving them lots of money and storage, and trying to set up situations where people are willing to throw away tons of cash in an attempt to disrupt the network. Sia is already very strong against most forms of attack, but we will be taking it that extra mile over the next 3 months or so.

In the more middle term, we will be adding support for filesharing and content distribution. The Sia of today can't really be a backend for YouTube, however the Sia of 12 months from now will be able to do that.


Q:

level-1 trauma ED RN here.

first off thanks for what you and the crew are doing; it sounds fascinating and at the same time compassionate (and frustrating! "pay to play," wow)

Q: What are your facilities/equipment availability like in comparison to a U.S. trauma center? E.g., in a U.S. level-1 trauma ED you have multiple O2 and suction setups, monitor, overhead X-ray, intubation supplies w/ video feed, central access equipment, rapid infuser, the whole sha-bang. I think we take it for granted but there's probably a million dollars worth of high-tech goodies in one trauma bay, and most big urban centers have at least 3 of them, plus half a dozen critical care rooms.

On your end, do you guys have anywhere near that level of available tech? Are you capable of monitoring all your patients or do you have to pick and choose who gets thrown on a monitor, etc?

Other Q: Does Ghana's emergency medical / ED system use an acuity scale like ESI? Do they use an overcrowding index like NEDOCS?

A:

Do you guys have a plan to increase open source contribution?


Q:

This is awesome, did you make a lot of $$$ from it?

A:

What's a typical day like for you?


Q:

Hey Scott! What do you think about solo travel? Is it a good experience or better to go with a friend?

A:

Sure:

The consensus verification logic is here.

It's verifying a type of transaction called a "Storage Proof." The storage proof type is defined here. The comments should hopefully explain everything well.


Q:

The doctors are actually going to be writing long reports about this when they return stateside and Im going to kick them in the shins like a good medic to get them to reply to your question as well. In the mean time, here is my paramedic answer:

What are your facilities/equipment availability like in comparison to a U.S. trauma center?

Paramedic N: Oh man. So There are no numbered beds or cots or anything in RED. Patients roll in as they come and take up position next to machines if they are available. We can have up to 11 patients in our zone at a time but we only have 5 functional 3 lead monitors and of those 5 we only have 2 with operational BP cuffs attached. We have no pulse oximetry attached to the monitors. There is one finger pulse ox machine for the whole ward. I thoroughly encourage the other volunteers to pack their own entire triage kit of stethoscope, BP cuff, pulse ox, thermometer, and shears. There are sometimes 4 working suction machines but usually only one works, there are no Yankauers, just half assed french caths that plug into the suction machines that have been used to the point of being only barely powerful enough to empty a cup of water. There is 2 working ventilators, which means that whoever is there first and has a paying family will get them and likely get to keep them. One operational ambu-bag for codes and one working blade for intubation. There are no constricting bands for IV access, we use infusion lines and a quick knot. There is no "code room".

No. I'm not making this up.

On your end, do you guys have anywhere near that level of available tech? Are you capable of monitoring all your patients or do you have to pick and choose who gets thrown on a monitor, etc?

Paramedic N: We arrived one morning to see an intubated patient who was both cold and pulseless but still attached to a working ventilator. The patient also had chest electrodes in place but somebody had removed the leads so the machine was off. When we placed the patient on the monitor we weren't too shocked to see that they were in fact in asystole (and probably had been for at least an hour, nurses do not round well). We work with the amount of tech we have and in accordance with the clinical severity of the patients, but there are also some inane protocols that are followed because its a government hospital and thinking outside the box can be thoroughly shunned.

Does Ghana's emergency medical / ED system use an acuity scale like ESI? Do they use an overcrowding index like NEDOCS?

Paramedic N: I'm gonna have the docs answer this question more in depth because I think they'll provide a better answer for you. So far as I understand it, the sorting of patients at triage follows the South African protocol guidelines via a scoring algorithm. I've not had any major issues with it yet other than that many nurses display a discouraging lack of critical thinking skills and will rely entirely on a binary algorithm instead of any clinical competency. Or perhaps I'm jaded, it's hard to tell some days :D

Good questions and it's awesome hearing from a fellow level one-er, thems were my EMT days before EMT-P!

A:

We do!

Up until now, Sia has largely been it's own community. Our last AMA was on the siacoin subreddit. Largely this was because we felt that the software was not ready for us to show off to the rest of the world.

Sia as of our most recent release is very usable, has a thriving community, and we think it's time to start spreading the word to other communities who are interested in decentralization. We have a plan for reaching out and getting people excited, especially among related open source projects such as Tox, Beaker, and even projects like Tor.


Q:

Considering our initial investment was $0, the ROI has been infinite.

A:

I get out of bed. Which I need assistance with. Someone dresses me and puts me in my chair. That I either listen to music or watch TV. Trying to read stuff. A lot of times I get sucked into the dark hole of reddit. Then I go to bed which I also need assistance with. Then repeat


Q:

Oh man. I highly recommend everyone travel solo at least one, purely as a learning and get-to-know-you experience.

But personally once I've gotten that growth out of the way I'm a big fan of shared experiences. Misery loves company :-P

A:

Sia has a whiltepaper which dives into this pretty well. https://sia.tech/sia.pdf


Q:

This is a dumb question but I was curious after reading you mention the soccer match the other day: how's the sports culture in Ghana? I know that soccer is huge but what's an average "night out with the boys" like? (Example: wings and beer while watching American football) What's the average Joe drinking? If a huge loss/win occurs do riots ever occur? Any huge rivalries?

A:

Nope, that isn't the secret :)

A price reward is an interesting idea. Currently we rely on the local host database to weight hosts according to various factors. For example, a host with 90% uptime should be weighted much higher than a host with 70% uptime. Higher weight == higher probability that the renter will form a contract with that host. So there is already a soft guarantee that higher uptime results in more profits. And of course, more uptime means the host is more likely to be online when an upload/download is requested; otherwise they miss out on that revenue.


Q:

Well you had to buy the books...

A:

This may sound dumb, but where do you see yourself in 10-25 years? Do you think technology will make your quality of life significantly better? What type of things do you see yourself wanting to do?

Thanks in advance!!


Q:

Thanks for the advice ;)

A:

How large do you see the Sia storage network getting in 2017 in terms of storage capacity?


Q:

Football is a part of the culture, but it seems to vary quite widely among the places where I've seen games. I watched a Chelsea game and there wasn't an empty seat in the place and the whole crowd lost their mind when Chelsea scored. Conversely, for the first match of the Africa Cup, I was watching with EMT L and Dr.G and although Ghana scored against Uganda, I was the only one cheering. Apparently there was some tension with the Black Stars (Ghana's team) and that was later explained.

As for the internal Ghanaian teams, the local Kumasi club is heavily supported and when those games are going on the spots with TV's showing the games are packed.

An average night out with the lads will usually swing through a "spot" which is the Ghanaian equivalent of a little pub. Usually a shack with a massive ice-chest full of beer. The beers are 675 mL in size and are 5 GHC (Roughy 1.25$ USD), most beers are pilsners though there is a Castle Milk Stout and an Africa Guinness Special that are delicious. I've not heard of any major rioting or hooliganism from football matches but I know the Accra-Kumasi football club rivalry is real enough that cab unions arent allowed to display team stickers if the union is predominantly for one team over another.

A:

I've run over the math a few times, and really 98% is the upper limit of where hosts are useful. If you are above 95%, you are doing about as much for the network as possible. 99.99% uptime of course is still useful, it's just that it's barely more useful than 95%.

That said, we really need hosts to be above 90% uptime for them to be useful to the network.

And, we actually do have penalties today for hosts with low uptime. They aren't as strong or as formal as we would like, but that's one of our primary goals for v1.2.0.


Q:

You're right. That lowers our ROI from infinity to around 3.50%.

A:

I don't know where I'll be in the future but I do hope I'm walking. I do think technology who do something amazing. Some things that I would love to do would be something space related. I love science in Space. Maybe working at a telescope or something? I also like to give standup comedy try. I'm also trying to learn voice acting so I'd like to see if that whould get me anywhere


Q:

Anytime!

A:

Well, I believe that the storage capacity of the network is already really high, well over 10,000 TB. Most of that capacity is simply not plugged in because the demand is not there - it'd be consuming electricity and headaches, and not providing any revenue.

A better question would be to ask where demand will be at the end of 2017, and I really don't know, but I'm hoping that we can push the growth of our network. At this point, we've crossed the biggest usability hurdles for most users.

I think my personal target would be 100,000 TB total in use on our network by the end of the year.


Q:

Thank you for the great response! Between your fantastic work in the region, Galactic Tinder, and your appreciation for a good pint of stout, you're legend in my book. Even if you are a Chelsea supporter...(or are you? It doesn't actually say you are but being as I'm a Gunners fan I just thought it was implied above.)

A:

I have a Java library too: https://github.com/javajared/Sia-Java


Q:

I started coding apps 1.5 years ago, and am doing very well. However, I have reached the point where I'd prefer some more advanced content to follow rather than Big Nerd Ranch - Any materials you could share that are practical, yet significantly more advanced (tutorials)?

A:

Firstly, you're inspirational as shit.

Now, questions!

  1. Given that you injured yourself in a BMX accident I take it you were active before - has that made being a quadriplegic particularly hard?

  2. What does the future look like? With physio how much improvement can you expect?

  3. Have your hobbies/general interests changed post-accident?

  4. How do you stay so positive? It's such an amazing outlook to have on life.

Apologies if you've already answered any of these, I'm about read now!


Q:

Hi Scott, love your service! I am curious if you would ever consider adding 'business class' section to your premium service? Do you see these type of mistake fares or big discounts on business class flights?

A:

How much data does Sia have stored on the network right now?


Q:

I love when Arsenal, Chelsea, or Man U play. I love when they play because they're typically good matches.

And because I love being the only one in the pub rooting against them each time.

I'm from America, man, I haven't got a club I support.

A:

Wow, I had no idea that this existed, thanks for sharing!


Q:

If I were you, and past that BNR point, I would just start coding projects and start looking to build a reputation or earn some additional income. Maybe look into freelance (some of those freelance mobile developers really rake it in) or try to build a reputation on GitHub. StackOverflow is the only resource material I've really needed following those first four books. There is just so much info on SO, if it goes down the internet is history.

A:
  1. it's made it very hard.
  2. no idea what the future looks like but I'm hopeful for the future with technology
  3. well besides BMX I also love playing guitar so that's another thing I can't do. But now I have a huge fascination with space. I'm trying to give voice acting a go. And I watch a lot of TV and movies
  4. I just try and laugh at everything as much as possible

Q:

I am considering it! Hoping to do it a bit later this year :-) It'd probably have to be a slightly different list since what's "cheap" for business class would shock people used to econ prices, you know?

But yes, I do every once in a while see big discounts for business fares! Found some $377 roundtrip US to Peru business class seats last year and just this week sent out €500 roundtrip Oslo to Zanzibar/Seychelles/South Africa in business.

A:

It's difficult to measure, but I'd estimate we are close to 100 TB at this point.


Q:

Any room for pharmacists on your team? Or to better phrase it: What could a pharmacist do to help?

A:

Can I use it for porno? Legal porn tho.


Q:

Like you I had ideas and issues which I solved. Any tips on discovering cool libraries to work with? or Apis? Stack is so huge, how do you find out whats "hot"?

A:

Can you still feel your penis? And can you ejaculate? If not what do you do in your free time?


Q:

You have to fly somewhere on the basis of food alone, where are you going?

A:

Do you guys have a plan to increase open source contribution?


Q:

Contact me via PM if you're interested in coming out this way, but for the other pharmacists lemme 'splain:

Paramedic N: Generally speaking, the most meaningful thing any volutneer can do in these circumstances is to provide educational and professional guidance/ support to interested parties or general public. While there is almost certainly a real need to combat local pharmacists here to sell anything from herbal snake oil bullshit to pushing cough syrup for back pain, there's plenty of need for honest people to come out and help provide medical direction for the local populace.

There are dozens of needs for hundreds of kinds of professionals. If the organization I'm in can't use you or doesn't need you, we can send you where you are wanted and needed. Somebody someplace needs a pharmacist who cares!

A:

It wouldn't be a very private cloud storage platform if we had some way to detect and ban porn.

In short, everything is encrypted and done from your own computer. You can think of us sort of like selling a hard drive. What you put on it is your business, and it's not even possible for us to snoop, let alone take action about it.


Q:

I love to browse GitHub. I typically do keyword searches, but they have trending pages as well.

A:

Sadly no. I haven't had an orgasm since I could walk. Honestly I don't know if I can ejaculate. I watch a lot of TV in my free time


Q:

Ohhhh great question. Can I give you three? If so, Japan, Mexico, and Spain, in no specific order.

A:

We do!

Up until now, Sia has largely been it's own community. Our last AMA was on the siacoin subreddit. Largely this was because we felt that the software was not ready for us to show off to the rest of the world.

Sia as of our most recent release is very usable, has a thriving community, and we think it's time to start spreading the word to other communities who are interested in decentralization. We have a plan for reaching out and getting people excited, especially among related open source projects such as Tox, Beaker, and even projects like Tor.


Q:

Do you guys have any RTs (respiratory therapists) at your site, or will there be a future demand for some? What are some of the challenges of managing an airway and ventilating a patient outside a typical American hospital setting?

How could an RT get involved and help with what you do?

A:

Does Sia protect against targeted attacks, where a malicious actor reads my contracts and DoSes all of my individual storage providers? (Or even worse, wipes their hard drives!)


Q:

great job, what books did you read?

A:

What exactly does your physical therapy consist of? Is your therapist just there to make sure you don't fall or is she actively teaching you how to use that cool ass exoskeleton?


Q:

Scott! Love your site! Have you ever thought about leveraging your service for larger group travel? You have fans. Many of us are like minded. Why not help put a group of us together and have us invade a small tropical island for a week? It could be good PR too.

A:

Nope, that isn't the secret :)

A price reward is an interesting idea. Currently we rely on the local host database to weight hosts according to various factors. For example, a host with 90% uptime should be weighted much higher than a host with 70% uptime. Higher weight == higher probability that the renter will form a contract with that host. So there is already a soft guarantee that higher uptime results in more profits. And of course, more uptime means the host is more likely to be online when an upload/download is requested; otherwise they miss out on that revenue.


Q:

Paramedic N: Again, when the docs get back I will have them answer this question as well. For now, here's what I've noticed and certainly made several notes on.

Do you guys have any RTs (respiratory therapists) at your site, or will there be a future demand for some?

There are no RT's that I'm aware of. Certainly none in the ED, and they are desperately needed. Only the nurses SORTA know how to work the ventilators and most of the time they keep them on 100% O2 for literally days. It's a mess and something that the doctors have been cluing me into helping to combat some.

What are some of the challenges of managing an airway and ventilating a patient outside a typical American hospital setting?

Paramedic N: Supplies. We're always either out of supplies or rushing last second to locate supplies. Without this reply falling apart into me just being bitter and complaining, there is little to no oversight in how the RED zone organizes its equipment. This usually means that one or two people in the whole team of 10 will know where certain supplies are, this means you have anywhere from a 90-80% chance of asking somebody to find something for you that's TIME SENSITIVE TO HAVE and they either don't know where it is or say we don't have it because they don't know where it is. Assuming you can accquire the needed intervention tools to keep an airway and provide oxygen to your patient, unless you have your own pulse oximeter, you won't have that reading.

I tell anyone who wants to come out here to bring an entire triage kit for yourself because the floor will not have it for you or you'll always be competing with others for the limited tools available.

If you are interested in coming out here, and I would encourage anyone to come if they are, please send me a private message and I will get you in touch with the appropriate people. For as awful as some days can be, the rest of them are filled with learning opportunities and incredible moments that I will remember until I'm older and fatter than I am now.

A:

If that is something you are paranoid about, you can use anonymity software such as Tor to disguise your contracts and make it difficult for an attacker to tell which hosts have your data. And even better, the attacker won't even know that you are who they want to target.

Data contracts also typically last 12 weeks, and are renewed every 6 weeks. To execute the DOS attack you describe, the attack would need to persist for 6 weeks straight, which is a long time, especially if some of your hosts are major hosts or have decent DDoS protections (some do).


Q:

The exact four books I read are:

Learning Obj-C

Learning Java

iOS Programming: The Big Nerd Ranch Guide

Android Programming: The Big Nerd Ranch Guide

However, I would now recommend learning Swift instead of Obj-C. At the time when I was looking into iOS books, good books on Swift were few and far between.

A:

Therapy consist a lot of strengthening what I do have and also maintaining what I don't. Ordinarily I do physical therapy in Baltimore at Kennedy krieger Institute but I'm doing it now in Richmond as a test run in case I get into VCU. The exoskeleton is good because it's good for my bones by weight bearing. I also use a FES bike for my legs. I attach electrodes to my muscles and it fires as I ride the bike. This helps keep my legs from atrophying and it is good for cardio


Q:

Hmm good question! I haven't yet, though it does sound like a perfect stepping stone on my path to world domination...

And your talk of a small tropical island just sweetens the deal. I'm in! Where do I sign up for your tropical excursion list, u/happytrailz1938?

A:

I've run over the math a few times, and really 98% is the upper limit of where hosts are useful. If you are above 95%, you are doing about as much for the network as possible. 99.99% uptime of course is still useful, it's just that it's barely more useful than 95%.

That said, we really need hosts to be above 90% uptime for them to be useful to the network.

And, we actually do have penalties today for hosts with low uptime. They aren't as strong or as formal as we would like, but that's one of our primary goals for v1.2.0.


Q:

Is it all voluntary? Do you receive a wage/expenses whilst on site?

A:

Are you guys hiring for a sales team?


Q:

Did you read them in that order or sort of all at once? Is learning obj C your first introduction to code at all or did you have any prior knowledge whatsoever?

A:

Okay... So... If they offered you built in fog machine and lasers... Would you wear that bastard all freaking day?


Q:

Hey Scott!

Have you personally gotten on a cheap flight to a certain destination that turned out to be an instant regret?

A:

I have a Java library too: https://github.com/javajared/Sia-Java


Q:

Paramedic N: All volunteer. Another guy before me encouraged me to write short stories on reddit and beg for donations. Said it helped him half fund a clinic as well as remain fed during his stay in Ghana. The doctors are also here as part of their last year of residency and their electives. No pay, all play.

A:

you can send applications to [email protected]


Q:

No prior knowledge whatsoever. Learning Obj-C was my first introduction.

A:

You forgot the disco ball


Q:

Ooo great question! Like I regretted going there or regretted buying the ticket?

A:

Wow, I had no idea that this existed, thanks for sharing!


Q:

How often, if at all do you see patients from smaller villages nearby Kumasi? I was in Ghana in the spring time, in the village of Boabeng roughly 2-3 hours north of Kumasi, the sister of one of our field assistants died suddenly on our last day. My entirely inexperienced guess was that perhaps it was a heart attack. Knowing that there is usually little to no ambulance service as we in Canada or the states would necessarily recognize especially in very rural villages, even if the people in the village knew the warning signs and symptoms for something like that, what do you think the chances of getting to a hospital, even as close as Nkoranza and surviving be? Or would there effectively be nothing really they could do in time given the lack of medial infrastructure?

A:

Thanks! I mean had you ever even used a terminal before that?


Q:

What is it like walking in the exoskeleton?does it feel like it's holding up your body weight well or not?

A:

Because of your emails, my husband and I booked flights to Munich from Memphis for less than 450 each(typical prices from Memphis to Munich is about 1500)!!! This was in November when there were so many great deals to European cities. Great deals hardly ever come from Memphis Airport so I ran around my office telling everyone to start booking trips and you got a whole bunch of new subscribers that day!

Are there times of year where whole groups of flights get crazy discounted? I thought it was interesting that almost all the major cities in Europe were <$500 the week of Black Friday. Coincidence?


Q:

Can I use it for porno? Legal porn tho.

A:

This is a great question because it's got a lot of issues in it that are worth unpacking. I'll answer it first and then harass the doctors to stop playing in the streets and answer as well.

Paramedic N: The National Ambulance Services of Ghana is a very new establishment within the Ghanian health services ministry. There are a bunch of various growing pains as a result; who owns the trucks, who pays for maintenance, how to patients pay, do patients pay at all, who pays the drivers and EMT's? Who pays for their equipment and training? So on, so forth. Like in the US and places Canada (I suspect, I'm often wrong) it is generally very expensive to operate a full time fire/ rescue service so they are typically manned by a volunteer force. Volunteerism is an extremely foreign concept here. So for rural and far flung villages it is very hard for them to get ambulance services, such that the only people with body carrying vehicles in town are almost always the mortuary services who have a very clear conflict of interests with regards to patient transport.

That said, depending on the signs and symptoms of a patient and the amount of time it could take to get a patient with recognizable positive signs of accute cardiac issues, sometimes there's just nothing you can do. That's regardless of where you are on the planet. In the US I've seen people fall over, code, and die in Wal-Mart. It's not because the ambulance was too slow or because no one around knew CPR. It was because the patient was so sick so severely so quickly that there was nothing that could be done in the field. Now I don't know the circumstances with the example you have provided so I don't know if a different outcome could have been possible for your field assistant's sister. I do know that there is a very weak medical system in place to handle acute MI's where I am in KATH, and by weak I mean 'it doesnt exist'.

It doesnt exist such that there was no aspirin for a patient with obvious clinical signs of MI readily available in the RED ward.


Q:

Lol I had no idea what a terminal was. Well, actually once at age 11 I bought a "hacking" book and managed to completely destroy my parents desktop. Everything was gone, and ubuntu was now the operating system.

Edit: destroying my parent's desktop was totally on accident.

A:

It's hard to explain but it's awesome I can't help but smile when I'm using it. It's so strange seeing my feet move below me and not being able to feel it. I forget how tall I actually am. It holds me up pretty well but I still need three people around me at all times. One person behind me to hold my hips. Someone in front to guide the walker. And someone to my side to hold my chest in case I lean too far forward


Q:

Amazing!! Ahhhh I so love hearing success stories :-) And thank you for spreading the word!

Re: timing, I think it was a coincidence. The biggest cause is an unadvertised fare war between the major airlines, and those pop up because of a multitude of factors like demand, unsold inventory, pricing, fuel costs, etc. but not so much a particular time of year.

A:

It wouldn't be a very private cloud storage platform if we had some way to detect and ban porn.

In short, everything is encrypted and done from your own computer. You can think of us sort of like selling a hard drive. What you put on it is your business, and it's not even possible for us to snoop, let alone take action about it.


Q:

Have you had to make any significant changes in how you do things in Ghana as opposed to in the US? IE, changing certain procedures and treatments to fit what resources you have available?

A:

What was your educational background before you started programming?


Q:

Did you lose touch with close friends after the accident?

What new hobbies did you pick up after the accident?

A:

Does Sia protect against targeted attacks, where a malicious actor reads my contracts and DoSes all of my individual storage providers? (Or even worse, wipes their hard drives!)


Q:

Paramedic N: I want you to think of the sterile field. Get that image in your head. Get it thoroughly out of your head now. It's not possible here in the ED.

A:

Economics degree from Northwestern. I have always been really introverted but had a love of learning, so I finished up high school and moved out at 16, and was probably very lucky that Northwestern chose to let me in at that age.


Q:

Yeah. Some friendships were based solely on BMX and sometimes people just grew apart regardless Still trying to find new hobbies, any recommendations?

A:

If that is something you are paranoid about, you can use anonymity software such as Tor to disguise your contracts and make it difficult for an attacker to tell which hosts have your data. And even better, the attacker won't even know that you are who they want to target.

Data contracts also typically last 12 weeks, and are renewed every 6 weeks. To execute the DOS attack you describe, the attack would need to persist for 6 weeks straight, which is a long time, especially if some of your hosts are major hosts or have decent DDoS protections (some do).


Q:

That sounds...utterly terrifying, actually.

A:

You started undergrad at 16 years old?


Q:

Start a podcast, especially if you're looking into voice acting.

Write a book (audiobook).

Karaoke

The first two are things I enjoy listening to, so I'm biased in my recs.

A:

Are you guys hiring for a sales team?


Q:

Paramedic N: The specialists and doctors try very hard to maintain sterile field but it's just almost impossible given the setting. We all know what to do but it's often very difficult or impossible to do it.

A:

16 and a half


Q:

What are some things (medically speaking) that we (living in the US) take for granted? What are some things that were shocking or "weird" when you started working in Ghana? Why did you decide to do this?

A:

How old are you? I'm a 30 year old civil engineer and I sometimes feel like my mind is not "plastic" enough to learn something new.


Q:

How's the dating life going? I mean you're Iron man so I imagine you're just killing it out there. Also wishing you the best on PT and recovery!

A:

What kind of speeds/bandwidth can we except? and will there be provisions to allow for different levels of speed.

For example if I want a cdn style storage for images, can I make sure my files are stored on fast connections with SSD drives?


Q:

Paramedic N: The Pay to Play system of payment for treatment was and still is alarming and appalling. At the ED in the US that's just not how things are done. I came to Ghana to work emergency medicine in austere conditions and to see if there were any clever tricks of the trade I could pick up and learn from or conversely anything I could teach to help.

A:

I am 23. If you ever feel like you can't do it, do what I do and head over to r/CrappyDesign. If some of those guys are professional programmers why can't I be?


Q:

it's meh. The last girl I dated said the chair was too hard for her. But I can't be mad at her because she was honest and upfront with me and to be honest it is pretty hard. Luckily I have some awesome friends that really make me feel loved

A:

On the release that's out today, you can expect speeds between 70 and 150mbps when uploading, and between 20 and 50mbps when downloading. Startup time is about a second I think.

In the future, upload speeds and download speeds will both be able to saturate any consumer connection, including gigabit connections. You will be able to easily select hosts that are faster or ping-time closer to you, with startup times being under 100ms.

SSD drives should not matter in this case, disk drives will be fast enough for any sort of content fetching and distribution. If you can find a measurable difference though, it would be simple enough to use that measurement when selecting hosts to figure out who is using drives that are fast enough for whatever application you have in mind.


Q:

As I'm sure access to CT imaging is limited, what role does point-of-care ultrasound play in an emergent setting in Ghana?

A:

Hi congrats on the app and more importantly teaching yourself a valuable new skill. Have you received any flack from purist event attendees who don't believe audience members should be encouraged to be waving their phones around all night?


Q:

What is your favorite leisure activity?

A:

thanks, and what about linear ordering for streaming buffered video?


Q:

Sorry for the delay in response, a block of questions got somehow skipped.

Dr. N: I've only been here a week so I don't believe I've 'seen enough' to effectively answer this question. Here's my take- without other resources, whatever we can see on a bedside ultrasound still has to be treated and that can sometimes not be readily apparent and available. It's a great adjunct for difficult to obtain IV's or in FAST application. Perhaps in a few more days I'll have a better answer for you.

A:

Actually, not yet! Have received a lot of spam though.


Q:

I just like being outside and hanging out with friends. It's hard to pinpoint exactly my favorite leisure activity is since I'm on the spot

A:

Files should already be downloading in linear order, as long as you wait long enough before opening the file you can probably get away with watching a video while it downloads already today.


Q:

Hi, do medical students ever come to you on electives?

A:

Did you enjoy working with Clemson? How much work did you do with them? I am an undergrad there in compsci


Q:

how did you become quadriplegic??

A:

Paramedic N: Both Dr. N and Dr. G are both last year resident students here in Ghana for a month each on electives!


Q:

Clemson has been the nicest team to work with. After publishing their app, they sent me a signed thank you card and a bobble head. Class act all the way.

A:

I broke my neck in BMX accident. I was trying to grind a handrail and I was going to much at an angle and my bottom bracket caught the rail so I flipped it went headfirst into the ground. No I was not wearing a helmet. The doctor said if I were wearing one it would've killed me giving my neck the extra leverage to internally decapitate me. Having said that I do believe that everyone should wear a helmet. Mine was a freak accident


Q:

Are the many women who do what you do? Are there extra precautions for foreign women in West Africa?

A:

Were you good at math before you started learning programming?


Q:

Are you first in line for experimental exoskeleton stuff or are you a customer/commercial supporter for stuff already on the market?

A:

Paramedic N: Are you asking about women who volunteer or Ghanaian women who work in emergency medicine? The volunteers we get receive a thorough on-boarding series of classes to help them understand general cultural differences and big no no's and red flag behavior. Ghana is wildly safe in comparison to, say, Lome, Togo, and as I stated earlier, so long as you keep your wits about you and you don't get drunk and wander down dark streets alone, you're probably gonna get home safe each night.


Q:

Yes, I've always been pretty decent at math, but math has so far not played a major role in my programming. There are usually libraries that can take some of the heaviest math problems (like fourier transforms) off the table for you.

A:

Just a customer/commercial supporter


Q:

Do you know u/salojin, reddit author, and fellow American working in Ghana's medical community?

A:

Would you say being good at math facilitated your ability to become proficient at programming at such a quick pace?


Q:

Hey man, what's your favorite movie?

A:

Paramedic N: Yea, he got me involved at KATH and MWB!


Q:

It had a lot to do with math, but not necessarily in the way you'd think. I did some alternative schooling in high school, which ended up in me teaching myself Algebra II, trig, pre-cal, and calculous all from books I bought off eBay. I think having a history of teaching myself new skills made this round much easier than it would have been otherwise.

A:

Shawshank redemption. And any of the MCU movies


Q:

A little off topic but how do you feel about your current ems protocols back home and what would you change in regard to the current state of ems?

A:

As someone who frequently has ideas for apps but has no idea how to get them off the ground is this more of a hobby or a job for you?


Q:

Have you ever considered a stem cell transplant to regenerate some feeling in your body?

A:

The conversation went like this:

Salo: Who the hell are you and what are you doing here?

Zigzag: I'm a paramedic from the US and I don't know what to do with my hands.

Salo: Me neither, come with me, let me introduce you to the clinical directors.


Q:

It's definitely a full-time effort. I'd say learning to code was a hobby, but programming has been a job.

A:

I would love to but it's still in early phases in the US


Q:

Got a question for EMT L or Paramedic N. There's some range of differences state to state, for example an EMT in my state can administer 11 medications where I've repeatedly heard some states won't allow an NREMT-B certified EMT to administer so much as oral glucose. What's the difference between what you guys were allowed to do in whatever states you practiced first response in before, compared to what you are permitted to do at your current job?

A:

Can you share what languages youve studied to make the apps? Thanks!


Q:

Assuming you can use the exoskeleton, would you rather fight 100 duck-sized horses or one horse-sized duck?

A:

Displaying levels of competency and providing copies of the medical protocols that you last operated under.


Q:

Yes, at the time there were no reputable books on Swift, so I learned Objective-C for iOS and Java for Android. I also picked up some basic PHP for backend server-side stuff.

A:

One Horse sized duck. Then find a way to domesticate it and then give it to my brother. He loves ducks


Q:

Have you worked anywhere in conflict areas that were attacked or bombed by an airstrike while you were there?

A:

Guess I'll ask here instead.

How is your stomach muscles? (where is the injury/complete or incomplete?) Doesn't seem to be much stability from the waist up on that suit. I've tried the ekso bionic suit, and there you have like a backpack strap in addition to what you have in this pic. Maybe making it very different to operate? Anyway, really cool to see someone else in almost the same situation as me!


Q:

Paramedic N: Yes. It was loud, we suddenly had more patients and less equipment. I don't recommend those environments.

A:

I have no use of my muscles from the chest down but the exoskeleton grabs my stomach it holds me up pretty well


Q:

What is the one thing you wish people back home who want to help West Africa through charitable endeavors knew?

A:

T7 Incomplete here! I've used an exoskeleton and had a lot of fun with it.

Do you find it heavy and tiring? I did after awhile and I was wondering if that was the general thought.

Wishing you well :) http://i.imgur.com/YY3XCqR.jpg


Q:

Paramedic N: How corrupt most of the systems are around here. If I had 200$ worth of supplies mailed to a person here, the local post master would 'look the other way to avoid customs' for a 50 USD bribe, because the arbitrary customs fees he can legally attach could end up costing the value of the donated supplies. The best way we have of getting major supplies sent to us is in checked baggage, and the majority of supplies we need are simple things like vital signs equipment (Pen lights, BP cuffs, stethoscopes, pulse oximeters, thermometers, etc).

I'll harass the doctors for other equipment or donation recommendations. But honestly, another volunteer had a fair amount of money gifted to him by donators on reddit and he ended up losing an unhealthy chunk to crooked contractors and post masters.

A:

Nice! I'm a little tired afterwards but not that much


Q:

Subspecialty surgeon here. For the physicians among you, are you employed by US medical centers? If so, tell me about the reception you received from the administrators when you decided to go to Ghana. I've thought about spending time at CURE in Uganda or maybe in Kijabe, but there is constant pressure from above to think about the impact it would have on RVUs. I'm curious how you're making it work with your employers.

A:

How can I help you and other quadriplegics?

I used to ride my BMX when I was a kid and I fell plenty of times. Through sheer luck I never got hurt. Life isn't fair. I want to know how can make your life better.


Q:

I am specifically sending your message to the two docs now via Whataspp to hurry up a response. If you do not hear back in an hour, message here again and I'll find them and harm them until they respond. :)

Dr. G: "Well we are residents so its completely different for us. I assume you would have to work it out with your employer."

Still awaiting a response from Dr. N

A:

Do you have any spare spinal cords laying around? Just treat us like any other people I think that would be the best way to help


Q:

How did Ben Linus infiltrate your team?

A:

How many times have people asked you if you can jerk off?


Q:

Ben Linus

Paramedic N: I Lol'd heartily.

A:

It's usually the first question once the awkward barrier comes down


Q:

Hi! What is the worst injury you have had to deal with? Have you felt prepared?

A:

Are you part of any research or clinical trials?


Q:

Paramedic N: Any injury that would be wildly survivable in the United States that is a death sentence here is the worst, in my mind. For example, in the imgur album are pictures of a fellow who received burns to 85% of his body. Although full thickness burns to that much of the body is a difficult to survive event, it's by no means a guaranteed death. But, for a confluence of factors here in Ghana, no one expected the fellow to make any sort of meaningful recovery and no one tried. So he eventually died a week after sustaining his injuries, for what amounted to reasons of apathy.

I've experienced patient care in austere or chaotic environments from disaster response to simply working in a crowded US, ED, but nothing will ever prepare you for when you know a patient is going to die because there simply aren't enough ventilators to use and no one wants to 'bag' the patient for hours by hand.

A:

Not yet, I'm keeping my options open for the right one. Because depending what you signed up for you can accidentally close the door to others that could be more beneficial


Q:

What is your protocol if a suspected Ebola patient arrives at the clinic?

A:

Where do you find the motivation to continue pushing? I guess I am asking how you rose out of what I anticipate was a dark depression when you became quadriplegic. I don't know if I could find the strength within myself.


Q:

Paramedic N: Panic a little and then put on gloves. There is a protocol in place, I've seen the triage algorithm and such but I've never heard it drilled or tested.

A:

Just laugh and Make sure you have people around you that you can talk to


Q:

Which public health agency would you contact? Seeing as you are Americans would you contact the CDC? I do not know enough about the Ghanese government to know how their public health system works.

A:

What's something that you're burdened by that you didn't expect to be a problem as a quadriplegic?


Q:

Paramedic N: I'm not sure at all, actually. I'm going to ask about this for sure tomorrow. Also, Ghanaian*

A:

Quite a few things. I have a strong opinion of inclines now. I have to be constantly aware of my body now. I have to do what's called weight shifts a lot. Basically my chair will lean back to 45° angle to relieve pressure off of my ass. If I don't I'm susceptible to a pressure sore. I've had one last year it was the worst thing ever. You can feel your butt getting numv when you sit too long but I can't which is why have to do pressure releases. This also means that I have to be turned when I sleep in bed. So in the middle the night someone will turn me to make sure I don't have constant pressure on one spot. Another thing is, and this is me in particular this doesn't apply to everyone, I can't sweat. So I have to drink a lot of water and be careful in the heat. If I'm outside I usually have one with me to pour on my head to cool me down. And of course going to the bathroom which I answered in another comment


Q:

So, I'm genuinely curious and I'm not trying to diminish your contributions. If anything, kudos for wanting to give back. That said, what % of your motivations are altruistic, and what % are "this would definitely look good on my resume"?

A:

Paramedic N: I had to come to terms with myself a long time ago about why I was interested in emergency medicine. The conclusion I reached was because I hoped that somebody as motivated as I am to do emergency work is who finds me when my turn to have a bad day comes. As for the resume building, I hadn't actually considered that much, I was just looking for something to do for a few months.


Q:

1 - Favorite Ghanaian food?

2 - Have you been to Kumasi Central Market?

A:

Paramedic N: Joloff with egg, veggie, and a bit of stew. And yes, fuck that place. The major construction to make the central market much more manageable is nearing completion and I think everyone in Ghana is gonna celebrate when it's done because jesus christ on a tricycle is that place intensely buggered up right now.

Ete sen?


Q:

Why not take the team into lesser served areas of America like Remote Area Medical?

A:

Paramedic N: I'll ask the other docs but I think the consensus here is that Trump is gonna make America great again or something.

I joke. Sorta. I'm still salty.

I came to Africa to see a different place and a different culture and a different setting. We all choose to volunteer in different places for different reasons, mine were purely for adventure. And frankly because I'm tired of the horror stories of Americans suing American's for nonsense. I'll ask the doctors their opinions when they re-appear.


Q:

Hey, guys! Y'all are incredible. Keep up the good work. It may be too late to run a question by you, but how wide is the scope of practice for, say, an EMT at your center? Are they able to really jump in and apply some more medic-level interventions, or are they still just, y'know, EMTs?

A:

Paramedic N: So in order for the US EMT's to be utilized by KATH I had to show them the entire breakdown of capabilities and trainings as provided from literature from the National Registry of EMTs. If you are an EMT with ACLS training, you are expected to understand how to execute ACLS in the event that you are the ranking provider during a code. If you are an EMT with PALs, same game. If you are a Paramedic you can provide any and all interventions as trained and certified with your up-to-date EMT-P card. Ghana is still learning how broad the scope is for EMT's so truly its a matter of demonstrating skills to the clinical director for MWB who disperses medics to KATH and then not being an idiot and providing appropriate care and treatment for patients. Several MWB EMT's were Army or Navy combat docs first, so although they carry a simple EMT cert, in the event of traumatic injury its just inherently understood that they will take the lead until the doctor arrives.

I hope that answered you question!


Q:

Are there some things that your new unit handles better than a US-based unit in terms of types of emergencies?

A:

Paramedic N: I'm not sure I fully understand your question, could you be a bit more specific?


Q:

What are some cultural differences that make it hard to treat patients?

A:

Paramedic N: I think the doctors will agree with me when I say very succinctly that there is a very very different value of work ethic associated with medical providers here and medical providers back in the United States. Now I've known some lazy nurses, I've known some slow moving doctors, but even the slowest nurse would run laps around some of the staff we have to corral into getting off their phones and helping freshly arrived patients.


Q:

When I was a Peace Corps volunteer in Madagascar I served as a translator for a group of American doctors and med students who were holding free clinics - some in rural areas, some VERY rural areas, and urban areas.

What is it like working with a translator? Was it more or less difficult than you thought?

Have you seen any extreme cases of alcoholism and/or pure neglect? Some of the craziest things I've seen were either from people drinking Malagasy moonshine, or letting something simple go unchecked, like schisto, and their testicle swelling up to the size of a grapefruit.

Thank you for all you do. You're saving lives.

A:

What is it like working a translator? Was it more or less difficult than you thought?

Paramedic N: So, when a patient talks for five minutes and the translator gives me a single sentence reply, that's when I know it's gonna be a long day. I've learned to adjust my questions to be answered quickly and easily and if there are wide discrepancies between what I say and what is translated I know to ask why.

Have you seen any extreme cases of alcoholism and/or pure neglect? Some of the craziest things I've seen were either from people drinking Malagasy moonshine, or letting something simple go unchecked, like schisto, and their testicle swelling up to the size of a grapefruit.

Paramedic N: Constantly. Alcoholism is rife in the villages here and lots of easily survived illnesses are left to fester and to amazingly damaging things to the hosts. I haven't seen much schisto, but man we know it when we see it.


Q:

haha being on the other end of the translating, I can tell you that that person was probably going on and on about something completely off topic, like how long it took them to find a bus to get there and they ran into their sister in law on the way there, and how the price of bananas has dropped so they're having trouble selling their harvest, and they finally got on the bus but the bus broke down on the way there, so that's why they were late and can I please have some red pills because it burns when I pee.

The translator's response: "it burns when I pee."

A:

Paramedic N: Yea that sounds about right.


Q:

Hey guys! First off, thanks for everything you're doing, it takes a very special person.

I'll actually be traveling to the Volta region, namely Ho and surrounding villages, for four weeks this May. I'll be studying any issues that arise when introducing improved sanitation, i.e. DIY composting toilets, in an attempt to make the transition as approachable and economically feasible as possible.

I obviously have some insight into the issue already but would be curious to get the point of view of someone working there, especially in the medical field. Assuming it's common in your area, my biggest question would be how people view inadequate sanitation/open defecation. Is it something so ingrained in many people that you'd expect a transition to improved sanitation to be difficult or do you see the potential and desire for improvement? Any other tips or words of advice on approaching this issue would be greatly appreciated.

A:

Paramedic N: OH BOY! While you're out there you should climb up the Wli falls and explore the upper set and the lower set, its absolutely beautiful and the hike is an ass kicker. I really enjoyed my time in Volta and look forward to returning at some point for a few days. Sanitation here is pretty abysmal, most common folks dont know that toilet paper is flushable so they'll toss it in a trash can by the toilet. If they run out of paper it's common to use the hand and then wipe it on the wall and repeat. Children openly defecating is quite normal, adults openly pissing on the sides of the streets or against building walls is so common that there are dozens of hilarious hand written signs telling people to stop pissing on their houses.

You have an uphill battle my friend, and it all starts with the entire culture not really understanding the value of sanitation or the utility of good sanitation devices like toilets and functioning sinks with soap. Let me know when you come in with a private message, I'll try to give you some guidance if you want!


Q:

Do you miss Paperwork/EMR ??

A:

Paramedic N: I can't hear you over how much fun I'm having not doing paperwork/EMR.


Q:

Hi, this is a question mainly to Paramedic N.

Given paramedics are typically work in Ambulances which are out-of-hospital, what is your role and what do your responsibilities entail now that you are IN-hospital?

Also, are you guys looking for additional paramedics?

A:

Paramedic N: I'm essentially a turbo-nurse here. MWB, the organization I'm with, utilizes paramedics for just about everything at all times, you should reach out to the organization here:

http://www.mwbhealthsystems.org/Pages/default.aspx


Q:

What's the biggest misconception you think westerners probably have about West African medical care?

A:

Paramedic N: That it's non-existent. There are great facilities and there are plenty of trained providers and supplies around KATH. It's just a matter of getting everything paid for in a timely manner, it seems.


Q:

Why don't they have their own first responders there. In Thailand they're untrained volunteers but, still they go scrape you up and take you to a hospital. What do they do when there are no Westerners around?

A:

Paramedic N: They do have a first responder network and national ambulance service. It's new and still getting their feet under them and providing pretty intense support under pretty rough circumstances. They do just fine with us white folks around. We just like to help where we can.


Q:

Have you gotten the chance to get to know any of the locals?

A:

Paramedic N: I live with them, yep. The guy who runs MWB is a Ghanaian born and raised outside of Kumasi.


Q:

Can Reddit do anything to help you?

A:

Paramedic N: Not sure, I suppose help me if I get kicked out of the KATH program for doing this AMA :D


Q:

Oh Bruni!

What precautions have you taken to protect yourselves from illness while in Ghana, and what did you think you should do before you arrived but in reality you aren't?

Have you dealt with any women's reproductive issues in your service?

Have you tried the yogurt from the kiosk on the UST campus?

A:

Paramedic N: We take doxy for malaria and wash our hands and clean the veggies and fruits we buy at market before cooking/eating them. There are several different expats around us, no associated with the medical missions, that are here with education missions for schools and they have a reproductive education agenda. I've not personally had any issues or run-ins with womens reproductive issues here, though I know its a hot button topic. And yes, I've bought some of the yogurt drink for the little hut at tech. It mixes will with protein powder so I can be swol and stuff.


Q:

Hello! First of all, thank you for the good work you have been doing. I have always wanted to work for 'Doctors without borders'. I have had a considerable amount of nursing experience but i am NOT a doctor. Is it possible for a person like me to enroll myself in the program?

A:

Yes absolutely, please reach out to me in a private message and I will direct you to the next major steps.

As a heads up to others with this same question: It will cost you about 2-3K USD to hang out here for anywhere between 3 weeks to 3+ months. THe most expensive part of your trip will be plane tickets and costs in country are extremely cheap.


Q:

Is it true that you're allowed to do so many more things to the patient than u r in the US? As an EMT?

A:

Paramedic N: Your question is asking if I do more with patients here in Ghana than I do with patients back in the US? If that is your question my answer is 'no'. I do everything as covered by the expectations and qualifications tested by the National Registry of EMT's. I will ask to learn new things from doctors as they offer and have demonstrated skills on cadavers, but that's really it. I'm already working with a pretty wide range of skills as a paramedic and I'm pretty happy with that.


Q:

Can I come volunteer with you guys ? I really have an interest in third world healthcare and am doing some gap years before med school.

A:

Send me a private message if you're serious. As a heads up it's about 2000-3000$ USD to come here for anywhere btween 3 weeks to 3+ months. Primary costs are flights here and some rent.

You have to have up to date certifications that are applicable but it will also depend on what you want out of the experience and what you wish to contribute!


Q:

Hey, thanks for this AMA! I myself have worked as a volunteer (nurse) in Ghana back in 2013 in Agona Swedru and Ho. Passed Kumasi multiple times, have you been to the market yet?

I have some questions:

  1. Do you witness alot of 'holiday' volunteers? When I was there it was come and go of undergrad medical students and adolescents fresh out of high school. What do you think of them? Do they contribute anything?

  2. How is the work relation with local nurses and doctors? Do you encounter any struggles?

  3. What do you think of the NHS (National Health Scheme)? Does it work in your eyes?

A:

Paramedic N: When the doctors come around I'll have them respond to your questions as well, for now here are my answers as a long term medic working in Kumasi.

Do you witness alot of 'holiday' volunteers? When I was there it was come and go of undergrad medical students and adolescents fresh out of high school. What do you think of them? Do they contribute anything?

We call that 'voluntourism' and it depends on the program they work with on whether or not there's any value in it. I think it's certainly an amazing experience for the EMT's and resident doctors as they roll through because there is nothing like this enviorment. As for their impact on the systems that they work in, no, I suspect they don't leave much footprint. I've been here a while now and I know the most impact I will have will be through teaching the major classes at other events and perhaps some of the quick on the spot lessons to nurses and doctors during specific events.

How is the work relation with local nurses and doctors? Do you encounter any struggles?

There is no rhyme or reason for who is extremely well trained and who isnt, who is highly motivated and who wants to hide away and make a free paycheck. The variation in work ethic and professionalism is wild and it generates different issues differently on different days.

What do you think of the NHS (National Health Scheme)? Does it work in your eyes?

Whatever the current system is that is currently employed by Ghana is not effective. I've pulled sheets over a lot of wildly recoverable patients because of the pay to play system in place here.