Waist Trainers are useless.
It’s a scam, a fraud and a deceit.

They use ladies who already have slim waists and flat tummies to advertise it.

If you wear it for “fashion”, that’s ok.
If you wear it for flat tummy, you are fooling yourself and wasting your money.

Happy weekend.

Waist trainers can harm you
Waist trainers can harm you.

Can cause skin irritation,
Can cause organ damage,
Can worsen heartburn,
Can cause breathing problems,
Cannot cause weight loss,
Cannot give flat tummy,

Sorry to break your heart
But actually, waist trainers can harm you.

Waist trainers cannot give you any curves that you never had naturally.

If you have the curve already,
A waist trainer may help it show.
If you never had any curves,
A waist trainer can never give you one.

If the hourglass was never there,
A waist trainer won’t give you one.

Waist trainers can’t cause flat tummy.
And it surely canNOT give you “curves”.

You take soft drinks, eat junk food, and swallow Eba at 2am like a hired killer;

If you like wear waist trainer,
Once you remove it, your tummy will fall down on your thighs like the wall of Jericho.

What a waist trainer does is to give you an ILLUSION of a flat tummy or a curvy appearance.But it is a temporary illusion.

A waist trainer NEVER changes your body on the long term, never gives you a flat tummy and it can NEVER make you curvy. Except you already had it naturally.

🧵For months, healthcare professionals have been hanging on to the guardrails of the top deck of the Titanic.

We have been screaming at the top of our lungs that there is an iceberg dead ahead and begging the captain to turn the wheel.

We have had other passengers who are

in the food hall and can’t see the iceberg from where they are standing mocking us accusing us of lying about the iceberg.

“There is no iceberg. You’re seeing things”

“Even if there is an iceberg it is smaller than predicted based on available models”

“You’re getting paid

to claim there is an iceberg.”

We are on the ship too. So we are watching the ship approach an iceberg knowing full well that we are going down with the ship.

Do we keep screaming? Even though nobody is listening? Do we jump ship and save ourselves? The water is freezing

and we don’t want to desert our fellow passengers.

Do we gather up the other passengers who can see the iceberg and form a human shield to take the impact on ourselves? Do we bum rush the captain and demand he turn?

Or do we stand still, silent, frozen in a state of fight or

flight? Paralyzed with sheer terror.

Never in a 14 year career would I have imagined I would see this day.

How are we supposed to feel when a critically ill patient has survived cardiac arrest

My last #tweetorial focused on the GCS. Now let's look at another hugely important clinical window into the brain: the pupil. What does a 'blown pupil' really imply? What about small fixed pupils? To understand this, we need to see how pupil size is governed. #FOAMed 1/20

The pupil has two functions, constriction and dilation, both under autonomic control. Sympathetics dilate the pupil and open the eyelid - easy to remember, because in 'fight or flight' mode, maximum information needs to get in to keep you alive. 2/20

By contrast, constriction is parasympathetic. Its main function is to regulate the amount of light on the retina, so in response to high light intensity (like a pen torch), both pupils constrict. 3/20

These parasympathetics have a straightforward course (literally). They hitchhike on the third nerve, which runs forward from the midbrain to the orbit to supply most of the extraocular muscles and eyelid. As they're superficial, they're vulnerable to extrinsic compression. 4/20

Plenty of things can compress the third nerve and produce mydriasis (a dilated pupil) - most classically a posterior communicating artery aneurysm. But in the context of an acutely comatose patient, it suggests something worrying: 'uncal herniation'. Why is this? 5/20

BURNING STUBBORN BELLY FAT

(A Thread)

Stubborn belly fat can be 'stubborn' for a variety of reasons.

- Your genetics
- Your calories aren't low enough
- Your hormones suck
- Your metabolism has dropped too much

A calorie deficit WILL eliminate this eventually, but often it's not realistic.

Let's get into this...

1. Your Calories

You may just be eating too much food.

If you're 160 pounds, yet you're averaging 2500 calories on most days while not doing any cardio, then it's just too much food.

There's nothing wrong with you, you just need to eat nutrient-dense, calorie-sparse foods.

2. Your Hormones

If you've got low T, you may reach a point in the diet where a calorie deficit just leads to further muscle loss, rather than fat loss.

To combat this:

+ OBVIOUSLY train hard with weights
+ Make sure you're sleeping properly

TBC...

+ Get your vitamin D
+ Get on TRT if the above doesn't work
+ Take 1-2 months at maintenance, if all the above doesn't work

Stress/cortisol is directly linked to low T and lack of sleep.

SO the solutions are the same for high cortisol.

How do remedies work? Gemstones/ yantrās /Effectiveness / examples / astrological causes

Remedies for karmic debts can work effectively but they have to be exercised in certain manner. For example in case of certain rogā, the medicine cannot be given in raw form while in others

medicine should only be given in raw form only.

Therefore, the modus operandi of remedies is very important.
The quantity of japa, Pooja, homam, ḍeepa etc. has to be decided for their effectiveness. For example, a childless couple suffering from Sarpa dośa cannot have a child

by mere lighting a lamp in front of ṇagas. In other cases where case is small, the remedies are also small. Some remedies are expensive and strong but they have to be followed in same manner. Some remedies requires expert tantric etc. without which they cannot be done. The ten

Mahāvidhya requires a proper initiate or sadhak of mahāvidhya which is rare to find. Only he/she can solve the problem.

Mantras taken from book have no power either because they are nailed or because they lack the power of the Guru or initiate who lives with the mantra. That

power is transferred to student when the mantra is whispered in his/her ears. The mantra, homam, prayers etc requires expert mantraśastri or tantric who can do the Poojas. Ordinary purohits are not aware of the proper ritualistic procedure so their Poojas might not work.

The story of Smallpox and how it was conquered....

A thread

12,000 years

That's how long Smallpox had been around, decimating whole civilizations and even wiping out others completely...the fall of the Roman empire was partly due to Smallpox

For years, this disease kept popping up and killing millions without a cure in sight

But it was until the 6th century that the disease really started making mad moves when it landed in Europe which was becoming a highly populated continent. That was when smallpox started doing big league numbers

This was later spread to other continents like Africa, Asia and the Americas, taken there by European traders and religious missionaries who wanted to spread the gospel to the "savages" who were doing very okay

We have all read, or at least some of us, about how smallpox was the major reason why conquering North America was easy, the white missionaries gave out blankets deliberately infected with smallpox to the native Indians and the disease took out 90% of indigenous people

1/ The classic presentation at morning report for hypercalcemia starts with polyuria, constipation and confusion. #UncleBob wanted to understand why - stimulated by @CuriousClinPod ? @HannahRAbrams @tony_breu @AvrahamCooperMD

2/ Let's start with confusion. Finding information on this is very non-specific but I think this quote helps: High calcium levels can be a catalyst for neuronal demise, possibly due to glutaminergic excitotoxicity and dopaminergic and serotonergic dysfunction.

3/ But colleagues and learners know that I am most interested in the polyuria. I have taught that hypercalcemia can cause nephrogenic diabetes insipidus, but the mechanism was unclear. Let's review how ADH works and then look at an interesting study that suggests an answer.

4/ Antidiuretic hormone stimulates water reabsorption: stimulating insertion of "water channels" or aquaporins into kidney tubule membranes which transport solute-free H20 through tubular cells & back into blood, -> decrease in plasma osms and an increase urine osms.

5/ Thus we need to stimulate ADH production and have aquaporins (specifically aquaporin-2) available for transport. In general nephrogenic DI occurs because of the lack of aquaporin-2(AQP2).

1. What are stem cells? What are the various types of stem cells? How are stem cells being used in medicine today? Can stem cells be packaged into pills and taken orally?

2. Stem cells are basically undifferentiated cells found in various organs of the body. Almost every organ has a reserve quantity of cells that are capable of maturing and replacing already existent cells in that organ.

3. There are different types of stem cells based on their origin and method by which they can be derived. There are embryonic, adult, tissue specific,multipotent, pluripotent, totipotent and induced pluripotent stem cells. See graphics below.

4. Stem cells are used in a variety of ways in medicine today. For instance, when a person has a blood or bone marrow disorder, they may receive a stem cell transplant. There is also a lot of work being done using stem cells on neurodegenerative disease research.

5. Stem cells, human stem cells need to be viable to be used in therapy. There is no way one can package then into capsules and administer them orally to a human being and immediately they find their way to a target organ 😂😂. Hakuna zvakadero. 6

Dental news you’ve missed this week.https://t.co/9KB8gbT2W8 healty for you.

CDO Sara Hurley speaks out after change in COVID-19 alert level

Now that we already have maxed out hospitals and still-rising Covid infection and death rate, mass evictions in winter with many times more looming, and have learned that, actually young people are dying from the virus...

Now that we know these conditions —viral and social—are also killing people at much higher rates through accidents, untreated medical conditions, overdose and exposure ....

Now that we know that warnings haven’t stopped people from traveling or large gatherings at anything like the degree needed and that going to work is a major cause of the continuing intensification of the pandemic

You’d think that a discussion of travel restrictions and more rigorous closure of unnecessary construction, retail, in-person instruction, gyms, restaurants and the like , with actual funding and rent/mortgage freezes to make this possible, would be, at least, on the table

But it’s not. The ruling class is literally banking on another couple hundred thousand preventable deaths.

As US hospitals make the necessary shuffle to accommodate the current wave, I would like to remind leadership about the study done on the psychological status of frontline hospital workers during NYC's spring Covid surge (thread).

As expected, many participants reported stress, anxiety, and depression. But the study also looked into *what* exactly made participants feel distressed.

This graph is showing % of participants who found these factors "highly distressing." Note in the work environment section (blue) the number of things that rank higher than patient deaths.

These include:
- Perceptions of a lack of control and/or uncertainty
- Performing clinical work that is outside of your specialty
- The need/expectation for healthcare providers to provide social support to patients in lieu of their families (due to visitation restrictions)

- Difficult triage decisions or rationing of care (potential or actual) due to resource scarcity
- And also fears related to getting/transmitting Covid within the work environment - in particular, the uncertain Covid status of other healthcare providers

Hot take: optics are better abstraction than lenses, in *all* use cases. Why? They make explicit all the things you're implicitly thinking about anyway when using lenses. I think they are really important in shaping how we think about bidirectional maps. A short thread. 👇 1/9

Optics make explicit 1) the internal state (residual) and 2) the fact that you need to have the base category either be Cartesian, or at the very least have the "get" maps be comonoid homomorphisms. Let's look at the state/residual.
2/9

In lenses, this state is always the same as the input and is implicit. This can be seen by repackaging the get map from get: X → Y to Δₓ;(get×X):X e→ Y×X. Now our new get map (in addition to computing the output) passes through the input. This is good for a few reasons. 3/9

First, this pleasantly symmetric with the put:X×Y'→X'. But also, this new map is now exactly the "left" map of an optic too. (It turns out put was all along the "right" map). This tells us that the passed-through input is actually the state we're remembering. 4/9

But most importantly, this formulation is now explicit in the use of the copy map Δₓ:X → X×X, which you might have not realized is needed if you were just thinking about the standard get-put formulation. Furthermore, when you were composing lenses, ... 5/9

@GoadGatsby WARNING: THIS POST CONTAINS INFO LIKELY TO MAKE STEAM COME OUT YOUR EARS
Personally, I don't use but I gotta ask b/as long time SA Counselor & Clinical Neuropsychologist,
What ARE these people so on re weed about? Theres NOTHING abt weed comes anywhere close to t/individual, 1/

relational, marital familial, societal and physical and mental health damage done by alcohol (ism) daily. PERIOD FULL STOP

& Research that was so long denied has found a plethora of bennies.

That's not to say no abuse occurs or is possible, (however, [stick with me here] 2/

I see a variety of WS groups currently abusing [t/great American symbol of home family & motherhood] MILK these days...
Hey, if it's a substance/any substance or something transduced or processes by your chemical brain [neurochemistry baby] use misuse, abuse addiction & 3/

deadly addiction is a thing, A BIG THING including "thought addiction," [we MH profs call this obsession] which seems a likely group DX for folks on the right who are virtually obsessed with weed as if it were Hitler, meanwhile they're tryna convince themselves he had a 4/

rational national plan on repeat. But I digress).
Bottom line: Cannabis Use/Abuse Disorder is far less (note t/word LESS) common, far less damaging both in t/short- & long-term & pop #s for Cannibis Use/Abuse are no where near those of alcoholics & the resulting death maiming 5/

[THREAD] memory loss and mental health. It is something that we don’t often put together. However, it is a very common issue for many individuals whose mental health is not doing well. So why do we get that memory loss? Is it permanent? Are there ways to cope with that?

The reason why memory loss happens is not because our brains are not working well or somehow not registering events but because we are so tuned in to our thoughts and emotions that we are not paying attention to our environment.

Given that we are not paying attention to what is going on around us, we are less likely to remember them. Also, issues such as depression and anxiety affect the way we sleep and sleep has been proven to be the time when short term memories are transferred into long term memory.

When we can’t sleep well, that process is disturbed and we may lose some memories during that process shift. Also, we may feel as unable to access our childhood or even recent memories when our mental health is not doing well and we may be scared that it is permanent.

However, in this situation, it is not so much that we have lost our memories. It is more a problem of retrieval. The memories are still there in our big library, but we just can’t find them. Furthermore, memories are highly dependent on our mood.

💥 Role of Stents in Dialysis Vascular Access - Tweetorial

⚡️Indications for Stent Use

⚡️Recent Clinical Trials of Stents in Dialysis Vascular Access

⚡️Complications associated with Stent Use

1/
@ASDINNews
#VascularAccessPearls

⚡️Arterio-venous (AV) Access
causes significant morbidity & mortality in patients on hemodialysis

⚡️Most AV access associated complications are due to vascular stenosis👇🏽
2/

⚡️Vascular Access care has evolved over the past 60 years:

-Scribner’s Shunt in 1960 ➡️
-Brescia-Cimino AVF in 1966 ➡️
-1st Balloon Angioplasty in 1981 ➡️
-1st Bare Metal Stent in 1988 ➡️
-1st Covered Stent in 1996 ➡️
-DCB use in 2012
3/

⚡️Despite these innovations, AV access stenosis remains a big problem

-Percutaneous Balloon Angioplasty (PTA) remains the 1st line therapy for stenosis but it is NOT very effective

-AVF patency after PTA is only 50% at 6-months & it is worse for AVGs👇🏽
4/

⚡️Neointimal Hyperplasia (NIH) causes vascular stenosis & it is due to:

-Hemodynamic stress
-Surgical trauma
-Cannulation needle trauma
-AVG

‼️But balloon angioplasty, the treatment for stenosis, can itself induce NIH & cause restenosis👇🏽
5/